CHAPTER 4: STRATEGIC AND SYSTEMIC MODELS

Study Guide for the National Marriage and Family National Licensing Exam 62 6. The recipient becomes conditioned to respond, and, as a result, the entire sequence is no longer necessary to maintain the symptom. For example, a father demands that his son engage in a nightly discussion at the dinner table. When the child attempts to participate, the father is irritated that his dinner is interrupted. The father is then critical of his son’s lack of conversation. The son is caught in a bind since both his attempt to talk and his silence are punished. For the child, the meaning of communication becomes unclear, and he develops a disordered style of communication that is labeled schizophrenia. During that same period Milton Erickson proposed radical new ways to change “psychiatric” symptoms and problems. The prevailing theoretical assumption was that symptoms stemmed from deep psychological problems. “Curing” the problem required that patients gain insight into the unconscious impulses governing their behavior. By contrast, Erickson, focused on the specific symptoms and problems presented by the patient. He believed first, that people had the ability to solve their own problems if they could be induced to try new behaviors; second, that change could be swift rather than a long arduous process; and finally, that the patient’s own natural resistance to change could, ironically, be used to bring about change. As a hypnotherapist, he developed many ingenious techniques for “getting people to do something different in the context of the old behavior, or to do the old behavior in a new context” ( Nichols & Schwartz, 1998, p. 358 ) . Erickson was masterful in his use of paradox . A paradox is a contradiction or a puzzle, and the interventions involving the use of paradox are based on the notion that families experiencing symptoms or problems find it difficult, or are naturally resistant to, instituting changes. In those cases, it is sometimes more useful either to forbid them to change or ask them to change in ways that seem to run counter to the desired goals. The therapist is counting on the family members’ rebelling against the directive, and as they do, the desired result is achieved. In a famous example—perhaps a fiction, but illustrative nonetheless—a farmer attempts to push his cow into the barn. The cow naturally resists by pushing back against the farmer. The farmer then is instructed to pull the cow backward by the tail away from the barn. The cow again resists by pulling against the farmer, but this time the cow’s resistance lands her in the barn. Strategic therapy models combine the concepts of the Palo Alto group and Erickson. The defining characteristics of these models of family therapy are: • a focus on current family communication patterns that serve to maintain a problem, • treatment goals that derive from the problem/symptom presented, • a belief that change can be rapid and does not require insight into the causes of the problem, • the use of resistance to promote change by applying specific strategies ( Piercy et al., 1996 ) .