CHAPTER 4: STRATEGIC AND SYSTEMIC MODELS

Chapter 4: Strategic and Systemic Models 91 beneficent, or functional—only that people have gotten used to it and that such habits are hard to break” (p. 16). The development of the symptom is neither good nor bad but understandable, given the context. The team has also altered its use o f rituals . “A ritual is an ordering of behavior in the family either on certain days…or at certain times” (p. 4). In the past, the ritual amplified a symptom to explode it. (The family might solemnly thank the symptomatic member each day for having the symptom.) More recently, the ritual consists of simultaneous conflicting directives. (The mother is asked to be simultaneously wife to her husband and mother to her daughter. But on even days she is told to be wife to her husband and on odd days, mother to her daughter.) In general, Boscolo and Cecchin believe that all interventions should try to do is perturb the system so that it can react on its own terms. Interventions, then, are not geared toward any particular outcome but rather to jog the system to find its own solution, often in ways that are surprising to all. The Milan team has been influenced by cognitive biologists (e.g., Humberto Maturana and Heinz von Foerster ) and radical constructivists ( Ernst von Glasersfeld ). Greater validity is given to the concept that reality is a social construct rather than based on “real” external events and objects. “Ideas, beliefs, myths, values, perceptions, fantasies, and other internal productions” (p. 19) assume greater importance. Families unconsciously construct maps or premises about their world to help them understand what is happening. The therapist looks for the premise that attaches the behaviors to a problem and tries to articulate it to the family. The family may then shift its premise and change behaviors accordingly. Thus, for the Milan team, meaning is primary, and the new behavior, in MRI terms, would be characterized as stemming from a second-order change. In the 1980s Boscolo and Cecchin split from Selvini and Prata, becoming the Milan Associates. The Associates focused on training, while Selvini and Prata focused on research. The training that they have done has helped shape the treatment model. The trainers worked in small private clinics; the trainees tended to work in public settings where the ideas espoused by the family systems therapists were met with hostility. In addition, the families were resistant to the idea that the whole family needed treatment, since the existing models suggested that only the person with the symptoms needed treatment. The trainees were dealing not only with families, but with the treatment milieu as well. Clearly, the larger context, or the “significant system” in which the treatment occurs had to be considered. The schools, courts, clinics and cultures that the therapists and families are involved with may all have an effect on the treatment. The impact of the feedback from the students and the systems has caused the Milan Associates to “think of themselves not as family therapists but as systems consultants” (p. 24). 