Any image and word simultaneously
expresses and conceals meanings. I seem to have been brought up
with a determination to discover unfashionably 'the truth'.
I've
never been satisfied with anything that seems too big for its
boots. My search has been for something honest and human. Entering
medicine, then psychiatry, then child psychiatry, to help people
or (as I would now see it in retrospect) to find myself, it seemed
- even in psychotherapy - not to have been about humanity. There's
more about this journey in Winding Up
and John Macmurray
My theory or position is that for
fields that deal with matters that are essentially strange to
human experience (eg biochemistry, neurology, some aspects of
psychiatry too), you will need special terminology. But for matters
that are to do with human beings and their personal and interpersonal
experience, we should need only ordinary common language. Macmurray
uses ordinary language, though he often makes it mean more!
I took, from Macmurray, a blueprint
model of human functioning A
Basic Model when I went in 1981 to my consultant job in Lanarkshire.
Only through the fire of real ground-breaking team work has the
blueprint become reality to the point where you throw it away.
I have been active in AFT since the
mid-1980s. After having a good run with psychodynamic psychotherapy
(including my own much valued analysis), it seemed to me that
family-systems ideas and the people attracted to them, were my
best bet. I wanted to put my energy into an extra-mural organisation
that might best use it. But my aim, as ever, has been to de-construct
the development of any unnecessary professionalising mystique
and language.
At first I worked hard to make the
term 'Family Therapy' broaden to include more systems than just
'families' and more kinds of work than just 'therapy'. But professionalisation
of Family Therapy was unavoidable. A distinction needed to be
made between the card-carrying Family Therapist, and those of
us that applied the ideas and methods to other branches of helping
professions. It's now called Systemic Practice as you can see
in AFT's strapline 'The Association for Family Therapy and Systemic
Practice in the UK'. And we psychiatrists, social workers, nurses,
psychologists, general practitioners, and so on, who apply family-systems
thinking and ways, are Systemic Practitioners. Remember that the
UK is still more of a welfare state system than, for example,
the USA. This makes a big difference to how you think and practice. A psychiatrist could - before other demands for diagnosis for all - offer to see clients without having to tag their problem
or what the psychiatrist did. Your income in the States is immediately tied
in with having to agree an acceptably mystifying name for the
condition and its treatment. Click here for more on labels.
Unfortunately, the term 'Systemic
Practice' is also mystifying. It also means a number of different
things inside the field. Outside the field and in the dictionary,
it refers to medicine and weed-killer given into the system instead
of just locally on the surface. You will see elsewhere (Potential
of Systemic Practice) here that I take it to mean skilled
basic ordinary good practice in the field of the helping professions,
including skills in working with clients and families within their
functioning systems, as well as teamwork within our own helping
systems and with other agencies.
I don't like the mystique of the
term used, but if you've got something coherent to say about anything,
it has to have a tag! Here, on the Web, the tag allows you to
instantly find out what lies behind the word. But I couldn't bring
myself to use a limiting and mystifying term for a web-page that
is all about the opposite! The web-page www.forallthat.com,
is a reference to Robert Burns's poem and song, A Man's a Man
For A' That, about how people who think they're something special
are human beings all the same - all Jock Tamson's bairns, as the
Scots also have it. It is therefore a - far preferable poetic
- mystification for my guiding theme of demystification. If you
want a metaphorical connection for me, I have occasionally linked
myself to the story of the 'child' who alone sees through the
'emperor's clothes' . . . so read on!
I would often say and do rather shocking things. Especially told in black and white, they would not be acceptable by any professional or ethical standard. Maybe now in retirement it is time to start trying to present and explain them. Recently I was contacted by someone who 25 years ago was doing a placement at a residential home when I was still a trainee child psychiatrist contributing to a case conference there. He described it like this:
I recall a young lad of about nine, J, at [the residential home] with an older sister. He regularly took his teddy into the grounds and went through the act of tying a noose in a piece of rope, and hanging his teddy from a tree branch. A troubled young man with the looks and usual demeanour of Oliver in the film musical of that name. Your considered opinion was sought at a case conference. The immediate expert response stuck with me, so you should take the credit. “Well it’s obvious” the expert said. ”He’s off his head.” I should state that you then went on to display insight into how the child was functioning, and give good advice about how he might best be supported. The initial remark, however, has stuck with me as a great example of how to put people at ease, and of how to encourage honest opinion giving, and engender discussion without the camouflage of jargon to hide behind.
That still looks shocking to me! But at least you have someone else's word that it and I helped the staff and, hopefully, J, by doing the demystifying opposite of what a child psychiatrist might be expected to do.