More About Demystification

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.

Nick Child