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THE PROCESS OF CHANGE.
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Analysis of Peggy Papp's book on family systems theory.... More...
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Paper Abstract:
Analysis of Peggy Papp's book on family systems theory. Organization of the book. Papp's approach to the therapeutic process. Issue of change. Discusses each of the 11 topics of the book including definition of the system, family's belief system, role of the therapist, interventions. Various types of procedures. Potential pitfalls of Papp's approach to family therapy.
Paper Introduction:
Peggy Papp's The Process of Change is a systematic introduction to family systems therapy that is organized topic by topic in eleven chapters. Papp's approach to her exposition of the therapeutic process begins and ends with the question of change. Since it is change that therapists hope to enable in the families they treat Papp approaches the entire subject as a series of questions about change: what is to be changed, what is meant by change, how can it be facilitated, and, above all, what are the variations in approach that produce change in its various forms. Papp employs numerous examples from therapeutic case histories, including a chapter by Joel Bergman and Gillian Walker that gives a concise version of a course of therapy in which violence was a major factor. But her discussion also centers on the advances in family therapy, made by investigators in several
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She does not address any of these problems and,while it is believable that the method has produced many successfuloutcomes, it is very hard to believe that these things are not issues. She points up theimportance of conducting therapy in the vernacular of the particular familyand the fact that different families will respond to different formulationsof their central dilemma of change. Papp begins with a considered discussion of the basic definition ofthe system. But her discussion alsocenters on the advances in family therapy, made by investigators in severallocations, regarding the use of paradoxical investigations. 36). In theselucid explanations she brings the focus around to change, noting thatchange and its connected issues "becomes the focal point of therapy" butnot, she explains, in terms of how to rid the system of the symptom but inasking how the system will function without it (p. Papp briefly describes "defiance-based" paradoxicalinterventions in which the explanation of the symptom's function wasachieved and the family was encouraged to continue it as it was currentlyfunctioning. Papp's introduction to the subjectsupplies examples of every topic, usually supplemented by snatches ofdialogue from therapy sessions. This isnecessarily a tentative idea at first but it is the means by which thetherapist tests the information s/he receives from the family and arrivesat an understanding of the reciprocity between symptoms and system. Thisenables the therapist to arrive at the crux of the family's therapeuticendeavor, developing a sense of what the consequences of change will be andwhether the family will regard such change as acceptable when viewed interms of its ramifications. Papp does not reflect on the eventual effect that this creationof an elaborate set of manipulations might have on clients who either graspthe nature of the pose immediately, perceive a mistakes in presentation atsome point during therapy, or have a clear view of the manipulation aftertherapy is completed. Papp's approach to her exposition of the therapeutic process begins andends with the question of change. The most striking aspect of al the innovativeideas presented by Papp is that, while such notions as paradox certainlyhave been used in family therapy for some time, once they are made theprimary mode the therapist seems to be involved in an ongoing attempt tosimply trick the family into changing. In this way she makes every fundamentalaspect of family therapy and the use of paradoxical interventions easilycomprehensible. But the usual paradoxical interventions are much more difficult toformulate and the process involves three principal steps: redefining,prescribing, and restraining. These problems include suchthings as the effects of previous therapists who have referred families andwhose influence is not properly countered, cases where a family member isalso under the care of another psychiatrist or therapist, or errors inassessing the source of the problems. ReferencePapp, P. Since a system is self-correcting the therapist must askwhat the symptom does to stabilize the system, how the family operates inthis process of stabilization, and what central issue is involved. (1983). Papp employsnumerous examples from therapeutic case histories, including a chapter byJoel Bergman and Gillian Walker that gives a concise version of a course oftherapy in which violence was a major factor. 13). Papp goes on to describe the use of panels of therapists as "Greekchoruses" that observe from behind a two-way mirror and can be used invarious ways to negotiate change. 37). Papp's discussion concludes with her account of the potentialpitfalls of her approach to family therapy. Peggy Papp's The Process of Change is a systematic introduction tofamily systems therapy that is organized topic by topic in eleven chapters. The next step in therapy is to set the terms, based on thehypothesis, in a contract with the family. 17). Papp principally discusses direct and paradoxicalinterventions here. If a change is allowed to take place the therapist expressesextreme reservations and cautions the family. But in order to grasp what it is doing as a system the family has tocomprehend the belief system -- the "combination of attitudes, basicassumptions, expectations, prejudices, convictions, and beliefs" -- thateach of the parents brings to the family system from her/his family oforigin (p. The therapist begins, however, by formulating a hypothesis, withoutwhich s/he "has no way to elicit or organize information" (p. Since it is change that therapists hopeto enable in the families they treat Papp approaches the entire subject asa series of questions about change: what is to be changed, what is meant bychange, how can it be facilitated, and, above all, what are the variationsin approach that produce change in its various forms. They can be used as observers whointervene -- outside the family's presence -- with therapists as occasionarises or they can be used as support for the family, offering praise andencouragement. Restraining is the step that involves thetherapist in restraining the family from changing whenever they seem aboutto do so. New York: Guilford Press. Such recommendations, of course, are greeted with outrage bythe participants and, it is hoped, encourage the person who is being usedin a triangulation to refuse to participate any longer. There is also a discussion of the ways in which aspects ofthese procedures are applicable to the counseling of couples, they are,however, discussed in the context of couples groups in the Brief Therapyproject. She gives the standard academic definition of "a self-corrective, homeostatic system which is error activated and regulatesitself through negative and positive feedback loops in order to maintainits equilibrium" and then breaks the definition down in several ways (p.6). Throughout the process thetherapist is constantly "worrying rather than rejoicing over progress" andif change takes place and reversion to old ways seems imminent thetherapist berates her/himself for having been persuaded prematurely by thefamily to allow the change (p. In different cases the therapist maywish to employ the metaphor of the fairy tale (with the implication thathappiness is earned by those who go through terrible times) or the use ofsome form of ceremony in which ghosts are laid (in which hidden fears thatsome undesirable circumstance will occur are brought out into the open anddiscussed). Papp's ownBrief Therapy Project (in which therapy was to be limited to twelve orfewer sessions) was the source of much of the background material on whichthe examples are based, and an account of paradoxical intervention in amedical setting is presented in one chapter, by Andrew Weinstein, as anexample of how the approach works. 14). This oversimplifies somewhat, butthe unavoidable impression is that Papp's approach is dependent on amastery of play-acting and maintenance of a set of attitudes and control ofsetting (including, especially, the supportive panel) that is -- at bottom-- false. She explains symptom formation in terms of the functions of symptomswithin the system and then explicates the dilemma of change. In Papp's approach the perception would, morelikely, be that they had been manipulated and that the therapist, and notthe family itself, was ultimately in charge of and responsible for thechange that took place--a result that is unlikely to encourage the brief-therapy family t believe it is capable of working on its own problems inthe future. The therapist's job, of course, is not to investigate andexplain this belief system to the family but to enable them to deduce forthemselves what has been happening. Atthis point Papp makes it very clear how the definition of a system works inpractical terms. Prescribing takes place once this definition of symptom and systemas "serving one another" has been reached and the therapist formulates aprescription of continued use of the symptom in a manner that ensures thatbehaviors are connected in terms of their functions and is "brief, concise,and unacceptable to the family" (p. They learn to listen to their ownmetaphorical language, follow the chain of behavior, and recognize implicitattitudes in the ways they describe themselves, each other, and the systemas a whole. Papp then outlines the means by whichinformation is gathered in the therapeutic process at the behavioral(observing behavior with an eye to revealing distortions), emotional(observing the function of feelings in the family and the forms that theytake), and ideational levels (how the family conceives of roles anddevelops expectations). Papp's example is a teenaged son who is abusive of his motherand the therapists hypothesis that his abuse arose at times when his motherwas depressed over the recent death of her mother. Her next major group of suggestions involves adjusting thetherapist's approach to the individual family. The Process of Change. The son's purpose inbecoming violent was to pull the mother out of her depression and the goalof the therapy was to look for a different manner in which he could dothis. But they are surely meant to perceive, in the process, howthe therapist uses paradox. 27). The point infamily therapy is not simply change for its own sake but developing aconscious understanding of how and why the symptoms arose in the firstplace and facilitating the family's understanding that change hasconsequences and changing these symptoms is entirely up to itself. This, however, can only be accomplished when the therapisthas developed a thorough, if evolving, understanding of the family's systemof belief. These are, however, standard kindsof errors and do not really confront the unusual aspects of the ideas Papppresents which are so heavily reliant on the use of paradox, short-termtherapy, and the use of the group or panel of therapists to advise or toparticipate in the process. This is done by "defining theconnection between the symptom and the system and posing the dilemma ofchange" and it is essential that the therapist be the one to set the termsbecause the one who does so is the one who controls the direction of thetherapy (p. Inordinary circumstances the therapist would use paradox as an occasionaltool which is meant to make the clients see themselves and their systemmore clearly. The former, including such things as advice,interpretations, or tasks, consists of prescriptions for actions that thetherapist feels might help with a problem that is capable of a fairly quicksolution. In redefining the unacceptable behavior thatis the symptom is redefined in terms of the goals the behavior is trying toaccomplish. The therapist then clings to thisprescription unwaveringly.
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