When only one member of the couple or family consults: Indirect therapy
by Isabelle Grometto.
The work with a single patient whose request concerns a problem involving the entourage, for whom the couple or family consultation is complicated, even impossible, will lead us to consider indirect therapy with, in the background, the link as a tool for change. . And it is one of the particularities of the Brief Therapy of Systemic and Strategic orientation to be able to rely on a device that allows it to work on the whole system by involving a patient to serve the change.
The current context linked to the spread of the coronavirus and the events we are going through today have organized our thoughts around the question of the link. Indeed, forced to live with our partners, families, roommates on one side, and deprived of our freedom to move around and regroup, that is to say cut off from other ties, we have seen the consequences of this pattern unpublished. Between alienating link and missing link, the color palette seemed to have been left on the shelf of the store closed for confinement, abandoning ¾ of humanity in front of a choice without choice, because in the end, the problem with the link is that it is difficult, if not impossible, to do without! Just as, as P. Watzlawick said, “even in silence, we communicate”.
In the Systemic and Strategic Approach, the link has become a lever, the link has become a support, a friend of change, it is at the heart of the theory, but also at the center of the practice. The founders of the Palo Alto School laid the foundations of a work which, 50 years later, extends throughout the world by integrating Wiener's cybernetics and its feedback principle, Bertalanffy's General Systems Theory. , and the analysis of interactions with Watzlawick's axioms of communication. Today's emulsion of this theoretical jumble is practical, pragmatic and non-prescriptive. The tools available to the Brief Systemic therapist can be used equally well in individual, couple, or family work. They also allow patients who wish to see their relationships change to become co-therapists, active actors in their dysfunctional system that they wish to transform.
The strategic tools will be used during the session, but also between the sessions and it is on this point that the approach diffuses its originality: Through the work in the session, the patient, cradled in metaphors, gently heckled by strategic questions, invited to open their eyes to the light of empathetic reframing and other small benevolent maneuvers to serve change, will be invited to evolve themselves and in their context. Through work, between sessions, the therapist will choose to give certain prescriptions rather than others. Specific tasks that have emerged over time and the evolution of the work of the MRI and then the research-interventions of Professor Nardone's team. Specific tasks targeting the care and management of the bond such as the evening chair, benevolent sabotage, the conjuration of silence, which you can find in the book "strategies for change, 16 therapeutic prescriptions", Vitry et al, Eres, 2020.
And this is how couple therapy without a couple or family therapy without a family in consultation will be possible and even sometimes preferable. The word of the patient, not subject to the censorship of those around him, will feel free from any judgment without having to choose couple or family therapy when he does not want it or when the other members in question are not motivated to follow him in consultation. And this is how a woman will be able to regain a little of the power that she has lost or has never managed to integrate into her couple, that a parent, by becoming an accomplice of the therapist, will be able to work out a strategy that will allow to act on the anxieties of his child who no longer wants to go to school or that a boss who is a little too authoritarian will change his behavior, faced with the target of his verbal attacks who has changed direction! As we can see through these few examples, the applications are multiple and possible, whether the patient is designated, that is to say a carrier of the symptom (he drinks, he is depressed, etc.) or not a carrier (the patient does not supports more the alcohol consumption of his spouse, undergoes the jealousy of the other…)
This circular systemic vision removes blinders and offers a broader view of the problem by opening up the field of possibilities. Circularity will be synonymous with shared responsibility that is more functional than the linear vision that pushes everyone to lay an accusing finger on the other by making them responsible for the problem (if our relationship is going badly, it's your fault!)
Finally, and as we have just seen, the tools of the therapy which are deployed in the session and between the sessions will have, in the link, an influence on which the therapist can count. Above all, it offers the systemic therapist the choice of weapons to combat the problem, with the complicity of the patient whom he invites to become an actor of change, changing his vision of himself, of others, and/or of the world!
