BOOKS

THE TACTICS OF CHANGE
Doing Therapy Briefly


Richard Fisch, John Weakland, Lynn Segal

(Original advertising copy from publisher Jossey-Bass 1982)

This new book offers proven strategies for treatment of many clinical problems -- including anxiety, depression, marital difficulty, sexual dysfunction, family conflict, psychosomatic illness, and drug or alcohol dependence. The author's tactics for bringing about change means that therapeutic intervention can be brief (usually lasting no longer than ten one-hour sessions) and more effective than most other current therapies.
The authors, pioneers in the field of strategic therapy, have tested and refined their approach with actual clinical cases for over sixteen years. They now build on their earlier book, Change, and draw from the work of other leading therapist, such as Milton Erickson and Jay Haley, to present a variety of techniques that have proven effective with all types of clients-- individuals as well as families, clients from varied socioeconomic backgrounds, and clients who have not responded to traditional psychoanalysis. The authors provide a comprehensive rational for doing therapy briefly, with detailed illustrations of specific techniques, so that therapists can apply the method to the broadest range of clinical problems.

OVERVIEW OF ORGANIZATION

The book opens with a concise explanation of the author's conception of human problems--how they begin, why they persist, and how they can be resolved quickly. It then goes on to discuss all the basic elements of treatment: maintaining control, setting the stage for treatment, conducting the first interview, assessing the patient's position (or point of view), planning overall treatment strategy, using specific interventions and terminating treatment.

Chapter Seven, the longest and most detailed section, examines situations that frequently arise during the course of treatment and provides extensive examples of what therapists can do, say, suggest or imply to initiate beneficial change. Case studies with commentary explain the reasons for the therapist's actions illustrate successful uses of techniques and further clarify the approach. The book concludes with a summary of the basic principles of brief therapy and their potential applications to many kinds of human problems.

DESCRIPTION OF CONTENTS

Chapter One: Practice -- and Theory examines underlying principles of brief therapy; explains why problems often persist despite repeated attempts to solve them; and proposes ways of breaking clients negative behavior patterns.

Chapter Two: Therapist Maneuverability maintains that the therapist must be in control from initial contact through termination and shows how therapists can take charge, overcome client resistance, direct the course of treatment and gain cooperation.

Chapter Three: Setting the Stage for Treatment considers how the course of therapy is shaped from the first contact with clients; recommended ways of handling difficult situations that often arise during initial contact; and points out what therapists can learn from the client's opening remarks.

Chapter Four: The Initial Interview presents techniques for obtaining specific information about clients' problems and treatment goals during the first meeting (even with clients who rapidly identify problems) and suggests how this information can be used for case evaluation and planning.

Chapter Five: Patient Position reveals the importance of understanding the patient's frame of reference and idiosyncratic values; also discusses how different points of view can be used in treatment to avoid engendering resistance and to enhance patient cooperation with needed therapeutic tasks.

Chapter Six: Case Planning offers suggestions for organizing data to formulate both overall strategy and specific interventions; spells out seven steps in case planning ( including assessing client's complaints and formulating realistic goals); and explains how to keep plans flexible so that they can be modified as the case progresses.

Chapter Seven: Interventions provides guidelines for handling the variety of situations that may arise during treatment; presents tactics useful in treating the full spectrum of problems encountered; and includes extensive illustrations of techniques from specific cases and at different stages of treatment.

Chapter Eight: Termination of Treatment looks at ways of ending treatment productively whether in resolved or unresolved cases; also recommends techniques that reinforce positive change, reduce client's fear of termination, and prepare for constructive resumption of treatment in stalled cases.

Chapter Nine: Case Study: The Aversive Adolescent, which reports the case of a rebellious adolescent girl who has just been released from Juvenile Hall, illustrates procedures for resolving family conflicts and helping parents regain control.

Chapter Ten: Case Study: The Anxious Violinist contains transcripts, with commentary, from an interview with a musician whose performance anxiety inhibited his earning a living; it demonstrates how therapists can work with agitated patients, help them relax, and get clear data about the problem.

Chapter Eleven: Case Study: The Stroke Victim's Family shows how brief therapy can be used to treat family problems related to physical illness--even if the identified patient is unwilling to or unable to be seen in treatment.

Chapter Twelve: Psychotherapy -- and Beyond summarizes the authors' views and describes the potential application of their techniques to improve human interaction and bring about needed change in many settings.

SUMMARY

This new book offers therapists a detailed set of guidelines for doing therapy briefly and effectively. The authors detail numerous strategies and techniques for promoting beneficial change-- ones that have proven effective in treating a variety of problems ranging from family conflict to such severe disorders as schizophrenia. They explain the guiding principles of brief therapy; provide step-by-step descriptions of the method, from initial contact through termination; and present transcripts, with commentary, of actual clinical cases with children, adolescents, adults, couples and families to illustrate successful application of specific techniques. All therapists -- psychologists, family counselors, social workers, psychiatrists, and others--whether in private, agency institutional, or instructional setting will find this book a valuable, practice.

The Dream of Reality

HEINZ VON FOERSTER’S CONSTRUCTIVISM

Do we humans actually discover reality, or do we just dream it up? Are our burgeoning stores of new knowledge merely our own creations? Our Enlightened western minds tend to think that the question is moot. We think we can be “objective” about what we see, that reality exists “out there,” apart from the observer. But the constructivist ar­gues that these beliefs hinder the understand­ing of ourselves and our relationship to the world.

In this thought-provoking volume, Lynn Segal describes the ideas of Heinz von Foerster, who has posed useful questions about our comfortable notions of what is real. Von Foerster. a radical constructivist, is a cybernetician. mathematician, physicist, and philosopher who has had a profound impact on the scientific conception of “objectivity.”

Beginning with the idea that we must know how we think before we “know” the rest of the world, this book closely examines the theory of objectivity from semantic, phil­osophical, and neurological perspectives. A chapter details how language structures our logical devices and therefore how we create the “things” we think we are discovering. Humberto Maturana’s system for handling the problem of objectivity is then introduced. The final four chapters integrate several con­cepts—computation, biocomputation, the nervous system’s structure and functioning, and closure—which attempt to account for cognition. Finally, an interview with Von Foerster is included as an appendix.

Those who are interested in the general question of what it means to know, as well as those who are interested in brain function­ing, constructivism, computer science, psy­chology and psychotherapy—particularly systems theory and psychoanalysis— will welcome this clear exposition of constructivism. Lynn Segal is a research associate of the Mental Research Institute in Palo Alto, Cali­fornia. He is the co-author (with Fisch and Weakland) of The Tactics of Change: Doing Therapy Briefly).



About Heinz von Foerster

Heinz von Foerster was born 1911 in Vienna. After completion of his studies (M.S.. Physics, Institute of Technology. Vienna; Ph.D. Physics, University of Breslau) he worked in various industrial research laboratories in Germany and Austria. In 1949 he moved with his family to the United States and joined the staff of the Department of Electrical Engineering at the University of Illinois, Urbana, Illinois, and, at the same time, became secretary of the Cybernetics Conference Program of the Josiah H. Macy, Jr., Foundation in New York. In this connec­tion he edited five volumes of the proceedings of these confer­ences: "Cybernetics: Circular Causal and Feedback Mecha­nisms in Biological and Social Systems.”

With colleagues of the department of physics, he established the Department of Biophysics and Physiology in 1957, and in 1958 the Biological Computer Laboratory, an international and interdisciplinary research laboratory for the study of the phys­iology, theory, technology, and epistemology of cognitive processes.

Professor von Foerster was a Guggenheim Fellow (1956/1957 and in 1963/1964), President of the Wenner-Gren Foundation for Anthropological Research (1963-1965), Presi­dent of the Society for General Systems Research (1976/1977), is a Fellow of the American Association for the Advancement of Science (since 1980), and directed the Biological Computer Laboratory from 1958 until his retirement in 1976. The list of his publications has approximately 100 entries.

Heinz von Foerster is now Professor Emeritus of the Depart­ments of Electrical Engineering and of Biophysics and Phys­iology of the University of Illinois and lives in California.

Preface by Paul Watzlawick, MRI, Palo Alto Ca

Lynn Segal has taken upon himself the exceedingly difficult task of presenting the life work of a famous scientist, translated into a readable non-technical language, in a relatively slim vol­ume, The difficulty is compounded by the fact that Heinz von Foerster defies any simple categorization, as he transcends the traditional academic boundaries of scientific disciplines. Like a belated renaissance man or — if one prefers— the forerunner of an era in which natural and humanistic sciences will begin to converge, he fascinates his listeners and his readers by his en­cyclopedic knowledge, coupled with the ease with which he es­tablishes totally new connections, and thereby forces us to ques­tion our traditional ways of conceptualizing the world. This is the process that Arthur Koestler called biosociation and credited with man’s creative power.

Heinz von Foerster is one of the leading members of that in­credibly gifted group of scientists who in 1949 got together under the auspices of the Josiah Macy Jr. Foundation for the purpose of studying “circular causal feedback mechanisms in biological and social systems.” It was Warren McCulloch, the chairman of these meetings, who invited Heinz von Foerster to present a theory of memory which he had developed when still in Vien­na, and which was, without his knowing it at the time, built on what are now called cybernetic principles. What thus began as the study of dynamic processes of a general nature soon revealed its specific importance for the understand­ing of man and his social interactions.

The realization that the observer, the observed phenomenon and the process of observa­tion itself form a totality, which can be decomposed into its ele­ments only on pain of absurd reifications, has far-reaching impli­cations for our understanding of man and his problems in which he literally “constructs” his reality, then reacts to it as if it existed independently of him “out there,” and eventually may arrive at the startling awareness that his reac­tions are the effect and the cause of his reality construction. This “curved space” of human experience of the world and of himself, this closure— as Heinz von Foerster calls it — finds its symbolic expression in the Ouroboros, the snake that bites its own tail, or its poetic expression in the words of T. S. Eliot, for whom “the end of all our exploring will be to arrive where we started and know the place for the first time".

Lynn Segal has succeeded in making this also the structure of this book whose last chapter “curves back” on the first and in­troduces the reader into what he has just read as if it were for the first time.