The Process of Change

Rating:
Summary: Reaction to Papp's The Process of Change
Review: The process of change by Peggy Papp was a good introduction to the world of family therapy. The author addressed many issues related to the family systems, and was able to show the process of change, that took place in many families Peggy Papp was to counsel. Family system is a complex, dynamic structure that involves in itself a lot of significant factors that contribute to either healthy or unhealthy development. Generally, each family system is very unique, and has its own dance, way of communication, rules - spoken or unspoken. A family could be compared to a tangled ball of yarn, and a therapist should be aware of many components, before trying to untangle it. Such components are alliances, coalitions, unspoken rules, disengagement and etc. The goal of the therapist is to gather this information as much as possible for better results and use specific strategies to bring the change into the family. Of course any insignificant change brought to the family influences it greatly. "Change exacts a price and raises the question as to what repercussions will be for the rest of the system" (Papp, 1983). Peggy Papp suggests gathering information on different levels of the therapy. I agree that in order to understand family patterns, it is important to comprehend how all levels are connected and influence one another. The levels are the following: ·Behavioral ·Emotional ·Ideational On the behavioral level the therapist should look for the events that direct to the happening of the problem in the family. Usually this is one of the most complex levels because in the beginning of the session it is hard to understand why family members act this or that way, and what caused them to do so. So the therapist gets a vague picture of the whole situation and many family secrets are still being hidden. On the emotional level the therapist's goal is to see how the family is communicating. The author calls it "the feeling level", how feelings are being expressed matters a lot during the therapy; this could give some cues to the therapist. Very often the problem lays in the following pattern: family members do not communicate with each other on a feeling level. Finally, the ideational level explores how the family perceives the problem, and what is the reaction to that perception. Papp states that the answer to understanding this level is revealed through the content and it would be helpful if the therapist gathers some information concerning the historical background of family members. What usually happens at this stage of exploration is that a certain theme revealed by the family member has a direct bearing on the presenting problem.

I found the use of group during therapy interesting and at times peculiar. At first I'd a feeling of being disturbed by the group if I were a therapist. But Peggy Papp mentions some good sides of using a group in the therapy. One of them is to support either an identified patient or support a therapist and his decisions. Another one is to "unhook" the therapist if the latter was too involved with the problem or unable to see the presenting problem. Here are the following models of the therapeutic triangles I was able to point out while reading the book:

1.Group - Client - Therapist This model seems mostly used during family therapy in The Process of Change. The group notifies the therapist if certain strategies can be used or the change is happening too fast.

2.Therapist - Client - Cotherapist In this case two therapists are working together and in a way holding each other accountable during the session. This is a very useful and effective technique to do both individual and family therapy. The therapists debate and argue with one another. They might also take planned positions in relation to a certain critical issue and debate these issues in front of the family. By hearing the debate between the therapists family can sometimes get a clear picture of the problem, its cause, learn the alternatives and see how they can better handle it.

3.Therapist One - Therapist Two - Therapist Three - Family

Each therapist takes his own side and formulates a hypothesis on the actions of the identified patient in the family. As the Russian proverb says, "Two heads are better than one", so in this case three therapists come up with a conclusion or a strategy to improve the family critical situation. It was interesting to notice that the role of a therapist no matter which model he uses, changes and fluctuates according to the flow of the therapy. One time the therapist(s) aligns with the identified patient, another time using a paradoxical intervention aligns with the "accusers" to push the IP to make a decision for himself or herself.

I found it very interesting when the therapist used a fairy tale as an effective therapeutic intervention. In the case Happiness is earned through suffering described by the author Robin, fifteen-year-old daughter, was giving hard time to her mother by keeping her up all night, because she had nightmares. The therapist made a good job by projecting the family situation in the form of a fairy tale. Introspection of the problem can be better comprehended if one looks at it from the spectator's standpoint. In the case described in the book the daughter seemed not to understand her "not-so-appreciative behavior" towards her mother after hearing the story, and her mother on the other side had a clear understanding of what the therapist was telling. It is important to note that the strategic therapist pushes the client to the point where he or she realizes the wrongdoing.

Peggy Papp was one of the therapists who recognized some of the failures and acknowledged the mistakes that were made during some sessions. I fully agree with the author that it is very hard to predict the outcome or know for sure how this or that technique would affect a client. Family is like a living organism and any modification or elimination of its components may lead to an unwanted result. Everything depends on how the family relates, cooperates with the therapist, if the family wants to change as a whole unit or just wants to fix one of its "units", what is going on after the session is over, at home, their thinking. I feel that it is the therapist's responsibility to realize that and act accordingly. I found the book very informative and innovative in the use of interventions and strategies.