Volume 22, Number 9 ·May 29, 1975Family Therapy: An ExchangeByJohn H. Weakland,Lynn Hoffman,Paul Watzlawick,Richard Fisch, Reply byElsa First
In response toThe New Wave in Psychiatry(February 20, 1975)
To the Editors:
I congratulateThe New York Reviewfor commissioning an overview of the family therapy field—a notable First [NYR, February 20]. For one thing, New York intellectuals have had a long association with a class of personal advisers or wise men known affectionately as "shrinks." Wise men, like psychotherapists of any type, are small businessmen. Questions of economic interests arise when the merits of rival therapies are presented, as in this essay, which claim to cut costs, take less time, and get better results.
For another thing, the few lay articles which have appeared on family therapy have described it as just another treatment method. Ms. First has made it clear that the family therapy movement is based on conceptual innovations which go beyond the concerns of mental health. There is a metaphysical frontier here which deserves to be more widely known. Ms. First has conscientiously taken on some of the abstruse ideas associated with this frontier (the "double bind" theory of the Bateson group; the cybernetic model for describing family "systems") and wrestled them down to ground level where they can be understood.
As an overview of the therapy aspects of the family movement, the article is not so successful. This may only represent a failure to be a good anthropologist. Perhaps Ms. First has not sufficiently immersed herself in this big, messy family therapy tribe to get a real idea of what is going on. For instance, she limits her discussion to what she calls the "systems theory" therapists (Haley, Minuchin, Weakland, Watzlawick, et al.) as opposed to the more analytically oriented schools. Yet she excludes the work of Murray Bowen. Bowen is a therapist respected by the psychodynamic people because he works with and through the family of origin, but he also envisions families as systems of interlocking triangles and shares many concepts with Minuchin. This seems like an inexplicable oversight.
But perhaps the exclusion makes sense. After all, when a practicing analyst is asked to write a piece on a movement whose premises challenge those of the analytic establishment, and which is beginning to gain ground even in New York, what can one expect? In any case, Ms. First has taken on only those names in the family field which are most antithetical to psychoanalysis, including one (Haley) whom she seems positively to dislike.
Early in the essay, the point is made that systems-theory therapy has a reputation for being "unpleasantly manipulative." This is the standard attack made by the psychodynamic schools of thought (including the analytically oriented family therapists) on the work of the writers and therapists reviewed in this piece. The reader, echoing Haley who originally made this point, might innocently wonder, "Aren't all therapies manipulative by the nature of things, especially those which pretend not to be, like psychoanalysis and the so-called non-directive therapies?" But before this question can be asked, Ms. First has shifted to what systems-theory therapists do and why. Because she has a way of making it all sound like comic opera in a good cause, the reader forgets about his question and thinks, "Well, this new systems kind of therapy sounds very interesting indeed."
Ms.Firstthenstartstotellaboutsomegoodresultsthathavebeenachievedthroughthenewtherapy,likekeepingschizophrenicsoutofhospitals,treatingextremelydisturbedadolescents,andofferinghopeforoneverygravedisorder,anorexianervosa.Theseresults,however,shedismissesaseithertrivial,orelseexplainablebyage-oldremedieswhichanalystsalsouse,like"relabeling"ofthe"transferencecure."Ther
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