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Foundations of Family Therapy: A Conceptual Framework for Systems Change

by Lynn Hoffman
Basic Books, 377 pp., $20.00

Foundations of Family Therapy is a fascinating encyclopedia of the history, schools, techniques, and masters of family therapy. During the past thirty years, family therapy has expanded into an organized and rigorous discipline within the larger field of mental health. Its theoretical scheme and its practical techniques and training contrast with those of other mental health disciplines, such as psychiatry, social work, psychoanalysis, and supportive forms of family counseling. Family therapy may be described as a movement: family therapists believe that their picture of mental disturbance is more “true” to reality, superseding both traditional forms of therapy and contemporary therapies which center upon the individual client.

In her enthusiastic survey of the field, Hoffman both advances the movement of family therapy and establishes it as a serious intellectual discipline. According to Hoffman, family therapy is not just “a novel therapeutic technique” or even another theory of mental disturbance; it represents “a new epistemology,” which touches on all the sciences and replaces traditional theories of personal motivation. Unfortunately, these larger claims are sometimes grandiose and often inappropriate when addressed to a stereo-type of contemporary psychoanalysis (which here is labeled “the psychodynamic approach”).

“Epistemology”—the theory of knowledge—and “conceptual revolution” have become popular terms in psychotherapeutic writing. A theory of human behavior which purports to reveal the true nature of reality by way of the metaphor of knowing carries weight among therapists today. Another frequently used term, “scientific revolution,” which is borrowed from Thomas Kuhn, attempts to give a theory a progressive quality and, thus, protect it from charges of dogmatism.

But these concepts are part of two separate, and conflicting, belief systems. One holds that there is an absolute true reality which may be accurately represented by the correct method, the other that theoretical schemes are relative to a specific culture and time. In Hoffman’s book, the Kuhnian approach, which might help to restore a healthy relativism to the discipline of psychotherapy, is used to isolate, and thereby elevate, the author’s point of view. She offers us the true epistemology—a “circular,” “systemic” method—through which the real world which exists behind the mirror is, at last, made manifest. Indeed, in the first sentence, we are told that “this book is a journey to a newly discovered kingdom, the world behind the looking glass.” To Hoffman, the advent of the one-way screen through which the family therapist observes the therapy sessions is “analogous to the discovery of the telescope”; through this clear glass, we are now able to “view the fauna of a realm that had always been before us yet never truly seen.”

The new “bicameral” vision, created by the one-way screen, has indeed revolutionized the study of therapeutic interactions, since a therapist is able to observe from two places. For the first time, the therapist is able not only to observe his own contributions to the therapeutic relationship but also to have these monitored by a third person. However, Hoffman’s larger epistemological claim, based on the analogy of the screen, is…

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