Human systems therapy.
There are many schools of psychotherapy and family therapy (e.g. Freud, 1938; Ellis, 1962; Beck, 1967; Watzlavick et al., 1967; Minuchin, 1974; Selvini Palazzoli et al., 1978; Andersen, 1987; White, 1990; Padesky, 1994; Anderson, 1997; Nelson, 1997).
It is useful to clarify, from a systemic perspective, the meaning of psychotherapy and family therapy for the purpose of this paper.
In systems theory, the system is different from the sum of its parts and there are emergent properties because of the properties of the members and their relations. Psychotherapy and family therapy act at different level systems, having different members.
In the case of psychotherapy, the system is the individual and the members of the system are the parts or components of the intelligent system. The first application of systems theory to individual psychotherapy was by Gray (1975) and the members of the system were the components of cognitive/emotional structures (Gray, 1973). In psychoanalysis (e.g. Freud, 1938), the components are that of the id, ego and superego, and in cognitive therapy (Beck, 1967) the components are basically the beliefs or cognitions. Narrative therapy (e.g. White, 1990) refers mainly to the 'stories' of people. In this sense, narrative therapy is individual constructivistic psychotherapy (Sharf, 2008). Milton Erickson (e.g. Erickson et al., 1976; Haley, 1985) used hypnosis and paradoxes in therapy at individual level. Systems therapy with individuals (Boscolo and Bertrando, 1996) is also a psychotherapy having elements from psychoanalysis, narrative therapy and the systems approach.
Family therapy is the therapy of the family as a whole and not psychotherapy of its individual components. In the case of family therapy, its focus is the relations of the members of the family, including the communicative ones, and the emergent properties of the family as a whole that influence the properties (e.g. the behaviour) of the individual members of the family. In another description, the focus of the family therapy is on the family ecology of the mind of the identified patient. Family therapy includes psychoeducation approach (Leff et al., 1982; Falloon et al., 1984) where the intervention is to change the relations of the members so that the critical comments are reduced and forms of interaction and decision making are changed. The basic approaches of the strategic (e.g. Watzlavick et al., 1967), structural (e.g. Minuchin, 1974) and pure systemic, also known as the Milan approach (e.g. Selvini Palazzoli et al., 1978), of the first-order cybernetics, are all applied at the family level changing the relations of the members of the family in one way or another. The "reflected team" approach (Andersen, 1987) of the second-order cybernetics it is also referred to family level. Family constellation therapy (Hellinger) is also at the family level.
There are systems therapies acting at many levels of the social level. Minuchin used an ecological framework for the treatment of children (Minuchin, 1970) applied in all systems where the child is a member (e.g. school, family, same class), but not at the individual psychological level. Henggeler's (1999) multisystemic approach is applied to family, organizations and wider social levels but not at the psychological individual level.
There are also family therapy methods, where the members of the family are under psychotherapy together, like psychoanalytic family therapy, cognitive family therapy and so on. For our purpose these therapies will be classified as psychotherapies and not as family therapies, although they could be called so.
There are also many integrative therapies that combine more than one method of therapy including human level and family level. In these cases, there is no unique theoretical approach applied at many levels but a combination of different theories and methods applied to each one (or many) at different levels. For example, Pinsof (1995) developed a combination of family therapy and individual psychotherapy as a type of integrated psychotherapy where he uses cognitive therapy at the individual level and the strategic approach at the family level.
According to the previous discussion, there is no method of therapy under the same conceptual framework that could equally be applied at individual and at family level systems, apart from a General Systems Therapy (Paritsis, 1989b), which has been presented in the past, nevertheless in a less developed form.
The use of general systems principles has the potential advantage of being equally applicable to many human systems hierarchical organization, such as individuals, couples, families, groups, social networks, organizations and socio-cultural systems.
This work will present an outline of a systemic method of therapy, potentially applied to many levels of human systems organization under the name of Human Systems Therapy (HST). Its presentation starts with the foundations on general systems and cybernetics and continues with the principles and techniques of therapy.
There are a number of new and significant features in this method.
Firstly, most of its principles have not been used before for psycho- or family therapy.
Secondly, the same relatively small set of general systems principles is applied to many levels of human systems hierarchical organization including individuals, groups, families, social networks and organizations, which, as holons (Koestler, 1967) interact (Baum, 1984) and thus have a nonlinear (multiplicative) effect (Paritsis, 1989). This influences the effectiveness of therapy.
Thirdly, since human systems have specialized subsystems to process information (Miller, 1978), a model of intelligence is used here that basically can have the same functions, both for the individual (Paritsis, 1987) and also for a group of persons (collective intelligence) such as the family (see Paritsis, 1998). It follows that a number of principles and techniques can be used for human intelligent systems at different levels.
Fourthly, a number of new therapeutic techniques are developed and used in HST.
Finally, its general systems principles allow a larger set of techniques to be used, coming also from other methods, in addition to its own techniques. The more general the principles are, the larger number of techniques is compatible to those principles. This is also expected to increase the effectiveness of the therapy.
FOUNDATIONS ON GENERAL SYSTEMS AND CYBERNETICS
Definition of an Open System and Its Implications for Therapy
There are many similar definitions of a system, such as 'a set of elements that interact', 'a whole of interacting elements', 'the set of elements, their properties and their relations' and 'a whole that is different from the sum of its parts'.
Among the three most characteristic systems concepts are (a) the role of relations (with emphasis on the circular ones), (b) the notion of emergence, namely that the properties of a system do not pre-exist in its elements but rather emerge from the interaction of its elements and (c) the role of context.
For the purpose of human systems therapy, an open system can be defined as the result of mutual influence between a set of elements, their properties, their relations and the emergent properties within a given context. According to this definition, a change in any part and set of the system may potentially change the others.
In order to better perceive and understand the above definition, the notion of holons (Koestler, 1967) is considered to be useful. Holons are a hierarchy of systems within systems with analogies among them such as the cells, the organism, the human, the family, the society. Each holon influences and is influenced by its neighbourhood in the hierarchy (Baum, 1984).
By considering the properties of holons in the definition of a system it follows that in the principle a change at a given level of holons and at a given part of them can in principle change the other (Paritsis, 1989). Because of the main circular relations among the parts of the system and between the human holons it follows that the result of influence of intervention at different parts and holons and/or between holons is not additive but multipliable. HST takes advantage of this assumption and intervenes at different parts and levels of human holons, to achieve outcomes that are more effective in less time and with less effort.
Characteristics of Human Systems Intelligence that Contribute to Human Systems Therapy
Human intelligence refers to information processing subsystems in living systems (Miller, 1978). In other words, human systems intelligence starts with the individual human intelligence and is extended to the collective ones (e.g. Paritsis, 1998) including couples, families groups and higher human systems. A general systems approach to human intelligence allows the application of a psychosocial intervention in therapy using the same methods of change and techniques to more than one levels of human systems intelligence including the individual and the family. In the context of general systems theory and in order to facilitate and make possible the development of HST, several concepts, ideas and models regarding human intelligence were employed, formed and further developed. There are four such main areas of human systems intelligence (HIS), namely epistemology, motivation, integration of cognitive--affective systems and living intelligent systems development.
Epistemology. A Co-synthetic One
McCulloch and Pitts, who contributed strongly to the development of the age of information via their presentation of logical neurons (McCulloch and Pitts, 1943) in the late 1950s did some experimental work together with Lettvin and Maturana on the vision of the frog (Lettvin et al., 1959). According to these findings they were unable to predict the response of the brain cells on the basis of the recordings from the frog's eye. Maturana and colleagues (Maturana et al., 1960) generalized that on vision and perception, in general, the brain largely during perception constructs the 'reality' of the eye and of the external word. This idea has been further developed towards a more general view of constructionism (Maturana and Varela, 1987).
Paritsis and Stewart (1983a) used published recordings from a study of macaque's eye which has similar colour vision as man, and by performing a simple regression were able to predict with high accuracy the response of the macaque brain to the macaque eye. After these findings the authors concluded that the intelligent system does not construct and rather synthesize an internal reality on the basis of the external one in a way that serves 'interests' of the intelligent system (e.g. development, survival, control and adaptation) within its environment (including the social), see also Paritsis (2005).
Motivation: Interaction for Satisfaction and Development
In order to specify a general human systems motivation namely a motivation for individual, couple, family or organization, Paritsis and Stewart (1979) performed a search of the bibliography for relevant empirical findings and theories. Some theories related motivation with action (e.g. Freud, 1938; Lorenz, 1952) and others related motivation with perception of a desirable state (e.g. Powers, 1974). Following from this the authors considered that in fact human systems are motivated towards interactions to the environment in a circular process, related with basic function of life (see Prigogine and Stengers, 1984) based on the interaction with the environment. In Pavlov's (1927) and Skinner's (1953) experiments, the satisfaction of a need is necessary in order for learning to take place, while this is not necessary in Tolman's latent learning (Tolman and Honzik, 1930) and in Bandura's (1977) experiments. After that Paritsis and Stewart (1979) suggested an additional motivation towards development of intelligence (including learning). To summarize, Paritsis and Stewart (1979) concluded that the basic motivation of human systems is towards interactions that lead to satisfaction and development, with development to increase satisfaction and satisfaction to develop the satisfied interactions in a circular way. Both are related to survival which underlay to both.
Integration of Cognition and Affect: Cognitive-Affective Subsystems and Zeugmas
Cognitive Affective Subsystems. According to the tradition of the application of systems on psychology, cognition and affect are integrated into cognitive/emotional structures (Gray, 1973). Cognitive/emotional structures have been used in psychotherapy (Gray, 1975) and in particular by altering the relations between particular cognitions and emotions. According to Royce (1982) at the lower levels of personality cognition and affect are separated, whereas at the higher levels they are integrated.
Furthermore, the integration of cognitive components and affect has been enriched including motivational components (Paritsis, 1985, 1987), on the basis of the model of motivation of Paritsis and Stewart (1979). Basic processes of cognition and motivation are described in the form of a control structure at the lower levels where they are separated (Paritsis, 1985, 1987). The integration of the affective (including the motivational ones) with cognitive components at a higher level is considered to be the result of learning (Paritsis, 1987). The change of the relations between the enriched components of cognitive and affective subsystems was used by HST (Paritsis, 2006) and it was the core of the method of HST in its first steps.
Zeugmas. Piaget (e.g. 1954) developed the concept and function of schemata in relation to the construction of reality in the child. Originally, the child formed sensory-motor schemata that related particular sensory with motor representations in order for the child to be able to adapt to the external world. As the child gradually developed concrete and then abstract concepts, new schemata were developed as interrelated units, representing the child's reality. Cognitive schemata were used in cognitive therapy (e.g. Padesky, 1994) and in some exceptions incorporated particular emotional components in order to be more efficiently applied in cognitive psychotherapy.
Recently, a method of psychotherapy called schema therapy combining cognitive, psychoanalytic and Gestalt methods has been developed (Young et al., 2003). A core concept in this method is the formation of Early Maladaptive Schemas comprising cognitive, emotional, sensational and memory components. Maladaptive behaviours are due to a (maladaptive) schemata resulting from unmet emotional needs originated in childhood.
Schemata are basically linear functional structures. They are connected inputs (perception), throughputs (beliefs) and outputs (choice of action). However, in order to have control and adaptability in the environment, a loop of circular causation is needed as in any control system. Such type of schema based on a feedback would be most suitable for the purpose of being a unit of interaction with the environment in order for the system to achieve its goals. Since the psychological theory of personality in systemic tradition includes the integration of cognition and affect, a kind of schema is needed to include besides the cognitive, affective components.
Due to the many uses of the term schema in therapy, and in order to describe representations of patterns of interaction of the human intelligent system with its environment as a result of learning--including cognitive and affective components--the term zeugma instead of schema was employed (Paritsis, 2003, 2006).
Zeugma can be defined as a kind of schema that includes representations of motivational, cognitive (including perceptions, goals and plans for actions) and emotional components that refer to particular interactions with the environment. Zeugmas can be activated (or inactivated) according to the presence or relevance of their components to a situation. The intelligent system having stored the already taken place past scenarios can activate (or inactivate) the appropriate zeugma in order to achieve its goals. Zeugmas can be changed by new events, syllogism or information.
Zeugmas can be used in HST not only on the basis of their cognitive components but also on the basis of their affective components and their relations, and thus a change in one of the components may change any of the others. Zeugmas include the potential of changing an emotion by the therapist related to a particular point of view in order to change a view and behaviour by the therapist activating another particular zeugma that includes a different point of view.
Zeugmas have applicability in a number of techniques of HST. Their application has the potential of achieving a very short-term therapy or even a one-session therapy. This is because, there is no need to alter part of the intelligent system but just to activate or inactivate a zeugma which can consequently trigger and bring more extensive and permanent changes.
Systems Development: Increase of Variety and Order
As development was a major directionality in human action, Paritsis and Stewart turned their interest to what are the main ingredients of development from cybernetics and systems view. Since adaptability and survival as Ashby (1958, 1981) proved was related to variety, increase of variety was taken as a basic component of development (Miller, 1978; Paritsis and Stewart, 1981, 1983b). Paritsis (1992) later put forward a law of optimal variety, namely an amount of environmental variety that optimizes intelligent systems development. A logical implication of optimal variety is co-evolution.
Following the publications of Prigogine that proved that evolution is related to the increase of order (Prigogine and Stengers, 1984), Paritsis incorporated in the basic components of development the increase of order together with variety (Paritsis, 1993b). Furthermore, for optimizing development the increase of variety has to be in balance with the increase of order (Paritsis, 1993a, 1999). For maximizing development an optimal environmental order needs to be in balance with an optimal variety.
PRINCIPLES OF THE METHOD OF THERAPY
Principles Based on the Definition of the System
Intervention at the Relations, the Emerging Properties and the Context (Principle One)
Intervention in the Relations. Intervention in the relations at a given level is a simple and effective way for bringing change in the global properties of a system.
At the first level, the system comprises its elements, their properties and their relations. Our interest is on the sub-systems that process information. If we consider the brain as a system, then its elements are the neurons. Their properties include communication via neurotransmitters to form neural networks that can realize psychological functions. Grossberg (1988), for example, designed neural networks that could simulate almost all basic psychological processes. The best way to alter the properties of the neutral network today (via psychopharmacology) is the intervention on the relations of neurons via intervention on their communication. All drugs influencing behaviour do exactly this. They influence communication via neurotransmitters.
At a more abstract level if the system that processes information is the psychological apparatus then its parts can be regarded to be cognitive, affective, sensational and behaviour. To bring change at the psychological level, a simple and effective way is to change the relations among cognitive parts, or among affective or among cognitive and affective. Cognitive therapy refers to the first case and HST incorporates all three cases (see Section 2.4.1).
If the system is the family the intervention is on family relations such as hierarchical (e.g. in structural therapy) or on the rules of contact (e.g. in strategic therapy).
Intervention in Sub-systems. If the system of intervention is the psychological system then one way is the intervention on sub-systems such as schemata as in the interventions of Padesky (1994) and of Young et al. (2003). Another way is to inactivate disadaptive or activate adaptive (or form) sub-systems namely zeugmas as in HST.
Intervention in Emerging Properties. The emerging properties of a human being relevant to our interest are behaviour and phenomenology. In addition, emerging properties are the psychological and intelligent (emotional and cognitive) functions. Thus, the issue of the emerging properties will be discussed in the principles based on the human intelligent system.
Intervention in the Wider Context. If the system is considered to be the individual human being, then the context is the family. If the system is the family then the context is the wider social environment. In this way the context may include other families, their properties and their relations and even emergent properties (e.g. the myths of a group of families) where the therapist can intervene.
Focused Interventions at Many Levels of Human Systems (Holons) Organizations (Principle Two) Since human systems are organized into holons the system at the lower level is a member of the higher system. In other words, the individual is a member of the family and the family is a member of the local society.
Furthermore, the members of the family and their properties (at the lower level) plus their relations contribute to the emergent properties of the family. The context of the individual being at a lower system are the other members of the family with their properties and their relations.
It is obvious that according to the definition of the system, the intervention at any level or at a part of a holon influences, in principle, all the other holons and the systems involved. In this way, the areas of intervention become very complicated and that is why the intervention needs to focus on specific points of the holons involved. These points are determined according to the hypotheses that the therapist has made. As there are circular causal relations among the parts of a system and between holons, the combined effect of an intervention at different points and levels corresponds to a multiplicative effect (of a nonlinear system) and not to an additive effect. In this sense, the HST is expected to have an advantage over other types of therapy concerning its effectiveness.
Principles Based on the Human Intelligence Characteristics
Use of Co-synthetic Epistemology (Principle Three) Perception (see Section 2.1) is based on the interaction of the observer and the observed. It follows that perception of the client's situation rests upon the relation (communication, interaction) of the client with the therapist. The therapist possesses his past experience and scientific knowledge, namely his knowledge and his meta-knowledge. Science is at a more advantageous position to perceive a reality useful for the adaptation of the human kind (see Paritsis, 2002, 2003, 2005). The therapist has to mainly take into account the scientific knowledge, the facts about the client and the views of the client, in forming hypotheses and designing interventions.
Restoration and Development of Interactions for Satisfaction and Development (Principle Four)
Classical family therapy regarded the maintenance of the equilibrium as the main function of the family, while according to Lynn Hoffman the goal of the family is its development. According to the first view the family will experience problems when the equilibrium of the family is disturbed, whereas according to the second view the problems arise when family development is blocked. The above views do not take much into consideration the satisfaction of family members and of the family as a whole. According to HST, the lack of satisfaction and development contributes to the development of problems in the family, and furthermore, satisfaction and development in human systems are examined and both have to be restored by the therapy if they are disturbed. The family members have to be equally satisfied and developed, if possible, and human systems have to continue its satisfaction and development.
Intervention on Cognitive-Affective Structures
This set of principles refers to the integration of cognition and affect, to the integration of cognitive and emotional intelligence.
Cognitive parts such as concepts or beliefs can be elements of these structures together with desires, emotions and motives.
They can be in the form of experiences or in the form of language or other abstract or metaphorical descriptions.
Therapy is interested in two types of cognitive-affective structures; the cognitive-affective relations within a network of such relations and that of zeugmas. Both of them are a result of learning.
Repair of the Dis-functional Cognitive-Affective Relations (Principle Five). The characteristic of this principle is to disconnect particular disadaptive relations of mainly affective with cognitive components and create new adaptive relations. The cognitive components include representations of the plans of actions, of behaviour or of events.
For example, in a person fear may be related to concept of attack and to another with concept of withdrawn. Fear of the father is considered as a relation between the emotion fear and the concept of father. The therapist, therefore, has to find methods to reduce this connection. In this way, this systemic approach of HST focuses the intervention at a relation (father-fear) and this is considered basic and possibly easier than changing a relevant belief. Altering relations between only cognitive or only emotional are also part of the method but it is considered as an exception.
Inactivate Disadaptive Zeugmas and Activate or Form Adaptive Ones (Principle Six). Zeugmas can be activated by the therapist when he or she emphasizes or brings in light particular components of zeugma such as the affective, cognitive (as particular points of view or plans of action) or their relations (e.g. through syllogism) as being present or useful. Zeugmas can also get activated by giving to the client system a role or activating a relation or behaviour. By activating some zeugmas are inactivating others and vice versa. Directly zeugmas are inactivated by discussing or sowing as damaging or false cognitive elements or undesirable implications and by inactivating particular emotions belonging to a zeugma.
Relevant techniques to this principle include the 'alchemy of behaviour' and 'presentations of logical consequences'.
Principles Based on Systems Development
Increase of Order and Variety
The presence of symptoms in mental disorders and in maladaptive behaviours produces a disordered variety resulting in extremely high levels of entropy. Psychological and psychiatric disorders can be viewed as a reduction of order and of variety. Thus, in a sense, therapy can be viewed as an increase in order and variety and thus a core strategy of HST has to be the increase in order and adaptive variety in the client's system.
Increase of Order (Principle Seven)
Order in systems and cybernetics sense is the opposite of randomness. It is related to a predicted and well-determined situation. Two types of order are of interest in therapy.
The first is referred to the organization and to the interaction of a system. The rules of contact, the hierarchy, the cohesion and co-operation in the family are related to this type of order.
The other type of order is referred directly to the processing of information. In the cognitive system, order refers to logical cohesion, to logical compatibility and to rationality. In the affective system, order refers to the compatibility of desires, motives and emotions among them. It also refers to the compatibility of actions with the cognitive and affective parts of the person.
The increase of order as a direction of therapy is concerned with all the above.
A relevant technique to increase order is 'reduction of incompatible states of affairs'.
Increase of Variety (Principle Eight)
The increase in variety is related to the increase in adaptive coping styles, of amount of information and of knowledge, of cognitive and affective components and their relations. The relations among these components of increased variety have led to adaptive behaviour in order to be therapeutic.
TECHNIQUES DEVELOPED IN THE CONTEXT OF HUMAN SYSTEMS THERAPY
The theory and principles of HST, based on general systems principles, allows as it is expected the use of the majority of techniques developed in family therapy within the wider systemic tradition.
Interventions on many holons namely at many levels of human systems organization can include methods and techniques found in ecological therapy (e.g. Molnar and Lindguist, 1990), in multi-systemic approach (e.g. Henggeler, 1999) and in network therapy (Klefbeck et al., 1986).
Interventions on the relations allow the use of the techniques of the first-order cybernetics relevant to the organization of the family, namely of the structural approach, concentrated on the hierarchical relations (e.g. Minuchin, 1974), and the strategic approach concentrated on the rules of contact of the family (e.g. Watzlavick et al., 1967; Selvini Palazzoli et al., 1978).
Furthermore, the model of man that includes (a) the epistemological approach of co-synthesis (perception through the interaction of the observer and the observed) (Paritsis and Stewart, 1983a; Paritsis, 2005) allows the use of methods and techniques based on second-order cybernetics. The realm of second-order cybernetics gave emphasis to the observer (Von Foerster, 1981), opened the road to constructionism (e.g. Maturana and Varela, 1987) and social constructionism (Gergen, 1982) and leads to techniques and methods of the reflective teams (Andersen, 1987), of the post-modern approach (Anderson, 1997) and of the narrative therapy (White, 1990).
The theoretical background of HST allows the use of the techniques and methods of the first-and second-order cybernetics, viewed in the wider context of general systems. Furthermore, the foundations and the principles of HST lead, during its development in the course of time, to a number of specific new techniques. The most important of them are the following.
Presentation of Logical Consequences
According to this technique, the therapist presents the logical consequences (possibly a caricature or exaggeration) of the client's cognitive, affective and behavioural components aiming to their change.
It is relevant to the Socratic method of following the logical implications of a person's way of thinking in order to arrive at refutable conclusions.
A related technique is the Jackson and Weakland's (1961) technique in which the therapist is asking the client to find proofs for his assertions. Another relevant technique is used in cognitive therapy, according to which the therapist asks the client to find proofs to his assertions. Both techniques can be partially considered as special cases of the presentations of logical consequences. This technique also increases the order in the system.
An example can be the case of the daughter of a person, who suddenly stopped to be the best student at her class and lost her interest in studies. The father told me that this started after a quarrel he had with his wife because she became jealous when one day he returned 20 min later at home than the expected time. He was a short, fat and not good-looking person. Then the therapist told his wife 'congratulation for your excellent opinion for your husband's sexual achievements. He is able to have a girlfriend to wait him ready for sex and for a few minutes to be able to satisfy her'. After that the wife became upset with the therapist, stopped any relations with him, but she also stopped being jealous and her daughter became again the first student at school and later finished the university with scholarship. This was a one-session therapy.
According to this technique, the therapist describes in as positive as possible way the properties and behaviours of the client system without lying.
A relevant technique is that of 'positive connotation' (Selvini Palazzoli et al., 1978) according to which, a positive comment on an undesirable symptom is a paradox. However, this is not the same as over-positive description. Another relevant technique is that of 'emphasizing the positive' (Henggeler, 1999) without being the same, since over-positive description refers to the 'negative' as well, and it is not a matter of emphasis but of a better view of particular properties and behaviour of the client.
Accepting the Past and Challenging the Present
A more precise description of the method is 'accepting present maladaptive cognitive-affective structures' as useful for the past and challenging them for the present time.
According to this technique, the therapist firstly accepts as 'adaptive' in the context of the past some presently maladaptive cognitive--affective relations or zeugmas as a result of past experiences, and after making positive comments about them, the therapist explains and discusses that the situation has changed and they are not adaptive any more at present time.
According to the author's knowledge there is no other relevant technique. This technique facilitates the rejection of the adaptive in the past and maladaptive at present cognitive-affective structures (leading to relevant strategies), which in turn facilitates the search and formation of new adaptive strategies.
A client for example, during his childhood, was damaging himself to avoid punishment or receiving love and interest from his parents while presently and at an adult environment this does not hold.
The Alchemy of Behaviour
The therapist acts in order to alter negative relations between two or more human systems into positive by changing the negative emotions into positive in one or more human systems involved.
This technique, specifically, is concentrated in altering emotions in order to change cognitions and actions. The ways to do so are too many. For example, by asking the husband and wife to have a pleasant time together, by emphasizing the good qualities of each one of them, by putting them in a situation of collaboration, by asking them separately to do good to each other or by asking them to offer a non-verbal (or verbal) expression of love.
An understanding of this technique is through activation of zeugmas having as members the positive emotions. Another way of interpreting change is that by changing the feelings and then the related (with positive feelings) cognitive elements within the cognitive affective structures lead to positive behaviour.
Reduction of Incompatible States
According to this technique, the therapist searches for incompatibilities between and within emotions, goals, desires, actions, motives, verbal descriptions, beliefs, points of view. After identifying them, the therapist points them out and discusses the choice one of them by the client.
This technique also increases the order in the system.
For example, a woman wanted her husband, who was a dentist, to return earlier at home and at the same time to earn a lot of money because they had to pay a high mortgage. The therapist, after pointing out the discrepancy asked her what she preferred more, the presence of her husband or the money. Then they made a compromise.
Another example of this technique is when the father of a schizophrenic was saying that real friends do not exist and that other people are dangerous, however, and at the same time the father accused his son that he has no friends. Then the therapist told the father that he had to congratulate his son because he follows his father's view and has no friends, or the father has to change his opinion about friends.
Solving Problems of Satisfaction and Development in an Alternative Way
The therapist identifies which important parts connected with satisfaction and development in the client's system are not fulfilled, while the client system either tried in a problematic way or did not try at all. Then, the therapist, in collaboration with the client, tries to achieve them using alterative ways.
In many cases, the past solutions of the client system are related with other problems.
This technique also increases the variety in the system.
For example, an identified patient developed negative symptoms of schizophrenia and disorganized behaviour for 2 years. This was started after the patient's wife left him because he was jealous. The patient's mother did not like his wife. The therapist then discussed and persuaded his mother that his wife is good to come back (independent of the symptoms of her son) and discussed ways of bringing her back. Surprisingly, in the next meeting, a week later, the schizophrenic symptoms were in full remission without any other intervention. It probably was a one-session therapy.
DISCUSSION AND CONCLUSIONS
HST is based on general systems principles, with most of them being the result of further elaboration, integration and development by the author of pre-existing general principles. Thus, it was named General Systems Therapy (Paritsis, 1989). However, this term that was originally given to HST had the disadvantage that it included both non-living and non-human systems. In addition, the term 'general systems therapy' may imply that it is a therapy for everything.
Because HST is based on general systems principles, it is natural to cover or integrate a number of other systemic therapies, in terms of theory, and of techniques.
For the same reason, of being based on general systems principles, this method is expected to be related to other non-systemic methods of therapy since their theory and principles may be sub-cases of general systems principles. This of course is applied to a lesser extent to non-systemic therapies than it is applied on systemic ones.
The relation of HST with the therapies of first-and of second-order cybernetics was discussed by introducing the techniques of HST.
There is a relation of HST with psychoanalysis mainly regarding the acceptance of non-conscious (unconscious) processes. In HST, the nonconscious processes are applied to all human systems such as the family, where many rules of contact are not aware. Another similarity is the direction of therapy towards reducing internal conflicts.
With cognitive therapy, a common feature is the intervention on cognitive processes also resulting in emotional changes. In cognitive therapy, the intervention is on cognitive process and through the change in them and in particular in the beliefs and schemata the emotions and the behaviour change. In the HST, the intervention is not only on the beliefs but also on emotions directly, with the change of emotions to activate different beliefs and behaviour.
HST has been applied and tested in the course of its development more on schizophrenics, although, by being a general systems therapy, it is expected to be applicable (and has been applied) to a wider range of cases than other methods.
This general systems method has already been applied to all cases coming to a psychiatric department of a general hospital where a number of therapists are working. Besides, HST is included, together with the other systemic and family therapy approaches in a 4-year course in family therapy programme since 1998.
Since the method is now at a point that can be presented in a more complete and integrated form and hence a more usable one, double blind controlled research trials are in progress. So far the results are encouraging, especially for serious psychiatric problems such as schizophrenia (e.g. Paritsis, 1989; Aivalioti et al., 2002; Paritsis and Lambraki, 2002; Aivalioti et al., 2005; Aivaliotou et al., 2006; Paritsis, 2006; Paritsis et al., 2007) and have been presented in conferences so as to get a feedback prior to the publication of the method through this paper.
Received 22 October 2008
Accepted 15 December 2009
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Nicholas Paritsis (1,2)*
(1) Department of Psychiatry and Behavioral Sciences, University of Crete, Iraklion, Crete, Greece
(2) Society for Systems Therapy and Intervention, Athens, Greece
* Correspondence to: Nicholas Paritsis, 20, N. Paritsi Street, Neo Psychiko, Athens 15451, Greece.
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|Title Annotation:||Research Paper|
|Publication:||Systems Research and Behavioral Science|
|Date:||May 1, 2010|
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