Book Review: Language, Structure and Change

At last a theory of psychotherapy that questions the dogmas and received wisdom that bedevil most other models in this field. Efran, Lukens and Lukens use the ideas of Chilean biologist Humberto Maturana to completely revise our understanding of the term "psychotherapy". The crux of their theory is the central role of language in the creation and resolution of problems, indeed in all aspects of human social existence. Language fragments and carves up unitary phenomena into separate parts that are then reified and made to interact with each other: in particular, it creates a split between self-as-subject and self-as-object, thereby fostering the illusion of the existence of an observer. Self-referential paradoxes arise from the reification of metaphors and the confusion of action and commentary, operations and semantics. Problems arise only at the level of commentary: at the level of operations an organism just does what it does, and it has only one option for action in a particular situation at a particular point in time. Concepts such as "control", "free will" and "self-determination" are metaphors, not operational realities. Language creates the illusion of choice and of the possibility of a conflict between choices.

This is perhaps the aspect of this theory that is likely to prove the least popular in the world of psychotherapy, and especially existential psychotherapy, where freedom and choice are seen as the core features of human life and much attention is given to the pathos of decision-making. Viewing freedom and choice as metaphors may even seem to invalidate the very project of psychotherapy. This is not so. Change is the necessary and inevitable result of an organism's constant interaction with the surrounding medium. We cannot "make change happen" - it happens by itself all the time, although we single out particular shifts as meaningful.

Since semantic space and perceptual space are closely interconnected, a change in the way we "language" an event will affect our experience: different "stories" have different implications for action. Paradoxically, the mere discussion of new options creates new action possibilities. If an experience is a conversation about an event and not just the event itself, psychotherapy can be construed as an alteration of that conversation. The therapist-client interaction cannot not change the participants, although the changes that do take place may not be the same as the client or the therapist intended to bring about. As well as doing away with fictitious inner entities, this theory eliminates the false opposition between "rational" and "emotional", and defines emotions as bodily predispositions that make certain classes of action more or less probable. There is no literal split between our "heads" and our "guts", but we do at times experience a contradiction between goals that simultaneously require incompatible bodily predispositions. The resolution of the contradiction then entails shifting to a broader frame of reference. Psychotherapy does not deal primarily with what happens "in someone's head", but with the negotiation of values and with patterns of living together.

The authors successfully demystify the myths of psychotherapy, daring even to challenge the sanctity of the "frame": rigid notions about scheduling and duration of sessions, seating arrangements, location, the issue of manipulation, all come under scrutiny and reveal a host of Psychotherapeutic prejudices rather than any clear rationale.

This is very dense book, packed with ideas, some of them challenging and counterintuitive, yet written in a simple and entertaining style - sometimes perhaps too simple to do justice to the complexity of the topics. It is a thoroughly refreshing book that will provide food for thought to the thinking counsellor

Antonia Macaro