Book Review: Therapy As Social Construction

Therapy As Social Construction edited by Sheila McNamee and Kenneth J. Gergen, Sage, London, £11.95, pb, 220 pp.

This book of papers is about the application of the theory of social construction to psychotherapy. It is about the philosophical impossibility of any position being defensible as 'the truth'.

Most psychotherapy still has its body, not just its roots, firmly embedded in the 'objective' empiricism of the 19th century modernist world. In traditional therapy the empirical structural analysis of the client's behaviour and /or unconscious leaves us in the position of viewing the client's story (or 'narrative text') as one which needs to be altered in some way to come more into line with the expert therapists 'Narrative Reality'. This fact is often dishonestly denied by many psychotherapists/counsellors who claim through one means or another to be able to adopt a neutral position. In my experience as a supervisor and psychotherapist I see many, many colleagues who seem to feel that they can and do know reality. It is my belief that this unconscious or conscious duplicity does more harm to clients and therapists than any of us realise.

The Theory of the Social Construction of Reality has roots which spread back to the Vedic Upanishads, with their doctrine of Maya and the unknowable Brahmin, to Taoism and the unknowable 'WAY'. Through the centuries various other individual voices have made themselves heard amongst the so-called objectivity of the empiricists. From Heraclitus (500 B.C.) to Vico Man constructs himself via his myths, his narratives', 1725 A.D., to the more familiar names of Kierkegaard, Brentano, Husserl and Wittgenstein and, more recently, to Gregory Bateson, T. Szasz and R.D. Laing.

P. Feyerabend, a physicist involved in quantum mechanics, shouted out the death knell of empiricism and logical positivism in his book 'Against Method' in 1975. He asserts that no one position, belief or

scientific 'proof can be defended as truth - all positions are relative. We can, possibly, contact an external reality but we cannot know when or if we are doing so.

This is a radical book about the power of politics and the invalidating effects of the therapeutic situation. It is about the avoidance of the currently much talked about iatrogenic effects of consulting an expert therapist. Kenneth Gergen was a sociology professor who eventually turned his efforts away from mainstream sociology to Social Construction of Reality Theory where once again the individual could emerge as important.

The first authors in this book want to attempt to redress the power imbalance. W. O'Hanlon talks of 'Collaborative Solution-Orientated Therapy'. Anderson and Goolishian speak of making the client the 'expert' of their own case as do some existential, some humanistic and some psychoanalytic therapies. Socratic questioning (à la van Deurzen-Smith) of the client is required in order to elicit their own subjective world. "Dialogical exchange facilitates the change in first-person narrative that is so necessary to change in therapy". Basically the therapist's aim in working with the client is for the client to develop a new story of his or her past, current and future life - to write a new narrative text of and for themselves. The last section of the book however is the most exciting for me. In his recent work Spinelli has defined self as 'a set of infinite possibilities'. J. Derrida, the linguistics philosopher, has shown how any text has not one structure beneath its surface but an infinity of structures. Belief in any one true structure is not only limiting but also a linguistic and thus philosophical impossibility (Wittgenstein). Fundamentally, post-structuralists reject the basic dualism inherent in structuralist thought, the oppositions such as conscious and unconscious, surface and depth, on which it operates. So too Gergen and Kaye talk thus:

To believe that one is successful is thus as debilitating in its own way as believing that one is a failure. Both are only stories after all.................. to crawl inside one (story) is to forgo the other, and thus reduce the range of contexts and relationships in which one is adequate.

p.

The therapist works with the client not merely to discover the client's one subjective reality but to teach the client how to construct for him or herself any number of alternative narrative texts to allow the client to construct their reality in an on-going way. Authenticity is not a state to be arrived at but a process in which to participate - give a person a fish and you feed them for a day; teach a person how to fish and you feed them for life.

Alan Jones