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Introduction and Table of Contents

In this collection, I bring together some of the almost 50 papers I wrote as a teacher of psychiatry and epidemiology – and as a practicing family therapist. It includes a paper (8) my partner Margaret Newmark and I wrote together on science as it interacts and sometimes interferes with this work, and a paper (7) by Margaret on multi-family therapy for schizophrenia, one of the masterful results of a project led by William McFarlane, in which Margaret played an important part.
For me, the most important publication in this collection is the one that appears here for the first time – Context Analysis of a Family Interview (2). This was the research done by Jane Ferber, John Schoonbeck and me, applying Albert Scheflen’s method of finding patterns of movement in a family interview – in this case, Don Jackson’s consultation with the Hillcrest Family.
A download of any of these papers is available by clicking on it in the Table of Contents.    The text of this Introduction continues below.

TABLE of CONTENTS

  1. Family Therapy – A View (with Andrew Ferber)
  2. Context Analysis of the Jackson film (with Jane Ferber and John Schoonbeck)
  3. Paper with Fred Sander on a literature course for Family Therapy
  4. The Invisible Village (culture and recovery in schizophrenia)
  5. The Uses of Diagnosis
  6. Art Government and Economy  (to come)
  7. A Practical Model for Treating Schizophrenia in the Real World  (by Margaret Newmark)
  8. The Misuse and Use of Science in Family Therapy (with Margaret Newmark)
  9. The Washington Heights Community Service
  10. Notes for a Cultural History of Family Therapy
  11. Some Historical Conditions of Narrative Work (on Michael White)
  12. Psychotherapy as a Rite of Passage
  13. Curriculum Vitae

INTRODUCTION (Continued)

This collection is one of three books. The first, “A Different Story – the Rise of Narrative in Psychotherapy, (2001)” used the story of my education to explain narrative therapy, one of the developments in psychotherapy that followed – and moved away from – Freudian psychoanalysis. That book addressed psychotherapy as a peculiar Western institution, influenced by the history of our cultures – especially American culture.

The second book, which I am working on now in my retirement, is a memoir that relates my life experience to the social class and the culture that I grew up in — the prosperity that oil and automobiles created during my lifetime. I try to understand there the effects of that culture on my choices and ambitions in life, especially the effects of the peculiar institution of my adolescence, St. Paul’s School; the first intentional community in my experience, and in many ways a prototype for the others..

This introduction to the Selected Papers is an appropriate place to point out a bright thread in the carpet – my concern with establishing a history of American social or public psychiatry. I first got interested in this history when, as the Director of Training of the Tremont Crisis Center residency training program in the South Bronx, I realized that our enterprise – community psychiatry – had no history.

The official history of psychiatry then (1970) was the story of the arrival of psychoanalytic enlightenment after the dark ages of witchcraft, and then the liberation of the seriously ill from the dungeon of the State Hospital by the new medicines. That was a familiar American story of technological triumph, with Freud, like Thomas Edison, turning on the light, and the pharmacologists, like Henry Ford, liberating us from the horse and buggy days of the asylum, substituting “chemical restraints” for costly and old-fashioned institutions.

Such a history ignored the ways in which our minds are basically social in their organization, both normal and deranged, and it also ignored the distinctly American tradition of exploring the social conditions of healing. More specifically it ignored my specialty of public psychiatry, the art and science of making new kinds of social structures and supports for our most vulnerable patients, who still had lives to live in the families, shops and neighborhoods of a society they found – upon leaving the asylum — not so totally transformed that it could be a good place for them to live and learn..

So, as I wrote in Chapter Three of A Different Story, I was fortunate early in my career to be able to hire two Columbia graduate students of history, Jan Goldstein and Hannah Decker, to teach the Temont residents an alternative social history of American psychiatry. As I sat in on that course,, I learned about the work of William James, John Dewey, H. S. Sullivan, G. H. Mead, Edward Sapir and Adolf Meyer. My education continued in a collaboration with Phyllis Vine, a professor of history at Sarah Lawrence, whom I met through the Friends and Allies of the Mentally Ill, and for whose book Families in Pain I wrote an introduction. Phyllis and I collaborated on chapters and papers about the consumer movement in social psychiatry, and she was graciously and greatly helpful to me in writing A Different Story.

Phyllis is now writing a history of mental health progress in this country. Through her and my other teachers of history, Stephen Rosenheck, on the faculty of the Public Psychiatry Fellowship, and Kim Hopper, anthropologist and historian of homelessness at the Columbia School of Public Health, I try to stay a scholarly course. The pieces numbered (10) and (11) below are later adventures in writing history.

I have written a short introduction to each of these papers, and here is an introduction to the whole collection, to suggest ways in which they hang together. In chronological order, the first paper is a collaborations with Andy Ferber (1), showing how two upstart newcomers to the field tried to define family therapy for themselves and the readers of Family Process at the beginning of their careers.

Next comes a paper (2) hitherto unpublished, presenting for the first time the work that Jane Ferber, John Schoonbeck and I did when we assembled under Andy’s leadership to be part of the new Family Studies Section of Bronx Psychiatric Center. We were fascinated by the work of Albert Scheflen, whose office was next door, and under his guidance we analyzed a film of a family consultation by Don Jackson, looking for the dance-like patterns of movement that Scheflen had found in his previous analyses of family therapy sessions. I tried unsuccessfully to get this work published in regular journals of the field in the 1970s, and placing it online with this collection settles an outstanding obligation of a lifetime.

The work of the Family Studies Section got under way in a collaboration with Fred Sander teaching a seminar on literature and family work, which he and I describe in ( 3 ). Next come two papers about working with psychosis., describing ways in which madness challenges the organization of the family and the community, and how those groups might respond . In schizophrenia, one of the members of that group dramatically fails to communicate and develop as expected. Successful responses to that challenge illuminate the nature of communication and development through the life cycle, and the impact of culture on the outcome (4) The effect of bipolar disorder on the family, and possible family responses to it, are the subject of a “response” paper I wrote for Family Process, emphasizing the positive use of that diagnosis. (5)

The paper entitled Art, Government and Economy (6), is a “think piece” I wrote at the request of the Dulwich Group, who were publishing a collection called “Bedtime Stories for Tired Therapists”. I let myself go in this tirade against the political scene of 1994, when I was mainly in private practice and feeling the effect that the medical insurance industry was having on my profession – turning it into a part of medicine that insurance companies didn’t want to pay for. Hilary Clinton had just failed to introduce European single-payer ideas, and Rudolf Giuliani, the mayor of New York, was proposing to sell the water supply to save money. I was sorely missing my role as an employee of the State Office of Mental Health.. I got to review that experience in 2002 when I was invited to give a talk (9) to colleagues in the Washington Heights Community Service, on the occasion of a celebration of the Service’s history.

While all this was happening in my life, my partner Margaret, who used her mother’s name – Newmark – during this part of her career, was working with a group headed by William McFarlane on the teaching and testing of multi-family therapy as a method that reduced the relapse rate of early episodes of schizophrenia. She wrote this description (7) of the method and rationale of this program for the Dulwich Centre Newsletter. Together (8) Margaret and I wrote a critique of the position of “scientific” thinking in the family therapy field.

Some of the themes in the first book, A Different Story, are continued and brought up to date in later papers (10, 11), confirming an earlier observation that family therapy and narrative therapy are not so much sciences as they are cultural institutions shaped upon our larger ideas about membership. Again, in these papers I am trying to write history. How these ideas look when they move from generalization to practice is exemplified in the final paper, which tells the story of an adventure in therapy drawn from my later experience (12).

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