Therapeutic practice as social construction

Abstract

Across a significant spectrum of the therapeutic profession, we find a gradual but ever intensifying convergence in conceptions of the therapeutic process. At the heart of this convergence lies the human activity of generating meaning. First and foremost, we find the therapeutic relationship one in which human meaning is not only focal, but also pivotal to the process of therapeutic change. The significant preparation for the contemporary movement has come from many sources. Humanistic/phenomenological/hermeneutic psychologists have long argued for the centrality of individual meaning to the therapeutic process; the pioneering work of George Kelly (1955) and the ensuing dialogues on constructivism also placed individual construal at the centre of the therapeutic relationship. The emergence of object relations theory in psychoanalytic circles further stressed the interdependence of meanings within family relations and between the therapist and client (Mitchell, 1988); similarly, Gestalt therapists shifted their focus towards the creation of meaning within the relational process. The work of the Palo Alto group - Eventuating in Watzlawick, Jackson, and Beavin’s 1967 classic, Pragmatics of human communication - extended this emphasis on interdependent meanings within families; Milan systemic therapists (Boscolo, Ceccin, Hoffman, & Penn, 1987; Campbell, 2003) carried this orientation forward into a range of new and challenging practices. More pointedly, however, a concern with the social as opposed to the individual origins of meaning making became increasingly focal.