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Part of the Tavistock Clinic Series, this book focuses on narrative and stories in Family Systems Therapy - particularly on how stories develop within the domain of a therapist's own theoretical, clinical and professional contexts. The aim is to allow the reader to understand the uses of stories in family therapy.This book offers a comprehensive overview of issues related to narrative which appear in a family therapy setting. Originally embarking on a joint project to share clinical experience, members of the Family Systems Group at the Tavistock Clinic discovered that what was common in their work was their emphasis on narrative. This discovery led in time to the development of a shared discourse about their diverse approaches to narrative which are carefully reflected in the contributions in this volume. Part One sets out the context of narrative with contributions on bilingualism and the family's experience of therapy, ending with a thought provoking critique of narrative. Part Two concentrates on applications of these ideas, providing analysis of multiple narratives in illness and loss, gender and language, neonatal care, adoption, divorce and refugee families.

This article describes how family therapists can routinely address the important, but often overlooked, issue of how some children may play parental roles in families. In some situations such as inadequate or absent parenting, a child is drawn into the parental subsystem and becomes identified as a ‘little parent’ in a process known as parentification. As well as gaining competence in caring, this experience may also become destructive to children in a number of ways. This includes loss of childhood and, as children are unable to fulfil the parental role adequately, low self-esteem, depression and other symptoms. The concept of family attachment scripts is used to understand the implications of a child crossing adult/child boundaries which can lead to looking after parents and siblings. Family therapy techniques help to redress the role reversal and enable the parents to take appropriate responsibility in the family. Work also focuses on how to prevent transmission of parentification down the generations. Therapists have often been parental children. How this can influence their work is illustrated by a specific case.

This paper's aim is to enable family therapists from whatever approach to address family attachments during their work. It explores the role of attachment in the family, and how to enable therapists to increase security in the family so that family members can solve their own problems during and after therapy. The article gives a brief overview of the nature of family attachment relationships and the influence of secure and insecure attachments within the family and their narrative styles. This is described in language that a therapist might readily hold in mind and share the ideas in dialogue with families. The paper discusses the interplay between insecure attachments and other family problems, such as parental conflict and disagreements over authority. It also discusses ways of establishing a secure therapeutic base and the influence of the therapist's own attachment style. The implications for family therapy practice are described and illustrated by work with a specific family.

Dans cet article, j’examinerai comment la parentification, dans laquelle l’enfant endosse des roles parentaux, se developpe dans le contexte d’un attachement insecurise. Je defends l’idee que la parentification est plus frequente qu’il n’est suppose en general. J’explicite la distinction entre la parentification d’adaptation et la parentification destructrice qui est associee a differents problemes de l’enfance. Dans cet article, la theorie de l’attachement est placee dans le contexte du systeme familial et je decris des concepts familiaux, telle la base de securite familiale (secure family base) et les scenarios familiaux, qui peuvent aider a comprendre la parentification. Je presente deux modes de relation d’attachement qui entrainent une parentification – insecurise/ambivalent et insecurise/controlant. Je discute de leurs modes de transmission transgenerationnelle. La therapie familiale peut proposer une intervention preventive dont le but est de reduire la parentification et d’interrompre la transmission transgenerationnelle. Un objectif primordial est de reduire le besoin qu’a un parent de recevoir des soins de la part de son enfant. Dans ce but, un travail peut etre effectue pour reduire les conflits entre les parents, liberant la possibilite que chacun d’eux puisse etre un soutien pour l’autre. Les enfants doivent etre « detriangules » de la relation parentale. Le travail transgenerationnel, incluant un travail avec les grands-parents, est recommande. Une therapie avec un enfant d’âge prescolaire illustre ces points ainsi que la prevention de l’instauration d’une parentification destructrice.

In this article, I will explore how parentfication, in which children take on parental roles, develops within the context of insecure attachments. I argue that parentification is more prevalent than is generally supposed. Adaptive parentfication is differentiated from destructive parentification, which is associated with a range of childhood problems. In this article, attachment theory is placed within a family systems framework and family concepts are described, such as a secure family base and family scripts, which can help to understand parentification. The ways in which two attachment relationships--insecure/ambivalent and insecure/controlling--contribute to parentification processes are delineated. Transgenerational patterns are discussed. Family therapy can provide a preventive intervention aimed at reducing current parentification and interrupting transgenerational transmission. A central aim is to reduce the need for a parent to turn to a child for care. To this end, work can be done to resolve conflicts between parents, thus freeing them to provide sufficient mutual support to each other. Children need to be detriangulated from the parental relationship. Working with transgenerational patterns, including work with grandparents, is recommended. Therapy with a family with a preschool child illustrates these issues as well as the prevention of the establishment of destructive parentification.

My 1979 paper described family mythology as a combination of the family's beliefs about itself (myths) and stories and legends that illustrate those beliefs. My ideas evolved to encompass family scripts which prescribe what is to be done about family beliefs. Rewriting family scripts and re-editing family mythology are seen as different punctuations of the same recursive therapeutic cycle. Narrative is also explored from an attachment research perspective, in which the coherence of narrative is shown to be associated with secure attachments, and hence coherence is a suitable goal for family therapy. A ‘family therapy story’ is told about our oldest tradition, that of always having to be ‘pioneers’, which cuts us off from new advances in research in other fields. Some interdisciplinary research in which the author was involved illustrates the value of collaboration between different perspectives.

The aim of this article is to make attachment research findings available in a form that family therapists can use. In attachment theory, parents are conceptualized as providing a secure base from which a child can explore. Family therapists, however, need a systemic concept that goes beyond the parent/child dyad. The concept of a secure family base is proposed, in which a network of care is made available for all family members of whatever age so that all family members feel secure enough to explore, in the knowledge that support is available if needed. Factors that contribute to the security or insecurity of the family base are outlined. The overall aim of therapy is to establish a secure family base from which the family can explore new solutions to family problems both during and after therapy. The role of the therapist is to help to resolve conflicts that threaten relationships, and to explore relevant belief systems that may be contributing to a sense of insecurity. The conceptual framework presented allows for an integration of family therapy techniques and ideas into a coherent whole. A new school of family therapy is not proposed.

Les interfaces entre les domaines intrapsychiques, interactionnels et intergenerationnels representent une nouvelle frontiere. A titre exploratoire, nous nous sommes exposes a une situation complexe mais controlable ainsi que le voient ceux dont l'interet principal se porte sur l'une de ces trois interfaces. Nous avons aussi entierement integre les sujets dans l'equipe, de facon a comprendre leur perspective subjective et a leur offrir une experience enrichissante. Nous avons commence avec une breve sequence de «triadification», c'est-a-dire passer d'une organisation familiale «deux plus un» a une organisation familiale «trois ensemble»

Insecurity in attachment relationships may promote family interactions that involve (1) “capturing” an attachment figure, (2) turning to an inappropriate attachment figure, (3) inappropriate responding to attachment behavior, and/or (4) anticipating loss, similar to past loss. In a family with two small children, family therapy over all the sessions involved reducing the need to “capture” (point l), with the therapist acting as a secure base for each family member (point 2) and exploring the anticipation of past losses (point 4), so that the parents could become a secure base for each other and their children (point 3). Coding from videotapes focused on a few minutes of intervention concerning the problem child. The interactions formed a pattern suggestive of a pattern of attachment with each parent. How the family contributed to the origins and maintenance of each pattern was illuminated by the above four influences of insecurity. L'insecurite dans les relations d'attachement peut favoriser les interactions familiales qui in-cluent (1) la “capture” d'une figure d'attachement, (2) le fait de se tourner vers une figure d'attachement inappropriee, (3) une reponse inappropriee au comportement d'attachement, et/ou (4) l'anticipation d'une perte, similaire a une perte passee. Ces quatre points fournissent une structure pour l'intervention et I'analyse des interactions familiales, dans le contexte de sessions de therapie familiale. L'intervention entraǐna la reduction du besoin de “capturer” (l), le therapeute agissant comme une base solide pour chaque membre de la famille (2) et explorant l'anticipation de pertes passtes (4), de facon A ce que les parents puissent devenir une base solide l'un pour l'autre et pour leurs enfants (3). A partir de cassettes video des sessions, les interactions qui se sont produites durant l'intervention avec la presence d'un enfant ont ete codees, les quatre points enumeres ci-dessus servant de guide. L'analyse a suggere un pattern repete de comportement de l'enfant envers chaque parent, ainsi que des manieres dont les patterns etaient maintenus par chaque membre de la famille.

Attachment theory carries implications for family therapy. From an attachment perspective, a fundamental aim of family therapy is to create a secure enough base within therapy for the family to explore how each member, and the family as a unit, can provide a secure base for each other outside of therapy. Family problems relevant to attachment may involve (1) turning to an inappropriate attachment figure, (2) competition for an attachment figure, (3) defensive responses to attachment cues, or (4) anticipation that losses similar to those of the past will recur. Sessions with a particular family illustrate how such attachment-related interactions may be identified and incorporated into treatment.

A father describes his open heart surgery, and states ‘I am not frightened of dying’. The therapist exclaims ‘I would be!’, and, turning towards Simon (aged 8), who is sitting next to his father, says, ‘Your father is brave! Do you think he always feels so brave inside?’ Simon looks up admiringly at his father and slowly shakes his head with a knowing smile. Father says ‘Well, it is not very nice coming round in that operating theatre’. He remembers how upset he was that his wife had not been there when he regained consciousness. She had told him that she had to be with the children; but he has never forgiven her for deserting him in his hour of need. He leans over and gives Simon a cuddle – or was it Simon who was cuddling his father. It is hard to tell. Simon is sitting next to his older brother Jeremy, who is 13. The two sit separating their parents. Mrs X says ‘I wonder if it’s all this talk of death that is upsetting Jeremy?’ Jeremy is so paralysed by obsessional rituals that he cannot get to school, or go to bed at night; he now sits slouching back in his chair, head and shoulders turned away from his father, but looking at the floor – and so also avoiding his mother’s gaze. She is hovering over him. He glances up at the therapist to give him a fleeting look of beseeching despair, but says nothing and returns his gaze to a point on the floor.

This final chapter will start with a brief conceptualisation of how families adapt to their roles in chronic illness and how the professionals can help. It will then describe work with a family with multiple illnesses giving verbatim accounts of some of their experiences of illness, and how the professionals contributed to that experience. Clinical implications for practice are outlined.

This chapter concentrates on the development of UK and European Community (EC) legislation in the field of organic food production (including processing). Why we need it, how it was developed and what is to be done in the future. For information about legislation in the USA please turn to chapter 10.

Briefly reviews provisions of incoming EC Regulation 2092/91 setting out Organic Food Standards.

Protective family scripts prescribe interaction that the family believes is needed to avoid potentially dangerous scenarios. Certain family legends provide moral tales that illustrate these dangers and hence reinforce these scripts. Together they contribute to family mythology. In the absence of adequate research data about specific effects of particular interventions, the therapist has to rely on his or her own beliefs about what works to change unhelpful family beliefs and interaction patterns. This essay examines the interplay between the two belief systems by exploring one of the author's own family legends and then seeing how its injunctions have been played out in his family therapy practice, thereby illustrating how myths and protective practices may be set up within the field of family therapy and its training.

(1986). Family scripts: A concept which can bridge child psychotherapy and family therapy thinking. Journal of Child Psychotherapy: Vol. 12, No. 1, pp. 3-13.

Certain families experience conflict in regulating their interpersonal distance because they are afraid of separation and intimacy. A couple that lives in the shadow of this double-ended catastrophe may triangle in a "go-between" to bring them together if they get too far apart, or separate them when they are too close. Ambivalence about the couple's relationship predisposes a family member, often an in-law or child, to be recruited to this role. The "go-between" ambivalence then becomes the couple's homeostat, and symptoms are likely to appear in this individual. Implications for family therapy are illustrated through a full-length case study.

The decision admit a disturbed adolescent to a mental hospital is all too often made by a hard-pressed duty psychiatrist, late in the day, but early in his training. The effects of this decision may well reverberate down the generations. At the Unit for younger adolescents at Hill End Hospital, St. Albans, Hertfordshire, England (5), the family, not the psychiatrist, makes the decision. This approach is based on the observation that when families eject their youngsters, parental authority is often disintegrating. Referral for admission provides a golden opportunity, not only for reversing the ejection process, but also for forging, on the anvil of a profoundly important decision, a more viable family authority structure. Therapeutic leverage is made available at the very heart of the family problem.

Family mythology includes false or edited beliefs about the present which may be coupled with family legends which support those beliefs. Families are particularly likely to use their histories dys-functionally if they either see the present as an exact replication of the past or, in contrast, deny that the past has any relevance whatever. Re-editing myths involves enabling families to alter their relationships and their self perceptions. This allows a fresh exploration of the past; a process which can support and encourage further change. Case material is used to illustrate this.

An In-patient Psychiatric Unit for younger adolescents uses the reason for admission as its main focus of work and hence concentrates its resources on pre-admission family meetings. The Unit seeks a reason for admission which can be understood by all concerned in terms not of the individual psychopathology of the adolescent but rather of the overall situation of the adolescent having to leave home. If no such reason is established, other methods of coping with the situation are discussed and admission is avoided. If a clear reason for admission does emerge, the Unit makes with the family a verbal agreement which states that reason, emphasizes the shared nature of the problem and defines the changes required before discharge can take place. During the period of admission, which gives the family a break to recuperate, the Unit's professional skills are offered to help them develop a better understanding of themselves, particularly those aspects which made separation necessary. Work is directed towards reunion. It is argued that by admitting adolescents only while families or institutions cannot cope, or by supporting them with offers to do so in the future should the need arise, the adolescent's long-term placement is maintained. Important emotional ties are not broken, but merely interrupted when absolutely necessary. Data are presented which suggest that this method shortens length of stay and prevents the admission of many referrals. The three essential and interdependent factors of the service which the Unit aims to offer are: (1) Resources (beds) with enough vacancies kept in reserve, enabling: (2) Collaboration with referring agencies when they want it, enabling: (3) Rapid involvement of referrers, families and the Unit in crisis work which often results in solutions other than admission, thus maintaining beds in reserve. There is a need for a deeper evaluation of the interactions involved and of the effectiveness of the Unit.