Last night I heard screaming
Loud voices behind the wall
Another sleepless night for me
It won’t do no good to call
Always come late
If they come at all
Listening to Tracy Chapman’s spine-tingling song Behind the Wall is an unforgettable experience, introducing a systemic perspective to human distress. Multiple viewpoints are provided, not just of the observed (i.e. overheard) abusive relationship but also of the observing systems. The narrative is told through a neighbour; the timbre of Tracy Chapman’s unaccompanied voice eloquently conveys the impact upon her.
Last night I heard the screaming
Then a silence that chilled my soul
Observing an ambulance drawing up, an overheard policeman
I’m here to keep the peace
Will the crowd disperse?
I think we could all use some sleep
The abuse taking place in private had become a public matter. The challenge the lyrics present to the listener arises from the complexity of emotions, power and helplessness, and responsibility involved. Heard four times, the song’s refrain Last night I heard the screaming … seems to punch the air like screams through the wall. Thoughts and feelings evoked by the song join the listener to the predicaments contained within it.
The whole (experience) of it is far greater than the sum of its parts: the song’s impact derives from not just the words contained, but also from the sparsity of the prose, and from its manner of delivery (where the unaccompanied voice reflects the isolation described). It illustrates an important systemic principle, which also crosses the arts (e.g. what makes a painting remarkable), physical science (the ‘wetness’ of water – more than a collection of H2O molecules), and social science (culture and subcultural values and beliefs, etc.).
But by also involving the listener so strongly, the song constitutes a post-modern (but insistent) invitation to responsibility. Without indicating how that could be done. Unquestionably, however, points of opportunity are apparent.
Writing before post-modern ideas, the early pioneers of family therapy wrote as observers, who joined families in order to effect change, and provided detailed descriptions of how to achieve that (what can be done, etc.), but without including themselves in any deep way. The subsequent introduction of social constructionism (which the 1st edition of Integrated Family Therapy pre-dates) transformed systemic training, because it placed far greater importance upon the stance of the therapist – their ethics, beliefs, and their capacity to meet with new families without adopting an unduly ‘expert position’ (which would inhibit shared meaning-making, and risk overlooking points of opportunity that might otherwise emerge). If the 1st edition anticipated this development in any way, it was by emphasising the importance of collaborative problem-solving between therapist and family, made explicit from the outset of meeting one-another.
Multiple perspectives and shared responsibility: Chapman’s song offers no direct invitation to take responsibility, instead this arises from experiencing the song i.e. from becoming a participant-observer. Obvious points of opportunity are apparent: from direct (or indirect) intervention, from immediate (to delayed) responding, involving the use of self (measured or without regard to own safety), either independently or having established a shared sense of purpose with others. This wide range of possible ways to intervene in fact applies to all clinical practice, selection according urgency of perceived need, professional discipline and experience (and therefore bias of perspective), and from the activation of our own emotional experience – influenced by implicit memory as well as by conscious thought.
However reasoned the response, there is rarely one way that is ‘right’, instead there may be several, even many, ways to be helpful. The only ‘wrong’ way – the song implies – is to do nothing. Reflecting upon one’s own position to the incident (both personal and professional), and to the multiple possibilities of the impact of an intervention on the whole (or bigger picture), the action might justifiably be with one aspect of the system rather than with another.
Whether active or subtle, any action is unarguably best concluded through a shared sense of purpose. Living in an atomised society, the abused person or perpetrator in Behind the Wall might have never met the neighbour whose own world was shaken by what she overheard. Without direct knowledge of the incident or of each other, opportunities for intervention from professionals involved with the neighbour might nonetheless be present. The policeman had power, could have done more but seemed helpless. Other possibilities: from a CPN or counsellor treating the neighbour for anxiety and depression; from social work services helping the abused woman to rebuild attachments with her children, placed with foster carers earlier; or from the neighbour’s GP, perhaps monitoring a repeat-prescribing regime to support recovery from biological symptoms of depression.
Any narrow professional view of the problem concerning them would miss the wider systemic implications of the neighbour’s night-time experiences. These less obvious opportunities for a systemic perspective are generally only discovered by enquiry or investigation – they rarely fall into one’s lap.
In short, however compelling a particular concern (whether it’s about an abused neighbour, a depressed or anorexic teenager, or a confused older person), a systemic perspective requires that a broad view is taken of whatever is presented as ‘THE concern’.
Remaining curious: a systemic family therapist strives to maintain a position of curiosity (which Auerswald many years ago had likened to that of “a non-blaming ecological detective”). By interconnecting the many parts of a presenting problem, maintaining factors to problems can be discovered, allowing new resources to be developed and existing resources maximised.
Systemic thinking leaves no room for reductionism. For example, that occurring when attention is concentrated on a single aspect of a problem presenting in health or social care (e.g. behaviour “kicking off in the ward”, “challenging behaviours” in a residential care unit, or “acting out” in the community) to the exclusion of a wider appreciation of its circumstances (i.e. ward, unit, family, or community context). Such understanding also requires the past to become known as well as the nexus of current relationships, which most of our case-examples illustrate.
Reductionism may also occur where therapists working in the public sector (whose clients are rarely in a position to select out a preferred therapist), hold partisan attitudes about which factors – social, psychological, or biological – to prefer or ignore. Mind-body splits aren’t just ‘old hat’, they are a further example of reductionism. For example, preventing an adequate recognition of the impact of childhood psychosocial adversity on current stress tolerance, and the constraints this imposed upon thinking, and in turn upon language. Similarly, categorical diagnosis risks becoming a caricature of understanding a patient’s predicament, a tick-box rather than an imaginative formulation of it.
Stuckness in systemic family therapy: another salutatory lesson from the history of family therapy! After a surge in the number of articles and conference workshops describing “stuck” families (“resistant” to whatever the family therapist/s had tried), these experiences began to be thought more systemically. Complexity was more readily acknowledged, including the perhaps narrow subjectivity therapists themselves brought to their work, recognising that past recourse to moral language had prevented delving deeper into the multiple possible reasons for an impasse. The days of an ‘expert’ therapist’s work being frustrated by family resistance were over. Remaining curious had become the new task.