Responding to Anger in Session

Responding to an Angry Monologue

Case Example

• We began last week’s session with this couple with the idea that this was likely to be ‘much ado about nothing’, largely premised upon the practitioner’s recent interview with Katrina (10), the original subject of this therapeutic process, in which it was clear she was functioning well, living comfortably across both households, differentially, doing well at school etc, and there was now nothing particularly substantial to address. This session was specifically scheduled to deal with the last vestiges of the marital relationship between her parents, post-divorce. We certainly got the last vestiges of the marriage – Kylie seriously impressive in her passivity and inertia, a somewhat disconnected, disassociated, ‘la belle indifference’, in the full face of Justin’s frustration and residual emotions, tilting loudly, angrily, inexorably toward thinly contained dysregulation.
• The practitioner asked each party for a request, and in consequence copped a frustrated and angry monologue from Justin about Kylie and her intrusions into his household and his parenting of Tyson and Katrina – he does have a point! The therapeutic challenge for the practitioner was how deal with Justin’s dominance of the session, how to interrupt and silence his frustrated and angry monologue for just a moment, how to get Kylie into an active, congruent, and coherent participation in the conversation, how to get the therapeutic dialogue back, how to restore therapeutic balance, neutrality. Practitioners are expected to privilege the voice of the client, but not the expense of the other voices in the therapeutic space. Neutrality, being even-handed, fair, are often in conflict with the voice of the client in family therapy. Individual therapy faces no such dilemma. Easy!
• The common-sense way out of this is impasse for each party to embrace their own responsibility for the position they find themselves in and exercise the separate and collective authority they each have in this situation, responsibly. Each party has in the past breached significant social and ethical lines resulting in major interruptions to their careers as teachers. Justin left teaching inconsequence; Kylie fought and found her way back in after being blacklisted by DECD. Justin appears to be emotionally, cognitively, and behaviourally clearer about this than Kylie. Kylie protests her innocence. Justin appears to accept that he stepped across the line and lives with his penalty of exclusion. We are not their judge and jury. Kylie, when she speaks in Justin’s presence, is a cognitive mess of inchoate temporal and spatial confusions, boundaries hither and thither, long winding tortured sentences that are almost impossible to make sense of sometimes. Tyson and Katrina have long been caught up in the middle of this nightmare of their parents, a nightmare that has never been fully transacted between these people and may never be transacted given Kylie’s requirement that she protect the fragile nature of her current position in an elite private school. To have fought her way back from the professional dead means that Kylie is a person to be reckoned with.
• Justin appropriated the therapeutic space with his monologue. The practitioner unintentionally colluded with this. Justin took each polite and appropriate practitioner response as an acknowledgement, an affirmation, encouraging him to continue, angry, repetitive, in a raised voice. Each response the practitioner gave was an opportunity to do something different that did not occur. The practitioner’s interaction and exchanges with Justin were familiar and repetitive, well within the bounds of the ordinary and convention. In these circumstances the practitioner’s options seem to evaporate, at least from inside themselves, dexterity is a supplanted by inflexibility. In principle, repetitive and reflexive accommodation is just as inflexible as repetitive and reflexive opposition. Each is a constraint to anything different occurring. Difference is processed out through repetitive and reflexive accommodation just as it is squeezed out by reflexive opposition. It is easier to see this with opposition than with accommodation.
• Family Therapy and Systemic Practice is intended to be a dialogue in a therapeutic space between multiple attached parties about matters of significant issue for or between those attached parties, usually manifest in a symptom or problem.
• When the therapeutic space is appropriated and dominated by the monologue of one party, the dialogue in that therapeutic space is thrown off balance, becomes unbalanced in a way that makes it difficult for that dialogue to continue with any therapeutic value. When the monologue is loaded with emotions, anger, or distress, it is conventionally difficult to interrupt that monologue and retrieve the therapeutic space. Practitioner’s ordinarily find themselves participating in the monologue notwithstanding their best efforts not to participate. Such participation is implicit in the practitioner’s response and the practitioner’s silence.
• To alter the emotion laden monologue of one party, the practitioner ordinarily needs to move outside the range of the conventional, outside what is ordinarily considered to be a polite, well-mannered, socially acceptable, exchange between people, and deal with that person in a more confrontational way, or to divert the monologue in a more calculated, tangential, way. Dealing with such a monologue can be uncomfortable, especially if the practitioner is it anyway avoidant around confrontation and conflict. The practitioner requires the full repertoire of choices and moves in relationship to search monologue such a monologue. This is not a social exchange where the risk of fracture and its consequences is entirely different. The practitioner has the very difficult task of dealing with the monologue on one hand and preserving the therapeutic relationship between all the parties on the other – a balancing act, something of a conundrum.
• The idea of the genius practitioner reframing the monologue and everything changing in consequence is a nonsense. Of course, many matters turn on the word of a genius practitioner. These are matters where the process of change is not excessively constrained by contextual factors. Reframing is clever and alters cognition when not opposed. If the problem or symptom is defined within a limited cognitive domain, then reframing is relatively straightforward. If that domain is expansive and fractured, reframing will encounter complexity and opposition.
• As the monologue becomes loaded with emotion, it also becomes gendered, and at that point the emotional and cognitive differences stereotypically associated with all forms of gender begin to permeate the exchange, over and above the content of that exchange. This includes the practitioner.
• Responsibility and authority are thrown off balance in this process, by this monologue, and by the pattern of interaction and accommodation that takes place around the monologue. The person dominating proceedings through their monologue assumes a certain authority not matched by responsibility, and the practitioner’s sense of responsibility intensifies as their legitimate authority is evaporated through their own complementary participation in the monologue itself. The longer the monologue, the more responsibility and authority are unbalanced. The practitioner experiences this; the practitioner can feel this occurring inside their own body; it is located physically, viscerally. This is troubling for the practitioner, especially as the conceptual and cognitive space tightens in and around them and their own entrails. The ordinary differences in that therapeutic space are amplified into a form of inequality that is difficult to remediate – the inequalities central to certain symptoms and problems addressed in Family Therapy become ossified. The client assumes some aspects of the practitioner’s role and becomes the director of proceedings.
• A monologue requires a high degree of complementarity to persist – a speaker and those who listen and remain silent – this is a complementary relationship. As the monologue persists it becomes increasingly inflexible – a form of inflexible complementarity. Complementary inflexibility is cognitively not clever.
• Practitioner’s will have to deal with the extraordinary sense of being emotionally, cognitively, and behaviourally corralled.  To recover dexterity the practitioner will need to not accommodate.
• The earlier the practitioner makes this move the better. Interaction of this order requires its opposite to recover flexibility, dexterity, and cognition. The practitioner will need to introduce a symmetrical move – a symmetrical exchange. Does the practitioner do this directly or indirectly?
• The practitioner’s legitimate role in Family Therapy is to manage the process in a way that is fair and just for everyone in that therapeutic space – that means ensuring each person has adequate dialogic, therapeutic, relational, cognitive, interactional, space and voice – about the matters to be addressed and that no one is silenced by the behaviour of someone else in that space.
• In family therapy and systemic practice, the symmetrical move must come from either the practitioner system or from the family system. The choice is not about symmetry – only where it is spatially and politically located, and what form it will take. The practitioner or someone else in the room needs to interrupt and directly support or oppose Brett’s monologue. The monologue must cease.
• To do this the practitioner must grasp the nature of symmetry and symmetrical interaction – similar or the same on both sides of an exchange. The practitioner or somebody in the family can match the emotion, intensity, and monologue of the first party by agreeing, disagreeing, supporting, or opposing. Symmetry can be negative, positive, close, distant, connected, or disconnected. An angry exchange is symmetrical; two people in love is symmetrical. Preparing a meal is often complementary. Eating the meal at the table together is usually symmetrical. Healthy relationship systems require a rich balance of cross-linked, symmetrical, and complementary exchanges.
• In a one symmetrical move the practitioner may ask or instruct Justin not to raise his voice, not to speak angrily. This may require the practitioner to move outside conventional and polite interaction. This can appear rude and confrontational. This is the practitioner asserting the implicit, institutionally validated, inequality of their position – pulling rank. Confrontation of this order is linked to the potential for relational fracture and the loss of influence in a relationship – exactly the opposite of what is intended in Family Therapy. There is nothing wrong with this move provided it works – provided Justin respects the practitioner’s authority in the therapeutic process the practitioner has been asked to take responsibility for.
• In a second symmetrical move the practitioner may agree with Justin, elaborate on his position, and draw a family member into this. The risk of relational fracture in the family and therapeutic systems is high with this move. This may be warranted in a child protection matter. If the continuance of the therapeutic system matters, this move requires the agreement from someone of significance in that family system.
• Third, the practitioner may put the symmetrical move at arms-length from themselves and persuade the family or a single, influential family member to oppose or agree with Justin and his monologue. This is a sideways move, a lateral move, a move outside the narrow confines of the monologue itself, outside the narrow confines of the direct relationship between the practitioner and Justin, open and across into the rest of the therapeutic system. This is possibly the most cognitively and therapeutically clever move.
• Fourth, the practitioner may ask both parties what benefit this tirade will have to them or the child. The practitioner goes meta to, the clients go meta to, and comment on the exchange itself. This symmetrical move can recover some of the lost complementarity.
• All of this is about the distinction between form and content. In objecting to the form, we are not necessarily disqualifying the content. That is often difficult for the client to comprehend. Form can reinforce or undermine content.
• There is an inverse relationship between the [length-emotional intensity] of the monologue and the flexibility available to the practitioner to make a symmetrical move. The longer and more intense the monologue the harder it is for the practitioner to make a move, the more they are condemned to making a symmetrical move. Always keep the therapeutic system alive and active; in that way simple, alternative, moves remain available to the practitioner. Call a halt to responding directly to the monologue, but not responding directly to a person commanding the therapeutic space is extremely difficult. Make liberal use of the apology as the culturally appropriate manoeuvre when not responding to a person dominating a particular space.
• It is necessary for each practitioner to learn the art of the unconventional, responses outside the range of the ordinary and polite. Learn the art of movement, gesture, statement, words, etcetera, that are not present in the everyday dialogue between people. Therapeutic practice is not ordinary dialogue.

Notes

1. Difference is life itself, the visceral belly of change, and when difference is present, we need to find a way to exploit such difference in the service of change. A contemporary systemic perspective privileges difference as the mover of change, not in a mechanistic way, not as cogs in a machine, more in an organic sense, with DNA as our metaphor, the permutations of four substances combined with the seemingly boundless variations of location and space, on each line of the double helix – our deepest understanding of difference. Difference is ever present on each individual strand of the double helix and constrained by the intimate relationship between these two strands of the double helix. Difference is naturally occurring in the world. We socially and biologically organised to manage naturally occurring difference. If there is no difference to apprehend then we do not exist. If we do not apprehend difference, we are dead. Ashes into ashes!
2. Reframing is a technique, primarily developed out of family therapy, that enables a person or a group of people a way of seeing a problem, a symptom, a situation, a person, or a relationship, differently, by altering the meaning of that problem or symptom. Reframing – the frame of reference a person or group of people use or view a situation from directly determines their point-of-view about that situation. Self-evident, perhaps a tautology. The literature on reframing is couched in magic and pays little heed to the opposition a reframe may attract, especially in fractured relational circumstances. A bower(note) ecogram will inform a practitioner and client about the viability of a reframe. A green, cooperative, alliance laden ecogram will present very little opposition to a congruent reframe. A red-line, fractured set of relational circumstances will most likely mean that a reframe will face stiff opposition from people deeply committed to seeing a person or a relationship in a particular way.
3. The explanation/intervention used was – “The fact is that the dark wounds of this marriage that once was are carried forward and played out through Tyson & Katrina – look like they will never end – there is a canker in the relationship – something eats away at one or both of you – eats the guts out of one you – the unforgiven will never be forgiven for whatever this is – for whatever this is – there is a boundary somewhere that was compromised or crossed by someone somewhere.
4. The concepts of symmetrical and complementary interaction are central to all of family therapy and systemic practice. These are the only forms of interaction. There is no other. Symmetry is about similarity, two sides of the same something being largely the same. Complementarity refers to two somethings when put together make a whole, much more than they would separately. In family therapy, interaction between family members is our main game, where the action, cognition, and emotion of one party is substantially like that of the other party, or conversely, where the action, cognition, and emotion of one party complements the actions, cognition, and emotions of the other party. Talking at each other is a symmetrical interaction. Talking and listening is a complementary interaction. The therapeutic relationship in interactional. The practitioner must learn how to observe and manage interaction, how to change interaction including their own interaction with any of the people involved. Interaction changes when one party to the exchange alters what they do or how they respond. Not yelling alters the pattern of symmetrical and complementary interaction between people in a family. The therapeutic relationship is defined by the pattern of symmetrical and complementary interaction between the practitioner and the entire family – should probably be slightly eccentric.
5. The practitioner says “this analysis is really helpful and accurate as to what happened in the session and how inequality and responsibility/authority shifted and stagnated in the room. The other thing that did not help is that she put the fight on the agenda, and I was avoiding it. I feared the session degenerating into what it did, so I avoided it until after I had called a break and got advice around this. I suspect my hesitation and the delay gave the fight greater authority than it needed to have. It also messed with my time management in the session which fed back into the problem. My avoidance also meant I was doubting my own ability to manage the situation which unbalanced responsibility and authority at that point and limited my sense of collective cognition. I took on too much responsibility, unbalancing responsibility/authority. The reality is, I had every resource I needed – a senior practitioner, an intervention team, and three other people in the room. I made the process and the space smaller rather than bigger, effectively corralling myself.”