A key underlying principle of practice at Bower Place is that inequality is the primary constraint to effective clinical practice. From this understanding, Bower(note), the protocols developed to guide all therapeutic exchanges, was developed. A key assumption is that all exchanges should, wherever possible, be conducted in both word and image. This translates into practice in the note taking process where all notes are printed in the full view of the client and questions, concepts and advice relayed though pictures and diagrams and given equal weight to the verbal exchange.
Concepts may be presented through simple pictures as metaphor to convey a more complex idea. For example, the idea of hierarchy can be represented like this.
However, it is not enough to have a recognisable image that appeals to the practitioner.
In 1984 Graham Martin, a key figure in Australian family therapy, published a paper entitled Metaphor: Complete or Incomplete. He wrote ‘that the best chance for a metaphor to work is for the given story to be as exactly parallel (that is, isomorphic) as possible so that its analogical meaning is accepted unconsciously. “I accept this as so”.…. The process of developing the metaphor seems to be to take the elements supplied by the clients in terms of personnel involved, their interactions, and the themes developed and translate these with suitable disguise into the story to be told, not in any way linking the story with the reality.’ He went on to say ‘Clinically, experience suggests that greater success, in terms of both acceptance and ultimate behavioural change, occurs more when the metaphor is derived – either directly from the content and themes presented or when an existing metaphor is matched thoughtfully and presented in the language and neurolinguistic mode of the family.’
When attempting to explain concepts and ideas to clients through images the need for a good fit is equally important. This became very clear when a family was presented with the bird image as a way of explaining the importance of hierarchy. They recoiled in horror with the youngest child exclaiming “Dad is terrified of birds!”. The image was quickly withdrawn, and a process of negotiation followed whereby the practitioner agreed to return to the next session with a drawing of pigs.
Martin, G. (1984) Metaphor: Complete or Incomplete, Aust. Journal of Family Therapy., 5:2, pp. 125-140
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