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Beyond familiar patterns

Writer's picture: Pavel NepustilPavel Nepustil

I think one of the role of us as family therapists is going beyond the family (or familiar) patterns. It may seem obvious but I mean it quite literally.

When we have a family with a girl who cuts herself, we have to try to build a space for something that does not have a space in the current daily life of the family. Of course, we must welcome the family as they are, with the current state of patterns, habits and relationships, but also to invite them to bring something else that is connected to it but its voice has been not yet heard too much. For example, the terrible experience of the girl with bullying 5 years ago. Or mothers´ anxiety troubles in her teenage years.


It might be interesting to think about space in this sense as well. Space where we meet. If we meet them in our office, how to make the space enough inviting for the old patterns and habits and at the same time, how to open it for something different?


I was trained as a systemic therapist of more „German-style“, I mean, more organized, focus-oriented and questions-oriented. Only chairs are needed because we only need to t-a-l-k. The design of my therapy room quite responds to it. 5 plain rattan armchairs around one small table. Nothing else, no pillows, no sofas, no blankets, no toys, no sandtray. Now, when I will probably be moving to another space, I already very vividly see how I am designing the room so that people have a choice where to sit, that is also inviting for children, men and women all ages, different gendres and religions.


But we also visit people in their homes and it brings another set of issues regarding the familiar and unfamiliar. Since people are in their own home, they might be not so much invited to go beyond the everyday patterns and habits. Which is actually very nice because they can be in the place where they feel safe and good. But slowly, after some initial sessions, we can start looking at the patterns we can see.


„He always sits at that place. Always,“ tells me father about his son pointing to a high bar stool.

„Yeah, that´s right, and I noticed that you also sit always at the same place, right?“ I replied.


I am sure you can see so many similarities from visits of your friends. Questions like „Where did you get this from?“ are those that (sometimes) take us to important moments of our lives that do not have much space in our daily conversations. Partly as a joke, I could say that the difference between a friendly visit and a therapeutic visit is that on a friendly visit, we do not stay with this comment for so long…


But let´s get back to the original idea that the basic purpose of family therapy is going beyond the patterns and habits. Why is that good for? This is an important question that is not so much asked, pretending that it is obvious. But it is not so obvious. We can only play, for 75 minutes, with the different perspectives, seeing it as interesting and important, and then, back to work! That means, back to the original patterns and habits.


And that´s why, in the first sentence, I wrote „familiar“. The difference that we can achieve together and is more sustainable is what is happening RIGHT NOW. Between ALL OF US. It means that we need to change OUR patterns, OUR habits. And it is a two-way process.


First, we can be invited to the change of pattern by the others. For example, when there is a medical doctor in the family, I often suppose that they will be critizizing our work of being too much „alternative“ or „non-professional“. So when this surgeon told me that he very much appreciates our work and that it is the best help they could get, I share my surprise with him, telling him that I was awatiting more medical approach to the issue and I am surprised that he enjoyed it. He puts his hands ahead with the palm side facing up pointing to his family. „This is not a medical issue,“ smiles slightly.


Secondly, we can also invite the change ourselves. The girl I mentioned once came to see us alone, so there was her, me and my colleague Lu. We talked about walking as a way of coping with too much stress. Lu started to elaborate on different ways of walking and I suggested that we could try it together. We stood up and walked a bit through the room. Maybe many therapists do things like that but I never! Me and my clients only sit! And now, we walked. I also told them, that it was my first time trying to do this. They laughed.


If we challenge these family / familiar patterns between us, we could start creating our own, joint patterns. For example, that it is possible to do something a bit weird sometimes. Or that it is possible to openly talk about different ways of cutting oneself. That it is possible to talk about our own prejudices and challenge them.


In few weeks, an international congress that I am co-organizing, takes place in Olomouc. Besides my organisational roles, I will also co-facilitate a workshop and a working group. The name of working group is „Open dialogue and psychedelics“ and I am doing this with my colleague, Jakub Černý. One of the points I would like to discuss there is that psychedelics are one of the ways how to go beyond the familiar patterns and habits in the neurosystem. And I think that in this way, the dialogue can be enriched.

Come and join us: https://dialog-conf.cz/

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