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Straight talk in the therapeutic session

Presenter: Paolo Bertrando Concerned for some years by the way therapy seems to have

become limited to questions, and questions about questions, and refl ections and refl ections about refl ections, I was looking forward to hearing about “straight talk”. Paulo began by pointing out, “Constructivism, social constructionism, and critical realism have been mostly preoccupied with the status of reality in therapy”. He warned us he was planning to address the status of truth in therapy, from both the patients’ perspective and the therapist’s. T is could be, for some, a heretical notion. Paulo trained in systemic family therapy in the 1980s with Luigi

Boscolo and Gianfranco Cecchin. Back then, whilst it was assumed clients would tell the truth, as they saw it, what was less clear was what therapists should say, and the relationship between this and that slippery notion, truth. Paulo said, “Actually, in my early days as a systemic therapist, I was taught not to tell my truth. I was presumed to say what I (or my therapeutic team) considered most useful. Strategic therapy, especially in those days, was centred on the idea of indirect infl uence”. A strategic therapist would not see it as important or useful to state his or her view of the truth but rather to say what was thought to be tactically useful. Sometimes, this could be the opposite of what the therapist actually believed to be true. T en, Paulo said, Everything changed with the advent of postmodernism and

constructivist therapies. Postmodern therapists, though, while ref aining f om strategic stances, tend to an extremely discreet position. T ey do not deny their truth, but they hesitate to speak openly of it. Paulo likened straight talk

to “parrhesia” – frankness of speech: what Michel Foucault described as, “T e f ankness, f eedom, and openness, that leads one to say what one has to say, as one wishes to say it, when one wishes to say it, and in the form one thinks is necessary for saying it” (2005, p. 372). Its roots lie in the ancient Greek art of rhetoric. T is entails adopting a way

However, Paulo cautioned, in order really to be straight talk, “ Constructivism, social constructionism, and

of speaking quite distinct both from strategic persuasion and metaphorical talk. Paulo said, Such an at itude entails the possibility (and the likelihood) of

telling patients things they do not like about themselves or their situation, but that are likely to foster change and self-refl ection. For example, a respected businessman seemed not to be respected

either by his wife and 22-year old daughter or by his brother and sister, who were also in the family business. Remembering the title of an early Italian movie, T e Tragedy of a Ridiculous Man, and careful not to sound off ensive, I asked, “Why is it impossible for you to be taken seriously?” I was here conveying my impression that his family was ridiculing him, and that he was himself fostering this process.

Context February 2012

as increasingly a feature of his practice, and wondered if it was to do with the population of clients he was seeing. Many had some kind of identity problem so, “It is possible that I become more clear – albeit tentatively – to help them face their own lack of clarity”. Straight talk has now become integrated into his approach alongside more typical ways of working systemically. T is was an interesting and, for me, a confi rming presentation.

Reference Foucault, M. (2005) The Hermeneutics of the Subject: Lectures at the College de France 1981-1982. Basingstoke: Palgrave Macmillan.

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critical realism have been mostly preoccupied with the status of reality in therapy

it should neither be intentionally used to trigger change, nor a provocation with a strategic aim. “At the same time, it is true that straight talk is relevant because it is not simply a statement of fact: it is relevant because it has some eff ect on the others. When I talk straight, I always run some risk, and I must be aware of it.” As I listened, I was reminded of a schoolgirl, continually arguing with her parents, schoolteachers and falling out with friends. I said, “It sounds to me like your mouth is your worst enemy”. She replied, “Are you saying I need to shut my trap?” “No, that just wouldn’t be you; but it might be worth making it an ally.” For the rest of that session, she mulled over how she could, in future, whilst retaining her integrity, respond diff erently to people – which could include “shut ing my trap”. Paulo described straight talk

Straight talk in the therapeutic session

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