Autobiography Of A Theory: Developing A Theory Of Living Human Systems And Its Systems-centered Practice (Book Review)
Authors: Agazarian, Yvonne M. & Gantt, Susan P.
Publisher: London: Jessica Kingsley, 2000
Reviewed By: Jeffrey Kleinberg, Summer 2001, pp. 54-55
Agazarian and Gantt, in their new book, Autobiography of a Theory take the reader on a journey that explores human development within the group terrain. We discover that helping an individual see his or her place in a wider human context through group experience reduces the pain of being alone and releases energy that reactivates personal growth. (The story, by the way, is Agazarian's with Gantt apparently serving as a guide.) This volume reframes the relationship among the individual, group life and treatment as we explore a Living Systems and Systems-Centered perspective that has been evolving over the last twenty years in seminars, workshops and in consultation rooms. It also tracks Agazarian's continuous debate with psychoanalytic thinking. Theories in our field often emerge from the struggles of their developers; individual introspection may lead them to think about big issues. Agazarian's examination of her early family life, losses, and satisfying experiences and her work with others have given rise to theory that has universal explanatory power.
In the beginning, we see her in her upper class, but frequently isolating estate in England. Her discovery process was born. Snapshots: "I was brought up to be seen and not heard;" "I could never guess when my mother would come and go;" "Sometime when I was about 4 years old, Nanny left and Teddy [Bear] disappeared. My mother said Teddy must have been stolen. It was Teddy who listened to all my questions, and Teddy whose tummy I hugged to my face, on the window box, behind my nursery curtains, when I had to cry."
A lonely experience in a convent, disillusion with religion, major losses, including that of her brother, suffered in World War II, separation from her father and his subsequent death, a short-lived marriage and the birth of a blind son (that later contributed to their moving to Philadelphia where the social services for the child were better than those provided in England), and meaningful service as an untrained junior nurse in a psychiatric ward for psychotics challenged an inquiring and struggling mind. A brief (and successful) stint in advertising, a recurring interest in becoming a therapist, learning that requirements of medical school (where she could be trained as a psychiatrist) would not permit her to earn money while studying, and seeking help to deal with the death of her mother from a therapist who was interested in training his patients to become therapists--all moved her closer to developing clinical theory.
Through training, demonstration workshops, and writing, Agazarian constructed, altered and deepened her theoretical understanding of how individuals become split-off from unwanted parts of themselves. She noted that systems therapists "discourage a group from splitting off and projecting frustrating differences into an identified patient or scapegoat" (p.69). The therapist works with the split-off parts by identifying working subgroups within the group-as-a-whole that represent the two sides of the conflict. The conflict thus is worked through not with the individual but through the subgroups.
At the Devereux Schools her questioning psychodynamic theory grew stronger when she heard complaints that the children were resisting talking with the staff. She observed that the groups of children and professionals were sitting too far from each other to communicate. She was told, "Don't give us geography, we want to understand the psychodynamics!" (p.70). Agazarian proposed that group dynamics were contributing to the problem more than were individual intrapsychic forces. She warned against scapegoating and pleaded that the so-called deviants possessed resources that the unit could use. Her observations were cast aside and her contract with the school was not renewed.
Agazarian continued to struggle with how to combine work at the individual level with group dynamics. Immersion in the Group Analytic Movement in England, led by S.F. Foulkes, helped refine her thinking. She came back to her own group, one that she felt was not dealing effectively with aggression, and modeled the more silent leader she had experienced within the Group Analytic movement. She was impressed that her group's members were able to articulate what they did not like about her prior leadership efforts; later they became more self-confident and independent.
Her involvement with the Tavistock movement convinced her that the leader's passivity narcissistically injured the members and contributed to malignant regression and primitive (and harmful) subgrouping. She concluded that the leader must continually clarify the group's goals and be sensitive to the need to develop group norms that enables the group to respond effectively to present issues instead of repeating the self-defeating patterns of the past. The leader also needs to identify how the group induces individuals to act-out the split-off projections placed in them by the group. Role and function were the bridge she was seeking between the focus on the group and the focus on the individual.
Agazarian's "continuing chase" led her to Lewin's Field Theory, to cognitive behavior therapy, transactional analysis, and then, short-term therapy developed by Davenloo. The last encounter turned her view of therapy upside down. Instead of working with an analytic attitude and following the patient, she witnessed Davenloo directing the patient through "challenge and pressure." She was astounded that he would confront the patient sharply, break through elaborate defenses and free the patient's ego. She wanted to focus on defenses as he had, but not use bullying as a way to confront. She realized she needed to be much more directive than she had been previously if she was to obtain the results she sought. She recalls: "Dr. Davenloo's emphasis on keeping a 'close eye' on the patient and his use of nonverbal cues to determine whether or not it was appropriate to put pressure on a patient were the kind of real world data that I respected and responded to" (p. 156).
Shortly thereafter, Agazarian was brought face to face again with the evolving gap between her systems world and her old psychoanalytic home. In the discussion of her demo group at the 1985 annual conference of the Eastern Psychotherapy Group Society, Anne Alonso shocked her with a question about the evident narcissism and "perverse" exhibitionism on display in her presenting the group to an audience of colleagues. After the group expressed their outrage at being labeled, and then stabilized their positive perceptions of the public demonstration, Agazarian realized that the psychoanalytic-driven thrust of the question illustrated how she no longer was operating within a psychoanalytic frame. Her departure from psychoanalysis was underscored in 1989 when she considered the relevance of Samson and Weiss's theory to group treatment. She felt "disloyal" and "devastated," experiencing "survivor guilt and shame," and that she was having a "nightmare:"
It suddenly became obvious to me that not only was the analysand in psychoanalysis encouraged to experience himself or herself as the center of the world, thus exacerbating the narcissistic pain at exposure, egocentric guilt and shame at separation, but worse, was forced into a mutual denial, preconscious to both the analyst as well as the analysand, that the analyst was really the center of the world! (p.163).
She began to abandon psychoanalytic constructs, such as that hate emanates from the superego; instead she came to believe that in group, hate stemmed from frustration within a social context and could be transformed into creative energy. Also, she saw identifying subgroupings and having members fully engage with their peers (and feel normal) in their subgroups weakened defenses and led to symptom relief. Interpretations of reenactments and uncovering unconscious conflicts that promoted those recurring patterns was not a part of her evolving theoretical and technical treatment base. Instead, she learned to interrupt seemingly defensive attempts as soon as she heard them:
'Because' almost always continues into an explanation and 'yes, but...' almost always pre-empts the other person's point of view. Interrupting as an intervention posed the challenge of intervening in such a way as to pique sufficiently the other members' curiosity so that the interruptions were experienced not only as frustrating but also useful for learning (p.200).
Defenses, then, are viewed as understandable responses to social reality and are therefore legitimate and universal, and not pathological.
To Agazarian's credit, through recent field research she has recognized that some authority issues and barriers to intimacy can best be understood from and analytic perspective. "This [discovery] was a great relief to me," she writes (p. 209). She was revisiting her intellectual home.
Both aspects of the book--Agazarian's autobiography and the evolution of her theory--brought me closer to this talented, creative and inquisitive therapist and to her clinical approach. She has never stopped questioning others as well as herself--the hallmark of both a rigorous explorer and a builder of clinical theory. Through her writing, presentations, training conferences and supervision, Agazarian has become a major player in contemporary group therapy. The story of Systems-Centered Practice is well told here and the reader emerges with a fuller understanding of the theory and the woman who developed it, and may feel inspired to do a bit of his or her own exploring as well.
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