Reality and Construction in Psychotherapy: Sense and Nonsense of this Distinction.

KURT LUDEWIG
Lecture at the IV. EFTA Conference in Budapest on 29th June 2001

Systemic Therapy appeared as a further development of Family Therapies at the beginning

of the 80s. The initial impulse came, as far as I can reconstruct it, 1981 from Paul Dell in
Zurich. He drew on ideas from theoretical biologists and other natural scientists like
Humberto Maturana, Francisco Varela, Ilya Prigogine and Heinz von Foerster. These ideas
gave a more comprehensive theoretical foundation to those that had been previously
advanced in family therapy by Paul Watzlawick, Mara Selvini Palazzoli and others.With his
legendary speech of 1981 Paul Dell initiated a new era in psychotherapy.
At present, that is, 20 years after, it is time to review and re-evaluate this new approach in
terms of benefits and costs. In my short presentation today I shall address and evaluate very
briefly a few central issues of Systemic Therapy.
But first, I would like to make my theoretical position clear: I understand modern Systemic
Therapy as an application of Systemic Thinking to the practice of psychotherapy, and in
turn, Systemic Thinking as a general way-of-thinking about mankind and human knowledge
that is grounded epistemologically in constructivism and ontologically in systems theory.
Reality and Construction: Contradictory terms?
From the point of view of a therapist I contend that both reality and construction are useful
and not contradictory notions. Broadly speaking, the term "construction" may be ascribed
to knowledge and "reality" to practice. Theoretically I follow Humberto Maturana and state
that: everything said is said by an observer". This general ontological statement implies
that all we can deal with are our constructions as observers, since there are no means of
attaining knowledge that go beyond human cognition. On the other hand, from a pragmatic
point-of-view it makes sense to contend that, with regard to all practical purposes, realities
do exist. This argument applies regardless of whether it addresses the so-called hard
realities" or the relational realities", that is, whether it pertains to objects, forms or
discourses. Assigning theory and practice to different realms of existence (or
phenomenological domains) takes into account that practitioners and theoreticians generate
different discourses which, even if they contradict each other, may still be perfectly valid.
While both the practitioner and the theoretician perceive their actions and feelings as
consistently real", the rational reflection about these actions and feelings cannot render
anything else but constructions". Distinguishing different realms of existence follows what
Humberto Maturana calls a clear logical book-keeping" and should end or, at least, limit
the misunderstandings that constructivism is supposed to allow for creating realities
arbitrarily.
What is reality? In a first approach it may be stated that real is what has real consequences.
Systemic Thinking disregards the objectivistic claim that the existence of reality could be
demonstrated independently from the perceiving activities of observers. Focussing on the
observer Systemic Thinking contends, instead, that all - relevant - existence derives from
the cognitive abilities of human beings. Stemming from the biological study of cognition
this contention substantiates the old epistemological conclusion that all knowledge is, in the
last consequence, construction. Although re-animating subjectivity modern constructivism
implies by no means that realities come about arbitrarily. Quite on the contrary! Realities
are seen as proceeding from the specific operationality of structurally coupled nervous

systems - or, in other words: from the common operationality of communicating observers.
And observers can bring forth only those realities of which they are capable of, namely,
only those that proceed from their structure determined possibilities. However, once such
constructions have been brought forth by observing (in-language) they become for all
practical purposes binding and unavoidable, that is, real and they remain that way until they
have been replaced by other realities that fit even better or are more useful. That being the
case, we may conclude that whatever we human beings consider to be real is both real and
construction. It is real at the pragmatical level of observation, and a construction at the level
of reflexion.
How real is real? From Systemic Thinking we learn that the quality of a reality is not an
inherent characteristic of itself but, instead, the result of an evaluating discourse or an
attribution done by observers who use similar criteria of validation. The criterion of
objectivity which prescribes the matching of the knowledge of an object with the object
itself reveals itself as unattainable since the object itself is only accesible through cognition.
Therefore, objectivity should be replaced by a more suitable criterion that includes the
observing activities as well as the motives of observation. Such a criterion - "viability" was proposed by Ernst von Glasersfeld. Personally, I prefer the term communicational
usefulness" which means that a piece of knowledge is useful when it allows different
observers to arrive at comparable results.
Evaluation. Systemic Thinking does away with objectivity and thus liberates scientific
discourse from metaphysical assumptions about an unreachable reality. Besides that, it
withstands the temptation of either affirming or negating the existence of a world that
transcends human cognition. Systemic Thinking constraints itself to the modest contention
that the world in which we live is the world that we constitute through the process of our
living.
In psychotherapy the adoption of constructivism enabled the emergence of a new approach,
Systemic Therapy, which is intended to be free of objectivisms and other logical
misplacements. This has been one the most important benefits from Systemic Thinking.
With regard to the costs, one difficult problem emerges in the domain of methodology. This
affects, very especially, empirical outcome and process research. Since therapy is supposed
to causally change the clients outcome research has been traditionally attached to the notion
of causality. That being the standard, the systemic approach faces a paradoxical situation: it
needs to prove empirically its usefulness but without either reverting to a disputable
concept of lineal causality or falling back into the oversimplications of mental
classification. A research is called for that translates the existing practice-based evidence
into a sound evidence-based practice. One possible way of handling this problem lies in the
application of new mathematical models as have been devised in chaos theory and
synergetics. Such a project has been carried out in Germany by Gnter Schiepek; first
publications about it dispose to an optimistic expectation.
Reality and Psychotherapy
For client and therapist as participants in a therapeutic process the question of whether or
not a reality exists that is independent of the observers has little or no relevance. Suffering
is the main motive that leads people to look for psychotherapy, and since suffering is an
emotion that is felt as real as it can be, there are no grounds for a debate about the reality or
constructivity of these motives. Seen though from the point of view of the reflecting

therapist this immediate evidence becomes disputable, and the discourse about it may lead
to different interpretations and evaluations. Precisely this difference of appraisal between
therapist and client has a great influence on practice. In fact, some newer results of
psychotherapy research confirm that not only the difference in assessment between clients
and therapists but also a partial emotional detachment between them is positively correlated
with acceptable outcomes. The therapist is therefore in a paradoxical situation having to
both accept and reject the clients understanding of him/herself, having to be also both
empathetically close to and emotionally distant from the client. Dealing with these
paradoxes is one major concern of clinical theory.
A Clinical Theory of Systemic Therapy
Drawing on the modern systemic theory of social phenomena I have suggested regarding
the subject matter of clinical theory as a sequence of social systems that are distinguishable
with respect to the communications that carry them and the themes involved. In general a
sequence of, at least, four types of social systems may be identified: 1) a problem-system,
2) a help-seeking system, 3) a non-specific help-system, and 4) a specific help-system, e.g.,
a therapy-system. I shall now address the first and last of these stages by shortly referring to
a theory of problems and its consequences for the therapists tasks.
Personal and interactional problems
Problems" may be defined as human situations in need of change. They are clinically
relevant if they trigger a suffering that becomes a motive for looking for therapy. Family
therapy as the forerunner of Systemic Therapy kept with tradition and defined problems as
structural conflicts or deficiencies, as dysfunctional patterns or communicational
disturbances affecting a social system, mostly a family. It was Harry Goolishian who in the
middle of the 80s formulated a new concept that allowed to re-conceptualize clinical
theory: the concept of the problem-determined-system. Basically, he turned the traditional
notion up-side-down and stated that not social systems have problems but, instead,
problems generate social systems. This idea had a revolutionary impact since if it were
thought through it would do away with the traditional notion of psychopathology that leans
so heavily on metaphorical semantics derived from reifications such as mental illness,
mental disorder, etc.
By way of a definition, human problems may be seen as arising out of an unsuccessful
attempt to alleviate an irritation (perturbation, disturbance, disorder) that is alarming
enough as to trigger suffering. The irritation overstrains (stresses) the possibilities of the
systems to react; the system can neither react adequately nor withdraw. As a consequence
first a personal problem" emerges which, depending on its emotional effect, may become
on top a communicative problem-system (this is the German term for a problem-determined
system). One characterizing feature of a problem-system is its stability. The
communicational process restricts itself to a tedious repetition of contents; alternative
communications that could eventually widen the scope, distract from the problem, or even
replace it altogether have little chance to succeed. The involved persons adjust gradually to
continously reproducing the problem; at the same time, the participants gain security that
things, at least, wont get worse.
In Germany after a good decade of work with the new concept of problem-system Tom
Levold, a German therapist and theoretician, began questioning it. He proposed to
distinguish between the narrative and the emotional aspect of a problem deploring that the

latter, namely, the subjective perception of a problem and all emotional states attached to it
had been mostly ignored in systemic clinical theory. This objection made it necessary to
introduce a notion addressing subjective experience but without disregarding the
communicational sphere. The concept of problem-of-living (Lebensproblem) seemed to
meet these requirements since it connects well with the fact that emotional dispositions
have a decisive influence on all processes of human life.
Evaluation. Generally speaking, the complemention of interactional with personal
problems re-opened the systemic field for discussion and co-operation with other,
individually oriented approaches of psychotherapy. Within the field of Systemic Therapy
the relationship between problems-of-living and problem-systems occupied a central place
in clinical reflexion; their interrelation being regarded as one of a structural coupling.
The tasks of the therapist
A methodology of psychotherapy must provide a framework of actions capable of
counteracting the dynamics sustaining the problems. Modern social theory, especially the
one proposed by the German sociologist Niklas Luhmann, together with the theory of
emotions as it has been developed in the last decade supplied the necessary elements for an
understanding of therapeutic change in terms of dissolving problems-of-living and
problem-systems. Since systemic therapist cannot guide their actions by causality their
basic task is to arrange for social encounters (i.e. therapy sessions, theoretically speaking:
marginal systemic conditions) which provide the clients with favourable conditions to
change on their own. A major condition for allowing oneself to probe unexpected
differences instead of continuing with repetitions is to feel safe. The therapist is therefore
required to keep an artistical balance" between empathetically appreciating the client and
thus making him/her feel sure and, at the same time, depreciating the problem in order to
stimulate change. The clients are stimulated to change preferences", that is, to shift their
attention from the problem and its circumstances towards alternatives and other resources
that are suitable for replacing the problem.
Having dispensed with lineal causality Systemic Therapy may not lean on causal principles
in order to shape therapeutic interventions. With this constraint in mind the therapist finds
him/herself in the middle of what I call the therapists dilemma" which says: Act
effectively without ever knowing in advance how, and what your action will trigger!". A
therapist who takes this dilemma seriously refrains from defining the goals of therapy
him/herself and from causally planning change. Instead, the clients are motivated to
formulate their own concerns and wishes in a way that guides the therapists actions. Yet,
the therapist remains responsible for arranging the therapeutic conversation in a helpful
manner. One way of coping with the therapists dilemma is to follow step-by-step a
pathway that begins with hearing the problem, continues with helping to formulate a
concern and then with negotiating an operable assignment and ends with drawing up a
contract based on the foregoing steps.
Evaluation. Dispensing with lineal causality has been one major contribution of Systemic
Thinking to psychotherapy. Likewise, it has also mislead some therapists to disregard the
influence of biography and generational legacies on the clients. If everything that matters is
communication, or as Niklas Luhmann puts it, sense-making", then there is no need to
accept the narratives that clients bring with them as explanation for their problems. From

the point of view of theoretical reflexion there is indeed no need for that; as Gianfranco
Cecchin points out, an attitude of irreverence against problems is here highly
recommendable. On the other side, since all sense-making" is, as well, for all practical
purposes true and real, depreciating the value of whatever makes sense to the clients would
not only be offensive but also detrimental for the course of therapy. Once again, a clear
logical book-keeping" is called for that helps to prevent confusion of phenomenological
domains. The empathetic acceptance of the clients reality and the questionning of its
inevitability need not contradict each other.
By way of a conclusion
A systemic approach to psychotherapy locates it phenomenologically in the realm where it
belongs, namely, that of sociality, since all that happens in psychotherapy is
communication. However, since the human being may only be adequately understood by a
simultaneous consideration of its biology and languaging, it follows, that at the level of
theoretical reflexion psychotherapy should be regarded as a complex social interplay of
likewise complex, multisystemic, bio-psycho-social unities, namely, human beings.
As a child of the closing 20th century, a time in which new scientific knowledge had begun
bypassing many of the blockades inherited from reductionism, Syste-mic Thinking enabled
us to simultaneously consider the complexity of biological, psychological and sociological
aspects constituting human existence without reducing these aspects in relation to one
another. The main benefits incurred from adopting this way-of-thinking have been to
relocate psychotherapy within a humanistic frame, to liberate it from its conceptual
dependency from the natural sciences, and to release it from the burden of a solely realistic
and individualistic stance.
Summing up, I believe that the overall benefits of Systemic Thinking for the theory and
practice of psychotherapy outweigh largely the entailed drawbacks and difficulties. This I
see as a good reason for supporting the further development of Systemic Therapy, not
allowing it dilute into a diffuse stream of traditional approaches as threatens to happen in
Germany, where a self-appointed Scientific Committee denied Systemic Therapy its
scientific status.

Acessado em 7.3.2005, em <http://www.kurtludewig.de/allg-Texte.htm#2>