No abstract

This paper presents a model for a therapeutic approach to the cultural systems of families. Using anthropologically derived concepts of material and ideational planes of culture, magic, and ritualistic intervention, the inducement of culture change in frozen familial systems is framed in dialectical terms. Four brief case studies are presented describing the systems engaged, the material-ideational rituals employed, and the cultural transformations induced. The paper concludes with a brief discussion of some of the theoretical and practical implications of this cultural approach to the family in therapy.

The second of a two-part presentation is made based on findings drawn from a research project focused on the conversion family: a unit having at least one child or adolescent member exhibiting a disabling physical disorder for which no corresponding organic problem can be found. Data from 16 cases referred for treatment/consultation are examined from an ethnographic perspective aiming at a holistic description of the cultural configuration common to these families. Within the frame of this cultural approach to conversion families in therapy, a number of issues involved in working with them are described and discussed. On the basis of experience gained in this work, a list of principles for therapy with conversion families is proposed and discussed. Every family . . . is somewhat different from every other, the difference consisting in the manner in which each develops its own version of the general cultural configuration. A family's culture-its variant of the general culture-always contains something that makes for tranquility and well-being, and something that makes for anxiety and misery.

This article employs a set of concepts developed by Mikhail Bakhtin in analysing the significance of language in therapeutic work. Employing his theoretical constructs, sequences of a videotaped transcript of a therapy session are analysed by a multidisciplinary team. This is combined with the notion of co-texted ritual in working with a woman who attempted suicide prior to this session. The findings suggest that co-texting gives direction to the meaning of ritual as well as the outcome of the therapeutic process. Bakhtinian concepts are found to be helpful in guiding, analysing and widening therapeutic processes. The findings also indicate that there is a need for a closer examination of ritual both as a constitutive and expanding force in narrative therapy. Finally, it is suggested that current assumptions about egalitarian relationships between therapists and clients require rethinking.

The concept of "culture" figured prominently in the development of family therapy. Recent conceptualizations, however, have tended to focus primarily on the ideational dimensions of culture. While not disputing that meanings and other ideas constitute significant features of group lifeways, this article proposes a return to earlier anthropological framings that incorporate material and ideational dimensions of cultures. To illustrate how his expanded concept may serve as a guide for therapeutic work, the article describes therapy with one family at a clinic in rural Scandinavia. We especially focus on the place of key symbols as historical links between the ideational and material dimensions of cultures. The perspective developed here is one of seeing cultures as sets of interpenetrating actions and ideas shaped by as well as shaping their practitioners.