I was initially tempted to reflect at length on the office "politics" that have resulted in the plight in the Children Mental Health Family Therapy Team I have been invovled in my clinical placement for the past eight months. There is anger in me over the abrupt managerial level decision for it to stop its therapy work despite it doing well for the past two years and continuing to have demands from referrals. I share the team's frustration that there has been a lack of considerations and thoughts for the best interest of the families in need.
I changed my mind while reading an interview with Luigi Boscolo and Gianfronco Cecchin, two of the four founding members of the original Milan approach, in the 1989 book entitled "Milan Systemic Family Therapy" (p155):
Cecchin: ... you have to accept the system you're working in as it is, the way you accept the family. You mustn't try to convince your colleagues of your way of working; you shouldn't get into fights with them, because, at that moment, you're not neutral.
Boscolo: When our first trainees went back to their workplaces, they tended to give the message to their colleagus: "We have a new theory that will make you more effective." The result was that they were wiped out.
Interviewer: What if they were faced with a decision to give medication or some other procedure that they couldn't believe in? What would you tell them to do then?
Cecchin: ... of course, you can't be neutral. All you can do is make it clear where you are coming from. For instance, if a person comes in who is breaking windows and acting crazy, you might give them medication and lock them up. Since at that moment you are being paid to be a policeman... you don't say "What's wrong with you?" or "Let's try to cure you." ...
Boscolo: ... [Neutrality is] a position to use only when you do therapy. I remember a trainee who said "I was driving on the highway and a car came up behind me and hit me. It was hard to find a positive connotation, but I did! I said 'This will help me to be more alert on the road.' " You have to protect yourself by protesting and getting angry; otherwise you won't collect any insurance.
I think the above discussion resonates a lot with the situation our team faced. At the wider context of how the team was formed and sustained, it is not surprising that in a setting where the decision makers were not supportive of systemic approaches to begin with, they would have felt threatened by its success and would choose to "wipe it out" when the opportunity comes. At an emotional level, I recognise that I am not and unable to stay neutral as I had been affected by this change and have only been able to see and hear from the team's perspective of the situation. From my professional point of view, I would see this to be an an unethical practice by the management, yet unfortunately, as a trainee, I am in no position to challenge or put forward a case to "fight". I am, however, comforted by the professionalism of the team, in strategising together alternative ways to hold and sustain therapeutic functions for existing families the team is seeing during this transitional crises.
While writing this now, the anger has ceased and in the midst of revising this one year's studies of systemic therapy, I am appreciating more and more how thinking of systems as a whole, and seeing problems and situations at different relational levels are helpful for me to come to terms with challenges and transitions better. While emotional reactivity in many contexts is regarded as undesirable or unhelpful, when managed well, I think it can still be appropriate to express some of it in real life situation, for it to be heard and safeguard personal and professional positions.
The above is written on 7 Jun 2010. I shall let these thoughts settle for a while, say for a few weeks, before coming back to reread and write some further reflections of this reflection.
29 Jun 2010: Reread the entry above and decided not to amend it, nevertheless, I do recognise what I wrote here is based on my hypotheses, which could not be verified with the management. There would also be as many ways to describe this experience as the number of people affected/ involved, or even more.
