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Constructivism, a philosophical position that emphasizes the human penchant for meaning making in understanding both psychological distress and therapeutic intervention, has influenced several current traditions of psychotherapy. Following a review of the historical contributions to this approach, this research paper considers two critical issues: the relationship between language and reality and the construction of the self, as viewed from both constructivist and related social constructionist perspectives. The paper then traces the implications of constructivism for the practicing therapist, reviewing four traditions that are characterized by a central concern with the person as interpreter of experience: personal construct therapy, developmental cognitive therapies, narrative approaches, and systemic orientations. The research paper concludes that constructivism is making a robust contribution to the further development of psychotherapy, both in terms of research and practice.
Outline
I. Introduction
II. Philosophical Heritage of Constructivist Assumptions
A. Constructivist Epistemology
B. Constructivist Psychologies
III. Current Issues in Constructivist Theory
A. Language and Reality
1. Constructivist Perspective
2. Social Constructionist Perspective
B. The Construction of the Self
1. Constructivist Perspective
2. Social Constructionist Perspective
IV. Constructivist Psychotherapies
A. General Orientation
B. Distinctive Traditions
1. Personal Construct Theory
2. Developmental Perspectives
3. Narrative Approaches
4. Systemic Approaches
V. Implications of Constructivism for Psychotherapy Research
I. Introduction
In both popular and professional writing, many schools of therapy are distinguished by their concrete clinical procedures, the fund of therapeutic techniques most closely associated with particular traditions. Thus, psychoanalysis is characterized by its historical preference for free association and dream reporting on the part of the client, and the interpretation of transference and defense by the therapist. For its own part, cognitive therapy is linked with various methods for evaluating, monitoring and disputing dysfunctional thoughts or beliefs both in and between therapy sessions (e.g., homework assignments). Likewise, behavior therapy is associated with counter-conditioning procedures (such as systematic desensitization), and contingency management (through the manipulation of reinforcement to increase or decrease desired or undesired behavior). Even family therapy is associated with a distinctive set of procedures, ranging from the use of paradoxical interventions to the challenging of dysfunctional coalitions or boundaries among family members. In each case, these approaches to therapy are linked in the popular and professional imagination with a preferred set of techniques, which govern the pattern of therapeutic interaction in a way that sets them apart from others.
In contrast, constructivist psychotherapy is characterized by the distinctive mind-set that guides it, more than by any particular set of procedures that distinguish it from other clinical traditions. Of course, the unique philosophical position that informs constructivist practice does subtly encourage some ways of working with clients, while constraining others, as we shall see below. But to understand the evolution of this form of practice, it is helpful to view it against the backdrop of what constructivist therapists believe, in order to gain a deeper appreciation of what they do. This will then allow us to consider variations in the constructivist tradition, which has begun to permeate traditional schools of therapy, ranging from the psychodynamic and behavioral to the humanistic and systemic. As the ‘‘family’’ of constructivist therapies has grown, so too has the repertory of clinical strategies associated with them, and the body of qualitative and quantitative research emanating from them. While a thorough review of the theoretical, empirical, and applied literature associated with this perspective is clearly beyond the scope of this research paper, the present research paper provides an initial point of entry into this burgeoning contemporary therapeutic tradition, and offers some leads for the reader interested in pursuing its implications for clinical scholarship, research, and practice in greater detail.
We begin with an examination of the philosophical heritage of constructivism and discuss the emergence of psychological theory from constructivist epistemology, the study of knowledge. We then consider two current issues pertaining to constructivist theory and therapy: first, the relationship between language and reality, and second, the construction of the self. Next, we compare and contrast four traditions of constructivist psychotherapy, including personal construct theory, narrative approaches, family systemic orientations, and developmental perspectives. Finally, we conclude by considering the implications of constructivism for psychotherapy research, and offer a critical evaluation of the current status of constructivist practice.
II. Philosophical Heritage of Constructivist Assumptions
A. Constructivist Epistemology
Although most constructivist scholars and practitioners acknowledge that a real, ontologically substantial world exists, they are much more interested in understanding the nuances of the person’s construction of the world than in evaluating the extent to which it accurately ‘‘represents’’ some external ‘‘reality.’’ Constructivists emphasize the development of a viable or workable construction of people, things, and events over the attainment of a singularly ‘‘true’’ rendering of one’s surrounds. This suggests that multiple meanings can be developed for the events in one’s life, and that each may have some utility in helping the person understand his or her experience and respond creatively and adaptively to it.
The idea that people actively and continuously engage in meaning-making processes, that is, construction, dates at least to the ancient Greek philosopher Epictetus who maintained people were more perturbed by their views of reality than by reality itself. But it was the Italian rhetorician Vico (1668–1744) who systematized the rudiments of a truly constructivist philosophy, tracing the origins of human mentation to the gradual acquisition of the power to transcend immediate experience. Vico argued that the origins of human thought lay in the attempt to understand the mysteries of the external world by projecting upon it the structures of human motives and actions in the form of myths and fables. This tendency to order experience through the application of such ‘‘imaginative universals’’ was eventually displaced, he thought, by the development of linguistic abstractions that permitted categorization of events and objects on the basis of single characteristics.
The work of Kant (1724–1804) also contributed significantly to a conception of the human mind as an active, form-giving structure. Specifically, Kant believed that experience and sensation were not passively written into the person, but that the mind transforms and coordinates the multiplicity of sense data into integrated thought. Because human beings can come to ‘‘know’’ only those phenomena that conform to the structures of the human mind, with its penchant for organizing the world in three-dimensional terms and imputing causality to events, humans are forever barred from contacting the ‘‘thing in itself,’’ a ‘‘noumenal’’ reality uncontaminated by human knowing.
At the threshold of the twentieth century, the German analytic philosopher, Vaihinger (1852–1933), embraced constructivist epistemology in asserting that people develop impressions of the real world and create workable fictions that help them to adjust and to meaningfully respond to people and events. Conceptual ‘‘artifices’’ (e.g., of mathematical infinity or of a ‘‘reasonable man’’), while having no exemplars in reality, performed a heuristic function in helping the person organize and integrate disparate pieces of knowledge or sensory data. Vaihinger categorized his Philosophy of ‘As If’ as a kind of ‘‘idealistic positivism,’’ to acknowledge the dual reliance upon hard data and impressions received by the sensory system along with a purposive, form-giving activity of the mind to create useful constructions.
Avenarius (1843–1896) and Mach (1838–1916) espoused a unique form of impressionistic positivism, known as empiriocriticism, that also contributed to the history of constructivist epistemology. Contemporaries of Vaihinger, Avenarius and Mach placed heavier emphasis on raw sensory data as the beginning point for human knowing processes. While maintaining that people constructed an understanding of the world based upon sensory data, their principles of economy and parsimony maintained that sense data were minimally embellished by activities of the mind. Despite this more empirical emphasis, these two authors, working separately, both recognized an active, organizing role of mental processes in rendering sense data more holistically.
Within this century, the work of Vaihinger, Mach, Avenarius, and others influenced Korzybski’s development of general semantics. Korzybski (1879–1950), a Polish intellectual working independently of established academic circles, essentially criticized the use of the verb ‘‘to be’’ and its conjugations because it tended to identify people or things, in an Aristotelian sense, with qualities or characteristics that often were meant only to describe them (e.g., ‘‘Terry is lazy’’). Such identity, Korzybski maintained, de-emphasized the multiplicity of meanings and modes of existence that characterize most phenomena, living or inanimate, and obscured the role of the speaker in attributing meaning to events. Korzybski’s negation of the use of ‘‘to be’’ makes it possible for people or things to be construed in different ways and provides a linguistic basis for a constructivist epistemology. Korzybski developed an approach to language usage, known as E (E-prime), that recommended persons use conjugations of ‘‘to be’’ sparingly or not at all in written or spoken language. The idea behind E-prime is that the map (in this case, language) is not the territory (other persons or things in the world).
B. Constructivist Psychologies
Constructivist epistemology provided a conceptual basis for three distinct psychologies in this century. First, the British researcher, Bartlett (1886–1979), applied constructivist concepts in his investigations of human memory processes. In his classic work on remembering, Bartlett maintained that memories were reconstructed out of bits and pieces of recollected information. That is, memories did not consist of stored, complete representations of past events that were recalled in toto. Bartlett viewed memories as past information unified by schemas, the threads of constructive processes that exist at the time information is remembered.
The Swiss genetic epistemologist Piaget (1896– 1980) was the second psychologist to establish a coherent theory founded on a constructivist basis. As a developmental psychologist with interests in children’s forms of knowing, Piaget chronicled how children’s meaning-making capacities changed as a function of both physical growth and active adaptation upon exposure to a succession of conceptually challenging experiences. Piaget contended that rather than representing a smooth ‘‘learning curve’’ over time, cognitive development was punctuated at critical points by qualitative transformations in the very style and form of thinking, permitting the eventual emergence of abstract, formal thought having a level of plasticity unavailable earlier in childhood. Subsequent developmentalists in the Piagetian tradition have extended this model into adult life, when still more subtle dialectical forms of thinking emerge to permit more adequate accommodation to the complexities of social life.
Finally, the American clinical psychologist, Kelly (1905–1967), became the first to develop a personality theory and psychotherapeutic interventions based upon a constructivist epistemology. Influenced by both Korzybski and the psychodramatist, Moreno, Kelly’s psychotherapeutic system exemplified constructivist thinking in that he viewed people as incipient scientists, striving to both anticipate and to control events they experienced through developing an integrated hierarchy of personal constructs. As will be discussed in a later section, Kelly viewed psychological intervention as a collaborative effort of the therapist and client to help the latter revise or replace personal constructions that were no longer viable. By making the reconstruction of personal belief systems the focus of psychotherapy, Kelly anticipated the work of later cognitive theorists and therapists. More generally, Kelly’s position that multiple, viable constructions can be developed for a given phenomenon and that no single version of reality is prepotent over others heralded the arrival of postmodern critiques of the humanities and social sciences.
Although overshadowed by psychology’s embrace of information processing perspectives on human mentation in the 1960s and 1970s, constructivist approaches experienced a strong resurgence of interest in the 1980s with the founding of The International Journal of Personal Construct Psychology in 1988. This forum was renamed Journal of Constructivist Psychology in 1994 to accommodate the growing diversity of constructivist scholarship beyond Kelly’s personal construct psychology. Increasing interest in constructivist theory, research, and practice in both individual and family therapy has enriched the field, spawning the diversity of constructivist perspectives outlined below.
A common thread among various constructivist scholars is that human psychological processes are proactive and form generating. Thus, rather than viewing people’s behavior as a mere reaction to the ‘‘stimuli’’ of the ‘‘real world,’’ constructivists view humans as actively imposing their own order on experience and shaping their behavior to conform to their expectations. Thus, a fundamental concern of constructivist psychotherapists becomes the study of the personal and communal meanings by which people order their experience, meanings that must be transformed if clients are to envision new (inter)personal realities in which to live. While most members of the broad family of constructivist approaches would endorse this basic position, they differ significantly in the emphasis they place on the individuality or communality of meaning making, and their corresponding emphasis on private interpretations of experience as opposed to broad linguistic and cultural processes that shape human action. For this reason, it is useful to examine two central issues in constructivist epistemology from the standpoints of both (personal) constructivist and social constructionist positions, to lay a groundwork for understanding the different foci and methods of the various ‘‘schools’’ of constructivist therapy that follow.
III. Current Issues in Constructivist Theory
Two areas in which there has been continuing elaboration of constructivist ideas involve first, the relationship between language and reality, and second, the construction of the self. The former issue bears directly on constructivist epistemology and the central role of language in ordering experience. The latter issue relates to the structural aspects of meaning systems and how they function together in creating temporally or situationally coherent identities. Each of these issues also carries direct implications for psychotherapy, although with different nuances in the case of constructivist versus social constructionist accounts.
A. Language and Reality
1. Constructivist Perspective
Perhaps the pivotal concept in a constructivist account of human nature concerns the relationship between human knowledge and reality. Specifically, constructivists reject or at least suspend the implicit epistemology of the modern social sciences, which assumes that one’s understanding of the world, especially the world of complex and dynamic interpersonal systems, can be considered ‘‘true’’ or justified to the extent that it corresponds to a reality external to the person’s knowing system. Instead, they posit that human knowers have no direct confirmatory access to a world beyond their grasp, no firm contact with a bedrock of reality that would provide a secure foundation for their constructions.
This posture of epistemological humility, for most constructivists, stops short of an ‘‘anything goes’’ relativism, insofar as the development of personal knowledge is constrained by the need for varying degrees of internal coherence, on the one hand, and the quest for consensual validation of our private constructions on the other. While the resulting meaning systems cannot be strictly ‘‘validated’’ in the sense of matching some objective criterion independent of the observer, they can nonetheless be judged more or less viable as guides to organizing our anticipations regarding our activities in and our accounts of our experiential world.
Language, in this constructivist view, represents a medium for articulating private discriminations, enabling us both to manipulate them symbolically and to inject them into the medium of public discourse. Using language as a straightforward instrument of ‘‘communication’’ is viewed as problematic insofar as commonality of construing becomes more of an aspiration than an assumption. This view of meaning as resident primarily in individual construction systems, which are bonded together by the thin substantiality of language, is most evident in ‘‘cognitive constructivist’’ accounts like Kelly’s that consider persons as agents capable of making choices and creating original, personal constructions with minimal interference by larger social systems or structures.
2. Social Constructionist Perspective
Social constructionists largely agree with cognitive constructivists in rejecting objectivist epistemologies that a real world exists and can be discovered by establishing a correspondence between the knower and the phenomenon to be known. Social constructionists, however, differ with constructivists regarding the centrality accorded to individually constructed experiences. That is, constructions of people, things, or events in the world arise from negotiations between persons rather than within them. The implication of this sociocentric view is that individuals’ constructions both derive from and contribute to the social and cultural contexts with which they are associated.
Given their attention to collective, rather than individual experience, language and linguistic processes occupy an even more central role for social constructionists than for constructivists. This increased emphasis is also reflected in social constructionists’ broader definitions of language to include all manner of semantic, semiotic, and symbolic methods of negotiating and disseminating meaning, rather than restricting it to the spoken or written word alone.
As a form of collective meaning making and coordinated social action, language can be used to create cultural tales that become repositories of socially constructed meanings from the past or from other societies or cultures. The availability of ready-made meanings that embody the local ‘‘truths’’ of one’s place and time implies that cultural narratives may ‘‘author’’ people, rather than vice versa, in the sense that they constitute prefabricated and socially validated patterns to which individual identities are expected to conform. Thus, in this constructionist view, language and culture predate the experience of any particular individual, and provide the ineluctable scaffolding for constructing one’s identity in relation to others.
B. The Construction of the Self
1. Constructivist Perspective
The personal quest for coherent and socially warranted knowledge carries with it clear implications for an image of the self. Like the ‘‘world,’’ the ‘‘self’’ is relativized and problematized in constructivistic discounts, stripped of stable traits or enduring features that define its essence. Instead, selves are constructed as a by-product of our immersion in language and practical activity, as one strives for personally significant ways of thematizing, organizing, and narrating experiences. Stated differently, people are their constructs, so that at least in a distributed sense, selfhood consists of an entire repertory of shifting and provisional patterns for understanding, engaging, and ‘‘storying’’ the world and other people. Because the majority of these patterns are tacit, only rarely articulated in symbolic or explicit ways for either for the person or for others, clear limits are imposed upon self-knowledge. At best, efforts to ‘‘know oneself’’ represent an attempt to impose an explicit order on the relatively abstract and durable themes that punctuate one’s lived engagement in the world.
Viewing self-development as oscillating between an extension of our forms of concrete activity in the world and the effort after an abstract reflexivity toward the self poses major challenges to modernist goals associated with an essentialized image of human nature. In particular, the loss of a fixed and ‘‘real’’ self erodes the value of ‘‘genuineness’’ or ‘‘congruence’’ in one’s relationships to others. That is, the multiplicity of selves that exists for each of us across time and contexts precludes the discovery of a primary or essentialized self, just as it undermines the quest to discover who a person ‘‘really is.’’ Thus, this postmodern conception emphasizes narrative elaboration over authenticity, and self-explanation over self-actualization.
2. Social Constructionist Perspective
Social constructionists and constructivists agree in rejecting the concept of a single, essentialized self. The social constructionist critique, however, runs deeper to challenge the very category of ‘‘self’’ as an individually based construct, viewing it instead as an historically circumscribed concept arising only fairly recently in Western culture, with its pervasive emphasis on individuality, autonomy, and personal responsibility. In contrast to this cultural trend, social constructionists view discussions of the ‘‘self’’ as merely one possible form of discourse, one that may be insufficiently attentive to the numerous ways in which our sense of identity is penetrated by relationships to significant others and even impersonal media, especially in the electronic age. In making this critique, social constructionists emphasize the fragmentation and incoherence of self in divergent social contexts rather than embracing the idea of an integrated agent whose coherence transcends such divergent social realities. In this view, therefore, characteristics of the self such as responsibility, purpose, agency, and so forth are seen as fictions derived from society’s construction of the individual, rather than as universal ‘‘facts’’ or ideals that generalize across different times and settings.
As might be expected in view of these differences, constructivism and social constructionism also differ in their endorsement of self-knowledge as a goal of life in general, or psychotherapy in particular. Whereas constructivists encourage the conscious elaboration of a multifaceted ‘‘self’’ and reflexive recognition of this process, social constructionists focus more upon the implicit ways in which practical engagement in specific contexts shapes one’s mode of self-presentation, with or without one’s conscious awareness or ‘‘choice.’’ This divergence contributes to a differential use of self-reflective versus social-conversational methods in various traditions of constructivist therapy, a topic to which we shall now turn.
IV. Constructivist Psychotherapies
A. General Orientation
Just as constructivists are suspicious of a psychological science that pursues a universal set of factual observations concerning human nature, they also distrust ‘‘scientific’’ forms of psychotherapy that establish highly standardized and manualized procedures for modifying human behavior. In addition, the growing family of constructivist interventions eschews methods that simply supply clients with supposedly more ‘‘functional’’ or ‘‘adaptive’’ ways of existing, thinking, or feeling rather than helping persons or families find their own unique way to adaptive meaning making. This suggests that at the level of clinical practice, constructivists accord both therapist and client an ‘‘expert’’ role in understanding what changes are necessary in the assumptive foundation of the client’s life.
Consistent with this emphasis, constructivists reject pathologizing diagnostic systems that focus on client deficits and deviations from supposedly ‘‘normal’’ patterns of behavior. Accordingly, they resist the common practice of applying universal categories of disorders that fail to capture the richness and subtlety of any given individual’s way of interpreting the social world and constructing relationships with others. For instance, a diagnostic category such as ‘‘major depression’’ merely describes a presumably maladaptive ‘‘mood disorder,’’ without conveying any information about the way the person’s meaning-making processes have ceased to be viable for construing life’s experiences. In contrast, constructivists prefer assessment techniques and working conceptualizations that are idiographic or tailored to each use, which examine both the positive and negative implications (from the client’s, family’s, or society’s standpoint) of clients’ ways of construing their lives and problems.
Because both therapist and client lack access to a straightforward ‘‘truth’’ beyond their constructions, neither can define hard and fast criteria for distinguishing ‘‘healthy’’ or ‘‘rational’’ beliefs or actions from those that are ‘‘disordered’’ or ‘‘irrational.’’ Given this ‘‘level playing field,’’ the therapist is left with the somewhat daunting task of building an empathic bridge into the lived experience of the client by attempting to construe his or her process of meaning making. Establishing this connection will help the therapist to understand the entailments of the client’s constructions of events and help negotiate their possible deconstruction and elaboration. The personalism of this encounter requires that the therapist have a sensitive attunement to the unspoken nuances in the client’s conversation, and skill in using evocative and metaphorically rich language to help sculpt their mutual meaning making toward fresh possibilities. To be successful, such ‘‘structural coupling’’ between client and therapist systems must ultimately move beyond bland generalizations about the nature of the ‘‘working alliance’’ and banal prescriptions for ‘‘effective interventions,’’ and instead foster a unique ‘‘shared epistemology’’ irreducible to the individual systems of either partner in the therapeutic relationship.
What ‘‘outcomes’’ might be valued in this constructivist approach to the counseling process? While the specific aims of psychotherapy are necessarily defined by the participants, at an abstract level, the goals of constructivist therapies include adopting a ‘‘language of hypothesis’’ by recognizing that one’s constructions are at best working fictions rather than established facts. As such, they are amenable to therapeutic deconstruction (e.g., through subjecting the same events to alternative ‘‘readings’’) and reconstruction (e.g., through acting upon alternative interpretations to realize their effects).
Although enhanced reflexivity toward the ‘‘self’’ may be a legitimate aim of this work, it is ultimately subordinated in importance to the aim of constructing a self with sufficient narrative coherence to be recognizable, but sufficient fluidity to permit continued tailoring to the varied social ecologies the client inhabits. Because new and tentative reconstructions of the self require social support, therapy typically also fosters a deepened engagement with selected others who can function as ‘‘validating agents’’ for the growing edges of the client’s provisional attempts at meaning making.
B. Distinctive Traditions
The last 10 to 20 years have witnessed a growing diversity of psychotherapeutic approaches that have embraced a constructivist epistemology. There is no single or unique constructivist psychotherapy, no single ‘‘approved’’ set of techniques that define constructivist interventions. Instead, a constructivist mind-set has percolated into most major traditions of therapy, from the psychoanalytic to the cognitive-behavioral, producing novel ways of conceptualizing therapeutic practice as well as a broad variety of associated change strategies or techniques. Our goal in this section will be to survey some of these developments, concentrating on four discernible therapeutic traditions within constructivism that make somewhat different assumptions about human change processes, and carry distinct implications for the role of the therapist.
1. Personal Construct Theory
The first tradition we will consider is Kelly’s personal construct psychology, which despite its status as the first consistent expression of clinical constructivism, continues to attract fresh adherents and generate new therapeutic strategies. Kelly’s psychotherapeutic approach derived from his unique conception of personality. Kelly employed the metaphor of the ‘‘person-asscientist’’ to characterize the ways in which people attempt to formulate personal theories to both anticipate regularities in their environments and to channel their behavior in relation to them. Central to Kelly’s theory is the idea that people create constructs, or basic dimensions of contrast, that help them to discover relevant similarities and differences arising from the people, situations, and events with which they interact.
More than other forms of constructivist intervention, personal construct therapy emphasizes the hierarchical nature of the person’s construct system. That is, some constructs are more central to the person’s meaning-making processes than other, more peripheral and subordinate constructs. For example, one person may evaluate all others primarily in terms of whether they are likely to form accepting, close relationships with him or her, or are likely to reject and abandon the person without warning. Moreover, the construing of another on either the ‘‘accepting’’ or ‘‘abandoning’’ pole of this construct is likely to carry sweeping implications for the person, resulting in a global appraisal of the other as an individual and the prospect of constructing a meaningful relationship with him or her. Another person may employ this construct in a much less central way, perhaps to understand the behavior of potential dating partners, and may see it as carrying fewer implications for the other’s personality or the relationship as a whole. Key to Kelly’s theory is that such constructs ultimately say more about the individual who formulates them, than about the person to whom they are applied.
Systems of personal constructs operating as an organized whole affect what phenomena a person can construe as well as how these phenomena will be interpreted. Continuing with the example above, the person who views others in ‘‘close versus rejecting’’ terms may not be able to understand the behavior of a person who wishes to form a friendly, but casual relationship. An implication of this, again echoing the sentiments of Epictetus, is that people are not victims of problems in reality as much as they suffer from the constraints and limitations of their construct systems.
Personal construct therapists believe that psychological problems stem from anomalies in the structure or operation of the person’s construct system. More specifically, a disorder consists of any personal construction that is used continually despite its repeated invalidation. Given this general conception of problems in living, various kinds of problematic experiences can be predicted.
Threat, for instance, results when the individual feels on the brink of an imminent, comprehensive change in core identity constructs, as when marital discord reaches a crisis point, and the threatened spouse recoils from the awful recognition that divorce will mean a wholesale reworking of his or her view of the self and world. Anxiety arises with the awareness that critical events are outside of the range of the person’s current constructs, that one confronts experiences that cannot be meaningfully construed or anticipated. Another problematic experience, hostility, results when the person continues to garner or even force support for one or more constructs after they have repeatedly led to unsuccessful predictions. For example, a husband who maintains that his wife should assume a subservient, domestic role and not seek employment, and who uses verbal or physical threats or abuse to keep her in the role he has constructed for her would be manifesting hostility in Kelly’s sense. Finally, personal construct therapists view the experience of guilt as stemming from the client’s awareness that he or she has been dislodged from central value commitments, as defined idiosyncratically within his or her construct system.
At a general level personal construct therapy helps the client examine his or her repertory of constructs and to find more meaningful constructions with which to face life challenges. In particular, the therapist first may help the client articulate constructs of significant others through use of the repertory grid or laddering techniques. In the former exercise the client may be asked to consider two or more persons he or she knows and then describe how the people differ. In this way the client’s basic dimensions of meaning are articulated as successively different groups of people are considered. The laddering technique helps the person examine the implications of systems of constructs as they are applied to some real life problem.
The therapist may then help the client expand the construct system so that a wider or more diverse range of people or events may be construed without the person experiencing fear or anxiety. The therapist may also help the client to create new constructions that revise or replace previous constructs. Therapy may also help to ‘‘tighten’’ a construct by requiring the client to examine its concrete, specific implications for the people and events encountered in life. Alternatively, it may be therapeutic for the client to ‘‘loosen’’ certain constructs so they become more flexible and are applied provisionally to a wider range of experiences. In the case of the person who perceived all relationships in terms of acceptance or rejection, therapy may help the person to apply this construct more selectively and discriminately than before. In summary, from this general perspective the therapist helps the client identify interesting problems that derive from his or her view of life, gather evidence in daily life about their viability or utility, and experiment with new or revised constructs. Thus, the role of the personal construct therapist is analogous to that of a coinvestigator, with the important questions to be researched being defined by the unique affordances and limitations of the client’s personal meaning system, rather than the therapist’s.
A specific technique pioneered by Kelly and modified by subsequent personal construct therapists is the fixed role technique. This technique was based upon Kelly’s observation that the dramatic license to portray a role sometimes led to the actor retaining some of the mannerisms and modes of thinking associated with the role after he or she stepped out of it. That is, temporarily assuming the role helped the person to develop or elaborate his or her construct system in useful and enduring ways.
The technique begins with the client writing a self-characterization sketch that the therapist then uses in drafting a new role for the client to enact. The new role may help the person to construe a wider range of people or events, to revise old constructs, or to help create new constructs. To be useful, the exercise must allow the client to enact a rather different—although not simply opposite—way of approaching life for a fixed period of time. As the therapist and client practice relating to an increasingly intimate set of figures from the client’s life in therapeutic role plays, and then experiment with generalizing the new role to real-life situations, the client may come to realize that ‘‘personality’’ is itself a construction, one that can (with effort) be reconstructed as one evolves. Thus, at the end of a time-limited period (typically only a few weeks), the client explicitly relinquishes the new role and considers its implications for his or her ongoing engagement with social life.
Despite its appearance more than 40 years ago, personal construct theory and therapy continue to attract the interests of new generations of researchers and clinicians. Repertory grid methodology has been used to review clients’ life histories, their vocational interests and preferences, and their construal of group members’ behavior, among other uses. Recent work on personal construct therapy has focused upon death and loss issues, agoraphobia, marriage and family interventions, and life-span development. This level of continued interest by researchers and clinicians underscores the enduring heuristic value of Kelly’s original vision, while permitting accommodation of the theory as it comes into contact with more recent additions to the constructivist family of approaches described below.
2. Developmental Perspectives
A second tradition in constructivist therapy includes a ‘‘fuzzy set’’ of approaches that share a focal concern with psychological development, and especially the development of self. Like personal construct theory, they view the evolution of personal meaning systems as the individual’s progressive attempts to create ‘‘working models’’ of self and significant others, but they place greater stress than does personal construct theory on the origin of these models in childhood attachment relationships. In keeping with constructivist epistemology, determining the authenticity of reported childhood events (e.g., whether the client as a child was or was not incestuously abused by a stepfather) is less critical than the conclusions the client has drawn about herself and others (e.g., that she must always accede to others’ needs, or that others cannot be trusted). In this sense, therapy consists of a sensitive search for the narrative truth of the client’s life, rather than detective work to ‘‘uncover’’ the literal events that supposedly shaped the client’s personality. By focusing attention on the domain of meanings, the therapist also is sensitized to the considerable range of personal reactions to any given ‘‘objective’’ event, as when childhood sexual involvement with a parent is viewed by one client as a shameful secret to be maintained, and by another as indisputable evidence for the contemptability of the opposite sex. Still a third client may view such involvement as an emotionally complicated but essential haven from the still more painful abuses of the other parent. In developmental perspective, these highly individualized themes are viewed as core ordering principles that shape much of the person’s subsequent experience of reality, identity, emotionality, and control.
In developmental therapies of this type, the therapist functions as a kind of psychohistorian, prompting the client to link current distress to problematic experiences from the recent or more distant past, and explore them more deeply. Theoretically, this involves helping the client subtly shift between two aspects of him- or herself, the experiencing ‘‘I,’’ which engages life in all of its emotional immediacy, and the explaining ‘‘me,’’ which attempts to give a coherent account of these experiences in rational terms. Because the tacit experience of events tends to precede the ability to articulate and evaluate them, the therapist frequently must assist the client to focus closely on problematic events, reliving them in ‘‘slow motion’’ in all of their emotional intensity in the session, to provide the ‘‘raw material’’ for interpreting the experiences in more useful ways. For example, a confused and self-critical client might trace her recent seemingly inexplicable loss of initiative to her sense of discomfort following an interaction with a male employer. The therapist might then encourage her to ‘‘unpack’’ the interaction in all of its sensory detail, discovering that the client experienced heightened anxiety at the point that her employer rolled his eyes during her presentation, in a way that was reminiscent of her father’s silent dismissal of her as a child. This might lead to further exploration of more remote scenarios, and to the thematization of her sense of insufficiency, especially in relation to men.
Among the specialized techniques that are compatible with this developmental perspective is the life review procedure, which involves attempting to piece together a more continuous sense of one’s biography by organizing one’s own memories by year, noting significant events, feelings, and developments in one’s self understanding on a chronological series of index cards that are added to over the course of therapy. Other forms of reflective writing (e.g., exploring one’s changed sense of self after a major early loss) are also frequently used by developmental therapists, either as an adjunct to formal therapy or a means of ongoing self-exploration. More than any specific outcome, the goal of such work is to develop the ability to transition between delicate attention to the nuances of one’s engagement in life, and the attempt to interpret them in a way that promotes ongoing reconstruction of one’s sense of self.
3. Narrative Approaches
The third tradition, the narrative approach, views life as organized by personal, familial, and cultural themes, and regards therapy as an intimate form of collaboration in editing the client’s life story. Narrative perspectives have burgeoned over the last 15 years as clinicians have found the generative and integrative characteristics of stories to be apt metaphors for individuals’ meaning-making processes. Most narrative therapeutic perspectives share the common view of the person as both author and hero of a life story that invariably includes an unexpected (and often unchosen) cast of characters, events, and twists on the temporal and situational plots of one’s life. In this way narratives lend coherence and integrity to one’s past as well as contribute to the way one anticipates the outcomes of a life story in the future.
Clinicians working in the narrative vein view emotional distress as resulting from or marked by a break, failure, or gap in one’s ongoing autobiography. Such narrative suspension leaves the person with a diminished capacity to emplot experienced events or subjected to unanticipated subplots that are markedly discrepant with what the person expected from life. For instance, the traumatic loss of a spouse later in one’s life removes a highly valued figure from the partner’s life story and necessitates the tragically painful revision of the partner’s storied role as companion, friend, caretaker, and lover, among others.
Most narrative therapeutic approaches share the goal of weaving painful, negative, or other unexpected events into the client’s dominant life narrative. That is, the client and therapist collaborate to help the person both live and author an active, integrated story. Here, the therapist functions as an editor or co-author in attempting revisions of the client’s life narrative. For instance, treatment for the bereaved spouse might focus on grieving the loss of the partner by examining how the person dealt with previous losses and the way these were integrated or interpreted in the larger framework of meaning that informs the person’s life. Emphasis also may be placed upon developing further roles with children, other family, and friends as a way to emplot a new life ‘‘chapter’’ without the deceased spouse.
Given the goals of narrative repair and reconstruction, therapists working from this perspective may employ a variety of literary techniques. Developing metaphors to help clients more clearly define problems, tease out the meanings of significant struggles and emotional experiences, and find solutions may provide benefits at all phases of therapy. Structured reminiscence may help the client identify salient events, people, and plots in their own stories over the course of their lives. Reminiscence for the grieving spouse may reveal how emotions of sadness, anger, or betrayal from previous losses were incorporated into the life narrative. Writing assignments, such as a letter to the deceased partner, journals, and dialogues may help to both bring problems into greater relief and to help transform them so they may be integrated with existing life stories. Other written documents exchanged between the client and therapist such as certificates of ‘‘readiness for change’’ or ‘‘completion of therapy’’ may help to document and certify real changes in the client’s life story.
In summary, narrative approaches to therapy include a rich and growing collection of constructivist methods for acknowledging and creating change in clients’ lives. As exemplified by the recent growth in both the number and types of books and scholarly articles on narrative themes, this field of endeavor appears to be among the most rapidly growing areas of constructivism.
4. Systemic Approaches
The fourth set of approaches includes variants of systemic family therapy, which generally reflect a social constructionist concern with ‘‘languaging’’ and its role in shaping the family’s definition of the problem. From this perspective, ‘‘psychological disorders’’ are not viewed as syndromes or symptoms that attach themselves to persons, but instead are defined in language through the interaction of those persons—including the identified ‘‘client’’—engaged in the problem. For example, whether a woman’s depressive withdrawal after the death of her stillborn child is considered ‘‘normal’’ or ‘‘pathological’’ is very much a matter for social negotiation, especially within the family context. Problems arise and are sustained in language when they are conferred a ‘‘reality’’ by individuals, family members, and the broader society, and particularly when they are attributed to deficiencies, deficits, or diseases in one individual. Therapy, in this perspective, consists of creatively helping participants in a problem system ‘‘language away’’ the difficulty by reframing it in a way that it is either viewed as no longer problematic (e.g., the mother’s continuing sadness is reconstrued as an attempt to maintain her connection to her deceased child) or becomes amenable to solution (e.g., her sense of loss might be validated by a shared family ritual acknowledging the place of the child in their collective lives).
In this approach to therapy, the therapist assumes the role of conversation manager, artfully eliciting divergent views of the problem within the family system and exploring their implications for each member. Because family members are often engaged in interlocking patterns of recursive validation (e.g., when the bereaved father’s confused withdrawal from his wife is viewed by her as emotional abandonment, and her resulting tearfulness is construed by him as further evidence for her ‘‘falling apart’’), the therapist must often find ways of exposing the hidden premises of each family member’s view, and prompting them to view their interaction, at least temporarily, in novel terms. Among the many techniques for accomplishing this are the use of circular questions, which inquire about perceptions among family members (e.g., ‘‘Who is most convinced that mom is suffering from major depression? Who is least convinced that this is what is going on?’’) and their relationships to one another (e.g., ‘‘Who in the family is next most depressed? Next? Least?’’).
Systemic therapists who operate from a constructivist standpoint also make use of novel therapy formats, such as the reflecting team, in which a group of clinicians observes a family therapy session, and then joins the therapist and family to share divergent, but provocative interpretations of the family’s difficulty. The aim of such interventions is not to determine the single ‘‘correct’’ interpretation of the complaint, but to dislodge both therapist and clients from habitual ways of thinking about the problem in a way that contributes to its maintenance. As the systemic therapies have continued to evolve, they have become increasingly open to ‘‘importing’’ concepts from more individual constructivist approaches (e.g., personal construct and narrative models) that help reveal the ‘‘selves’’ within the system, and that provide a means of tacking back and forth between individual and family level work across the course of a given therapy.
V. Implications of Constructivism for Psychotherapy Research
Constructivism and the epistemological approach that undergirds it possess profound implications for guiding inquiry in science in general and for the social and psychological sciences in particular. Work in all science is essentially a human enterprise because people formulate hypotheses, devise working models, conduct experiments, interpret data, and prepare scientific papers and reports. To the extent that the constructivist image of human nature questions our degree of contact with either a knowable world or a knowable self, it shakes the foundations of modern psychological science conceived as the cataloging of factual observations and their systematization into unified theories in the natural, physical, or social sciences.
Constructivists view science instead as continuous with other forms of knowing, yielding inherently partial and positional perspectives reliant on the models and metaphors of a particular place and time, even when it formulates general ‘‘laws’’ of human functioning. This implies that the theories and ‘‘laws’’ that have been developed in all of the sciences represent complex and organized constructions that have been elaborated to varying degrees. Each field also may enjoy different amounts of coherence among theoretical constructions.
Conceptualizing science in this manner may raise fundamental and provocative questions for some about whether observing the same results about a thing, event, or a person with different methods or at different times reveals successively more ‘‘accurate’’ or ‘‘real’’ characteristics or just reflects a coherent system of constructions that function somewhat equivalently. The former position seems to assume a realist or objectivist position that reality can be known and that science incrementally advances by developing more accurate or realistic knowledge through successive approximations of theories and their research paradigms. The latter position of constructivism deemphasizes ‘‘knowing reality’’ by focusing instead on coherent, viable, and workable constructions of relevant phenomena. A question that follows from the constructivist perspective concerns the methods and criteria for determining how construction systems are viable and workable. When and under what conditions is a construction system viable and when does it appear to lose its ability for meaning making?
Within psychology, tensions exist between realist/ objectivist positions and those that assume a more constructivist stance. These tensions can, in part, be traced to the long-standing dialectical relationship between nomothetic and idiographic perspectives on psychological inquiry. Typically the experimental psychologies (social, cognitive, biological, and so forth) have attempted to catalog observations about human nature that are invariant over time and place, that is, to use a nomothetic approach. In focusing more on the life phenomena of individuals, the clinical sciences have developed a more idiographic approach to their field of inquiry. While nomothetic and even quantifiable generalizations about human behavior may be attempted at the level of abstract theory, constructivists ultimately contend that the lived particulars of the person’s knowing systems can be best understood through adopting an idiographic and qualitative approach to the study of concrete individuals in their unique social ecologies.
The differing foci of constructivist and realist/objectivist approaches in psychology presents a dilemma for how these methods of inquiry may interface with each other and how the fruits of each paradigm may be incorporated by the other. How can generalizations about the ‘‘average anorexic’’ from the nomothetic perspective be of use to the therapist engaging this particular client and the way she constructs her role in life? Similarly, what is the utility of individual constructions, no matter how rich and clinically informative, when trying to discover and articulate fundamental principles of human behavior? At a more general level, what would psychological science look like if all research were conducted at the idiographic and qualitative level associated with constructivist inquiry?
Such questions face those who study psychotherapy outcome. In trying to document the ‘‘real world’’ effects of therapeutic interventions, researchers may use instrumentation and assessment techniques that fail to capture the subtle nuances of human change. Yet, persons may report greater happiness, adjustment, or ability to proceed with life despite producing unremarkable profiles on standard instruments. How does the realist/objectivist outcome researcher account for this phenomenon? Constructivists would propose using idiographic and ipsative measures that are uniquely tailored to the work that is being undertaken in psychotherapy. Methods such as goal-attainment scaling, content analysis procedures, and repertory grids may both help trace the client’s level of achieved change and permit the outcome researcher to compare the extent to which clients as a group received benefits.
Beyond these issues in the assessment of therapeutic outcome, lie the questions of what constructivism has contributed to psychotherapy research, and what psychotherapy research has revealed about the nature of constructivist psychotherapy. As implied above, constructivists have actively pursued the development of both qualitative and quantitative procedures for tracking human change processes, particularly at the level of meanings that reflect one’s evolving appraisal of the self, life problems, and significant relationships over the course of therapy. While such procedures add refinement to nomothetic measures of personal change, they essentially operate within the traditional paradigm for the study of psychotherapy.
A bolder contribution being made by some constructivists is the development of new paradigms for research on psychotherapy process, which attempt to identify ‘‘markers’’ of significant in-session change episodes (e.g., points of sensed internal conflict or confusion) and then pinpoint the processes that facilitate their positive resolution (e.g., therapist initiated confrontation of the inner ‘‘split,’’ or use of metaphor to place experiences in a new perspective). At a more general level, constructivists have also pioneered the development of models of research that actively involve clients as co-investigators and interpreters of a study’s results, and that foster deep-going reflection on the part of investigators about shifts in their methodological and conceptual commitments across the course of their research programs.
What has research taught us in turn about the distinctive processes or outcomes of constructivist therapies? In a sense, a definitive answer awaits further study. As fairly recent contenders in the psychotherapy arena, the approaches described in this research paper have yet to receive the empirical attention given to more ‘‘mature’’ therapeutic traditions. In addition, the abstract and philosophic nature of constructivist theory has discouraged more traditionally trained investigators, who are understandably drawn to simpler models that work with a limited range of concepts and techniques. However, the preliminary research that has been conducted on these novel forms of practice suggests that they are often more acceptable to clients than more regimented, prescriptive alternatives, that they can be effective for even quite discrete problems such as speech disfluencies, phobias, and social anxieties, and that they are adaptable to a range of formats including individual, group, and family therapy. With recent and ongoing efforts to examine their efficacy in the treatment of eating disorders, sexual abuse, and other serious clinical problems, we are optimistic that they will continue to contribute to the refinement of both psychotherapy research and practice.
Bibliography:
- Mahoney, M. J. (1991). Human change processes. New York: Basic Books.
- McNamee, S. & Gergen, K. J. (Eds.). (1992). Therapy as social construction. Newbury Park, CA: Sage.
- Neimeyer, R. A., & Mahoney, M. J. (Eds.). (1995). Constructivism in psychotherapy. Washington, DC: American Psychological Association.
- Rosen, H., & Kuehlwein, K. T. (Eds.). (1996). Constructing reality: Meaning-making perspectives for psychotherapists. San Francisco, CA: Jossey-Bass.
- Journal of Constructivist Psychology, published quarterly. Philadelphia, PA: Taylor and Francis.
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