Theory and Practice of Systemic‐Dialogical Therapy

Abstract

Systemic‐dialogical therapy originates from an evolution of Milan systemic therapy, through a reflection on Bakhtinian dialogue and on power and knowledge dynamics in therapeutic sessions. The model considers both emergent patterns in human interaction and the dialogical nature of human exchanges in which emotions play a relevant part. Such theoretical considerations prompted the creation of specific practices, such as emotional micro‐hypothesising, considering heteroglossia in the session, dialogue with the context, finding one's place in the relational network, and fostering relational responsibility in both therapist and clients. The practice of systemic‐dialogical therapy is illustrated by a clinical case study.

What Does it Mean to Work ‘Dialogically’ in Open Dialogue and Family Therapy? A Narrative Review

“…This mindset is summarised by Anderson (2012, p. 15) as being a ‘hospitable host and guest.’ This means that therapists communicate the importance of the client and the value of their stories and perspectives, while also remaining aware that they are guests in learning about the client's life. The therapist follows rather than leads the client’s narrative and aims to create an atmosphere of safety that allows the expression of all the present voices as easily as possible (Anderson, 2002; Bertrando & Lini, 2019; Haarakangas, Seikkula, Alakare, & Aaltonen, 2007; Olson, Seikkula, & Ziedonis, 2014; Seikkula, 2008, 2011; Seikkula & Arnkil, 2006; Seikkula & Trimble, 2005). Finally, therapists are advised to respect and take seriously all contributions and perspectives and avoid coming to one fixed ‘understanding’ of a problem as this can block the development of further dialogue and new meanings (Anderson & Goolishian, 1988).…”

“…In dialogue, a commitment to polyphony views all perspectives as equally valuable, creates more possibilities for change and negates competition over who has the more valid description or diagnosis of the problem. The role and mindset of the therapist is to respond in such a way that promotes further dialogue and creates new understandings that are co‐created by all participants (Bertrando, 2007; Bertrando & Lini, 2019; Seikkula, 2002).…”

“…In general terms, the therapist is advised to slow down the conversation to allow silences, time for thinking (Anderson, 2002; Haarakangas, Seikkula, Alakare, & Aaltonen, 2007; Seikkula & Arnkil, 2006; Seikkula & Trimble, 2005) and the expression of emotions (Andersen, 1987; Bertrando & Lini, 2019; Olson, Seikkula, & Ziedonis, 2014; Seikkula, 2011; Seikkula & Trimble, 2005). By allowing time to think and speak, a person is able to put words to past experiences, as well as emotions and current concerns, and thus transform non‐conscious embodied experiences into spoken narratives (Seikkula, 2008), which are then open to possible transformation (Anderson & Goolishian, 1988).…”

“…For Bakhtin (1981, 1984), the ‘self’ of a person is constantly changing in response to continuing dialogues and people come to know themselves through their relations with others. In every social interaction people bring their own previous experiences, explanations, and understandings, including their own unique speaking practices (Anderson, 2005; Bertrando & Lini, 2019; Robinson, 2011; Seikkula & Trimble, 2005). Meaning is constructed through the interaction between these different experiences and perspectives by exchanging and considering alternative explanations (Andersen, 1987).…”

“…The transformative view sees dialogue as beneficial due to its ability to create new, multifaceted, and collective understandings of a problem (Anderson & Goolishian, 1988, 1992; Bertrando & Lini, 2019; Eiterå et al., 2015; Haarakangas, Seikkula, Alakare, & Aaltonen, 2007; Rober, 2005a). The more voices that are present in a meeting, the greater the number of possibilities for developing new understandings of the problem (Seikkula & Trimble, 2005) and therefore more possibilities for change.…”