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The adult ideology as practical reasoning : a study of child psychotherapy Parkinson, Gary 1975

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THE ADULT IDEOLOGY AS PRACTICAL REASONING: A STUDY OF CHILD PSYCHOTHERAPY  by GARY CHARLES PARKINSON B.A., U n i v e r s i t y o f Saskatchewan, 1961 M.A., U n i v e r s i t y o f Saskatchewan, 1970  A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE  REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY  In the Department of .Anthropology and S o c i o l o g y  We a c c e p t t h i s t h e s i s as conforming t o the required  standard  THE UNIVERSITY OF .BRITISH COLUMBIA May, 1975  In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree t the Library shal make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of m y Department by his representatives. It is understood that copying or publication of this thesis for financial gain shal not be alowed without m y written permission.  Department of ANTHROPOLOGY & SOCIOLOGY The University of British Cou lmba i Vancouver 8, Canada  6  ABSTRACT The doing  ' t o p i c ' f o r t h i s t h e s i s was formulated  f i e l d work-in a c l i n i c  a f t e r many months o f  o f f e r i n g p l a y therapy  to disturbed children.  I was s t r u c k by t h e f a c t t h a t the o r g a n i z a t i o n o f a c t i v i t i e s , the therapy t a l k , and t h e t h e r a p i s t ' s e x p l a n a t i o n s appeared from the b e g i n n i n g common-sensical, t r a n s p a r e n t , r e a s o n a b l e . the  t o be  I take t h i s reasonableness  ' t o p i c ' and ask how i t was p o s s i b l e f o r me, on t h e b a s i s o f t a l k  as heard  i n t h e s e t t i n g , t o d i s c o v e r and d e s c r i b e t h e r a t i o n a l i t y o f the s e t t i n g — see events,  e t c . , as i n s t a n c e s - o f - a - p a t t e r n - o f - b e h a v i o r , and c o n c o m i t a n t l y  how t h e r a p i s t s were a b l e t o make t h e i r work appear r a t i o n a l . c o n s i s t s o f my e x p e r i e n c e  The d a t a  i n the s e t t i n g and more s p e c i f i c a l l y o f the t a l k  located i n that setting.  This formulation c l e a r l y  locates this thesis i n  an emerging body o f l i t e r a t u r e which t r e a t s t h e r e s e a r c h e r s achievement o f making sense as the s u b j e c t o f i n q u i r y . It  i s a study o f p r a c t i c a l r e a s o n i n g , by which I mean t o emphasize  t h a t psychotherapy accounts  were t i e d t o the everyday p r a c t i s e s o f t h e r a -  p i s t s i n ways t h a t a r e n o t c a p t u r e d by i d e a l i z a t i o n s o f t h e o r e t i c a l accounts,  etc.  expectancies,  An o v e r l o o k e d  f e a t u r e o f those accounts  i . e . , those t a k e n - f o r - g r a n t e d  us t o see t h e adequacy o f accounts, It  views o f the world  reasonableness  i s proposed t h a t i t i s our t a k e n - f o r - g r a n t e d  s o c i a l a c t o r s which accomplishes  a r e background that  enable  of explanations, e t c .  views o f ' c h i l d r e n ' as  t h i s i n the f i e l d  setting.  This i s  r e f e r r e d t o as an a d u l t i d e o l o g y o f c h i l d h o o d and t h i s n o t i o n i s e x p l i c a t e d i n r e l a t i o n t o the therapy  activity.  Considerable  d e t a i l i s g i v e n on the  use o f one f e a t u r e o f the i d e o l o g y , the r e l e v a n c e o f f a m i l i e s i n r e l a t i o n to  children.  The  adult ideology  i s o f f e r e d as an i n t e r p r e t i v e schema which a l l o w s  adult actors to continuously children.  make sense o f , manage, o r g a n i z e f o r , t a l k t o  I t i s c l a i m e d t h a t t h i s i s an omni-present schema i n the  s e t t i n g , t h a t , i n f a c t , i t s u p p o r t s what i s r e f e r r e d t o as t h e p s y c h i a t r i c i n t e r p r e t i v e schema.  I t i s demonstrated t h a t i t i s n o t simply used t o  explain p a t i e n t behavior but i t i s a device (showing competence), h a n d l i n g explaining  relapses  conversations  f o r managing r e l a t i o n s h i p s (saying what has t o be s a i d ) ,  and t h e r a p y d e c i s i o n s , and so on.  I t i s then proposed t h a t t h e a d u l t i d e o l o g y my p r a c t i c a l t a s k — i t explanations  enabled me t o make sense o f the a c t i o n s ,  o f the t h e r a p i s t s .  substitutes  i n the s e t t i n g . and  The two schemas a r e  f o r one another then b u t a r e r e s p o n s i v e t o d i f f e r e n t t a s k s We a r e l o o k i n g a t o c c a s i o n e d a c c o u n t s — t r e a t i n g  understanding t h e r a p i s t s .  adult ideology  accounts,  Presumably the p s y c h i a t r i c i n t e r p r e t i v e  schema a l l o w s t h e r a p i s t s t o make sense o f p a t i e n t s . not  be seen as a s o l u t i o n t o  The c l a i m f o r t h e e x p l a n a t o r y power o f t h e  i n the s e t t i n g i s then withdrawn.  however t h a t the a d u l t i d e o l o g y  children,  It is still  claimed  i s a f e a t u r e o f o u r s o c i a l w o r l d and t h e  e x p l i c a t i o n o f f e r e d here s h o u l d be seen as a s u b s t a n t i v e  'discovery . 1  TABLE OF CONTENTS  ACKNOWLEDGMENTS  vi  PREFACE  '  v i i  CHAPTER 1  2  INTRODUCTION:  THE SEARCH FOR A PROBLEM  C h i l d Therapy as a P u z z l e  1  My I n d u c t i o n t o the S e t t i n g  7  T y p i c a l S i g h t s and Sounds  19  Footnotes.  42  THE PSYCHIATRIC'INTERPRETIVE SCHEMA Footnotes  3  'NORMAL'CHILDREN  45 78  AND THE THERAPIST'S CORPUS OF KNOWLEDGE . . . .81  Footnotes  4  1  91  THE 'FAMILY' AS A RESOURCE FOR PRACTICAL REASONING P a t i e n t s as F a m i l y Members B r i n g i n g N o t i o n s o f 'Mom'  93 94  and 'Dad' t o Therapy  98  F a m i l y S t r u c t u r e and Making Sense  105  ' C o n s t r u c t i n g ' the 'Family'  110  Making the M o t i v a t i o n a l Accounts P r o b l e m a t i c  115  F a m i l y T a l k as Management  117  Misbehavables and P e r m i s s i b l e s  132  Footnotes  139  iv  5  REASONABLENESS AND THE ADULT IDEOLOGY  154  F e a t u r e s o f t h e Ideology  156  Ideology as a Source o f E x p l a n a t i o n s o f P a t i e n t  Behavior  • . 163  C o n s e q u e n t i a l i t y o f the Ideology  166  Footnotes  172  THE STATUS OF THE IDEOLOGY  176  Footnotes  7  141  My D i s c o v e r y o f the Ideology  The  6  •.  192  CONCLUSION  193  Footnotes  199  BIBLIOGRAPHY  200  v  ACKNOWLEDGEMENT  I would l i k e t o thank Matthew S p e i e r  who i n i t i a t e d my i n t e r e s t i n  ' c h i l d r e n ' as a t o p i c o f i n q u i r y and i n f l u e n c e d i n t e l l e c t u a l development.  t h e d i r e c t i o n o f my  A s p e c i a l thanks t o Roy T u r n e r f o r k e e p i n g me  g o i n g and l e a d i n g me t o an u n d e r s t a n d i n g o f a n a l y s i s w i t h o u t which t h i s document would n o t have been  possible.  I would a l s o l i k e t o acknowledge t h e f i n a n c i a l a s s i s t a n c e Canada C o u n c i l which made my graduate s t u d i e s possible.  vi  and t h e r e f o r e  this  o f the research  PREFACE  These remarks are t o be taken as " i n s t r u c t i o n s " on how f o l l o w i n g document.  t o r e a d the  T h i s t h e s i s has the s t r u c t u r e o f a d e v e l o p i n g a r g u -  ment and c o n s e q u e n t l y p o s i t i o n s are taken a t p o i n t s o n l y t o be abandoned later.  T h i s development c o i n c i d e s i n a d i r e c t way  w i t h my  an o b s e r v e r o f the scenes d e p i c t e d i n the e a r l y c h a p t e r s .  development as A t one  level  then, the document i s an a u t o b i o g r a p h i c a l d e s c r i p t i o n o f changes i n the o b s e r v e r over the course o f many months i n which I attempted t h i n g o f t h e r a p y a c t i v i t y f o r the p r a c t i c a l purpose  t o make some-  of producing  this  dissertation. While the s u b s t a n t i v e i n t e r e s t pursued i s the p l a y t h e r a p y events which o c c u r i n a community work s e t t i n g i t i s t o be seen as an of p r a c t i c a l reasoning.  The  examination  focus i s on member's a c c o u n t i n g p r o c e d u r e s  which a c c o m p l i s h the e s s e n t i a l t a s k o f making a c t i v i t i e s , e v e n t s , s a t i o n s , e t c . , appear r e a s o n a b l e , l o g i c a l , a p p r o p r i a t e , e t c .  conver-  I t i s then  a study o f accounts and t h e i r l o c a t i o n i n the f i e l d - w o r k s e t t i n g .  While  c o n s i d e r a t i o n i s i n i t i a l l y g i v e n t o the accounts o f t h e r a p i s t s , the r e p o r t i s r e f l e x i v e i n t h a t i t s p r e p a r a t i o n and r e a d i n g are a l s o seen as worthy of  examination.  vii  CHAPTER 1 INTRODUCTION:  THE SEARCH FOR A PROBLEM  C h i l d Therapy as a P u z z l e E a r l y i n my graduate s t u d e n t dren's t a l k , p a r t i c u l a r l y  career  I became i n t e r e s t e d i n c h i l -  i n t h e way i n which a d u l t s t a l k t o c h i l d r e n .  My i n t e r e s t i n t h i s s u b j e c t prompted me t o c o n t a c t outpatient  t h e d i r e c t o r o f an  s e r v i c e f o r d i s t u r b e d c : c h i l d r e n and t h e i r f a m i l i e s .  resuming my graduate s t u d i e s , I had worked as a r e s e a r c h e r health f i e l d  and had had some involvement w i t h  However, my c h o i c e o f a f i e l d for  1  child  Prior to  i n the mental  psychotherapists.  s e t t i n g was determined p r i m a r i l y by t h e need  a p l a c e where I would be a b l e t o observe f r e q u e n t  encounters between  a d u l t s and c h i l d r e n . Initially,  I had hoped t o be a b l e t o d i s c o v e r and d e s c r i b e  the p r o c e d u r e s t h a t a d u l t s use when t a l k i n g t o c h i l d r e n . t h i s t a l k was t o take p l a c e d u r i n g ered  important.  The f a c t  that  " t h e r a p e u t i c " encounter was n o t c o n s i d -  That i s t o say, I f e l t t h a t t h e p r o c e d u r e s t h a t I was  l o o k i n g f o r would o c c u r I a l s o suspected  regardless o f the f u n c t i o n o f the contact. t h a t a s e t t i n g which i n c l u d e d p r o f e s s i o n a l p s y c h i -  a t r i s t s , s o c i a l workers and p s y c h o l o g i s t s working w i t h would p r e s e n t  some o f  obvious problems f o r a 'layman . 1  disturbed children  I was n a t u r a l l y appre-  h e n s i v e about how I would e x p l a i n my s o c i o l o g i c a l i n t e r e s t i n t h e r a p y and, more i m p o r t a n t l y ,  how I would be a b l e t o make sense o f the p r o c e d u r e s and  ' p r o f e s s i o n a l t a l k ' which I expected t o encounter.  I t seemed  t o e x p e c t a s p e c i a l i z e d s e t t i n g t o i n c l u d e knowledge, v o c a b u l a r y  1  appropriate and  2 s k i l l s which the  'layman' would be u n f a m i l i a r w i t h .  o r d e r t o p r e p a r e m y s e l f f o r my attempted  t o l e a r n something  T h e r e f o r e , and i n  f i r s t meeting w i t h the d i r e c t o r , I  about psychotherapy  with c h i l d r e n .  I  r e t u r n e d t o an i n v e s t i g a t i o n o f t h i s l i t e r a t u r e over the f o l l o w i n g weeks and months as I became a c q u a i n t e d w i t h the c l i n i c and i t s a c t i v i t i e s .  little  These f i r s t e x p l o r a t i o n s o f the how-to-do psychotherapy  manuals d i d  t o r e l i e v e my  that  a n x i e t y as I r e p e a t e d l y found the warning  psycho-  therapy w i t h c h i l d r e n i s an e s p e c i a l l y d i f f i c u l t and f r u s t r a t i n g undert a k i n g , something with care.  which even a f u l l y t r a i n e d p r o f e s s i o n a l s h o u l d  approach  F o r example:  Even a h i g h l y t r a i n e d c l i n i c i a n w i t h many y e a r s o f e x p e r i e n c e i n a d u l t t h e r a p y i s p r o f e s s i o n a l l y u n q u a l i f i e d t o engage i n c h i l d therapy u n l e s s he has had s u p e r v i s e d p r e p a r a t i o n f o r work w i t h children. 2  And: Psychotherapy w i t h c h i l d r e n i s , i n many r e s p e c t s even more d i f f i c u l t than t h e r a p y w i t h a d u l t s , and r e q u i r e s e x t e n s i v e study and c o n s i d e r a b l e s u p e r v i s i o n t o master.3 Or: Students o f t e n f i n d t h a t work w i t h c h i l d r e n r a i s e s i s s u e s and t e c h n i c a l problems which never o c c u r r e d i n t h e i r c o n t a c t s w i t h adults.^ And  interestingly: You may have t o have been a c h i l d w i t h i n your own c o n s c i o u s memo r y t o be a b l e t o t a l k c o m f o r t a b l y w i t h a c h i l d . ^  Thus, w h i l e I b e l i e v e d t h a t t h e r e were c e r t a i n t h i n g s t o be d i s c o v e r e d i n therapeutic encounters—as  i n any o t h e r a d u l t - c h i l d c o n t a c t — i t was  some unease t h a t I embarked on my F o r one  first visit  t o the c h i l d r e n ' s  with  clinic.  t h i n g , I f e a r e d t h a t I might w e l l have t o be a ' t h e r a p i s t ' i n  o r d e r t o make p r o p e r sense o f the events which I wanted t o study. B e f o r e t a l k i n g about my  i n d u c t i o n t o the therapy s e t t i n g , I would  3 l i k e t o r e l a t e some o f the a d v i c e  that I discovered  i n the l i t e r a t u r e , and  d i s c u s s some o f the d i f f i c u l t i e s t h a t I had i n l o c a t i n g t h a t Since  I knew l i t t l e  about the s e t t i n g , I f e l t t h a t I s h o u l d  take an examination o f t h e l i t e r a t u r e i n o r d e r presentation.  I began w i t h t h e  t h a t I would f i n d t h e m a t e r i a l I wanted indexed under  "psychotherapy - c h i l d r e n " . discovered  under-  t o improve my f o r t h c o m i n g  T h i s examination p r o v e d i n t e r e s t i n g .  common-sense n o t i o n  literature.  My s e a r c h  t h a t most o f the i n f o r m a t i o n  "children -psychotherapy".  d i d n o t prove f r u i t f u l u n t i l I t h a t I wanted was t o be found under  I f one l o o k s under p s y c h o t h e r a p y , he w i l l  f i n d t h a t . i t i s e s s e n t i a l l y an index o f m a t e r i a l s  relevant to adults.  S i m i l a r l y , i f one looks  a t textbooks o f p s y c h i a t r y , he w i l l t y p i c a l l y  only passing  t o t h e s p e c i a l problems a s s o c i a t e d w i t h  psychiatry.  references  The l i t e r a t u r e r e f l e c t s a  child  s e t ^ which i s made up o f psycho-  t h e r a p y and c h i l d p s y c h o t h e r a p y, p s y c h i a t r y and c h i l d p s y c h i a t r y . t r a s t t h i s with a s e t of psychotherapy-adult, c h i l d ; apy  and c h i l d p s y c h o t h e r a p y .  r e f l e c t the way o t h e r  find  In r e t r o s p e c t t h i s  Con-'  or adult psychother-  'discovery'  aspects o f our world are organized,  appeared t o  i . e . , there i s  6  the w o r l d and t h e r e  are c h i l d r e n .  My f i r s t examination o f the l i t e r a t u r e a l s o r e v e a l e d distinct perspectives—psychoanalytic  d e s c r i p t i o n s o f psychotherapy,  b e h a v i o r i s t i c d e s c r i p t i o n s o f problems, t h e o r y therapy, general  advice  A f t e r my f i r s t v i s i t ,  and a d v i c e  f o r doing play  on how t o t a l k t o and i n t e r v i e w c h i l d r e n , e t c .  I r e c e i v e d some i n s t r u c t i o n s on how t o p r o c e s s these  different perspectives.  I learned  s p e c i a l form o f therapy c a l l e d learned  a number o f  that the c l i n i c p a r t i c i p a t e d i n a  "play therapy".  In subsequent weeks I  t h a t t h i s was a l s o r e f e r r e d t o as " r e l a t i o n s h i p " o r " n o n - d i r e c t i v e "  t h e r a p y , and t h a t some o f the r e s p e c t e d  authors i n t h i s f i e l d  included  4 V. A x l i n e ,  7  E. E r i k s o n ,  t i o n s were not g i v e n authors and tions, etc. reference  others  8  R. M o u s t a k a s ,  H.  Ginott.  s t r i c t l y as " i n s t r u c t i o n s " , but  occurred  I felt  and  9  These i n s t r u c -  1 0  references  t o these  i n the c o n s t r u c t i o n o f e x p l a n a t i o n s ,  s a f e i n assuming t h a t t h e r e was  t o these a u t h o r s , " t h e o r i e s " , and  descrip-  some r e l a t i o n between  the o r g a n i z a t i o n o f  the  literature. It  i s a common o c c u r r e n c e t h a t an author w r i t i n g about psycho-  therapy w i t h c h i l d r e n s e t s up the p r o c e s s as p r o b l e m a t i c f a c t t h a t the p a t i e n t i s a  'child',  ( i . e . , i s not  t o l i s t some o f the s p e c i a l problems which he  because o f  an a d u l t ) , and  sees and,  by  the  goes on  i m p l i c a t i o n or  s p e c i f i c a t i o n , t o o f f e r s o l u t i o n s f o r them. The  psychotherapist  may  suggest t h a t :  A p r i m a r y d i f f e r e n c e between a d u l t s and c h i l d r e n must be r e c o g n i z e d . T h i s i s t h a t a c h i l d r e q u i r e s much wooing and g i v i n g . The examiner must use many words e x p r e s s i n g r e a s s u r a n c e , i n t e r e s t , and p r a i s e . F o r example, he might say, "What a t a l l b u i l d i n g you have made"; "You got t h a t r i g h t on the t a r g e t " . H It  seems r e a s o n a b l e t o p r a i s e , humor and  t o make h i s a c t i v i t i e s appear t o be f r e q u e n t l y i n the  successful.  I was  t o see  to t r y  this  form o f p r a i s i n g the c h i l d ' s appearance and h i s p l a y  a c t i v i t i e s , a s s i s t i n g him not k e e p i n g s c o r e  encourage the c h i l d , and  with a c t i v i t i e s to insure success,  o r , perhaps,  i n d a r t games, e t c .  In a s i m i l a r manner, another author suggests t h a t : I n t e r v i e w i n g young c h i l d r e n u s u a l l y r e q u i r e s a good d e a l o f v e r b a l a c t i v i t y on the p a r t o f the t h e r a p i s t . Adults, after a b r i e f i n t r o d u c t i o n t o an i n i t i a l i n t e r v i e w , w i l l commonly t a l k f o r l o n g p e r i o d s , twenty t o t h i r t y minutes not b e i n g unusual; c h i l d r e n may say o n l y a sentence or two spontaneously.-'2  I observed t h i s i n d i f f e r e n t s t r a t e g i e s d e s i g n e d t o get the c h i l d t o t a l k ; common among t h e s e was general",  something l i k e ,  "can we  o r "what's g o i n g t o happen n e x t ? "  make up a s t o r y about  the  5 In terms o f t h e r a p y t e c h n i q u e s  we  are informed t h a t :  ... p l a y a c t i v i t y i s the c h i l d ' s n a t i v e t o n g u e — h i s n a t u r a l way o f showing how he f e e l s about h i m s e l f and the s i g n i f i c a n t p e r s o n s i n his l i f e . The t h e r a p i s t must be a b l e not o n l y t o comprehend p l a y language but a l s o t o communicate h i s u n d e r s t a n d i n g c l e a r l y t o the child. 1 3  I am  c e r t a i n t h a t the r e a d e r  i s not  o f therapy o r t h a t i t i s used and technique.  As p a r e n t s  and  recognized  a d u l t s we  between the c h i l d and h i s p l a y . parents  s u r p r i s e d t o f i n d t h a t p l a y i s a form as a s p e c i f i c  therapeutic  know t h a t a s p e c i a l r e l a t i o n e x i s t s  While the l i t e r a t u r e suggests t h a t some  are upset because they f e e l t h a t t h e i r c h i l d r e n are coming t o  the  14 clinic  "just to play",  which shows how  they can r e p o r t e d l y be  s a t i s f i e d with  an  account  the c h i l d e i t h e r uses p l a y t o work out problems from h i s  p a s t by r e p e t i t i o n , o r by c o n s t r u c t i n g a microcosm o f h i s w o r l d a n t i c i p a t e s his worries. 'complaint', was  While I d i d not w i t n e s s a p a r e n t making' t h i s p a r t i c u l a r t h e r a p i s t s t o l d me  even i n s t r u c t i n g a p a r e n t  child's play—while  the p a r e n t  t h a t i t d i d i n f a c t happen.  i n how  One  therapist  t o make p s y c h i a t r i c sense o f h i s  observed h i s c h i l d from b e h i n d a one-way  mirror. In a s i m i l a r f a s h i o n , s o c i o l o g i s t s s i n c e the work o f G. H. Mead have taken i n t o account the f u n c t i o n o f p l a y i n the emergence o f the c h i l d ' s 'self'." ^ -  This i s s t i l l  a s t r o n g t r a d i t i o n i n the s o c i a l s c i e n c e s  w i t n e s s e d by the r e c e n t w r i t i n g s o f p e o p l e l i k e N. D e n z i n ^ and 1  B.  as Sutton-  17 Smith.  The  p l a y o f c h i l d r e n i s seen as such a s t r o n g and c o n s t i t u t i v e  feature of childhood  t h a t i t i s a r e s o u r c e which can be  p r a c t i t i o n e r s of therapy, s o c i a l s c i e n t i s t s ,  examined by  etc.  In terms o f u n d e r s t a n d i n g the p a t i e n t we  are  cautioned,  The c h i l d may not always seem r a t i o n a l i n h i s communication from an a d u l t p o i n t o f view and y e t , from the c h i l d ' s frame o f r e f e r e n c e , he i s communicating something o f r e a l down-to-earth f e e l i n g s . A  6 t h e r a p i s t who i s too l i t e r a l - m i n d e d and who cannot t o l e r a t e a c h i l d ' s f l i g h t i n t o fantasy without o r d e r i n g i t i n t o a d u l t meaningfulness might w e l l be l o s t a t t i m e s . ^ 8  and: The w o r l d which the c h i l d c o n s t r u c t s between the ages o f f o u r and e i g h t i s dynamic, menacing, a n i m i s t i c and governed by i r r a t i o n a l causality. Inanimate t h i n g s are not o n l y a l i v e and f u l l o f cons c i o u s n e s s , but they are a l s o m o t i v a t e d and a b l e t o p u n i s h . It i s a w o r l d i n which moral laws are e x a c t i n g and severe.^ Or: W e l l - e s t a b l i s h e d mature a d u l t s who have put c h i l d i s h t h i n g s once and f o r a l l b e h i n d them f i n d the c h i l d ' s s o l i l o q u i z i n g uncomfortable from o t h e r p o i n t s o f view. Not o n l y i s the c o n t e n t o f t e n b i z a r r e , but the thoughts are f r e q u e n t l y jumbled t o g e t h e r and j u x t a p o s e d , and nons e q u i t u r i s a normal p a r t o f speech. This q u a l i t y of syncretism can be extremely d i s t u r b i n g and l e a d t o a g r e a t d e a l o f c o n f u s e d u n d e r s t a n d i n g on the p a r t o f the a d u l t . ^ u  These p i e c e s do t o the reader,  of advice  and  s u b s c r i p t i o n t o a model d e s c r i b i n g the  Although the i n s t r u c t i o n s above t e l l us how  a l l k n o w — t h e normal c h i l d .  had  'normal dis-  framed i n terms o f  These accounts sound r e a s o n a b l e  t o us because, as members o f the c u l t u r e , we what c h i l d r e n are  sure they  to deal with  t u r b e d p a t i e n t s , a l a r g e p a r t o f those i n s t r u c t i o n s are c h i l d r e n we  as I am  i t became apparent t h a t t h i s r e a s o n a b l e n e s s  something t o do w i t h our child'.  appeared r e a s o n a b l e t o me,  a l l share some knowledge o f  like.  I s h a l l conclude t h i s review o f what how-to-do-psychotherapy manuals s a i d about making sense o f the c h i l d - a s - p a t i e n t w i t h a couple o f which demonstrate t h a t t h i s a d v i c e to c h i l d r e n .  I t i s not  also included  information  j u s t a matter o f knowing how  on how  t o handle and manage them.  For  advice  example:  Most c h i l d r e n should be g i v e n s e v e r a l minutes n o t i c e t h a t the o f the s e s s i o n i s coming. -'2  to t a l k  to i n t e r p r e t or  understand c h i l d r e n f o r , i n a d d i t i o n t o t h i s , a l a r g e p a r t o f the t e l l s the r e a d e r how  points  end  7 And: Some c h i l d r e n l i k e t h e i r words sounded back t o them w i t h o u t l i k e an e c h o .  change,  2 2  Or: When t h e t h e r a p i s t meets the c h i l d f o r t h e f i r s t time, he g r e e t s him w i t h a b r i e f h e l l o , d i s p e n s i n g w i t h f o r m a l i n t r o d u c t i o n s and s o c i a l amenities. He does n o t comment about t h e weather o r about how n i c e i t i s t o get acquainted. He does n o t d e s c r i b e t o a t e a r f u l c h i l d t h e w o n d e r f u l t o y room, n o r does he ask him i f he would l i k e t o come t o the play-room. The t h e r a p i s t assumes r e s p o n s i b i l i t y f o r l e a d i n g t h e c h i l d t o t h e room by s a y i n g t o t h e mother, "Johnny and I a r e now g o i n g to the playroom". He extends h i s hand t o t h e c h i l d and o f f they go. . . . Some o f t h e gambits used i n p l a y therapy a r e u n d e s i r a b l e because they convey hidden a c c u s a t i o n and t h r e a t s t o c h i l d r e n . The q u e s t i o n , "do you know why you a r e h e r e ? " may imply t o t h e c h i l d , "You would n o t be here i f t h e r e were n o t something wrong w i t h you". . . The statement, " I wish you would t e l l me what b o t h e r s you" does n o t make sense t o t h e c h i l d . . . . The statement, "Don't you have some q u e s t i o n s you want t o ask me about why you a r e h e r e ? " w i l l most p r o b a b l y b r i n g a b r i e f "no" and an end t o t h e c o n v e r s a t i o n . When c h i l d r e n do n o t know t h e t h e r a p i s t they have no reason t o t r u s t him, e i t h e r with questions o r with answers. ^ 2  Now t h a t I have g i v e n t h e r e a d e r a b r i e f i n t r o d u c t i o n t o the 'problems' o f c h i l d psychotherapy  (as f o r m u l a t e d  by members o f t h e p r o f e s -  sion) , and a sample o f some o f t h e a d v i c e on how t o handle t h e problems which someone who works w i t h c h i l d r e n i n a t h e r a p e u t i c environment might have, I would l i k e t o g i v e an account o f my i n d u c t i o n t o t h e s e t t i n g . My I n d u c t i o n t o the S e t t i n g The by s p a c i o u s  c l i n i c i s a s p r a w l i n g a r r a y o f governmental b u i l d i n g s surrounded lawns and l a r g e wooded a r e a s .  p l a y a r e a i s v i s i b l e and, upon approaching reading clinic  "Children's C l i n i c " .  From t h e p a r k i n g l o t a s m a l l t h i s , one can make o u t a s i g n  As I was t o d i s c o v e r l a t e r , t h e c h i l d r e n ' s  i s o n l y a s m a l l p a r t o f t h e programs conducted a t t h i s  complex.  Upon e n t e r i n g t h e c l i n i c one approaches a r e c e p t i o n i s t who i s l o c a t e d so as t o c o n t r o l access t o the o f f i c e and t h e program a r e a o f t h e building.  Next t o the r e c e p t i o n i s t ' s desk i s a w a i t i n g a r e a which i s  8 equipped w i t h l i g h t r e a d i n g m a t e r i a l i n c l u d i n g , as might be s e l e c t i o n o f c h i l d - r e a r i n g pamphlets. f o r the use  A waiting  expected, a  room o b v i o u s l y  of c h i l d r e n i s s i t u a t e d b e h i n d the r e c e p t i o n i s t ' s desk,  ahead o f t h i s i s an i n s t i t u t i o n a l c o r r i d o r w i t h many d o o r s . o f these doors were e l e c t r i c s i g n s s a y i n g turned "kit  equipped  out, were never u s e d ) . (refill)  s u p p l i e s " , and  "do  not e n t e r "  Over some  (which, as i t  Other doors were marked " o b s e r v a t i o n "toy s t o r a g e  e x p e r i e n c e f o r a v i s i t o r t o see  room".  I t would be  adults c a r r y i n g toys  from one  f l o o r , or e s c o r t i n g a c h i l d i n o r out o f one  on,  o f these rooms.  c h i l d r e n p l a y i n g i n the c o r r i d o r s w i t h guns and  room",  a common room t o  another, p u l l i n g a wagon f u l l o f t o y s , p u s h i n g a sand t r a y a c r o s s  o f t e n see  and  the  One  would  h o l s t e r s buckled  r i d i n g a t r i c y c l e , pushing a d o l l c a r r i a g e , c r y i n g , running, t a l k i n g  t o the r e c e p t i o n i s t ,  or p a t t i n g a dog.  w i t h t h i s area over the next y e a r .  I was  T h i s was  t o become v e r y f a m i l i a r  the main p l a y t h e r a p y  area.  I: w i l l have more t o say about i t l a t e r . Upon a r r i v a l I p r e s e n t e d m y s e l f t o the r e c e p t i o n i s t who see t h a t my me  name was  i n the d i r e c t o r ' s appointment book and  to h i s secretary.  floor.  As  impression  t h a t the c l i n i c was  room on the  the  There were many empty  o n l y company i n the w a i t i n g  room c o n s i s t e d o f a few  guide and  seen even one  t o u r he  i n the c l i n i c .  second  room I g a i n e d  some c h i l d r e n ' s magazines.  toys,  At t h i s  point  child.  Upon our meeting the d i r e c t o r suggested t h a t we D u r i n g our  then announced  very q u i e t .  back i s s u e s o f T.V. not  d i r e c t e d to a waiting  I proceeded t o the second f l o o r w a i t i n g  o f f i c e s and my  I had  I was  checked t o  t a l k e d about the c l i n i c and  t o u r the  I t a l k e d about my  facilities. interest  I t happened t h a t the p r o v i n c i a l m i n i s t e r o f h e a l t h  a l s o scheduled t o make h i s f i r s t t o u r o f the  f a c i l i t i e s t h a t day  was  (this  9 may have accounted f o r the absence o f c h i l d r e n ) and t h i s became b o t h a p o i n t o f d i s c u s s i o n and a v e h i c l e f o r t a l k i n g about the f u t u r e o f t h e clinic,  about governmental a t t i t u d e s towards i t , and so on. I learned  t h a t t h i s s e r v i c e complex was known as t h e B r i t i s h  Columbia Youth Development C e n t e r and was a community s e r v i c e f o r c h i l d r e n and  adolescents  ( i . e . , those under t h e age o f 17) w i t h p s y c h o l o g i c a l ,  s o c i a l and l e a r n i n g problems.  The core o f the program can be t r a c e d back  t o a C h i l d Guidance C l i n i c which was s t a r t e d i n Vancouver i n 1932. r e t a i n i n g some o f t h e s t r u c t u r e , t h e p r e s e n t  While  c l i n i c appeared t o be  24 i n v o l v e d _n an i d e n t i t y c r i s i s . The  Center o f f e r s three  l a r g e program a r e a s .  Each o f t h e s e  e n j o y s a g r e a t d e a l o f autonomy and each has i t s own d i r e c t o r . programs c o n s i s t o f (a) a r e s i d e n t i a l u n i t which p r o v i d e s l o g i c a l treatment f o r up t o 45 a d o l e s c e n t s ;  school  or perceptual  s e t t i n g and/or e x t e n s i v e  i n t e n s i v e psycho-  (b) a p s y c h o l o g i c a l  c l i n i c f o r c h i l d r e n and a d o l e s c e n t s .who a r e d o i n g p o o r l y of emotional, behavioral  The  education  i n s c h o o l because  problems and need a s p e c i a l i z e d  p s y c h o l o g i c a l examination;  and (c) a  f a m i l y and c h i l d r e n ' s c l i n i c which o p e r a t e s b a s i c a l l y as an o u t - p a t i e n t s e r v i c e f o r c h i l d r e n and f a m i l i e s .  I t was t h e d i r e c t o r o f t h e C h i l d r e n ' s  C l i n i c t h a t I was t a l k i n g t o and i t was t h i s s e r v i c e t h a t I was t o be i n v o l v e d w i t h over t h e next y e a r .  H e n c e f o r t h I w i l l use the term  t o r e f e r t o o n l y t h e F a m i l y and C h i l d r e n ' s The  c l i n i c provides  Clinic.  a wide range o f s e r v i c e s .  I t s services  speech t h e r a p y , d i a g n o s t i c and c o n s u l t a t i o n s e r v i c e s , a p r e s c h o o l a team which t r a v e l s t o a r e a s o f t h e p r o v i n c e community team o f s o c i a l workers o p e r a t i n g centre,  "clinic"  include  centre,  w i t h o u t youth s e r v i c e s , a  o u t o f a community  health  a t r a i n i n g s e t t i n g f o r treatment s t a f f , an o r i e n t a t i o n s e r v i c e f o r  10 community s e r v i c e p e r s o n n e l , for  c h i l d r e n , and  a f a m i l y t h e r a p y program, a treatment program  even a summer camp.  I t was  the apparent  p r i o r i t y given  t o d i r e c t treatment s e r v i c e s t h a t s t i m u l a t e d  crisis  some s t a f f members, and  f e l t by  work, t h e r e was  throughout the  decreasing the  identity  course o f my  much t a l k about the p o s s i b i l i t y t h a t the c l i n i c  field  might  be  25 turned  into a staff training  centre.  I e x p l a i n e d t o the d i r e c t o r t h a t I was how  adults talk to c h i l d r e n .  be and  are seen as  i n t e r e s t e d i n l e a r n i n g about  T e n t a t i v e l y , I proposed t h a t c h i l d r e n c o u l d  " s p e c i a l c o n v e r s a t i o n a l i s t s " and  t h a t t h i s may  represent  an i n t e r a c t i o n a l problem f o r - i a d u l t s / t h e r a p i s t s — a problem f o r which I might d i s c o v e r some s o l u t i o n s i f I c o u l d examine t h e i r t a l k . p r o p o s a l was p r e t e d my saw  met  w i t h ' u n d e r s t a n d i n g and  This  enthusiasm f o r the d i r e c t o r i n t e r -  i n t e r e s t as a concern w i t h the  f e a t u r e s o f communication.  He  immediate p r a c t i c a l b e n e f i t from t h i s i n q u i r y f o r he hoped t h a t i f one  c o u l d d i s c o v e r the p r o p e r t i e s o f " t h e r a p e u t i c communication", t h e s e p r o p e r t i e s c o u l d be  taught t o p a r e n t s  and  to teachers  and  t h i s might  d e c r e a s e the chances t h a t these a d u l t s would undo the b e n e f i t s which c h i l d r e n d e r i v e from t h e r a p y .  L i k e the p s y c h o t h e r a p y manuals, he  t o suggest t h a t t h e r e are  'good' ways and  and  have, out o f n e c e s s i t y , d e v e l o p e d a  that psychotherapists  o f t a l k i n g t o them. saw  me  pursuing  He  'bad'  t h i s prompted me  t h e r a p y manuals t o determine what t h e r a p i s t s see c h i l d r e n and what a d v i c e what the how  they have t o o f f e r .  t h e r a p i s t s i n the c l i n i c  saw  'good'  as p r o b l e m a t i c ,  way and  t o r e t u r n t o the psycho-  as problems i n t a l k i n g t o  I a l s o intended  as t h e i r problems, and  they a c t u a l l y t a l k e d o f t h e i r p a t i e n t s .  appeared  ways t o t a l k t o c h i l d r e n ,  appeared i n t e r e s t e d i n , saw  t h e s e f e a t u r e s and  the  to f i n d  to look  I f I could discover  out  at  the  f e a t u r e s o f t h e i r t a l k t h a t were s p e c i f c a l l y d e s i g n e d f o r c h i l d r e n , I  felt  11 t h a t I would have something. The  d i r e c t o r gave me  complete a c c e s s t o the c l i n i c .  I was  become i n v o l v e d w i t h the s t a f f i n the d i r e c t s e r v i c e program, and d e c i d e d t o c o n c e n t r a t e on those t h e r a p y were o l d enough t o be r e a s o n a b l e recorded).  equipped was  I  settings that included children  speakers  (and c o u l d thus be heard  I wanted t o p a r t i c i p a t e i n the t h e r a p y i n a way  cause as l i t t l e  able to  d i s r u p t i o n as p o s s i b l e .  One  and  t h a t would  o f the p l a y rooms  was  w i t h a one-way m i r r o r and w i t h a u d i o - r e c o r d i n g equipment and  g i v e n access t o t h i s a r e a .  who  I t t u r n e d out t h a t the a m p l i f i e r  I  and  tape r e c o r d e r were not f u n c t i o n i n g p r o p e r l y and the d i r e c t o r undertook t o have the equipment improved.  Little  r e g u l a r use had been made o f the o l d  equipment, b u t o t h e r s used the o b s e r v a t i o n room more f r e q u e n t l y a f t e r I arrived. D u r i n g my f i e l d work.  He  first visit  the d i r e c t o r h e l p e d me  i n t r o d u c e d me  t o another  i n v o l v e d i n p l a y therapy with c h i l d r e n . and  showed g r e a t enthusiasm  her a t work, and was  anxious  information.  The  s e s s i o n t h a t he had  members.  to  She  actively  e x c i t e d about her work  t o t a l k about the s k i l l s  someone o b s e r v i n g i n v o l v e d i n therapy,  soon became my  d i r e c t o r a l s o i n v i t e d me  i n v o l v e d i n another  t o see him  t o observe  clinic  g r e a t e s t source a diagnostic  program and  the  i n order to provide advice f o r other  I t happened t h a t the p l a y room which was  o b s e r v a t i o n room was suggested  She was  was  my  scheduled w i t h a new. p a t i e n t f o r the f o l l o w i n g week.  T h i s c h i l d was had been asked  s t a f f member who  a t the p r o s p e c t o f h a v i n g  about c h i l d r e n , about problems, e t c . of  t o get s t a r t e d on  staff  a t t a c h e d t o the  not a v a i l a b l e the f o l l o w i n g week so the  t h a t I simply s i t i n the p l a y room i t s e l f .  director  He  therapist  instructed  s i t i n a c o r n e r , f a r enough away t o be removed from the c e n t r e o f  me  12 activity  b u t n o t so f a r t h a t i t might appear t h a t I was h i d i n g .  my f i r s t  experience with a t h e r a p i s t t a l k i n g t o a p a t i e n t .  reproduced  some o f t h e f i r s t  T h i s was  I have  minutes o f t h a t s e s s i o n so t h e r e a d e r can  share my e x p e r i e n c e . I. 1 1.  T:  (  ) a man who works w i t h me sometimes.  2.  R: H i .  3.  C: H i .  4.  T:  That's Gary, t h i s i s F r a n z . ((pause)) Would you l i k e t o keep your j a c k e t on o r would you l i k e t o take i t o f f ?  5.  C:  (  6.  T:  You w i l l l e a v e i t on, s u r e . What I thought we would do i f we c o u l d spend a l i t t l e time t o g e t h e r and we would p l a y t o g e t h e r and then when we spend some time I c o u l d take you back t o your classroom.  7.  C:  Okay.  8.  T:  Do you go back home a t lunchtime?  on  )  ((pause))  Do you have l u n c h  here? 9.  C:  No.  10.  T:  Where do you go f o r lunch?  II.  C:  I don't know.  12.  T:  Do you, where do you u s u a l l y go f o r l u n c h . home?  13.  C:  No.  14.  T:  No. ((pause)) W e l l we can ask Mrs. ( t o know what you have done t o your head. happened?  15.  C:  Don't know.  16.  T:  ( ) would you l i k e t o have a look through t h i s t o see what we've g o t and you can t e l l me what you're i n t e r e s t e d i n . ((long pause)) A monkey and some c a r s . ( ( s a i d i n enumerative v o i c e ) )  17.  C:  I'm g o i n g t o p l a y w i t h  this.  ((pause))  Do you go  ). I'm i n t e r e s t e d ((pause)) What  13 18.  T:  Okay. That's a t r u c k . ((pause)) I think I ' l l get a l i t t l e c h a i r and s i t down. ((pause)) Maybe I can h e l p you w i t h some o f the t o y s . ( ( l o n g pause)) What e l s e can we see. ( ( c h i l d i s s t a r t i n g t o take t o y s o u t o f t h e box.))  19.  C:  I don't know.  20.  T:  That's a r e d c a r .  ((pause))  I can see t h i s .  ( ( l o n g pause w h i l e c h i l d p l a y s w i t h c a r ) ) 21.  T:  I t ' s stuck i n t h e , stuck i n t h e sand.  34.  C:  (  35.  T:  I wonder what i t i s .  36.  C:  I don't know.  37.  T:  What does i t do?  38.  C:  When you, when those guys a r e dead i t t a k e s hospital.  39.  T:  When a guy i s dead i t takes them t o t h e h o s p i t a l . What's i t g o i n g t o do here?  50.  T:  Now I wonder what t h i s i s .  51.  C:  Don't know.  52.  T:  I t ' s t h e same s o r t o f t h i n g as t h i s .  )  ((pause))  Is i t ?  I'm g o i n g t o g e t t h i s .  ((pause))  (you) a t the  ((long  What i s t h i s ? ( ( p o i n t s t o ambulance))  but i t ' s one t h a t ' s used by t h e army, by t h e s o l d i e r s . 53.  C:  (  )  54.  T:  These men can bend.  55.  C:  (  56.  T:  What do you t h i n k i t might be?  57.  C:  Don't know.  58.  T:  We can guess c a n ' t we.  59.  C:  A ship.  60.  T:  A ship.  )  What's t h i s ?  ((pause))  pause))  itmThmmm  (+)  75.  T:  What i s t h i s , do you know?  76.  C:  Police car.  77.  T:  Yea, b u t what i s t h i s on top?  78.  C:  Don't know.  79.  T:  What would you c a l l i t ?  80.  C:  Don't know.  ((pause))  He's g e t t i n g  some sand.  ((pause))  I don't know what t h i s i s . 81.  T:  You don't know?  82.  C:  A house.  83.  T:  A house.  143.  T:  Have you g o t a c a r ?  144.  C:  Yea.  145.  T:  Can you t e l l me about your c a r ?  146.  C:  No.  147.  T:  Can I ask about i t ?  148.  C:  Yea.  149.  T:  Is i t a b i g car?  150.  C:  Yea.  151.  T:  What c o l o r  152.  C:  I've g o t a whole bunch.  153.  T:  A whole bunch o f ,  154.  C:  Cars.  155.  T:  Cars. his  ((said  softly))  is it?  I see.  ((face  shows he r e a l i z e d  c h i l d was t a l k i n g  about  toys.))  B e f o r e showing how t h e t h e r a p i s t  was a b l e t o use t h i s t a l k t o  c o n s t r u c t a d i a g n o s i s , o r a t l e a s t t o f o r m u l a t e a problem, I want t o make  15 one  observation  conversation  t h a t I t h i n k the r e a d e r w i l l a p p r e c i a t e .  above does n o t sound strange  o r e s o t e r i c , r a t h e r i t sounds  v e r y much l i k e an a d u l t t a l k i n g t o a c h i l d .  Although we may be s t r a n g e r s ,  we can f o l l o w t h e s e s s i o n and make some sense o f i t — i t Perhaps I s h o u l d  That i s , t h e  sounds  reasonable.  a l s o p o i n t o u t t h a t i t i s p o s s i b l e t o see a number o f t h e  p o i n t s which were r e f e r r e d t o i n t h e l i t e r a t u r e o p e r a t i n g  i n this  short  transcript. A s h o r t time a f t e r o b s e r v i n g  t h i s p l a y s e s s i o n I j o i n e d the t h e r a -  p i s t as he t r i e d t o make some o b s e r v a t i o n s suitable f o r a report.  about t h e c h i l d t h a t would be  I Used t h i s o p p o r t u n i t y  t o d i s c o v e r what sense  he had been a b l e t o make o f t h e c h i l d ' s p l a y and t a l k .  The f o l l o w i n g 26  then a r e some o b s e r v a t i o n s  t h e t h e r a p i s t r e p o r t e d t o me.  1.2 R: I s e e , he was going through the box the whole time, s o r t o f t h a t same o l d t h i n g o f t a k i n g o u t t o y s and, T:  That's r i g h t . There's no s o r t o f , t h e r e ' s no e x p l o r a t i o n o f t h e room. He s e t t l e d down t o t h i s p a r t i c u l a r t a s k f o r t h e whole time w i t h o u t much r e f e r e n c e t o a n y t h i n g e l s e going on around him. Now whether your presence was l i m i t i n g o r n o t I don't know. Uh, maybe t o some e x t e n t . But compared w i t h t h e s o r t o f b e h a v i o r which most seven y e a r o l d s show when, i f they came i n t o t h i s room, f o r example, i s c e r t a i n l y a wider range o f s t y l e s i n t h e playroom. But, t h e r e ' d be much more l o o k i n g around and e x p l o r i n g , and a s k i n g q u e s t i o n s . 'Gee look a t t h i s ' , o r some s u r p r i s e o r e x c i t e m e n t .  R:  Even on the i n i t i a l  T:  Yea, r i g h t . Oh yea. . . . And I'd r e a l l y r a t e t h i s k i d as b e i n g q u i t e f a r a l o n g the i n h i b i t e d s c a l e , uh, what an i n h i b i t i o n means i s n ' t too c l e a r . Uh, I'm making a guess from what I.know about the k i d when I say I t h i n k he may be d e p r e s s e d - - a t t h i s t i m e — t h i s k i d . And t h e r e a r e one o r two c l u e s here; the theme o f g e t t i n g s t u c k , t h e stuck f e e l i n g , w i t h t h e need f o r some r e s c u e , and t h e odd l i t t l e t h i n g l i k e the ambulance, t h e r e f e r e n c e t o t h e dead, where t h e guy then takes him t o h o s p i t a l . There was something e l s e I t h i n k . Maybe i t ' s j u s t these few c l u e s . Ah, t h e s o r t o f t h i n g t h a t t h i s p l a y wasn't going anywhere. There was no, t h e r e was v e r y l i t t l e l i f e t o i t . I t was p a r t l y , w e l l w e ' l l come t o t h a t , i t ' s p a r t l y t h e r e c i t a t i o n , i t was the naming p r o c e s s . Perhaps t h i s may be another problem a l t o g e t h e r  v i s i t t o t h e room?  16 but l e t ' s j u s t c a l l i t i n h i b i t i o n f o r t h e moment b u t w i t h t h e p o s s i b i l i t y t h a t the i n h i b i t i o n may be p a r t o f the d e p r e s s i o n . T h i s g i v e s an i n d i c a t i o n o f my f i r s t involvement w i t h a t h e r a p y I felt  session.  t h a t some important d i s c o v e r i e s might be made i f o n l y I c o u l d g e t .  b e h i n d the s u r f a c e  l e v e l o f t h i s t a l k so I r e t u r n e d  t o t h e manuals i n an  attempt t o l e a r n what s o r t s o f t h i n g s t h e r a p i s t s a t t e n d  t o when t a l k i n g t o  child-patients. Having been g r a n t e d a c c e s s t o t h e c l i n i c ,  I approached some o f t h e  members o f the s t a f f who were u s i n g t h e p l a y rooms on a s c h e d u l e d b a s i s . I observed and taped therapy s e s s i o n s on a r e g u l a r b a s i s and o f t e n w i t h the t h e r a p i s t s about t h e i r work. occasions  such as c o f f e e b r e a k s , i n p o s t  I a l s o learned  talked  a g r e a t d e a l on  session conferences during  which  the t h e r a p i s t would r e p o r t on what happened t h a t day, i n c o n v e r s a t i o n s p r i o r t o a s e s s i o n i n which I would be i n s t r u c t e d by t h e s t a f f on what t o look f o r , and on those o c c a s i o n s  on which I o v e r h e a r d a member o f the s t a f f  g i v i n g d e s c r i p t i o n s o r accounts o f problems, p a t i e n t s , o r p r o c e d u r e s t o another member.  In a d d i t i o n t o these,  which I asked q u e s t i o n s  t h e r e were s c h e d u l e d c o n t a c t s  during  about p l a y therapy, c h i l d r e n , s p e c i f i c p a t i e n t s ,  therapist's actions, e t c . I attended the c l i n i c months and, d u r i n g  on a f a i r l y  r e g u l a r b a s i s f o r a p e r i o d o f 18  t h a t time, I observed over 50 t h e r a p y s e s s i o n s .  These  were u s u a l l y conducted by s o c i a l workers b u t o f t e n i n c l u d e d a p s y c h i a t r i s t and/or s t u d e n t t h e r a p i s t s . i n order  T y p i c a l l y , I would v i s i t  once a week  t o f o l l o w a p a r t i c u l a r p a t i e n t through a therapy program.  However, I would a l s o t r y t o observe o t h e r read  the c l i n i c  case f i l e s , e t c . , d u r i n g my  sessions, v i s i t with t h e r a p i s t s ,  visit.  I encountered two major m e t h o d o l o g i c a l problems.  Although both o f  17 these are common problems i n ' o b s e r v a t i o n a l ' s t u d i e s they s h o u l d be noted h e r e . on my  The  f i r s t o f these was  a c t i v i t i e s as a r e s u l t of the way  had been d e f i n e d .  Initially  'talk' that occurred  I had  the l i m i t a t i o n s t h a t were p l a c e d i n which my  d e s c r i b e d my  i n the t h e r a p y room, and  t h i s as an i n t e r e s t i n communication.  r o l e i n the s e t t i n g  p r o j e c t i n terms o f  the s t a f f had  the  i n t a k e committee d i d i t s work.  the  interpreted  Much l a t e r i n the study, I  t h a t I would l i k e t o observe a wider range o f a c t i v i t i e s and c u r i o s i t y about how  perhaps  decided  e x p r e s s e d some  I wondered  how  r e f e r r a l s were made t o the c e n t r e , how  the i n t a k e committee judged a p p l i -  cants  a p p l i c a n t s were s l o t t e d i n t o an  as t o s u i t a b i l i t y , e t c . , and how  appropriate The  program. d i r e c t o r agreed t h a t I s h o u l d be a l l o w e d  the i n t a k e committee s l i g h t l y acquainted some i d e a o f who  (of which he was  one  I was  and what I was  doing  i n the c l i n i c .  They e x p r e s s e d  'communication'.  I felt  r e q u i r e d a r e d e f i n i t i o n o f my  not  to  would have  research i n t e r e s t s .  another o c c a s i o n , my  peutic necessity.  t h a t t o have c o n t i n u e d  not  I s a t through  p r e s e n c e caused so much t e n s i o n t h a t I d e c i d e d  a t t e n d any more meetings.  On  only  i n t e r e s t i n t h e i r a c t i v i t i e s f o r they c o u l d  t h e i r d o i n g s here were r e l a t e d t o  meeting but my  A l t h o u g h I was  w i t h some o f the members on t h i s committe, they a l l had  some bewilderment about my see how  a member).  t o a t t e n d a meeting o f  r o l e became r e s t r i c t e d because o f  D u r i n g the f i r s t  few  observation  sessions,  therathe  t h e r a p i s t made i t a p o i n t t o i n f o r m the p a t i e n t a week i n advance t h a t o r she was me  going  t o be o b s e r v e d .  t o the p a t i e n t on the day  place.  The  then f o l l o w e d t h i s up by  on which the f i r s t o b s e r v a t i o n was  T h i s procedure a l l o w e d  policeman o r p a r e n t .  He  the c h i l d t o f e e l secure  c h i l d was  he  introducing t o take  t h a t I was  a l s o shown the p l a y room from  not my  a  18 vantage p o i n t b e h i n d the one-way m i r r o r I was  a b l e t o see.  f o r me mirror.  f o r a few As  The  f i r s t p a t i e n t t h a t I observed c o n t i n u e d  weeks, t o ask  about me,  and  t o t r y and  the o b s e r v a t i o n  look through  T h i s meant a r r i v i n g e a r l y and  room a f t e r I was  Eventually  I was  sure t h a t the p a t i e n t had  forced to.discontinue  observing  d i d not appear t o be  this  Both the t h e r a p i s t and  assumed t h a t i f the p a t i e n t d i d not someone was  b e h i n d the m i r r o r .  see me  I t was  he would not be  child While  reminded t h a t  o f the therapy room. While these may  be  27  I was  observing  i t was mirror  might be  unable t o observe the c h i l d r e n i n areas To have done so may  construed  safe  him.  I never knew when a c h i l d who  h a l l s , I found t h a t I was  a  'paranoid'  taken t h a t the c h i l d c o u l d o n l y c o n c e i v e o f the p e r s o n b e h i n d the  Since  avoid  researcher  that could provide  Without c h a r a c t e r i z i n g the p a t i e n t as  as someone t h e r e t o check up on  to  this  a l s o assumed t h a t the c h i l d would  not have a c a t e g o r y s t r u c t u r e a v a i l a b l e t o him i d e n t i t y f o r me.  child  leaving  a problem w i t h f u t u r e p a t i e n t s , I c o n t i n u e d  o f the t h e r a p y room.  the  departed f o r  because o f the p o t e n t i a l f o r i n t e r f e r e n c e w i t h h i s t h e r a p y .  them o u t s i d e  to perform  a r e s u l t o f t h i s , the t h e r a p i s t suggested I a v o i d the  i n the h a l l s whenever p o s s i b l e .  home.  so t h a t he would know e x a c t l y what  have j e o p a r d i z e d  my  in  the  outside welcome.  as l i m i t a t i o n s , they are a l s o p e r t i n e n t  examples o f the problem o f managing one's r o l e i n the c o n s t r u c t i o n o f  an  28 ethnography. Much l a t e r ,  I e x p r e s s e d a d e s i r e t o t a l k w i t h some o f the  or w i t h an e x - p a t i e n t own  i n order  conceptions of therapy.  to discover I was  something about the  discouraged  from d o i n g the  because i t might i n t e r f e r e w i t h the t h e r a p e u t i c p r o c e s s . not t o attempt the  I was  patients  children's former also  l a t t e r because o f the danger o f " r e a c t i v a t i n g " the  told  19 c h i l d ' s problem a t a time when he would have no one t o h e l p him though i t . T h i s was n o t s t r i c t l y  speaking  f e a r o f a ' r e l a p s e ' , b u t r a t h e r a concern  t h a t t h e c h i l d might " r e l i v e " the t h e r a p y e x p e r i e n c e his  and then  re-experience  a n x i e t i e s , w o r r i e s , f e a r s , e t c . were he t o be engaged i n such a con-  versation . Although  I c o n t i n u e d t o see my problem as t h a t o f t h e ' t a l k ' t h a t  goes on between the t h e r a p i s t and p a t i e n t , I c o n t i n u e d t o accumulate a g r e a t d e a l o f i n f o r m a t i o n about t h e o p e r a t i o n o f t h e s e t t i n g i t s e l f and p a r t i c i p a t e d i n many c o n v e r s a t i o n s w i t h t h e t h e r a p i s t s .  Without  really  knowing why, I c o n t i n u e d t o t r y t o make as much sense as p o s s i b l e o u t o f the l a r g e r s e t t i n g .  T h i s non-therapy-room m a t e r i a l was t o prove  instru-  mental i n the r e d e f i n i t i o n o f my problem a t a time when most o f my  field  work was over. T y p i c a l S i g h t s and Sounds In t h i s s e c t i o n I would l i k e  t o i n t r o d u c e t h e r e a d e r t o some o f  those t h i n g s t h a t 'anyone' might hear, a s h o r t time  i n the c l i n i c .  s e e , understand,  i f they spent even  Drawing on my e x p e r i e n c e ,  I take t o be t y p i c a l s i g h t s and sounds o f the therapy  I will  r e p o r t what  setting.  While I was w a i t i n g t o see t h e d i r e c t o r one a f t e r n o o n , h i s s e c r e t a r y / 29 r e c e p t i o n i s t began t o t e l l me about the p a t i e n t who was b e i n g seen.  His  v i s i t was ' r e p o r t a b l e ' because o f the way he had come t o have an a p p o i n t ment on t h i s p a r t i c u l a r a f t e r n o o n . and asked  t o see t h e d o c t o r .  this patient.  The t e l l e r  The c h i l d had telephoned  the c e n t r e  T h i s was a p p a r e n t l y a r e g u l a r p r a c t i c e f o r  and the r e s e a r c h e r saw t h i s as a ' r e p o r t a b l e '  event because i t s t o o d i n marked c o n t r a s t t o the r e g u l a r procedure which p a t i e n t s appeared a t the c l i n i c . event gave i t a q u a l i t y o f b e i n g  'cute'.  by  The unusual nature o f t h i s T h i s drew my a t t e n t i o n  20 t o the procedures  by which p a t i e n t s t y p i c a l l y came t o the c l i n i c .  C h i l d r e n do n o t make themselves p a t i e n t s . guardians,  Their parents or  u s u a l l y on the a d v i c e o f t e a c h e r s , c o u r t s , o r d o c t o r s a c t as  intermediaries.  Parents  arrange  for referrals, v i s i t  the c l i n i c t o  e x p l a i n the p r o b l e m - w i t h - t h e i r - c h i l d , make appointments, and see t h a t t h e c h i l d appears,  and sometimes they become p a t i e n t s themselves.  most a d u l t p a t i e n t s , t h e c h i l d i s n o t a v o l u n t a r y p a t i e n t .  Unlike Interestingly,  i n c o n t r a s t t o a c a s e l o a d o f a d u l t s , t h e c h i l d r e n d i d n o t appear t o miss appointments.  Those c h i l d r e n who c l a i m e d t h a t they d i d n o t want t o e n t e r 30  the p l a y room were simply l e d o r on o c c a s i o n c a r r i e d i n t o i t . R e f e r r a l i s made t o t h e c e n t r e through agency which r e q u e s t s a p a r t i c u l a r s e r v i c e .  a d o c t o r o r a community A j o i n t i n t a k e committee  which c o n s i s t s o f t h e F a m i l y and C h i l d r e n ' s C l i n i c and t h e P s y c h o l o g i c a l E d u c a t i o n C l i n i c reviews  t h e case and, i f i t i s a c c e p t e d ,  i t i s assigned  t o a program d i v i s i o n and, t y p i c a l l y , t o a s p e c i f i c t h e r a p i s t . o f t h e d e c l i n e o f d i r e c t treatment, s o l e l y f o r p l a y therapy.  Because  few c h i l d r e n appeared t o be a c c e p t e d  I n s t e a d , most c a n d i d a t e s  f o r therapy  came from  some o t h e r program w i t h i n t h e c e n t r e , e.g., t h e p r e s c h o o l c e n t r e . F o r many p a t i e n t s , therapy was simply a p a r t o f t h e time t h a t they spent a t t h e c e n t r e and they appeared t o see i t as a r o u t i n e p a r t o f t h e i r 31 school experience.  These c h i l d r e n a r e u s u a l l y met by t h e t h e r a p i s t  a f t e r c l a s s and l e d o r c a r r i e d t o the p l a y room. a r r i v e w i t h a p a r e n t on t h e i r f i r s t  Other p a t i e n t s t y p i c a l l y  few v i s i t s b u t , f o r t h e remainder o f  t h e i r program, they o f t e n come t o the c e n t r e by t a x i o r w i t h a v o l u n t e e r driver.  On one o c c a s i o n t h e t h e r a p i s t h e r s e l f p i c k e d t h e c h i l d up a t h e r  home and r e t u r n e d h e r a f t e r t h e hour. the w a i t i n g a r e a , a l t h o u g h  I seldom saw p a r e n t s w a i t i n g i n  a t l e a s t one p a r e n t appeared t o w a i t f o r h i s  c h i l d i n h i s car. Those c h i l d r e n coming t o the c l i n i c s p e c i f i c a l l y f o r p l a y u s u a l l y e n t e r e d the b u i l d i n g alone and were g r e e t e d by the She would r e c o g n i z e them and the t h e r a p i s t a r r i v e d . waiting area. was  therapy  receptionist.  f r e q u e n t l y engaged them i n c o n v e r s a t i o n  I t was  until  uncommon f o r the c h i l d to s i t i n the  Sometimes the p a t i e n t would e n t e r the therapy room which  a d j a c e n t t o the w a i t i n g a r e a and p l a y w i t h the t o y s u n t i l he heard  the  t h e r a p i s t coming. I t was  n o t uncommon t o f i n d c h i l d r e n roaming about the h a l l s  a d u l t s would approach them t o d i s c o v e r t h e i r reason  f o r being there.  might, f o r example, be o v e r - e x t e n d i n g  their v i s i t  complex.  c h i l d r e n appeared t o p r o v i d e  The presence  o f unattended  r a t i o n a l e f o r l o c k i n g doors;  P l a y Room:  They  away from the s c h o o l the  t h r e e doors were c o n s i s t e n t l y l o c k e d , namely,  the o b s e r v a t i o n room, the toy s t o r a g e room, and The  and  the k i t r e f i l l  room.  P l a y therapy r e q u i r e s a c e r t a i n amount o f p r e p a r a t i o n by  the t h e r a p i s t .  These p r e p a r a t i o n s can be thought  o r t e c h n i c a l , and  (b) t h e r a p e u t i c .  First,  U n l i k e most v e r b a l t h e r a p i e s , p l a y therapy s e t t i n g , i . e . the  'play room', and,  o f as  (a) a d m i n i s t r a t i v e  l e t us c o n s i d e r the  former.  i s c a r r i e d out i n a s p e c i a l  s i n c e t h e r e are a l i m i t e d number o f  these s p e c i a l s e t t i n g s , i t . i s n e c e s s a r y  t h a t the s t a f f work out a  32 schedule through  f o r t h e i r occupancy. the r e c e p t i o n i s t .  a t the same time o f day t h e r a p i s t had  and  The  t h e r a p i s t u s u a l l y r e s e r v e d a room  P a t i e n t s were seen once o r twice a week, u s u a l l y i n the same room.  I t appeared t h a t each  a p r e f e r e n c e f o r a p a r t i c u l a r s e t t i n g and  scheduling  was  seldom p r o b l e m a t i c . The two  c l i n i c has a number o f rooms a v a i l a b l e f o r therapy  o f t h e s e are used f o r group a c t i v i t i e s , two  activities;  a r e s m a l l p l a y rooms w i t h  22  observational  facilities,  (these were o n l y used once o r t w i c e t o my  knowledge and then o n l y because the o t h e r rooms w i t h o u t o b s e r v a t i o n  rooms were o c c u p i e d ) ,  rooms which were used almost e x c l u s i v e l y as  p l a y rooms, and two l a r g e rooms f u l l y equipped as p l a y rooms. the two l a t t e r - m e n t i o n e d groups and c o n t a i n s other used.  two l a r g e  rooms i s s e t up t o p r o v i d e  One o f  f o r occasional  family  a s o f a and arm c h a i r as w e l l as p l a y equipment.  The  room was the most f u l l y equipped and appeared t o be the most h e a v i l y Unlike  the o t h e r s  i t had a c h i l d ' s washroom, a b l a c k b o a r d , a s i n k ,  as w e l l as a bench which extended around a l l o f the a v a i l a b l e w a l l s . T h i s was the room t h a t most o b s e r v a t i o n s While s c h e d u l i n g  were made i n .  o f the rooms d i d n o t appear t o be a problem, i t  f r e q u e n t l y happened t h a t the p a t i e n t thought " h i s room" had been v i o l a t e d . C h i l d r e n were t y p i c a l l y t o l d t h a t the p l a y room was " t h e i r s " and  f o r the hour  t h a t they c o u l d do what ever they l i k e d w i t h i t ( w i t h i n r e a s o n a b l e  l i m i t s of course).  On one o c c a s i o n  the t h e r a p i s t and p a t i e n t had gone  u p s t a i r s f o r a few minutes and, upon r e t u r n i n g , found two c h i l d r e n from the w a i t i n g and  a r e a i n the room.  T h i s appeared t o be a s i g n i f i c a n t  event  the t h e r a p i s t t o l d the c h i l d t h a t he had a r i g h t t o be annoyed a t  this intrusion.  L a t e r , b o t h o f them agreed t h a t they s h o u l d  room whenever they had t o l e a v e  lock the  i t i n the f u t u r e .  Another p o t e n t i a l problem a r i s e s when a c h i l d from one room wants t o e n t e r another c h i l d ' s room. v i o l a t i o n was  A c h i l d who proposed t h i s k i n d o f  told:  1.3 T:  No, playrooms a r e v e r y s p e c i a l p l a c e s Tanya. Your playroom i s a v e r y s p e c i a l p l a c e , and no o t h e r p e o p l e , no o t h e r c h i l d r e n come i n i t when you're i n i t , and no o t h e r c h i l d s h o u l d go i n t o any o t h e r c h i l d ' s p l a y room.  23 It  was a l s o n o t uncommon f o r t h e c h i l d t o expect t o f i n d t h e room  the way he had l e f t i t t h r e e days, o r even a week p r e v i o u s l y . instance, consider  the f o l l o w i n g  For  conversation.  1.4 C:  Now look what they d i d .  T:  What d i d they do?  C:  They messed i t up.  T:  W e l l I ' l l t e l l you what N i c k , i t what you want, ( d e a l ) .  i t ' s your t u r n now and you can do w i t h  T h i s may have been one reason why t h e r a p i s t s would attempt t o remove obvious t r a c e s o f t h e former 'owner' when p r e p a r i n g F o r example, one c h i l d was a l l o w e d hour.  f o r a next s e s s i o n .  t o p a i n t on t h e w a l l s d u r i n g h e r  T h i s n e c e s s i t a t e d t h e immediate b r i n g i n g t o g e t h e r  o f other  i n t e r e s t e d p a r t i e s a t t h e end o f t h e s e s s i o n who would then view t h e p i c t u r e so i t c o u l d be washed o f f i n r e a d i n e s s one  occasion,  be p r e s e r v e d dismantled  f o r the next p a t i e n t .  a photographer was c a l l e d i n so t h a t the p r o d u c t i o n f o r the record.  On  could  S i m i l a r l y , t h e sand t r a y scenes would be  and t o y s would be r e p l a c e d i n the box.  A major c o n s i d e r a t i o n  in  removing t h e t r a c e s o f former occupants was t h a t the new p a t i e n t would  be  i n f l u e n c e d by t h e work o f t h e p r e v i o u s  c h i l d and thus f a i l  t o provide a  ' f r e e ' sampling o f h i s own p l a y . Some f e a t u r e s o f t h e p l a y room were p h y s i c a l l y r e c o n s t r u c t e d f o r each p l a y s e s s i o n .  Each t h e r a p i s t has a l a r g e t o y box which c o n t a i n s a  v a s t assortment o f s m a l l t o y s , e.g., a n i m a l s , human f i g u r e s , t r e e s , guns, cars, trucks, fences,  caps, b a l l o o n s , e t c .  p i s t ' s o f f i c e o r i n t h e p l a y room.  This i s stored i n the t h e r a -  This c o l l e c t i o n o f toys i s placed i n  the p l a y room p r i o r t o each s e s s i o n and the t o y s may o r may n o t be taken  24 out o f t h e i r box  before  the s e s s i o n b e g i n s .  items which can be moved from one  room t o the o t h e r .  sand t r a y s , a p a i n t i n g e a s e l , a m i n i a t u r e and  chair set.  There are a l s o s e v e r a l l a r g e  house, and  In a d d i t i o n t h e r e i s a s t o r a g e  These i n c l u d e a child-sized  two  table  room w i t h a l a r g e a s s o r t -  ment o f t o y s , i n c l u d i n g guns, r i f l e s , wagons, t r i c y c l e s , games, b a l l s , swords, s t u f f e d a n i m a l s , baby c a r r i a g e , d o l l s , models, p a i n t s , paper, crayons, t r a i n s , puppets, and  tools.  The  therapy s e s s i o n , w i l l a r r i v e e a r l y and p a r t i c u l a r p a t i e n t t h a t w i l l be  geared t o what we  may  'sampling' h i s p l a y .  seen.  T h i s s e l e c t i o n and  was  preparing  not open i t .  He  t o l d me  'normal c h i l d ' w i t h  the  f o r a newcomer p l a c e d h i s t o y box then arranged some paper and f a c i n g one  i n an age  or a ' p l a y e r ' , t h a t i s , the c h i l d was  One  therapist  i n the room but  did  L a t e r , the t h e r a p i s t  group i n which he  c o u l d be  a 'talker'  o l d enough t o be a b l e t o t a l k t o  o f the s i t u a t i o n , he might w e l l want t o With the t o y box  them.  a wide  c r a y o n s , and p l a c e d b o t h o f  another.  t h e r a p i s t w i t h o u t the medium o f the t o y s .  be  i n t e n t i o n of  T h i s means t h a t the t h e r a p i s t must p r o v i d e  t h a t the c h i l d was  with toys.  arrangement o f  seen f o r the f i r s t time the arrangement may  c a l l the  the c h a i r s a t a s a f e d i s t a n c e  the  preparation.  range o f o b j e c t s and note what the c h i l d does w i t h who  for a  arrange the room i n response t o  o b j e c t s has been r e f e r r e d t o as t h e r a p e u t i c I f the c h i l d i s b e i n g  therapist, i n preparation  However, because o f the  the  nature  ' r e g r e s s ' t o the s a f e t y o f p l a y i n g  c l o s e d , the c h o i c e would be. up t o  the  p a t i e n t r a t h e r than the t h e r a p i s t . When one hyperactive  was  c h i l d who  was  d e s c r i b e d as " p s y c h o t i c " and was  scheduled  t o use  the p l a y room, the t h e r a p i s t would remove  as many t h i n g s as p o s s i b l e from the room. " p e r s e v e r a t i o n " which was  reportedly  A symptom o f h e r p s y c h o s i s  d i s p l a y e d i n her i n a b i l i t y t o s t o p t a k i n g  was  things  25 from the t o y box i t was  u n t i l i t was  a l l gone, e t c .  completely  empty, o r t o pour sand out  In o r d e r t o manage t h i s  reduce the s t i m u l i t o a minimum.  Normally,  child,  until  the t h e r a p i s t would  however, t h e r e were a l a r g e  number o f t o y s i n the room. The  arrangement was  kept c o n s i s t e n t f o r each p a r t i c u l a r c h i l d  one week t o the next and he was work out  was  p r o v i d e d w i t h those r e s o u r c e s needed t o  ( i . e . , p l a y out) h i s problems.  t o go i n t o d e t a i l ,  from  Although  this  i s not the p l a c e  i t became e v i d e n t from the t h e r a p i s t ' s t a l k t h a t t h e r e  some supposed r e l a t i o n s h i p between 'toys' and  'problems'.  Some  33 examples o f the t h e r a p e u t i c s e l e c t i o n o f t o y s f o l l o w s . seen as h a v i n g "dependency needs", t h a t i s , a c h i l d who enough l o v e and a t t e n t i o n and was  still  striving  A c h i l d who  was  d i d not r e c e i v e  to s a t i s f y  those needs,  s h o u l d have access t o r e s o u r c e s t h a t a l l o w him t o " r e g r e s s " .  For  example, h i s p l a y room would i n c l u d e a baby b o t t l e f i l l e d w i t h water, d o l l s , mud,  etc.  A c h i l d who  was  assumed t o harbour a g r e a t d e a l o f  up anger would be g i v e n cap guns, swords, p u n c h i n g clowns, w i l d  (e.g., a s t u f f e d b e a r ) , puppets o f f i e r c e A c h i l d with a s p e c i f i c anxiety.  l o o k i n g animals,  pent  animals 34  darts, etc.  a n x i e t y w i l l be g i v e n t o y s r e l a t e d t o t h a t  F o r example, a c h i l d who  was  concerned  about a h o s p i t a l  visit  would be g i v e n the o p p o r t u n i t y t o p l a y w i t h m e d i c a l t o y s , a c h i l d w i t h a f e a r o f f l y i n g would be encouraged t o p l a y w i t h b a l l o o n s , t o y a i r p l a n e s , f e a t h e r s , e t c . , a c h i l d w i t h an apparent  s e x u a l m i s i d e n t i f i c a t i o n may  p e r m i t t e d t o p l a y w i t h l i p s t i c k , eyeshadow, bubble b a t h , e t c . , one  be  with  r e p r e s s e d f e e l i n g s about h i s p a r e n t s o r s i b l i n g would be g i v e n a d o l l f a m i l y , and  so on.  always as obvious fications  While the s e l e c t i o n o f a p p r o p r i a t e t o y s was as the examples g i v e n above, t h e r e were s i m i l a r  a v a i l a b l e which governed the s e l e c t i o n o f most  items.  not justi-  26 Because p l a y therapy  i s essentially a non-directive a c t i v i t y ,  these  t o y s were n o t g i v e n t o the p a t i e n t b u t were p l a c e d i n t h e room so t h a t they  c o u l d be used  (or avoided) as he wished.  An e x c e p t i o n  t o t h i s was  an o c c a s i o n on which a t h e r a p i s t had a c q u i r e d a new t o y (padded c l u b s ) and urged t h e p a t i e n t t o use them f o r two s e s s i o n s . Before o f t h e therapy  c o n c l u d i n g t h i s b r i e f d e s c r i p t i o n o f t h e s i g h t s and sounds s e t t i n g I w i l l g i v e the r e a d e r  p l a c e d u r i n g the therapy  hour i t s e l f .  some sense o f what  As e x p l a i n e d e a r l i e r ,  takes  the t h e r a p i s t  t y p i c a l l y arranges t h e room p r i o r t o t h e p a t i e n t ' s a r r i v a l and, a t t h e appointed  time, e i t h e r c o l l e c t s t h e c h i l d from h i s c l a s s r o o m  be n o t i f i e d o f h i s a r r i v a l .  or waits t o  There i s o f t e n a d i s p l a y o f p l e a s u r e , by t h e  t h e r a p i s t , on s e e i n g the c h i l d a g a i n .  To t h e o b s e r v e r  g r e e t i n g s were o f a form t h a t one would n o r m a l l y  some o f these  expect e i t h e r from p a r t i e s  who had met a c c i d e n t a l l y o r from p e o p l e who had met a f t e r a l o n g absence from each o t h e r . by  F o r example, t h e t h e r a p i s t would o f t e n g r e e t t h e p a t i e n t  c a l l i n g o u t h i s f i r s t and l a s t names i n a l o u d , exaggerated v o i c e .  A f t e r a g r e e t i n g the p a i r would u s u a l l y go t o t h e p l a y room, however, sometimes t h e r e were o t h e r a c t i v i t i e s t h a t had t o be taken care o f f i r s t . F o r example, t h e t h e r a p i s t might have t o a t t e n d t o some b u s i n e s s . t h a t was not r e l a t e d t o t h e p a t i e n t whom he was s e e i n g . telephone  He might have t o make a  c a l l o f drop something o f f a t t h e o f f i c e .  In t h e l a t t e r  case,  the c h i l d would o f t e n go w i t h t h e t h e r a p i s t t o t h e o f f i c e and then r e t u r n w i t h him t o t h e p l a y room. The  t h e r a p i s t ' s o f f i c e was g i v e n a s p e c i a l accent by b o t h t h e  t h e r a p i s t and p a t i e n t although  i t was n o t used f o r p l a y t h e r a p y .  On one  o c c a s i o n a c h i l d brought a f l o w e r f o r t h e t h e r a p i s t and they went t o h i s o f f i c e t o p l a c e i t i n a vase.  The o f f i c e was a l s o used as a p l a c e t o  27 d i s p l a y some o f t h e p r o d u c t i o n s and  each o f f i c e c o n t a i n e d  wall.  t h a t c h i l d r e n had c r e a t e d  during  therapy,  a t l e a s t one o f the c h i l d r e n ' s p a i n t i n g s on t h e  The o f f i c e was a l s o used as a space t o s t o r e some o f the t o y s  a p a t i e n t wants t o t r e a t as h i s own, s p e c i a l p r o p e r t y .  Since  that  a l l o f the  p a t i e n t s use t h e same t o y s and t h e r u l e s do n o t a l l o w a c h i l d t o take anything  home, t h e t h e r a p i s t would o f t e n agree t o p u t c e r t a i n t o y s  a cupboard u n t i l the next  away i n  session.  Even though t h e d e t a i l s o f t h e p l a y room have been arranged i n advance, some t h e r a p i s t s would a l l o w p a t i e n t s t o s e l e c t t h e i r own t o y s the t o y s t o r a g e  room.  T h i s was a d e v i c e  f o r gathering  information  from  about  the p a t i e n t . • That i s , the c h i l d ' s s e l e c t i o n o f t o y s was an i n d e x o f h i s f e e l i n g s , problems, needs, e t c . a p a r t i c u l a r model t o g e t h e r he  repeatedly  during  s e l e c t e d a dinosaur,  F o r example, one p a t i e n t enjoyed p u t t i n g the session.  I t was s i g n i f i c a n t  that  t h e r e b y d e m o n s t r a t i n g t h e need o f an  i n h i b i t e d , good c h i l d t o be v i o l e n t , angry, monstrous, e t c . i t was a l s o u s e f u l t o see what t o y s the p a t i e n t a v o i d e d .  Conversely, This s e l e c t i n g  time was n o t seen as p a r t o f the t h e r a p y hour, b u t was r e g a r d e d as a p r e session a c t i v i t y .  One t h e r a p i s t became concerned w i t h t h e i n c r e a s i n g  amount o f time t h a t a p a r t i c u l a r p a t i e n t took t o make h i s s e l e c t i o n . Each week he took l o n g e r  and- l o n g e r .  "shopping" and e x p l a i n e d  t h a t the l e n g t h e n i n g  a device  f o r avoiding  the play session  The t h e r a p i s t r e f e r r e d t o i t as o f t h e "shopping time" was  itself.  Upon e n t e r i n g t h e p l a y room, t h e t h e r a p i s t c l o s e s the door and s i t s down.  The t h e r a p i s t spends t h e m a j o r i t y  o f h i s time i n t h e p l a y room  s i t t i n g i n a c h i l d ' s c h a i r o r on a low bench. may be spent i n a c t i v i t i e s  Varying  l i k e mixing p a i n t s , reaching  amounts o f time things  from a h i g h  cupboard, p l a y i n g an a c t i o n game, o r i n managing an a c t i v e c h i l d .  Some  28 t h e r a p i s t s may  spend most o f the hour s i t t i n g i n the same l o c a t i o n ,  while  o t h e r s w i l l move about i n o r d e r t o s t a y r e l a t i v e l y c l o s e t o the p a t i e n t . The  t h e r a p i s t may  remain i n a c t i v e d u r i n g the hour or he may p a r t i c i p a t e  d i r e c t l y i n some o f the p l a y a c t i v i t y , e.g., a cap gun  f i g h t , take command o f a regiment o f s o l d i e r s , o r move some o f  the t o y s about. nature.  he might engage i n a sword or  Sometimes h i s p a r t i c i p a t i o n w i l l be o f a more i n d i r e c t  He might a s s i s t the c h i l d i n h i s p l a y by m i x i n g p a i n t s , g e t t i n g  water, r e a d i n g i n s t r u c t i o n s f o r him,  winding up t r a i n s , f i x i n g guns, e t c .  Whatever the form o f p a r t i c i p a t i o n , the t h e r a p i s t t r i e s t o d i r e c t h i s a t t e n t i o n t o the p a t i e n t a t a l l t i m e s . The play.  c h i l d i s f r e e t o do whatever he wishes and  On  some o c c a s i o n s , however, he w i l l  the t h e r a p i s t i n s t e a d .  The  t y p i c a l l y e l e c t s to  " a v o i d " the t o y s and  p l a y a c t i v i t y may  talk  with  be the expected ones o f  p l a y i n g games, p l a y i n g w i t h d o l l s , b u i l d i n g i n the sand t r a y , drawing, p a i n t i n g , e t c . , o r may handcuffing  include undressing  the t h e r a p i s t and  l o c k i n g him  p i s t o l t o a t t a c k the t h e r a p i s t who exploding  two  and  c l i m b i n g i n t o the  sink,  i n the bathroom, u s i n g a water  i s t r y i n g t o get i n t o a r a i n c o a t ,  o r t h r e e r o l l s o f caps a t a time, throwing a p u n c h i n g clown  a g a i n s t the w a l l s , p a i n t i n g on the w a l l s , throwing d a r t s a t a drawing o f h i s teacher,  etc.  Although the p l a y s e s s i o n s were u s u a l l y c o n f i n e d  the p l a y room, i t was  not uncommon f o r the t h e r a p i s t and p a t i e n t to  to go  o u t s i d e f o r a swim, t o p l a y i n the gymnasium, t o p l a y on the t r a m p o l i n e ,  or  t o go t o the p a r k . The p l a y sequence may a model, i t may  c o n s i s t o f a s i n g l e a c t i v i t y such as b u i l d i n g  c o n s i s t o f many p l a y a c t i v i t i e s ,  d a r t s , b u i l d i n g i n the sand, o r i t may  such as drawing, p l a y i n g  c o n s i s t o f one  a c t i v i t i e s broken by p e r i o d s o f c o n v e r s a t i o n .  o r more p l a y  In more or l e s s v e r b a l  29 s e s s i o n s , the t a l k may  be connected t o the p l a y or i t may  focus upon o t h e r  concerns. The  therapy  be  shortened  to  engage i n any  s e s s i o n s were scheduled  i f the p a t i e n t was  without  anxious t o go and  f u r t h e r p l a y or t a l k .  hour i f the c h i l d was exception  too  'worked up'  of the hour and  This helped  encouraged him  would sometimes t e r m i n a t e in  t o the time and,  encouraged  the p a t i e n t how  to f i n i s h h i s play.  end  many minutes were termination  F u r t h e r , the t h e r a p i s t  an a c t i v i t y which he d i d not f e e l was  worthwhile  o r d e r t o move on t o something e l s e .  have seen, p l a y i s indeed  t h a t these  invokes  the i d e a o f p l a y i n g and,  a c e n t r a l focus here,  one  s e s s i o n s produced a minimum o f c o n v e r s a t i o n  h i m s e l f " i n and over the course  case.  Instead,  of h i s play.  the hour almost i n v a r i a b l y had  a c t i v i t y and  often  talking.  Much o f t h i s t a l k was  "talked  However, t h i s was  not  the appearance o f a  v e r s a t i o n ' w i t h the p a r t i c i p a n t s t a k i n g r e g u l a r and  o r i e n t e d t o the p l a y a c t i v i t y .  months.  The  o f a treatment program which had  p a r t i c i p a n t s had  s e a r c h i n g f o r a key  f o r a toy  j u s t returned  The was  lasted for several  to the p l a y room a f t e r  train.  1.5 1.  C:  It i s , ( ) I ' l l j u s t put my ( ) i n t h e r e and f o r g e t i t , i f I f o r g e t i t you can always remind me.  2.  T:  Mmhhmmm, okay.  I might  ((2.0)) Oh Dana", I ' l l // t e l l you what.  the  'con-  o r d e r l y turns at  f o l l o w i n g t r a n s c r i p t s were taken from a s e s s i o n w i t h a p a t i e n t who approaching the end  as  might w e l l assume  i n c l u d e d l o n g p e r i o d s o f s i l e n c e or p e r i o d s where the c h i l d simply to  the  Almost  towards the  t o p r e p a r e the c h i l d f o r the  S i n c e the term " p l a y t h e r a p y " we  c o u l d not be  could  o r r e f u s e d t o stop p l a y i n g .  the t h e r a p i s t attended  i n the hour.  hour but  A s e s s i o n c o u l d a l s o run over  o f a s e s s i o n he would f r e q u e n t l y t e l l left  t o l a s t f o r one  30 3.  C:  (  ) g e t i t r i g h t away and then I ' l l save i t , f o r a f t e r .  ( ( s t a r t s o u t the door)) 4.  T:  W e l l , I ' l l t e l l you, w e ' l l , w e ' l l g e t i t l a t e r okay.  5.  C:  Unn.  6.  T:  Dana.  7. 8.  C: T:  ( Yea.  9.  C:  Anyways I don't know how much money I've g o t i n here.  10.  T:  Yea. We've got, o n l y , ( ( c l o s e s door)) about e i g h t minutes l e f t , so you can go a f t e r t h e s e s s i o n and g e t i t , okay.  11.  C:  F i v e , oh, oh.  12.  T:  Yea, h e r e ' s one t h a t ' s a l l i n t a c t .  ((annoyed))  ) r i g h t away.  ((12.0))  Huh. ( ( r e f e r r i n g t o t h e new t r a i n  t h a t has been brought back t o t h e playroom)) 13.  C:  No I don't have 16 e i t h e r .  I don't even have 16 c e n t s .  14.  T:  What do you have?  15.  C:  15.  16.  T:  15?  41.  C:  Hey, something came o f f , o f the e x t r a t r a i n . Oh i t came o f f t h e back t h i n g , t h e b l u e t h i n g . The wheels a r e s t i l l on i t , s t i l l on t h e b l u e t h i n g .  42.  T:  You have another c a r here t o o .  43.  C:  I know. ((4.0)) Oh d r a t , the r e d t h i n g and t h e b l u e t h i n g have one on i t . ( ) missing.  44.  T:  I ' l l t e l l you something about t h a t Dana, you have t o be q u i t e g e n t l e w i t h i t o r the hooks come o f f .  45.  C:  They do?  46.  T:  Quite e a s i l y , yea.  W e l l t h a t ' s j u s t what you need i s n ' t i t .  ((2.0))  That's one t h i n g t h a t you have t o t r y  and be q u i t e p a t i e n t w i t h o r i t doesn't work. 47.  C:  (  48.  T:  Right.  ) b u t i t came o f f .  don't  31 49.  C:  (  )  50.  T:  Do you know why  51.  C:  Nope.  52.  T:  Have any i d e a why i t came o f f ? ((2.0)) W e l l , I t h i n k i t was because you had t o r e a l l y be i n such a h u r r y t o g e t i t out o f the box.  53.  C:  Ahhh.  54.  T:  Hmmm?  55.  C:  T h a t ' s not why  56.  T:  You  57.  C:  Nope.  58.  T:  I think  59.  C:  I don't.  60.  T:  Mmrnmhmm  61.  C:  Hey  62.  T:  Well  i t came o f f ?  ((scoff))  don't t h i n k  i t came o f f . so?  so.  ((+))  // f i r s t o f a l l i t ' s not made v e r y w e l l but,  s e c o n d l y when  t h i n g s a r e n ' t made v e r y w e l l I guess you have t o be more c a r e f u l . ((7.0)) I t h i n k sometimes we k i n d o f wreck t h i n g s f o r o u r s e l v e s a t times. 63.  C:  (  64.  T:  D i d you g e t i t ?  65.  C:  Yep.  66.  T:  Good f o r you.  67.  C:  1 fixed i t .  81.  C:  Oh, oh, now t h i s t h i n g s t h i n g come o f f . I d i d n ' t even f o o l around rough w i t h i t .  82.  T:  No, okay. ((1.5)) So sometimes t h i n g s break j u s t because t h e y ' r e not made v e r y s t u r d y , not v e r y s t r o n g , and o t h e r times I t h i n k t h i n g s get broken because we handle them r o u g h l y because we're i n such a h u r r y t o g e t them g o i n g .  ) now  I got the t h i n g back  Good f o r  you.  ((As the s e s s i o n ends the p a t i e n t s t a r t s the box))  The  red things.  "throwing" the t r a i n back  And  into  32 91.  T:  R e a l l y f e e l i n g k i n d o f mad a t those t h i n g s huh.  92.  C:  Yea e s p e c i a l l y f o r b r e a k i n g .  93.  T:  Okay, maybe k i n d o f mad a t me t o o , f o r , s a y i n g i t had something t o do w i t h what you were d o i n g .  94.  C:  I'm n o t mad a t you.  95.  T:  No.  96.  C:  I f I am mad a t you I'm mostly mad a t t h e t r a i n s .  97.  T:  irmhnunm  98.  C:  (  99.  T:  Yep, you can go and g e t the pop now.  (+) ) can o f pop.  On another o c c a s i o n ,  the t h e r a p i s t t r i e d t o t u r n t h e p l a y  i n t o d a t a by e n c o u r a g i n g the p a t i e n t t o e l a b o r a t e the  on h e r a c t i v i t y .  In  f o l l o w i n g case the c h i l d had j u s t f i n i s h e d p a i n t i n g and the t a l k i s  b u i l t around t h a t o b j e c t .  The t h e r a p i s t r e g a r d e d t h i s p a t i e n t as a  s p e c i a l case because o f the s e r i o u s n e s s had  activity  o f h e r problem.  A t one p o i n t he  s a i d t h a t t h e r e was the s t r o n g p o s s i b i l i t y t h a t the p a t i e n t might be  psychotic. 1.6 1.  T:  I wanted t o s i t down.  ( ( p u l l e d up a c h a i r ) )  2.  C:  I don't know.  3.  T:  mmm  4.  C:  I dont' know.  5.  T:  You don't know who / I s i t a man o r a l a d y ?  6.  C:  A monster.  7.  T:  That's a monster.  8.  C:  He's f a l l i n g down.  9.  T:  He's f a l l i n g down.  /  Who i s t h a t ?  33 10.  C:  He has no wings.  11.  T:  No  wings.  Was he t r y i n g , what's he d o i n g up t h e r e i n t h e sky?  Is t h a t , i s t h a t t h e sky up t h e r e ? 12.  C:  He f a l l down and i t s r a i n i n g .  13.  T:  And i t s r a i n i n g .  14.  C:  Yes, poor monster.  15.  T:  Poor monster.  16.  C:  Yes.  17.  T:  He's f a l l e n down and i t ' s r a i n i n g on the monster.  18.  C:  Yes.  19.  T:  What k i n d s o f t h i n g s d i d the monster do?  20.  C:  He s a i d  21.  T:  He s a i d go away r a i n .  22.  C:  Yes, and, and, and he, and he, r a i n e d a l l day a l l n i g h t .  23.  T:  inmhmm, so the monster s a i d go away r a i n b u t the r a i n j u s t k e p t  (  So bad t h i n g s a r e happening t o the monster.  like  that).  on coming down, huh. 24.  C:  Yes.  ((pause))  And, and, t h e r e a moon.  25.  T:  A moon.  26.  C:  I t s dark.  27.  T:  And i t s dark o u t s i d e .  28.  C:  Yes.  29.  T:  And t h e r e i s no sunshine.  30.  C:  NO.  31.  T:  So i t s dark n i g h t and i t s r a i n i n g .  32.  C:  Yes.  33.  T:  And the monster i s f a l l i n g down.  34.  C:  And, and t h e r e i s a thunder storm.  35.  T:  Thunder.  34 36.  C:  Yes.  37.  T: Wowww.  38.  C: On h i s , on h i s  39.  T: On h i s f o o t .  40.  C: Yaa,  41.  T: Ouch, ouch, ouch.  42.  C: Yes. (  foot.  and he says ouch, ouch, ouch, l i k e  In o t h e r  )  cases,  we can hear t h a t the t h e r a p i s t i s t r y i n g t o get  c h i l d t o t a l k about h i s f e e l i n g s . therapy f o r a long time and was have a r e l a p s e .  that.  The  about t o be d i s c h a r g e d  Here, the c h i l d has  been 'mock h i t t i n g '  f o l l o w i n g p a t i e n t had  the  been i n p l a y  when he appeared t o  a p a i r of boxing gloves  on and  has  the t h e r a p i s t .  I. 7 1.  T: Yep. Ah, would you l i k e t o pop me one i n the nose w i t h those. (Hitting yourself?) ((pause)) You must be f e e l i n g p r e t t y a w f u l hmm? ((pause)) F e e l i n g k i n d o f angry a t y o u r s e l f f o r / /  2.  C: Watch t h i s .  3.  T: F o r d i s a p p o i n t i n g Mum.  4.  C: ouch,  5.  T: Don't you?  6.  C: Unnhnn  7.  T: Angry a t y o u r s e l f f o r , cause you  8.  C: Nope.  9.  T: Or t h a t you're  uunhnn  (-) I don't do t h a t .  .'(-)  10.  C: Nope.  II.  T: Or mental?  12.  C: Nope.  13.  T: mmm?  retarded?  t h i n k you're  stupid?  35 14.  C:  Nope.  15.  T:  I t h i n k so.  16.  C:  Guess what?  17.  T:  What?  18.  C:  (  19.  T:  I t h i n k , I t h i n k you're j u s t a r e a l l y f i n e  ((pause))  W e l l Tim,  ) fellow.  T a l k i s f r e q u e n t l y b u i l t around t h e t o p i c o f "what k i n d o f room t h e p l a y room i s " , w i t h numerous comparisons t o t h e home o r c l a s s r o o m . Consider  the f o l l o w i n g three  examples.  I. 8 1.  T:  You know // what?  2.  C:  ( . . . terrible )  3.  T:  John.  4.  C:  mmm  5.  T:  I want t o t a l k  6.  C:  (What?)  7.  T:  8.  C: Yea.  9.  T:  ((tone o f r e c o g n i t i o n ) ) t o you f o r a s e c .  Sometimes we can have these k i n d s o f e x p l o s i o n s p l a y room, hey?  When t h e r e  here i n t h e  i s flames come o u t o f t h e caps and s t u f f ,  10.  C: Yea.  II.  T:  12.  C: Yea.  13.  T:  And we don't want a l l . . . . .  T:  Hmmm.  But, t h e p l a y room i s a d i f f e r e n t  from home i s n ' t i t ?  1.9 1. 2.  C:  ((pause))  No I don't swear.  Sometimes I b e t y o u even swear.  36 3.  T:  Hmm? You know, one p l a c e where i t i s r e a l l y good t o swear i s r i g h t here i n the p l a y room.  4.  C:  I know.  5.  T: That's r i g h t . things, r i g h t  6.  C:  (  7.  T:  Hmm?  ((pause))  Why y o u can even s a y f u c k and a l l t h o s e  here.  you want t o ((pause))  the d a r t s  )  A t home though I t h i n k i t sometimes bugs Mom  i f you swear. 8.  C:  (Watch t h i s )  9.  T:  Oh wow.  10.  C: Watch t h i s .  11.  T:  ((throwing a b a l l  around))  I missed i t .  12.  C:  (  13.  T:  14.  C:  Yep r i g h t here i n the o l d p l a y room, t h a t ' s a good p l a c e t o , l e t i t a l l out. You can swear ( ( l o u d n o i s e ) ) y e l l , and a l l those t h i n g s . ((pause)) Wowee. The k i c k o f f .  )  15.  T:  But r e a l l y though, Mum sometimes g e t up t i g h t when k i d s swear a t home. But i f you swore i n the p l a y room you know I wouldn't even be shocked. You know t h a t ?  16.  C:  ( ( s l i g h t laugh))  17.  T:  Whoops.  Heyy, beauty, beauty  18.  C:  ((slight  laugh))  19.  T:  I t h i n k you'd l i k e t o take t h a t b a l l and heave i t as h a r d as you c o u l d . ((pause)) Good one.  20.  C:  Ahhh  21.  T:  Ohhhh. F o r a minute I thought you were g o i n g t o wear t h e garbage can. ((pause)) Go man go. Wow.  Come back h e r e . shot.  as f a r and  37 I. 10 T h i s t r a n s c r i p t i n v o l v e d t h e same p a r t i c i p a n t s as t r a n s c r i p t 1.5 and i s from the "next" therapy s e s s i o n , o c c u r r i n g a t what the r e s e a r c h e r h e a r d as the e a r l i e s t o p p o r t u n i t y f o r the t h e r a p i s t t o g e t i t i n . 1.  T: You know Dana,  ((an i n t e r e s t i n g tone o f v o i c e ) )  2.  C: What?  3.  T: I was r e a l l y t h i n k i n g about the l a s t time you were h e r e , and I t h i n k I must have been sounding l i k e a, a naggy o l d , Mom o r Dad.  4.  C: Unnhnn  (-)  5.  T: Huh?  6.  C: Unnhnn  7.  T: I t h i n k so.  8.  C: You weren't.  9.  T: I was t h i n k i n g  (-)  that  10.  C:  (noise)  II.  T: t h a t I wasn't r e a l l y b e i n g  12.  C:  13.  T: mmmhmm  14.  C:  15.  T: F o r a l o n g time Dana I have been t e l l i n g you t h a t you s h o u l d be a b l e t o do t h i n g s you want t o do i n t h e p l a y room,  16.  C:  17.  T: -and I've been t e l l i n g you t h a t i t ' s okay t o g e t angry, and s t u f f l i k e that.  18.  C:  19.  T: W e l l and then l a s t week when you came and you wanted t o do some t h i n g s , t h a t you r e a l l y wanted t o do and I s a i d you c o u l d n ' t do them. Do you remember? ((2.0)) L i k e you wanted t o g e t some pop, k i n d o f e a r l y i n t h e day.  20.  C: mmhmm  (  (  q u i t e f a i r t o you.  two men . . . tanks . . .  )  (+) )  //  v  I know.  I know.  (+)  These p a r t i c u l a r samples o f therapy t a l k have n o t been s e l e c t e d t o  38 demonstrate any p a r t i c u l a r p o i n t s , b u t a r e o f f e r e d as examples o f t y p i c a l therapy hours.  T h i s chapter  has p r e s e n t e d  some o f t h e o b s e r v a t i o n s  'anyone' who p l a c e d h i m s e l f w i t h i n t h e s e t t i n g f o r a r e a s o n a b l e time c o u l d have made.  The m a t e r i a l s i n t h i s chapter  o f t h e i r t y p i c a l i t y and a r e i n t e n d e d  that  length o f  were s e l e c t e d because  as d e s c r i p t i o n s o f t h e work t h a t i s  done i n a p a r t i c u l a r s e c t i o n o f t h e c e n t r e . Although I had embarked upon my r e s e a r c h a t t h e c l i n i c w i t h some uncertainty,  I was s u r p r i s e d t o f i n d t h a t I c o u l d e a s i l y see t h e r e a s o n a b l e -  ness o f the a c t i v i t i e s t h a t went on t h e r e .  That i s , they made sense t o me.  L a t e r , t h i s was f o l l o w e d by a l e n g t h y p e r i o d d u r i n g which I doubted t h e r e a s o n a b l e n e s s o f my o b s e r v a t i o n s .  The former i m p r e s s i o n  was t h a t t h e  happenings t h a t went on i n t h i s s e t t i n g would have made sense t o anyone ( i . e . , whether they were o r were n o t members o f the s e t t i n g ) .  As l a y  members, we may assume t h a t some o f t h e a c t i v i t i e s r e p o r t e d would (or could) have been done i n o t h e r ways, b u t I would suggest t h a t any competent c u l t u r a l member would have no problem i n s e e i n g t h e r e a s o n a b l e n e s s o f these activities. ing  By s a y i n g the s e t t i n g would make sense t o anyone, I am p o i n t -  t o t h e common-sensical o r g a n i z a t i o n o f t h e s e t t i n g , e.g., t o the use  o f p l a y , t o the g r e e t i n g s t r u c t u r e s , t o t h e f a m i l y i n t e r m e d i a r i e s , e t c .  I  would l i k e t o p o i n t as w e l l t o the apparent v i s i b i l i t y o f the p a t i e n t ' s motives, t o the awareness o f t h e c h i l d as a d e v e l o p i n g  being,  t o the  common sense procedure o f g e t t i n g c h i l d r e n t o t e l l  s t o r i e s , t o the o v e r a l l  reasonableness o f the t h e r a p i s t - p a t i e n t t a l k , e t c .  While we may wonder  how t h e r a p i s t s a r e a b l e t o account f o r t h i s t a l k as t h e r a p e u t i c , we do n o t doubt t h a t i t i s an adequate and a p p r o p r i a t e way t o t a l k t o c h i l d r e n . While we may know l i t t l e  about psychotherapy, we a r e a b l e t o p r o v i d e  adequate m o t i v a t i o n a l accounts f o r why t h e s e t t i n g appears t h e way i t does,  39 o f what the t h e r a p i s t i s t r y i n g t o do i n the p l a y a c t i v i t y , o f the t i o n o f t o y s , and so on and so f o r t h . "adequate" accounts  We  selec-  can a l s o p r o v i d e adequate  (and  always means a d e q u a t e - f o r - a l l - p r a c t i c a l - p u r p o s e s ) m o t i v a t i o n a l  f o r what the p a r t i c i p a n t s are d o i n g .  That i s n o t t o say t h a t  we  would a l l agree on these m a t t e r s , however, because we  are competent members  of  As members, we  the s o c i e t y , we  can produce  c o n s t a n t l y p r o v i d e accounts  reasonable accounts.  f o r . a l l k i n d s o f a c t o r s and a c t i o n s i n the  spontaneous and r o u t i n e p u r s u i t o f our d a i l y I f we  affairs.  a t t e n d t o the c a u t i o n a r y remarks g i v e n a t the b e g i n n i n g o f the  c h a p t e r , i . e . , those c o n c e r n i n g the " d i f f i c u l t i s s u e s and t e c h n i c a l lems" which are t o be expected i n working w i t h c h i l d r e n , we  prob-  could  now  argue t h a t these are not a c t u a l problems and suggest i n s t e a d t h a t  our  o r d i n a r y and uninformed  u n d e r s t a n d i n g o f what i s g o i n g on here i s s u f f i c -  i e n t f o r a l l i n t e n t s and purposes. of  this  I found myself a s s a i l e d by q u e s t i o n s  nature. While  these o b s e r v a t i o n s appear t o be r e a s o n a b l e , we must remember  t h a t these o c c a s i o n e d i m p r e s s i o n s r e p r e s e n t something be and i s r e f e r r e d t o as "therapy" o r "treatment".  t h a t i s supposed t o F o r the a d u l t s o f  t h i s s e t t i n g , the o c c a s i o n s c i t e d above are not s i m p l y an o p p o r t u n i t y t o meet and talk, t o c h i l d r e n , r a t h e r , they are supposed t o add up t o making disturbed children better.  Our o b s e r v a t i o n s s h o u l d be g i v e n an o r g a n i z a -  t i o n a l r e l e v a n c e — t h a t i s , they s h o u l d be j u s t i f i a b l e i n terms o f the o r g a n i z a t i o n a l g o a l o f therapy. accounts, we relevant.  While we  c o u l d p r o v i d e many adequate  must wonder whether o r not they would be While we  psychiatrically  can make sense o f the o b s e r v a t i o n s , what sense do  members o f the s e t t i n g g i v e t o them? they a t t r i b u t e m o t i v a t i o n s ?  What do they see g o i n g on?  How  the do  In s h o r t , what i s the r a t i o n a l e which makes  40 these s i g h t s and sounds p s y c h i a t r i c a l l y r e l e v a n t ? get beyond the immediate sense o f r e a s o n a b l e n e s s  F u r t h e r , how can we t o occasioned  reason-  ableness? I doubted t h a t t h e r e would, o r s h o u l d , be a correspondence my accounts  and those o f the t h e r a p i s t .  between  E s s e n t i a l l y , I f e l t t h a t any  sense t h a t I c o u l d make o u t o f the s i t u a t i o n was n o t t h e same sense t h a t the t h e r a p i s t was making b u t was i n s t e a d r o o t e d i n my own i n a d e q u a c i e s . The  themes o f 'reasonableness'  and 'doubt' were r e c u r r i n g ones f o r  me d u r i n g the a c t u a l f i e l d work and d u r i n g the numerous times when I s a t down and t r i e d t o make sense o u t o f t h e d a t a t h a t I had c o l l e c t e d . c o n t i n u e t o be e s s e n t i a l f o r t h e remainder  of this  They .  paper.  These two themes p r o v i d e d me w i t h my i n i t i a l problem.  While  I  had e n t e r e d t h e s e t t i n g t o s e a r c h f o r t h e p r o p e r t i e s o f a d u l t - c h i l d c o n v e r s a t i o n , I found I was spending the a c t i v i t i e s  a g r e a t d e a l o f time t h i n k i n g about  ( i n c l u d i n g t a l k ) . t h a t went on i n t h e s e t t i n g i t s e l f .  when t h i n k i n g about and d i s c u s s i n g t h e c o n v e r s a t i o n s , I found engaged i n c o n s t r u c t i n g the a c t o r s ' m o t i v a t i o n s .  Even  myself  My i n t e r e s t  then  s h i f t e d t o a concern w i t h how I was a b l e t o make sense o f t h e s e t t i n g , its to  a c t i v i t i e s and p a r t i c i p a n t s .  Because I doubted my i n i t i a l  make sense o f t h e a c t i v i t i e s , I attempted  ability  t o d i s c o v e r the r e a l  signif-  icance t o t a l k , events, e t c . In  summary, I have p r e s e n t e d c e r t a i n i m p r e s s i o n s o f a work s e t t i n g  which "any" o b s e r v e r might have made. to  p e r c e i v e the 'reasonableness'  I have a l s o emphasized o u r a b i l i t y  o f a c t i v i t i e s and events w i t h o u t  any s p e c i a l knowledge about t h e i r o r g a n i z a t i o n a l r e l e v a n c e . to  having  In an e f f o r t  d i s c o v e r the r e a l s i g n i f i c a n c e o f e v e n t s , we s h a l l now p r o c e e d t o  examine how the t h e r a p i s t s themselves  see these doings as something which  41 adds up t o 'therapy'.  I was a s s i s t e d i n t h i s u n d e r t a k i n g by the accounts  and e x p l a n a t i o n s o f f e r e d by the t h e r a p i s t s . f o u r we w i l l  look a t the o r g a n i z a t i o n a l  In c h a p t e r s two, t h r e e and  r a t i o n a l e as d i s c o v e r e d w i t h i n  the s e t t i n g and a t the corpus o f knowledge the t h e r a p i s t s employ i n the i n t e r p r e t i v e work o f making  sense.  42 Footnotes  ""This i n t e r e s t arose from a seminar w i t h Matthew S p e i e r . 2 H. G i n o t t . Group Psychotherapy w i t h C h i l d r e n . New York: McGrawH i l l , 1961, p. 125. 3 J . Schulman, J . C. Kaspar and P. Barger. The T h e r a p e u t i c D i a l o g u e . Springfield: C h a r l e s C. Thomas, 1964, p . 134. 4 M. R. Haworth. C h i l d Psychotherapy: P r a c t i c e and Theory. New York: B a s i c Books, 1964, p. 35. 5 . J . Anthony. "Communicating T h e r a p e u t i c a l l y w i t h the C h i l d " . Child P s y c h i a t r y , 3 (1964), p . 115. 6 F o r an example o f t h i s ' l o c a t i o n ' o f the l i t e r a t u r e , examine t h e following bibliographies: U n i t e d S t a t e s Department o f H e a l t h , E d u c a t i o n and W e l f a r e , Research i n I n d i v i d u a l Psychotherapy: A B i b l i o g r a p h y , 1969; and E. D. D r i v e r , The S o c i o l o g y and Anthropology o f Mental I l l n e s s : A Reference Guide, U n i v e r s i t y o f Massachusetts P r e s s , 1965. The l a t t e r p i e c e , a l t h o u g h i t i s supposed t o be a comprehensive survey, c o n t a i n s o n l y one r e f e r e n c e t o c h i l d r e n . 7 See p a r t i c u l a r l y Dibs i n Search o f S e l f , Boston: Houghton M i f f l i n , 1964. 8 See C h i l d h o o d and S o c i e t y , New York: Norton, 1950; o r " S t u d i e s i n the I n t e r p r e t a t i o n o f Play",. G e n e t i c P s y c h o l o g y Monograph, 22 (1940), 557-671. 9 See C h i l d r e n i n P l a y Therapy, New York: M c G r a w - H i l l , 1953; o r , E x i s t e n t i a l C h i l d Therapy, New York: B a s i c Boos, 1966. Op. c i t . ~""S. L. Werkman. "The P s y c h i a t r i c D i a g n o s t i c I n t e r v i e w w i t h C h i l d r e n " . American J o u r n a l o f O r t h o p s y c h i a t r y , 35 (1965), p . 767. 12  J . Schulman, e t a l . , Op. c i t . , p. 138.  13 H. G i n o t t , Op. c i t . , p. 176. E a r l i e r G i n o t t had s a i d , " t o a c o n s i d e r a b l e e x t e n t the c h i l d ' s p l a y i s h i s t a l k and t h e t o y s a r e h i s words." p. 51. 14 See f o r example, H. G i n o t t . " P l a y Therapy: The I n i t i a l S e s s i o n " , American J o u r n a l o f Psychotherapy, 15 (1961), 73-88. C h a r l e s W. M o r r i s , (ed.) Mind, S e l f and S o c i e t y . i t y o f Chicago P r e s s , 1934, pp. 135-226. 1 5  Chicago:  Univers-  43 1 6  " T h e Work o f L i t t l e C h i l d r e n " , New S o c i e t y ,  17 (1971) 12-14.  17 66-69.  "Child's Play:  Very S e r i o u s  Business",  Psychology Today, Dec. 1971,  18 V. A x l i n e , " P l a y Therapy Procedures and R e s u l t s " , American o f O r t h o p s y c h i a t r y , 25 (1955) p. 623. 19 J . Anthony, Op. c i t . , p. 108. 20 21  Journal  I b i d . , p. 109. S.L.  Werkman, Op. c i t . , p. 769.  22 H. G i n o t t .  Group Psychotherapy w i t h C h i l d r e n , p. 91.  23 H. G i n o t t . " P l a y Therapy: The I n i t i a l S e s s i o n " , American J o u r n a l o f Psychotherapy, 15 (1961), p. 74. 24 T y p i c a l l y , C h i l d Guidance C l i n i c s have a p s y c h i a t r i s t as d i r e c t o r , a number o f s o c i a l workers and a l e s s e r number o f p s y c h o l o g i s t s working under him. 25 D u r i n g the w r i t i n g o f t h i s r e p o r t t h e c h i l d r e n ' s s e r v i c e was i n f a c t d i s c o n t i n u e d and s t a f f members were d i s t r i b u t e d among o t h e r e x i s t i n g community s e r v i c e s . 26 The t h e r a p i s t had c o n t a c t e d me t o see i f I had made a t r a n s c r i p t o f the e a r l i e r s e s s i o n s i n c e he had n o t made notes a t the time. 27 I c o u l d f r e q u e n t l y w i t n e s s t h e i r a r r i v a l and overhear t h e i r convers a t i o n s through the open door o f the therapy room. 28 For a more thorough examination o f t h i s aspect o f e t h n o g r a p h i c s t u d i e s see G e r a l d Berreman, "Behind Many Masks: Ethnography and Impress i o n Management i n a Himalayan V i l l a g e " , S o c i e t y f o r A p p l i e d A n t h r o p o l o g y, #4, 1962. 29 In a d d i t i o n t o a d m i n i s t r a t i v e d u t i e s , t h e d i r e c t o r had a few r e g u l a r p a t i e n t s and saw o t h e r s on a c o n s u l t a t i v e b a s i s . 30 Those who take the i n t e n t i o n a l p e r m i s s i v e n e s s o f the s e t t i n g v e r y s e r i o u s l y argue t h a t c h i l d r e n s h o u l d have t h e freedom t o r e f u s e t h e r a p y . 31 A t h e r a p i s t r e p o r t e d the f o l l o w i n g e p i s o d e . Due t o some unusual c i r c u m s t a n c e , he had t o d r i v e a p a t i e n t home a f t e r t h e r a p y . A t the p a t i e n t ' s house they met some o f the neighborhood c h i l d r e n and the p a t i e n t i n t r o d u c e d the t h e r a p i s t as h i s 'teacher'. 32 The d i r e c t o r has a s u f f i c i e n t l y l a r g e o f f i c e t o enable him t o use i t as a p l a y room. "  44 The examples t h a t f o l l o w are from f i e l d n o t e s . . An e l a b o r a t i o n o f t h i s may be found i n H. G i n o t t , "A r a t i o n a l e f o r s e l e c t i n g t o y s i n p l a y t h e r a p y " , J o u r n a l o f C o n s u l t i n g Psychology, 24 (1960) 243-246. 34 'Aggression' and 'dependency' were the two c e n t r a l e m o t i o n a l s t a t e s ascribed to p a t i e n t s . They were t y p i c a l l y r e f e r r e d t o as a u n i t , i . e . , one g e t s 'angry' because o f unmet 'dependency' needs.  CHAPTER 2 THE  PSYCHIATRIC INTERPRETIVE SCHEMA  Although the scenes p o r t r a y e d i n Chapter 1 appeared  eminently  r e a s o n a b l e and obvious they c o u l d n o t remain so f o r me as a s o c i o l o g i s t . T h i s was n o t simply a 'play' s e s s i o n , for  t h e purpose  ' d i s t u r b e d ' c h i l d r e n were p r e s e n t  o f becoming ' b e t t e r ' , and the a d u l t s were p e r f o r m i n g a  t a s k r e f e r r e d t o as therapy.  F o r them t h e r a p y was work—work  c o n s i d e r a b l e s k i l l and t r a i n i n g .  requiring  In s h o r t , I took i t t h a t t h e r e was some  o r g a n i z a t i o n a l s i g n i f i c a n c e t o those s i g h t s and sounds.  As a s o c i a l  s c i e n t i s t I f e l t o b l i g a t e d t o r e j e c t t h e r e a s o n a b l e n e s s o f my f i r s t ing  view-  and s e a r c h f o r something b e h i n d the scenes t h a t would make them  eventful.  I d i d n o t know what my s e a r c h was f o r b u t I d i d f e e l I would  have t o d i s c o v e r how the t h e r a p i s t s made sense o f these scenes.  Although  I was a b l e t o a t t r i b u t e meaning t o what I saw, s u r e l y t h a t would n o t be the same meaning a p r o f e s s i o n a l t h e r a p i s t a t t r i b u t e d t o them.  That i s t o  say, I assumed t h a t t h e r e would be a p s y c h i a t r i c i n t e r p r e t i v e schema which would enable the t h e r a p i s t t o understand events i n another way. A g r e a t d e a l o f my time i n the f i e l d was spent s e a r c h i n g f o r the ways i n which t h e r a p i s t s managed t o make sense o u t o f t h i n g s t h a t I as a layman found t o be mundane and u n e v e n t f u l .  Most o f the m a t e r i a l t h a t I  g a t h e r e d was the r e s u l t o f my i n i t i a l e f f o r t s t o make m y s e l f a competent member o f the s e t t i n g r a t h e r than any d e l i b e r a t e e f f o r t t o uncover t h e p s y c h i a t r i c s i g n i f i c a n c e o f the s i t u a t i o n .  I found t h a t I c o u l d conduct  m y s e l f as a competent p a r t i c i p a n t by a s k i n g a p p r o p r i a t e q u e s t i o n s ,  46 o f f e r i n g adequate s o l u t i o n s , s e e i n g the r e l e v a n c e etc.  In s h o r t , I took i t t h a t I had  same way  as the t h e r a p i s t s saw  the c l i n i c ,  I was  them.  o f accounts g i v e n  begun t o see On  a c t i v i t i e s i n much the  the b a s i s o f my  experience  a b l e t o c o n s t r u c t a r a t i o n a l account and  defined i n t e r e s t i n occasioned chapter  t o show how  I was  d e p i c t e d i n Chapter 1. Not  accounts.  I t i s the i n t e n t i o n o f  l e t me  i n d i c a t e how  t a l k about the s e s s i o n s t h a t I w i t n e s s e d , and These c o n v e r s a t i o n s  t h i s was  this  those  possible.  often a party  about the c h i l d and  occurred  before  standardized  play with  o r a f t e r a therapy Not  c h i l d r e n on a r e g u l a r b a s i s have  ways o f t a l k i n g about t h e i r a c t i v i t i e s .  i n f o r m a l accounts o r e x p l a n a t i o n s  to  the  s e s s i o n , a t c o f f e e time, a t meetings, d u r i n g i n f o r m a l t a l k s , e t c . s u r p r i s i n g l y , p e o p l e who  recon-  l a t e r when I developed a more c l e a r l y  o n l y d i d I observe therapy s e s s i o n s , I was  problems i n v o l v e d .  The  a b l e t o make sense o f scenes such as First  at  d e s c r i p t i o n of  the s e t t i n g , s p e c i f i c a l l y o f the happenings i n the p l a y room. s t r u c t i o n of t h i s data occurred  me,  T h i s came out i n  o f the c h i l d r e n s ' b e h a v i o r  rather  than  i n our more formal d i s c u s s i o n s about p s y c h i a t r y , psychopathology, e t c . This provided  me  with  a way  observed, t h a t i s , I looked had  heard and  t o make sense o f the s e s s i o n s t h a t I  f o r the r e l a t i o n s h i p between the t a l k t h a t I  the events t h a t took p l a c e i n the therapy room.  Psychotherapy, l i k e o t h e r p r o f e s s i o n s o c c u p a t i o n s ) i s a theory-governed a c t i v i t y . " " t o and  had  embedded i n e x p l i c i t  t i o n s about human n a t u r e ,  ( i . e . , i n contrast to The  (and sometimes d i v e r s e )  the e t i o l o g y and  enterprise i s related f a c t s and/or assump-  development of d i s e a s e s ( i . e .  p r o b l e m s ) , p e r s o n a l i t y development, the source o r sources o f problem  47 solving, etc.  While most members o f the p r o f e s s i o n p a r t i c i p a t e i n t h e  a c t u a l d o i n g o f therapy alone, and  a handful  o f people devise,  elaborate  communicate t h e t h e o r e t i c a l s t r u c t u r e s o f t h e p r a c t i c e .  As I r e p o r t e d  e a r l i e r i n t h i s study, I embarked upon a study o f the r e l e v a n t during  t h e i n i t i a l p a r t o f my r e s e a r c h  t o pieces o f l i t e r a t u r e .  the r e l e v a n c e  I took i t t h a t one c o u l d , and s h o u l d , see  The r e l a t i o n between t h e two s h o u l d  t h e a c t u a l a c t i v i t y as an e x p r e s s i o n  theoretical  t o p a r t i c u l a r authors  o f t h i s l i t e r a t u r e t o t h e on-going, p r a c t i c a l a c t i v i t i e s a t  the s e t t i n g . "See  literature  a t t h e c l i n i c and, l a t e r , members  o f t h e s e t t i n g a f f o r d e d me w i t h f u r t h e r r e f e r e n c e s and  upon  r u n something l i k e  this:  o r document o f the p e r t i n e n t  materials".  On a few o c c a s i o n s  I was drawn i n t o d i s c u s s i o n about t h e d i f f e r e n c e s  between v a r i o u s models o f b e h a v i o r . o f t e n c o n t r a s t t h e i r methods w i t h ,  The t h e r a p i s t s t o whom I t a l k e d would f o r example, t h e work o f o t h e r  o f t h e c l i n i c who p r a c t i c e d b e h a v i o r a l m o d i f i c a t i o n .  members  I soon came t o  r e a l i z e t h a t t h e i r a c t i v i t i e s were governed by d i f f e r e n t s e t s o f t h e o r i e s . That i s , i t was n o t o n l y t h a t some members accomplished t h e i r therapy i n d i f f e r e n t ways b u t t h e r e was a fundamentally d i f f e r e n t t h e o r e t i c a l s t r u c t u r e which governed t h e i r a c t i o n s . to discover  On t h e o t h e r hand, a l t h o u g h I was a b l e  some d i f f e r e n c e s i n t h e ways i n which t h e t h e r a p i s t s w i t h whom  I was i n v o l v e d p r a c t i s e d p l a y t h e r a p y , I d i d n o t see any c o n t r a d i c t i o n s here.  Instead  I saw these d i f f e r e n c e s as d i f f e r e n c e s i n p e r s o n a l i t y o r  s t y l e r a t h e r than as i n d i c a t i o n s t h a t they s u b s c r i b e d  tod i f f e r e n t  t h e o r e t i c a l models. In t h i s c h a p t e r I w i l l . o c c a s i o n a l l y make r e f e r e n c e s ature.  T h i s can be seen as a f u r t h e r a s p e c t  of the r a t i o n a l i t y o f the s e t t i n g .  2  o f my s e a r c h  t o the l i t e r f o r an account  I found t h a t I was a b l e t o see t h e  48 a c t i v i t i e s a t the c l i n i c as a document o f the l i t e r a t u r e , and I f e l t i t was a p p r o p r i a t e  that  t o do so.  I sometimes noted d i s c r e p a n c i e s between what t h e r a p i s t s a c t u a l l y did  and what the l i t e r a t u r e c l a i m e d  t h a t they s h o u l d  do.  On one  occasion,  I t o l d a t h e r a p i s t t h a t something she d i d appeared t o be a c o n t r a d i c t i o n 3 o f what A x l i n e had w r i t t e n . the r e l e v a n c e not  She d i d n o t q u e s t i o n  the f a c t t h a t I saw  o f A x l i n e ' s work t o h e r a c t i v i t y , b u t e x p l a i n e d  agree w i t h the p o i n t i n q u e s t i o n .  (a) a c t u a l s e s s i o n s  o f p l a y therapy,  t h a t she d i d  As an o b s e r v e r , I had a c c e s s t o (b) t h e r a p i s t s remarks and d i s c u s -  s i o n s about these e v e n t s , and (c) t h e o r e t i c a l e x p l a n a t i o n s which resembled and seemed t o b e a r upon the s e s s i o n s  and accounts  that I witnessed.  I found t h a t the l a t t e r two a l l o w e d me t o make p s y c h i a t r i c sense o u t o f the  former, i . e . o u t o f the a c t u a l s e s s i o n s  that I witnessed.  T h i s c h a p t e r then i s a b r i e f r e p o r t on how I s t a r t e d w i t h my e x p e r i e n c e o f p l a y therapy and c o n s t r u c t e d  first  an account and d e s c r i p t i o n o f  the r a t i o n a l i t y o f the s e t t i n g and i t s a c t i v i t i e s . -  I was l o o k i n g f o r  the p s y c h i a t r i c s i g n i f i c a n c e o f happenings and I take my account and d e s c r i p t i o n t o be a v e r s i o n o f the p s y c h i a t r i c i n t e r p r e t i v e schema. s t a t u s o f t h i s schema i s u n c l e a r  The  s i n c e i t was never e x p l i c i t l y r e f e r r e d  t o i n the s e t t i n g nor t r e a t e d s y s t e m a t i c a l l y . ment based on member's t a l k , e t c .  Rather i t i s my  While I am s u g g e s t i n g  accomplish-  t h a t t o some  degree what I r e p o r t i s how t h e r a p i s t s make sense o f events I would n o t argue t h a t what I p r e s e n t  i s a l l they make o f the e p i s o d e s r e p o r t e d .  i s always p o s s i b l e t h a t t h e r a p i s t s w i l l  It  suggest t h a t they meant more than  what I understood. The  following m a t e r i a l i s organized  around a s e r i e s o f p u z z l e s  e x p e r i e n c e d as I f i r s t w i t n e s s e d p l a y t h e r a p y .  As I became more f a m i l i a r  49 w i t h the s e t t i n g these p u z z l e s were r e p l a c e d w i t h a " p s y c h i a t r i c  account"  which made e v e n t f u l what was p r e v i o u s l y u n e v e n t f u l . I w i l l b e g i n t o p r e s e n t t h i s i n t e r p r e t i v e schema l o o k i n g a t what I f i r s t e x p e r i e n c e d : the t h e r a p i s t watching,  ( r a t i o n a l e ) by  the p a t i e n t p l a y i n g w i t h t o y s and  p a r t i c i p a t i n g i n , commenting on t h a t p l a y .  The  f o l l o w i n g t r a n s c r i p t i s from a s e s s i o n w i t h a p a t i e n t I had been o b s e r v ing  f o r some time and who had been i n therapy f o r s e v e r a l months b e f o r e  I arrived.  He was p l a y i n g i n the sand t r a y w i t h some v e h i c l e s .  2.1 1.  T:  You know t h a t sometimes p e o p l e g e t stuck j u s t l i k e ,  t r a c t o r s and  trucks. 2.  C:  What do you mean by g e t s t u c k ?  3.  T:  W e l l , I t h i n k t h a t sometimes people have t h i n g s t h a t bug 'em, problems t h a t b o t h e r them/  4.  C:  Mmhmmm  5.  T:  and sometimes they g e t stuck w i t h them and they don't know how t o get o u t o f them, they don't know how t o stop d o i n g the t h i n g s that bother other people. ((pause))  9.  T:  But you know t h a t j u s t l i k e you can h e l p a t r a c t o r t o g e t unstuck t h a t ' s the way i t i s w i t h people sometimes t o o .  10.  C:  That wasn't t h e t r a c t o r t h a t was s t u c k .  19.  T:  Oh I see. ((pause)) So, sometimes p e o p l e can be h e l p e d t o g e t unstuck t o o so they know how t o cope w i t h t h e t h i n g s t h a t a r e , ( )//  (+)  50 20.  C:  I t h i n k I'm g o i n g t o r o l l my s l e e v e s up.  35.  T: imThinmm clinic?  36.  C:  mmmm  37.  T:  J u s t t o g e t o u t o f d o i n g work a t s c h o o l ?  38.  C:  mmhmmm (+)  39.  T:  Is t h a t what i t f e e l s l i k e t o you? Mmmm? ((pause)) Well, t h e r e are. some o t h e r reasons t h a t you come t o t h e c l i n i c t o o .  40.  C:  Why?  41.  T: W e l l because we k i n d o f t h i n k t h a t , y o u weren't f e e l i n g t o o happy inside yourself.  (+) ((pause))  ((pause))  John, why do you t h i n k you come t o the  J u s t t o g e t o u t o f d o i n g my work a t s c h o o l .  Why Are You Here?  The f i r s t p u z z l e  f o r me was t h a t o f d i s c o v e r i n g  what was 'wrong' w i t h t h e p a t i e n t s whom I o b s e r v e d . contribute t o t h i s puzzle i f we c o n s i d e r  A number o f i s s u e s  and we can perhaps b e s t b e g i n t o a p p r e c i a t e  t h e above t r a n s c r i p t  and,  p a r t i c u l a r l y U35.  I found t h e  s e s s i o n from which t h i s t r a n s c r i p t was taken t o be ' r e p o r t a b l e ' I mean t h a t I saw i t as d i f f e r e n t enough from o t h e r seemed t o warrant some comment).  sessions  them  (by t h i s  that i t  In c o n t r a s t t o t h e p e r m i s s i v e  and non-  4 directive  stance  t h a t I had come t o expect i n p l a y therapy i t seemed  obvious here t h a t t h e t h e r a p i s t was p u s h i n g t h e p a t i e n t and c o n f r o n t i n g him  w i t h h i s problems.  The t h e r a p i s t l a t e r . a g r e e d t h a t t h i s was t r u e ,  but t h a t he f e l t t h a t they had been c o a s t i n g l o n g enough. A l t h o u g h t h e t h e r a p i s t does n o t b e l i e v e t h e p a t i e n t when he c l a i m e d t h a t he comes t o t h e c l i n i c  (U36) " j u s t t o g e t o u t o f d o i n g my work a t  s c h o o l " , b u t chooses t o see t h i s as an e v a s i o n it  i n s t e a d , we might ask how  i s t h a t a p a t i e n t can spend s e v e r a l months i n t h e r a p y w i t h o u t  about why he i s t h e r e .  talking  However, remember t h a t t h e c h i l d i s n o t a  51 voluntary patient;  as t h e t h e r a p i s t says i n U41, "... we k i n d o f t h i n k  t h a t you weren't f e e l i n g t o o happy i n s i d e y o u r s e l f " . c h i l d r e n are not voluntary when he t e l l s  patients.  It i s typical  Most a d u l t s would agree w i t h  that Ginott  us t h a t :  The d e c i s i o n t o r e c e i v e o r r e j e c t p s y c h o t h e r a p y , l i k e d e c i s i o n s c o n c e r n i n g m e d i c a t i o n s and v a c c i n a t i o n s , should n o t be l e f t t o t h e c h i l d but t o the adults responsible f o r the c h i l d . . . . L i t t l e c h i l d r e n cannot make wise c h o i c e s i n m a t t e r s t h a t a r e beyond t h e i r ken. 5 The  c h i l d does n o t u s u a l l y come t o t h e r a p y w i t h "something t o t a l k about".  Although i t i s assumed t h e c h i l d knows t h a t he has a problem i t i s u s u a l l y assumed t h a t he. i s n o t c a p a b l e o f a r t i c u l a t i n g i t .  Thus i t becomes  incumbent upon t h e t h e r a p i s t t o d i s c o v e r why t h e c h i l d i s "not f e e l i n g too happy i n s i d e " . ^ Although I was i n t e r e s t e d i n t h e n o t i c e a b l e  absence o f a problem  t o p i c and r e a l i z e d t h a t the c h i l d ' s s t a t u s as a'child'may account f o r t h i s absence, I a l s o n o t e d a f u r t h e r absence h e r e .  That i s , S u l l i v a n ' s The  7 P s y c h i a t r i c Interview therapy sessions  suggests t h a t t h e i n i t i a l i n t e r v i e w i n a d u l t psycho-  should,  i d e a l l y , p r o c e e d through s e v e r a l s t a g e s .  c a l l s t h e f i r s t o f these t h e " f o r m a l the  f i r s t contact  inception".  and may c o n s i s t m i n i m a l l y  He  T h i s stage b e g i n s w i t h  of a therapist greeting a  p a t i e n t by name, i n v i t i n g him i n t o t h e o f f i c e , and o f f e r i n g him a s e a t . It  i s recommended t h a t t h e t h e r a p i s t then opens up t h e s e s s i o n by s t a t i n g  why he t h i n k s t h a t t h e p a t i e n t has come t o see him. t e r m i n a t e d when t h e p a t i e n t b e g i n s t o p r o v i d e his  problems.  T h i s stage i s  some i d e a s about h i m s e l f and  The p a r t i c i p a n t s i n t h i s i n s t a n c e  a r e immediately  account-  a b l e t o one another i n s o f a r as they must demonstrate some r e l e v a n t and appropriate Not  reason f o r the v i s i t . o n l y i s the c h i l d t h e r a p i s t f r e q u e n t l y a d v i s e d  t o avoid  this  52 k i n d o f t a l k d u r i n g t h e e a r l y s e s s i o n s b u t the same sense o f a c c o u n t a b i l g i t y does n o t a p p l y .  N e i t h e r o f t h e p a r t i c i p a n t s can be c i t e d o r rebuked  f o r f a i l i n g t o mention  t h e reason f o r the v i s i t .  absence  Not o n l y d i d I note an  o f t a l k about t h e reason f o r t h e v i s i t b u t f u r t h e r , any sense o f  s t a g e s seemed t o be absent.  One s e s s i o n seemed much l i k e t h e o t h e r s  except f o r t h e f a c t t h a t the t h e r a p i s t and the c h i l d became more f a m i l i a r w i t h each o t h e r . Now, c o n s i d e r t h i s e x c e r p t from a f i r s t  session with a c h i l d .  2.2 1.  T:  . . . a man who works w i t h me sometimes.  2.  R: H i .  3.  C: H i .  4.  T:  That's Gary, t h i s i s F r a n z , ((pause)) Would you l i k e t o keep your j a c k e t on o r would you l i k e t o take i t o f f ?  5.  C:  (  6.  T:  You w i l l l e a v e i t on, s u r e . What I thought we would do i f we c o u l d spend a l i t t l e time t o g e t h e r and we would p l a y t o g e t h e r and then when we have had some time I c o u l d take you back t o your classroom.^  on  )  I t i s taken f o r g r a n t e d t h a t a c h i l d w i l l be anxious enough when coming i n t o a new o r s t r a n g e s e t t i n g and s h o u l d n o t be pushed t o worry he i s i n t h a t s e t t i n g .  about why  Thus, treatment programs may p r o c e e d f o r q u i t e a  l o n g time w i t h o u t any mention  o f t h e reason f o r t h e v i s i t .  As G i n o t t  p o i n t s o u t , "the c h i l d ' s c o n c e p t u a l i z a t i o n o f t h e meaning o f t h e r a p y can come o n l y from e x p e r i e n c e , n o t from v e r b a l explanations".""^ I f , a f t e r a l e n g t h y time, t h e p a t i e n t c o n t i n u e s t o d i s p l a y a l a c k o f concern o r u n d e r s t a n d i n g f o r t h e "why" o f h i s v i s i t s , attempt  t o f o c u s upon t h i s i s s u e .  (As i n t r a n s c r i p t 2.1)  the t h e r a p i s t may Here, t h e  t h e r a p i s t r e l i e s upon the p a t i e n t ' s i n t u i t i v e a b i l i t y t o understand why  53 he i s i n here and t o a c t upon t h i s  insight.  The sequence above d i d not appear t o c o n s t i t u t e an unusual o p e n i n g . T h i s r e l a t i v e absence o f d i r e c t t a l k about problems c o n t r i b u t e d t o one o f my  first  i m p r e s s i o n s o f p l a y t h e r a p y , i . e . I found t h a t i t was  l a c k e d any noteworthy e v e n t s .  dull  and  F i e l d notes f o r an e n t i r e hour might  c o n s i s t o f comments such as " p l a y e d w i t h t o y s o l d i e r s " , "had a game o f d a r t s " , "asked what time i t was",  etc.  Very l i t t l e  appeared t o be  happening. Remember t h a t i t was  the d i r e c t n e s s o f the t h e r a p i s t ' s remarks  t h a t made the s e s s i o n r e p o r t e d i n t r a n s c r i p t 2.1 u n u s u a l .  While  one  might e x p e c t an a d u l t p a t i e n t t o t a l k about many p e r s o n a l m a t t e r s , the t y p i c a l c h i l d p a t i e n t r e v e a l s extremely l i t t l e the is How  p l a y room.  about h i s l i f e  outside of  Many hours o f c h i l d t h e r a p y appear t o be j u s t p l a y which  g o i n g nowhere.  However, t h i s r a i s e s a c r u c i a l q u e s t i o n ,  specifically,  do the p s y c h i a t r i s t s make sense o u t o f t h i s a p p a r e n t l y mundane and  uneventful For  activity? the s t r a n g e r t h i s r a i s e s the v e r y q u e s t i o n the t h e r a p i s t  asked the p a t i e n t , t h a t i s ,  "Why  has  do you t h i n k you come t o the c l i n i c ? "  Although most c h i l d r e n are r e f e r r e d t o the c l i n i c because o f b e h a v i o r a l problems such as bed w e t t i n g , a n x i e t y , temper tantrums, d o i n g p o o r l y i n s c h o o l , s t a r t i n g f i r e s , e t c . , t h e r a p i s t s t e n d t o r e g a r d such o f f e n s i v e b e h a v i o r s as symptoms o f some deeper problem.  The r e a l problem i s  assumed t o l i e somewhere i n the c h i l d ' s s e l f - c o n c e p t i o n , h i s f e e l i n g tone, his  p e r s o n a l i t y , o r h i s p a t t e r n o f development.  In s h o r t , i t i s a  problem which i s n o t e a s i l y l o c a t e d o r d e s c r i b e d . ^  While we  could a l l  r e c o g n i z e a broken l e g o r a f e v e r as a genuine m e d i c a l problem t h i s i s not  the case w i t h ' d i s t u r b a n c e ' used as a g l o s s f o r i n t r a p s y c h i c problems.  54 One  o f my  e a r l i e s t d i s c o v e r i e s was  appeared t o be normal c h i l d r e n and sequences and  other  I was  the d i s c o v e r y  that patients  able to recognize  doings as documents which p o i n t e d  their  t o some  problem o n l y when I l i s t e n e d t o the t h e r a p i s t s ' r e p o r t s . decided  play  underlying  Thereby, I  t h a t the p r o c e s s o f becoming a competent o b s e r v e r e n t a i l e d a c q u i r -  i n g the a b i l i t y t o t u r n the mundane w o r l d o f a c h i l d ' s p l a y i n t o something which had As  psychiatric significance. I soon d i s c o v e r e d  t h i s was  not a problem f o r me  alone.  Groups  o f s t u d e n t s from the s o c i a l work s c h o o l were o f t e n a l l o w e d t o w i t n e s s sessions  o f p l a y therapy and  see n o t h i n g t h i n g was  s t u d e n t s f r e q u e n t l y remarked t h a t they  wrong w i t h the c h i l d r e n .  A l t h o u g h they c o u l d see  could  t h a t some-  wrong w i t h s e v e r e l y d i s t u r b e d c h i l d r e n such as a u t i s t i c c h i l d r e n ,  they f r e q u e n t l y  f a i l e d t o see  any problem w i t h c h i l d r e n who  t o f l y , t a l k e d about dead b i r d s , r e f u s e d d o l l f o r a walk i n the h a l l , , and  had  a desire  t o h i t the punching clown, took a  so on.  Instead  they seemed t o f i n d  such  12 t h i n g s t o be  r e a s o n a b l e and  expectable instances  of behavior.  I t i s never assumed t h a t c h i l d r e n are p a r t i c i p a t i n g i n p l a y therapy by a c c i d e n t o r by  chance, i n s t e a d t h e r e  i s always the  assumption t h a t the p a t i e n t s u f f e r e d from some d i s t u r b a n c e . t i o n of disturbance  came out i n many ways.  explicit T h i s assump-  However, i t became e s p e c i a l l y  c l e a r through a p o p u l a r joke which suggested t h a t members o f the were r e l u c t a n t t o b r i n g t h e i r own because they f e a r e d t h a t o t h e r a t i c i n t h e i r behavior. for  staff  c h i l d r e n t o the c l i n i c Christmas  t h e r a p i s t s would d i s c o v e r  party  something problem-  T h i s seems t o have many i n t e r e s t i n g i m p l i c a t i o n s  us. Over the course o f my  study, I found t h a t I was  i n c r e a s i n g l y able  t o make p s y c h i a t r i c sense out o f the c h i l d r e n ' s a c t i v i t i e s i n the  55 p l a y room. suggest  I see t h i s accomplishment as the c e n t r a l i s s u e h e r e .  t h a t we  I  can b e g i n t o look a t t h i s accomplishment i n terms o f  (a) the n a t u r e and c o n s e q u e n t i a l i t y o f c h i l d r e n ' s p l a y ,  (b) through  v a r i o u s meanings t h a t can be a s s i g n e d t o a c h i l d ' s reasons p a r t i c u l a r t o y s and  a c t i v i t i e s , and  (c) through  the  for selecting  a c o n c e p t i o n o f the  child  as an a c t o r i n a common-sense s o c i a l s t r u c t u r e . However, t h e r e i s a p r e v i o u s p o i n t which needs some c l a r i f i c a t i o n . I suggested  t h a t p l a y s e s s i o n s appeared t o be d u l l , r o u t i n e and  As i t t u r n e d out, t h e s e were r e l a t e d t o the v e r y o b j e c t i v e s o f  uneventful. therapy.  Dr. Weininger, speaking about c h i l d ' s p l a y and t h e r a p y , d e s c r i b e d the o b j e c t i v e o f p l a y therapy was  achieved,  and c l a i m e d t h a t t h i s o b j e c t i v e c o u l d be  i n the f o l l o w i n g  and  way.  ( I t seems t h a t a r e l a t i o n s h i p develops) between the t h e r a p i s t and c h i l d so i t i s s u f f i c i e n t l y s a f e f o r the c h i l d t o b e g i n t o e x p l o r e some o f the f e e l i n g s t h a t he has, and he can o n l y e x p l o r e them i n the c o n t e x t o f the r e l a t i o n s h i p t h a t e x i s t s between h i m s e l f and the therapist. What he does i s make use o f c e r t a i n k i n d s o f p l a y m a t e r i a l s , these may be d o l l s o r these may be o t h e r k i n d s o f t h i n g s , they may be a n i m a l s , they may be bows and arrows, they may be paper and p e n c i l , b u t he makes use o f t h e s e m a t e r i a l s t o b e g i n t o e x p l o r e the problems he has. G r a d u a l l y , as he has the r e l a t i o n s h i p between h i m s e l f and the t h e r a p i s t , the freedom p e r m i t s him t o e x p l o r e them i n g r e a t e r depth and e x p e r i e n c e some o f the a n x i e t y t h a t he a c t u a l l y has w h i c h . i n f a c t h e . i s d e f e n d i n g a g a i n s t e x p e r i e n c i n g . The p l a y therapy p e r m i t s him, a l l o w s him t o e x p e r i e n c e the a n x i e t y because t h e r e i s t h i s s a f e p e r s o n , t h e r e i s t h i s p e r s o n upon whom he can have a dependency r e l a t i o n s h i p . The c h i l d v e n t i l a t e s these problems, b e g i n s t o e x p l o r e them; . . . In o t h e r forms o f t h e r a p y t h e r e i s no i n t e r p r e t a t i o n and the c h i l d i s g i v e n t h e freedom and h e l p e d by r e f l e c t i o n o f some o f the t h i n g s he i s d o i n g , t o b e g i n t o extend h i s p l a y so i t becomes a v e h i c l e through which he can e x p l o r e the problems, but p r i m a r i l y through which he can go back on, i f t h e r e i s such a t h i n g , h i s own t r a c k o f development, and have more adequate r e l a t i o n s w i t h o t h e r k i n d s o f p e o p l e , so he i n f a c t no l o n g e r has a problem.13 How  d i d I come t o see t h i s as a r a t i o n a l way  t o accomplish  As a s t a r t i n g p o i n t , I d i s c o v e r e d t h a t t h e r a p i s t s o f o t h e r p e r s u a s i o n s o f t e n c i t e d the  therapy?  theoretical  ' d u l l n e s s ' t h a t I have a l r e a d y r e f e r r e d t o  and thought o f t h i s as a " s t r a n g e " way  t o do t h e r a p y .  i s t h a t the t h e r a p i s t j u s t i f i e s c a l l i n g p l a y therapy e x t r a o r d i n a r y appears  We  can ask how i t  'work' when n o t h i n g  t o happen.  I had t o l e a r n not o n l y how  t o make sense o f the p a t i e n t ' s p l a y ,  but a l s o t o see the i m p l i c a t i o n s o f the therapy t e c h n i q u e .  That i s , I  had t o l e a r n t o see p l a y therapy as a good and r a t i o n a l way c h i l d r e n w i t h b e h a v i o r a l problems b e t t e r . p r o v i d e d me w i t h i n s t r u c t i o n s on how  o f making  A g a i n , the t h e r a p i s t ' s  to accomplish t h i s .  talk  I t seemed t o  i n v o l v e , a t l e a s t i n p a r t , some u n d e r s t a n d i n g o f the c h i l d ' s  emotional  development, o f the ways i n which r e l a t i o n s h i p s w i t h i n the f a m i l y a f f e c t e d t h i s development, and the c h i l d ' s need f o r l o v e , acceptance, and so on are i n t r i n s i c p a r t s o f t h i s development.  understanding,  I had t o l e a r n t o o ,  t h a t the c h i l d would o n l y be f r e e t o change w i t h i n the a p p r o p r i a t e r e l a t i o n s h i p , s p e c i f i c a l l y , i n a r e l a t i o n s h i p which a l l o w e d him t o express h i s p e n t up  emotions.  I began t o see the r a t i o n a l i t y o f t h i s i n the f o l l o w i n g L a t e r , t h i s a l l o w e d me  way.  t o l o c a t e numerous o t h e r documents o f i t i n the  therapy e v e n t s . 2.3 1.  T:  Janet?  2.  C:  What?  3.  T:  I c a n ' t r e a l l y see from here, do you t h i n k I s h o u l d move c l o s e r ?  4.  C:  Do you want t o t r y and see a l l the b o a t s ?  5.  T:  Yea, do you want me  6. ' C: 7.  T:  to?  Yea. Okay.  Here, I was  ( ( t h e r a p i s t moves c l o s e r ) )  p u z z l e d as t o why  the t h e r a p i s t had asked the  child's  57 p e r m i s s i o n t o move c l o s e r t o the sand t r a y i n o r d e r t o see what was going on.  A f t e r the s e s s i o n , t h e t h e r a p i s t e x p l a i n e d t h a t c h i l d r e n a r e under  the c o n s t a n t s u r v e i l l a n c e and c o n t r o l o f a d u l t s , however, t h e p a t i e n t i n p l a y therapy  s h o u l d f e e l f r e e o f these r e s t r i c t i o n s .  That i s , t h e c h i l d  s h o u l d be made t o f e e l an e q u a l p a r t n e r i n the r e l a t i o n s h i p which o b t a i n s between him and t h e t h e r a p i s t . I w i l l p r o v i d e some f u r t h e r i n s t a n c e s o f t h e r a t i o n a l i t y o f t h e r e l a t i o n s h i p ^ f o r i n s t a n c e , i n the f o l l o w i n g i n c i d e n t . S i n c e t h e r e l a t i o n s h i p was t o do some o f t h e work o f e a r l i e r  parent-  c h i l d r e l a t i o n s h i p s , t h e r a p i s t s attempted t o s t i m u l a t e a h i g h degree o f r a p p o r t , t r u s t , s e c u r i t y , and c o n f i d e n c e so t h a t t h e p a t i e n t c o u l d b e g i n t o experiment w i t h h i s own a c t i o n s and f e e l i n g s . r e l a t i o n s h i p can be sensed f o l l o w i n g statement. and,  The importance o f t h i s  i n t h e s a t i s f a c t i o n which i s e v i d e n t i n t h e  The p a t i e n t had expressed  her t r u s t i n the t h e r a p i s t  soon a f t e r t h e s e s s i o n was o v e r , t h e t h e r a p i s t s a i d t o me:  2.4 T:  That's a tremendous t r i b u t e you know. I don't o f t e n g e t t h a t .kind o f t h i n g , where k i d s say you have my d o l l and I ' l l have y o u r s . Because ah, w e l l , i t ' s g o t a l l k i n d s o f , p r o b a b l y a l l s o r t s o f s e x u a l o v e r t o n e s , o r undertones, b u t simply t h e r e c o g n i t i o n t h a t t h i s i s something I can t r u s t you w i t h , t h a t i s I'm coming back, and i t ' s going t o be s a f e . And I t h i n k t h a t she was g r a t e f u l t o me f o r h a v i n g begunv.to d e a l w i t h her concerns.  T h i s s h o r t e x c e r p t p o i n t s t o t h e importance o f t r u s t and i t s r e l a t i o n s h i p t o and importance i n t h e r a p y  and g i v e s us some important  f i n d i n d i c a t i o n s as the t h e r a p y p r o g r e s s e s . her concerns  without  i d e a s about how we  S i n c e t h e c h i l d can d e a l . w i t h  any d i r e c t c o n f r o n t a t i o n , i t i s always d i f f i c u l t t o  a s c e r t a i n whether o r n o t the c h i l d has s u f f i c i e n t c o n f i d e n c e i n the t h e r a p i s t t o be a b l e t o sense t h a t he can a c t o u t and d e a l w i t h h i s problems.  58 Or c o n s i d e r  the f o l l o w i n g between a t h e r a p i s t and a s t u d e n t :  2.5 T:  So t h a t ' s t h e mo-, y e a so t h e o t h e r t h i n g s i s t h a t she h a s n ' t r e a l l y g o t t e n a n y t h i n g from t h e mother, the f a t h e r r e l a t e s t o h e r , t h e f a t h e r r e l a t e s t o h e r and mum r e a l l y doesn't, and mother h a n d l e s h e r now by l i t e r a l l y c h u c k i n g h e r o u t o f t h e house anytime o f the day o r night.  S:  (  T:  Yea. So t h a t t h i s i s the t h i n g you see ( ) . She anger, she f e e l s the rage and she can't express i t i n and t h a t ' s okay, b u t you know what I t h i n k t h e t e a c h e r the c l a s s r o o m i s t o say "look I know you've been (  S:  mmhmmm (+)  T:  I t h i n k f o r t h e k i d who's s o , who.'s been g e t t i n g so much h e l l as a result of ( ) she needs t o know t h a t somebody knows t h a t ( ) i t ' s u n d e r s t a n d a b l e you know.  The  t h e r a p i s t i s e x p l a i n i n g why p a s s i v i t y and t o l e r a n c e  ) f e l t the the c l a s s r o o m , i s doing i n ).  are c a l l e d f o r i n  s i t u a t i o n s t h a t would n o r m a l l y evoke some a c t i v e response from an a d u l t . I t was through i n s t a n c e s  such as these t h a t I began t o see t h a t the  t h e r a p i s t ' s a c t i o n s , h i s p a s s i v i t y , t o l e r a n c e , and a c c e p t a n c e , were i n t e n t i o n a l e f f e c t s which were d i r e c t l y r e l a t e d t o and had consequences f o r the child's  actions. I t i s obvious t h a t such c o n s t r a i n t s p r e s e n t  therapist.  c e r t a i n problems f o r the  Some o f these were obvious t o me from t h e o u t s e t  t a l k which I h e a r d o f t e n appeared t o be v e r y  strange.  2.6 C:  I'm p u t t i n g , I'm p u t t i n g a model t o g e t h e r  T:  You're g o i n g t o p u t a model t o g e t h e r  C:  The one you gave me.  2.7 C:  I want t o go away.  T:  Hmmm/  today.  today hey.  since the  F o r example:  59 C:  I want t o swim i n the p o o l  (at gym).  T:  You wanted t o go away from me.  I s t a r t e d t o n o t i c e v a r i o u s k i n d s o f r e p e a t sequences and r e f e r r e d t o them 14 c o l l e c t i v e l y as the echo t e c h n i q u e .  I t was n o t uncommon f o r an exchange  o f s e v e r a l u t t e r a n c e s t o f o l l o w a p a t t e r n i n which t h e t h e r a p i s t r e s t a t e d what t h e c h i l d had s a i d . 1.6).  simply  (For an example o f t h i s see t r a n s c r i p t  In c o n t r a s t , a t h e r a p i s t showed me how the f o l l o w i n g c o n v e r s a t i o n  was i n a p p r o p r i a t e i n terms o f the o v e r a l l d e s i g n o f p l a y t h e r a p y .  I t went:  2.8 C:  I guess i t ' s tough on g r a n d f a t h e r s i s n ' t i t ?  T:  Tough on g r a n d f a t h e r s ?  C:  Yea.  T:  How i s i t tough on g r a n d f a t h e r s ?  C:  I dont' know why.  T:  But i t ' s tough on g r a n d f a t h e r s huh?  C:  (  T:  Thank you T e r r y .  C:  mmhiruxim  T:  Grandfathers  ) I s i t tough on g r a n d f a t h e r s t o work?  (+) b u i l d roads?  ((pause))  Humm?  She e x p l a i n e d t h a t : 2.9 T:  . . . ( t h i s ) l e f t me s p i n n i n g . I , I was r e a l l y p u z z l e d because he, u s u a l l y when he's been b u i l d i n g roads I've been s a y i n g "what k i n d o f road i s i t ? " and today I thought w e l l h e l l I've been through t h a t r o u t e , you know, so I'd j u s t be q u i e t . And then he comes o u t w i t h t h a t b i z a r r e statement, l i k e , " I t ' s r e a l l y tough f o r g r a n d f a t h e r s " and you know i t was r e a l l y b i z a r r e .  R:  I f o r g e t what you d i d , you d i d make, you d i d t r y and say, y o u j u s t s a i d " I t ' s tough f o r g r a n d f a t h e r s ? " hoping he would c a r r y on.  60 T:  Yea, and n o t h i n g happened. And a t one p o i n t I s a i d " i t ' s tough f o r g r a n d f a t h e r s b u i l d i n g roads?" and he s a i d yea. But t h a t was, t h a t was bad t h e r a p e u t i c a l l y on my p a r t because I l e d him i n t o t h a t , ' y o u know. I s e t him up w i t h an answer. Whereas I would have been b e t t e r o f f t o say, l i k e I say, I t r i e d once though, I s a i d " i t ' s tough f o r g r a n d f a t h e r s ? " hoping he would e m b e l l i s h b u t n o t h i n g happened. But I s h o u l d have s a i d a g a i n , "how i s i t tough?" A x l i n e makes the f o l l o w i n g p o i n t about s a y i n g t h e c h i l d ' s words  r i g h t back t o him. dure;  She. p o i n t s out t h a t t h i s i s o f t e n t h e c o r r e c t p r o c e -  had the t h e r a p i s t s a i d i n s t e a d :  "You a r e a f r a i d and your mother doesn't pay a t t e n t i o n t o your f e a r s and t h a t s c a r e s you s t i l l more", she i s g e t t i n g ahead o f t h e c h i l d and i n t e r p r e t i n g h i s remarks. Perhaps t h e i n t e r p r e t a t i o n i s c o r r e c t , b u t t h e r e i s the danger o f t h r u s t i n g something a t t h e c h i l d b e f o r e he i s ready f o r i t . 1 5 1  So f a r , I have emphasized how the o b s e r v e r comes t o see an o r d e r or r a t i o n a l i t y i n a s t r a n g e o r e s o t e r i c s e t t i n g .  Although the c e n t r a l  i s s u e has been t h a t o f making sense o f t h e c h i l d ' s a c t i v i t i e s i n the p l a y room, i t i s a l s o e s s e n t i a l t h a t we see how t h e t h e r a p i s t ' s  activities,  as m o t i v a t e d accomplishments complement and i n some way account f o r t h e c h i l d ' s doings during  the session.  The f a c t t h a t I was a b l e t o under-  stand what the t h e r a p i s t was d o i n g was e s s e n t i a l f o r my c o n c e p t i o n what was g o i n g on i n t h e e p i s o d e s t h a t I have I take i t t h a t the d i s c o v e r y to p r o v i d e  of  reported.  o f r a t i o n a l i t y amounts t o t h e a b i l i t y  adequate accounts o f e v e n t s .  show how events may be s a i d t o c o n t a i n  In t h i s case, I am t r y i n g t o some importance f o r t h e r a p i s t s .  L e t us now r e t u r n t o our c e n t r a l problem, i . e . , t h a t o f making sense o f t h e p a t i e n t ' s a c t i o n s and a c t i v i t i e s . have a c q u i r e d  While I do n o t c l a i m t o  t h e competence t h a t a t h e r a p i s t would d i s p l a y i n making  sense o u t o f these e v e n t s , I g a i n e d some u n d e r s t a n d i n g o f how c h i l d r e n ' s p l a y can be made i n t o p s y c h i a t r i c a l l y r e l e v e n t There a r e many i n s t a n c e s  data.  i n which a d u l t s use p l a y w i t h c h i l d r e n t o  61 mask o t h e r t a s k s .  A s c h o o l nurse might p a i n t a f a c e on the c h i l d ' s  arm  p r i o r to g i v i n g him  an i n n o c u l a t i o n , o r the photographer o f t e n g i v e s  toys  t o c h i l d r e n as a way photographs.  to capture  However, i t was  t h e i r a t t e n t i o n so t h a t he can take  their  not the case t h a t the t h e r a p i s t uses p l a y  i n o r d e r t o mask some o t h e r more s e r i o u s a c t i v i t y , r a t h e r , the p l a y i s i t s e l f the t h e r a p y .  T h i s became c l e a r when p a r e n t s  c h i l d come here t o p l a y ? " t h a t they  ask:  "Why  does  T h e r a p i s t s do not answer t h i s q u e s t i o n  my  implying  are u s i n g p l a y t o keep the c h i l d busy so t h a t he won't r e s i s t  the cure which they have designed  f o r him.  Rather, they t a l k e d about the  ways i n which a c h i l d communicates h i s problems v i a h i s p l a y and uses p l a y as a r e s o u r c e  f o r resolving h i s problems. " -  man  might see the c h i l d ' s a c t i o n s as  was  t r a i n e d t o see i t as therapy  e s s e n t i a l i f we  Anthony, who  This understanding  laywho  is  sessions meaningful.  i s the mentor o f one  says t h a t p l a y therapy  the  "nothing but p l a y " , the p e r s o n  c o u l d do so.  are t o make these  In s h o r t , a l t h o u g h  o f the t h e r a p i s t s a t the  i s grounded i n the f a c t  clinic,  that  i t p r o v i d e s a t r a n s i e n t , i l l u s i o n a l t r a n s f o r m a t i o n whereby the c h i l d i s no l o n g e r a h e l p l e s s homunculus i n an overwhelmingly l a r g e w o r l d , but a v e r i t a b l e G u l l i v e r among the L i l l i p u t i a n s , e x e r c i s i n g h i s omnipotence over a m a l l e a b l e , n o n - r e s i s t a n t u n i v e r s e . 1 7 , The  c h i l d o f t e n f i n d s t h a t he cannot cope w i t h ' h i s adult-made environment  and r e s o r t s t o the n o n - r e s i s t a n t world  o f t o y s where he  h i m s e l f a manageable r e p l i c a o f t h a t l a r g e r w o r l d . w i t h the o p p o r t u n i t y  I t i s a world  f o r c e s t h a t he cannot c o n t r o l . h i s image o f the  This provides  him  t o f i n d h i m s e l f through h i s a d v e n t u r e s .  E. E r i k s o n c a l l s the p l a y room and c h i l d ' s microcosm.  f i n d s and makes f o r  i t s c h a r a c t e r i s t i c toys  he can manage and  the  i s not swept a l o n g  S i n c e the c h i l d ' s p l a y i s f a s h i o n e d  ' r e a l w o r l d ' , i t i s p o s s i b l e f o r the o b s e r v e r  by  after  to discover  the  ' r e a l ' c h i l d i n and by way o f h i s p r e t e n d a c t i v i t y .  Erikson  says  further: What i s i n f a n t i l e p l a y then? . . . i t i s n o t t h e e q u i v a l e n t o f a d u l t play. That i t i s n o t r e c r e a t i o n . • The p l a y i n g a d u l t steps sideward i n t o another r e a l i t y ; t h e p l a y i n g c h i l d advances forward t o new s t a g e s o f mastery. I propose t h e t h e o r y t h a t t h e c h i l d ' s p l a y i s the i n f a n t i l e form o f t h e human a b i l i t y t o d e a l w i t h e x p e r i e n c e by c r e a t i n g model s i t u a t i o n s and t o master r e a l i t y by experiment and planning.-'8  While the c h i l d ' s a c t i v i t i e s may appear t o be f a n t a s y , p r e t e n c e o r make believe, Erikson  i n s t r u c t s us t o see t h a t , i n h i s apparent s u s p e n s i o n o f  r e a l i t y , the c h i l d i s r e c r e a t i n g h i s w o r l d and h i s r e a l f e e l i n g s , e t c . I take t h i s t o mean t h a t , i n a developmental sense, t h e c h i l d has the c a p a c i t y t o express h i m s e l f ,  i . e . , t o communicate h i s f e e l i n g s , t o  show h i s u n d e r s t a n d i n g o f t h e w o r l d , and t o r e v e a l h i s wishes, wants, and f e a r s , through h i s r e l a t i o n s h i p t o t o y s .  T h e r a p i s t s * r e f e r t o t h i s as  the c h i l d ' s n a t u r a l mode o f e x p r e s s i o n . An  important r e a l i z a t i o n i n t h e h i s t o r y o f p s y c h o t h e r a p y was t h a t  the t e c h n i q u e s and t o o l s used i n a d u l t p s y c h o t h e r a p y , however s u c c e s s f u l they might be i n t h a t c o n t e x t ,  d i d n o t n e c e s s a r i l y work as w e l l when used  w i t h c h i l d r e n , f o r they a r e fundamentally d i f f e r e n t c r e a t u r e s and  from.adults  o f t e n cannot be t r e a t e d i n the same way t h a t a d u l t s a r e t r e a t e d .  Hug-Hellmuth was the f i r s t t o use p l a y i n t r e a t i n g d i s t u r b e d c h i l d r e n , b u t i t was M. K l e i n who r e a l i z e d t h a t spontaneous p l a y c o u l d be used as a d i r e c t s u b s t i t u t e f o r the v e r b a l f r e e a s s o c i a t i o n used so s u c c e s s f u l l y by 19 -.' Freud i n the treatment o f a d u l t s .  However, i t s h o u l d be n o t e d t h a t  Freud, i n t r e a t i n g " L i t t l e Hans", used Hans' p l a y as a r e s o u r c e t o g a i n i n s i g h t s i n t o h i s problems.  The t e c h n i q u e o f o b s e r v i n g  p l a y as a method f o r d i s c o v e r i n g h i s u n d e r l y i n g elaborated  i n order a child's  problems has been g r e a t l y  and a v a r i e t y o f d i f f e r e n t approaches have been developed.  In  63 a l l o f t h e s e , however, t h e r e i s assumed t o be a r e l a t i o n s h i p between what the c h i l d does w i t h the t o y s i n the p l a y room and the s t a t e o f a f f a i r s i n which the c h i l d w i l l f i n d h i m s e l f when he l e a v e s . As a s t r a n g e r , I became aware o f the s i g n i f i c a n c e o f t o y s and p l a y through a number o f d i f f e r e n t i n c i d e n t s . d i d n o t c o n t a i n simply  F o r example, I saw t h a t t h e room  a random s e l e c t i o n o f t o y s .  Rather the t h e r a p i s t  s e l e c t e d s p e c i f i c t o y s and p o s i t i o n e d them i n the room.  I t was apparent  t h a t the s e l e c t i o n t h a t she made was r e l a t e d t o h e r u n d e r s t a n d i n g c h i l d and h i s o r h e r problem.  F o r example, when p r e p a r i n g  who was over anxious about a h o s p i t a l s t a y and s u r g e r y , spent  c o n s i d e r a b l e time i n l o o k i n g f o r some m e d i c a l  d o c t o r ' s bag w i t h  some instruments  o f the  for a child  the t h e r a p i s t  toys.  She found a  i n i t and p l a c e d i t i n the room which  the c h i l d would be u s i n g . I t might o c c u r t o the r e a d e r t h a t t h i s i s s i m i l a r t o what a concerned p a r e n t who wished t o show a c h i l d what h o s p i t a l s were l i k e might do. The  p a r e n t might encourage the c h i l d t o p l a y w i t h a 'doctor bag' i n o r d e r  t o assure him, and t o make t h i n g s f a m i l i a r and l e s s f r i g h t e n i n g f o r him. However, t h i s i s n o t what the t h e r a p i s t had i n mind i n the above mentioned episode.  As soon as the m e d i c a l  t o y s were p l a c e d i n the room a l l o f the  c h i l d ' s a c t i o n s became c o n s e q u e n t i a l  f o r the t h e r a p i s t .  I f she chose n o t  t o p l a y w i t h them, she was seen t o a v o i d them and t o demonstrate h e r anxiety;  i f she p l a y e d w i t h them o n l y towards the end o f the s e s s i o n ,  t h i s c o u l d be seen as p r o g r e s s ; sent ambivalence;  p l a y i n g , w i t h them i n s p u r t s c o u l d  and, i f she p l a y e d w i t h them c r e a t i v e l y , t h i s  i n d i c a t e t h a t she was working through h e r a n x i e t y i n a r e a l i s t i c Note t h a t , i n t h i s i n s t a n c e , t h e m e d i c a l important  repre-  could way.  t o y s became a c e n t r a l and  p a r t o f the i n t e r a c t i o n a l environment i n a way t h a t  other  objects d i d not. attached  F o r example, no s p e c i a l p s y c h i a t r i c s i g n i f i c a n c e was  t o t h e f a c t t h a t the c h i l d d i d n o t draw on t h e board o r d i d n o t  f i n d t h e rubber b a l l i n t h e bottom o f the t o y box. my o b s e r v a t i o n s  a t the c l i n i c , v e r y  Over t h e c o u r s e o f  few s i n g l e o b j e c t s  came t o assume t h e  importance t h a t t h e m e d i c a l k i t had h e l d f o r t h i s p a t i e n t , however, e v e r y toy can be assumed t o be as important under some c i r c u m s t a n c e s . one  way o f p r o v i d i n g an adequate e x p l a n a t i o n  Thus,  o f the p a t i e n t ' s b e h a v i o r  then i s t o p o s i t a s p e c i a l i n t e r a c t i o n a l environment i n which some o b j e c t s are i n e s c a p a b l y  r e l a t e d t o the p a t i e n t i n important ways.  I f a child i s  angry b u t does n o t p l a y w i t h t h e punching clown, i t can be assumed t h a t he i s d e l i b e r a t e l y a v o i d i n g n o t o n l y t h e clown b u t h i s anger.  I t i s also  p o s s i b l e t o l o c a t e a c h i l d ' s problems by watching how he r e a c t s t o t h e t o y s i n the p l a y room, e.g., i f he a v o i d s  t h e w i l d animals and p l a y s  with  the d o m e s t i c a t e d ones i n s t e a d , we c o u l d assume t h a t he was a v o i d i n g h i s anger.  However, b e f o r e  attempting t o provide  an account o f the  p a t i e n t ' s r e a c t i o n s t o t h e t o y s , t h e t h e r a p i s t w i l l attempt t o gauge h i s emotional l e v e l  f o r h i s a c t i o n s a r e t o be i n t e r p r e t e d i n l i g h t o f t h i s .  My second n a i v e  observation  was r e l a t e d t o t h e o b s e r v a t i o n  above.  D u r i n g t h e e a r l y stages o f my f i e l d work, I o f t e n became annoyed w i t h t h e t h e r a p i s t s because they appeared t o be t r a p p i n g t h e c h i l d .  That i s , I  f e l t t h a t the c h i l d had no escape because whatever he d i d was seen as significant.  T h e r a p i s t s made  (or t r i e d t o make) p s y c h i a t r i c sense o u t o f  a l l o f h i s a c t i o n s a l l o f the time.  On t h e o t h e r hand, I: o f t e n  thought  t h a t perhaps t h e c h i l d was t i r e d , t h a t he had t o go t o t h e bathroom, o r t h a t he d i d n ' t have t h a t p a r t i c u l a r t o y a t home, and so on.  That i s , i n  c o n t r a s t t o the t h e r a p i s t , I often t r i e d to provide  motivation  for h i s actions.  a normal  65 What we h a v e h e r e explanation" atrically  i s a clarification  amounts t o , i . e . , i n o r d e r  adequate.  hungry,  t o be a d e q u a t e  I t may b e p e r f e c t l y a d e q u a t e  f o r h i s c h i l d ' s b e h a v i o r by appealing less,  o f what an " o c c a s i o n e d  to the fact  i t must be  f o r a parent that  e t c . , b u t t h e s e would n o t be a p p r o p r i a t e  adequate psychi-  t o account  he i s t i r e d ,  rest-  f o r the occasion  of  20 therapy.  This  Children  often  p a i n t would o f t e n finished  became c l e a r painted  f o r me  i n the following  with watercolours  r u n down t h e p a p e r w h i l e  p i c t u r e would be t r e a t e d  at a large  the c h i l d  as 'data'  instance. easel  and t h e  was p a i n t i n g .  by t h e t h e r a p i s t .  The  I proposed  t h a t p e r h a p s t h e f i n i s h e d p r o d u c t was a s much t h e r e s u l t o f t h e way the  paint  Although final  r a n down t h e e a s e l  as a guide  t h e t h e r a p i s t acknowledged t h a t  shape o f t h e p i c t u r e , he c l a i m e d  was m a k i n g a c h o i c e — e v e n example,  turn  t h e flow  that with  i t i n t o an a n g e l  o r n o t ? d i d he i n c o r p o r a t e  we  can see that  any adequate  o r a monster,  each  stroke  choice.  the patient D i d he, f o r  i t a s a mess? e t c .  of the play  activity  life.  affected the  a c a t o r a t i g e r ? d i d he  the d r i p o r leave account  intrapsychic  of the paint  i f . i t was a n u n c o n s c i o u s  it  notions  t o the patient's  that  finish Thus,  i s built  upon  o f the i n t e n t i o n a l i t y of the action. A  competent  t h e r a p i s t would n o t c l a i m  were n e c e s s a r i l y t h e c o r r e c t , interpretation.  Rather,  o r even t h a t  there  t h e r a p i s t move t o w a r d s a b e t t e r  can  be p r o v e d w r o n g a n d r e c o n s i d e r e d ,  was o n l y  one c o r r e c t  o r they  c a n be c o n f i r m e d .  c o m p e t e n c e d o e s n o t seem t o r e s t u p o n h i s a b i l i t y  p a r t i c u l a r , s i n g l e a c t i o n b u t on h i s a b i l i t y  the  whole  range o f a c t i o n s . a c t i o n was j u d g e d  Thus  to help  understanding of the patient.  any  particular  t h e i n t e r p r e t a t i o n s made  i n t e r p r e t a t i o n s a r e 'guesses', designed  the  therapist's  that  The  to interpret,  t o see the p a t t e r n  I r e a l i z e d that  i n and o f i t s e l f  They  t h e way i n w h i c h  was f a r l e s s i m p o r t a n t  behind some than  66 its  place  i n the  larger pattern.  T:  . . . y o u g e t a p a t t e r n do y o u s e e , e m e r g i n g , s o t h a t a f t e r I g e t s o m e t h i n g l i k e t h i s , um, i t makes i t , a n d a f t e r a few t i m e s i t makes i t e a s i e r f o r me t o f i g u r e o u t w h a t ' s g o i n g o n .  I want t o e m p h a s i z e consequential pist's  f o r the  interpretive As  child's in  again  was  above,  like  and  therapist  every  I will  one  now  said:  of the  briefly  categorized.  For  the  therapist  relies  i n h i s environment  feelings  and  can  possible  could  see  t o see  'angry'  who  what t h e  toys).  i n the  meanings.  As  I take  first  Ginott  child an  activity  thera-  p l a c e because  a  resource toys  were  of  ambulances  However,  f o r the  or  objects  therapist  only  (However, i t i s a l s o  which allows  they  a  that  instruments  others.  them.  i t that particular  as  of aggression,  want t o h e l p  did with  used  fact  Many o f t h e  example', g u n s w e r e s e e n a s  people  p a i n t i n g as  therapist  actions i s  d e s c r i b e the  be  problems.  were seen as p o s s e s s o r s  cars represented  he  child's  upon t h e  d r a w i n g o r p a i n t i n g m a t e r i a l s became m e a n i n g f u l  after  the  toys  h i s hidden  v i o l e n c e , w i l d animals police  one  schema.  r e a c t i o n t o the  readily  each  therapist.  suggested  interpreting  how  As  the  child  to  avoid  t o y s were s e l e c t e d by  communicated  these  kinds  the  of  says:  S i n c e a s m a l l c h i l d ' s i m a g i n a t i o n makes u r i n e o f e v e r y f l u i d a n d f e c e s o f e v e r y messy s u b s t a n c e , s a n d , w a t e r , p a i n t , and c l a y p r o v i d e e x c e l l e n t means o f s u b l i m a t i n g u r e t h r a l a n d a n a l d r i v e s . No p l a y room f o r s m a l l c h i l d r e n i s c o m p l e t e o r a d e q u a t e w i t h o u t s u c h m a t e r i a l s . E n u r e t i c c h i l d r e n s h o u l d be g i v e n p a i n t and r u n n i n g w a t e r , e n c o p r e t i c c h i l d r e n , mud a n d b r o w n c l a y . F i r e s e t t e r s s h o u l d have capguns, s p a r k l e r s , and f l a s h l i g h t s . A l l c h i l d r e n should f i n d i n the p l a y r o o m m i n i a t u r e u t e n s i l s f o r c o o k i n g a n d s e r v i n g a s means t o s u b l i m a t e o r a l n e e d s , d o l l s t h a t can be d r e s s e d and u n d r e s s e d t o s u b l i m a t e s e x u a l d r i v e s , and p u n c h i n g b a g s , t a r g e t s and guns t o s u b l i m a t e aggressive drives. . . . A c h i l d s h o u l d be l e d t o e x p r e s s a n g e r by p u n c h i n g d o l l s a n d d e s t r o y i n g c l a y f i g u r e s , . . . The t h e r a p y s e t t i n g must p r o v i d e m a t e r i a l s t h a t a l l o w g r o w t h i n t h e r e p e r t o r y o f s e l f expression. 2 1  While  the  toys  are methodically  chosen by  the  therapist  to  relate  67 to  the  child  objects state  in a  i s then  s p e c i a l way,  s e e n t o be  o f mind.  Ginott  the  patient's  m o t i v a t e d by  makes t h i s  the  own  selection of  nature  of  them as  play  h i s p r o b l e m s and  his  clear:  Appropriate t o y s make i t e a s i e r f o r t h e t h e r a p i s t t o u n d e r s t a n d t h e meaning o f the c h i l d ' s p l a y , thus f o r example, children usually p l a y o u t f a m i l y s c e n e s u s i n g d o l l s t h a t r e p r e s e n t mother, f a t h e r and sibling. I n t h e a b s e n c e o f s u c h d o l l s , a c h i l d may symbolically p l a y o u t f a m i l y t h e m e s by u s i n g b i g a n d l i t t l e w o o d e n b l o c k s . But t h e e x a c t m e a n i n g may e s c a p e t h e t h e r a p i s t . . . . H o w e v e r , when a f a t h e r d o l l i s p u t on t o p o f a m o t h e r d o l l , t h e t h e r a p i s t h a s l e s s room f o r misinterpretation.22 In is  searching  possible  f o r the  t o b u i l d upon t h e  tute  for.  real  objects—guns,  be  character  of  assumed t h a t  baby h a v i n g This  he  a particular selection, i t  the  object  are  that  i t is a  miniature  fences, takes  i s simply  a drink,  etc.  (Exceptions  a drink thirsty,  i . e . , he  between a i i t h e r a p i s t  that  i s a c t i n g out  c h a r a c t e r i z a t i o n of  a p p e a r s t o be  objects  of  he  monsters  i s pretending  dependency  of  clothes,  from a baby b o t t l e i t i s not but  substi-  replicas  animals, people, v e h i c l e s , c a r r i a g e s , baby  If a patient  versation  behind  I t i s i n t e r e s t i n g t h a t most t o y s  baby b o t t l e s , t r e e s , games).  motivation  and  taken  t o be  a  needs.  became c l e a r i n t h e  following  con-  and " m y s e l f .  2 ."10 T:  Y e a , I remember, i t h a p p e n s o f t e n t h a t w e ' r e d o i n g funny l i k e , John p e r s i s t e n t l y chooses dinosaurs.  R:  And  T:  Oh  R: T:  there yea,  are  other  there's  things  cars,  and  to  choose  boats,  and  dinosaurs.  It's  from? planes.  Yea. Yea. And g e n e r a l l y t h e d i n o s a u r s a r e f e r o c i o u s l i k e d i n o s a u r s are u s u a l l y t h o u g h t o f as n o t , . the most f e r o c i o u s , dangerous c r e a t u r e s t o walk earth, . . . I t r y t o use t h a t , . . . So I t r y , k i n d o f s e e " o k a y , d i n o s a u r s , now d i n o s a u r s a r e maybe we c a n g e t i n t o J o h n ' s a n g e r a b i t . "  to  t h i n g s , y o u know, . . they're mostly the face of the I t r y and t e n d t o ferocious beasts  In t h i s e x c e r p t ,  we see how i t i s a l s o p o s s i b l e t o c h a r a c t e r i z e the c h o i c e  o f an o b j e c t as e v e n t f u l a c c o r d i n g  t o t h e frequency w i t h which i t was  chosen. While i t i s p o s s i b l e t o a c h i e v e some degree o f u n d e r s t a n d i n g by attending  t o the p a t i e n t ' s i n i t i a l  ongoing p a t t e r n o f h i s p l a y i n g . t h a t made t h i s apparent t o me.  c h o i c e , one must a l s o a t t e n d t o t h e I w i l l , p o i n t o u t a few o f the t h i n g s  Consider the f o l l o w i n g :  -2.11 T:  Now t h a t ' s t h e s o r t o f t h i n g where you've g o t a seven y e a r o l d who simply p u l l s t o y s o u t and p u t s them i n t o t h e t r a y , un, and i g n o r e s r e l a t i o n s h i p s so no g r o u p i n g o c c u r s o r v e r y l i t t l e g r o u p i n g o c c u r s , you know you may b r i n g o u t a h o r s e , and may b r i n g o u t another h o r s e , and y e t t h e two h o r s e s have no r e l a t i o n s h i p t o each o t h e r . That s o r t o f t h i n g happens i n o n l y v e r y young c h i l d r e n who a r e j u s t a t the s o r t o f o b j e c t naming stage, c h i l d r e n who a r e r e t a r d e d , some c h i l d r e n who a r e b r a i n damaged, uh, who o f t e n a c t u a l l y go through the whole t h i n g v e r y q u i c k l y .  The  reference  i n t h e above t r a n s c r i p t s i s t o a p a t i e n t who spent t h e whole  session taking the toys i n t h e sand t r a y .  from the box, naming them, and then p l a c i n g them  F o r t h e t h e r a p i s t t h i s k i n d o f a c t i v i t y was n o t e -  worthy because o f t h e p a t i e n t ' s age.  What i s e v e n t f u l i s t h e f a c t  that  the c h i l d p a i d no a t t e n t i o n t o t h e s t r u c t u r e o f t h e sand t r a y placement, t h a t i s , what r e s u l t e d from the 'play' was a random assortment o f t o y s which bore no o b v i o u s r e l a t i o n s h i p t o one another.  The t o y s the c h i l d 2 3-  was p l a y i n g w i t h were a p a r t o f Lowenfeld's "world p i c t u r e t e c h n i q u e " miniature  r e p l i c a s o f p e o p l e , animals., f e n c e s ,  miniature  'world' c r e a t e d by the p a t i e n t r e v e a l s t h e degree o f h i s  disturbance  etc.  The r e s u l t a n t  and g i v e s some s u g g e s t i o n s as t o what t h e d i s t u r b a n c e  In t h i s c o n t e x t , confused, e t c .  is.  the above mentioned c h i l d ' s w o r l d view i s c h a o t i c ,  69  This nessed  and  explained An  incident  took place  I strongly by  felt  examining  examination  of  the  i n the  that  the  the  ("what's t h i s ? " ) , a n d  that  he  to  explanation  the  a  around  fence  ously  therapist  i n terms o f  the  intrapsychic  building stuck;  a  the  solitary  fence so  objects  around  on.  i t was  i t was  For  e x a m p l e , he  had  see  find  here.  the  the  and  the  the  patient  out  always  and  t o me  ocean  one  thought provided  child. as  of  t o be  well.  building  splash  tame a n i m a l s  getting  him.  patient  baby o u t s i d e ;  t h e s e were c o n s i d e r e d  f o r the the  etc. Did  flow of  in a  the  dangerbattle;  vehicles  significant.  i d e n t i f i e d with  this.  of  large  blocks could  Since  i n i t , i t follows  that  the his  of  attend and  also  the  to  one  of  whether note  was  the  meaningful  of play  child's  more t h a n  become i n v o l v e d ,  activity  activity.  to  would  child  e s s e n t i a l problem  content  play  the  therapist  a unit  the  He  the  that  the  the  therapist  s t y l e of  saw  as  initiated  the  then making the  animals;  I simply  The  went l i k e  reality  wild  player.  Even the  what c o u n t e d  activity of  to  and  animals  impersonal,  the  observer  surprised patterns  on  etc.  novice  leaving  be  therapist  t h i s account of  wit-  scenes.  would note  the  a  the  always necessary  personal,  excited  wild  assumed t h a t  orderly,  life  I  and  that  rejected  comments r e f e r e s s e n t i a l l y t o  but  play  person  A l l of  i n these  These  the  h o u s e and  that  therapist  r e l a t i o n s h i p s were p o i n t e d  i n the  engaging  and  Further,  a  of  the  possible  The  parents  near;  it.is  session  " n a m i n g game" c o u l d  show t h a t  continue.  Many o t h e r k i n d s Placing  child's  transcript will  naming  an  therapy  i n t e r a c t i o n s between the  this  was  first  tidy,  effect  that  reluctant, f o r him.  activity  and  meaningful  seemed t o b e  that  of  of  child's play fears  and  using  i s taken  anxieties  As  was  many  way  this.  i t was  discover  One  play  learning the to  will  flow have  to of  elements  intersect  70 with  the  play  at  anxiety  and  one  ing  the  content  the  following  could of  Thus, and  instead  could  strategy in  the  was  which  the  then  play  to  the  t r y and  bring The  might  i f her  activity,  say,  anxiety  i.e., did  the  rejection) refer  to  mention of  the  play  the  it  i s also possible  the  activity  i s , one  could  to  those  level  look  therapist  was  the  her  that  s p e e d e d up.  One  a medical  while  seeing  the  f o r any  move on  to  another  activity?  bag  child  that?"  looking  He  disjuncture did  previous had  t h e r a p i s t noted  be  the  source of  session  seen  follows:  so  had  far.  that  contained  (i.e.,  disrupted.  of  the  f e e l i n g s of Both of  anger  these  her  the  therapist. from the  disruption  outside  However,  activity  i n the  or  examples  disruption i s located  d i s r u p t i o n coming  In  an  a p a t i e n t was the  earlier  in  on.  may  f o r evidence  feelings so  by  so  postponed.  surface  of placing seeing  be  rose  s e n s i t i v e area  the  as  not  t o be  trouble  i . e . , i n a comment b y see  to  in  expressed  t o work o u t  that  having  the  could  anxieties  examin-  itself.  content  of  play. A  he  itself,  operation  enough t i m e  you  and  activity  child's  made c l e a r t o me  and  to mention eyes or  she  s i t u a t i o n s i n which  of  That  a  was  surgery  m e n t i o n e d was  m o t i o n s become more e r r a t i c ? At  This  normal p r o c e s s had  "Are  the  i m m e d i a t e p r o b l e m was  the  child  A n o t h e r was  He  see  that point.  since  heighten  something about h i s p r o b l e m by  a n t i c i p a t e d eye  I have a l r e a d y  room.  s c e n e s may  patient's  d e a l t with.  playing.  could  at  therapy  allowing  had  be  play  play The  the  of  f e a r s , he  they  the  r e l a t e d to  to hurry  Play  then discover  scene.  extreme a n x i e t y obliged  some p o i n t s .  making  largest period session  he  had  'progress' of  for  her  creative play  described  her  that  play  as  71 2.12 T:  S t r a n g e s o r t o f , a t one p o i n t s h e c a n d e a l w i t h h e r c r e a t i v e l y i n t h a t s h e ' s y o u know p r e p a r e d t o a d o p t imitation of r e a l i t y .  R:  mmhmm  T:  And t h e n , a t t h e (worst) she g o e s b a c k t o t h e s o r t o f r e g r e s s i v e s t u f f w i t h sand, m i x i n g o f p a i n t , baby s o r t o f s t u f f . It's f a i r l y t y p i c a l I suppose i n a p l a y therapy s e s s i o n t o get t h i s , t h e s e swings are v e r y marked.  Here, however, the reality,  and  that  i s making p r o g r e s s .  she  bolism she  of  was  the  regressive  play  engaged This  normal  her  t h e r a p i s t saw  activity.  with  h i s problems  rules  The  and  of  i s evident there  I immediately play  room.  a whole,  the  the  child  works out  that  the  then w i l l  child  regress  will to  regressive periods  are  two  more p u z z l e s  One  there  kinds  to  indicate  upon t h e  current  the  that  these  sym-  of play  r e g r e s s i v e was  as  noted  relation  that  'regressive'.  from c r e a t i v e t o  and  her  characterization relies  expected  for a while  conclusion,  f o r the  Taken as  upon a r e c o g n i t i o n o f  changes  I t i s t o be  Progress  mention.  tendencies.  i t i s assumed t h a t  play  In  child's creativity,  i n , i . e . , ' c r e a t i v e ' and  sequence  since  stage.  objects  the  anxiety very a very close  that  appeared  therapist told  a  seen  as  concerns  in  be  an  able  earlier  to  cope  safer  diminish. I would  t o be  a  like  to  special set  of  child:  2.13T:  and, and y o u do t h a t .  C:  Why?  T:  Cause t h i s  can  a l s o swear i n t h e  i s a place  where k i d s  play  can  do  room even i f y o u  wanted  to  p r e t t y much w h a t t h e y w a n t  to.  2.14, T:  Sometimes I b e t y o u even  C:  No I d o n ' t  T:  Hmrnm? Y o u know, o n e p l a c e w h e r e i t ' s r e a l l y h e r e i n t h e p l a y room.  C:  I know.  T:  That's r i g h t . things, right  C:  (  swear.  Hmmm? swear.  C:  (  ((pause))  Yep r i g h t a l l out. Wowweee.  C:  The k i c k - o f f .  to  Why  A t home  though  c h i l d r e n were a l l o w e d  that a child emotions. the c h i l d  tolerant  )  I t h i n k s o m e t i m e s i t , b u g s mom  t o make  t o p a i n t on t h e w a l l s , t o s h o o t  s h o u l d be g i v e n  I t i s important makes p r o g r e s s  relationship,  c a n now b e s e e n  helps  as t h e r e s u l t  b e h e l d t o a minimum  (a) p a r t i c i p a t i n g  i n an a c c e p t i n g and  a n d (b) e x p r e s s i n g h i s c o n s t r i c t e d  the relationship  of the  t h e freedom t o e x p l o r e and e x p e r i e n c e  that restrictions by  bottles,  or the therapist, e t c .  opment w i t h i n t h e s a f e t y o f t h a t r e l a t i o n s h i p . tions  i f you  the therapist  u n b e l i e v a b l y l o u d n o i s e s , t o smash  throw d a r t s a t a drawing o f a t e a c h e r  since  say fuck and a l l those  h e r e i n t h e o l d p l a y room, t h a t ' s a g o o d p l a c e t o , l e t i t You c a n swear, y e l l , and a l l t h o s e t h i n g s . ((pause))  a water p i s t o l ,  idea  good t o swear i s r i g h t  )  Some o f t h i s p e r m i s s i v e n e s s  his  you can even  the darts  watch t h i s  T:  with  ((pause)) here.  y o u want t o  T:  Other  swear.  t o develop.  emotional  devel-  The r e d u c t i o n o f r e s t r i c -  Ginott puts  i tnicely  when h e  says: Many c h i l d r e n h a v e b e e n s c o l d e d o r s p a n k e d f o r m e s s i n g w i t h m o t h e r ' s typewriter, fooling with brother's flashlight, or playing with father's tool k i t . Nothing conveys permissiveness t o these c h i l d r e n a s much a s t h e p r e s e n c e o f s u c h m a t e r i a l s f o r t h e i r own u s e .  73 Noisemaking t o y s such as drums, pegboards, xylophones, a i r r i f l e s , and cap guns serve the same purpose. They communicate l o u d and c l e a r the a d u l t ' s b a s i c s p i r i t o f tolerance.'24 T h e r a p i s t s a l s o take i t t h a t t h e r e a r e some a c t i v i t i e s t h a t r e l a t e t o the c h i l d ' s problem.  I t i s o f t e n p r o f i t a b l e t o a l l o w t h e c h i l d t o do  and f e e l t h i n g s t h a t he has n o t been a b l e t o do i n o t h e r s e t t i n g s .  I once  q u e s t i o n e d a t h e r a p i s t about a c h i l d ' s a c t i o n s . .2.15 R:  W e l l how do you t h i n k the k i d , what's g o i n g on f o r t h e k i d when he throws d a r t s a t t h e b a l l o o n s , and sometimes p r e t e n d i n g t h e b a l l o o n s are you?  T:  W e l l , I don't know, I t h i n k he can g e t i n t o i t , you know, t h a t i s , t h a t he can r e a l l y k i n d o f a c t o u t t h e f e e l i n g s o f anger he has towards me. And I t h i n k t h a t ' s k i n d o f a r e l i e f i n a sense. ( ) ((pause)) I t h i n k f o r C h r i s t o o i t might make him f e e l r a t h e r brave and d a r i n g . And I t h i n k he can g e t some s a t i s f a c t i o n from t h a t . Some o f t h e assumptions here s h o u l d be pursued.  It's a "relief"  f o r t h e c h i l d t o express h i s anger w i t h the t h e r a p i s t because he was n o t a l l o w e d t o e x p e r i e n c e anger i n o t h e r r e l a t i o n s .  Perhaps when he g o t angry  w i t h h i s p a r e n t s , as a l l c h i l d r e n do, he was n o t p e r m i t t e d t o express h i s f e e l i n g s b u t was made t o f e e l g u i l t y f o r b e i n g angry w i t h h i s p a r e n t s i n the f i r s t p l a c e .  A c h i l d w i t h t o o many r e s t r i c t i o n s o f t h i s s o r t may  become t i m i d , m a n i p u l a t i v e o r many o t h e r t h i n g s .  However, i f he i s  a l l o w e d t o vent h i s f e e l i n g s i n the p l a y room, he may come t o see h i m s e l f i n a d i f f e r e n t way (e.g., 'brave', and- ' d a r i n g ' ) , and l e a r n t o keep up t h i s image o u t s i d e o f t h e therapy s e s s i o n . T h i s r e l a t e s d i r e c t l y t o my f i n a l p u z z l e . the p a t i e n t ' s problems and g a i n e d an u n d e r s t a n d i n g the c h i l d i n a f a m i l y c o n t e x t .  While  As an o b s e r v e r , I saw o f them o n l y by p l a c i n g  I have n o t t a l k e d about t h e p a t i e n t ' s  f a m i l y t o t h i s p o i n t , I do n o t mean t o suggest t h a t i t was n o t seen as an  74 important talk  about  father's in  factor.  Without  exception,  the s i t u a t i o n of h i s family,  occupation,  the family,  the family's  and so f o r t h .  i n c i d e n t a l b u t were r e l e v a n t the  child.  tions. with  Children's  the c h i l d ' s s i b l i n g  theories  about  I assumed, t h a t  regions.  This  family's 'evil',  strict  with  often  related to their typically colors  contrasting people  problem only  religious belief,  and h i s concomitant  traumas  i n d i c a t i o n s o f what m i g h t be t h e m a t t e r  made p s y c h i a t r i c a l l y r e l e v a n t  symptom o f t h e p a t i e n t ' s  rearing,  none o f t h e s e  i n d i c a t e d by c o n t r a s t i n g that  position, his  were  productions  h i s t a l k suggested  child  included  features  A s a t h e r a p i s t t o l d me, o n e p a t i e n t  a c l e a r dichotomy  often  t h e t a l k about a p a t i e n t  need  produced  situa-  paintings  ( r e dand b l a c k ) and  inhabited  sense  family  these  and c o u l d  two  be s e e n a s a  when i t was s e e n a s a d o c u m e n t o f h i s  h i s struggle  with  the notions  t o be naughty o r m i s c h i e v o u s ,  H e r e i s some o f t h e t h e r a p i s t ' s t a l k a b o u t t h a t  o f 'good' a n d (i.e.,  evil).  child:  2.16 T:  . . . come o n s o u n d i n g v e r y g o o d , a n d I g u e s s t h a t ' s t h e way i t i s a t home. I w o u l d g u e s s f r o m . t h e way h e ' s i n t e r a c t i n g i n t h e p l a y r o o m t h a t a t home ( ) y o u c a n ' t do t h i n g s b e c a u s e y o u w o u l d l i k e t o do t h a t b e t t e r o r because y o u p r e f e r , y o u have t o be r a t h e r a b o u t t h e w h o l e t h i n g a n d d o i t f o r t h e g o o d o f somebody know, i t ' s n o t l e g i t i m a t e i f i t h a s a s e l f i s h m o t i v e , a t suspect. C e r t a i n l y f r o m o b s e r v i n g h i m i n t h e p l a y room get that impression. There  actions  i s a constant  as outcomes o f h i s e v e r y d a y  a n c e t o them. is  that  into h i s real can  There  a manipulator  problems  attempt by t h e r a p i s t s  i s a great  life  assume t h a t  there  psychiatric  d i f f e r e n c e between assuming t h a t  he h a s i n h i s f a m i l y . That  t o see the p a t i e n t ' s  and t o g i v e  and assuming t h a t h i s b e h a v i o r  problem.  selfless else. You home I one w o u l d  This  i s , given  i s some p r o b l e m  a  child  i s the r e s u l t of the  provides  that  signific-  us w i t h  the c h i l d  i n h i s home  life.  some i n s i g h t  i s manipulative,  we  75 This  kind  of evidence  i s u s e f u l not  p r o b l e m s were vague, b u t  a l s o i n cases  glance,  For  and  of  t o be  changing her  fication icance  However, t h e s e  when i t was  discovered  specifically  brothers,  towards her  her  mother.  i n the  rationality (although  In 1.  I  atrict for  the  setting  (a)  children  the  Instead  of  seeing  see  i t as  systematic  (c)  I no  longer  saw  To  some e x t e n t ,  therapists. o f my  own.  able  following  That  seen  to have a  i n the  I could  see  well  play  I began  of  negative  to feelings  things.  a description of because  of  the  I was  already  setting.  following I saw  that they and  had  merely  p a t i e n t s as  psychi-  normal  problems. I began  to  disturbed children. as p l a y , b u t  progress,  same s e n s e o f  to acquire  a  transformations  repetitive,  to help  trust,  t o make t h e  i s , I began  family  attention given  room were o p e n t o  activities as  signif-  observations:  programme d e s i g n e d  as  identi-  p s y c h i a t r i c relevance  this  hour^as d u l l  child's  sex  picture of  first  whiskers  a different  f a t h e r and  f o r the  t o do  growing  i n terms o f her  a different  T h i s produced the  therapy  the  documents o f p r o b l e m s , (d)  talked of  differential  have p r o v i d e d  events  i n which  (b)  a  at  be  I moved f r o m a p o s i t i o n w h e r e i n  t o one  appeared,  a competent p a r t i c i p a n t t o the  I made t h e  a l l of  problem  made s e n s e  the  I was  interpretation.  me.  they  searching and  child's  who  easily  have q u i t e  by  setting.  summation, that  we  chapter  unwittingly)  found  how  where t h e  symptoms w e r e g i v e n  i n terms o f  Now,  therapy  of  a girl  p o s i t i v e f e e l i n g s towards her  I began t h i s events  example,  i n cases  where the  name t o J o h n c o u l d  problem.  situation, her  obvious.  only  as  etc. events  as  the  a psychiatric rationality  76 2.  I also learned  t h a t i t was  not  s u f f i c i e n t to explain a patient's  b e h a v i o r i n terms o f the nature o f p a i n t , the time o f day, etc.  body u r g e s ,  Rather, p s y c h i a t r i c accounts i n v a r i a b l y l e a d the t h e r a p i s t t o  f e a t u r e s o f the p a t i e n t ' s l i f e o u t s i d e intrapsychic functioning).  o f the p l a y room  These e x p l a n a t i o n s  (or t o h i s  came about by  seeing  the therapy room as an i n t e r a c t i o n a l environment i n which a l l a c t i o n s were the r e s u l t o f i n t e n t i o n a l (even when unconscious) 3.  To a c h i e v e p s y c h i a t r i c u n d e r s t a n d i n g one motivational  to provide  adequate  statements w i t h r e s p e c t t o those c h o i c e s .  done i n many ways, but the most f r e q u e n t accounts framed i n terms o f the members and  had  choices.  and  'family'.  consequently t h i s p r o v i d e s  was  most i n t e r e s t i n g were A l l c h i l d r e n are  an u b i q u i t o u s  s t a n c e s i n which t o f i n d the m o t i v a t i o n s  This  set of  family circum-  f o r the p a t i e n t ' s p l a y room  behavior. 4.  Thus we  have moved from our  initial  interest in psychiatric  relevance  t o a c o n s i d e r a t i o n o f mundane knowledge about c h i l d r e n , f a m i l i e s , problems, e t c . As  I became more f a m i l i a r w i t h the t h e r a p i s t ' s a c c o u n t s , I became  more d i s s a t i s f i e d w i t h my a f f e c t i o n stemmed from two the  new  u n d e r s t a n d i n g o f the s e t t i n g .  sources.  F i r s t , w h i l e t h e r e was  s t r u c t u r e o f p s y c h i a t r i c accounts was  t h i s was  never made e x p l i c i t f o r me.  never a c q u i r e  dis-  a claim  supported by a body o f  that  theory,  Consequently, I f e l t t h a t I c o u l d  an adequate u n d e r s t a n d i n g o f how  o f the events o f the p l a y room.  This  p s y c h i a t r i s t s make sense  Secondly, I became i n c r e a s i n g l y aware o f , 25  and  i n t r i g u e d by the s e t o f membership c a t e g o r i z a t i o n d e v i c e s  appeared i n t h i s s e t t i n g . the o c c a s i o n e d  categories  One of  out  could,  that  f o r example, n a i v e l y assume t h a t  ' p a t i e n t ' and  ' t h e r a p i s t ' would be  adequate  77 for  categorizing  frequently neither  the p a r t i c i p a n t s .  referred  However,  t o as 'adults'  the category of 'patient'  I found  and ' c h i l d r e n ' nor the a c t i v i t y  t h e members  were  and, f u r t h e r ,  that  o f 'therapy'  were  ever  2_ mentioned  t o the ' c h i l d . 1  was t h e o b s e r v a t i o n  the p o s s i b i l i t y  o f sounding  therapists  often talked  and  having  the patient  the  corpus  o f knowledge r e p r e s e n t e d by t h e t h e r a p i s t ' s  that  respond  like  a 'child'.  c o n t a i n e d a g r e a t d e a l o f common s e n s e  shared with  the therapists.  psychiatric and  point,  common s e n s e  atric  me b a c k t o w h e r e  and s e a r c h e d  i n this  raises  interpretive  families.  therapists  o f what  circle  was o n e that  I  sense  with  doubted  relevance.  t o a new a w a r e n e s s a b o u t  some s e r i o u s q u e s t i o n s a b o u t schema, b u t b e f o r e  and I want  I had s t a r t e d  At  this  this  t h e embededness  setting.  T h i s corpus  the nature  turning t o these, corpus  t o emphasize the e s s e n t i a l  description  o f the r a t i o n a l i t y detail.  Up t o t h i s  I want  accounts  t o examine  reasonableness  The n e x t  children  p r o v i d e d by  p o i n t I have p r e s e n t e d  of the setting.  of the psychi-  o f knowledge about  i s c o n s t r u c t e d from  structure.  p r o v i d e more  accounts  I saw a n d h e a r d ,  for i t s psychiatric  explanatory  will  common  I had begun.  some o f t h e f e a t u r e s o f t h e t h e r a p i s t ' s and  t o see that  knowledge  we h a v e come f u l l  This  •  on t h e r e a s o n a b l e n e s s  reasonableness,  T h i s l e d me  a parent  reasoning—something  relevance  observations  like  that  That i s :  theory  This brought  of  about  Related to this  of this  a rather two  broad  chapters  78 Footnotes  ""For a b r i e f i n t r o d u c t i o n t o t h i s l i t e r a t u r e see R. M. P a v a l k o , S o c i o l o g y o f Occupations and P r o f e s s i o n s , ( I t a s c a : F. W. Peacock P u b l i s h e r s Inc.) 1968. 2 By " r a t i o n a l i t y " I would l i k e t o employ C i c o u r e l ' s usage: " . . . r a t i o n a l i t y means the o b s e r v e r ' s model o f how the a c t o r decides-what i s 'reasonable', 'proper', ' l o g i c a l ' , ' a c c e p t a b l e ' , ' l e g a l ' , and so f o r t h d u r i n g the course o f a c t i o n . " As an o b s e r v e r , I was c o n s t a n t l y engaged i n the c o n s t r u c t i o n o f a 'model' o f what seemed r e a s o n a b l e , p r o p e r , l o g i c a l , expected, u s u a l , a c c e p t a b l e , e t c . i n t h i s s e t t i n g . T h i s was based on the t a l k o f o t h e r s i n the environment. I am t a l k i n g about the background e x p e c t a n c i e s t h a t made events r e a s o n a b l e , e t c . See, A. C i c o u r e l , The S o c i a l O r g a n i z a t i o n o f J u v e n i l e J u s t i c e , John Wiley and Sons, 1968, p. 46. 3 . V. A x l m e i s one o f the major advocates o f p l a y t h e r a p y and her work i s h e l d up as an example o f 'good' ( i f u n a t t a i n a b l e ) t h e r a p y . 4 T h i s k i n d o f t h e r a p y i s sometimes r e f e r r e d t o as ' n o n - d i r e c t i v e therapy'. That t h i s c h o i c e i s t h e o r y governed i s e v i d e n t i n the f o l l o w i n g statement by G i n o t t : "The d i f f e r e n c e between the two s c h o o l s o f thought i s s u c c i n c t l y summarized i n t h e i r d e f i n i t i o n s o f p e r m i s s i v e n e s s . According t o one approach, p e r m i s s i v e means the acceptance o f a l l b e h a v i o r as i t appears i n the (therapy) group. . . a c c o r d i n g t o the o t h e r approach, p e r m i s s i v e n e s s means the acceptance o f a l l symbolic b e h a v i o r as i t appears i n therapy. . ..." "The Theory and P r a c t i c e o f T h e r a p e u t i c I n t e r v e n t i o n i n C h i l d Treatment", J o u r n a l o f C o n s u l t i n g Psychology, 23 (1959), p. 160. ^H. G i n o t t , " P l a y Therapy: The I n i t i a l S e s s i o n " , American J o u r n a l o f Psychotherapy, 15 (1961) p. 74. Compare t h i s t o a r e c e n t l e t t e r t o Ann Landers. Dear Ann: I am 35. My husband i s 40. We are b o t h v e r y busy w i t h c a r e e r s . I'm b e g i n n i n g t o f e e l a l i t t l e s e l f i s h because our e i g h t y e a r - o l d c h i l d won't have a b r o t h e r o r s i s t e r u n l e s s we g e t busy. My husband doesn't c a r e one way o r the o t h e r . I f r a n k l y don't l i k e the i d e a o f g o i n g back t o d i a p e r s and b o t t l e s . But I f e e l g u i l t y . Should we ask our daughter i f she would l i k e a b r o t h e r o r s i s t e r and s e t t l e i t once and f o r a l l ? - ??? Answer: A d u l t s who would a l l o w an e i g h t - y e a r - o l d t o make such a d e c i s i o n sound downright f o o l i s h t o me. I t h i n k you have more than you can handle r i g h t now. Vancouver Sun, Aug. 20, 1974. On the b a s i s o f a survey J . Goodman and J . Sours r e p o r t : "Only t h r e e c h i l d p s y c h i a t r i s t s i n d i c a t e d t h a t they b e l i e v e d p r e s c h o o l and e a r l y l a t e n c y c h i l d r e n c o u l d c a r r y on a meaningful p r o b l e m - o r i e n t e d d i s c u s s i o n " . The C h i l d Mental S t a t u s Examination, New York: B a s i c Books, 1967, p. 15. 7  The P s y c h i a t r i c I n t e r v i e w , New  York:  W.  W.  Norton  and Co.,  1954.  79 8 F. Swanson a d v i s e s : " S i n c e t e c h n i c a l l y the c h i l d i s t h e p a t i e n t , the t h e r a p i s t might b e g i n by a s k i n g him what brought him t o the c l i n i c — w h a t are some o f the t h i n g s he and h i s p a r e n t s worry about. R e l a t i v e l y few c h i l d r e n can v e r b a l i z e t h e i r problem i n i t i a l l y . . . . Most c h i l d r e n a r e c l e a r l y aware o f t h e i r problems o n l y w h i l e t h e problems a r e happening. . . B e s i d e s , young c h i l d r e n have r e l a t i v e l y l i t t l e p e r s p e c t i v e about b e h a v i o r , l i f e , families. They have l i t t l e b a s i s f o r comparison. To them, ' t h i s i s the way l i f e i s ' . " P s y c h o t h e r a p i s t s and C h i l d r e n : A P r o c e d u r a l Guide, Pitman P u b l i s h e r s Co., 1970, pp. 30-31. Schulman, e t a l , who c r i t i c i z e t h e r a p i s t s f o r t h i n k i n g o f c h i l d r e n as "immature, dependent, r e l a t i v e l y h e l p l e s s and t o be p r o t e c t e d " , suggests: "our i n t e r v i e w , t h e r e f o r e begins w i t h an e x p l a n a t i o n o f the r o l e o f the t h e r a p i s t . T h i s merges i n t o a d i s c u s s i o n o f problems i n g e n e r a l and s p e c i f i c problems which t h e c h i l d i s experiencing". The T h e r a p e u t i c D i a l o g u e , p. 146. 9 A c o n t i n u a t i o n o f t h i s can be found  i n t r a n s c r i p t 1.1.  10 H. G i n o t t , Group Psychotherapy w i t h C h i l d r e n , p . 87. " _ i n o t t says, "The aim o f a l l therapy. . . i s t o e f f e c t b a s i c changes i n the i n t r a p s y c h i c e q u i l i b r i u m o f each p a t i e n t " . Group Psychotherapy w i t h C h i l d r e n , p. 2. 1  12 T h i s i s a common o c c u r r e n c e . F o r example, L. J . R e d l i n g e r i n h i s r e s e a r c h i n a r e s i d e n t i a l treatment c e n t r e f o r d i s t u r b e d c h i l d r e n p o i n t e d out t h a t some members o f the treatment s e t t i n g " t r e a t as p r o b l e m a t i c t h e o f f i c i a l view o f the c h i l d r e n as s i c k , and i n some cases r e j e c t the d i a g nosis". "Making Them Normal", American B e h a v i o r a l S c i e n t i s t , 14 (1970) pp. 237-253. 13 From a t a l k g i v e n on C.B.C. Radio. 14 Schulman, e t a l , f o r example r e f e r t o t h i s as a "simple c o n t i n u i n g response". Op. c i t . , pp. 93-94. 15 V. A x l i n e , P l a y Therapy, New York: B a l l a n t i n e Books, I n c . , ( r e v i s e d e d i t i o n ) 1969, p. 99. " ^ A l l t h e r a p i s t s can p r o v i d e an account o f the f u n c t i o n o f p l a y f o r children. F o r example, " p l a y a c t i v i t y i s the c h i l d ' s n a t i v e t o n g u e — h i s n a t u r a l way o f showing how he f e e l s about h i m s e l f and the s i g n i f i c a n t p e r s o n s and events i n h i s l i f e " . G i n o t t , Group Psychotherapy w i t h C h i l d r e n , p. 176: " P l a y , t h e c h i l d ' s most n a t u r a l medium o f e x p r e s s i o n . S i n c e i t i s e s s e n t i a l t o p r o v i d e t h e c h i l d w i t h the o p p o r t u n i t y t o use h i s n a t u r a l t o o l s and modes o f e x p r e s s i o n , we see a t once t h a t p l a y a c t i v i t y i s an important f a c t o r i n t h e r a p e u t i c work w i t h c h i l d r e n " . F. A l l e n , Psychotherapy w i t h C h i l d r e n , New York: W. W. Norton and Co., 1942, p . 122. 17 J . Anthony, "Communicating T h e r a p e u t i c a l l y With The C h i l d " , C h i l d P s y c h i a t r y , 3 (1964) p. 107. 18 ' E. E r i k s o n , C h i l d h o o d and S o c i e t y , New York: W. W. Norton and Co., 1950, p . 222.  80 """For an account o f t h i s development P l a y , Penguin Books, 1968.  see S. M i l l a r , The P s y c h o l o g y o f  20 "Whatever t h e c h i l d does o r says i s always used by t h e examiner t o r e l a t e t o t h e problem f o r which t h e c h i l d was brought by t h e p a r e n t " . H. R. B e i d e r , " P s y c h i a t r i c D i a g n o s t i c I n t e r v i e w s w i t h C h i l d r e n " , J o u r n a l o f American Academy o f C h i l d P s y c h i a t r y , 1 (1962) , p. 658. 21 "A R a t i o n a l e f o r t h e S e l e c t i o n o f Toys", J o u r n a l o f C o n s u l t i n g Psychology, 24 (1960), p. 246. 22  I b i d . , p . 243.  23 A t e c h n i q u e made a v a i l a b l e by Lowenfeld i n 1939, see, M. Lowenfeld, "The World P i c t u r e o f C h i l d r e n " , B r i t i s h J o u r n a l o f M e d i c a l P s y c h o l o g y , 18 (1939), 65-101. 24 Op. c i t . , p. 244. 25 The n o t i o n o f 'membership c a t e g o r i z a t i o n d e v i c e ' i s taken from Harvey Sacks, s e e , "An I n i t i a l I n v e s t i g a t i o n o f t h e U s a b i l i t y o f Convers a t i o n a l Data f o r Doing S o c i o l o g y " , i n D. Sudnow (ed.) S t u d i e s i n S o c i a l I n t e r a c t i o n , New York: F r e e P r e s s , 1972, pp. 31-74. .'•'••26 When asked about t h e h e s i t a t i o n i n t h e f o l l o w i n g t h e t h e r a p i s t s a i d she never used t h e term "therapy" w i t h a c h i l d p a t i e n t . T: 'Cause I t h i n k y o u r e a l l y l i k e t o take a p i e c e o f our t h e r - our s e s s i o n home w i t h you. ((pause)) You l i k e t o have something t o remind you o f o u r time t o g e t h e r , huh.  CHAPTER 3 'NORMAL' CHILDREN AND Chapters rationality the  logical, d r e w my  3 and 4 a r e a f u r t h e r  o f the therapy  therapists'  THE T H E R A P I S T ' S CORPUS OF KNOWLEDGE  setting.  activities  That  as meaningful  acceptable, e t c . attention  e x p l o r a t i o n and d e s c r i p t i o n  1  i s , they  events,  My d i s e n c h a n t m e n t  t o a primary  and fundamental  tell  how  of the  I came t o s e e  o r as r e a s o n a b l e ,  with  'psychiatric  proper,  theory'  property of practical  reason-  2 ing,  that  i s , t o "background  expectancies observers taking  decide  that  f o r u s i f we w i s h accounts  The n o t i o n o f b a c k g r o u n d  t o answer t h e q u e s t i o n :  a r e adequate  f o r understanding  proper  i s clear  that  t h i n g b u t make  do t h i s .  engaged  actors i n the world  i t apparent  that  do  what i s  are adequate.  Thereby,  I would  On t h e o n e h a n d , c h i l d r e n who  are also  seen  like  adequacy  a c t i o n s and under-  to outline  some o f t h e  visible. a r e seen  they  a s c h i l d r e n who a r e more o r l e s s  found  our notions o f normality are e s s e n t i a l  business  o f therapy.  Specifically,  patients  a t the c l i n i c  as " d i s t u r b e d c h i l d r e n " ,  and, as such,  I mean t h a t  f o r making  normal.  sense  a l t h o u g h we may we w i l l  also  I  of the  l a b e l the  recognize  h a v e a n d d i s p l a y many o f t h o s e  81  as d i s t u r b e d  On t h e o t h e r h a n d , a n d a t t h e  same t i m e ,  are children  n o t o n l y do t h e  are continually  their  attend the c l i n i c  o r a s c h i l d r e n who h a v e p r o b l e m s .  that  life  t h e y h a v e done s o and a r e o b l i g a t e d  o f making and showing t h a t  b a c k g r o u n d e x p e c t a n c i e s t h a t make t h i s  children  of daily  T h e r a p i s t s a s members o f t h e l i f e - w o r l d ,  i n the process  standings  they  "How  place? It  to  i s vital  expectancies".  that  qualities  82 w h i c h we  would expect  some e x a m p l e s o f how significance One the  of  clinic  relevant  i n the the  deals  to  and  and  contrasting  thing  they  i n every  s a i d and Let's  way  did  i n which  aspect could  contact  made, i n t r o d u c t i o n s nothing  t o do  patients and  as  with  the was  to the  begins  an  This  t h e n g o e s on  and  was  play  t o do",  have  in  while is  two  behavior.  or,  On  thought of  the  clinic  the  saw  as  and  "normal  their  contrary,  treated  to  be  most o f  instead  the were  the  first  A l l o w me interview  has  to  made c l e a r i n p s y c h o t h e r a p y  handling  what  normal.  appointments  i s oriented  six  patients  I t i s clear that  ( i . e . how  t o manage p a t i e n t s .  following  Thus  t h e r a p i s t w e r e managed, e t c . , )  problems but  on  and  that  considered  the  made a b o v e .  room and  how  conversely  were n o t  com-  i s "a n o r m a l  therapists usually  patients  i s often  article  of  some p a r t i c u l a r a c t i o n  made w i t h  This  pattern  their behavior.  patients'  to offer  i s that  what h a p p e n s h e r e  t h e f i r s t e n c o u n t e r between t h e r a p i s t and c h i l d p r e s e n t s t e c h n i c a l problems t h a t c a l l f o r immediate decisions.4 He  give  c h i l d r e n come t o  i s made e v i d e n t  some s t a n d a r d  latter point  the  an  to  I will  observer might n o t i c e  c h i l d r e n , much o f  i s , the of  be  children.  Ginott  that  that  i n t h e r a p i s t s ' r e m a r k s on  ate.  i n regard  Secondly,  That  consider  normality  s i x year o l d  that".  normal c h i l d r e n .  disturbed  them t o  for a  follows,  t h e r a p i s t s o f t e n make s e n s e o f p h e n o m e n a b y  f o r example,  d o n ' t do  In what  normal c h i l d .  First,  expectable  to have.  room. things  f o r the  say,  as  play  of  with disturbed  they might  year olds  child  notions  first  i m p o r t a n t ways. paring  any  manuals to  by  elaborsaying:  many  advice.  The t h e r a p i s t f a c e s h i s f i r s t p s y c h o - l o g i s t i c p r o b l e m : how t o l e a d a c h i l d t o t h e p l a y r o o m w i t h a minimum o f s h e d d i n g o f b l o o d , s w e a t , t e a r s , and o t h e r f l u i d s . The s e n s i t i v e t h e r a p i s t u n d e r s t a n d s t h e c h i l d ' s f e e l i n g s i n the s t r a n g e s i t u a t i o n , . . .He anticipates with sympathy t h e s c e n e o f s e p a r a t i o n b e t w e e n m o t h e r a n d c h i l d , . . . He knows t h a t t h e c h i l d r e n may c r y , r e f u s e t o l e a v e m o t h e r , d e c l i n e t o  83 e n t e r the p l a y room, o r demand t h a t mother comes w i t h them; o r t h a t mother may c r y . . . . When t h e t h e r a p i s t meets the' c h i l d f o r t h e f i r s t time, he g r e e t s him w i t h a b r i e f h e l l o , d i s p e n s i n g w i t h f o r m a l i n t r o d u c t i o n s , and s o c i a l a m e n i t i e s . . . . He extends h i s hand t o t h e c h i l d and o f f they go.-' Concomitantly,  occupational resources  abound w i t h i n f o r m a t i o n on how t o g e t  c h i l d r e n ' s c o o p e r a t i o n , what c h i l d r e n l i k e t o do and what they don't to  do, how t o t a l k t o them, and so on.^  like  Throughout t h e emphasis i s upon  children. T h i s a t t e n t i o n t o p a t i e n t s as c h i l d r e n i s seen most c l e a r l y i n the use o f toys as therapy the e x p e c t a b l e  devices.  As suggested e a r l i e r , t h i s i s n o t based upon  f e a t u r e s o f p a t i e n t s , b u t upon our i d e a s about what a l l  c h i l d r e n are l i k e .  A l t h o u g h t h e r a p i s t s make a k i n d o f sense o u t o f the  c h i l d ' s p l a y t h a t the l a y member n o r m a l l y for  would not, the a c t s o f p r o v i d i n g  t h a t p l a y and o f s e e i n g a r e l a t i o n s h i p between the c h i l d ' s p l a y and  o t h e r t h i n g s appear t o be q u i t e r e a s o n a b l e . it  I suggest f o r example, t h a t  i s no d i f f e r e n t than the way i n which a p a r e n t may see h i s c h i l d ' s  f u t u r e c a r e e r i n the k i n d s o f t o y s t h a t he s e l e c t s , o r i n h i s i n t e r e s t i n  7 o r a b i l i t y t o use p a r t i c u l a r t o y s . use t o y s i n the playroom. apparently  S i m i l a r l y , i t appears r e a s o n a b l e t o  The t h e r a p i s t ' s s e l e c t i o n o f t o y s ,  while  j u s t i f i a b l e on t h e r a p e u t i c grounds a l o n e , appears t o be based 8  l a r g e l y upon i d e a s about what a l l c h i l d r e n l i k e t o do.  Furthermore, t h i s  s e l e c t i o n takes age and sex d i f f e r e n c e s i n t o account. In t h e f o l l o w i n g i n s t a n c e , we see how age d i f f e r e n c e s r a i s e  consid-  e r a t i o n s f o r the t h e r a p i s t . 3.1 T:  I f . I go downstairs ( ( t o t h e day care c e n t r e ) ) and t h e r e ' s a l i t t l e f o u r o r f i v e y e a r o l d p l a y i n g w i t h some puppets, and i f I say, "who i s i t ? " , t h e y ' l l say "mommy o r daddy". Ah, they g e t r i g h t i n t o i t . But f o r some one l i k e C h r i s o r John ( ( o l d e r c h i l d r e n ) ) i t would be v e r y h a r d f o r them t o t e l l you t h a t t h a t was mommy o r daddy they were j u s t pounding w i t h the hammer.  «  84 This  follows  learned tion  from the n o t i o n  t o mask t h e i r  t h a t yoking c h i l d r e n a r e h o n e s t  feelings,  o r h a v e not  yet learned  c a n be p a s s e d on t o what c a t e g o r i e s o f h e a r e r s .  some t h e r a p i s t s s u g g e s t beneficial  and t e n d s  that having  a young c h i l d  t o s p e e d up t h e p r o c e s s  and have n o t y e t  about what  informa-  In a s i m i l a r  manner  i n family therapy  because  the c h i l d  i s both  i s so  9 honest. Attendance pist  i n t h e f o l l o w i n g way.  w h a t was  chairs.  Some p a p e r  two l a r g e  that  He p r e p a r e d  toys  a small  were  was  t h e r o o m a n d was room w h i c h  s e t i n t h e room.  o f such  i t was  able  although  to present  Some o b j e c t s  a space t h a t would  T h e r e were numerous o t h e r behavior.  the c h i l d  instances  health  to discover h i s  a t a b l e and  two  on t h e t a b l e a n d o n e  The t h e r a p i s t  a n a g e t h a t he m i g h t w a n t  to talk.  time i n  group o f p u b l i c  contained  n o t opened.  to play  wishing  thera^  T h e t h e r a p i s t ' s t o y b o x was  I f t h e t o y s w e r e made t o o o b v i o u s  appropriate  a patient f o r the f i r s t  for a visiting  play.  (drawing m a t e r i a l s )  d i s p l a y e d by another  and w r i t i n g m a t e r i a l s were p l a c e d  i n t h e room a l t h o u g h  the c h i l d  seeing  session  I observed him preparing  intentions.  placed  He was  t o be a d e m o n s t r a t i o n  nurses.  or  t o t h e a g e o f t h e p a t i e n t was  explained  either to talk may  have f e l t  were n e c e s s a r y look  less  also  or to  obligated  however,  threatening.  i n w h i c h t h e r a p i s t s spoke o f age  F o r example:  3.2 T:  I'm  really  R:  Y e a , a h , I'm aside  impressed not sure  with what  Tanya as a c h i l d  Yea, I t h i n k  R:  Y e a , s h e seems  T:  More  so than  with.  i t i s b u t s h e seems v e r y  from the k i n d o f t h i n g s  T:  t o work  s h e seems q u i t e  unusual,  t h a t maybe seem b i z a r r e , o r , precocious.  t o know w h a t ' s g o i n g  s a y some o f t h e e l e v e n  on. year  olds  I'm  seeing.  I mean  85 R:  Y e a , a n o t h e r t h i n g t h a t s t r u c k me and l o o k a t t h i n g s .  T:  today  I t doesn't  The  conversation  nevertheless reserve  s e e m t o me above  t o be  concerns  d e s c r i b e d as  f o r c h i l d r e n who  manner t h a n  one  typical a very  provides claimed  an  are  she  would  t h a t the  t h e i r parents We  can  arranged  that  these  given  account  and  those  see  the  who  assumptions  stand  will  not  - _  choice  a therapy  device  i t i s consequential  which behavior nificance.  patterns  The  are  are  abnormality  For who  of  are  and  has  and  model o f a d i n o s a u r  told  me  the p a t i e n t  i t can  will  age.  therapy  I t should  relevance  as  hate  to a difference i n  i s seen  be  room noted  (or in  the  c o n s e q u e n c e s as w e l l .  happen t o the  used  be  t h a t they  i n which the  other  i s a document o f  i n d e s c r i b i n g a p a t i e n t who  is  'grown-up'  always p s y c h i a t r i c a l l y  f o r what w i l l typically  of  admit  children.  This practical  unusual,  will  o f t h e way  age  example,  child  a standard  be  given  the  persistently  in  therapy.  a psychiatric  For  sig-  problem example,  a  chose t o c o n s t r u c t  a  that:  3.3 T:  . . .  Most k i d s w i l l  d i n o s a u r and t h e n ( you've s e e n them a l l .  c h o o s e one,  you  know, maybe t h e y ' l l  ) i t ' s a bore.  For  for deciding  presenting  (development d e r a i l m e n t ) , o r o f managing d i f f i c u l t i e s . therapist  o l d who  1  i s o f t e n due  about n o r m a l i t y  ideas about n o r m a l i t y  year  contemplate.  that lay adults usually  reference to the  understanding  relevant.  instance,  olds to  age. ®  of h i s actions.  organizationally) as  category  their  appropriateness  of our  year  disturbed five  d i f f e r e n c e between c h i l d r e n  because  of play  five  a c t i n g i n a more s o p h i s t i c a t e d o r  might expect  adequate  of  precocious,—a  T h e s e e x a m p l e s d e m o n s t r a t e how  Our  t h e way  Yea.  R:  is  was  Y o u ' v e s e e n one  do  one  dinosaur,  86  The  fact  child's  t h a t most k i d s non-conformity.  standing  like  dinosaurs, first  get bored with  the following:  there  place.  This  i n turn since  this  i s a document o f t h i s  becomes t r a n s l a t e d i n t o an u n d e r -  he p e r s i s t e n t l y c h o o s e s  must be s o m e t h i n g w h i c h  As t h e t h e r a p i s t  activity  to build  a t t r a c t s him t o dinosaurs  says:  T:  I t r i e d t o s e e , o k a y d i n o s a u r s , now d i n o s a u r s maybe we c a n g e t i n t o J o h n ' s a n g e r a b i t .  are ferocious  The  therapist decided  o f dinosaurs  attracts (i.e.  that  John's a t t e n t i o n  o f h i s problem).  a t hand, t h e p a t i e n t ' s  i t i s the angry nature and t h i s  Everything problem  i n the  now  stands  that  as a document o f h i s a n g e r  now makes a new s e n s e .  and even  beasts,  the course  The b e h a v i o r  o f treatment  a l lf i t  together. T h e r e a r e many o t h e r their  age c o h o r t s .  instances  The f o l l o w i n g  i n which  descriptions  the patients  a r e compared t o  a l l r e f e r t o t h e same  patient.  T:  That's r i g h t . T h e r e ' s n o s o r t o f , t h e r e ' s n o e x p l o r a t i o n o f t h e room. He s e t t l e d down t o t h i s p a r t i c u l a r t a s k f o r t h e w h o l e t i m e w i t h o u t much r e f e r e n c e t o a n y t h i n g e l s e g o i n g o n a r o u n d h i m . . . . B u t c o m p a r e d w i t h t h e s o r t o f b e h a v i o r w h i c h m o s t s e v e n y e a r o l d s show, i f t h e y came i n t o t h i s room, f o r e x a m p l e , i s c e r t a i n l y a w i d e r r a n g e o f s t y l e s i n t h e p l a y room. B u t , t h e r e ' d b e much more l o o k i n g a r o u n d a n d e x p l o r i n g and q u e s t i o n s ; "Gee l o o k a t t h i s " o r some s u r p r i s e o r e x c i t e m e n t .  Or:  T:  Uh, y e a , u h , t h e k i d ' s  language  itself  i s p e c u l i a r h i s syntax  i s a  b i t shaky w h i c h i s t h e most t h a t had been n o t i c e d i n t h e c l a s s r o o m t o t h i s p o i n t , w h i c h i s n ' t s o now, u h , s e n t e n c e s t r u c t u r e , s e n t e n c e c o m p o s i t i o n i s n ' t good. H e ' s g o t some f a i r l y g o o d s e n t e n c e s ; "I t h i n k t h a t i s a f i s h , y e a t h a t i s " , " T h e r e g o a c a r , a w h e e l , two w h e e l s , who d o n ' t g o t some w h e e l s " . S o y o u know i t s p r e t t y i m m a t u r e s o r t o f syntax.  87 Or: 3.7 T:  I t h i n k t h e t h i n g t h a t , t h e f i r s t t h i n g t h a t s t r i k e s me i s c o n s t r i c tion i n this child's behavior. What's he s i x o r s e v e n I g u e s s ? Seven. The r a n g e o f l a n g u a g e , t h e r a n g e o f f a n t a s y , t h e r a n g e o f p l a y , uh, t h e r a n g e o f p l a y r o o m b e h a v i o r , i s q u i t e n a r r o w , uh, compared w i t h o t h e r c h i l d r e n . Therapists,  see  actions  as  (stage). ferent  immature bited'  and  recognize  Here,  the  that too,  age  egies.  the  stage  normality so  of^planning  myself,  the  rather  i s thereby  to  his  of  guide  i s heard  as  'constricted',  'inhiand  c h i l d ' s development.  d e v e l o p m e n t may  go  i s a powerful  astray  resource  at  age  dif-  adults-in-the-making  the  but  a particular above uses  speech p a t t e r n as  i n a vacuum  of  p a t i e n t mentioned  c h i l d r e n as  members who  process  was  relevant  i s also  i s an  age  on.  useful  that  i n the  behavior these  any  We  moment.  f o r making  from  s e t t i n g , the  idea  This  of  the  he  the  Consider  sense  the  b o t t l e breaking  was  thus h i s  of  child's actions  to  a  as  recognizing rules,  following  smash b o t t l e s  activitity  a n g e r o v e r t l y and  the  age-  strat-  tradi-  ways o f m a k i n g  activities  patient  therapy  family's  assumptions provide  treatment  of  i s s i m i l a r to  i n terms of h i s  why  express h i s  had  the  'deviance'  construction  managing, p a t i e n t s .  had  of  when  recognition  characteristics.  Both of  f o r , and  instances  i n terms  a n t i c i p a t i o n and  of patient's  explained  child  at  behavior  for a child  characterized  look  therapist, reporting his  explained  the  have been c o n s i d e r i n g  m o t i v a t e d by  A  forms,  We  don't see  inappropriate  appropriateness  conformity  and  us,  actions.  There  tions,  He  the  appropriateness  age-stage  or  i t i s adult  W h i l e we  being  child  that  and  r e s t of  just that  'depressed'.  of patients'  stage  i t ' s not  i n c o r r e c t verb and  realize,  the  appropriate  Thus,  or  like  sense  examples.  colleague against  the  a procedure, f o r anger, having  and wall.  getting  been  88  released  i n this  relations. choice  T h e t h e r a p i s t made  of activity  physical because  i tboth This  water, p a i n t  like  routinely allow  h i s patients  that  dangerous  much  things  i t was g o o d activity  objective  f o r why p a t i e n t s  good  d e s t r u c t i o n , and  a n d make a g r e a t  fora  child  noise.  a n d was f u n f o r  were a l l o w e d  s w e a r , a n d s o many o t h e r  this  same t h e r a p i s t t o l d  things  to  spill  w h i c h we  would  how h e o f t e n  about the water.  f o r c h i l d r e n t o work o u t t h e i r  while  away f r o m t h e i r  o f every  took one  T h e p a t i e n t was i n h i b i t e d , a n d a  was h i s a n x i e t y  Somewhat r e l a t e d t o t h i s  The t h e r a p i s t  anxiety  about  some  parents.  assumption  are accounts  will  test the limits  they  c a n g e t away w i t h b o t h now a n d i n t h e f u t u r e ,  about t h e nature  as a p a r t i c u l a r l y  "noise,  i t s therapeutic  t o t h e swimming p o o l .  document o f h i s i n h i b i t i o n said  to this  i n h i s everyday  c h i l d r e n t o do.  On a n o t h e r o c c a s i o n of  t o break  accounted  on t h e w a l l s ,  indirectly  a c t i v i t y was s a i d t o b e a p p r o p r i a t e  accomplished also  reference  i t involved  This  children often  child.  not  because  activity".  Therefore, the  way, w o u l d n o t b e e x p r e s s e d  o f how  the patient  new s i t u a t i o n , e i t h e r t o s e e j u s t how or i n order  o f t h e s e t t i n g and i t s p a r t i c i p a n t s .  much  to find out  F o r example:  3.8  T:  She's v e r y  i n t e r e s t i n g , s h e ' s b e e n t e s t i n g me,  d a y I t o l d h e r t h i s was t h e s o r t o f p l a c e whatever your impulses a r e . S:  Yea.  T:  A n d some k i d h a d b e e n  S:  Oh  T:  So I that week said  S:  and p a i n t e d  ah  (  she c o u l d  on t h a t w a l l  over  ) and, l a s t d o , y o u know  there.  dear. a s s u r e d h e r t h a t t h e k i d who d i d t h a t d i d n ' t g e t p u n i s h e d f o r e i t h e r , a n d t h a t was o k a y . So a h a l f - h o u r l a t e r s h e s a i d , " n e x t I'm g o i n g t o p a i n t " , a n d s h e s a i d , "on t h e w a l l " ((last phrase i n a soft voice))  ((laughs))  Yea.  89 The  child's  wall,  r e q u e s t i s n o t t o be h e a r d  b u t as a  'method'  being punished. parameters  for finding  simply as a request t o p a i n t  o u t i f she c o u l d r e a l l y  I t i s one o f t h e c h i l d ' s  of the relationship  However, t h i s  type  and/or  of testing  setting.  c o n t i n u e s t o engage  tionship, of  i t may b e s e e n  i n "testing"  as an attempt  do s o w i t h o u t  f o r discovering the  12  i s time-bound.  a p p l i e s when t h e o c c a s i o n o r p a r t i c i p a n t s patient  methods  on t h e  a r e new  That  i s , i t only  f o r the c h i l d .  i n the early  If a  stages o f the r e l a -  t o annoy o r m a n i p u l a t e  other  members  about  one o f  the setting. On a n o t h e r  his  patients,  occasion, a student speaking  to a therapist  t o l d him:  3.9 S:  I t h i n k she r e a l l y r e s i s t t o o much.  In t h i s  case,  clothing home.  wanted y o u t o take  the patient  after  had taken  the therapist  As t h e s e s s i o n  off  as adequate  psychiatric  boundaries from we  How  about  t o be t o l d  how  desire  to interpret  what t o do.  They  stand.  she c o u l d n o t take forced  them  to "find" come  limits  Ginott  the feathers taken  children's behavior, like they  says:  i.e.  t o be g i v e n r u l e s o r d e r i v e a sense i s resisting  t o have t h e a d u l t  rules. r e f e r e n c e t o such  was  t o have  E v e n when t h e c h i l d  c a n s e e an u n d e r l y i n g n e e d a n d d e s i r e  In  them i n h e r  does t h e s t u d e n t ' s statement  and t o have them e n f o r c e d b e c a u s e  knowing where t h e y  she d i d n ' t  reasoning?  i n seeing the patient's  away i s a n a s s u m p t i o n like  her that  drew t o an e n d , t h e t h e r a p i s t  f e a t h e r s a n d a s k h e r f o r them.  children  some f e a t h e r s a n d h i d d e n  had t o l d  the  Involved  away t h e f e a t h e r s ,  of security discipline  enforce the  90  B o t h i n t h e r a p y and i n l i f e , c h i l d r e n n e e d a c l e a r d e f i n i t i o n o f a c c e p t a b l e and u n a c c e p t a b l e b e h a v i o r . T h e y f e e l s a f e r when t h e y know t h e b o u n d a r i e s o f p e r m i s s i b l e a c t i o n . Therefore, limits should be d e l i n e a t e d i n a m a n n e r t h a t l e a v e s no d o u b t i n t h e c h i l d ' s m i n d a s t o what c o n s t i t u t e s u n a c c e p t a b l e c o n d u c t i n t h e p l a y r o o m . ^ 1  Many o f  the  activities  appropriate,  reasonable,  expectancies  of  adequacy.  and  I will  i n t h e p l a y room a p p e a r t o b e  e t c . , o n l y b e c a u s e we  f o r normal c h i l d r e n refer  to the kinds  as  of  can  use  a resource  accounts  our  adequate, background  for determining  t h a t we  have been  their  looking  14 at  as  examples o f p r a c t i c a l A  feature of practical  transparency would have  like  or  to  further  reasonable, degree o f our,notion  As  an  observer,  of normal c h i l d r e n  corpus  o f knowledge.  o r g a n i z i n g f o r , and  to  our  common s e n s e next  the  therapist,  of  that reasoning,  I felt  and  We  can  I was  using this  reasoning  and,  In making  and  while  s u r p r i s i n g ways i n w h i c h  i s appropriate,  reasoning.  as  sense  chapter such,  I found is a  ideas about the  i t comes t o b e  used  are  o f t h e most  specific  i s a part of  a  the  frequently appeal like.  important  family, i t w i l l as  that  of a patient's actions,  children  one  I  therapists  e x p l o r a t i o n of the p r a c t i c a l  c e n t e r i n g on  namely our  children.  assume t h a t  t o them, t h e r a p i s t s  i d e a s a b o u t what n o r m a l i s a further  of  reasonableness,  g r a d u a l l y a c q u i r i n g some  reported i n this  i n responding  chapter  of  as  psychiatric  in  The  i s the  i t s understandings  i t s status.  i n understanding  of p r a c t i c a l  therapist's  reasoning  for deciding i f a patient's behavior  etc.  skill  clarify  reasoning.  psychiatric  common-senseness o f  some m e t h o d s  feature  psychiatric  resource.  reasoning features  uncover  91 Footnotes  ~"I want t o draw a t t e n t i o n t o the f a c t t h a t psychotherapy r e p o r t s and accounts are t i e d t o the everyday p r a c t i c e s o f the working t h e r a p i s t i n ways t h a t are n o t c a p t u r e d by the i d e a l i z a t i o n s o f t e x t b o o k s , t h e o r i e s , etc. I am a t t e n d i n g t o psychotherapy as p r a c t i c a l r e a s o n i n g . 2 See Schutz, C o l l e c t e d Papers 1: The Problem o f S o c i a l R e a l i t y . The Hague: M a r t i n u s N i j h o f f , 1962. See, too H. G a r f i n k e l ' s " S t u d i e s o f the Routine Grounds o f Everyday A c t i o n " , i n S t u d i e s i n Ethnomethodology, P r e n t i c e - H a l l , 1967, f o r a d e t a i l e d d i s c u s s i o n o f background e x p e c t a n c i e s . By background e x p e c t a n c i e s I r e f e r t o those s e t s o f t a k e n - f o r - g r a n t e d i d e a s t h a t p e r m i t the i n t e r a c t a n t s t o i n t e r p r e t these remarks as adequate accounts i n the f i r s t p l a c e . F o r example, t h a t which i s t a k e n - f o r - g r a n t e d i n s e e i n g the adequacy o f the t h e r a p i s t ' s statement, "What's he s i x o r seven I guess?" 3 I w i l l r e t u r n l a t e r t o a s i m i l a r q u e s t i o n : How does the r e a d e r d e c i d e t h a t the accounts I p r o v i d e d o f therapy and t h e r a p y s e s s i o n s were adequate? 4 " P l a y Therapy. The I n i t i a l S e s s i o n " , American J o u r n a l o f Psychot h e r a p y , 15 (1961), p. 73. 5 I b i d . , p. 75. (emphasis added) ^Some f u r t h e r examples o f t h i s a r e : "Some c h i l d r e n are so accustomed to b e i n g asked q u e s t i o n s by r e l a t i v e s and f r i e n d s t h a t they have ready answers, d e s i g n e d t o p l e a s e o r annoy". F. Swanson, Psychotherapy w i t h Children: A P r o c e d u r a l Guide, Pitman Pub., 1970, p. 34. "Talking slowly and d e l i b e r a t e l y i s one o f the f i r s t r e q u i s i t e s o f i n t e r v i e w i n g c h i l d r e n . , C h i l d r e n tend t o hear verbs more a c u t e l y than o t h e r p a r t s o f speech". J . Goodman, J . Sours, The C h i l d Mental S t a t u s Examination. New York: B a s i c Books, 1967, p. 38. " C h i l d r e n can e a s i l y be i n f l u e n c e d by suggestion". I b i d . , p. 33. In e v e r y case, the t h e r a p i s t i s i n s t r u c t e d t o see h i s p a t i e n t s as c h i l d r e n . 7 For an example o f how t h i s i s used i n everyday l i f e c o n s i d e r the f o l l o w i n g l e t t e r t o Ann Landers. Dear Ann: Our f i v e - y e a r - o l d son l o v e s to p u t on my c l o t h i n g , h i g h h e e l s and makeup and p r e t e n d he i s "Mama". Jimmie i s a b e a u t i f u l boy, w i t h a f u l l head o f c u r l s and he p r e f e r s p l a y i n g w i t h d o l l s t o the rough-and-tumble games o f boys. L a s t Christmas I gave him a dump t r u c k and a t e a s e t . He never p l a y e d w i t h the dump t r u c k but l o v e s the t e a s e t . I used t o t h i n k i t was c u t e , the way Jimmie got hims e l f up l i k e a l a d y , b u t I'm b e g i n n i n g t o wonder i f perhaps h i s l i t t l e game might t u r n i n t o something s e r i o u s , and permanent. Can you a d v i s e me. Answer: Very young c h i l d r e n o f t e n c r o s s - d r e s s , b u t by the time a boy i s f i v e o r s i x he s h o u l d be p r e t t y w e l l over t h a t s o r t o f t h i n g . The most r e v e a l i n g c l u e was your subconscious encouragement. Why would a mother g i v e a boy o f ANY age a t e a s e t ? I suggest t h a t you d i s c u s s t h i s w i t h a c o u n s e l l o r , l e a r n why you are t r e a t i n g your son as i f he were a g i r l and get some guidance on how t o t u r n him around. Vancouver Sun, Nov. 9, 1974.  92 8  See my  e a r l i e r comments on toy s e l e c t i o n , pages 63-68.  9 See f o r example, V. S a t i r , C o n j o i n t F a m i l y Therapy, S c i e n c e B e h a v i o r Books, I n c . , 1964.  and  " ^ P r e c o c i o u s n e s s i s u s u a l l y seen as a p o s i t i v e q u a l i t y . " I f on the o t h e r hand", as Swanson p o i n t s out, "the c h i l d t a l k s s e r i o u s l y o f h i s w o r r i e s , expresses a s i n c e r e wish f o r h e l p f o r h i m s e l f and concern f o r the w e l f a r e o f the r e s t o f h i s f a m i l y , the chances a r e t h a t he's burdened, depressed, too s e r i o u s , and t a k i n g f a m i l y r e s p o n s i b i l i t i e s p r e m a t u r e l y " . F. Swanson, Op. c i t . , p. 31. "^Notions o f normal c h i l d r e n appear i n many o t h e r o r g a n i z a t i o n a l p r a c tices. F o r example, Emerson i n h i s study o f J u v e n i l e C o u r t r e f e r s t o "normal d e l i n q u e n t s " . "In c o n t r a s t , d e l i n q u e n c i e s t h a t g i v e an i m p r e s s i o n o f unplanned s p o n t a n e i t y and impulse suggest normal c h a r a c t e r . I f the a c t appears as the p r o d u c t o f a whim, o f an i n a b i l i t y t o r e s i s t t e m p t a t i o n , normal c h a r a c t e r i s g e n e r a l l y a s s e s s e d . . . . In g e n e r a l , a d o l e s c e n t s are assumed n o r m a l l y t o engage i n a c e r t a i n amount o f i l l e g a l a c t i v i t y " . Judging D e l i n q u e n t s . A l d i n e , 1969, pp. 117-118. 12 See f o r example, H. G i n o t t on c h i l d r e n ' s i n t e r v i e w i n g t e c h n i q u e s i n " P l a y Therapy: The I n i t i a l S e s s i o n " , Op. c i t . , p. 80. 13 "The Theory and P r a c t i c e o f T h e r a p e u t i c I n t e r v e n t i o n " , J o u r n a l o f C o n s u l t i n g Psychology, 23 (1959) p. 162. 14 F o r a d i s c u s s i o n o f p r a c t i c a l r e a s o n i n g see H. G a r f i n k e l "What i s Ethnomethodology", i n S t u d i e s i n Ethnomethodology. P r e n t i c e - H a l l , 1967, pp. 1-34; and Roy t u r n e r , Ethnomethodology, Penguin Books, 1974, p a r t i c u l a r l y the s e c t i o n on " p r a c t i c a l r e a s o n i n g " , pp. 83-194.  CHAPTER THE This pists end  FAMILY AS  chapter  patient's  i s a further  2 I suggested  f a m i l y w e r e an  which good p s y c h i a t r i c room.  could  sense  families  can  I had  i n order  t h i n g s i n the  significant  f o r me.  'instructions' these  instructions  see  the  role  to rely  d i d and  reasoning.  to  the most i m p o r t a n t The  know t h a t  factor  In t h i s  r e a d e r who  source.  I will  assortment resource  used  I will  aspect of the  i s familiar with  the  in this display  of rules,  about  schema  them.  the  play about  F o r example, w h i l e  and  h i s problems,  I had  family before they the  family.  the  by  on w h a t I l e a r n e d  t h e y were i m p o r t a n t  chapter  theoreticians  in explaining  f a m i l y was  why  interpretive  I began t o r e a l i z e the  assumptions  At  I to  became  extensiveness of  I began t o and,  the  l o o k f o r what  consequently,  came  ' f a m i l y ' as a r e s o u r c e f o r d o i n g p r a c t i c a l p s y c h i -  atric be  therapeutic events.  heavily  of a child  r e c e i v e d on  thera-  of h i s a c t i o n s i n the  context of the c h i l d ' s  I had  of the  made o u t  to understand  Thereby,  that  as  p a r t of the  be  REASONING  o f t h e ways i n w h i c h  t h a t knowledge o f and  give behavioral descriptions  these  will  PRACTICAL  examination  important  I discovered that  children's  to  RESOURCE FOR  make p a t i e n t ' s a c t i o n s u n d e r s t a n d a b l e  o f Chapter  see  A  4  how  the  the  relationships,  i n making p s y c h i a t r i c  the  clinic,  family  sense  corpus  literature  of emotional  i n the  r e a d e r why  therapist's  o f t e n invoke  onset way  show t h e  (and t h e  also term  an 1  93  knowledge.  etiological While  the  a much b r o a d e r  re-  i s a g l o s s f o r a wide  e x p e c t a t i o n s , e t c . ) was of the  this  psychopathology  disturbance. i t was  of  on  f a m i l y as  I consider  used  child's behavior,  as  a  i n managing  94 a therapy events  session,  o f the play  Patients  as F a m i l y  An  f o rproviding  accounts  o f the  Members o f t h e t h e r a p i s t ' s corpus o f knowledge  awareness o f p a t i e n t s  feature  'adequate'  room.  essential feature  ubiquitous utive  and a l s o  o f the category  a s f a m i l y members.  'child'.  While  This  i s an  i s a constit-  o n e may h a v e  patients  2 without  f a m i l i e s , one does n o t have  children without parents.  b e g i n b y o u t l i n i n g some o f t h e w a y s i n w h i c h useful  resource An  i n understanding  examination will  demonstrate  his  family  i s n o t always  ing  statement  followed  was d i r e c t e d t o w a r d  that  innocuous  the connection  (or even f r e q u e n t l y )  immediately  a colleague  the 'family'  shall t o be a  the c l i n i c .  o f the following  therapists  I found  I  conversation  b e t w e e n two  between t h e p a t i e n t and  a d i r e c t one.  upon t h e d e p a r t u r e  The  follow-  of a patient.  who h a d j u s t come t o t h e p l a y  It  room t o s a y  hello: 4.1 T:  He a s k e d me, he s a i d "do y o u g o t o c h u r c h ? " I s a i d "no". He l o o k e d a t me i n d e s p a i r a n d h e s a i d " s i n n e r , s i n n e r " . . . . Y e a , I'm r e a l l y , t h a t ' s , now I'm r e a l l y d o n e , I'm f i n i s h e d .  The  s t a t e m e n t was made  things one  about  the s e t t i n g .  m u s t know t h a t  Further,  the family  such  arose  a strict  religious  In order  manner, b u t i t r e v e a l s t o make  h i s f a t h e r was a m i n i s t e r was s e e n  what t h e y p r e a c h e d . problem  i n a joking  t o be v e r y  Although  from the c o n s t r a i n t s family.  We  i n a fundamentalist  and t e n s i o n s  likely  that  was n o t s e e n  do n o t t y p i c a l l y  a n d , i f we d i d , we w o u l d  sense o f the c h i l d ' s  strict,  the child  some i n t e r e s t i n g  which  think  take  i s , they  sect.  practiced  as r e l i g i o u s , h i s are expectable i n  o f c h i l d r e n as  i t as  statement,  being  precociousness.  95 The  joke then i s not  'atheist'  a  a r e l i g i o u s p a t i e n t would not  (a n o n - c h u r c h - g o e r  mediator of First,  that  this  child  at  information.  is typically  As  becomes a  set  of  party  can  anticipate this  family  ely,  the  then hinder In a  child  can  influences  t h e r a p y by  also  as  for a  S i m i l a r l y , one of  member o f  a  therapist  uses  moment, b u t  one  the  first  the  what t h e i r  the  see  family  attend  can  and  w h a t we  a  attend  as  a  like  t o how  i n two  ways.  family's  Rather, h i s  situations.  As  family a  third  when a member o f  a  makes f o r a c l o s e f i t  know o f  family.  his  Alternativ-  a n s w e r t o h i s p a r e n t s who  could  therapist. the  patient  i s not  s e e n as  Upon e n c o u n t e r i n g  merely  a child,  one  i s responsible  for  contributed  to his.present  problems,  t o what The to  sense the patient  family  i s , and  m u s t be  for understanding some f u r t h e r  what t a k e s p l a c e  of  the  instances  i n the  him,  attributes to  the :central q u e s t i o n  resource to give  the  manages h i m ,  has  return  a mediator  is  internalized his  family.  values,  family  an  explanation  that  f a m i l y who  be  the  recognize  therapist's  clearly  I will  play  seen  the  as,  how  the  child  in  o f ways  r o o m may  a  a in  get  family.  expect  that that  children often t h e y w o u l d be  p a r e n t s w o u l d make o f  whatever happens i n the parents.  and  that  routine  This  i t s members.  I would  I observed would not  and may  family.  which t h e r a p i s t s back t o  of  to  response  a member o f  look  but  for himself.  d i s c r e d i t i n g the  his beliefs  activities  think  family-line.  might r e l a y  warrantably  etc.  the  e i t h e r c a s e , we  but  family  need not  child's behavior  child  The  r e a d y made r e s p o n s e s  i s taking  between the  rate)  assumed t o have  values.  one  a r e s u l t he  any  tolerate  I asked  therapy  did  things  allowed  this,  t o do  play  this.  be  room t h a t  a t home a n d  f o r i t seems l o g i c a l  setting will  a t h e r a p i s t about  i n the  transmitted  one  I wondered  to  assume  to  the  that  child's  96 4.2 R:  I t w o u l d b e i n t e r e s t i n g t o f i n d o u t , o r maybe y o u know, w h a t t h e p a r e n t s d o w i t h w h a t h e b r i n g s home f r o m t h e t h e r a p y , b e c a u s e h e m u s t g o home a n d t a l k a b o u t i t .  T:  Yea. ((pause)) I d o n ' t know. It's surprising, I s u r p r i s i n g how l i t t l e k i d s t a l k a b o u t t h e i r t h e r a p y home. . . . S o p a r e n t s w i l l come i n d e s p e r a t i o n a n d on i n t h e r e ? " ( ) Some o f t h e more d i s c r e t e  t e l l you i t ' s sessions at s a y "what's g o i n g parents w i l l say  " I d o n ' t a s k h i m a b o u t i t b e c a u s e I know h e n e v e r t a l k s a b o u t i t a n d I n e v e r a s k c a u s e I f e e l t h a t ' s h i s t i m e " . . . . Ah, one t i m e I remember i t was q u i t e s h o c k i n g , a h , ( ) h a d drawn a p i c t u r e o f t e a c h e r on t h e b o a r d and s h o t a t i t w i t h p o p guns. So, J o h n r e a l l y t h o u g h t t h a t was f a n t a s t i c s o h e w e n t r u n n i n g d o w n s t a i r s a n d t h e f i r s t t h i n g h e d i d t o mum was s a y " h e y mum we j u s t s h o t t h e p o p g u n at Mrs. Jones". A n d l i k e t h e m o t h e r l o o k e d y o u know, k i n d o f t a k e n aback, b u t she j u s t dropped i t . T h u s , t h e r e a r e o c c a s i o n s when t h e t h e r a p i s t i n c i d e n t m i g h t be r e p o r t e d t o a c h i l d ' s that  the family w i l l  usually not  expect  that  show some d i s c r e t i o n there w i l l  r e c e i v e a n y 'news' f r o m  a b o u t what"<s g o i n g fear  their  child,  they  Some p a r e n t s h e s i t a t e  would  r a t h e r n o t have r e v e a l e d i n d i s c r i m i n a t e l y .  know  t o hope  may b e r e v e a l i n g  matters  Parents  and, i f they  o f t e n ask d i r e c t  they  think that  some f a c t o r  i n handling the matter.  since  shows, o t h e r p a r e n t s  the c h i l d  that  and has r e a s o n  b e some r e p o r t a b l e e v e n t s  o n i n t h e p l a y room.  that  parents  sees  which  do  questions t o ask the family  And, as t h e f o l l o w i n g  t h e r e i s some i n f o r m a t i o n w h i c h t h e y  must  about.  4.3 T:  I n f a c t we h a v e o n e m o t h e r who s a y s , " y o u ' l l t e l l me w o n ' t y o u i f h e r u n s o v e r me w i t h a t r u c k " . ((laughs)) That's a p r e t t y astute mother. The  family it  fact  that  i n f o r m a t i o n from  can a l s o be p s y c h i a t r i c a l l y  gives the t h e r a p i s t  ment.  This type  a reason  the therapy  r e l e v a n t i n o t h e r ways.  t o hope  o f communication  session w i l l  f o r a change  reach the  For instance,  i n t h e home  between t h e t h e r a p i s t  environ-  a n d t h e home  never  97 seemed t o  take the  much more s u b t l e has  cases,  ways.  t r e a t him the  t r e a t the  possible  to  Therapists  and  by  and  deal  with  to  i s to  clinic,  involvement The  of  was  felt the  child  therapy  other  that  family  members may that,  from p a r e n t  to  felt  that  one  at  child  t h i s may  knowing a n y t h i n g  be  that  this  the  the  therefore  approach does n o t  h o p e he  can  consisted  i n the  Thus, them  who  effort  was  have t o  l e a s t on through  report  therapist.  a more s i g n i f i c a n t  about p r o f e s s i o n a l  the cope  in  coping at  a  discuss third  sense.  there  the  positive  this  party  later. (the  I f other  assign  child.  them t o  Since  i t is  i t i s seen  should  not  be  a  'family')  members a  therataken  as channel  I n t e r e s t i n g l y enough,  , the  and  i n a p o s i t i v e manner.  successful,  problem  'ethics  come t o  of  p a r e n t s would r e l a t e to  each other,  surface,  ideal  latter,  more  time.  therapy program  the  made t o  on  in a  of  and  t r e a t i n g the  the the  was  the  be  i t is  a c q u i s i t i o n of  behavior  following  will  work a l l t h e  thereby  I will  patient  possible  i n the  the  essential.  In  i n many  information  confront  in  patient  i t is  parents.  to  i f t h e r a p y w e r e t o be  f a m i l y was  than the  appropriate  that  of  c h i l d ' s a t t i t u d e s and  become p a t i e n t s , , an  pist  home a n d  so  hope t h a t  r e l a t i o n s h i p between the  family  child  and  always the  that  because  occurred  parents w i l l  treating children.  o r g a n i z a t i o n a l l y important  the  i n the  f a m i l i e s were seldom p a r t  i n the  Many t h e r a p i s t s  the  but  I t i s assumed t h a t ,  behavior  this  of  Here  While  changes  hope t h a t ,  behavior,  the  . . . ",  have been a l t e r n a t i o n s between the  the  family.  there  say,  that  change  that  family without having  there  f a m i l i e s and  mechanisms.  reflect  the  Needless  with his  the  changing  r e f l e c t e d i n the  Historically,  objective  disturbed  often  i n a d i f f e r e n t manner.  family  d i r e c t way.  treating  your parents  c h i l d ' s problem o r i g i n a t e d  communicated  is  "Tell  changed h i s p r e v i o u s  come t o  to  form:  f o r the child  child will  i t is  since,  assume  not  that  of  the  a d u l t s are  source about in  of  talking  concern.  Indeed  the p a t i e n t ,  the  sand  him.  I observed  t r a y w i t h i n easy  the p a t i e n t  However, t h i s  h e r p r o g r e s s , and  Through t h i s how  about  98  3  a therapist  their  and  t o as  the  a  major  talking child  played  them.  ' r e p o r t a b l e e v e n t s ' , we  i s constantly attended  always  parent  worries while  hearing distance of  notion of  i s not  can  begin  to  see  a member o f some f a m i l y  4 structure.  T h i s l e a d s us  'reportability' namely t h a t  through  t o see  finished"  after  Contained  i n that  expectancies family,  the  Indeed,  they  Bringing  a  having  Klein  intrinsic  joke  i n the  a patient  r e p o r t i s the  a l s o p r o v i d e the  events  on  are e s s e n t i a l  character of reasoning,  I t i s background  therapist her  assumption  t o any  the  feature of practical  tell  logic  take  remarking  that  she  of  was  Background  o f s e p a r a t i n g p a t i e n t s i n the  understanding  o f the  w h i c h we  Notions  of  'Mom'  and  'Dad'  to  as  psychotherapy,  f o r example,  Therapy  with  there i s a technique  followers of referred  S.  Freud  feelings  t h a t he  (such as h i s p a r e n t s ) t o w o r k on  relationship.  5  and  onto those  There  feasability  has  has  encourages about the  the p a t i e n t  the  therapy  to transfer  any  deep-  This permits  f e e l i n g s w i t h i n the been a  by  a phenomenon o u t s i d e o f t h e  therapist.  technique  both  context o f the  long s t a n d i n g debate  of using this  with  or  t o as " t r a n s f e r e n c e  I t allows  the  have  society.  situation.  about  same  family, etc.  may  This i s a k i n d of neurosis which i s generated  therapist  "was  a sinner.  neurosis".  seated  expectancies  t h a t she  a family.  appropriateness of attending to concerns  In t r a d i t i o n a l M.  how  o f background expectancies.  w h i c h a l l o w us  members o f  an  t o see  therapy  room  him  the  and  therapy  in child psychiatry  children  since  the  99 patient  i sactually The  l i v i n g with  h i s parents  following conversation  focuses  r a t h e r than  on t h i s  remembering  them.  issue.  4.4 T:  B u t most p e o p l e  R:  With c h i l d r e n ?  T:  With c h i l d r e n . ((pause)) But t h a t by and l a r g e i t ' s unnecessary i n most c a s e s t o u s e i t , i n t r e a t m e n t . What h a p p e n s b e f o r e t h a t , s u r e i t i s a very strong tendency t o see f a m i l i a r things i n t h e r e l a t i o n ship. Which i s n o t s u r p r i s i n g . Ah, o r t o t r y a n d c r e a t e f a m i l i a r t h i n g s , a h , s u c h a s t h i s g i r l was d o i n g t o me y e s t e r d a y . Ah, o r a h , "What make i s y o u r c a r ? My d a d d y ' s g o t a C h e v . " Trying t o get some s i m i l a r i t i e s a s a p o i n t o f c o n t a c t ; o r a h , a t a s l i g h t l y more c o m p l i c a t e d o r d e e p e r l e v e l , e x p e c t i n g me t o b e h a v e i n a way t h a t a parent would. I h a d o n e c h i l d , a n i n e y e a r o l d , who, t h e o n e . I t o l d y o u a b o u t who r u n s a l l o v e r t h e p l a c e , a n d s p e n d s m o s t o f t h e t i m e o n t h e t r a m p o l i n e , a h s h e h a s p u s h e d me t i m e a n d t i m e a g a i n t o t h e p o i n t where I have t o s a y no. " I want t o t a k e t h i s . I want t o t a k e t h a t . I want f o u r b o x e s o f c a n d y " . When I s a y i t ' s t i m e t o f i n i s h s h e w a n t s t o go a n d do s o m e t h i n g e l s e . So s h e ' s c o n s t a n t l y p u s h i n g me t o s a y no. A h , now i t t u r n s o u t t h i s i s t h e t h i n g s h e f i n d s m o s t d i f f i c u l t to take from h e r p a r e n t s , and t h e t h i n g h e r p a r e n t s f i n d most d i f f i c u l t a b o u t her.' A n d t h e y r e s p o n d v e r y h a r s h l y , s o t h a t , ahm, i t a u t o m a t i c a l l y b r i n g s t o h e r a f e e l i n g o f 'nobody l o v e s me'. And we t a l k e d a b o u t t h i s a n d s h e g o t t o t h e p o i n t w h e r e s h e c o u l d f e e l t h a t my 'no' was d i f f e r e n t t h a n mommy's 'no'. Except on o c c a s i o n s when I s a i d 'no', a n d s h e s a i d , " T h a t ' s a Mommy's n o " .  R:  She u s e d  T:  that  feel  that transference neurosis  does  happen.  phrase?  Y e a , a n d we h a d a l o o k  a t i t t o s e e what t h e f e e l i n g  w a s , maybe i t  was t h e way I s a i d i t o r maybe i t was t h e t o p i c we w e r e t a l k i n g a b o u t , o r maybe i t was t h e way s h e was r e c e i v i n g i t . But she had a tendency to r e p e t i t i o n and ( ) and she's going t o r e c r e a t e s i t u a t i o n s here v e r y much l i k e t h e s i t u a t i o n s s h e c r e a t e s a t home. And she's g o i n g t o a n t i c i p a t e t h a t I'm g o i n g t o r e a c t i n ways t h a t s h e ' s f a m i l i a r With. And t h i s i s o f t e n o f course t h e f i r s t ( ) that occurs t o t h e c h i l d t h a t we d o n ' t b e h a v e , I d o n ' t b e h a v e l i k e h e r f a t h e r , o r m o t h e r , w i t h b e h a v i o r t h a t s h e b r i n g s home. But there's t h e expect a t i o n , there's t h e statements o f f a m i l i a r i t y . Y o u do t h i s l i k e Dad o r Mom, o r y o u l o o k l i k e D a d or.Mom. Ah, t h e n t h e e x p e c t a t i o n , oh yea, a n d sometimes t h e r e ' s a d e l i b e r a t e attempt t o r e c r e a t e a s i t u a t i o n , e v e n t h o u g h i t ' s an u n c o m f o r t a b l e o n e , o r one t h a t ' s g i v e n them p r o b l e m s , g i v e n them p a i n . So a h , i n t h o s e s e n s e s , I h a v e n ' t w o r d e d i t w e l l , b u t i n those senses there i s a t r a n s f e r e n c e o f s o r t s , i n t h a t t h e r e a l i t y may b e d i s g u i s e d b y t h e c h i l d ' s w o r k o n i t ; w h a t t h e c h i l d ' s p e r c e i v i n g may n o t c o r r e s p o n d w i t h w h a t a c t u a l l y i s , because o f t h e expectations, t h e inner expectations that a r i s e as a r e s u l t o f e x p e r i e n c e w i t h h e r own p a r e n t s . Ah, k i d does something  100 a n d s h e s a y s " y o u ' r e mad a t me". A n d I'm n o t a w a r e o f b e i n g mad n o r o f h a v i n g a n a n g r y e x p r e s s i o n o n my f a c e . A n d a h , " S h a r r o n , I'm n o t aware o f b e i n g a n g r y w i t h y o u " . Sort o f looks a b i t c l o s e r ; "No maybe y o u ' r e n o t " . But she's expecting t h a t s o r t o f p a r e n t a l r e a c t i o n f r o m me. The the  psychiatrist  notion  therapy "mom"  of transference  since  neurosis,  o r "dad" and does so w i t h o u t  us n o t o n l y  i n direct  in  the c h i l d ' s  demands.  play  events  room w h i c h  requests  attempts  That  home.  understanding  than would otherwise The  father home. with  f o r there  are events  that  take  place i n  t h e above m e n t i o n e d  of the play  patient's  b u t as instances o f  to recreate room.  i n a more r e a s o n a b l e  as i n s t a n c e s  the parent-child  Thus,  us w i t h  expectancies  a resource f o r  a n d t h o r o u g h - g o i n g way  some.things  t o be seen and This, too,  i s a n d m u s t b e s e e n a s a f a m i l y member.  t o avoid  sounding  like  to construct  r e l a t e s back  relationship.  are going  o f parent-like behavior.  h i s therapist i s essentially  therapist  i s available  a mommy's n o " , b u t a l s o  as questions  T h e p a t i e n t m u s t b e made t o f e e l  therapeutic  This  be seen by t h e t h e r a p i s t as r e c r e a t i o n s o f  outside  i s an e f f o r t  This  i n play  be p o s s i b l e .  usually tries  his parents. the  "that's  For instance,  shows how t h e p a t i e n t  therapist  i s , there  therapist anticipates that  heard by t h e c h i l d further  like  a s a member o f t h e f a m i l y p r o v i d e  her questions  accept  be s e e n t o b e t r e a t i n g h i m l i k e  t o "push t h e t h e r a p i s t " i n o r d e r  child  therapists  i t i s n o t always necessary  a r e n o t seen simply  r e l a t i o n s h i p which obtains about t h i s  that, while  any encouragement.  statements  can e a s i l y  i n the c h i l d ' s  continued her  i n effect  the p a t i e n t can r e a d i l y  to  the  i s saying  the child's  an atmosphere  The  mother o r  that  contrasts to  t h a t t h e r e l a t i o n s h i p t h a t he h a s  different  than  t h a t w h i c h he h a s w i t h  t o t h e r a t i o n a l e o f t h e environment and In constructing this  relationshipthe  c a n u s e h i s common-sense k n o w l e d g e a b o u t w h a t p a r e n t s  are like  101 and a  about what t h i n g s  might sound o r look  like  the actions  of a parent  resource. A  and  t h e r a p i s t was r e c o u n t i n g  some o f t h e d i f f i c u l t i e s  r e f e r r e d t o a c a s e where a p a t i e n t  cookies  the  play  all  patients,  child  room a l o n g  of the play  with  quently,  own t o y s ) .  a rule  it  like  to  This  She s a i d t h a t  However, h a v i n g  take  saying  said this  a "parent's  i tthat  a b o u t what p a r e n t s  are like  heard merely  is  not like  the patient's  this  that  room a n d t a k e  The  a s many  to the child,  could  only  she t h e n  take  realized  the hearing  and thereby  that  That's  avoids  h a s some  notions  i m i t a t i n g them, r a t h e r , a t  t o the potential hearing  the patient i s not to t h a t she  parents. a p a t i e n t was p l a y i n g  cautious  won't mind us p l a y i n g  okay w i t h h e r .  that  and she r e v o k e d h e r d e c i s i o n  S i m i l a r l y , cancellation of the rule  h e s i t a n t :or o v e r l y  mom  three  she gave  i n t h e wet sand  Although  i n her play,  t r a y , an  I d i d not feel the therapist  4.5 I think  orf o r  had annoyed h e r and, conse-  the c h i l d  w h i c h i s always p o t e n t i a l l y messy.  was b e i n g  an e x c e p t i o n ) .  a s a change o f mind b u t a s a document o f t h e f a c t  On a n o t h e r o c c a s i o n  she  than  the t h e r a p i s t simply  she can a t t e n d  t o some a c c o u n t .  be  activity  and were u s u a l l y p l a c e d i n  the therapist r e a l i z e d that  I t i s not that  may g i v e  cookies  r u l e " and revoked i t .  because o f t h i s .  o n g o i n g moment,  (Candies and  was n o t d o n e i n a l l c a s e s ,  t h e r u l e was a l s o a v a i l a b l e t o t h e c h i l d  any  with  hungry.  t o go i n t o t h e s u p p l y  cookies.  I  h i s hands and p o c k e t s  (This p a r t i c u l a r t h e r a p i s t allowed the c h i l d r e n t o  she f o r m u l a t e d  sounded  here  b u t i t seemed t o b e a r u l e r a t h e r  a s he wanted. their  involved  room s u p p l i e s  the toys.  had been p e r m i t t e d  cookies select  filled  a n d b e g a n t o e a t a s i f he w e r e v e r y  were r o u t i n e l y a p a r t  T:  as  with  t h e mucky s a n d  and water.  that said:  ' 102 The about that are  the p o s s i b l e  i s not whether the  consequences  g o i n g t o s a y o r do. things but  their  playing  child  that  conduct.  o fher  such  That  children i s not  (I h a v e a l s o  seen  as f a i l i n g  showing  know".)  these p o s s i b i l i t i e s  invoke the  t o the c h i l d ' s  concern  note  about what t h e i r  parents  they always  school,  about  children  reminding  I t i s always  about  for  that  t o see a  t o o much c o n c e r n , o r  i t s parents.  i d e a o f the c h i l d  them-  possible  a s showing  worry  t o us as an account  teachers reprimand  Numerous i n s t a n c e s o f t h e r a p y t a l k tion  that  a concern  R a t h e r we s h o u l d  i s available  t o show e n o u g h c o n c e r n ,  the a p p r o p r i a t e concern  was d i s p l a y i n g  t o worry  t o say  a description  t o wash t h o s e y o u  child  action.^  i n t h e mud o n t h e way home f r o m  "mother has  as  here  one can w a r r a n t a b l y e x p e c t  such of  issue  However, a l l o f  a s a member o f t h e  displayed  the t h e r a p i s t ' s  f o r what h i s o r h e r p a r e n t s m i g h t  say.  family. attenFor  example:  4.6 C:  Yea,  and  he swears a l o t .  T:  Does h e swear a l o t ?  C: Y e a . T:  Hmm.  ((pause))  Sometimes  C:  No I d o n ' t  T:  Hmmm? Y o u know o n e p l a c e w h e r e i t ' s r e a l l y h e r e i n t h e p l a y room.  C:  I know.  T:  That's r i g h t . things, right  C:  (  even  swear.  T:  Hmm?  swear.  ((pause)) here.  you want t o p l a y ((pause))  I will  I b e t you  Why y o u  darts  A t home t h o u g h  s a y more a b o u t  can  even  good t o swear  say  is  right  fuck anda l l those  ) I think  permisslbles  i t b u g s mom i f y o u s w e a r .  later,  but  a possible  interpre-  103 tation  of  the  mention of  therapist  has  been encouraging  attends  to  the  possibility  " H e r e i s someone s a y i n g parents this  say  that.  I think  display this  an  an  adequate  never heard  to  swear and By  utterance  to  child  i s thinking  i f you  to  I t o do?" the  any  The  swear", and  Instead,  that  formulating  to  say  w h a t she  can  be  'evil'.  feels  the  I take  i n order  uses  patient  has  t o be  Further,  she  i t as  the  the  as  said:  i s able  to  I know  my  i . e . , "At  room.  i n that  for home  to I  take  conversation.  this  child  t h e r a p i s t was the  able  child  had to  use  might  to i t .  f a m i l y member, t h e that  and  like:  a device  play  to decide both that  mother might o b j e c t  the  sanction,  indicate that  i t that  room  something Now  The  therapist provides  g o i n g on  which would  follows.  play  swear.  parental  a c c o u n t o f w h a t was reference  i s as  swear i n the  i t is a l l right  recognizing  common s e n s e k n o w l e d g e  like  child  the  What am  i t b u g s mom  swearing problem.  her  the  last  e s s e n t i a l d i f f e r e n c e b e t w e e n home a n d  t o be  I had  i n the  that  that  assumed c o n c e r n by  though  a  don't  "mom"  this  i s one  show t h e  therapist i s place  where  able you  p a t i e n t what t h e r a p y  is  about. Consider  the  following:  4.7 C:  Here,  T:  So  C:  Yeaa.  T:  Do y o u Mmm?  that's  What i s a t parents  Paula.  and  my  cookie?  know t h a t I ' l l l i k e y o u e v e n i f y o u d o n ' t g i v e me Even i f you wanted t o e a t t h a t c o o k i e y o u r s e l f . issue other  n u m e r o u s ways t o  here  i s a notion  adults  encourage  characterize  of  sharing.  This  i s an  c h i l d r e n to perform.  someone who  doesn't  things?  activity There  share but,  for  are the  which  104 offender,  the p e n a l t y may  be  the  l o s s of f r i e n d s .  Here, the t h e r a p i s t i s  demonstrating t h a t t h e i r f r i e n d s h i p does not depend on f o r c e d Another t h e r a p i s t complained about a p a t i e n t who permission  t o do  inconsequential  the p a t i e n t ' s c o n s t r i c t i o n . p a r e n t s and  the c h i l d who  Permission  T h i s was  c o n t i n u a l l y asked  seen as a document o f  i s t y p i c a l l y given  asks f o r p e r m i s s i o n  t y p i c a l l y require permission with h i s  things.  sharing.  t o c h i l d r e n by  t o do t h i n g s t h a t don't  can be assumed t o have a t r o u b l e d r e l a t i o n s h i p  parents.  The  f o l l o w i n g i s a f i n a l example o f how  are brought i n t o the therapy room.  We  notions  of  'mom'  and  have been l o o k i n g a t one  of  'dad' the  ways i n which t h e r a p i s t s i n t e r p r e t p a t i e n t ' s a c t i o n s , i . e . as m o t i v a t e d by the u n d e r l y i n g Therapists  i d e a t h a t the t h e r a p i s t i s l i k e the  child's  a n t i c i p a t e many o f the motives t h a t p a t i e n t s may  them on the b a s i s o f the s t a n d a r d i z e d In the i n s t a n c e s  parents.  ascribe  to  r e l a t i o n a l p a i r of p a r e n t - c h i l d .  examined above the t h e r a p i s t does not  simply  formulate  those motives but uses such a s c r i p t i o n t o encourage the c h i l d t o p l a y i n the mud,  t o swear, e t c . , i n o r d e r t o a c c o m p l i s h the o b j e c t i v e s o f t h e r a p y .  Consider: 4.8 T:  You  know Dana,  ( ( i n t e r e s t i n g tone o f  voice))  C:  What?  T:  I was r e a l l y t h i n k i n g about the l a s t time you were here, and I must have been sounding l i k e a, a naggy o l d mom or dad.  C:  Unhnn  T:  Huhh?  C:  Unnhnn  (-)  T:  I think  so.  (-)  I think  C:  You  T:  I was  C:  weren't. thinking  that  //  ((noise))  T:  that  I wasn't r e a l l y  The  t h e r a p i s t w e n t on  about the  freedom to  occasions  on  they  could  heard that  that,  y o u r own  there  (being  or  an  a p o l o g y , we  should  put  the  formulation  i n terms o f  or  dad),  allows  makes w h a t t h e  her  actions. therapist  the  explain  To  have  and  would have to  to  the  understand. play  Family  the  my  play  the  were  unfair  therapy  hour.  i t may  appear  the  instructions  room, t h e r e  activity  i t i s appropriate  so  that  the  that  the  patient  t o have h e a r d i t  category—'therapist'. a proper hearing to  f o r the  i t s interactional  family  are  category  good r e a s o n s  f o r the  i n terms o f  that  a  sounded  consequence.  child  To  the  role  of  of  inappropriate.  child  such explanations  could  not  be  mom  and  f o r those kinds  t h e r a p y would have been concepts  patient  ( i . e . , a naggy o l d  relevant  explanation  knowledge,  given  the This  expected  were n e v e r u s e d  in  room.  Structure  making  I often  of  there  t e r m s and  To  and  I w o u l d now for  couched  involved  a  of  therapist i s doing  that  goals  attend  i n the  goes w i t h  i s a more r e l e v a n t of  of having  that while  and  formulation  you.  appear demanding o r  use  dad"  unfair),  to  in spite  thing  possible  " n a g g y o l d mom  l a s t week  fair  would have t o  best  Although her like  do  say  quite  t h e r a p i s t i s suggesting  of  way,  to  she  make t h e  The category  which  being  Making  like  to  Sense look  sense of p a t i e n t ' s  learned  a t how  behavior.  about p a t i e n t ' s  the  patient's I shall  f a m i l i e s i n the  f a m i l y was  b e g i n by  course  of  invoked  describing  how  therapy-related  106 discussions.  F o r i n s t a n c e , I was a p a r t i c i p a n t t o a c o n v e r s a t i o n  a t h e r a p i s t and a v i s i t i n g  between  s t u d e n t - t h e r a p i s t i n which the p a t i e n t who was  t o be observed i n a few minutes was b e i n g d e s c r i b e d . was t h a t she d i d n o t want t o be a g i r l .  The c h i l d ' s problem  The f o l l o w i n g t a l k t r a n s p i r e d .  4.9 1.  T:  So, and then i n an ( e t h n i c group) f a m i l y t o have a g i r l , i s okay, t o have a l i t t l e g i r l  who's a burden and says  2.  S:  Yea, i t ' s a l i t t l e b i t f a r o u t .  3.  T:  So I t h i n k f o r h e r she would r a t h e r n o t be a g i r l  4.  S:  Oh r e a l l y .  5.  T:  and ah, ah,  ((tone and e x p r e s s i o n  at a l l .  of recognition))  6.  S:  Is there anything  7.  T:  Yea she does, she a l o t o f t h i n g s l i k e , she she would l i k e w h i s k e r s , ah, a l l s o r t s o f t h i n g s l i k e , ah, I'm l o o k i n g f o r something t o p u t water i n , ah, and mother h a s n ' t g i v e n a g r e a t d e a l t o h e r I don't t h i n k .  8.  S:  How many c h i l d r e n a r e t h e r e ?  9.  T:  Three i n t h e f a m i l y .  10.  S:  And she's t h e o l d e s t ?  11.  T:  She's the youngest.  12.  S:  The youngest.  13.  T:  And t h e r e ' s  14.  S:  Ahhh.  15.  T:  Who a r e v e r y n i c e , v e r y p o l i t e , If  (  ((pause))  two o l d e r  ) when she does  that?  *  brothers.  ((again a voice o f r e c o g n i t i o n ) ) (  ).  t h e problem i s w i t h t h e c h i l d we might n a i v e l y wonder what a l l  o f t h i s t a l k i s about.  That i s , the c h i l d says she would l i k e t o grow  w h i s k e r s and t h i s i s s u r e l y evidence o f some i n t r a p s y c h i c r a t h e r than f a m i l y problem. student  However, i t i s c l e a r t h a t b o t h the t h e r a p i s t and t h e  saw a r e l a t i o n s h i p between t h e i r t a l k about t h e c h i l d ' s f a m i l y  107 and  the d i a g n o s i s o f h e r problem.  T h i s i s made c l e a r f o r us  r e c o g n i t i o n a c t i v i t i e s done by the s t u d e n t - t h e r a p i s t 14).  L e t us  look a t these two  four  ("oh  o r b e t t e r sense o f t h a t i n f o r m a t i o n .  so t h a t when t h e i r e x p e c t a t i o n s  for a g i r l  family.  are not met,  i s a l s o c a l l e d t o account.  And  T h i s i s an  their tolerance  but the c h i l d ' s s t a t u s as a g i r l  f e e l t h a t her  o n l y i s the b e h a v i o r i t s e l f  Because o f  responses i t i s assumed t h a t  i t i s p r o b a b l y f o r t h e s e reasons t h a t she does n o t want t o be  information  by. the t h e r a p i s t i s not  which the p a r e n t s had  given, him.  the  the r e s u l t o f some  Rather, the warrant f o r  members o f t h a t e t h n i c group view c h i l d r e n p l u s some p e r s o n a l  i.e.,  f a m i l y which i n d i c a t e s t h a t they are r e p r e s e n t a t i v e s they are It  how  knowledge o f  o f t h a t group,  typical.  should  a l s o be  added t h a t the t h e r a p i s t has  i n t h i s case f o r a s h o r t time so t h a t what we discovery  sex.  a girl.  making these statements r e s t s i n h i s common-sense knowledge about  the  for  criticized,  f a m i l y ' s r e a c t i o n s t o her are r e l a t e d t o her  T h i s account p r o v i d e d  an  t o h a v i n g sons than daughters  Not  child will  contains  girls—attitudes  t h a t c h i l d i s f u r t h e r reduced.  the p r e v a l e n c e o f these a t t i t u d e s and  she  b e g i n n i n g t o make  U t t e r a n c e one  the e t h n i c background o f the  e t h n i c group t h a t i s s a i d t o a t t a c h more v a l u e  ,  i s now  f a m i l y ' s a t t i t u d e s towards boys and  which are a c c e n t u a t e d by  and  P r i o r to t h i s excerpt,  been informed o f the c h i l d ' s d i f f i c u l t i e s and  assumption about the  4  r e a l l y " ) i s the r e s u l t o f a  sudden r e a l i z a t i o n on the p a r t o f the s t u d e n t .  some new  (utterances  acts.  I take i t t h a t u t t e r a n c e  had  i n the  o n l y been  are h e a r i n g  involved  are her  own  procedures.  There f o l l o w s an e f f o r t by the s t u d e n t - t h e r a p i s t f e a t u r e s o f the p a t i e n t ' s f a m i l y t h a t may  be r e l e v a n t .  to discover Thus, i n  other  utterance  108 eight, the  he  asks,  patient  "How  i s the  reasonable,  given  oldest the  on  boys  t h a n on  of  this  expectation  the  No  matters  we  have  the  ten)  Since  family  the  other  see  the  first  the  (or t h i r d ,  s e e n as  way  that  the  weight  That was  fourth,  is, a  the  etc.)  she  c o r r e c t guess would  in  that  However,  shows t h a t  the  girl.  a t t r i b u t e d to  relevant.  "error" a  value  bear  child  or  that  more  consequences had  would have been be  guess  suggest,  puts  b o r n may  i f their  student's  i n the  is, I  c h i l d r e n would not.  second  relevance  that  first  Consider  i s , i t would not  can  now  second  sees  this  That  One  like,  w i s h we  a  had  worth" with a possible  patient's  fourteen)  child  that  often  to h i s  she  can  "Why  boys".  roles.  explanation  behave This  Of  that  respond her  the  as under-  not  like  The  to  the  patient's  s i t u a t i o n i s scanned  child's intolerable For  the  patient  as  very  "...  the  to  very  nice,  patient with  some-  which becomes,  "We  identify the  "self-  therapists  with  behavior.  t a l k i s not  i t i s a methodically  her  this  scolding  patient  and  that  therapist confirms  i t also provides  this  a  your brothers",  allows  indicate  problem  siblings.  brothers  parents  course,  f o r the  emphasize  session, family  imagine the  don't you  three sex  now  or  seems t o  patient's  were a boy.  further d e s c r i p t i o n of  I want t o therapy  i s , parents  the  amounts t o w i s h i n g  polite".  (utterance  some r e l a t i o n s h i p b e t w e e n t h e  comparing  providing  thing  recognition  position.  b e h a v i o r by  a  (utterance this  student's  shown.^  sibling  by  that  situation properly  Her she  that  "She's the  immediate  That  stand,  talk.  seems p e r t i n e n t .  formulation.  stood  i n a way  The  three  i t follows  instead'  family?"  the  there?".  e s p e c i a l l y disappointed  Thus h i s q u e s t i o n asked  of  previous  girls,  p a r e n t s m i g h t be  student  many c h i l d r e n a r e  just small  constructed  for clues  to  talk prior  exchange i n which the  patient's  to the  problem.  109  )  Further,  i tprovides  not only  understanding o f the p a t i e n t there the  i s a family  child  also  patient's  and h i s / h e r  about  family  see problems.  frightened,  and h e r problem.  independent  sexual  identification  the t h e r a p i s t then  accomplishes  things.  and  helps  i tprovides  t o transform  family-related  i n instances  parents  are told  able  course  account  'trouble'  where t h e c h i l d therapy,  i t allows  the patterned  actions  o f reasoning.  accounts f o r the patient's with solve  some i d e a s  problems,  looks  child,  That  about t h e  children are a n d s o o n c a n come However,  having  at the child's family.  This  of the offending  behavior  This  Such  c a n be  seen  i s r e m o v e d f r o m h i s home, w h e r e t h e  and so on.  t h e t h e r a p i s t t o make  of the patient  source  Further,  a b o u t what i s i m p o r t a n t  sense o f t h e c h i l d ' s to i t .  follow  i s , i t provides  doings.  patients,  i n t o a therapy problem.  b e h a v i o r by a s c r i b i n g a c r e d i b l e m o t i v a t i o n a l that  that  are organizationally relevant.  t o enter  Concomitantly,  a reasonable  i t from a  accounts  clearly  too,  i n their  any knowledge  i s , the r e a l i z a t i o n  found such problems,  First,  o r behavior  o f any knowledge o f t h e c h i l d ' s f a m i l y .  several  i s a  a r e l a t i o n s h i p between  t h e y do s o w i t h o u t  That  angry, have  Whenever t h e r e  discover  just play  Often  family.  and adequate  structure.  s e e more t h a n  actual  but a reasonable  and one c a n e x p e c t e d l y  Therapists they  a possible  I t shows,  from an u n d e r s t a n d -  adequate  i t provides  to the patient  motivational the t h e r a p i s t  a n d how h e c a n b e s t  h i s problem. In  addition  intervention warrant  t o such  into the l i f e  considerations,  i tprovides  o f the c h i l d .  I n an immediate  i s a v a i l a b l e t o us i n t h e p r e s e n c e  h o w e v e r , a f u r t h e r w a r r a n t may b e r e q u i r e d .  of the c h i l d  a warrant f o r sense,  such a  a t the c l i n i c ,  C i c o u r e l , i n h i s study o f  110 the j u v e n i l e j u s t i c e system found t h a t t h e f a m i l i e s o f o f f e n d e r s  who were  g o i n g t o be charged w i t h a crime were l a b e l l e d much more s e v e r e l y than the f a m i l i e s o f youths who were n o t g o i n g t o be charged.  Given the r e l a t i o n -  s h i p between c h i l d r e n and t h e i r f a m i l i e s , i t may be n e c e s s a r y t o p r o v i d e warrant i n terms, o f some problem i n t h e f a m i l y .  I suggest t h a t t h i s has  something t o do w i t h o u r i d e a t h a t f a m i l i e s , and f a m i l i e s alone, s h o u l d be r e s p o n s i b l e  Constructing  a  are or  fortheir children.  the Family  Although t h e r a p i s t s use t h e i r knowledge about a p a t i e n t ' s f a m i l y t o inform  their diagnosis,  the r e v e r s e  a l s o holds true, that i s , given the  a c t i o n s o f t h e p a t i e n t i t i s p o s s i b l e t o c o n s t r u c t an a p p r o p r i a t e f o r him.  family  C o n s i d e r t h e f o l l o w i n g statement.  4.10 T:  You know l i k e , so I k i n d o f f e e l g i v e n t h e f a m i l y s i t u a t i o n and what he i s , he might have, t o , h i s b a t t l e s might be m a n i p u l a t i v e . ((pause)) He can't openly express; t h a t he'd l i k e t o do something ( d e v i a n t ) . He has t o do i t k i n d o f m a n i p u l a t i v e l y . . . .He comes on sounding v e r y good, and I guess t h a t ' s the way i t i s a t home. , I would guess from the way he's i n t e r a c t i n g i n the p l a y room t h a t a t home, t h a t you can't do t h i n g s because you: would p r e f e r , you have t o be r a t h e r s e l f l e s s about t h e whole t h i n g and do i t f o r t h e good o f somebody e l s e . You know, i t ' s n o t l e g i t i m a t e i f i t has a s e l f i s h motive, a t home I suspect. C e r t a i n l y from o b s e r v i n g him i n the p l a y room one would g e t that impression. I do have o t h e r k i d s who say, "I don't want to.do t h i s anymore, I'm t i r e d o f b l o w i n g them up". . . . So I r e a l l y g e t the f e e l i n g a t l e a s t a t home, the message he g e t s a t home i s t h a t you t h i n k o f the o t h e r guy f i r s t and. then you have t o a c t l i k e t h a t . In t h i s case t h e t h e r a p i s t d i d n o t know what k i n d s  c h i l d r e c e i v e d a t home b u t was a b l e t o c o n s t r u c t the f a m i l y by o b s e r v i n g had  his patient.  a possible description of  In the l a s t p l a y s e s s i o n t h e t h e r a p i s t  been m a n i p u l a t e d i n t o blowing up some b a l l o o n s .  admit t h a t he d i d n o t want t o do t h i s . m a n i p u l a t i o n r e q u i r e d more i n f o r m a t i o n  o f messages t h e  (The v e r y  The c h i l d would n o t s e e i n g o f t h i s a c t as  than t h e a c t i t s e l f p r o v i d e d , e.g.,  Ill I d i d not problem,  see  i . e . the  a l t h o u g h he himself  it).  child  needed t o  t o do  so.  for  and  the  the  family  a  noises  order  of  with  to  in this  coasting  been good  was  due  to  would not m i g h t be  i t and  the  child's  light  he  and,  could  i n the  Here,  the  allow  transcript  act,  each has  not  the  prob-  implications  that  abovementioned p a t i e n t  session  the  she  the  activity,  agreed  to  therapist allowed especially since  the  she  patient.  I t was  clear that  that  the  child  had  to  continue.  said that  the  do  drum.  told  t h a t he  appeared  Further,  was  good one.  was the  too  noisy  t h e r a p i s t had  t o be  reasonable  I suspect sanctioned  a poor musician.  that  the  Nor  activities,  to  i f the  was on  c e r t a i n constant  parents  respond to  perhaps,  that  he  was  even though  of  too  much n o i s e  I able the  basis  features  action A  to  tell of  could  playing  the  the  session which  The  a poor  I knew n o t h i n g  t h e r a p i s t d i d not  be  complained  something  intentionally placed  f o r making  I t became c l e a r t h a t ,  rearing  or,  I  to  xylophone  success  to  Finally,  session  earlier  the  the  been a l l o w e d  on  whole  had  was  r e l u c t a n t l y made  accompany him  f o r the fact  child  t h e r a p i s t encouraged him  she  a c t u a l l y been  say,  the  h a v e b e e n d o n e a t home w i t h o u t . i r r i t a t i n g h i s p a r e n t s .  This  a  the  i n the  the  Later,  room.  he  early  i n which  patient.  in  that  of  given  instead,  this  Remember t h a t  had  family  seeing.  separated,  playing,  find  cian.  family.  instance  appear i n a good  the  this  session  Very  noisy  with  had  the  with  c a n n o t be  t o keep him  surprised  spent  further  frustration, etc.,  d e s c r i p t i o n of  another  a xylophone.  was  a  other.  given  in  s e e n as  always wanted t o  consistent  I observed  few  was  express anger,  The  a b o v e seems t o be lem,  This  child  musi-  xylophone  about  the  know i f t h e  patient  or  told  had  i f the  been  session  had  the  family's  child-  be  assumed.  That  i n a known way,  they w i l l  been  is react  112 to  the  class of  example, he  i f the  i s not  child  permitted  I of  activities  shall  i s a member i n t h e  of  these  The  two  more e x a m p l e s o f  contained  instances  child  r e f e r s to  frequently  some o b j e c t  how  the  engaged  t h a t was  patient  clearly  deal  s i g n i f i c a n c e i n the  child's.choice of  he  significant  made when p a i n t i n g ,  activity.  How  lem  i n these products?  The  "how"  of  patient's  involved to  see  could ings his  was in a  the be  the  as  of his  as  an  to  see  his  take  f a m i l y because  i t that she  to  his  represent, the  only  At  struggle  to  and  see  The  pictures  see  even  why  which a  were  great  i n the  ges-  p a i n t i n g was  a  patient's  prob-  the  paintings?  knowledge o f  of  this  the  with  the We  such the  actively  i t was  good and  evil.  that point,  with  f a m i l y was  and  They  religious can  now  to  find  instructions that  see  teachthat  feelings  i t i s possible  family,  possible  evil.  dichotomy between h i s  to  and  talk  a  solution  I was  able  c h i l d ' s problem.  t h e r a p i s t chose t o  thought t h a t  his  sections  able  Because of  from h i s  a document o f the  room.  above.  b a s e d upon h e r  representation  family.  relevance  play  i n t e r p r e t these  patient's  religion.  problem apart  as  begin  that- t h e  as  i n t o two  even  the  many o f  i n d i c a t i o n s of  o f h i s own, w i s h t o d o  H o w e v e r , i t was painting  that  discover.  i n d i c a t i o n of  might w e l l  patient's  the I  soon t o  and  colors  not  f i n d i n g s was  relevant  and  find  one  i n the  t h e r a p i s t was  I could  one  can  fundamentalist  family  paintings  them.  I was  s e e n as  those e x p r e s s e d by  for  How  child's paintings  taken  about the  can  therapist's  family,  It  the  divided  While  that  assumed  see  mentioned  in painting  different colors.  tures  I came t o  activities  painted of  be  For  swear.  f a m i l i e s for understanding patient's  first  same way.  c a n n o t make a mess a t home, i t c a n  to  give  of which A  tell  me  these  t h e y were c o n s e q u e n t i a l .  f a c t s about That  is,  she  the  113 saw  them as  the  painting.  of  the  the  providing  to  patient's  assign  of  tion.  former  could  problem here  the  family  i s that  as  the  s e n s e was  providing  a c c o u n t s were recall  that,  framed i n my  lies  in i t s ability  immediate  not  relevant  is  used  as  any  of  discovered  about  the  student)  doing  the  that  a resource  I  is, I  In  contrast,  see -  motivation  The interpreta-  about  play  many, o f  family  can  as  You  will  to  the  however,  these the  frame  in  the  psychiatry  outside  influenced  r o o m and  to  these  attempted  power o f  making  and  by  of  the  external  immediate i f this  a different  were a l l charac-  psychiatrically family.  m o r e e x p e r i e n c e w h i c h d e m o n s t r a t e s how I was  the  i s done.  for motivation  p s y c h o t h e r a p y w o u l d t a k e on  i n therapy.  chooses  work o f  fashion.  the  for actors,  a great  on.  information  actions  structures  actions  deny t h a t t h e  of  in this  child's  looked  a c c o u n t s make r e f e r e n c e one  one  patient's  frequently  motivational  i s , to  so  activity.  was  accounts of  sense  therapy.  piece  of  qualities,  some s e l e c t i o n  particular  observations,  psychotherapy  provide  that  information  instead,  a particular  (and  that  does not  motivational  L e t me  to  piece  information  to discover  also provide  child  any  telling,  environment.  relationship  In  just  accounts,  This  ter.  account  in a psychiatricallyrelevant  environment,  t o be  to  adequacy o f  processes.  t h a t was  motivated  and  f o r s u c h an  earlier  immediate  composition,  adequate  motivated  situated motivational patient's  i t s chemical  its artistic  given, above are  i n the  therapist  a number o f ways t o make  i t i n terms o f  the  made s e n s e o u t  of  depends upon i t s r e l e v a n c e What t h e  at  she  occasion  a l m o s t any  but  are  how  the  that  i s used  that  become r e l e v a n t  look  t o have r e l e v a n c e  family  is possible  there  art.lessons,  I t i s obvious  patient's  'adequate' a c c o u n t o f  i t that  One  i t has  accounts  It  I take  painting.  However, t h e  an  making a v i d e o - t a p e  the  for a  family student-  114 therapist about  who a d v i s e d m e p r i o r t o t h e s e s s i o n  t o o b s e r v e were v e r y  group therapy. expected did  I took  t o see.  talk  about  mean t h a t  although  home  so that  he h a d t o l e t . i t  I discovered  For  later  that  family  a stranger  and, i f t h i s  parents w i l l We the  began t o the f i r s t  I took t h i s t o  being  i s that  session.  This  who  n o t swear  from  that  h i s family  account  I f we s e e  i ti s told,  account  d i d n o t know t h a t  we c a n  knew  he c o u l d n o t  certain behaviors t o relationships.  t o be r e s p o n s i b l e  i t i s a warrantable  children  could  room.  a s e t of standardized a parent  t h a t one  play.  (at l e a s t i n middle  can see common-sensically  c h i l d ' s swearing  i n which  party can expect  can expect  their  I was t o l d  t h e p e r s o n who g a v e t h i s  i s n o t so, then  discourage  into  and t h e r e f o r e  s i m i l a r manner, one c a n e x p e c t  session.  a l l out i n the therapy  However, a t h i r d  in a family—a  example,  child  the children  the student-therapist  t h i s was a c h i l d  i s brought  of the child's family  s w e a r a t home.  be  t h e t h e r a p i s t was  most o f t h e f i r s t  something t o the e f f e c t t h a t  o n c e m o r e how t h e f a m i l y  obtain  I could  t h e s e s s i o n . w h i c h had j u s t f i n i s h e d had n o t been so bad  i n t e r m s o f what i t does on t h e o c c a s i o n  nothing  that  we h a d j u s t w a t c h e d was t h e t h i r d ) .  a l l , i t was n o t t o b e s e e n a s a t y p i c a l  included  I noted  I assumed t h a t  t h e p a r t i c i p a n t s h a d sworn d u r i n g  this  about t h e chaos which  t h e v i e w i n g however,  were  t o manage i n  some o f t h e p a r t i c i p a n t s a n d how t h e y h a d b e h a v e d d u r i n g (The s e s s i o n  see  as a warning  A t t h e end o f t h e hour,  session.  after  t h e c h i l d r e n whom we  and e s p e c i a l l y d i f f i c u l t  n o t seem t o b e s o b a d a f t e r a l l . aware o f t h i s .  at  this  During  also  of  aggressive  that  for his  absence.  In a  class families)  that  swearing.  an e q u a l l y  p l a u s i b l e account o f  swears f r e q u e n t l y  so that  what  happens i n t h e p l a y  r o o m i s n o d i f f e r e n t f r o m w h a t h a p p e n s a t home.  swearing might then  take on t h e c h a r a c t e r  o f 'so what'.  While  this  His would  115 be  an e q u a l l y  since  p l a u s i b l e account,  i t w o u l d n o t be seen  i t would n o t be adequate on t h i s  as r e l e v a n t  t o the c h i l d  as a problem.  might have been adequate had t h e f a m i l y  been t h e p a t i e n t  would  poor  serve  as evidence  practices.  of the family's  However, t h e a c c o u n t  forms t h e c h i l d ' s b e h a v i o r way o f d e s c r i b i n g  an a g g r e s s i v e  activity  the  o f t h o s e who c o u l d  easily  hear I  something The  fora child,  i t as a s i g n  take  i tthat  that  researcher  has noted  ing  i n light  'dad';  perhaps The  behavior  understanding  Making M o t i v a t i o n a l As  child  swears i n  sanction,  we c a n  aggression, e t c .  about  swearing n o t j u s t as  parents but to adults  i n general.  swears one o f t h e c h i l d r e n o f t h e house  "My d a d ' s u p s t a i r s y o u know".  discussion  about  family  therapists  t o provide  i n the l a s t  b u t was a n a p p e a l  This  sounding  i s interest-  like  'mom'  or  e x a m p l e was n o t m e a n t  then  t o f a m i l i e s , and c h i l d r e n  f o r the reasonableness o f the account o f demonstrate  the student's  patient.  Accounts  Problematic  we h a v e s e e n , m o t i v a t i o n a l  appear t o be r e a s o n a b l e members o f s o c i e t y .  this  hostility,  and by i t s r e a s o n a b l e n e s s  of that  this  i s a  inescapable.  about t h a t  f a m i l i e s , i n order  aggressive  child  description of the family  t o be a c l a i m in  i ti s  swearing  as a  o n m a n y ' o c c a s i o n s t h a t when c h i l d r e n a r e i n h i s  like,  of earlier  to their  trans-  can see swearing  that  enforce  c h i l d r e n see sanctions  i s o f concern  say something  and n o t i n g  properly  i n s o f a r asi t  by t h e s t u d e n t - t h e r a p i s t  Knowing t h a t  of disrespect,  own h o u s e a n d a v i s i t i n g might  child.  It  o r improper c h i l d - r e a r i n g  t o a p r o b l e m b e c a u s e we  sanctionable presence  given  occasion  accounts  stated  i n terms o f t h e f a m i l y  a n d t o b e b a s e d o n o u r common- s e n s e k n o w l e d g e a s  H o w e v e r , i t was some t i m e b e f o r e  I began  t o s e e them  116 as  i n t e r e s t i n g o r i m p o r t a n t phenomena.  when  I chanced  t o question  e x p e r i e n c e was i n f o r m a t i v e  'I f i r s t  became i n t e r e s t e d i n t h e m  the reasonableness  o f a p a r t i c u l a r account.  and I s h a l l  i t f o r the benefit  report  My  of the  reader. A  child  who was i n t h e e a r l y  I knew w o u l d b e a l o n g of  activities  continued  that  s t a g e s o f what b o t h  treatment program, d e l i g h t e d  appeared t o be d e s i g n e d  t o ask f o r things  when  as  an attempt  doing  i t .  getting ative  The t h e r a p i s t s a i d t h a t  express h i s anger saw t h i s attention  not  h i s parent  this. definite perhaps question  and love  and t h a t  the patient  was n e g l e c t e d  was  a n d was n o t  had e s t a b l i s h e d  a manipul-  from h i s mother and a l l o w  f o r we  i fthis  need  c a n (even i f t h e y  a l l know t h a t i s denied  him t o  h i s anger.  was a c t i n g  this  way  What d i d n o t make i n the play  a n d was s h o w i n g h i m a t t e n t i o n .  feeling of guilt f o r suggesting  f o r having  children  they w i l l  get negative  t h a t he would be a n g e r e d a t t h i s  However, o n c e h a v i n g q u e s t i o n e d  also  session.  a characterization o f the a c t i v i t y  a s an a d e q u a t e a c c o u n t ,  some way o f e x p r e s s i n g the c h i l d  t h e whole  These  indirectly.  a l s o makes s e n s e  why  they occuped  the patient  would g e t a t t e n t i o n  t o g e t i t i n w h a t e v e r way t h e y It  and so on and so f o r t h .  from h i s mother and t h e r e f o r e  approach t h a t  require  to provide  He  t h a t he c o u l d n o t  t o a n n o y t h e t h e r a p i s t , h e d i d n o t know why  much l o v e  I  was a b l e  program  t o annoy t h e t h e r a p i s t .  things,  were n o t j u s t i s o l a t e d i n c i d e n t s , r a t h e r , the researcher  i n an e x t e n s i v e  i t had been e s t a b l i s h e d  have them, he d e l i b e r a t e l y s p i l l e d  While  t h e t h e r a p i s t and  attention).  deprivation sense,  room s i n c e I asked  and  the therapist  question  t h a t h e r a c c o u n t h a d n o t been an a d e q u a t e declared  was  t h e t h e r a p i s t was  an i n a p p r o p r i a t e  r a i s e d t h e i m p l i c a t i o n t h a t my  find  however,  the therapist, I experienced  asked  attempt  purpose  about a and  one.  f o r doing  My  117 research now  a t the  i n danger o f being As  able.  i t turned  explained  in  much t h e  that  i f one  by  same way  theory  That  of  suggest  child  competence To  as  a  the  atric  accounts.  ing.  family are  Family  way  Talk We  this  as  will  i n the  still  .  .  activity.  9  could  play  child  room b e h a v i o r  will  relate  by  but  I am  t h e r a p i s t s they of  their  are  account  i n terms o f  r e s t s not  accounts  adults  suggesting  be  found  accounts  to are  for a l l practical i n terms of  its telling.  sanctionable  not  will  telling,  adequate  to other  I would and  that  a  also  their  t h a t t o d o u b t them i s t o q u e s t i o n  one's  member. have been  to  be  l o o k i n g a t how  common s e n s e  notions  t h e r a p i s t s i n constructing reasonable  look  this  a t how  as  practical  'family talk'  psychiatric  i s used' i n a  psychireasonsomewhat  setting.  concerned with  I want t o  therapy to  was  t h a t the  f a m i l y and  evident  clinic  manage r e l a t i o n s h i p s .  W i e d e r and  purpose  Management  section.but  compare t h e  real  avail-  a d e q u a c y o f an  used by  like  t h a t my  a more a d e q u a t e e x p l a n a t i o n  occasion  I have r e f e r r e d t o  I w o u l d now  different  the  warrantable  t h i s p o i n t , we  about  not  given  patient's  self  social  and  r e l a t e s to his parents.  on  disturbance,  i s so  was  accounts  i s , the  are  one  consistency—the  t h a t he  the  t h a t these  reasonableness  there  rather, 1  false  t h e r a p i s t d i d add  pushes the  i n terms of  purposes.  been a  exposed.  a rule of  insupportable;  framed  had  out,  However, t h e  be  be  clinic  look  By  setting  show how way to  of the  practical  talk  of  the  p s y c h i a t r i c reasoning family provides  i n t r o d u c t i o n , i t m i g h t be h a l f w a y house examined by  at h i s attention to  the  " c o n v i c t code"  as  a way  in to  h e l p f u l to D.  Lawrence  a  persuasive  118 There are the  staff  set  i s responsible  looking back  and  two  out  their  the  other,  to  other  f o r the  welfare.  to  demands t h a t  conduct. dren to  are  do  This  parents  the  one  accountable  are  to  of  accountability to of  the  C o n s i d e r how accountable. their  The  activities  aggressive, actions  by  called  to  appealing  their the  as  to  community  example, t h e y o f t e n  staff,  the  their  the  researcher  because of  Similar  r e a s o n s were g i v e n  failing  to  the  meetings,  to  be  own  the  be  the  relationexplain  say  they  his  chil-  failure that  are itself."'"  0  in a position  that  the  halfway house  are  being.  accounts and  f o r a wide range  others  They e x p l a i n other  can  placed  demonstrated  may or  residents  could  not.talk  way  that  other  residents  etc.  or  community  they  sharing  for  (e.g.,  from meals,  that  f o r not  the  justify  same way,  may  researcher,  relationship to  ways  of  t h a t we  well  of  etc.  on,  sure  and  staff  nature  absence  latter's  and  concern  r e l a t i o n s h i p , wherein  not  i f i t can  provide  felt  report  superordinate  the  be  them t o f i t  showing  i n various  the  c h i l d r e n i n the  residents  their  i n general,  to  of d i r e c t o r s ) .  their  I am  making, a p a t h e t i c ,  For  attend  While  jeopardize  the  on  things  etc.  residents  that  board  parent-child  authority.a  the  trouble  the  subordinates  former  the  to  be  i s supposed  needs, h e l p i n g  and  can  f o r such  r e l a t i o n s of  each other or  former  one  of p a r t i c i p a n t s i s responsible  i s that  them t h r o u g h  other  to  namely,  r e l a t i o n s h i p where  i s , the  them, a n d , set  halfway house,  in a  accountable here  chores,  In  actions  one  community,  accountable  accountable  only  i s s i m i l a r to  household  stand  That  counselling  accountable  What I mean b y ship  they  other.  While  are  staff,  and  l a t t e r p r o v i d i n g for their  community,  both  of p a r t i c i p a n t s i n the  residents,  f o r the  i n t o the  for  the  sets  a beer with  These were a c t i o n s  about  see  as  justify or  of  rude, such  convicts.  something  to  might i n t e r p r e t  this.  the  for  researcher,  f o r which they  were  119 accountable  to other residents,  Since accountable  staff  as a f e l l o w  f o r t h e way t h a t  or failure,  provide  excuses,  they handled  and so on.  That  i s t o say, they  the s t a f f  had t o j u s t i f y  who h a d n o t made a r r a n g e m e n t s t o p a y h i s b i l l  able  In order  accounts,  i n terms o f which they  the "convict  code".  the discharge of a when t h i s  that  including  (and thus  o f inmate  life  accounts.  uncoop-  t h e r e s i d e n t s and f o r t h e i r  was p e r s u a s i v e b e c a u s e than  that  hislife. as w e l l  accounts  of the staff  as t h e i r  concern  about  both  which  t h i s ' c o d e was a p e r v a s i v e a n d p o w e r f u l  o f the halfway  own"actions appealed  and f a i l u r e  Since the s t a f f  T h i s was  t o and t a l k e d  house).  Consequently,  (and t h e r e s e a r c h e r ) h a d t o u s e i t i n o r d e r t o a c c o u n t  tence,  t h e y be  their  Because o f t h e r e l a t i o n s h i p  feature  other  resident  was c o n t r a r y t o  i t was n e c e s s a r y  T h i s c o d e was r e f e r r e d  and r e s i d e n t s ,  one  h a d t o be a b l e t o  f r a m e d many o f t h e i r  o b t a i n e d between s t a f f  of  were  t h e r e s i d e n t s o f t h e h o u s e h a d a'' b o d y o f  t h e r e s i d e n t s and by t h e s t a f f .  staff  they  f o r t h e way t h i n g s w e r e  o f the actions of the residents,  was d i s c o v e r e d t h a t  "rhetoric" called  such  friend.  behavior. It  by  to provide  t o make s e n s e  erative  o r as a  t h e m , f o r p r o g r a m demands, f o r  e x p l a n a t i o n s , and j u s t i f i c a t i o n s  F o r example,  rules.  convict  members w e r e r e s p o n s i b l e f o r t h e r e s i d e n t s ,  success  going.  either  with  f o r the behavior  r e s p e c t t o them.  to serious obligations t o meet t h e s e  had c o n t i n u a l l y  they  The code of a  obligations  t o demonstrate  f o rthe residents,  the  system  may c o s t  their  compe-  too appealed  to the  code. In pist  the psychotherapy  f o r some o f h i s a c t i o n s  example)  although  accountability.  clinic  i s accountable  (he may make e x c u s e s  the therapist (This  the patient  tries  f o rbeing  away, f o r  t o c r e a t e an atmosphere  i s o n e way t o make v i s i b l e  t o the thera-  o f minimal  a c o n t r a s t to- t h e  120 p a t i e n t ' s home).  The t h e r a p i s t , however, i s both a c c o u n t a b l e f o r t h e  p a t i e n t and a c c o u n t a b l e t o o t h e r s , e.g., p a r e n t s , s u p e r i o r s , c o l l e a g u e s , etc.  L i k e t h e s t a f f o f t h e halfway house, t h e r a p i s t s a r e a c c o u n t a b l e f o r  the p r o g r e s s o f t h e i r p a t i e n t s .  I want t o demonstrate  1 1  i n this  section  t h a t t h e f a m i l y s e r v e s as a r e s o u r c e f o r these accounts and as such we can t h i n k o f ' f a m i l y t a l k ' as a r h e t o r i c . L e t me c l a r i f y what I mean by the t h e r a p i s t b e i n g a c c o u n t a b l e f o r the p r o g r e s s o f t h e p a t i e n t ' s treatment.  I n an e a r l i e r s e c t i o n I show how some  t y p i c a l f e a t u r e s o f t h e r a p y p r e s e n t e d problems f o r me. t o understand what was happening  s i n c e t h e r e was a minimum o f d i r e c t  v e n t i o n , t h e treatment was n o t always  inter-  o b v i o u s , many c h i l d r e n d i d n o t d i s -  p l a y obvious s i g n s o f d i s t u r b a n c e , etc.. therapist..  I found i t d i f f i c u l t  These were n o t problems f o r t h e  However, t h e r e a r e many t h i n g s which were and a r e concerns  both f o r myself and f o r the t h e r a p i s t .  F o r example, some c h i l d r e n were n o t  s u i t a b l e f o r t h e r a p y and had t o be d i s c h a r g e d , o t h e r s g o t worse o r had a r e l a p s e , some p a t i e n t s made v e r y r a p i d p r o g r e s s w h i l e , w i t h o t h e r s , p r o g r e s s was minimal.  The t h e r a p i s t i s a c c o u n t a b l e f o r r e c o g n i z i n g p r o g r e s s  o r , c o n v e r s e l y , f o r n o t i n g i t s absence a c t i o n i f necessary.  and must be p r e p a r e d t o take r e m e d i a l  That i s , t h e t h e r a p i s t i s c l e a r l y a c c o u n t a b l e f o r  12 outcomes. I want t o suggest t h a t t h e f a m i l y i s f r e q u e n t l y used as a r e s o u r c e t o p r o v i d e such an account, e s p e c i a l l y .'in i n s t a n c e s o f f a i l u r e . suggest t h a t t h e r a p i s t s a r e never s e l f - c r i t i c a l ,  they a r e .  T h i s i s not t o You w i l l  recall  a t r a n s c r i p t on page 60 i n which a t h e r a p i s t d e s c r i b e d an a c t i o n as "bad therapeutically".  D u r i n g my r e s e a r c h , I w i t n e s s e d numerous' o c c a s i o n s i n  which t h e r a p i s t s c r i t i c a l l y examined what they d i d and sought a d v i c e from s u p e r v i s o r s and o t h e r s .  N e i t h e r am I s u g g e s t i n g t h a t t h e accounts a r e an  121 act  o f deception A  to  child  the c l i n i c  or collusion.'  whom I o b s e r v e d  i n a day care  sessions  twice  last  a week.  After  session,  saw h e r .  When a s k e d  quickly  that  the child  we h e a r  this  as an e x p l a n a t i o n  is  i t an adequate  this  she behaved  pair  of the reported  As p a r t  which the both the  she had d i s p l a y e d t h e  the therapist r e p l i e d f o r a month.  behavior?  i t formulates  (parent-child)  over one's l i f e .  about t h i s ,  during  o f the c h i l d ' s apparent  appears reasonable because  relationship  that which  I would  the c h i l d  we know t h a t  very How  regression?  do  Why  suggest  a s a member  w h i c h we know t o h a v e a p o w e r f u l  of this,  was  therapy  i n a way t h a t  h a d b e e n home w i t h h e r m o t h e r  account  The c h i l d  a n d came t o p l a y  the Christmas vacation,  and I t h o u g h t t o be worse t h a n  t i m e we  h e r problem.  program a t t h e c l i n i c  had not had a therapy  therapist  t i m e was o f p a r t i c u l a r i n t e r e s t  because o f the seriousness.of  involved  child  f o r a long  that  of a  influence  i t has the a b i l i t y  t o block  13 the  possible In  the  influence  the instance  family  o f other cited  the t h e r a p i s t had n o t spent  n o r d i d she have a second-hand r e p o r t  it  i s not a f a c t u a l statement  It  i s possible  received gesting  contrary absence  instead  much l o v e that  behavior.  adults.  that  one c a n u s e t h i s That  from therapy,  have been e q u a l l y  feature  influence  the c h i l d  c h i l d r e n i n ways  a f t e r any  (who h a d d e v e l o p e d  t o have been so p l e a s e d than  their  necessarily regress.  f o r the c h i l d  b e h a v i o r would be even b e t t e r  Christmas.  of the rhetoric to predict the child's  i s n o t t o say that,  children will  possible  ment t o t h e t h e r a p i s t )  ideal  thus,  S i m i l a r l y , t h e t h e r a p i s t was n o t s u g -  i s , knowing t h a t p a r e n t s  to the therapeutic  spent  a l l h a d a good time and t h a t  and a t t e n t i o n .  with  o n how i t was s p e n t ;  a b o u t t h e way t h e f a m i l y  they  the vacation  before.  long  Indeed,  i t would  a strong  attach-  t o be back w i t h h e r t h a t h e r  122 The account appeals t o a n o t i o n o f competing work o f one a d u l t can be undermined by o t h e r s -  i n f l u e n c e s by which t h e  The t h e r a p i s t has t h e c h i l d  f o r an hour o r two every week, w h i l e t h e f a m i l y has h e r f o r most o f the remainder.  T h i s i s s i m i l a r t o the d i s c u s s i o n one hears a t a PTA meeting  d u r i n g which some t e a c h e r i n v a r i a b l y says, "We can o n l y do so much.if t h e p a r e n t s don't c a r e " .  The p a t i e n t i s i n e s c a p a b l y a f a m i l y member and t h a t  membership i s seen t o have consequence f o r t h e s u c c e s s o r f a i l u r e o f the therapy. While most p a t i e n t s came t o the c l i n i c o n l y once a week, changes a r e sometimes made i n t h i s s c h e d u l e .  A c h i l d who i s j u s t b e g i n n i n g p l a y  t h e r a p y may be seen t w i c e a week and then s w i t c h e d t o weekly v i s i t s as t h i n g s improve. visits  On o t h e r o c c a s i o n s a p a t i e n t may be s w i t c h e d t o two  a week i f problems appear t o be d e v e l o p i n g .  I t was n o t uncommon  t o hear t h e r a p i s t s commenting upon the frequency o f v i s i t s . 4.11 T:  With l i t t l e k i d s I f i n d , w e l l when I saw T e r r y remember when I f i r s t saw T e r r y I saw h e r twice a week, t h i n g s seemed t o go much b e t t e r .  R:  Yea.  T:  Cause, from, a whole week i n between i s a v e r y l a r g e chunk o f time, b u t t h r e e o r f o u r days i s n ' t much.  R:  Yea.  T:  And what happens here i s s i g n i f i c a n t enough t o them t h a t they g e t involved i n i t .  The t h e r a p i s t appeals t o a c h i l d ' s sense o f time i n which a week can be thought o f as a "very l a r g e chunk o f time" w h i l e " t h r e e o r f o u r days much".  I n some ways t h i s account i s b u i l t around  a n o t i o n o f how l o n g t h e  i n f l u e n c e o f a therapy s e s s i o n can be expected t o l a s t . appeals t o the competing  isn't  This notion  i n f l u e n c e s w i t h which a c h i l d has t o cope.  123 There were a l s o some p a t i e n t s f o r whom t h i n g s weren't g o i n g so w e l l . The  t h e r a p i s t and o t h e r s f e l t they were making p r o g r e s s and then, f o r some  reason, problems developed.  U n l i k e the e a r l i e r d i s c u s s i o n o f r e l a p s e s the  problems were n o t r e l a t e d t o the l e n g t h o f time between v i s i t s b u t , r a t h e r , to  changes i n the p a t i e n t ' s f a m i l y . One  young p a t i e n t had been making such p r o g r e s s t h a t he was  about  be r e t u r n e d t o r e g u l a r s c h o o l and have h i s weekly v i s i t d i s c o n t i n u e d . d e n l y he appeared  t o get worse and these p l a n s had t o be p u t o f f .  p i s t s a t t e n d t o the f a c t t h a t c h i l d r e n may  i n the above case.  happening  Sud-  Thera-  become m a n i p u l a t i v e when they  a n t i c i p a t e the end o f t h e i r t h e r a p y , but t h i s was problem  to  not thought  t o be  Rather, the t h e r a p i s t s a t t e n d e d t o what  the was  i n the c h i l d ' s f a m i l y .  4.12 T:  Things a r e n ' t g o i n g w e l l w i t h , a t Rufus'. F a t h e r i s 59, f o s t e r f a t h e r i s 59, and he's l o s t two j o b s i n the l a s t y e a r due t o change of o p e r a t i o n s on the j o b , changes o f equipment o r something. So he's been out o f work a l o t , and a p p a r e n t l y now he's r e a l l y depressed and the f o s t e r mother says a c l o u d o f gloom hangs over the house. . . and what e l s e i s happening, when f a t h e r gets l i k e t h i s he o v e r i n d u l g e s Rufus and Rufus hates him f o r i t , and mother and f a t h e r are f i g h t i n g because he's l e t t i n g Rufus walk a l l over him. So t h i n g s a r e n ' t v e r y w e l l , i n f a c t we might, we might have t o p u l l him out o f t h e r e which I r e a l l y hate t o do, cause he's been t h e r e s i n c e he was f o u r months old. But they haven't done a v e r y good job o f him, you know, ( ) l i k e I c o u l d go on h a v i n g him work out the anger and so on he e x p e r i ences d a i l y but t h a t ' s l i k e p u t t i n g on a bunch o f bandaids. . . . Things were g o i n g w e l l because the p a r e n t s a l s o working i n therapy f o r a l o n g time, and then they were dropped, because they were d o i n g w e l l , and because ( ) and then they k i n d o f back s l i d , you know, so. . . when k i d s say and do the k i n d s o f t h i n g s Rufus does they o b v i o u s l y have a l o t o f a g g r e s s i o n , l o t s o f anger, and the l a s t two times I had Rufus i n the p l a y therapy room he, he's r e a l l y , r e a l l y been angry, l i k e he t a k e s I n d i a n c h i e f s , o r one o f the Indians and smashes i t i n t o a c o r n e r , l i k e r e a l l y , .'. . So we know i t ' s coming from somewhere and we t h i n k i t ' s r e l a t e d t o f a t h e r , and i t ' s k i n d o f hard t o p i n down why. In  t h i s account t h e r e are a number o f ways i n which the  interpretive  124 schema o f change  the  i n the  stances; his  patient  the  things  notion  neither  i s also  t r e a t i n g the  of  serious  intimately  as  beginning  of  the to  appropriateness  be  of  t i m e when t h e  family  anger i s thought  e.g.,  family's  without getting  this  inconsequential.  We  to  to  was  a  circum-  the  source  i t is  said  also  t o be  relapses of  "foster father  i s 59".  could  be  are  that  One  could  in  found  of  as  of  i t s practitioners.  understanding  e a c h and  our  of  the  of  therapy; in  his  room.  he  may  put  his  and  child  the  Instead,  i n a way  that  i t s underlying invoke such  the  things  events  are  therathe  for  the home.  events the  which  genetic limita-  usually  preserves  theories, the  at  possible we  a  immediately  problematic  knowledge and  family  into  from the  i n terms o f  is  family  that  this provided  relapses  that  i f the  be  and  i s 59",  u n u s u a l and  Therapists so  that,  family  foster family  remove t h e  explained  every p a t i e n t  play  a  "Father  o f p r o g r e s s become p e r f e c t l y r e a s o n a b l e outside  as  Later,  therapy,  competence o f  told  the  consequential  therapists, etc.  r o u t i n i z e d and  enterprise  said  explain  paucity the  family  they  thought of  t h e r a p y and  the  the She  option  are  h i s progress,  I t i s , perhaps,  conversation.  the  concern with  c h i l d ' s recovery,  child's condition,  c h i l d r e n , the  of play  the  r e f e r r i n g to  explored.  make-up o f  validity  A  of  Relapses  source  in his  later,  a bunch o f bandaids";  patient's  bound t o g e t h e r .  amended t h i s  lack  child  on  the  a change  to note t h a t  obstacle  made a p o i n t  tions  the  nor  foster family.  should  "putting  important  superficial  becomes a  pist  with  considered  relationships, etc. It  that  of  nature  some o f w h i c h a r e  is identified  were g o i n g w e l l  motivated  family  new  i s used,  problem- i s l i k e n e d t o  that the  family  and  find  the the  same r e s o u r c e s as  relapses  attributable to  and a  in  125 The  Difficult The  in  simply  always  very  the case  children  nature  because  some p o i n t  the  Patient of play  the expectations  that  therapy  c h i l d r e n become  patient  I f this  I was  treated  i n play  therapy,  that,  The  h i s cooperation.  of handling  therapists  w o u l d be n e c e s s a r y shown t h e i r  suggestion  managed.  that  T h i s was  eventually  be  means o f discharged  a t h e r a p i s t and a  suggested  out that  a frequent  That  this  that,  i n order  the parents  w o u l d be  quickly  I'm  g e t t i n g dismayed,  and of  with h i s  the c h i l d not  uninterested.  t o t r e a t the c h i l d , i t  as w e l l  that  be  showed a l a c k o f  was  even though they had  The c o n v e r s a t i o n  required,  could  seemed c o n s i s t e n t  i s , not only  student-  the prob-  a number  repeatedly  t h e p a r e n t s were e q u a l l y  lack of interest.  the c h i l d  that  the program very  but the patient  problems.  to involve  I t seemed t h a t  ended w i t h t h e  i s , i f the parents  discharged.  p r o b l e m and, a s one t h e r a p i s t  commented:  4.13 T:  Such  t o take i t  The t h e r a p i s t s h a d t r i e d  a n u l t i m a t u m was  therapy,  At  therapies,  o r b y some o t h e r  i n which  he g o t b o r e d w i t h  s h o w i n g an i n t e r e s t i n t h e r a p y ,  enter  or attend,  w h i l e he h a d d i f f i c u l t i e s  The t h e r a p i s t s p o i n t e d way  children.  i n need o f therapy.  t o get him i n v o l v e d  interest.  not  some o l d e r  were t a l k i n g a b o u t a p r o b l e m p a t i e n t .  strategies  however, i t i s n o t  In a l l . n o n - i n t e r v e n t i o n i s t  a member o f a c o n v e r s a t i o n  would w i t h o l d  already  with  p e r s i s t s , the patient w i l l  t h e p a t i e n t was  family's  start  most c h i l d r e n w i l l f i t  r e s i s t a n t a n d c a n n o t be e a s i l y  to cooperate,  e v e n t h o u g h he i s s t i l l  with  that  can undermine t h e treatment program by f a i l i n g  resisting.  therapist  ensures  a r e so minimal;  can even  c a n n o t become p a t i e n t s .  seriously,, by f a i l i n g  lem  therapy  i n c a s e s w h e r e I'm  working with  a k i d and  would  126 n o t h i n g ' s h a p p e n i n g w i t h the f a m i l y , b e c a u s e you can g i v e them a l l s o r t s o f n i c e m e s s a g e s i n t h e p l a y room, i n t h a t s p l e n d i d h o u r a week, but. . . This by,  i s a clear made e a s i e r , The  case  statement  o f how  o r o b s t r u c t e d by  therapists  therapy  d i d not  their  work b e i n g i n f l u e n c e d  parents.  f o l l o w i n g comments w e r e made b y  i n which  see  seem t o  a therapist  concerning  another  begin.  4.14 T:  . . . i n d i c a t e s t o me anyhow, t h e p a r e n t s n e e d f o r i n v o l v e m e n t . I t ' s a J a p a n e s e f a m i l y a n d t h e b o y i s 11 I g u e s s , a n d h e , a n d one, two, f i v e k i d s i n t h e f a m i l y . There's a couple o f teenage g i r l s and a t w e l v e y e a r o l d , and G e o r g e i s t h e o l d e s t s o n , Dan's a y o u n g e r b r o t h e r , Dan i s f i v e , who was b o r n l i k e f i v e y e a r s a f t e r A r n o l d , h a d t h e s o l e c l a i m t o b e i n g t h e s o n a n d man o f t h e f a m i l y . But A r n o l d i s l i k e e x t r e m e l y i n h i b i t e d a n d w i t h d r a w n , I'm j u s t w r i t i n g a r e p o r t on i t , h e , he c o u l d n ' t p l a y w i t h a n y t h i n g . T h e r e was n o t h i n g i n t h i s w h o l e c l i n i c t h a t was i n t e r e s t i n g , y o u know, e v e r y t h i n g was r i d i c u l o u s , a n d a w a s t e o f t i m e , e v e r y t h i n g was r i d i c u l o u s o r t o o c h i l d i s h , o r m o r e , o r s o m e t h i n g Dan, Dan w o u l d l i k e t o p l a y w i t h b u t n o t me. He d i d , a l l he w o u l d do was m o d e l s a n d h e w o u l d c o m p l a i n i n t h i s v e r y a d u l t t o n e a b o u t how a w f u l i t was a t home and how h i s s i s t e r s p u t on t o o much make-up a n d t h e g i r l s w e r e a l w a y s f i g h t i n g a n d i t ' s w o r r y i n g mom a n d d a d and i t was m a k i n g t h e w h o l e h o u s e h o l d upset. So he w o u l d j u s t r e a l l y i d e n t i f y w i t h t h e a d u l t s a n d h a v e no p a r t o f b e i n g a c h i l d o r k i d . So I w e n t on l i k e t h a t f o r a y e a r , a h , t h e p a r e n t s saw a t h e r a p i s t f o r a w h i l e . They had a c r i s i s w i t h t h e 17 y e a r o l d ( ). And t h e y came i n k i n d o f on a c r i s i s b a s i s , b u t when i t was s o l v e d t h e y d r o p p e d o u t . Then t h e y were a l s o i n f a m i l y t h e r a p y w i t h a p s y c h i a t r i s t and d r o p p e d o u t o f t h a t . So we c o u l d n ' t do much w i t h h i m , b u t we c o n t i n u e d on w i t h A r n o l d a n d f i n a l l y , oh y e a , I h a d a t a l k w i t h A r n o l d a b o u t l i k e he h a d t h i s n e e d t o b e s u c h a b i g b o y a n d he c o u l d n ' t r e l a x a n d b e a c h i l d . A n d he said: "we d o n ' t do t h i n g s l i k e t h a t i n o u r f a m i l y " , y o u know. W h i c h i s I t h i n k a g o o d p i c t u r e o f w h a t h a p p e n s a t home, l i k e , a n d f a t h e r t o l d me t h a t a few y e a r s ago he s a i d t o A r n o l d , y o u ' r e a b i g b o y now, when y o u go t o b e d a t n i g h t w e ' l l s h a k e h a n d s , . . . They're a p e r f e c t f a m i l y , b u t t h e y ' r e so b l o o d y c o n s t r i c t e d i t ' s u n b e l i e v a b l e , a n d , a n d i t comes o u t i n A r n o l d . He's a f r a i d t o b e a n y t h i n g b u t t h e man i n t h e f a m i l y . . . . So i t o c c u r r e d t o me, okay he g e t s a l l k e e n a n d he g e t s e x c i t e d a n d t h e n he g o e s home, a n d h e ' s b a c k i n t o a v e r y s t i l t e d a t m o s p h e r e , a n d he h a s a week o f t h a t between s e s s i o n s , . . . So i t ' s r e a l l y d i f f i c u l t a n d I d o n ' t r e a l l y know how This  we're g o i n g  t o make i t .  i s a powerful  between s u c c e s s  i n therapy  e x a m p l e o f how and  therapists  the p a t i e n t ' s f a m i l y .  see  the Not  relationship o n l y do  features  127 of  the  f a m i l y p r o d u c e many o f  things has  about  been  start  i n terms o f an  We  adult  could  a child  being  who,  t h a t he  This  trained,  expected a  I ability  his  and  a naive  to provide  one  a difficult  about the  scenario  indication of  reasonable  failure).  Sometimes t h e s e  of  a private psychiatrist.  therapist  things  the  furnished  an  endless  and  and  who,  so  faced upon  r e p l i e d "How  since  work o u t  This  of  should  therapists  are  know, w h a t i s  a  therapist lies  accounts of progress  amount o f  this  as  they  ideally  membership p r o v i d e d  treatment program i t s e l f .  Families  reluctant, disturbing, etc.,  should  of  going  was  the  as  we  formulated  be  a l l of  seen  can  now  about as  his  (this  the  sex  mistakes  understanding  adequate m o t i v a t i o n a l  and,  in  t a l k among  i n terms o f  however, an  explanations can  kind  r e l a t i o n s h i p ) , or  Most f r e q u e n t l y  reasonable  the  see,  in  of  terms  accounts i t also  status  uncooperative,  which might a f f e c t the  of  the  uninterpatient's  therapy.  I have been d e m o n s t r a t i n g provided  is  t h e r a p i s t was  a c c o u n t s were f o r m u l a t e d  therapists with  in  skill  (especially i n a cross-sex  d i d not  family.  success  He  was  therapy.  d e m o n s t r a b l y do  t h a t were b o t h p s y c h i a t r i c a l l y r e l e v a n t  ested,  adult.  child any  problem  patient  matter,  indeed  descriptions  T h e r e was  the  the  an  the  s i t u a t i o n i n which a  t o know, a n d  of  of  a  much l i k e  the  feeling that  participate in child  supervisor  paid  have the  are  patient.  colleagues.  why  not  imagine  w o u l d be  expect that  includes  can  too  there  Although  It i s interesting that being  often,  impossible.  does not  f o r some r e a s o n , was  q u e s t i o n e d by  with  one  him.  patient  naively  I know?"  on  f o r a year,  the  c h i l d ' s problems but,  t h a t make t h e r a p y  b e e n made w i t h  much l i k e  with  family  i n therapy  has  stated  the  the  accounts of  how  some o f  the  ways i n w h i c h  t h e y made s e n s e o f p a t i e n t ' s  therapists  behavior,  explained  128 relapses, recognized  problems, a n t i c i p a t e d d i f f i c u l t i e s ,  ence t o the c h i l d ' s f a m i l y . i n the t h e r a p i s t ' s  e t c . , by r e f e r -  The f a m i l y appeared as a p o w e r f u l  resource  reasoning.  In c o n t r a s t t o t h e halfway house where t h e " c o n v i c t code" was a c o n s t r u c t i o n o f the  inmate and because o f i t s n a t u r e was a l s o used by the  s t a f f , the f a m i l y t a l k i s n o t a c h i l d ' s i n v e n t i o n b u t an a d u l t I would l i k e t o suggest t h a t t o some e x t e n t , in this setting.  Unlike  i t i s a persuasive  construction. rhetoric  a d u l t t h e r a p y , wherein the p a t i e n t may be  expected t o t a l k o f h i s f a m i l y , t h e c h i l d p a t i e n t was n e i t h e r encouraged nor  expected t o do so.  He was however, expected t o demonstrate t h a t he  understood t h a t h i s problem o r i g i n a t e d i n h i s f a m i l y .  I f he  continued  t o a c t as i f h i s f a m i l y were i r r e l e v a n t t o what he was d o i n g i n t h e p l a y room, he was seen t o be a v o i d i n g h i s problems. never o v e r t l y c h a l l e n g e d preted  it.  Although c h i l d r e n were  on t h i s p o i n t , t h i s i s how the t h e r a p i s t s  C o n s i d e r the f o l l o w i n g c o n v e r s a t i o n s  inter-  i n which the t h e r a p i s t  uses t a l k about the f a m i l y t o r e l a t e t o the p a t i e n t ' s problem. 4.15 C:  I don't c a r e . ( ) I don't c a r e . Say i t e x a c t l y t h e same way I say i t .  T:  How would he say i t ?  C:  E x a c t l y the way I j u s t s a i d i t .  T:  L i k e , " I don't  care".  C:  No.  care".  T:  Does your dad ever g e t mad Simon.  C:  No.  T:  No!  C:  A p a r t from when  " I don't  (  ) starts a fight.  That's what dad would say.  T:  Mmhmm, and then dad gets mad?  C:  Yea. How do you l i k e t h a t f o r a p i c t u r e .  T:  You know i t ' s okay f o r people t o g e t mad Simon.  And: 4.16 1.  T: I f you were n i c e t o him he would f o l l o w you a l l t h e way home.  2.  C: Hmmm.  3.  T: Do you t h i n k so?  4.  C: Mhmm.  5.  T: Hmmm.  6.  C: She'd p r o b a b l y say, "where i n t h e w o r l d d i d you f i n d t h a t t h i n g ? "  7.  T: There t h a t ' s another  8.  C: She'd p r o b a b l y t e l l me (  9.  T: What do you t h i n k your dad might do?  10.  C: Come o u t w i t h h i s gun, and shoot i t .  Your mom would p r o b a b l y scream though.  See a d i n o s a u r i n your  backyard.  l e g a l l together. ) , p r o b a b l y t e l l my dad t o come.  But I won'd l e t Dad shoot  it. I f he shot i t , I'd g e t dad t o shoot me i f he s h o t the dinosaur. 11.  T: Would you?  Why i s t h a t Simon?  12.  C: Cause I l i k e d i n o s a u r s .  13.  T: Okay.  17.  T: So i f dad s h o t your p e t d i n o s a u r you'd g e t r e a l mad a t him hey.  18.  C: Mmhmmm.  19.  T: and what would you do.  20.  C: Get him t o shoot me.  21.  T: Get him t o shoot you;  maybe you'd f e e l l i k e s h o o t i n g dad.  130 22.  C:  No way.  23.  T:  No way?  24.  C:  I f I d i d shoot dad, then I'd have t o go t o j a i l .  25.  T:  Hmmm.  Maybe you'd g e t r e a l angry a t dad though.  The t h e r a p i s t thought t h a t Simon was " t o o good". was always  She s a i d t h a t he  under p r e s s u r e from h i s f a m i l y t o behave h i m s e l f .  As a r e s u l t ,  he never admitted t h a t he might be angry w i t h someone o r e x p r e s s e d h i s anger openly.  There was so much c o n s t r i c t i o n from the f a m i l y t h a t he c o u l d  not express h i s normal  emotions,  a pathological condition.  e s p e c i a l l y h i s anger, and t h i s had become  The above two c o n v e r s a t i o n s a r e m e t h o d i c a l  •attempts by t h e t h e r a p i s t t o g e t the c h i l d t o express h i s anger w i t h members of h i s family.  In the f i r s t  i n s t a n c e , she t r i e d t o show Simon t h a t  i f t h e r e were o c c a s i o n s on which dad,got mad, then i t was a l r i g h t f o r o t h e r people  ( i n c l u d i n g t h e p a t i e n t ) t o g e t mad as w e l l .  In t h e second  tran-  s c r i p t , t h e t h e r a p i s t c a p i t a l i z e s on a s i t u a t i o n i n which t h e c h i l d c o u l d imagine t h a t he would be angry w i t h h i s f a t h e r and asks him how he would express h i s anger.  The c h i l d ' s answer, " g e t him t o shoot me",  i s a con-  f i r m a t i o n o f h i s p r o b l e m — h e would r a t h e r d i e than express h i s anger. t h e r a p i s t c l o s e s t h i s attempt w i t h a c l e a r and r e l e v a n t "Maybe you'd be r e a l angry a t dad though".  statement:  Thus, c h i l d r e n were o f t e n  t e s t e d i n d i r e c t l y t o determine whether they r e c o g n i z e d how t h e i r and f e e l i n g s were i n f l u e n c e d by t h e i r  The  actions  families.  Some o f t h e t r a n s c r i p t s t h a t have been p r o v i d e d make i t c l e a r  that  p a r e n t s , t o o , a r e expected t o see the r e l a t i o n s h i p between the f a m i l y ' s c i r c u m s t a n c e s and t h e c h i l d ' s b e h a v i o r .  I f they r e f u s e t o r e c o g n i z e t h i s  r e l a t i o n s h i p , they can then w a r r a n t a b l y be c l a s s i f i e d as problems.  And,  i f they do n o t c a r e f o r t h e w e l l b e i n g o f t h e i r c h i l d , t h e i r c h i l d o r  131 children  can u l t i m a t e l y  be t a k e n  w i t h p a r e n t s b u t , a t one p o i n t , about  her ability  t o make p r o g r e s s concern  away f r o m  them.  I overheard  t o give her c h i l d i n play therapy.  I h a d no r e a l  contact  a mother e x p r e s s i n g h e r concern  the security  that  The t h e r a p i s t  she needed  later  i n order  characterized  this  f o r me a s f o l l o w s :  4.17 T:  You h e a r d m o t h e r s c o n c e r n r i g h t a t t h e end, she s a i d she's b e g i n n i n g t o w o r r y about h e r c a p a c i t y t o be l e v e l , ah, she t h i n k s R o b i n i s l a c k i n g s t i l l i n b a s i c t r u s t and s e c o n d l y t h a t she h e r s e l f i s v e r y w o r r i e d about h e r r e a c t i o n , she's j i t t e r y (and what n o t ) . ( ) s h e ' s a p e d i a t r i c n u r s e h e r s e l f s o t h a t ' s why I was m a k i n g 1  the l i t t l e anymore. I adult be, in  joke with her that  suggested  construction  and i s , used this  setting  earlier rather  i n this  i ti s p o s s i b l e  daughter  with  for  complaint,  section  talk such  where?"  I am c o n t e n d i n g  had  my p r o b l e m  understood  come t o u n d e r s t a n d  gloss  I take  used  one's  w o u l d be most  i t t h e r e may w e l l b e g r o u n d s  with talk  be wrong?"  of the family  and w i t h  answers t o  a r e n ' t we g e t t i n g  t h e r e i s some o b l i g a t i o n  any-  u p o n members t o  talk.  h a d become d e f i n e d a s a t t e m p t i n g  their  i t can  c a n be c o n s e q u e n t i a l .  a response  a s " w h a t ' s g o i n g o n h e r e ? " o r "Why  the relevance o f such  pists  a t home", s u c h  "must t h e p a r e n t s a l w a y s  that  because  I t i s persuasively  as a r e s o u r c e t o p r o v i d e adequate  questions  As  that  work  say, t o a t e a c h e r ' s q u e r i e s about  has been concerned  i s used  construction  i t s d e n i a l by a p a r e n t  t o respond,  don't  a s a n a c c o u n t i n g d e v i c e was a n  a therapist's  i n the context o f therapy.  This  see  the family  defences  way o n o t h e r o c c a s i o n s .  "She's n o t l i k e  the popular  how s u c h  than  however, s i n c e  Although  inadequate  that  our professional  environment that  f o r the things talked  a n d , s u b s e q u e n t l y , how I t h o u g h t  environment, about  t o d e s c r i b e how  above),  I found  that  was u s e d  the family,  t o make many  thera-  that  (as a  different  I  132 situations  appear  "Misbehaviors" With  t o be  natural,  some s m a l l e x c e p t i o n s , t h e e x a m p l e s  how  than  from  actual  notions of the  actual practice One there  of  relax  feature  feature That  essential  f o r an  insights  was  t o be  successful,  constraints.  and  expect  i t may  be  i s treated  members h a d example,  The t o do  to  show  understanding  of  understanding  that  e.g.,  i s that  activity  writing  differently  accent.  differs  the  the  particstandard have  by  be  seen  that  as t h e  both p a r t i e s  i n one  talk  for  o c c u r s as  a  treatment. to  14  a prescription.  advise h i s patients must d i f f e r  from procedures  which allows the d o c t o r to get  i n o r d e r t o make t h e i r  Freud would  suggested  Most p e o p l e  the t a l k i n g  e a r l y p s y c h o a n a l y s t s were w e l l  Y o u r t a l k w i t h me  He  T h i s s t r a t e g y became a  g i v e s i t a unique  illnesses  s i m p l y an  the treatment proper,  attention.  like  necessary that  o f t h e d o c t o r - p a t i e n t r e l a t i o n s h i p may  talk  the r e s e a r c h e r  seeing.  •  this  and  from  this.  physical  i s , i t i s not  the  and  o f t h e ways i n w h i c h p s y c h o t h e r a p y  strictly  t o have been  I w o u l d now  ways o f h e a r i n g , s p e a k i n g  some o f t h e s e  come t o a c c e p t a n d  treating  are also  sociological  of psychotherapy  One  so.  therapy.  of Freud's  t h a t , were t h e r a p y  referred  o r between a t h e r a p i s t  sessions of therapy.  family  are normative  ipants  and  and " P e r m i s s i b l e s "  c o n v e r s a t i o n s between t h e r a p i s t s rather  appropriate, understandable  and  I t follows i s given  special  aware o f t h e work  appear  as  that  that  'therapy'.  For  that: r e s p e c t from  an  ordinary  con-  versation. Whereas u s u a l l y you r i g h t l y t r y t o keep t h e t h r e a d o f y o u r s t o r y t o g e t h e r and t o e x c l u d e a l l i n t r u d i n g a s s o c i a t i o n s and s i d e i s s u e s , so as n o t t o wander t o o f a r from t h e p o i n t , h e r e y o u must p r o c e e d d i f f e r e n t l y . . . s a y w h a t e v e r goes t h r o u g h y o u r m i n d . ^ 1  Member's c o n c e r n s  with  sequencing  and  topicality  are  through  and  through  133 normative  and  moral  concerns.  F u r t h e r , c o n s i d e r Menninger's  advice:  He i s t a l k i n g i n t h e p r e s e n c e o f t h i s p e r s o n i n a way i n w h i c h he w o u l d n o t s p e a k i n t h e p r e s e n c e o f a n y o t h e r human b e i n g . This u n s e e n p e r s o n a c t i n g i n a c o m p l e t e l y u n e x p e c t e d way i n t h a t he i s n o t r e s p o n d i n g a s a n y o r d i n a r y human b e i n g w o u l d t o t h e s e v e r y earnest appeals. ^ 1  The by  therapist  too,  responding One  based well  on  as no  of the  these  as w i t h  well with  avoids  those  normative  constraints of t o p i c a l i t y ,  " o r d i n a r y human b e i n g  early  strategies,  insights.  adults.  children  T h i s was  "free  initially  with  used  that this  this  was  accounted  immaturity),  an- e s s e n t i a l l y  non-conversational therapy  developed.  We  for  free  from  Millar's  child  f o r by  had  see  developed  association",  because o f h i s  statement  how  was  patients  s t r a t e g y d i d not  the p a t i e n t ' s subsconscious  can  not  17  namely t h a t o f  When i t a p p e a r e d  (interestingly,  would".  etc.,  as  work  saying  that  general  (play therapy)  play i s a  was  substitute  association.  When u n c h e c k e d b y f a c t s o r demands o f o t h e r s , human b e h a v i o r a n d t h i n k i n g i s m o t i v a t e d by t h e w i s h e s o f t h e i n d i v i d u a l . In p l a y , i n d r e a m s , i n f a n t a s y , c h e c k s f r o m h a r d f a c t s do n o t o p e r a t e , t h e y a r e d e t e r m i n e d by wishes. ^ 1  This  is clearly  normative play  order  a variation  is effectively  o r dream) w i t h o u t  cess.  As  with  session likes by  that this  giving  play  i s typical  here.  room.  an  subverted  by  latter  example this  of  a s s o c i a t i o n wherein  a l l o w i n g the  child  interfering  the  h i s room f o r t h e instruction  may  some " m i s b e h a v i o r "  comes t o s t a n d  told  h o u r and be  he  can  illustrated  with  this  child,  of  i t may  prospecial-  maintained.  first  play  do  and  whatever made  actions. be  (or  t o be  deemed  Of  he  concrete  that i s "permissible" in  for a class  d e p e n d i n g u p o n w h a t i s known a b o u t t h e  d u r i n g the  the  to act  construction of this  accomplishment t h a t has  f o r t h e p a t i e n t t o be be  free  "demands o f o t h e r s "  interactional  will  This  And  the  theme o f  a l l other psychotherapies,  "moral accent", i s an It  of the  the  course,  necessary  134 to  set  limits  feature  f o r him.  These misbehaveables  of psychotherapy.  K l e i n makes t h i s  are  clearly  seen  as  a  clear.  More i m p o r t a n t s t i l l , I f o u n d t h a t t h e t r a n s f e r e n c e s i t u a t i o n — t h e backbone o f t h e p s y c h o a n a l y t i c p r o c e d u r e — c a n o n l y be e s t a b l i s h e d and m a i n t a i n e d i f t h e p a t i e n t i s a b l e t o f e e l t h a t t h e c o n s u l t i n g room, o r t h e p l a y room, i n d e e d t h e w h o l e a n a l y s i s , i s s o m e t h i n g s e p a r a t e f r o m h i s o r d i n a r y home l i f e . For o n l y under s u c h c o n d i t i o n s c a n he o v e r c o m e t h e r e s i s t a n c e a g a i n s t e x p e r i e n c i n g and e x p r e s s i n g t h o u g h t s , f e e l i n g s , and d e s i r e s , w h i c h a r e i n c o m p a t i b l e w i t h c o n v e n t i o n , a n d i n t h e c a s e o f c h i l d r e n f e l t t o be i n c o n t r a s t t o what t h e y have b e e n taught.—-" Thus, room s t a n d s is  there  i s a deliberate effort  in contrast  formulated  by  the  to the  to establish that  p a t i e n t ' s home.  the  I n many c a s e s ,  therapy the  contrast  therapist:  4.18 T:  You  know w h a t ?  C:  (  T:  Terri.  )  C:  Miranm.  T:  I want t o  C:  What?  T:  S o m e t i m e s we hey.  C: T: C: T: C:  talk  can  have  for a  sec.  these  kinds  of  explosions  here  i n the  Yea. When t h e r e  i s flames  come o u t  of  the  caps and  stuff.  Yea. But  the  play  room i s d i f f e r e n t  f r o m home i s n ' t  it?  Yea.  T:  And  we  C:  I'm  g o n n a , my  Or:  t o you  don't want - dad  a i s m a k i n g me  a play  room i n t h e  basement.  play  room  135 4.19 T:  Okay, y o u home.  C:  (That's)  T:  You can  C:  No.  T:  know we  good  can  p a i n t on  you  can't  do  i t at  walls.  c a n ' t do i t a t home, n o , you, downstairs?  No, c a u s e i t ' s n o t g o o d i t ' l l make mom mad.  C:  the w a l l here but  and  t o do  you  can't  i t there.  do  i t i n the  And  i f you  classroom,  d i d i t a t home  Yea.  T:  But  we  can  There what can  be  do  are  here.  play  points.  First,  set which  includes  this,  of  above  can  some  tells  room.  term  'this'  'here' that  'there'.  why  In  this like  i s always  setting  suggest  us  I w o u l d now  'here'  However, t h e  s i n c e we  standing  the  i n s t r u c t i o n s simply  say  20  statement  i n the  where e l s e .  . . .  a l s o n u m e r o u s " i n s t a n c e s when t h e  done  Klein's encouraged  i t here.  operates  regards  heard  occasion,  as  one  end  location),  meaningful  this,  one  can  and  additional  i n a more p o w e r f u l  i s only to  i s permitted  t o make two  t o be  (context,  'here'  conduct  look  at  a  and  way  given  of  some-  than  the  under-  Emanuel  21' S c h e g l o f f ' s p a p e r on that the  'here' speaker  is a  f o r the the  appropriate  'there'  a matter of  are  hearer  of  on  relevancies of in his  of place.  l o c a t i o n which  the the  family.  basis  of  child, The  Schegloff  i s methodically  their we  can  child  demonstrates selected  identities  and  see  locates  how  he  seems t o be  able  by  locations. the  t o do  this  routine.  Secondly, therapist  formulation  formulation  Thus, g i v e n  as  the  the  t o be  specific seen  as  instances  of  representatives  "misbehaviors" of  the  whole  s u g g e s t e d by class of  the  "misbe-  136 haviors".  Given  other  appropriate  class  i s listed  patients i.e.,  items  that  have  to discover  the case  t h i s would be i m p o s s i b l e ) , o f items might  appear  could  that the rather,  i n such  a  list,  be e x p e c t e d t o  (These a r e u s u a l l y v i o l a t i o n s o f t h e a d u l t as making a n o i s e ,  swearing, little  Consider  i t i s easy  I t i s never  e s p e c i a l l y parents,  such t h i n g s  something,  haviors".  class.  (indeed,  adults,  ment, a n d i n c l u d e  Patients  of the hearer,  t o s e e what k i n d  him f o r doing.  destroying  i n that  in full,  are able  things  sanction  the relevancies  and making  trouble  the following  messing  things  environ-  up,  mistakes).  i n discovering  this  c l a s s o f "misbe-  excerpt:  4.20 C:  What's  ya'name?  T:  My name i s P a u l a ,  C:  Ellen'n  T:  Y o u l i k e me, I l i k e y o u t o o . Y o u know t h a t , t h a t I ' l l l i k e i f y o u do something t h a t y o u r e a l l y f e e l l i k e d o i n g i n h e r e . w a n t t o p o u n d o n t h i n g s a n d s o o n y o u c a n do t h a t , hum.  C:  I like  The  r e l a t i o n s h i p between t h e s e two a c t i o n s  I like  Note  demonstrated that in  this  play  very  fast))  that,  place.  by requesting  We  an ' a d u l t '  i taddressed  i s t h a t b o t h o f them a r e "misbe-  to paint  of this  on t h e w a l l ,  relationship.  c a n make t h i s  hearing,  that  consequences.  he c o u l d  sound  We  the c h i l d has  can e a s i l y see  Such a l i c e n s e e a s i l y  v  t o do t h i n g s  of i t without includes  the f i r s t  what i t w o u l d be  The c h i l d ' s o p t i o n  license "  n o t do o u t s i d e  a misbehavior  strange by g i v i n g  is, by asking  t o an a d u l t p a t i e n t .  a n d s o o n " may b e s e e n a s a  room t h a t  you even I f you  on t h e w a l l .  was t h e i n t e n t i o n o f t h e t h e r a p i s t i n f o r m u l a t i n g  formulation  things  ((said  an u n d e r s t a n d i n g  the f i r s t  were  you.  to paint  haviors".  w h a t ' s y o u r name?  t o "pound on within the  facing certain  permission  doing  to "paint  serious on t h e  137 wall", etc. second for  Some a n a l y s i s o f the f i r s t a c t i o n must be done b e f o r e a  suggests i t s e l f .  C o n c o m i t a n t l y , the c h i l d can be expected t o l o o k  and f i n d t h e r e l a t i o n s h i p between t h e f i r s t a c t i o n and some f e a t u r e o r  f e a t u r e s o f h i s biography. I t i s c l e a r t h a t i n c o n s t r u c t i n g t h e "moral atmosphere" o f t h e p l a y room, the t h e r a p i s t takes an a d u l t ' s view o f c h i l d r e n even w h i l e he i s a t t e m p t i n g t o appear t o be d i f f e r e n t from o t h e r a d u l t s .  The " m i s b e h a v i o r s "  t h a t he c i t e s a r e t y p i c a l a d u l t concerns even i f they a r e g i v e n a p o s i t i v e r a t h e r than a n e g a t i v e c o n n o t a t i o n here.  A d u l t n o t i o n s about t h e f a m i l y  were an important r e s o u r c e i n the v e r y c r e a t i o n o f the t h e r a p y room where, through  'here' and ' t h e r e ' statements, t h e p l a y room i s c o n t r a s t e d t o home,  and t h e p a t i e n t i s encouraged in his family.  t o p e r f o r m a c t s t h a t would n o t be a c c e p t a b l e  F u r t h e r (and we must say " f o r the a d u l t " ) , t h i s appears t o  be a p e r f e c t l y l o g i c a l way t o handle  children.  Summary We began t h i s i n q u i r y w i t h a review o f t h e everyday of  the c l i n i c .  I proposed  s i g h t s and sounds  t h a t most o f these were t r a n s p a r e n t .  That i s ,  on some l e v e l , we a l r e a d y had an adequate u n d e r s t a n d i n g o f what was happening,  accepted i t as r e a s o n a b l e , and so on.  A l o n g w i t h t h i s , we seemed t o  be a b l e t o make sense o u t o f t h e c o n v e r s a t i o n s t h a t o c c u r r e d d u r i n g t h e r a p y sessions.  I t was then proposed  t h a t we make matters p u z z l i n g by d o u b t i n g  t h e i r t r a n s p a r e n c y and s e a r c h i n g f o r t h e i r p s y c h i a t r i c r e l e v a n c e .  During  my f i e l d work, I a c q u i r e d some measure o f competence whereby I c o u l d see the p s y c h i a t r i c r e l e v a n c e o f t a l k and e v e n t s .  That i s , I came t o see  t h e r a p y i n much the same way as the t h e r a p i s t s saw i t , and I was a b l e t o do t h i s by s t u d y i n g t h e accounts t h a t t h e s e t t i n g p r o v i d e d .  Chapters,2,  3 and  138 4 are intended with  as a d i s p l a y  of practical  the problem o f understanding  what I have r e f e r r e d  w h a t was g o i n g  t o as t h e " t h e r a p i s t ' s  f i n d i n g s were p r e d i c a t e d on t h e r a p i s t ' s stand also  and i n t e r p r e t emphasized  especially, reasoning, family in  the events  other  (a) how b a c k g r o u n d (b) u n d e r s t a n d i n g s  Although  the preceeding  the p s y c h i a t r i c reasonable, although task  like  My  i t t h a t they  under-  o f knowledge,  are necessary  for practical  a n d , (c) t h e p a t i e n t ' s  me t o make s e n s e  o f numerous  a t t h e adequacy o f those  events  accounts.  as a r e p r e s e n t a t i o n o f  s c h e m a , i t seemed t o b e b o t h  i . e . , a c t i o n s appeared i s organized  t o be a p p r o p r i a t e .  adequate and  How  f o r and r e v o l v e s around  a  i s i tthat, specialized  and knowledge, e x p l a n a t i o n s  reasonable,  a c t i o n s so a p p r o p r i a t e , and r e a s o n i n g  be  further  i n the next  found  i n t h e ways d e p i c t e d h e r e .  i n f o r m a t i o n was p r e s e n t e d  t h a t r e q u i r e s much t r a i n i n g  explored  f o r and  d i d for therapists.  t o look  interpretive  the setting  and I take  o f normal c h i l d r e n  These enabled  Confronted  o f knowledge".  f e a t u r e s o f t h a t corpus expectancies  much t h e same way t h a t t h e y w o u l d now  talk,  reasoning.  on, I l o o k e d  corpus  of the setting  essential  as a resource.  I  psychiatric  chapter.  so l o g i c a l ?  sound so This  will  I  139 Footnotes  """In the h i s t o r y o f c h i l d p s y c h i a t r y one can d i s c o v e r a t r a n s i t i o n from a b i o l o g i c a l and g e n e t i c e t i o l o g y t o an environment ( i . e . , home) e t i o l o g y . See, f o r example, J . L. Despert, The E m o t i o n a l l y D i s t u r b e d - Then and Now, New York: Grunner, 1965; o r R. C r u t c h e r , " C h i l d P s y c h i a t r y - A H i s t o r y f o r Development", P s y c h i a t r y , 6 (1943) 191-201. 2 T h i s i s a v e r s i o n o f Harvey Sack's n o t i o n o f ' s t a n d a r d i z e d r e l a t i o n ship p a i r s ' . See, H. Sacks? "An I n i t i a l I n v e s t i g a t i o n o f the U s a b i l i t y o f C o n v e r s a t i o n a l Data f o r Doing S o c i o l o g y " , i n D. Sudnow (ed.) S t u d i e s i n S o c i a l I n t e r a c t i o n . The F r e e P r e s s , 1972. 3 I n t e r e s t i n g l y t h i s s e p a r a t i o n i s a l s o .for t h e ' p r o t e c t i o n o f the t h e r a pist. I t i s f e l t t h a t such a sympathetic bond may develop between t h e r a p i s t and c h i l d t h a t he o r she may be l e s s than u n d e r s t a n d i n g w i t h the p a r e n t .  4 T h i s was a concern s h a r e d by a l l members o f t h e s t a f f . On one o c c a s i o n i t was d i s c o v e r e d t h a t a p a r e n t would be a r r i v i n g e a r l y t o p i c k up h e r c h i l d . The t h e r a p y s e s s i o n had s t a r t e d l a t e r than scheduled and a c o l l e a g u e was concerned enough t o s l i p a note under t h e p l a y room door t o advise the t h e r a p i s t . The t h e r a p i s t and p a t i e n t were n o t i n the room and returned ' l a t e ' . The s t a f f l a t e r e x p r e s s e d some embarrassment about what the p a r e n t might t h i n k o f the matter. 5 For an i n t e r e s t i n g d i s c u s s i o n o f ' t r a n s f e r e n c e n e u r o s i s ' i n a d u l t t h e r a p y see E . S c h e g l o f f , "Toward a Reading o f P s y c h i a t r i c Theory", B e r k e l e y J o u r n a l o f S o c i o l o g y , 8 (1963) 61-91. "Needless t o say, i n t h i s p a r t i c u l a r example, t h e t h e r a p i s t d i d n o t have the mother's assurance t h a t i t was a l l r i g h t t o p l a y i n t h e mud. However, i t i s o f t e n the case t h a t a d u l t s can speak f o r one another when dealing with c h i l d r e n . 7 I t s h o u l d be added perhaps t h a t t h e adequacy o f t h i s account a l s o r e q u i r e s some common sense u n d e r s t a n d i n g s t h a t c o u l d be c h a r a c t e r i z e d as 'sexist'. Q A. C i c o u r e l , The S o c i a l O r g a n i z a t i o n o f J u v e n i l e J u s t i c e . John W i l e y and Son, 1968. 9 D. L. Wieder, "The C o n v i c t Code, A Study o f a M o r a l Order as a P e r s u a s i v e A c t i v i t y " , U n p u b l i s h e d D o c t o r a l D i s s e r t a t i o n , Department o f S o c i o l o g y , UCLA, 1969. ""There a r e many n o t i o n s l i k e 'accountable', 'rights', 'entitlements', ' j u s t i f i c a t i o n s ' , e t c . t h a t a r e through and through member's n o t i o n s . Such i n t e r a c t i o n a l i s s u e s a r e i n need o f s o c i o l o g i c a l examination. There i s some m a t e r i a l on these i s s u e s i n an a r t i c l e by M. G. S c o t t and S. M. Lyman, "Accounts", American S o c i o l o g i c a l Review, 1968, and, more i n d i r e c t l y , i n the w r i t i n g s o f E. Goffman, H. Sacks, and A. C i c o u r e l ; see p a r t i c u l a r l y , A. C i c o u r e l , "Delinquency and t h e A t t r i b u t i o n o f R e s p o n s i b i l i t y " , i n R. S c o t t and J . Douglas (eds.) T h e o r e t i c a l P e r s p e c t i v e s on Deviance, B a s i c Books, 1972.  140 am u s i n g ' a c c o u n t a b l e i n a member's sense h e r e . On most o t h e r o c c a s i o n s I am r e f e r r i n g t o G a r f i n k e l ' s s p e c i a l usage: "When I t a l k about the a c c o u n t a b l e c h a r a c t e r o f a f f a i r s o r when I t a l k about a c c o u n t s , I am t a l k i n g about the a v a i l a b i l i t y t o a member o f any o r d i n a r y arrangement o f a s e t of located practices". "The O r i g i n s o f t h e Term Ethnomethodology", i n R. T u r n e r (ed.) Ethnomethodology, Penguin Books, 1974, p. 17. 1  12 For an i n t e r e s t i n g examination, although n o t supported by d a t a , o f those accounts we c a l l "excuses" and " j u s t i f i c a t i o n s " see M. S c o t t , S. Lyman, Op. c i t . They a l s o mention the use o f f a m i l y accounts i n non-therapy conversations. 13 As another example o f t h i s c o n s i d e r the f o l l o w i n g e x c e r p t s from a l e t t e r t o Ann Landers. Dear Ann: As a t e a c h e r , I would l i k e t o pass a l o n g a set of rules f o r parents. I f f o l l o w e d they a r e guaranteed t o produce a s p o i l e d b r a t who w i l l l a t e r develop i n t o a t h o r o u g h l y messed-up a d u l t . 1. I f your c h i l d has t r o u b l e w i t h t h e t e a c h e r don't go t o t h e s c h o o l and t a l k t o the t e a c h e r . Run d i r e c t l y t o t h e p r i n c i p a l , t o the s u p e r i n t e n d e n t o f s c h o o l s , o r t o t h e head o f t h e s c h o o l board. I t ' s always b e s t t o go s t r a i g h t t o the t o p . 5. I f your c h i l d r e p o r t s t h a t t h e t e a c h e r embarrassed him i n f r o n t o f the whole c l a s s f o r some l i t t l e t h i n g he d i d , phone t h e s c h o o l and make i t c l e a r t h a t you w i l l n o t p e r m i t any t e a c h e r t o d i s c i p l i n e your c h i l d because he i s v e r y s e n s i t i v e - "not l i k e most c h i l d r e n " . . . . Vancouver Sun. 14 Schulman, e t a l . , suggest t h a t t h e c h i l d be g i v e n an account o f t h e t h e r a p y e n t e r p r i s e which i n c l u d e s a r e f e r e n c e t o t h e t h e r a p i s t as a " t a l k i n g doctor". The T h e r a p e u t i c D i a l o g u e , S p r i n g f i e l d : C h a r l e s C. Thomas, 1964, p. 147. 15 S. F r e u d , "On B e g i n n i n g t h e Treatment, The Q u e s t i o n o f t h e F i r s t Communications", C o l l e c t e d Works, v o l . 2, p . 355, B a s i c Books, 1959. 16 K. Menninger, Theory o f P s y c h o a n a l y t i c Technique. New York: Basic Books, 1958, p. 72. 17 F o r a c l e a r i l l u s t r a t i o n o f how t h e r a p y c o n v e r s a t i o n s must t r a d e on normative h e a r i n g s , see Roy Turner, " U t t e r a n c e P o s i t i o n i n g as an I n t e r a c t i o n a l Resource" i n Robert W i l s o n (ed.) Ethnomethodology L a b e l i n g Theory and D e v i a n t B e h a v i o r , Routledge & Kegan P a u l , o r Bruce K a t z , " C o n v e r s a t i o n a l Resources o f Two-Person Psychotherapy", u n p u b l i s h e d M.A. T h e s i s , U.B.C. 1971. 18 S. M i l l a r , The Psychology o f P l a y . Penguin Books, 1968, p. 25. 19 M. K l e i n , "The P s y c h o a n a l y t i c P l a y Technique", O r t h o p s y c h i a t r y , 25 (1955) 226.  American J o u r n a l o f  20 F o r example: T: You know though t h a t I ' l l l i k e you even i f you do something t h a t you r e a l l y f e e l l i k e d o i n g i n here. I f you want t o pound t h i n g s and so on you can do t h a t , hum. E. S c h e g l o f f , "Notes on a C o n v e r s a t i o n a l P r a c t i c e : Formulating Place", i n D. Sudnow, (ed.) S t u d i e s i n S o c i a l I n t e r a c t i o n . The F r e e P r e s s , 1972.  CHAPTER 5 REASONABLENESS AND Although s t r u c k me reject  o n my  first  to therapists  make o f t h e e v e n t s . the p a t i e n t s , ing  understanding.  and doubted  Although  both  many m o n t h s I v i s i t e d  and t h e t a l k  During  that  ies,  time  normal  it.  that  and  activities  ascribed  an e x p e r t  I was m a k i n g a l l t h e r e was t o  therapist  and r e s e a r c h e r  t h a t we h a d r e a c h e d  "understood"  that  understand-  etc.  initial  While could talk  I took  I remained  t h e p l a y room a n d t r i e d o f my  talking  realize  that that  and t h e r e b y  p u z z l e d about  to get behind  about  my  about  experience  patients,  familwhich  t o an u n d e r s t a n d i n g o f  the events  the scenes  that  t o make  took  some  place  better  F u r t h e r , I found  the therapists the talk  that  to colleagues I discovered that  the setting;  terms o f a r e s o u r c e I h a d f a i l e d criptions  about  observations.  competently  etc.  and p a t i e n t .  a l l o f these t o be descriptions  w h a t I saw i n ways w h i c h w e r e a d e q u a t e motivations,  a t t e n d i n g t o t h e p l a y room  a great deal of talk  t o t h e p l a y room a c t i v i t y  F o r a long time  sense  the c l i n i c  t r a n s p i r e d between t h e r a p i s t s  I also heard  children,  were e x t e r n a l  to  I willingly  that  events, e t c . , I doubted  events  I  setting  b y t h e same r o u t e . For  in  viewing the therapy  IDEOLOGY  a s b e i n g r e a s o n a b l e , I was t o r n b e t w e e n w h e t h e r t o a c c e p t o r  t h e a d e q u a c y o f my  knowledge  THE ADULT  that  i s , I could account f o r  for-all-practical-purposes,—their  I was a b l e t o g i v e my  t o take  seriously,  h a d p r o v i d e d f o r me. I had heard  141  about  accounts i n  namely, At this  children,  the very  des-  point,  I began  patients,  therapists,  142 families,  e t c . , might w e l l  f o r me.  On  t o as  anything esoteric  etc.  suggest that  I propose  motives,  of  basis  1  our  accounts,  at their both our  to recognizing that  very own  reasonableness.  practical  That  therapists,  behind  l o o k b a c k a t my  we  of that  therapy  (e.g., i n i n a p p r o p r i a t e syntax,  saw  t h i n g s as  recognized play  may  characteristics  activity,  children  sensibility  attributed  testing  the  o f the  n o t have been a good  understood  s t r a t e g y , saw  I  assuming route than  vocabulary  do  of  transparency f o r making  that  then  seeing  the  of  sense  resource the  able to  (and y o u r s  will  find  termin-  a  form  (e.g., emotional  why  to their  punishment  of  that,  non-sequitors, etc.);  o f u s i n g p l a y as child  i t s adequacy,  c o n v e r s a t i o n s as b e i n g  family-based motives  limits,  I was  o f k n o w l e d g e we  were a b l e t o r e c o g n i z e the  the  be  scenes.  children such  to  i t too  e v e n t s might a l s o be  accomplishment of  corpus  and  a resource  reasoning. the  play.  ones.  reasonableness I had  which  reasonableness,  a different  shared  I  appear  Instead of  i s , I began t o see  r e a s o n i n g about  s e a r c h f o r something  reasonableness  the  by  of  Rather,  same s i n c e o u r  explanations, are  doubting  t h e r e does not  concern.  the  way  I have emphasized  understandings  routes are  i t did  p r o g r e s s , and  t r y t o remedy t h i s  and  accounts  schema" by  o f knowledge.  central  that  a b l e t o c o n s t r u c t what  that  account  from  I f we the  that  of the t h e r a p i s t ' s p r a c t i c a l  a t e my  agree  r e p o r t e d corpus  become o u r  that  I was  interpretive  I progressed  that  f o r my  r e a d e r would  Throughout  arrive  for therapists  t h e i r p a t i e n t ' s problems,  i n the  i t s h o u l d now  laymen,  insight,  Therefore, r a t h e r than  therapists  events  of  the  seems r e a s o n a b l e .  same t h i n g  "the p s y c h i a t r i c  make s e n s e  I hope t h a t  logic,  the  the b a s i s of t h i s  have r e f e r r e d therapists  do  of  reading)  like those  we  the of  also  therapy,  states) in actions,  recognized  for spilling  age-appropriate behavior,  their  drinks  recognized  stages o f growth, understood  the  reasonableness  of children  voluntary patients,  the  reasons  not being encouraged  The  l a y person  talk  to the  manner. my  to  basis  and  these  my  'adults'  actors that  recognize t y p i c a l T h u s i t was  parency the  own  as  social  reasoning.  In the world  this  talking  stock of  this  expert operate  knowledge  and  I used  i n the  i n making  understanding a set of  to same  sense  of  of  typifications  to c o n s t r u c t m o t i v a t i o n a l accounts  and  f o l k wisdom w h i c h  interpretive  accounted  schema.  f o l k wisdom i s a l s o a constitutive  With  f o r the  this  a feature of  f e a t u r e of the  trans-  insight  came  psychiatric  setting.  Let  me  insight.  about  Garfinkel  and  reasoning s k i l l  actors.  e n a b l e d me  It i s in fact  to develop  f o r my  being  behaviors.  my  that  practical  common s e n s e  of the p s y c h i a t r i c  recognition  try  etc.  o f my  v i e w i n g was  'children' about  children,  The  first  accepted  not  the  actor's practical  interest  i n the  events  of  suggests:  I n e v e r y d a y s i t u a t i o n s w h a t he knows i s a n i n t e g r a l f e a t u r e o f h i s competence. What he knows, i n t h e way he knows i t , he a s s u m e s p e r s o n i f i e s h i m s e l f as a s o c i a l o b j e c t t o h i m s e l f as w e l l as t o o t h e r s a s a b o n a f i d e member o f t h e g r o u p . He s a n c t i o n s h i s c o m p e t e n c e a s a b o n a f i d e member o f t h e g r o u p a s a c o n d i t i o n f o r h i s b e i n g a s s u r e d t h a t h i s g r a s p o f the meanings o f h i s everyday a f f a i r s i s a r e a l i s t i c grasp.^ If  we  his  social  ness field is  s t a r t w i t h t h e n o t i o n t h a t w h a t one competence,  i s a result setting  and  that  I will  refer  the reasonableness  transparency, interpretive  'knows', we  what competence  some c o m p e t e n c e i n v o l v e d  competence.  acknowledge t h a t  o f w h a t one  "just  i n the to this  of our  clinic as  initial  children.  can  the  an  then  setting adult's  integral  feature of  above r e p o r t e d r e a s o n a b l e -  i s at stake?"  e t c . , o f the p s y c h i a t r i c schema o f  knows i s an  ask  i n regard to  It i s clear other than competence,  viewing of the  setting  reasoning i s a result  this  that  there  professional and  contend  and o f an  the adult's  144 W r i t e r s such as Thorne,  2  Leach  s e e i n g and h e a r i n g i s normative and produces w a r r a n t a b l e is  'naive',  'foolish',  and  one  'stupid', etc.  notions of c h i l d r e n being  Sacks  4  have suggested t h a t a l l  a v i o l a t i o n o f t h i s normative  i n f e r e n c e s , e.g.,  ways t o h e a r , see, t a l k t o , o r g a n i z e  The  3  order  doesn't know the c u l t u r e ,  one  There are f o r example, normative for, children.  'cute' o r p r e c o c i o u s  Our  common-sense  are p r o d u c t s  of that  seeing.  most c e n t r a l n o t i o n o f t h i s normative o r d e r i s the a d u l t member's  n o t i o n o f c h i l d r e n as s p e c i a l c u l t u r a l o b j e c t s .  It i s this  a s - d i f f e r e n t - f r o m - u s which produces a c h a r a c t e r i z a t i o n o f  seeing-them-  'cute'  a c t i o n t h a t f o r o t h e r c a t e g o r i e s o f a c t o r s would be u n e v e n t f u l able  (e.g., making your own  doctor's  There i s ample evidence  literature.  t o demonstrate t h a t as a d u l t s we T h i s was  i n f o r m a t i o n on p s y c h o t h e r a p y w i t h The  or  sanction-  appointment).  o f c h i l d r e n as s p e c i a l ' c u l t u r a l o b j e c t s . note about how  f o r an  conceive  suggested i n a  previous  c h i l d r e n i s p l a c e d i n the  n o t i o n o f c h i l d r e n as s p e c i a l c u l t u r a l o b j e c t s i s d i s -  p l a y e d , however, i n the v e r y o r g a n i z a t i o n o f s e r v i c e s .  That i s , a d u l t s  see c h i l d r e n as a s p e c i a l c a t e g o r y w i t h i n the p o p u l a t i o n among whom s p e c i a l needs can be i s not simply  i d e n t i f i e d and  s e r v i c e s developed t o meet those needs.  This  a r e f e r e n c e t o mental h e a l t h s e r v i c e s but a p p l i e s t o a wide  range o f a c t i v i t i e s and  s e t t i n g s , e.g.,  dren's d e n t i s t s , c l o t h i n g s t o r e s , l i t t l e c h i l d r e n ' s movies, e t c .  (Although  sick children's hospitals, c h i l league s p o r t s , c h i l d r e n ' s books,  t h e r e a r e e v e n t s d e s c r i b e d as  'adult'  movies t h i s d e s c r i p t i o n does a d i f f e r e n t k i n d o f work than t o d i f f e r e n t i a t e it  from ' c h i l d r e n s ' m o v i e s ) .  c h i l d r e n as c o m p r i s i n g simply  two  As a n a l y s t s we  d i s t i n c t groups but  the case t h a t t h e r e i s the world  seem strange  and  can t h i n k o f a d u l t s  and  f o r the a d u l t members i t i s  t h e r e are c h i l d r e n .  I t would  f o r example, t o t h i n k o f a l l h o s p i t a l s as a d u l t ' s h o s p i t a l s .  145 ( I t may dren,  w e l l be  that  etc.) with  the  i s , that  Further other  'adult' the  extension  The  this  strength of  o f what o t h e r on  any  them.  occasion,  While  being  mean t h a t  arguing  on  that  not  only  we  that  this  do  that  the  to  chil-  adult hospitals,  c h i l d r e n need  to  be  be  striking  an  Invoking  categories  be  of  feature  only  relevant.  in talk as  The  of  t o be  the  for  the  and  paramount  organized  on  will  category  any  significance of  the  this  and  seeing  seeing.  This  the  referenbasis  occasion  be  case t h a t a t  will  reality  adequate but  one  and  the  'child'  of this  relevant. least fact  the then  children feature  c h i l d p s y c h o t h e r a p y where t h e  'child'  that  clerk-customer,  on  and  of  between  fact  adequate  for a person  hearing  about  the  i s a contact  'adult'  referentially  appears  occasion  categories  the  therapist, with  is but  is  patient  remarkable  'adult'. the  category  categories  actor  i s t h a t the  referentially  adequate  sanctionable  culture, i . e . , that  teacher-student,  only  world  our  c h i l d r e n i t i s always the  r o u t i n e l y r e f e r r e d to as  are  e.g.,  not  of  h a v e n o r m a t i v e ways o f h e a r i n g  i s always a  particularly  an  appears  i s a t t e s t e d t o by  inescapable  every  that with will  how  world  whenever t h e r e  notion  referentially  'child'  other  belief  category,  categories  categories w i l l  category  all  this  I t i s an  relevant.  frequency,  the  a d u l t movies,  feature  omni-relevant  o f f i c e r - p r o b a t i o n e r , the  these  others.  of  are  category  is  i s our  'child'  across  am  this  and  does n o t I  a d u l t books,  i s a normative  probation  one  of  i s t h e way  children.  participants  tially  are  'child'  regardless  that  there  this  of  two.  cut  that  evidence  A powerful category  case  i t s use  constructs  I t provides  'child'  i s not  provides  h i s own  solutions to  actions  solutions to  the  without  and  consequence. the  understands  As  b a s i c problem the  actions  problem o f making sense.  with of  of  Schutz  has  brought  subject  of  to  our  attention  i n q u i r y and  has  the  study of  given  us  the  natural  a t t i t u d e as  many i n s i g h t s i n t o member's  a  procedures  5 withxn  that  objective fashion  attitude.  The  s t r u c t u r e w h i c h m u s t be  i f projects  of  appears as  a massively  himself.  For  organized  and  accomplishes objective through  by  action  a process  means o f  and,  structure  says:  world  The  the  having  'childhood'  c a t e g o r i c a l types,  In  the  i s evidently  an  must  already  is part  one  of  this  substance  reference  world  gear  being  f o r what  i s a categorization given  "typification".~  It  actor  consequence  "Typification, perceiving  adequate  successfully.  i n t o which the  of  resistant  in a practically  i s e x p e r i e n c e d as  notion  further,  Schutz c a l l e d  furnishes  affected  i s s e e n as  i n that world.  structure  t o be  organized  structure  attitude  reckoned with  are  members t h e n , t h e this  term McKinney it  natural  and  to  this  structuring  e s s e n t i a l and  intrinsic  7 aspect folk  of  the  basic  typifications  about  the  world;  orientation of provide  ways t o All  of  It or  "stock  solve  can  t a l k to people, this  provides  is this  how  us  kind  "issues  of  and  in  are  necessary:  some s t r o n g  way  complete  cultural  cations,  rather,  (1)  their  a massive us  from v a r i o u s avoid  a way  to  we  can  amount o f  actors  refer to  show how  I am  represent  a child-patient. not  the  suggesting way  children  a g r e e m e n t among members o n I want o n l y  to  suggest  that  that  typical  characters  biographies,  motivations, and  as  etc.  actions.  'common-sensical',  t h i s knowledge i s used  to  psychotherapists Two  points  these  'are' the  These  knowledge  typical  typical  t e c h n i c a l problems" which with  the  actors,  understand  now  situations".  with  offending,  k n o w l e d g e t h a t we and  e n c o u n t e r when c o n f r o n t e d tion  to  with  to  they provide  expect  o f knowledge",  those  members w i t h  f o r example,  o f p e r s o n s , w h a t one  actors  nor  of  clarifica-  folk  typifications  that  there  is  these  typifi-  features  a l l members,  of  psychotherapists  147 i n c l u d e d , engage i n a g r e a t d e a l o f common-sense t a l k about c h i l d r e n and t h i s knowledge i s i n t e r a c t i o n a l l y v i t a l . adequate accounts, etc.  demonstrations o f l o g i c , i n s t a n c e s o f  (2) F u r t h e r , I am not a r g u i n g t h a t t h e r e i s no  ledge about c h i l d r e n . product and  F o r example i t p r o v i d e s f o r  I f we  appropriateness,  ' s c i e n t i f i c ' know-  c o n s i d e r s c i e n t i f i c knowledge t o be  the  o f s c i e n t i f i c r a t i o n a l i t y t h e r e are c l e a r l y such i n q u i r i e s  accounts  of, children.  into,  However, the p r a c t i c e o f p s y c h o t h e r a p y 3  e x h i b i t s not s c i e n t i f i c r a t i o n a l i t y , but common-sense r a t i o n a l i t y . The work o f p s y c h o t h e r a p i s t s , l i k e t h a t o f a l l members o f the c u l t u r e who  work w i t h c h i l d r e n , i s embedded i n t h e - n a t u r a l a t t i t u d e and  of childhood.  As a r e s e a r c h e r and an o b s e r v e r my  on t h a t member's u n d e r s t a n d i n g geared  i n t o t h a t same m a s s i v e l y  a c t i v i t y was  (or background e x p e c t a n c i e s ) ; organized  structure.  a b i l i t y t o make sense o f the s e t t i n g ' s a c t i v i t y and ness amounted t o s e e i n g t h a t both myself as a d u l t s .  and  My  i t s notions also b u i l t  I, t o o ,  was  awareness o f  my  seeing i t s reasonable-  the t h e r a p i s t were o p e r a t i n g  I t i s our s t a t u s as a d u l t s which accounts  f o r the adequacy o f  what has t r a n s p i r e d . These f o l k understandings 9 Sacks  o f c h i l d r e n . h a v e been t a l k e d about by  10 and S p e i e r  as an " a d u l t i d e o l o g y o f c h i l d h o o d " and  we  use t h i s i d e a t o f u r t h e r our i n q u i r y .  Before  me  c l a r i f y what I mean by the term 'ideology'."'""'"  By t h i s n o t i o n I i n t e n d (hearing, t a l k i n g  These n o t i o n s o f what c h i l d r e n are  l i k e are deeply embedded i n the n a t u r a l a t t i t u d e .  T h i s i s not t o  however, t h a t t h i s simply r e p r e s e n t s a body o f knowledge. a schema f o r v i e w i n g category of a c t o r s .  the w o r l d  and  that  examining t h e i r usage l e t  t o p o i n t t o the normative ways a d u l t s have o f s e e i n g s , to, o r g a n i z i n g f o r , etc.) c h i l d r e n .  I suggest  suggest  Rather, i t i s  f o r making sense t h a t i s shared by  I t i s e s s e n t i a l l y i d e o l o g i c a l i n s o f a r as i t i s a  a  148 viewing  f o r w h i c h one  c o m p e t e n t member o f competence  as  an  wastebasket  attempts,  the  as  accomplished  He  a very  i s at  Not  their  achievements  To  challenged  the  was  the  are  the  own,  turning ago,  i s used  Sacks  Speier  our  and  Sacks d e l i v e r e d  ventional  way  a  "where d i d  do  know s o  little  of  dren;  the  children's  that  feel  allow  i n that too  would  to  manner  like  seen  i t .  i t makes no  are  Let  be  adequate, Although  confident  sense t o  challenge  supposed to  us  now  look  on  would  to  as  after  go  d i f f e r e n t from s a y i n g  reasonable  adults  using  better  him  c h i l d r e n feel*more  etc.  drawn a t t e n t i o n c h i l d r e n on  about  to  are look  I  i f to  me".  built  on  after  a t how  He the  consequence of  the' a d u l t  i t s head. the  the  term  "As  posed questions  c o n t r o l of not  A  ideology  few  beginnings of  children.  ' c h i l d r e n ' come f r o m ? " o r ,  a b o u t them?"  warrantable  one's  unsuccessful  would  though a d u l t s  my  a  example.  would  adult  i s very  questions  'culture';  as  literature.  wisdom o f  for formulating  s u c h as  spread  this  l e c t u r e which contained  tions we  i n the  status  i n point,  i n a way  child  i s such t h a t  have b o t h  conventional  an  t o have u n d e r s t o o d  ways i n w h i c h  ideology" and  the  another  this  c h i l d ' s development, happiness,  "adult  given  made s e v e r a l  that  not  therapist's explanation of  case  wastebasket  grounds t h a t  their  the  therapist's explanation  f o r me  i t on  viewer's  a patient playing basketball  had  have h e l p e d  "your e x p l a n a t i o n  understanding  the  I watched  The In  me  s u c c e s s f u l , t h r o w and  only  have  therapist,  i t .  Let  explained  i t w o u l d have b e e n odd  Both the  stake.  A f t e r he  later a  on  different matter—even  could  an  group hinges  activities.  successful.  the  accountable.  therapist positioned  having  but  held  a hoop.  success.  have been  be  observations  assure  to other  the  adult  D u r i n g my the  can  adult  He  years an  asked  unconques-  'ex-children', about the  like  why  nationwide  competence by  treating children  by  chil-  children;  149 etc.  This  ignores the  appears t o be a s t r a n g e  areas  their with  teachers,  etc.  parent,  these  questions our  issues  community  i s reflected  t h a t he p o s e d  cannot have t h e i r attitudes  Surely  way a r o u n d  as Sacks  without  version above,  doing  kind  they  o f care,  a l l i t can t o a s s i s t i n  parent,  concerned  "culture of  o f 'our' c u l t u r e )  i s insightful  assumptions.  child  culture.  the right  of the d i s t i n c t  own c u l t u r e s i n c e  are just  concerned  i n t h e c h a r a c t e r i z a t i o n s o f good  mother, n e g l i g e n t  a miniature  taken-for-granted  are warrantably  a r e we p r o v i d i n g  Sacks a l s o began t o t a l k than  under the guidance o f  a r e we p r o t e c t i n g o u r c h i l d r e n f r o m d a n g e r , e t c .  over-protective  (rather  segment o f  o f how o u r c h i l d r e n a r e g r o w i n g u p — a r e  i s the wider  growing-up p r o c e s s ,  How we h a n d l e  i t completely  t h e development o f competence i n  A s a d u l t s we  s a t i s f a c t o r y progress, etc.,  both  b y w h i c h t h e y become a d u l t s  the fundamental problem  stimulation, the  i . e . , i t ignores  and t h e p r o c e s s  parents,  making  because  t h a t we s e e a s c e n t r a l t o a n y i n q u i r y i n t o t h i s  population,  children  s e t of questions  and t h i s ,  l i k e the  i t challenges  many o f  F o r e x a m p l e , we  a l l know t h a t  children  their  knowledge, s k i l l s , o r pre-competent  c h i l d r e n a r e d e p e n d e n t upon a d u l t s Do c h i l d r e n r e a l l y  the intervention of adults?  childhood"  because  sized replicas,  suggests!  citizen, etc.  activities  versions  rather  than  and  of adult  the other  p a s s on knowledge  12 13  The partially should  notion because  o f a culture of childhood i t bypasses  do) t o a n d w i t h  the usual  children.  This  i s potentially unsettling  concerns  a b o u t what a d u l t s  concept has been e x p l o r e d  do ( o r recently  14 in  a b o o k b y M. E . Goodman.  demonstrates  the notion  Sacks'  notion  unlike  one t h a t  Goodman i s w o r t h  of a  o f an ' a d u l t Sacks might  looking  'culture of childhood'  ideology'. make:  a t because she  without p o s i t i n g  She b e g i n s w i t h  a statement n o t  150 The l i t e r a t u r e on c h i l d development, i n c l u d i n g a s c h o l a r l y j o u r n a l p u b l i s h e d under t h a t name, i s enormous. So i s the l i t e r a t u r e on c h i l d r e a r i n g - on s o c i a l i z a t i o n . These.and o t h e r s t u d i e s r e p o r t what a d u l t s see when they observe c h i l d r e n , and what a d u l t s do f o r and t o c h i l d r e n . Culture of childhood studies, i n contrast, report on what c h i l d r e n see as they observe the world i n which they f i n d themselves.15 Goodman goes on t o p r o c l a i m the need f o r a s c i e n c e which would be c o r r e c t i v e f o r the f a l l a c i o u s assumptions o f a d u l t s . upon them a r e l i k e l y t o be  a  "Systems b u i l t  f a u l t y a t b e s t and d i s a s t r o u s a t worst,"  she  16 says.  So,  r a t h e r than attempt t o d i s c o v e r what e i t h e r a d u l t s o r  c h i l d r e n see,  she c l e a r l y addresses h e r s e l f t o the a d u l t ' s problem  concerns w i t h  " c h i l d r e a r i n g and pedagogy".  and  s c i e n t i f i c reasoning  appear t o the l a y r e a d e r t h r e a t t o the s o c i a l  Goodman then looks t o  f o r s o l u t i o n s t o these problems.  science  While t h i s  may  t o c o n s t i t u t e a c h a l l e n g e , i t does not p r e s e n t  a  sciences.  I n t e r e s t i n g l y enough, S p e i e r has p r o v i d e d t i o n s the s o c i a l s c i e n t i s t s ' o f the f i e l d o f  and  concern w i t h  a f u r t h e r twis.t and  children.  F o r example, he  quessays  socialization:  A s e t o f working assumptions i s deeply e n g r a i n e d i n the c h o i c e o f r e s e a r c h problems and f i n d i n g s t h a t r e s u l t . I would l i k e t o r e f e r t o t h i s s e t o f s u p p o s i t i o n s as the c l a s s i c a l f o r m u l a t i o n o f socialization. I t r e a t i t as c l a s s i c a l because i t i s a f o r m u l a t i o n t h a t i s r o o t e d i n a d u l t f o l k l o r e o r common-sense u n d e r s t a n d i n g s about children. A d u l t p r o f e s s i o n a l s d o i n g s o c i o l o g i c a l s t u d i e s have o r i e n t e d t h e i r work around a s e t o f i m p l i c i t c o n v e n t i o n s . Taken t o g e t h e r these conventions d i f f e r from l a y i d e o l o g y o n l y i n so f a r as i t i s s y s t e m a t i c a l l y working out p r o f e s s i o n a l problems and s o l u t i o n s t h a t are r e s p o n s i v e t o the i d e o l o g y , i . e . , how s c i e n t i f i c a l l y c o r r e c t the i d e o l o g y i s , how e f f e c t i v e i t might be, how c o u l d i t be remedied, e t c . ^ 1  L i k e Goodman, he i s t r y i n g t o r a d i c a l i z e our approach t o the study c h i l d r e n but  i t i s c l e a r t h a t Goodman has not escaped the  Although i t i s impossible  'adult  of  ideology'.  t o escape the i d e o l o g y e n t i r e l y , i t can  be made i n t o a t o p i c as w e l l as a r e s o u r c e .  18  That i s , one  uses  the  151 ideology who  to discover  the  as  child  ideology  example, with the  ideology,  but  essentially recognizes t h a t we  one  is  omni-relevant  simply  a  hoced  w o u l d be but  the  previous (both  A  adult  elaborate  things to For  r e q u i r e s one  to  l e a r n a new  notion  seeing  of  of  the  a  employ set  of  "culture  adult  'children'. appears  to  i n t e r p r e t i v e schema. upon and  deal  solve  He  he claims  problems  ideology.  statement  the  and  that  Speier "taken  cannot  t o make one  together of  this  see  i s an  and  clarification.  categorization of  a l s o make t h i s these  that  p o i n t ) , we  the can  ideology be  than  displayed.  t o emphasize  at this  that  I will point  that  found,  through  i n t e r p r e t i v e schema t h a t In  'child'  conventions  i s that  children other  children's actions.  c o n t i n u a l l y employed  choose  problems even though  like  that  such  floor'  the  ideology  t o p i c , I would  ideology  like  of  influence  'getting the  features  common-sense a s s u m p t i o n s  t o make s e n s e o f  I would  way  can  have t o  with  research  possible reading  finite  the  of  adult  Sacks  H o w e v e r , one For  the  more t h a n  appears t o ,  set of  escaped.  later  my  ideology".  ideology. ad  little  leaving this  Speier  a new  for  still  the  the  c h i l d r e n ' s knowledge.  d i d not  some o f  researcher  i n terms o f  R a t h e r , he  begin  i s a much b r o a d e r  from w i t h i n  accepts  To  light  formulation  there  If  adult  'children'.  minimize  problems  Speier  interpretation of  have done  as  i t that  provide  the  can  approach, however,  i t does not  with  Before  say,  I take  Thus, the  at children's devices  to  that  formulated  formulate  i s to bring  Speier's  childhood  c h i l d r e n i n terms o f  This  for recognizing  childhood"  of  looked  speakers. since  ideology.  developmental models.  productions  ideology  culture of  refusing to  S p e i e r has  adult  rules  by  rearing or  examine the  or  e x p l i c a t e the  i s i n t e r e s t e d i n the  of  of  and  form  an  is listed, this  i s continually  sense,  say  cannot  the  ideology  more a b o u t  I mean more  by  this  152 i d e o l o g y than a s p e c i f i a b l e way.of l o o k i n g a t c h i l d r e n , I mean t o imply an i n e s c a p a b l e way o f l o o k i n g a t c h i l d r e n . In drawing a t t e n t i o n t o the " i m p l i c i t "  conventions  mentioned above,  S p e i e r has o f f e r e d f i v e themes t h a t he took as c e n t r a l t o the i d e o l o g y . These a r e t o be seen n o t j u s t as f e a t u r e s o f the s o c i a l s c i e n t i s t s but o f the a d u l t i d e o l o g y .  ideology,  They a r e worth l i s t i n g as an i n i t i a l view o f  what we mean by the i d e o l o g y . 1)  C h i l d r e n are  adults-in-the-making.  2)  C h i l d r e n g e t s o c i a l i z e d o r 'made' i n t o a d u l t s m a i n l y by a d u l t s who t e a c h ' c u l t u r e ' , 'norms', ' v a l u e s ' , ' r o l e s ' , 'behavior systems', e t c .  3)  C h i l d r e n p r o g r e s s i v e l y develop i n t o competent s o c i a l members.  4)  C h i l d r e n ' s development can be e i t h e r s u c c e s s f u l as they grow up through stages o f l i f e o r i t can be d e v i a n t anywhere along the way.  5)  C h i l d r e n a r e d e f e c t i v e s o c i a l p a r t i c i p a n t s by v i r t u e o f precompetence at b e h a v i n g p r o p e r l y . ^ 9  The having  i m p l i c a t i o n o f these  conventions  i s t h a t t h e c h i l d i s seen as  a s p e c i a l s t a t u s i n any a d u l t - c h i l d c o n t a c t .  i n t e r a c t i o n a l features o f the ideology are contained  The most s i g n i f i c a n t i n the notions o f the  c h i l d as a d e f e c t i v e s o c i a l p a r t i c i p a n t and i n t h e i d e a t h a t i t i s a d u l t s who p r o v i d e  c h i l d r e n with the s k i l l s  and knowledge by which they  are t o  become competent p a r t i c i p a n t s .  One can e a s i l y see how i n t e r a c t i o n s g e t  fashioned  i n order t o ' s o c i a l i z e ' c h i l d r e n .  around these  resources  a p p l i e s p a r t i c u l a r l y i n t h e household b u t h o l d s well).  (This  f o r o t h e r s e t t i n g s as  On t h e o t h e r hand, i t i s p o s s i b l e t o l e a r n something o f the  c h i l d ' s d e f e c t i v e p a r t i c i p a t i o n by o b s e r v i n g  a d u l t concerns w i t h  helping  20 the c h i l d t o p a r t i c i p a t e i n c o n v e r s a t i o n s  and o t h e r a f f a i r s .  see how t h e i d e o l o g y i s a major f e a t u r e governing and c h i l d r e n .  One can  c o n t a c t between a d u l t s  153 S p e i e r h a s b e g u n t o d e m o n s t r a t e how t h i s the p r o p e r t i e s o f conversations.  ideology i s reflected i n  He i s p a r t i c u l a r l y  interactional  consequences o f " r e s t r i c t e d  dealings with  adults.  of  and m a i n t a i n i n g a c o n v e r s a t i o n w i t h  get  initiating  t o be a s p e a k e r I would  of can up  cutting  a list  claim of  to repeat that, while  l e a r n e d and used.  process  and problems  Returning  o f ad hoeing  c a n be brought  now t o my  field  a d u l t i d e o l o g y c a n be u s e d  actions,  accounts,  i nthe  in his  solve the problem  a n a d u l t o r how d o e s h e  21 conventions  provide  i s not a definite  i s , i t i s n o t my of children.  a way  o b j e c t which  intention Rather,  i t i sour  schema a n d , a s s u c h ,  b y w h i c h new o c c a s i o n s ,  t o draw  consists  events,  under i t s a u s p i c e s .  work p u z z l e ,  t o account  I contend  that this  f o r , o r t o make  sense  notion of  of, therapists'  e x p l a n a t i o n s , e t c . , as w e l l as f o r o u r experience o f  reasonableness.  therapeutic  While  t h e r a p i s t s may p r o v i d e  accounts  i n terms o f  g o a l s , t h e b u r e a u c r a t i c o r g a n i z a t i o n o f t h e program, t h e b i o -  g r a p h y o f t h e p a t i e n t , e t c . , we w o u l d schema i s t h e f o u n d a t i o n adult  these  t h a t t h e i d e o l o g y i s an i n t e r p r e t i v e  a continuous  their  That  t h a t shows how a d u l t s c o n c e i v e  actions,  an  conversation.  i n t o the ideology, the Ideology  be l i s t e d ,  of the c h i l d  F o r e x a m p l e , how d o e s t h e c h i l d  i n an on g o i n g  like  rights"  interested  ideology w i l l  argue t h a t t h e a d u l t  f o r a l l o f these  be u s e d  t o focus  t h e members o f t h e s e t t i n g .  accounts.  The n o t i o n o f an  on t h e i n t e r p r e t i v e  The n a t u r e  of this  interpretive  schema employed b y  schema c a n be  determined  22 through  an e x a m i n a t i o n  offered  as a d e v i c e  tional  rationale.  responses, all  of actions i n the setting.  f o r making  sense  o f both  The adequacy o f a c c o u n t s ,  the v a l i d i t y  o f reasoning,  The i d e o l o g y  the events  and t h e o r g a n i z a -  the appropriateness o f  the transparency  are provided by the a d u l t ideology.  i s  o f motives,  etc.,—  154 In  review,  sense o f to  the  i t and  from i t d e r i v e the  lay person,  and  although  the  they  setting  to  tent with able  other  ideology  i n our  My  Discovery Let's  those  the  look  previous  aware o f  I was  d e v e l o p e d by  the  may  only  i d e o l o g y was  treat  i t as  see  to  piece  a  a  are  subscribe the  culture. that  o f t e n more  findings, their  s o l u t i o n t o our  The  of  pressing,  explanations  place  talk,  using  the  in a  e a r l y query  about  specialized  work  activities,  e t c . are  found.  a d u l t s we  As  how  consisare  same i n t e r p r e t i v e s c h e m a  that  23  puzzlement  the  notion  Speier,  and  discovery  science  accounts given them t o g e t h e r  by to  of the  Before an  however,  this  clearly  instance  of  much t i m e  using  not  social an  expert  more t e c h n i c a l t h a n  decisions  t h a t take  e v e n t s by  f o r making  ideology.  t o us.  after  b o t h be  adult  to  their  adult ideology.  S a c k s and  I t was  with  occasion  adult  and  c o m p e t e n t members o f  display of p s y c h i a t r i c reasoning  clinic,  dealing  as  layman  'scientific'  provides  life.  a t my  of  therapist  the  device  Ideology  manifestation  tions.  omni-relevant  s i t u a t i o n s where c h i l d r e n a r e  everyday  of  to  for activities;  to understand  use  status i s on  the  seem r e a s o n a b l e  we  the  uses of  adult  possible  appeal  i s an Both  consequences o f  may  remain occasioned The  their  therapist's talk  the  was  ideology  (children's) a c t i v i t i e s .  Although  it  adult  adult  ideology.  formulated  finding.  which  see  I now  ideology  field  form a p a t t e r n .  that  I  at  i t had  been  saw  the  of  is a  research  that  the  the  i t s implica-  that  notion  literature,  instances That  constructed  argue  I began t o develop  t h e r a p i s t s as  I  to appreciate  Although i n the  as  Then, r e a l i z i n g  that notion,  how  I b e g a n my  I failed  i n the  to  I and of  an  I began I may i t .  to  be I  began  ideology  i s , I r e s o l v e d my  the  and  puzzle  155 about what was happening i n t h e p l a y room and I c l a i m t h a t t h e m a t e r i a l s presented i n the preceding related  c h a p t e r a r e an adequate account o f t h e r a p y  concerns. Here i s an example o f how I d i s c o v e r e d  a c c o u n t s , and a c t i o n s o f t h e t h e r a p i s t . 1.  a pattern  i n the e x p l a n a t i o n s ,  I noted  A p a t i e n t ' s t a l k about dead b i r d s was accounted f o r i n terms o f h i s f a t h e r ' s death.  2.  A p a t i e n t ' s sex i d e n t i f i c a t i o n problem e x p l a i n e d  i n terms o f f a m i l y  responses and s t r u c t u r e . 3.  An apparent r e l a p s e was accounted f o r i n terms o f the time spent a t home w i t h mother.  4.  A p a t i e n t ' s p a i n t i n g was e x p l a i n e d the  5.  i n terms o f the moral c h a r a c t e r o f  family.  A p a t i e n t ' s swearing was e x p l a i n e d  i n terms o f the e x i s t e n c e  of a  f a m i l y r u l e s a n c t i o n i n g such b e h a v i o r . 6.  A s e s s i o n was s a i d t o be good f o r t h e p a t i e n t because i t p r o v i d e d an a c t i v i t y not permitted  7.  a t home.  A p a t i e n t ' s anger was e x p l a i n e d  i n terms o f t h e f a t h e r ' s  employment  status. 8.  A p a t i e n t ' s l a c k o f p r o g r e s s was e x p l a i n e d the  9.  i n terms o f the need f o r  f a m i l y t o be i n t h e r a p y .  I a l s o found myself c o n t r i b u t i n g t o t h i s p a t t e r n , explanation  e.g., o f f e r i n g an  o f a p a t i e n t ' s apparent n o n - s e q u i t o r i n r e l a t i n g a r o c k i n g  c h a i r t o "somebody o l d " by p o s i t i n g the p o s s i b l e e x i s t e n c e grandmother who used a r o c k i n g  of a  chair.  There appeared t o be a r a t h e r long l i s t o f i n s t a n c e s U s i n g the documentary method,  23  such as t h i s .  I began t o see events such as these  156 as  a document o f  able If  t o use  the  the  other  one  s e e n as  be  accepted. told  a  the  to  the  the  adult  that  that  relied  further,  ideology.  w i l l be  same m a n n e r a s  of  features  some n o n - t h e r a p y  Features of 1.  the  then  able  find  to  use  further  someone who  display i n the  the  of  to  an  tapes  older  This was case  too".  not  and  of  so  t h a t he  a very the  who  was  that  unlike  These  seen  too  therapist's  the  room.  skills  would  disturbed  t o keep score  child  and  e x a g g e r a t i o n was  not  I saw  discov-  brother  important  play  I  in  effort  their  home,  instances  child,  are  there further  pattern.  these  accounts  upon our  the  to  he  notes  shared  common s e n s e  understanding  of  the  d e v e l o p what I w i l l r e f e r  to  as  are  a l l features  above.  To  consistent with related  depend upon o u r  'family'. features  t h a t were c o n s t r u c t e d  demonstrate  that  everyday happenings  the  for  in  of some-  reasonableness  I w i l l also  pro-  examples.  Ideology  A l l of  behavior  to  These  are  to  was  instances.  of his possession  his parents.  i t was  l e t me  what the these  and  further  family  field  existence  introduced  succeed  clear  the  by  underlying  meaning and  take t h i s  plain  of  family  find  c h a p t e r s he  apparent exaggeration  mother i s " c r a z y  strategy  pressure  I t was  vide  to  the  .  a p p e a r t o be  a patient  game a s no  to  that  convince  the  previous  multi-consequentiality  When I was  documents o f  To  the  much p r a i s e d  attempt  I was  their  at  consequence of  and  an  was  back  patient's  the  as  dart  of  of multi-consequentiality  e x a m p l e , when I r e e x a m i n e d my  successful  to  the  nature  such instances.  that  was  multi-consequential  idea  looks  of  For ered  the  reader  notion  the  are  the  above  instances  instances of  a  of  feature  using  the  I will  patient's  call  the  family  to  ex-  omni-relevance  of  157 f a m i l y membership and i t s m u l t i - c o n s e q u e n t i a l i t y . c o n s t i t u t e an o c c a s i o n e d  The i n s t a n c e s  above  a p p l i c a t i o n o f t h i s f e a t u r e and a r e o f t h e same  character  as a p a r e n t ' s concern t h a t the " p u b l i c " w i l l  character  o f the f a m i l y on t h e b a s i s o f t h e i r c h i l d r e n ' s manners i n  restaurants,  o r as a t e a c h e r ' s  concern t h a t c h i l d r e n from  f a m i l i e s need s p e c i a l a t t e n t i o n .  2.  judge t h e moral  "deprived''  24  The f a c t t h a t the c h i l d i s an i n v o l u n t a r y p a t i e n t  (and o f t e n  does n o t know t h a t he has a "problem") and i s o c c a s i o n a l l y f o r c e d t o go (and sometimes c a r r i e d ) i n t o therapy i s a f e a t u r e o f what everyone knows; i . e . , t h a t c h i l d r e n can n o t be r e s p o n s i b l e  f o r making d e c i s i o n s s i n c e they  do n o t know t h e i r own e m o t i o n a l o r p h y s i c a l s t a t e s . character  then as the p a r e n t ' s a b i l i t y t o see t h a t h i s c h i l d i s t i r e d ,  even when he i s making a n o i s e ness.  I t i s o f t h e same  and r u n n i n g around and denying h i s ' t i r e d -  Or, the p a r e n t who knows t h a t a c h i l d must be hungry.  3.  25  The t h e r a p i s t ' s c h a r a c t e r i z a t i o n o f a p a t i e n t as a " p l a y e r " o r  a " t a l k e r " and h i s a b i l i t y t o see t h e immaturity  (regressiveness)  of play  a c t i v i t y i s an o c c a s i o n e d  o f age and stage  appropri-  ate b e h a v i o r .  a p p l i c a t i o n of notions  We know t h a t c h i l d r e n have d i f f e r e n t s k i l l s ,  think  ent thoughts, e x p e r i e n c e d i f f e r e n t emotions, and so on, a c c o r d i n g age. be  These d i f f e r e n c e s a r e r e f e r r e d t o as s t a g e s .  differto their  This reasoning  may  compared t o t h a t o f the p a r e n t who t h i n k s t h a t t h e i r daughter i s now  too o l d t o enjoy, a p p r e c i a t e  o r p l a y w i t h d o l l s , o r t o t h e businessman who  acknowledges t h a t c h i l d r e n go through a stage wherein they a r e e s p e c i a l l y l i k e l y t o do some s h o p l i f t i n g .  26  158 4.  The  t h e r a p i s t ' s use o f p l a y as a form of therapy.and  ability  t o determine the moral c h a r a c t e r of the player, d e r i v e s from the i d e a t h a t t h e r e i s some s p e c i a l r e l a t i o n between c h i l d r e n and p l a y ; some ways an a c t i v i t y which i s u n i q u e l y c h a r a c t e r as i s the r e a s o n i n g  theirs.  o f the p a r e n t who  T h i s i s o f the same i n f e r s the moral  o f the c h i l d r e n i n the neighbourhood from the way f a t h e r who  that i t i s i n  character  t h a t they p l a y , or  the  sees the concerns and/or a b i l i t i e s o f h i s c h i l d r e n i n t h e i r 27  "playing  school".  5.  The  t h e r a p i s t ' s s e e i n g o f human needs  (such as dependency)  the e f f o r t t o h e l p the c h i l d g e t back on the p r o p e r experience  such needs and work through them can be  o f our n o t i o n s about developmental d e r a i l m e n t . c r e a t u r e s who  go through stages  stopped or be  side tracked.  t r a c k so t h a t he  seen as an a p p l i c a t i o n  We  know t h a t c h i l d r e n are  As such., . t h i s r e a s o n i n g  c h a r a c t e r t o t h a t o f the p a r e n t who  t e l l s h i s doctor  i s of a  6.  The  on how  the  emotional  t h e r a p i s t ' s f r e q u e n t p r a i s e o f p a t i e n t ' s appearance and  n o t i o n t h a t c h i l d r e n can be time.  similar  t o remedy the problems.  f r e q u e n t p h y s i c a l c o n t a c t i s , i n p a r t , an o c c a s i o n e d  any  the  t h a t h i s c h i l d does  not seem t o be a normal c h i l d , o r the teacher'who e v a l u a t e s advises parents  a p p l i c a t i o n of  commented upon, e v a l u a t e d ,  the house v i s i t o r who  c h i l d ' s c o l o r i n g a b i l i t y , o r the s t r a n g e r who  the  the  touched, e t c . a t  As such, i t resembles the a c t i o n s o f the s a l e s c l e r k  admires the c l o t h i n g o f a c h i l d - c u s t o m e r ,  be  are t y p i c a l l y a t t r i b u t e d t o  c e r t a i n s i g n i f i c a n t a d u l t s whereas r e h a b i l i t a t i o n i s assumed t o be  s t a t e o f p u p i l s and  can  o f development which, a t any p o i n t can  Derailments  r e s p o n s i b i l i t y of a l l adults.  and  who  praises a  r u f f l e s the h a i r o f a young  159 passer-by.  7.  The  t h e r a p i s t ' s s e l e c t i o n o f p l a y o b j e c t s which a l l o w the  t o make a mess, t o express h i s anger and t o make a n o i s e , and  aggression  the a p p r o v a l o f those  towards the t h e r a p i s t ,  a c t i v i t i e s i s an  occasioned  a p p l i c a t i o n o f the n o t i o n t h a t c h i l d r e n are v i o l a t o r s o f a d u l t ments" and  t h a t they may  have a "need" t o be  o f the same c h a r a c t e r as the r e a s o n i n g  like this.  As  "environ-  such, i t i s  o f the f a m i l y t h a t has  a p l a y room  f o r t h e i r c h i l d r e n , the p a r e n t a l a p p r o v a l o f p l a y s c h o o l s , and frequent  assignment o f o l d c l o t h e s t o c h i l d r e n as w e l l as the  sanctioning of v i o l a t i o n s .  Whether o r not one  even the negative  approves or d i s a p p r o v e s  c h i l d r e n d i s t u r b i n g the normative environment w i t h t h e i r n o i s e , breaking  t h i n g s e t c . , they are r o u t i n e l y seen as c r e a t u r e s who  counted on t o do such t h i n g s and  t h e i r a c t i v i t i e s : , or i g n o r e s them. 29  s p e c i a l items, However, one  c l o t h i n g , and  of  fighting, can  be  are unable t o c o n t r o l themselves.  e i t h e r p u n i s h e s them, or p r o v i d e s  child  One  so on  i s always aware o f  for their  '  presence.  8.  The  t h e r a p i s t ' s awareness o f the p a t i e n t ' s need t o t e s t  l i m i t s of a s i t u a t i o n and h i s e f f o r t s t o h e l p him d i s c o v e r those a h e a l t h y way  i s an o c c a s i o n e d  the  limits in  a p p l i c a t i o n o f the assumption t h a t c h i l d r e n  always t r y t o d i s c o v e r the l i m i t s and need t o know them so s e l f - c o n t r o l i s possible. l e a d e r who  As such, they are r e l a t e d t o the r e a s o n i n g  o f the r e c r e a t i o n  "comes on s t r o n g " w i t h h i s f o l l o w e r s so t h a t they w i l l know t h a t -  they cannot g e t away w i t h a n y t h i n g w i t h him, r e a l i z e s t h a t he has  or the group l e a d e r  l o s t c o n t r o l o f the group by b e i n g  too  who  "soft".  160 9.  Therapists  o f t e n took some p a t i e n t s t o the gymnasium as a  f i n a l p a r t o f t h e i r therapy hour and a l l o w e d them t o jump on t h e trampoline.  T h i s was e x p l a i n e d  steam".  as a way o f l e t t i n g t h e c h i l d  " l e t o f f some  I t was f e l t t o be e s p e c i a l l y n e c e s s a r y w i t h those p a t i e n t s who  had  b u i l t up a l o t o f emotion  had  not released i t e f f e c t i v e l y  clowns, e t c . ) .  (e.g., anger) d u r i n g  (by t a l k i n g about i t , h i t t i n g t h e punching  Rather than send t h e p a t i e n t home i n t h i s s t a t e , t h e  t h e r a p i s t gave him some e x e r c i s e . the n o t i o n  T h i s i s an o c c a s i o n e d  the r e a s o n i n g  10.  application of  t h a t c h i l d r e n a r e v i c t i m s o f t h e i r b o d i e s and/or emotions and  need p h y s i c a l a c t i v i t y t o make them c i v i l . .  gym b e f o r e  t h e t h e r a p y hour b u t  As such, i t i s somewhat l i k e  o f the r e c r e a t i o n l e a d e r who has h i s charges run around t h e  he t r i e s t o t e a c h  them the r u l e s o f a new game.  The t h e r a p i s t ' s a s s i s t a n c e  i n making the c h i l d ' s a c t i v i t i e s  s u c c e s s f u l f o r them, f o r example, h i s moving t h e "hoop", g i v i n g the c h i l d a second chance i n a game, making mistakes i n adding up s c o r e s , to out perform the p a t i e n t i n competitions,  failing  e t c . , w h i l e done f o r good  p s y c h i a t r i c r e a s o n s — s u c h as removing p r e s s u r e  from t h e c h i l d , n o t f r u s -  t r a t i n g the p a t i e n t and t h e r e b y s i d e - t r a c k i n g the s e s s i o n , speeding up a c t i v i t i e s which a r e n o t p r o d u c t i v e ,  etc.--are  occasioned  the assumption t h a t c h i l d r e n a r e pre-competent a c t o r s . t h e r a p i s t ' s a s s i s t a n c e has t h e same c h a r a c t e r regulates a c h i l d ' s d i e t , teachers  who h e l p  applications of As such t h e  as t h a t o f the p a r e n t who  students with t h e i r winter  b o o t s , o r t h e s p o r t coach who d e l i b e r a t e l y f a i l s t o h i t t h e b a l l . *****  11.  *  While the t h e r a p i s t ' s . p r o v i s i o n o f c o o k i e s ,  candies,  or soft  d r i n k s may have some p s y c h i a t r i c s i g n i f i c a n c e i n t h a t i t e s t a b l i s h e s an  161 atmosphere o f t r u s t of  the n o t i o n t h a t c h i l d r e n  giving As  them t r e a t s  such  the  c l e r k who  and  gives the  (something  This  would not  the  general  features of  notions  of the  the  will  be  able to  find  of  course,  to find  events  application  the  which  t h a t we  t h a t the  i s a resource  Thus, the  members now  takes  on  are  often said  behavior.  to or  somewhat a k i n t o t h o s e  of the  store  s t r a n g e r i n the park  listing,  therapy  a different  sometimes as  trinkets  instances of  I t p r o v i d e s us w i t h  other  As  earlier  shares  rather i t i s offered  room a r e  the  I f the  the  some  who  adults).  therapist's  reader  therapy  I have  operate.  This  l a y person  and  distinction  data  features  and,  I would What we  between  would  the  previously, this  i s because the  is  the  room i n t e r m s o f  suggested  the  reasoning  features.  f o r a long time.  as  the  some o f  goes back o v e r  instances of these  different  of the  expert,  the  adult  and  this  l a y and  is  expert  character.  i s common f o r l a y m e n a n d from, and  ata l l .  suggest  events  by  reason  could continue  f o r both  rewarded  shows how  therapists  so.  different  the  a l l share.  necessarily  It  of  application  f o r no  with  innumerable  i s e x p l a i n i n g the  same way  ideology  do  an  encouraged, e t c . ,  gives h i s small c l i e n t s  thereof.  that that activity  understandings is  s h o u l d be  a d u l t i d e o l o g y and  he  doing  pacified,  adult ideology.  occasioned  be  won,  a definitive  events  an  suggest  who  i s n o t meant as  e x a m p l e o f how  sharing, i t i s also  a b a l l o o n , the  dentist  w h i c h he  be  a c t i o n s are  child  or the  can  sometimes  therapist's  h i s popcorn,  an  t h a t comes t h r o u g h  experts  t o each  see  i n competition with  c l a i m t o have the  truth  I t i s o f t e n assumed t h a t t h e  their  knowledge  each other.  a b o u t human o r o t h e r  task of the  as  Experts types  expert, because of  of his  162 specialized example, tion  knowledge  our e a r l i e r  and c h i l d  false  i s t o remedy t h e knowledge o f t h e layman. mention o f the c h i l d  development  assumptions  characterized  experts  socializa-  and i n c o r r e c t p r a c t i s e s o f t h e layman.  In a s i m i l a r  o f a s someone who  as s o c i o l o g i s t s and c h i l d  and P o l l n e r  suggest  i s supposed  An e x a m i n a t i o n  t o remedy  of the practises of  t h e r a p i s t s demonstrates  u l t i m a t e l y u s e t h e same r e s o u r c e s  Zimmerman  on  to correct the  m i s t a k e s made b y t h e l a y p e r s o n . .  such experts  literature  i t as an e f f o r t  way t h e t h e r a p i s t c a n b e t h o u g h t the  rearing  For  as the l a y person  that  does.  that:  S o c i o l o g y ' s a c c e p t a n c e o f t h e lay;member's f o r m u l a t i o n o f t h e f o r m a l a n d s u b s t a n t i v e f e a t u r e s o f s o c i o l o g y ' s t o p i c a l c o n c e r n s makes s o c i o l o g y an i n t e g r a l f e a t u r e o f t h e v e r y o r d e r i t s e e k s t o d e s c r i b e . I t makes s o c i o l o g y i n t o a n e m i n e n t l y f o l k d i s c i p l i n e . . . . ^ (  While an  I am s u g g e s t i n g  a d u l t member o f t h e s o c i e t y ,  tions  b e t w e e n t h e two.  do.  T h e s o c i o l o g i s t who  shows h i s e x p e r t i s e all  adults  "What  rely  I am n o t a r g u i n g , t h a t  i n common. "Why  of social  that  therapist practices h i s expertise  arise  from and r e l y  upon t h i s  by a t t e n d i n g  same r e s o u r c e .  c a n we make t h e c h i l d  remedy t h e c h i l d ' s s e l f - c o n c e p t ? " ,  "Why  did this  do c h i l d r e n deviants?",  S i m i l a r l y , the  t o problems  better?", child  that  developments?",  The q u e s t i o n s feel  they  practices  d o some c h i l d r e n become  c l a s s on p e r s o n a l i t y  distinc-  resources  s u c h a s "How  common s e n s e k n o w l e d g e o f t h e w o r l d .  - "How  a r e no  b a s e d on t h e v e r y  Questions  child  concerned with  there  i s i n t e r e s t e d i n , say, s o c i a l i z a t i o n  actors?",  i s the influence  the therapist, i s  l i e i n the a c t i v i t i e s  by answering q u e s t i o n s  social  u p o n members'  the s o c i o l o g i s t , l i k e  The d i f f e r e n c e s  know a n d s h a r e  become c o m p e t e n t or  that  )  which  that  "How  become  he i s  d o we disturbed?", o  etc.,  are also  common.  concerns which the l a y adult/parent  Relatedly,  they  share  assumptions  and t h e expert  about c h i l d r e n being  have i n  socialized  163 o r made i n t o a d u l t s b y a d u l t s who t e a c h systems, special  and so on.  the l a yexpert  that  as the behavior Let  us take  for  the therapy  The  Ideology In  setting  o f i t s use.  Folk  to explain  wissuch  of children.  a second  look  a t what t h e a d u l t  ideology  accomplished  occasion.  as a Source o f E x p l a n a t i o n s  a similar  fashion  t o colleagues  and o t h e r s  by reference  patients,  and themselves. because  of Patient  Behavior  t o t h e way i n w h i c h I was a b l e  e t c . , t h e r a p i s t s were a b l e  explained  behavior  i s n o t b a s e d on  i s and must be u s e d b y e i t h e r p a r t y  children,  be  roles,  dichotomy  o r e s o t e r i c knowledge, b u t on t h e o c c a s i o n s  dom i s a r e s o u r c e things  Therefore,  them v a l u e s ,  That  i t c o u l d be  to explain  to typifications  t o explain the behavior  this  of families,  of their  i s t o say, the patients' behavior  could  typified.  31 A in  similar  use o f the ideology  which the t r o u b l e with  c o u l d be seen  of a pattern.  u n r e a s o n a b l e demands, d i s r u p t e d t h e s e s s i o n , something p e c u l i a r t o him alone  i a r problem with  F o r e x a m p l e t h e p a t i e n t who made e t c . , was n o t s e e n t o s u f f e r  b u t was t a k e n  new p a t i e n t s a n d h i s b e h a v i o r  What may h a v e a p p e a r e d t o b e a s p e c i a l  Similarly,  t h e p a t i e n t who s w o r e c o n t i n u o u s l y  a familiar  case by t e l l i n g  c o u l d n o t s w e a r a t home. and fits  unproblematic  i n that the goal  i s now  was t o b e e x p e c t e d  ( i n terms o f understanding Finally,  problem  was t r a n s f o r m e d  The d i s r u p t i v e b e h a v i o r  i n t o a known p a t t e r n .  problematic  how t h i s  a s an example o f a  familiar.  from a unique  of a child  now s t a n d s  as  who  explained  i f n o t management) s i n c e i t  t h e p a t i e n t who h a s a r e l a p s e ,  o f therapy  famil-  was s e e n a s " t e s t i n g t h e  limits".  into  telling"  a p a r t i c u l a r p a t i e n t c o u l d b e made f a m i l i a r b y  showing i t t o be an i n s t a n c e  from  i n the "story  while  i s made more d i s t a n t , d o e s n o t  164 discredit another verted  the  therapy program.  familiar pattern, the  Rather,  that  i s , that  therapist's efforts.  The  i t becomes a n o t h e r influence  family  of  of  the  the  instance  of  f a m i l y has  patient  sub-  is offered  as  32 an  explanation  of  the  patient's  These e x p l a n a t i o n s treatment of, one  of  response  deliberate  behavior the  or  the  and,  with  also  serve  them a p p e a r t o be  While  the  f a m i l i a r i t a l s o makes t h e i r t o l e r a n t of  the  some e x c e p t i o n s ,  the  been e x p l a i n e d  t h e r a p i s t should  last  a  short  when t h i s  while  and  same p a t i e n t  t r a n s f o r m e d by behavior  and,  the thus,  term i s i t s e l f  behavior,  and  the  reasons  since  create  are  by  g i v i n g meaning t o  so  that  events  t h e y became an the  the  "new"  atmosphere and  Since  since  the  appears reasonable After  above  that  a l l , i t will  only  i t becomes  the  response using  the as  sensible  therapist, or  to  directly  It structured  o r by of  placing a the  "kind  "adult  explanations or  of  the the  patient  i s , they  some s e t  indirectly  (and  patient's  That  outcome o f  or  tolerant.  ideology"  rational.  of  influenced  i s aware o f  therapist's  them i n the of  manipulative  i t becomes l e s s  term  the-reasonable  action of  of  example,  with his disruptive behavior  always taken t h a t  instance  For  However,  p a t i e n t was  i s doing.  patient's  w i t h h i s demands.  things. an  outcome  open r e l a t i o n s h i p .  offered  behavior  i t i s not  example,  such  therapist's  a p p e a r t o be  f o r w h a t he  For  help  continues  a gloss)  circumstances which the Indirectly  will  with  the  reasonable.  " t e s t i n g " , _ t now  f o r w h i c h I am  make t h a t  behaviors  along  makes t h e  disruptive behavior  goes along  therapist's  r a t i o n a l and  response  t h e r a p i s t , i n t o bugging  Those t h i n g s  made t h e  go  as  t o make t h e  explanation  s e t t i n g i s supposed t o have a permissive  b e h a v i o r has  the  troubles  to,  choice.  therapist i s very  patient  of  behavior,, thus making i t t y p i c a l .  context  by. the  environment of  a  pattern  action".  p a t i e n t who  symbolically  painted  the  165 struggles  of  virtue  the  of  'good' a n d account  'evil'  given.  becomes s e e n as That  c h i l d r e n are  n a t u r a l l y m i s c h i e v o u s ) who  ical  patriarch.  This  f o r the  motivational  structure  In  more g e n e r a l  t e r m s t h e n , what t h e  does i s s t r u c t u r e  actions  of  the  patient  (adequate) c o u r s e ing  enables  to provide This  was  the an  was  of  family  of  reasoning"  boy"  her  by  actions  a  saw  the  an  via this  explain  display  of  by  a  child  puritanand  a  outcome o f  patient,  to  a  saw  of  the  girl  who  outcome o f  the  family's or  a  that  to  explanation  of  reason-  his  actions,  f o r him,  concern with  outcome o f  this  the  in  might  best  " w a n t e d t o be structure  motivational  terms  course  child the  etc.  the  "correct  obtain  the  correct  explain  therapist explained the  that  course  environment  family,  posa  and account  t r e a t m e n t becomes o b v i o u s  of  and  '  could  look  n o r m a l c h i l d r e n , and to  as  t'o  i n s u c h a way  i n order  explanation,  painting  (appeal  therapist's  The  behavior  a c t i o n of  Knowing t h a t  therapist also  adequate  reasonable. We  i n the  foster family  expected  i s seen as  reasonable  response or  relapse The  S i m i l a r l y , the  and,  form  the  "ideology"  child.  relapse.  patient.  the  the  therapeutic  i n t o a new  i s s e e n to. be This  and  by  the  action"  patient.  understand the  i n dramatic  the  placed  results.  values.  reasoning  undergoing  troubles  h a v e t o be  a p p e a r t o be  appropriate  of  t h e r a p i s t ' s environment  therapist to  displayed  p a t i e n t who  sible  of  the  f o r the  the  of  i s s t r u g g l i n g under a  symbolism  plausible  etc.)  kind  i s i t i s seen as  (and  provides  "that  at  the  other  adult  ideology  features  displayed  c h i l d - p a t i e n t behavior. the  ideology  constitutive  part  and  t h e r a p i s t and  patient,  of  the  was  not  an  setting.  (talk  and  family, as  talk  of  simply  a  way  as  a  t a l k I have o f f e r e d  d e s c r i p t i o n but  I t occurred  colleague  the  e a r l i e r ) then  However, t h e external  of  was  i n t a l k between  t h e r a p i s t and  itself  a  therapist  researcher  and  166 s h o u l d be examined i n terms o f these r e l a t i o n s h i p s . suggest  To do so would be  t h a t the i d e o l o g y i s more than an e x t e r n a l e x p l a n a t o r y  device  to  but,  whatever i t s f u n c t i o n , i s c o n s e q u e n t i a l on the o c c a s i o n o f i t s t e l l i n g . While I suggested  e a r l i e r t h a t the i d e o l o g y was  out o f the s e t t i n g i t was  c o n s e q u e n t i a l f o r me  a l s o c o n s e q u e n t i a l f o r me  while  and o t h e r s , i n the  setting.  The  C o n s e q u e n t i a l i t y o f the My  own  Ideology  t a l k o f the f a m i l y e t c . , was  i n s o f a r as I was  a b l e t o ask a p p r o p r i a t e q u e s t i o n s ,  e x p l a n a t i o n s , a c t i o n s , e t c . , and,  petence on f a i t h and  as some one who etc.  I hasten  seen as  see the r e l e v a n c e  The  r e a d e r w i l l have t o take my  As a r e s u l t , I was  of  com-  t o add t h a t t h i s competence does not  (or f e e l l i k e ) a t h e r a p i s t .  understood  setting  through t h i s , came t o be seen as a  competent member o f the s e t t i n g .  t h a t I s h o u l d be  c o n s e q u e n t i a l i n the  what was  Rather, I was  going on, knew something about  seen as a person  who  imply seen therapy,  c o u l d be asked f o r o p i n i o n s ,  33 used as a sounding board, e t c . manage my  The  i d e o l o g y was  f o r me  then a way  to  competence.  S i m i l a r l y , as we appeal t o the i d e o l o g y  saw  i n t r a n s c r i p t 4.9,  a.student-therapist could  ( t a l k o f the f a m i l y ) t o c o n s t r u c t a s e t o f  about the p a t i e n t which were r e l e v a n t t o h i s problem. a student o b s e r v e r  On another  questions occasion  upon watching a s e s s i o n i n which a young p a t i e n t l e f t  the p l a y room s e v e r a l times d u r i n g the therapy hour, commented t o the therapist: 5.1 0:  Does she say good-bye a l o t h e r s e l f ?  T:  No.  No,  nor n o r m a l l y ,  t h i s i s a s e p a r a t i o n theme, i t ' s p a r t l y  a  167 h o s p i t a l t h i n g , I t h i n k a l s o t h a t she r e c e n t l y s t a r t e d she h a s been i n o u r day c e n t e r d o w n s t a i r s s o s h e , O:  She s a y s g o o d - b y e a l o t a r o u n d t o mother?  While  I saw t h i s  that,  i n watching  at  hand,  it  then  the d o l l  looking  t o appear  to child  exists  talk of  room.  family  to their their  parent),  testing  their  alone  are.  desires,  i n the play  that obtain  i n this  of a pattern  which  the t h e r a p i s t to enter  t h a t t h e r a p i s t s are unconcerned  However, t o t r e a t  w o u l d mean t h a t e v e r y t h i n g  and prepare  enables  toys,  t h a n o f t h e u n i q u e p e r s o n s who  i s not t o suggest they  This  By  of limits,  needs,  s e e n as an i n s t a n c e  o f any one p a t i e n t .  This  situation,  uses o f p l a y ,  t o make t h e p a t i e n t ' s b e h a v i o r  The b e h a v i o r  the unique person,  which  each p a t i e n t as a i s known a b o u t  f o r a s e s s i o n , how t o . u n d e r s t a n d  and a c t i o n s e t c . , would have t o be a c q u i r e d  how  the patient's  anew o n e v e r y  occasion  t h e i r use. Conversely,  the  (e.g.,  some a c t i o n  f o r the therapists?  t o strangers,,  i n terms o f ' p a t i e n t s ' r a t h e r  to organize  By i d e n t i f y i n g  colleague.  consequential  f o r them  the therapist)  a n d manage t h e m i n s u c h a way a s  and competent  responses  situation.  unique person  (and p r e s u m a b l y  outcome o f f a c t o r s b r o a d e r t h a n t h o s e  independently  therapy  I  conversations  the therapist i s able  particular  with  anxiety.  development p a t t e r n s ,  categories  room t h e r a t i o n a l  the  on t h e i s s u e  ideology  etc., their  significant  think  p l a y i n g r o u t i n e s , he h a d f o c u s e d  f o r an a c c o u n t o f i t i n t h e p a t i e n t ' s  How was t h i s  etc.,  i t was c l e a r  t o be an adequate  appealing  Does she s a y goodbye  as 'overconfidence',  as a d i s p l a y o f competence.  i s p o s s i b l e t o generate  fantasy,  questioning  that of separation  heard h i s t a l k and  student's  t h e home now t o o .  kindergarten,  by a p p e a l i n g  therapist's actions  t o t h e knowledge o f c h i l d r e n i n g e n e r a l ,  appear t o be t h e r a t i o n a l  outcome o f a  motivated  168 consideration. the  play  actions On  To a p p e a l t o a g e - a n d - s t a g e  room h a s b e e n p r e p a r e d are r a t i o n a l  many o c c a s i o n s ,  also  handle  consideration  actions  the observer,  the  setting. Further,  t o generate  authoritatively providing parent  I provided tioning  further  accounting  children".  t o make v i s i b l e  could  therapists  o f questioning.or  o f t h e 'trauma'  could  the r a t i o n a l i t y o f  u s e i t a s a way t o  a topic.  F o r example, by  and r e l e v a n c e  was s o t r a n s one's  experienced  and, i n r e t r o s p e c t ,  I suggest  I d i d not feel  I could  even though  appropriate  appeal t o the ideology i n  I myself  that  I  F o r t h e t h e r a p i s t , and  a f u r t h e r e x p l i c a t i o n was t o r i s k  on w h i c h  a g o o d way t o  I was d i s s a t i s f i e d  that  from  there  reasonably  with  competence. queswere  ask f o r  the account  that  given. 'ideology'  causes o f events  tices the  end a l i n e  such an account  The the  served  a conversation,  one i n s t a n c e  many o c c a s i o n s  "that's  of the child-patient.  student-therapists  t o request  like,  make t h e t h e r a p i s t ' s  y o u h a v e t o do t h a t w i t h  an a c c o u n t whose a p p r o p r i a t e n e s s  that  i s , I could  t o statements  the ideology  while  That  one's  by the t h e r a p i s t s , b u t I  o f t h e r a p i s t s r a t i o n a l outcomes o f an  o f the nature  for  order  them f o r them.  why  accidental, habitual, etc.).  a c c o u n t s were p r o v i d e d  c h i l d r e n " , o r " I suspect  i n explaining  i n a p a r t i c u l a r way i s t o show how  than haphazard,  r a t i o n a l by appealing  made i n n u m e r a b l e  was  such  came t o p r o v i d e  actions  (rather  typifications  was a l s o like  useful  relapses  to situations external  f o rthe therapists  and l a c k o f p r o g r e s s  t o the therapy  room.  i n transferring from t h e i r  As s u g g e s t e d  prac-  earlier,  t h e r a p i s t - p a t i e n t r e l a t i o n s h i p i s one i n w h i c h t h e t h e r a p i s t i s  responsible therapist,  f o r the patient's  treatment, progress,  by v i r t u e o f h i s s p e c i a l s k i l l s ,  etc.  That  i s , the  t r a i n i n g , knowledge, and so  169 on,  i s i n a position  t o intervene i n the l i f e  is,  t o help the patient  solve) h i s problems.  knowing what i s h a p p e n i n g to  the case  priate  file)  with  their patients,  on t h e s t a t u s o f e a c h  f o r example, t h i n g s appear i s n o t made a f t e r  ate  the program has f a i l e d .  t o suggest  therapist  that  has f a i l e d .  relationship  An a d e q u a t e  aware o f what i s h a p p e n i n g  the  i t i s appro-  able to reasonably  states, e t c .  That  time,  talk  i s , that  i n some way t h e  typically  does then  (therapist  appeal  and have  i s manage t h e  and r e s e a r c h e r o r  i s provided to display  and t r a n s f e r s  pro-  i t may b e a p p r o p r i -  a r e beyond h i s c o n t r o l  and h e a r e r  account  being  the therapist w i l l  What t h i s  between t h e t e l l e r  colleague).  that  the therapist  t h e blame t o a p l a c e o u t s i d e o f  setting. T h i s may  therapist  appear t o r a i s e  knows t h a t  actions etc.  t o be e m i n e n t l y  acquired  reasonable  otherwise t o suggest their  one would that  risk  families  Without  his'status don't  attend to  'incompetence',  we h a v e h e a r d  appeared  adequate grounds f o r  a s a c o m p e t e n t member o f t h e  matter.  n o t i o n s o f t h e adequacy o f t h e s e  researcherd i d .  this  a hearer has t o  accusations',  The a c c o u n t s  and adequate.  that  However,  a n d , a s members, we  'false  do a s w e l l ) .  i . e . , although the  the family.  I t i s always the case  as ' p a s s i n g t h e buck',  (As t h e t h e r a p i s t s  society  he a c c u s e s  t h e adequacy o f o t h e r s ' accounts such  thinking  questions of deceit,  he i s a t f a u l t ,  n o t w h a t I am s u g g e s t i n g .  evaluate  the  cases  t h e therapy program.  a b l e t o r e p o r t (add  t o know when  a reasonable  t h e f a m i l y as a s e t o f f o r c e s t h a t  subverted  is  In such  (that  t o go w r o n g w i t h t h e t r e a t m e n t  gram o r i f p r o g r e s s  is  being  patient,  t h e p a t i e n t ' s moods, n e e d s , e m o t i o n a l If,  to solve  They a r e a c c o u n t a b l e f o r  or inappropriate to discharge patients,  predict  to  of the c h i l d  I suspect accounts  that  therapists  i n t h e same way  170 While  i t i s possible to refer  t o t h e a d u l t i d e o l o g y as s i m p l y  interpretive  schema f o r m a k i n g s e n s e  of behavior  patients, applied  i t s h o u l d n o t be t h o u g h t  t o t h e p l a y room  therapists, quential  students,  etc.  I t was  researcher, parents,  i n o t h e r ways a s w e l l .  relationships,  I t was  i s clearly  related  a schema w h i c h used  and i s t o be  i n that setting  e t c . , a n d i t s u s e was  a way  by  conse-  t o manage c o n v e r s a t i o n s ,  and o r g a n i z a t i o n a l a c t i v i t i e s .  management w o r k in  scenes,  o f as s i m p l y  of therapists  an  The s u c c e s s  t o the reasonableness  of that  of the ideology  explaining patient behavior.  Summary Starting with play  room a c t i v i t y  reasoning. achieving to  a puzzle  a b o u t my  ability  I constructed a reasonable  t o make a d e q u a t e account  I d i s c o v e r e d some o f t h e m e t h o d s w h i c h understanding  and e x p l a i n i n g t h e i r  claim that the reasonableness  of  of psychiatric  therapists  actions.  of psychiatric  sense  use f o r  I then  reasoning  proceeded  (my a c c o u n t  of  34 it)  was  Not  only  for  therapy  for  a l l o f the r e l a t i o n s h i p s  device  t o be  i n our background  expectancies  i s the a d u l t i d e o l o g y adequate related  events,  i t i s interactionally i n the.setting.  a l l o f t h e above appears  the ideology t i e s  be remembered  useful  o f t h e i d e o l o g y was That  a way  understand  a n d d e s c r i b e t h e way  i n the f i e l d  setting.  and  all-of-a-piece,  unrelated events,  problem.  operated  and c o n s e q u e n t i a l  organization, etc.  intensive practical t o adequately  accounts  I t i s i n p a r t a management  t o be c o h e r e n t  t o g e t h e r many s e e m i n g l y  t h a t the account  or the adult ideology.  f o r providing reasonable  f o r handling conversations, relationships, While  i.e.,  found  the solution  i s , i t s o l v e d my  i t should  f o r an  puzzle of discovering that  therapists  The patients  adult  and  ideology  i t clearly  power o f t h e i d e o l o g y practical  problem.  solves  t h e t h e r a p i s t ' s problems o f managing  s o l v e d my  should L e t us  be  problem.  My  seen i n r e l a t i o n  reconsider  claim  f o r the  explanatory  to the s o l u t i o n  the status o f t h i s  of  ideology.  my  172 Footnotes  "We propose t o suspend c o n v e n t i o n a l i n t e r e s t i n the t o p i c o f members p r a c t i c a l i n v e s t i g a t i o n s and urge the p l a c i n g of e x c l u s i v e emphasis on i n q u i r y i n t o p r a c t i c a l i n v e s t i g a t i o n s themselves, l a y or p r o f e s s i o n a l . The t o p i c then would c o n s i s t not i n the s o c i a l o r d e r as o r d i n a r i l y conc e i v e d but r a t h e r i n the ways i n which members assemble p a r t i c u l a r scenes so as t o p r o v i d e f o r one another evidence o f a s o c i a l o r d e r as o r d i n a r i l y conceived". D. Zimmerman, M. P o l l n e r , "The Everyday World as a Phenomena", i n Jack Douglas (ed.), Understanding Everyday L i f e , A l d i n e , 1970, p. 80. H. G a r f i n k e l , S t u d i e s i n Ethnomethodology, P r e n t i c e - H a l l , 1967, p. 273. For a d i s c u s s i o n o f 'doubt' and the a c t i v i t i e s o f p r a c t i c a l t h e o r i s t s and s c i e n t i f i c t h e o r i z i n g , G a r f i n k e l , "The R a t i o n a l P r o p e r t i e s o f S c i e n t i f i c and Common Sense A c t i v i t i e s " , In S t u d i e s i n Ethnomethodology, 1967. 2 J . P. Thome, "On H e a r i n g Sentences", i n J . Lyons and R. Wales (eds.) P s y c h o l i n g u i s t i c Papers, Edinburgh Univ. P r e s s , 1966. 3 E. Leach, " A n t h r o p o l o g i c a l A s p e c t s of Language: Animal C a t e g o r i e s and V e r b a l Abuse", In E. Lenneberg, New D i r e c t i o n i n the Study of Language, M.I.T. P r e s s , 1964. 4 P a r t i c u l a r l y l e c t u r e n o t e s , 1966-1969. 5 The c e n t r a l n o t i o n s o f Schutz' work can be found i n C o l l e c t e d Papers 1. M. Natanson (ed.) The Hague: M a r t i n u s N i j h o f f , 1967. ^Op.  c i t . , p.  59  f.  7 John C. McKinney, " T y p i f i c a t i o n s , T y p o l o g i e s and F o r c e s , 1969, p. 1.  S o c i a l Theory", S o c i a l  Q  For a d i s c u s s i o n o f the d i f f e r e n c e between s c i e n t i f i c r a t i o n a l i t y and common sense r a t i o n a l i t y see H. G a r f i n k e l , "The R a t i o n a l P r o p e r t i e s o f S c i e n t i f i c and Common Sense A c t i v i t i e s " , Op. c i t . 9 H. Sacks, i n a tape r e c o r d e d l e c t u r e d e l i v e r e d i n the summer o f 1968 t o the c o n f e r e n c e on "Language, S o c i e t y and the C h i l d " , sponsored by Department o f Anthropology, B e r k e l e y . ^M. S p e i e r , "The C h i l d as C o n v e r s a t i o n a l i s t : Some C u l t u r e C o n t a c t F e a t u r e s o f C o n v e r s a t i o n a l I n t e r a c t i o n Between A d u l t s and C h i l d r e n " , i n Roy T u r n e r (ed.) S o c i a l i z a t i o n , B a s i c Books, f o r t h c o m i n g . 1(  T h i s i s a concept w i t h a l o n g and d i f f i c u l t h i s t o r y and I use i t w i t h h e s i t a n c y but i t conveys my e s s e n t i a l p o i n t w e l l . I r e a l i z e that t h i s term i s used by Dorothy Smith i n a v e r y d i f f e r e n t manner and I do not c h a l l e n g e t h a t usage. See p a r t i c u l a r l y , "Women's P e r s p e c t i v e as a R a d i c a l C r i t i q u e o f S o c i o l o g y " , S o c i o l o g i c a l I n q u i r y 44, (1974) 7-14; and " T h e o r i z i n g as Ideology", i n R. T u r n e r , Ethnomethodology, Penguin Books, 1974. 1 1  173 12  While the e x c i t i n g work o f the Opies has been a v a i l a b l e f o r some time s o c i o l o g i s t s have made l i t t l e o f i t . See f o r example, I. Opie, P. Opie, The Lore and Language o f S c h o o l c h i l d r e n . London: Oxford U n i v e r s i t y P r e s s , 1959. 13 The n o t i o n o f a c h i l d r e n ' s c u l t u r e was f i r s t brought t o my a t t e n t i o n by H. Sacks and M. S p e i e r . See f o r example, M. S p e i e r , "The Everyday World o f the C h i l d " , i n J . Douglas (ed.) U n d e r s t a n d i n g Everyday L i f e . A l d i n e , 1970. I t i s almost i m p o s s i b l e t o f i n d use o f t h i s n o t i o n i n the s o c i a l s c i e n c e s although the concept o f c u l t u r e has been a p p l i e d t o innumerable other populations. There appears t o be some r e c e n t i n t e r e s t i n the n o t i o n ' as evidenced by the work o f M. Goodman, M. S p e i e r , and more r e c e n t l y R. McKay; see, "Conceptions o f C h i l d r e n and Models o f S o c i a l i z a t i o n " , i n R. T u r n e r (ed.) Ethnomethodology. Penguin Books, 1974, pp. 180-194; and H. D r e i t z e l , C h i l d h o o d and S o c i a l i z a t i o n : Recent S o c i o l o g y #5. New York, M a c m i l l a n , 1973. 14 New  The C u l t u r e o f C h i l d r e n : C h i l d ' s Eye Views o f S o c i e t y and York: Teachers C o l l e g e P r e s s , 1970. I b i d . , p. 1 6  Culture.  2.  Ibid.  17 M.  S p e i e r , "The  C h i l d as C o n v e r s a t i o n a l i s t " , pp.  1-2.  18 F o r a d i s c u s s i o n o f ' t o p i c ' and 'resource' see Don Zimmerman, P o l l n e r , "The Everyday World as a Phenomenon", i n J . Douglas (ed.) U n d e r s t a n d i n g Everyday L i f e , pp. 80-103. 19 Op. c i t . , p. 2.  M.  20 F o r examples o f t h i s the r e a d e r can look back t o the m a t e r i a l s p r e s e n t e d e a r l i e r , p a r t i c u l a r l y those p i e c e s o f a d v i c e on how t o t a l k t o c h i l d r e n , how t o g r e e t them, e t c . 21 See p a r t i c u l a r l y , " S o c i a l i z a t i o n and S o c i a l P r o c e s s i n C h i l d r e n ' s Conversations", unpublished Doctoral D i s s e r t a t i o n , U n i v e r s i t y of C a l i f o r n i a , B e r k e l e y , 1969; and "The C h i l d as C o n v e r s a t i o n a l i s t " , Op. c i t . 22 The n o t i o n o f ' i d e o l o g y ' has been used i n m e d i c a l s o c i o l o g y t o d i s t i n g u i s h between ' s c h o o l s ' o f therapy. S t r a u s s e t a l have been a b l e t o group t h e r a p i s t s i n t o t h r e e groups (somatherapy, p s y c h o t h e r a p y , s o c i o therapy) by the a n a l y s i s o f q u e s t i o n n a i r e items they b e l i e v e d r e f l e c t e d the i d e o l o g i e s . Presumably one c o u l d do the same w i t h c h i l d p s y c h i a t r y . What t h i s n o t i o n o f i d e o l o g y p o i n t s t o i s a s e t o f s a n c t i o n a b l e b e l i e f s , assumptions, knowledge t h a t s u p p o r t s one's membership i n some p r o f e s s i o n a l community. I t was not simply t h a t the r e s e a r c h e r s were a b l e t o r e c o n s t r u c t p r o f e s s i o n a l i d e o l o g i e s but i t was taken t h a t those b e l i e f s , e t c . were shared, t r a n s m i t t e d , r e i n f o r c e d , s a n c t i o n e d , e t c . by c o l l e a g u e s . For examples o f t h i s usage see, A. S t r a u s s , L. Schatzman, R. Bucher, D. E h r l i c h , M. Sabshin, P s y c h i a t r i c I d e o l o g i e s and I n s t i t u t i o n s . Free P r e s s , 1964; or  174 M. R. S h a r f , D. J . L e v i n s o n , " P a t t e r n s o f Ideology and Role D e f i n i t i o n • Among P s y c h i a t r i c R e s i d e n t s " , i n G r e e n b l a t t e t a l , (ed.) The P a t i e n t and, the Mental H o s p i t a l . Free P r e s s , 1957, pp. 2633-285. More r e c e n t l y see, P. E l l i o t t , " P r o f e s s i o n a l Ideology and S o c i a l S i t u a t i o n " , The S o c i o l o g i c a l Review, 21 (1973) 211-228. 23 F o r a d i s c u s s i o n o f the documentary method see H. G a r f i n k e l , "Common Sense Knowledge o f S o c i a l S t r u c t u r e s : The Documentary Method o f I n t e r p r e t a t i o n i n Lay and P r o f e s s i o n a l F a c t F i n d i n g " , i n S t u d i e s i n Ethnomethodology. "The f o c u s on p r a c t i c a l r e a s o n i n g emphasizes t h a t the t a l k accomplishes scenes and t h e i r c o n t a i n e d a c t i v i t i e s ; i t emphasizes t h a t members are - as a c o n d i t i o n o f t h e i r competence - r e n d e r i n g scenes i n t e l l i g i b l e , reasonable, accountable, t h a t t h e i r world i s a constant doing and a c h i e v i n g . ' P r a c t i c a l ' a c t o r s make and f i n d a r e a s o n a b l e world; t h e i r d o i n g so i s t o p i c a l l y a v a i l a b l e f o r the s o c i a l s c i e n t i s t " . R. Turner (ed.)., Ethnomethodology, Penguin 1974, " I n t r o d u c t i o n " , p. 10. 24 C o n s i d e r the f o l l o w i n g c o n v e r s a t i o n r e p o r t e d by a l o c a l newspaper w i t h a mother whose 13 y e a r - o l d son had k i l l e d a s t o r e employer the n i g h t previously. "She s a i d the boy r a r e l y s t a y e d out l a t e except when he s t a y e d a t a f r i e n d ' s house. Monday he l e f t t o go t o s c h o o l a t about 8:30 a.m. a f t e r l e a v i n g her a note s a y i n g he was g o i n g t o see h i s f a t h e r . She d i d not see o r hear him again u n t i l Tuesday a f t e r n o o n . Not u n t i l 4:30 p.m. Tuesday d i d he a r r i v e home t e l l i n g h i s mother, she l a t e r t o l d the Vancouver Sun,, t h a t he had been s t a y i n g w i t h h i s f a t h e r . Unsatisfied the mother took him t o p o l i c e h e a d q u a r t e r s " . Vancouver Sun, December 4, 1974. The concern o f a l l r e a d e r s o f t h i s s t o r y was puzzlement over why a 1 3 - y e a r - o l d would murder. Although we l e a r n t h a t the mother and f a t h e r do not l i v e t o g e t h e r , the mother's r e p o r t p o r t r a y s a 'normal' f a m i l y l i f e i n which she has c o n t r o l o f her son, i . e . , she was a good mother. 25 T h i s i s f u r t h e r d i s p l a y e d i n the treatment p h i l o s o p h y i n h e r e n t i n j u v e n i l e delinquency l e g i s l a t i o n . 26 C o n s i d e r the opening l i n e s o f The Way t o the S t a r s , a book f o r boys (and p a r e n t s ) i n the cub program: "cubbing i s a program f o r boys o f 8, 9, and 10 y e a r s o f age working w i t h a d u l t s who understand and have an appreci a t i o n o f the n a t u r e and needs o f boys o f t h i s age". National Council of Boy Scouts o f Canada, (rev.) 1968. One can a l s o l o o k t o Dr. Spock f o r d e s c r i p t i o n s o f the ' t e r r i b l e twos', ' t r y i n g t h r e e s ' , e t c . 27 See f o o t n o t e 4 i n c h a p t e r t h r e e . 28 C o n s i d e r the reader's, problem f o r Ann Landers. Dear Ann: We have a four-month-old baby who i s v e r y c u t e . She has a d a r l i n g p e r s o n a l i t y , i s v e r y f r i e n d l y and i s always s m i l i n g . The problem i s n ' t the baby's, i t ' s mine. I hate i t when people t r y t o touch h e r . E s p e c i a l l y i f they appear t o have a c o l d . Sometimes they have j u s t coughed i n t o t h e i r hands and then they want t o put t h e i r germy f i n g e r s on my c h i l d ' s f a c e . It d r i v e s me w i l d . S a l e s p e o p l e who handle d i r t y money a l l day are the worst offenders. How do they know who was the l a s t one t o touch t h a t money? He o r she might have had some t e r r i b l e d i s e a s e . Hands o f f . Answer:  175 Your p r e o c c u p a t i o n w i t h germs goes beyond a mother's n a t u r a l c o n c e r n . . . . P l e a s e d i s c u s s t h i s w i t h your p e d i a t r i c i a n and h o p e f u l l y he can remove the k l i n k e r from your t h i n k e r . Vancouver Sun, June 11, 1974. 29 One can d i s c o v e r ample evidence o f t h i s i n l e t t e r s t o the e d i t o r where c i t i z e n s complain about the need t o c o n t r o l those who occupy p a r k s , roam i n packs, break windows, make l o u d , n o i s e s , e t c . F o r example, c o n s i d e r t h i s d e s c r i p t i o n from a l e t t e r t i t l e d : " V i g i l a n t e s Form Around S l o c a n Park". "Night a f t e r n i g h t , 30 t o 50 youths come t o break t h i n g s and keep the t a x p a y e r awake. M e t a l garage doors w i t h the w r i n k l e d l o o k , windows are n o n - e x i s t e n t , garbage cans f l a t , contents'everywhere, c a t s w i t h t h r o a t s c u t , r o c k s on sun-decks". Vancouver Sun. 30 Op. c i t . , p. 82. 31 T h i s n o t i o n o f " s t o r y t e l l i n g " i s taken from D. L. Wieder, The C o n v i c t Code: A Study o f a Moral Order as a P e r s u a s i v e A c t i v i t y . Unpubl i s h e d D o c t o r a l D i s s e r t a t i o n , Department o f S o c i o l o g y , U.C.L.A., 1969. 32 I have a l s o found t h a t p h y s i o t h e r a p i s t s working w i t h c e r e b r a l p a l s i e d c h i l d r e n w i l l e x p l a i n the p a t i e n t ' s l a c k o f p r o g r e s s w i t h h i s w a l k i n g s k i l l s on the way the p a r e n t s handle the c h i l d a t home. A document on t h i s h a n d l i n g i s the f a c t t h a t p a r e n t s c a r r y t h e i r c h i l d r e n from t h e c l i n i c t o the c a r . 33 A t one p o i n t a s u p e r v i s o r suggested I h e l p h e r i n making a f i l m about p l a y t h e r a p y , she appealed t o my " s e n s i t i v i t y " t o what t r a n s p i r e d i n therapy sessions. 34 I t s h o u l d be n o t e d t h a t I am n o t s u g g e s t i n g t h a t the a d u l t i d e o l o g y has the same s t a t u s the c o n v i c t code does i n the halfway house as r e p o r t e d by Wieder.  CHAPTER 6 THE In the p r e c e d i n g resource  f o r making  satisfactorily  the p r a c t i c a l continuous  sense  i n the  resource  i n the  setting  setting,  defending  of  the  setting  to  the  "of course"  that  they  they  had  had  did.  not  the  come t h r o u g h status of that Earlier  a  knowledge to.  w h a t was  enterprise  behind  and  the  proved  aspects o f the  i n the  of  'real' therapy  to  sights  t o be  and to  a  I t formed  activities  a  which  t o make s e n s e  finding. room.  Often, Although  I  of  found  the  members  i d e o l o g y , I b e g a n t o make r e f e r e n c e s  actions i n dealing with talk  "what was  children—"of  t o , e t c . , p a t i e n t s i n the  argued  with  colleagues that  really  r e a d e r , h o w e v e r , we  g o i n g on".  m u s t now  the  This  s t o p and  way adult may  consider  ideology. r e p o r t i t was  activity.  That  suggested  demonstrated  i s explanation.  that  That  that  child  i s , there are bodies  (e.g., t h e o r i e s o f p e r s o n a l i t y  I have a l s o  encounter  a  occasionally  to the  in this  theory-governed  i t as  of t h e i r  account  I t a l l o w e d me  i d e o l o g y a l l o w e d me  to think of, treat, I had  ideology i s a  study.  spoken o f the  nature  setting.  further  adult  i t s function  i d e o l o g y p r o v i d e d an have  the  adult  a n d ' e x p l a i n i n g phenomena.  to bring  I began t o t r e a t  myself  course"  that  the  F u r t h e r , i t p r o v i d e d the key  therapy  under  IDEOLOGY  about  chapter.  f o r examining  Upon f i n d i n g the  therapy  inquiries  first  me  THE  I s h o w e d how  of the  reasoning of the  g e s t a l t which enabled I observed  chapters  t e r m i n a t e my  sounds p r e s e n t e d  STATUS OF  development)  a major  that  are  is  theoretical can  consequence o f the  i s , therapists 176  of  psychotherapy  constantly  be  appealed  therapy answering  177 'why q u e s t i o n s ' about the p a t i e n t ' s a c t i v i t i e s i n t h e p l a y room and can answer s i m i l a r q u e s t i o n s about t h e i r own a c t i o n s .  F o r example:  The t h e r a p i s t must be a l e r t t o r e f l e c t the unspoken wishes o f t h e silent child. The c h i l d ' s h a n d l i n g o f the doorknob may be s a f e l y i n t e r p r e t e d as "you want t o go out". 1  While we can see t h a t t h i s i s an ' e x p l a n a t i o n ' o f the h a n d l i n g o f t h e doorknob, we c o u l d ask i n what sense i t i s theory-governed. e x p l a n a t i o n s found  That i s , a r e t h e  i n the therapy s e t t i n g the consequence o f the a p p l i c a -  t i o n o f some s p e c i f i c t h e o r y which t h e r a p i s t s r e s o r t t o ?  Do e v e n t s ,  a c t i o n s , e t c . f o l l o w n e c e s s a r i l y from a t h e o r y ? As was t h e case w i t h t h e a d u l t i d e o l o g y , t h i s p s y c h i a t r i c was ever e x p l i c i t l y  l a i d o u t f o r me  'theory'  (although r e f e r e n c e was made t o i t  i n s o f a r as I was d i r e c t e d t o the l i t e r a t u r e , i . e . , t o n o t i o n s o f c h i l d development, e t c . )  During my f i e l d work I a l s o a c q u i r e d a c e r t a i n  competence which a l l o w e d me t o see t h i n g s i n much t h e same way as t h e therapists did. schema".  I have r e f e r r e d t o t h i s as t h e " p s y c h i a t r i c  The r e a d e r w i l l r e c a l l t h a t t h e s t a t u s o f t h i s schema remained  a p u z z l e f o r me. ideology).  (The p u z z l e which I r e s o l v e d by a p p e a l i n g t o t h e a d u l t  My problem w i t h the schema can now be i d e n t i f i e d as a two-  f o l d concern:  (1) What was t h e 'evidence'  i n the s e t t i n g ? Although  f o r the explanations provided  and (2) What were i t s boundaries? o t h e r laymen w i t h whom I d i s c u s s e d my f i e l d work p r e s s e d  me t o make e v a l u a t i v e statements and  interpretive  about the adequacy o f p s y c h i a t r i c  theory  i t s e f f e c t i v e n e s s (they asked, "Does therapy r e a l l y work?"), t h i s was  n o t my i n t e r e s t .  I had t r o u b l e g e t t i n g h o l d o f t h e p s y c h i a t r i c schema  because o f d i f f i c u l t i e s i n o b t a i n i n g evidence t o t h i n k about i t s s t a t u s .  As Hutten  f o r i t and t h i s f o r c e d me  i n speaking  about e x p l a n a t i o n s  says:  178 We s a y t h a t we h a v e e x p l a i n e d a phenomenon i f we c a n s a t i s f y a t l e a s t two c o n d i t i o n s . F i r s t , we m u s t p r o v i d e a t h e o r y a n d a l a w , o r s e t o f l a w s , b y means o f w h i c h we c a n d e s c r i b e t h e phenomenon a n d r e l a t e i t t o o t h e r s i m i l a r , phenomena. A n d , s e c o n d , we m u s t b e a b l e t o o b t a i n from the theory a p r e d i c t i o n , i . e . , a h y p o t h e s i s about a f u t u r e o c c u r r e n c e o f t h e phenomena; i f t h e e v e n t d u l y a r r i v e s , we r e g a r d t h e h y p o t h e s i s a s c o n f i r m e d artd we a c c e p t t h e t h e o r y a s a v a l i d e x p l a n a t i o n o f the phenomenon. 2  Prediction  i s a k i n d of evidence  r e l a t i o n s h i p between d i f f e r e n t number o f  individual  situations  and  anger, between  The  their  p u z z l e was  therapy,  e x p l a i n e d by  the  know t h a t t h e leave?  the  time,  therapist.  to previous  all  appealed able  o f the  what would s i m p l y by  I have you  to t e l l  count  as  watching  an the  which  into  the The  these  occurrence  had  the  experience.  i n s t a n c e o f an  event  sessions.  can  We  i s , the  a predictive  one.  aspect  puzzle:  etc. know w h a t  do  you  a desire to  " I f you've  seen i t  statements  explanations that I  time.  Even i f I had  have been a b l e  related  to those  t o my  puzzle  to  known tell  variables as  the  must t r a n s f o r m e v e n t s T h i s was  had,  the  (explan-  problem  me.  between e v e n t s  Before  depen-  the  refer  observer  like,  family  authoritatively  i t " , or other  I would not  adult ideology solved for  o f my  Given  t o be  a  parents  I d i d not  indicated  instances-of-a~pattern-of—behavior.  relationship  and  f o r e x a m p l e , How  doorknob  come t o know a b o u t  of  symbolism,  relationships,  a  s e e was  some k i n d s  religious  Whenever I a s k e d ,  variables',  That  to expect  family situations  w h i c h w o u l d work n e x t  'independent  observer's problem. ations)  of  between  answer t h a t I r e c e i v e d went s o m e t h i n g  that  not  only  us  p r o b l e m s , between r e l a p s e s and  child's playing with  as  was  new  f o r e a c h new  a s many t i m e s  I  some k i n d s  i t allows  What I d i d come t o  o r p a i n t i n g s and  that, having  would happen n e x t  phenomena.  relationships—relations  d e n c y , between r e l a p s e s and terminating  because  and  explanatory  returning to t h i s ,  l e t me  k n o w i n g what t h e b o u n d a r i e s  v a r i a b l e s was  introduce the  t o the  explanatory  not second schema  179 were. less for to  I suggested and  the be  tion  inescapable, that therapist  relevant. f o r the  important an  earlier  and  I felt  not  c o u l d be  the  w o u l d be ways.  s c h e m a was  was  both  a possible  e v e n t was  not  overwhelmed. Here  i s an  relent-  data  c l e a r w h a t o r when s o m e t h i n g  Obviously, every  therapist  that  i s , every happening  i t was  i n unexpected  encounter  that  source  would  r e l e v a n t i n every  However,  come situa-  some t h i n g s became  example o f the  detail  with  which  screened:  E v e n b e f o r e t h e i n t e r v i e w i t s e l f , much c a n be l e a r n e d a b o u t t h e r e l a t i o n s h i p b e t w e e n m o t h e r a n d c h i l d . . . •. What i s h e r m a n n e r a s she h e l p s a l i t t l e c h i l d w i t h a d i f f i c u l t z i p p e r and b u c k l e s ? Does she t a k e f u l l c a r e o f t h e o u t e r c l o t h i n g f o r a c a p a b l e o l d e r child? D o e s he s w i s h a n d h i t h i s m o t h e r w i t h h i s c o a t a s he t a k e s i t off? Do t h e y s i t - c l o s e t o g e t h e r on t h e c o u c h o r a s f a r a p a r t a s possible. . . . Is t h e r e i r r e g u l a r i t y i n the c h i l d ' s walk; d o e s he l i m p , w a l k on h i s t o e s , o r d r a g h i s f e e t ; d o e s he s l a p t h e f u r n i t u r e a s he w a l k s b y ; d o e s he r a c e a h e a d , c l i n g t o h i s m o t h e r , o r l a g f a r behind. 3  Nothing data of  seems t o e s c a p e  f o r the  these  the  interpretive  actions.  eye  o f the  therapist.  schema so t h a t  Any  something  W h i c h w o u l d become i m p o r t a n t  event  c o u l d be  c o u l d become  made o f  h o w e v e r was  not  any  easy  to  see. The  therapist  go w i t h w h i c h (or  "a c h i l d  The  child; with  outcomes w i l l  "after  problem.  The  this  child's  fact".  therapist  would have  identification to  a l l o w him  the  therapists  problem") w i l l  come t o p a s s .  discovered  born  i . e . , the  this  t h e o r y does n o t  last  does not p r e d i c t which o f these  sibling  "slap  Rather, Recall  the  the  say  that  furniture  significance  that  Rather,  i t c o u l d . t h e n be  female  "this a s he  o f the a sex  goes  by".  possible  action  is  identification  c h i l d r e n who  e x p l a i n e d by  therapists  will  child"  given a patient with  partially  Similarly,  sequences  innumerable  the p a t i e n t w i t h  d i d not p r e d i c t  order.  not  to p r e d i c t which o f the  such problems.  problem,  do  action  d i d not  were a  the  sexual  reference predict  180 that of  c h i l d r e n who h a d b e e n t r a u m a t i z e d  "dead b i r d s " .  referring  Rather,  t o a death  became r e l e v a n t a patient's  they explained  i n the family.  only  by a death  i n t h e f a m i l y would  t h e t a l k o f dead b i r d s by  The f a c t  o f a death  a f t e r i t was r e l a t e d t o a s p e c i f i c  continual  requests  talk  for permission  i n the family  event.  t o do t h i n g s  Finally,  i n the play  room  were seen as documents o f h i s c o n s t r i c t i o n and h i s p o s s i b l e  feelings of  responsibility  f o rh i s father's  n o t have  predicted  a bereaved  that  death  son would  and a t h e r a p i s t c o u l d  ask f o rpermission  t o g e t toys  from the  t o y box. The was u s e d  p s y c h i a t r i c i n t e r p r e t i v e s c h e m a was n o t used p r e d i c t i v e l y , b u t  f o rthe post  patient's  behavior.  explanations  that  status  I h a d some d i f f i c u l t y  These was o n l y  had that  i t .  achieved  continued  a s o l u t i o n t o my  Clearly,  a method  schema a n d  of i t s indefin-  be u s e d  o f t h e schema  "observer's problem".  f o r transforming  The a d u l t  the adult  t h a t were a d e q u a t e  etc.,  t o make t h e s t a t u s  a f t e r a number o f m o n t h s i n t h e f i e l d t h a t  pattern-of-behavior.  satisfactory  what i t w i l l  hoc nature o f  this  implication i s that  i n the  to explain  explain i t .  features  I d i d have  display  An o b v i o u s  o f the post  i n understanding  whereby i t c a n n o t be p r e d i c t e d  n e x t o r how i t w i l l  It  and d e s c r i p t i o n o f r a t i o n a l i t y  I t was p r e c i s e l y b e c a u s e  coming t o terms w i t h ite  hoc discovery  ideology  ideology  allowed  fora l l practical  events  reasoning.  p r e c i s e l y because  they  trade  example, whatever t h e t h e r a p i s t ' s  Accounts  Specifically,  i n t o instances* this  f o r accounts  and  for  that  I  I saw  -of-ame.  explanations  I t a l l o w e d me t o make  sense o u t o f t h e s e t t i n g and i t s e v e n t s  of practical  I discovered  accomplished  purposes.  puzzling.  and, as such,  i s a  a r e adequate, s a t i s f a c t o r y ,  on o u r f o l k wisdom a b o u t a t t r i b u t i o n o f motives  children.  For  t o the patient  181 when he T:  it  told  a patient  that:  I t h i n k mom w o n ' t m i n d us p l a y i n g w i t h That's okay w i t h h e r . was  child  reasonable that  to explain  i t was  alright  children  often get  they  into  get  ation  t h e mucky s a n d  h i s statement  t o go  dirty.  as  an  Perhaps  they  enjoy  Similarly,  to suggest  that  a l l know  therapist's  referring  t h e r a p i s t was  the that  more o f t e n t h a n  the  h a v e some t h e o r e t i c a l the  We  but  although  f o r a p a t i e n t ' s i n c r e a s e d d i s t u r b a n c e by  h a v i n g b e e n w i t h h i s m o t h e r may  it,  water.  to reassure  a h e a d a n d make a m e s s .  trouble for i t .  seems a d e q u a t e  effort  and  not,  explan-  to the p a t i e n t s  grounding,  i t also  a t t e n d i n g to the  influence  4 of parents It  on  the  emotional  i s interesting  that,  of their  in a  provides  accounts  ideology  also provides a reasonable  less  time,  I thought  they If  'theory', As  sense.  say  they  observer's  were so,  are  one  way  theory,  the  o f what i s g o i n g  doing,  the  demonstrated,  these and  on.  i d e o l o g y makes  example, w h i l e  therapists  suggested  expect  a discovery of  i d e o l o g y was  adult  a c t i o n s and  theory,  m i g h t be  this  perfectly  adult  f o r some  i d e o l o g y w o u l d be  a theory to d o — i t  recognize the  that  Regard-  and,  and  i s an  based  techniques,  and,  accounts. on  child's  the  adult  emotional  occasioned  as  a  explains things. o f what  made i n t e r p r e t a t i o n s  e x p l a n a t i o n s were p o s t hoc  interpretation  adult  observer's problem  to view the  objectives,  and  problem.  They e x p l a i n e d t h e i r  terms o f p s y c h i a t r i c  I have  i s theory governed  i t might c h a l l e n g e the p s y c h o t h e r a p i s t ' s accounts  were d o i n g .  explanation  account  d i s c o v e r y of the  f o r i t d o e s w h a t we  a theory  play,  my  solved their this  s e t t i n g which  T h e r a p i s t s t o o h a v e an that  children.  e x p l a n a t i o n s i n terms o f t h a t  o f what t h e r a p i s t s  adequate  how  and  state  as  The  in  I have  'real'  ideology. state  application  they  of  in his the  For  182 special  r e l a t i o n s h i p seen t o o b t a i n  Moreover, w h i l e the  family  their  i n t e r p r e t a t i o n s appeal t o the value  a p p l i c a t i o n s o f the omni-relevance  we w e r e t o t r e a t t h e a d u l t  characteristic  t h a t we c o u l d  dictability.  That  to p r e d i c t behavior however.  oral  expect,  i s , on t h e b a s i s i n the therapy  influences  displays  and thus p r e d i c t t h a t  disruptive behavior  Similarly  o n e c a n n o t assume t h a t  home w i l l  account  or  that  "he to  he c a n n o t "since  influence one's  first  t i o n problems. probable sexual  that  born  first  identification  stay  i s clearly  will  S:  How many c h i l d r e n a r e t h e r e ?  T:  Three  S:  And she's t h e o l d e s t ?  T:  She's t h e y o u n g e s t .  be  able  n o t the case  suggests  emotional  that  and  behavi-  w i t h h i s mother. i n the child's  room.  To say t h a t  swear a s w e l l " ,  be used  Finally,  do n o t a l l o w  t o account  born  I will  with  or that reference  common s e n s e n o t i o n s  status give  about  one t o p r e d i c t  f o r sex i d e n t i f i c a -  t r a n s c r i p t , i tappeared  problems.  pre-  d e l i b e r a t e l y swear i n t h e r a p y " ,  on b e h a v i o r  born o r l a s t  i n the family.  that  i n the therapy  a l l seem a d e q u a t e .  structure  status  one s h o u l d  a c e r t a i n moral environment  swearing  In a previous one's  This  s w e a r s a t home, h e w i l l  of sibling  further  t h e r a p i s t s would blame a p a t i e n t ' s  s w e a r a t home, h e w i l l  everyone  of families.  demand o f i t , w o u l d b e  of the ideology  a p a t i e n t whom we h a v e m e n t i o n e d e a r l i e r ,  that  play.  structure of  way, a  of the ideology,  on a p r o l o n g e d  fora child  i s showing d i s r e s p e c t " ,  the  of  indeed,  i n this  on c h i l d r e n c a n be seen i n t h e i r  unusually  "since  ideology  setting.  One c a n n o t t a k e a f e a t u r e  parental  c h i l d r e n and t h e i r  and t o t h e psycho-developmental needs o f c h i l d r e n , I s u g g e s t e d  t h e y were o c c a s i o n e d If  between  t o be  equally  were adequate  i tagain  here.  accounts  183 S:  The  youngest.  T:  And  there's  S:  Ahhh.  two  ((tone o f r e c o g n i t i o n ) )  While the natives  older brothers.  t h e r a p i s t may  i n terms o f  obvious.  For  present  a psychiatric  e x a m p l e we  The  know t h a t b e i n g  adequacy o f these  I found  their  know t h a t b e i n g  a first  born  t h e r e f o r e the  youngest  a girl  seen the  theory,  some d i f f i c u l t i e s ,  reasonable.  have  child  with  two  oldest child  alternative  two  alter-  adequacy t o child  be  (oldest)  alternative  may  seems  a l s o makes s e n s e b e c a u s e  older brothers  can  make f o r a  we  difficult  situation. The expect of  adult ideology  a theory  competing  ment. peting  In  to  a i d us  alternatives,  the p r e v i o u s  does n o t  in selecting we  should  example  alternatives—first  have t h i s  born  the  discovery of  can  see  hoc  discovery of rationality.  i t d i d not or  last  to  the  see  a  finding,  the  reasons  adequacy o f the of  first  That  a child's  trampoline  p a t i e n t who  accounting born  for a child's  appropriateness having  born.  or  made h i s own  list  that require-  a behavior,  I t allows f o r the  we  com-  one  f o r the  discovery  is  post  of  'logicalness' , properness' , etc. I t allows  us  f o r a sexual i d e n t i f i c a t i o n problem,  in  l a s t born  findings.  status, etc. given  the  and  pop  I t a l s o accounts  appointments;  the  I t allows  death  about h o s p i t a l i z a t i o n  of providing cookies time.  from a  t o choose between  that i s , given  i s i t allows  constriction  anxiety  us  If  What i t d o e s a c c o m p l i s h  i t i s a method o f making  adequacy o f  terms o f e i t h e r  allow  i s appropriate, etc.  'reasonableness' , 'appropriateness'., than  correct alternative  look elsewhere t o s a t i s f y  'appropriate' behavior,  t h a t i t makes s e n s e ,  Rather  the  kind of p r e d i c t i v i t y .  to  of h i s father;  because o f  see the  separation;  for patients;  f o r the  us  the  reportability  necessity for having  a  logic of rule  the  184 about n o t t a k i n g toys to  cover  many o t h e r  Further, allow for of  this  do  note  display.  Obviously  i n this  that the behavior  We  consequentiality;  their  f o ra particular  body  the omni-relevance  states;  age o r s t a g e  c h i l d r e n ' s need  particular  reasonably  these  features.  particularly as  disruptive  developmental  limits,  F o r example,  etc.  behavior  derailment,  f o r a month  ship) .  allows  of  the family  are  reasoning  Any t o many  one t o s u g g e s t  as t e s t i n g t h e  as a r e s u l t  (theomni-relevance  o f having  o f f a m i l y member-  that the display i s a  the p r e d i c t i v e  outcomes, and because  result  power t o s e l e c t  a  the features o f the ideology  i n the setting  and enabled  formed  i t as a  'theory'.^  to find  rationality  t o my o b s e r v e r ' s  t h e b a s i s o f my  me t o c o n s t r u c t a  o f t h e t h e r a p i s t ' s work a n d r e a s o n i n g .  I was a b l e  solution  etc.  i s the ideology?  description  a  t h e awareness o f  f o r by a p p e a l i n g  i t was e x p l a i n e d  What I am c l a i m i n g i s t h a t t h e i d e o l o g y  which  i s seen as  the l i m i t s ,  n o t p r e d i c t a b l e o n a n y o c c a s i o n , we c a n n o t t r e a t  practical  they  environment.  s e t of behavior  What t h e n  since  may b e s e e n a s a n i n s t a n c e o f a c t i n g o u t ,  Because t h e i d e o l o g y does n o t have single  t o a number  i n children  o f development;  be accounted  account  o f f a m i l i e s and  how b e h a v i o r  to test  to  t h e y o u n g p a t i e n t who e n g a g e d i n  As a m a t t e r o f f a c t ,  The i d e o l o g y  be used  as s t a g e - a p p r o p r i a t e b e h a v i o r ,  b e e n home w i t h m o t h e r  room d o e s n o t  we made r e f e r e n c e  the denial of r e s p o n s i b i l i t y  could  c o u l d be extended  displayed i n the play  development d e r a i l m e n t s ;  of  list  setting.  chapter  t a l k e d about  n o t know o r u n d e r s t a n d  behavior  this  features o f the ideology w i l l  In the previous  features.  appropriate  etc.  activities  one t o p r e d i c t w h i c h  these  its  home;  i n the therapy  rational  I t was a r e s o u r c e b y setting.  I t provided  problem b u t not n e c e s s a r i l y t h a t o f the  185 therapists.  How  I Put the Ideology The  realizing my  L e t us l o o k b a c k  reader w i l l that  recall  understandings  aware o f t h i s ,  referred  t o as an " a d u l t  further  that  I put the ideology together  I was a b l e t o make a d e q u a t e  common-sense  that  this  The  started  t o look into  T h i s amounted t o r e c o g n i z i n g t h a t  that  accounts,  this  accounted  the setting's  on  f o r the  o r g a n i z a t i o n , and  t h e r e s e a r c h e r and t h e r a p i s t s  understanding,  r e a s o n a b l e n e s s was b u i l t  framed  families. relation  with this  and most i m p o r t a n t  were t h o s e  I then  shared a  o f motives.  whose  first  After  I began t o t r a n s f o r m events  I suggested  of the therapist's  Starting accounts  this.  . ' p r a c t i c e s ' , ' b e h a v i o r s ' , e t c . were b a s e d  I n o t h e r w o r d s , I saw t h a t  vocabulary  t o accomplish  and used  resource had been p r e v i o u s l y  ideology.  understandings.  reasonableness so o n .  'accounts',  after  of the setting,  ideology of childhood".  instances-of-a-pattern-of-behavior.  common-sense  sense  of children  I noted  instances of this  'explanations',  the ideology.  Together  becoming  for  a t how I a s s e m b l e d  That  group  I accumulated on a normative  o f common  sense  instances of view  accounts  of children. that  I  collected  i n t e r m s o f a c a u s a l r e l a t i o n s h i p b e t w e e n c h i l d r e n andi s , I take  between p a r e n t s  i tthat  i ti s a piece of folk  and c h i l d r e n  wisdom t h a t t h e  i s transparent or easily  available to  us. I instances  referred o f such  to this  as p r a c t i c a l  reasoning i n the therapist's  r e a s o n i n g was a n o c c a s i o n e d a p p l i c a t i o n were o f f e r e d  as an a l t e r n a t i v e  were n o t assembled  r e a s o n i n g and assembled  predictively  work.  of folk  to psychiatric  I showed how  reasoning.  accounts.  b u t were assembled  a number o f  Folk  their  accounts  These i n s t a n c e s  a s t h e y were u s e d .  I  186 began t o of  the  other  see  family such  family's  and  appeared  instances  on.  preventing  patients  appropriate  not  imposed  setting.  able  chapters  research  findings. i n the  now  want t o  the  ideology  assembling display  the  setting,  an  the  the  way  o r .they  this  adult  setting.  be  recalled  c o u l d be  the  s e e n as  me  d i s p l a y the  ideology  events  was  to  the  t h a t would  employed w i t h i n  the  of  the  at  a report  of  ideology  the  my  of  my to  own  reasonableness  instances  I  ideology  I t was  reasoning  as i t  relation  external to the  the  itself.  folk  of  of t h e r a p i s t s .  assembled w i t h i n as  of  look  ideology  not  the  to  the  I used  practical  count  reasoning  way  clarify  was  of was  of  ideology.  clearly  t h i s —  analysis  One  and  see  environment.  recognition  i n the  instances  the  motives,  members made s e n s e  reasoning.  documents o f  and  i t was  a month  practical  this  them) i s a s  ideology  c h i l d r e n t h a t enabled  I discovered  saw  the  that  setting.  I initially  that  noted  o f how  i n the  as  the  for this  ideology  initial.conclusion  the  display of  be  f i n d i n g s c o u l d be  assemble  resource  that  a  a  spent  environment of  documents o f  rather  account  instances  to  that  h i s having  s e l e c t i o n of  I t should  those  and  by  seeing  toys,  etc.  terms  correspondence between  c h i l d r e n , by  'the  in  discovered  c r y i n g , the  of  The  f o r and  documents o f  discovered  (and  formulated  l o c a t e innumerable other  of p r a c t i c a l  about  the  motivated  was  instances  The setting.  ideology  of  knowledge accounts  was  discredit  should  the  be  display of  setting,  to  looked  f a m i l y t h e n became an  o f f e r e d as  I t s use  It  from  i s , my  previous  used  to  from o u t s i d e  t h e r a p i s t s was  setting.  the  behavior,  That  may  and  noting  that of  The  that  I was  age  by  t h a t were  d i s p l a y e d w e r e t a k e n t o be  reasoning,  is  I did this  s t a t e and  so  accounts  reasonable  d i s r u p t i v e behavior  Suggesting  the  the  t o be  instances.  mother and the  a number o f  emotional  patient's with  that  of  the the  therapy  187 ideology  and  c o u l d be  used  as  a document o f  underlying  pattern being  problem.  Having  itself  was  then used to d i s c o v e r  of  notion  the  accounts as  of  only  those  an  upon  a document o f  seeing  the  of  the  a part  an  adult's  what would is  not  properly The  ad  hoeing  This  i n order  suggest  that  i s the  ability  to  i s of  the  that  of  I was  fact.  use  ideology  the  i t was  not  continuous  act of  I was  reported  able  to  aware  to  take  discover  the  ideology  is  possible to p r e d i c t  setting.  The  ideology  f o r making f i n d i n g s . i s open t o  of behavior  itself  ideology  able  pattern  the  I was  Although  i t i n the  further pieces  I initially  felt  that  t h e r a p i s t s were d o i n g ,  ideology,  i t i s now  that  displaying.  I am  construct  observer's  the  While  (the  under  i s the  to provide  continuous its  finding  since  adequate  d i s c o v e r i n g and  auspices. the  accounts  describing  of  rationality  interest.  While what t h e  to  r a t h e r a method  the  s o l v e d my  something which  I found after  able  pattern  pattern,  i n t e r p r e t i v e schema t h a t  to b r i n g  I t i s the  This  underlying  I was  instances  but  to  events. that  i s an  an  o f knowledge",  as  finding  itself).  hearing  only  "stock  count  ideology  i s not  finding  a  ideology and  underlying  additional instances.  ideology.  ideology  come t o  ideology  documents o f  adult  instances of  the  the  ideologyJ  We  the  ideology.  the  continuous  but  the  and  reader  the  ideology  acts  clear that  might  This add  of  of  were a b l e provided  i t i s not  report  the  The  the  the  solution to  is itself that  finding  a  i s of  the  find  are  rationality a very  use  a display of  i t i s not  acts of  to  demonstrate of  the  t h e r a p i s t ' s work b u t  is itself  display itself  to discover a  a way  i.e., displaying their  displaying;  finding.  providing  that your reading  I t i s not acts  I was  the  of  practical  the  the  adult my  work  adult  further display  of  s i g n i f i c a n c e but that  i s of  ways t h e  interest  researcher  setting.  problem.  For The  me,  188 therapists ing,  too have immediate p r a c t i c a l  etc.,)  f o r which  the p s y c h i a t r i c  problems  (in understanding,  interpretive  schema p r o v i d e s  managa  solution. We We  now  h a v e two  began w i t h  appeared  any  and  of  setting  t o have a  "what was  of  the  adult  of  the  'reality' As  accounts as  two  n o t be  has  o f the  are not  therapy  suggested  t o be  seen  as  taken  a replacement  vice-versa).  are demonstrably these  accounts  interpretive  those  accomplish a  used  by  made  These  explicit  a l l o w e d them t o work f o r the  accounts this  apparent  i n order to  I p r o v i d e d an  finding  lack  and  as  a  find  account  description  setting.  competitors. The  Rather,  adult  they  however,  like  ideology i s not  have the  made more s e n s e  to suggest  same s t a t u s  f o r me,  that as  these  s h o u l d be  f o r psychotherapeutic accounts  I w o u l d now and  setting.  schema).  t h e y were seldom  i t as b o t h  same e v e n t s .  similar  and  i n the p r e c e d i n g paragraphs,  of the  as  To  treated  accounts  course,  of  to get behind  in this  as o f f e r e d  s t r u c t u r e which  g o i n g on".  i d e o l o g y and  been  since  events  Because o f t h e s e p u z z l e s and  I attempted  really  status  flexible  every occasion.  rationality,  out  (or, the p s y c h i a t r i c  t o have a p u z z l i n g  and  f o r the  the p s y c h o t h e r a p e u t i c accounts  members o f t h e continued  kinds of accounts  and  (and,  t h e s e two  accounts.  t h e y have e s s e n t i a l  seen should  of accounts  While  one  features i n  common. It ive.  has  been p o i n t e d out t h a t n e i t h e r  N e i t h e r the t h e r a p i s t  nor  the  of these  accounts  are  predict-  r e s e a r c h e r c o u l d know b e f o r e h a n d  what  7 was that  t o become a n a child  child's  i n s t a n c e of the  whose f a t h e r  apparent  had  schema.  died  r e l a p s e s would be  b e e n home f o r a m o n t h .  In both  The  would t a l k  therapists  could not  o f dead b i r d s ,  or that  know a  explained with a reference to h i s having  cases, the  schema e n a b l e s  the  user to  see  189 these events as i n s t a n c e s - o f - a - p a t t e r n - o f - b e h a v i o r . methods f o r the p o s t hoc resources  d i s c o v e r i n g of r a t i o n a l i t y ,  f o r s e e i n g the adequacy, a p p r o p r i a t e n e s s ,  etc. of events. L e t me  They c l e a r l y have the  now  They are  both  and b o t h  are  l o g i c a l n e s s , properness,  same s t a t u s as  accounts.  c l a r i f y the r e l a t i o n s h i p between these two  sets  of  accounts. 1.  I t has  theory was  not  been suggested t h a t my  c o u l d be  i n i t i a l puzzlement w i t h p s y c h i a t r i c  r e s o l v e d by p r o p o s i n g t h a t , as an i n t e r p r e t i v e schema, i t  a p r e d i c t i v e theory  but  a resource  f o r the p o s t hoc  discovery  of  rationality. 2.  Initially,  I t e r m i n a t e d my  noticed that I could provide the a d u l t i d e o l o g y .  And  search  f o r an answer t o t h i s p u z z l e when I  adequate accounts of the s e t t i n g by means o f  t h i s was  a resource  t h a t d i d not  r e l y on  the  p s y c h i a t r i c i n t e r p r e t i v e schema. 3.  I proposed t h a t the apparent r e a s o n a b l e n e s s o f the  explained  through the a d u l t i d e o l o g y which i s a r e s o u r c e  the r e s e a r c h e r , 4.  I t was  s e t t i n g could  t h e r a p i s t s , and  reader  be  that i s shared  by  alike.  proposed t h a t the a d u l t i d e o l o g y  i s a l s o an i n t e r p r e t i v e schema  which i s used f o r the p o s t hoc  construction of r a t i o n a l i t y .  r e s p e c t , both s e t s o f accounts  ( i . e . the a d u l t i d e o l o g y  and  In the  this psychi-  a t r i c i n t e r p r e t i v e schema) are e s s e n t i a l l y the same. 5.  I t was  shown how  the a d u l t i d e o l o g y  as developed h e r e , c o n s t i t u t e s a g  d i s p l a y o f my 6.  We  can now  own  p r a c t i c a l reasoning  ( r a t h e r than t h a t o f the t h e r a p i s t s ) .  propose t h a t the a d u l t i d e o l o g y  the t h e r a p i s t s i n the same way  i s r e l a t e d t o the work o f  as the t h e r a p i s t ' s use  theory  i s r e l a t e d t o the a c t i v i t i e s o f the p a t i e n t s .  allows  me  o f the p s y c h i a t r i c The  adult  ideology  t o make p e r f e c t l y adequate sense o f the t h e r a p i s t ' s work j u s t as  190 psychiatric  theory  accounts of  the  While competition, a d u l t s , we does not not  or  are  relevancies, and  therapist. structing  essential suggest  both  to  the  that  Accounts etc.  of  that  does not  this very  the  was  their  be  The  be  the  the  these  i s the  i t provides  of  a  My  and  not  task,  am  my  for  as  a  the  researcher,  organizational  corresponding I am  I  Therapists'  s o l u t i o n to  adequacy,  i s that  ideology  therapists  s e t t i n g and  researcher's of  the  tasks  of  the  interested in  con-  a key  and  to  the  two  the  and  i t s appeal  ethnography  of patients,  to organizational  make them i n t e r c h a n g e a b l e the  ethnography  separated  They a r e  or  occasioned  use  i n an  in  i t is  assessment. same  of  To  each.  explicate.  situation, intentions,  always o c c a s i o n e d .  therapist i n treating children i s placed  the  alternatives.  i s supposed t o  from the  of  and  i n t e r p r e t i v e schema have t h e  to miss  happens  a c c o u n t o f what happens  behaviors and  a c c o u n t o f what  therapist)  is a therapist's  emotions  author.  adult  therapists.  therapy.  from the  s o w o u l d be  not  only  provided  criteria  behavior  t h i n g w h i c h an can  t h e r a p i s t s were r e a l l y  in  therapist in treating children.  ideology  that  of  treatment procedures  fact  status  i s the  graphy,  the  ( i n c l u d i n g the fact  adequate  were  case.  could  ideology  enterprise  account  t r a i n i n g of  or  foremost of  adult  perfectly  structures  the  ethnography of  a l l differ  and  setting, i . e . , of  Thus,  are  adult  P s y c h i a t r i c theory  responsive  This  the  from the  setting. the  output  to provide  two  that  the  responsibilities,  setting  derives  an  ethnography;  Thus, the  The  the  i s not  or  a l l adults  i n the  First an  that  skills  constructing  that  suggesting  that  ones.  involved  therapists  actions.  I was  see  that  real  placement,  the  that now  allow  have appeared  undermine the  problems  in  i t may  can  problem of  my  child's  suggesting  skills  seems t o  For  organizational  bio-  example, structure,  191 and becomes r e s p o n s i b l e etc.  Further,  to parents,  he o p e r a t e s  s h a r e d by h i s c o l l e a g u e s . portray  what  s y s t e m he criteria the  i s going  i n terms o f c r i t e r i a Further,  the s o c i a l  on i n a s e t t i n g .  i s responsible  for providing  As  other  i s t h e same, t h e p r a c t i c a l  researcher's  a part  of a  a sociological  A c c o u n t s must be  evaluated,  f o r which they provide  understood, solutions.  tasks  community  agencies,  o f adequacy which a r e  o f adequacy which i s shared by h i s academic  setting  tasks  supervisors,  task  i s to  student-university  study  according  colleagues.  of the p a r t i e s  etc. in relation  to a  Although  differ.  to the  practical  192 Footnotes  """H. G i n o t t , " P l a y Therapy: The I n i t i a l Psychotherapy, 15 (1961), p. 3.  S e s s i o n " , American J o u r n a l o f  2 E. H. Hutten, "On E x p l a n a t i o n i n Psychology and i n P h y s i c s " , B r i t i s h J o u r n a l f o r the P h i l o s o p h y o f S c i e n c e , 7 (1956), p. 74. 3 F. Swanson, P s y c h o t h e r a p i s t s and C h i l d r e n : A P r o c e d u r a l Guide. Pitman P u b l i s h i n g Co., 1970, pp. 27-28. 4 I am s u g g e s t i n g t h a t i t i s t h i s r e s o u r c e which gave a sense o f r e a s o n a b l e n e s s t o a l l o f c h a p t e r s one through f o u r . 5 The ' f i n d i n g ' i s t h a t the a d u l t i d e o l o g y enables one t o make sense of t h i s s e t t i n g . 6 I t s h o u l d be c l e a r t h a t I have never s e r i o u s l y suggested t h a t we consider i t a theory; i t i s an i n t e r p r e t i v e schema. 7 T h i s does n o t deny t h a t one can a c t as though the schema i s p r e d i c t i v e . Q  I t i s c l e a r t h a t t o check what I see a g a i n s t my r e a d i n g o f t h e t h e o r y simply has no r e l e v a n c e t o t h e o p e r a t i o n o f t h e c l i n i c . Therefore, I cannot comment on t h e inadequacy o f t h e t h e o r y b u t o n l y on the i r r e l e v a n c e of my assessment o f the t a s k o f t h e r a p y . ' P r e d i c t i v i t y ' i s not required for the task o f therapy. What matters i s t h a t t h e r a p i s t s p o s t hoc use of the schema enables them t o do whatever has t o be done, s a i d , e t c .  CHAPTER  7  CONCLUSION It  may  o f making ing  this  This  study  treat  was no  a l l there  will  be  i s the  I would  like  you  i s t r e a t e d as  and  e x p l i c a t i o n as  the  previous and  chapter  having  The  ideology  said  social  t h a t the  is a practical  as  more.  and  study.  feature  of  and  his What  -  the then,  accomplishment.  production  that nothing  scientist  produc-  informant  a t o p i c worthy o f  a practical  task  sociological  'adult ideology')  of  the  The adult  remained, i . e . ,  'con-man'.  Although  accomplishment  there  i s some  ideology  solution to  residue. that  i s not give  not  be  not  the  have been a  e x p l i c a t i o n of  The  an  was  solution to  the  193  My  i s i t the  ideology  a  same  my  thera-  remains  study.  e x p l i c a t i o n i s that of the  the  power o f  ideology  this  'adult' nor  explication of  a  explanatory  contribution of  that of  i t .  the  r e t a i n e d i s the  The  just  treat  I claimed  i t may  setting.  to  emerging body o f  the  recalled  t h e r a p i s t s may  i t does c o n s i d e r a b l y  ' c o n v i c t code',  further sociological  ideology  himself  the  problem of  explicate a  was  What c a n  in this  an  practical  through  and  problem although  task.  ideology  the  the  that  journey  discover  'discovery'. of  the  i s t r e a t e d as  (a)  i n the  sociological  practical pist's  the  left  production  It  the  was  contention  sense  that this  satisfied  researcher  that discovery  was  further  of  (e.g.,  reader  locatable within  o f making  world  ideology  and  I t i s my  i n which the  impression  the  only  s t u d i e s h a v e done i s  social  there  t o the  in fact  is clearly  experience  these  (b)  sense has document.  research own  have o c c u r r e d  the however  treatment treatment  social scientists= then  as  a  sub-  194 stantive  'discovery'.  Before report.  Recall  setting of  concluding  (and  t h a t on  to children  was  as b e i n g  those  not  immediately  talk  strategies on  and  on  my  first  The  o f a d u l t and  s i n c e the and  one  this  scripts  there with Invoking  of  p s y c h o t h e r a p i s t s w o u l d h a v e an work t h a t w o u l d n o t  make t h e  that  I witnessed  I  had  initially  attributed  the  activity  had  acquired their  producing  of therapy  an  analysis  me  to understand  to  provide  an  a portrayal  psychiatrically  r e l e v a n t and  presented  as  another  way  and  a  sense  away, manage the  of  and  so on. and  This  through  One  to  various  list  could  go  reasonable, look back  could read  'layman'  to  the  I suggested  schema t o a c c o m p l i s h  of events  After  t h a t I had.  all,  training. t h a t I had  tran-~  that  their I  therapists  and  a work  the  recognized  acquired a s k i l l were d o i n g  happenings. schema and  data.  than  setting,  practitioners task  of  which and  I took  enabled  was  this  able to  reconstructed  transform routine events  significant a t the  was  When I b e g a n my  therapists  therapy  this  grounded,  interpretive  to look  and  conversations  t o use  r e a d e r were t o  'expert'  what t h e p a t i e n t s and  t o show how  lead  i n therapy,  obvious.  theoretically  of the p s y c h i a t r i c  I experienced  therapy  w o u l d h a v e t o h a v e more s i g n i f i c a n c e  through  schema i n o r d e r  was  through  same s e n s e  account  of the  i t a p p r o p r i a t e , f o r example,  interpretive  I realised  adequate  etc.)  I recognized  I f the  t o them. .  was  skills  was  activities  this  understanding.  categories of  activities  child  structure of  to greet,  felt  w o u l d be  some l e v e l  the  how  to talk,  viewing  transparency  and  the  common-sensical.  chapter  literature,  child  child  first  of the  reasonable.  a b o u t why the  r e t r a c e the  viewing  a d v i c e on  eminently  for getting  transparent,  the  briefly  exposure t o advice,  i t s reasonableness.  talk  l e t me  Chapter  two  this  into  then  m a t e r i a l s reported i n the  be  was first  195 chapter—a  p s y c h i a t r i c a l l y meaningful way.  With the r e a l i z a t i o n t h a t I c o u l d make r e a s o n a b l e  p s y c h i a t r i c sense  (but n o t do t h e r a p y ) — p r e s u m a b l y i n the same way t h e r a p i s t s d i d — c a m e t h e awareness t h a t t h e accounts on which I had c o n s t r u c t e d t h i s schema made sense because they were common-sensical. d i s c o v e r a p a t t e r n i n those  accounts.  I t was t h i s which enabled In c h a p t e r s  me t o  t h r e e and f o u r then I  c o n s t r u c t e d two f e a t u r e s o f what I r e f e r r e d t o as the t h e r a p i s t ' s corpus o f knowledge which I c l a i m e d was supported children.  by t a k e n - f o r - g r a n t e d - v i e w s  of  Two f e a t u r e s were c o n t i n u o u s l y used t o make sense o f therapy  happenings, namely, the n o t i o n s o f 1) p a t i e n t s as 'normal' c h i l d r e n , and 2) p a t i e n t s as f a m i l y members. Concentrating  on the second n o t i o n , I demonstrated i n c h a p t e r  that i t i s eminently  reasonable  four  t o t h i n k o f c h i l d r e n as f a m i l y members and  I show how accounts o f the f a m i l y a r e used i n t h e s e t t i n g .  The ' f a m i l y '  was used i n many ways, some o f which would n o t have been expected. a resource  to construct conversations,  i n t e r p r e t children's motivations, relevant actions, etc.  It is  o f f e r advice, fashion r e l a t i o n s h i p s ,  e x p l a i n r e l a p s e s , propose  Although i t appeared r e a s o n a b l e  therapy-  t o use t h e n o t i o n  o f p a t i e n t s as f a m i l y members, and t h i s i s a r e s o u r c e we a l l share,  i t was  not a v a i l a b l e t o me beforehand t o know when o r how t h i s would be used. I t was n e c e s s a r y  t o ask the f o l l o w i n g q u e s t i o n :  how was I a b l e t o  c o n s t r u c t t h i s account and d e s c r i p t i o n o f the r a t i o n a l i t y o f the s e t t i n g on t h e b a s i s o f my e x p e r i e n c e  i n the setting?  A l l s o c i a l actors face the  problem o f s e e i n g events as i n s t a n c e s - o f - a - p a t t e r n - o f - b e h a v i o r ,  and presum-  a b l y t h i s i s what t h e p s y c h i a t r i c i n t e r p r e t i v e schema accomplishes f o r therapists.  However t h i s schema was never made e x p l i c i t f o r me.  was a v a i l a b l e t o me was a c o n s t a n t  flow o f accounts which I took t o  What  196 represent me  the  although  p s y c h i a t r i c schema.  the  scenes d i d  I proposed preceding  of  the  those  n o r m a t i v e ways o f  me  see  to  see  events  provided of  events  the  led  one,  atric used  the  seeing  of  i . e . , the  consequences adult  If this to  the  provides  the  f o r the  After  adult  the  t h a t the  making  adults.  provides  providing  and t o go  f o r , or  This  of  I suggested  ideology  was  and  ideology  as  that the  could this  adequacy  seriously I  the  the  well  was  but psychi-  ideology  as  how  relationships.  i t  was had  The  decisions, explaining accounts  the  of  why  relapses,  conversations,  first  was  a display of examine  c o n s t r u c t i n g the a  the  two  of  extensively  reported. the  therapist's  status of  display of  account  t h e r a p i s t ' s d e s c r i p t i o n s and  chapters  employed  the  s o l u t i o n t o my  a d e q u a t e d e s c r i p t i o n and  the  is, I  as  supports,  almost everything  only  allowed  knowledgeable.  back through  in fact  well  controlling  sounding  t h a t we  That  t o e x a m i n e how  adequate  w h a t I t o o k t o be  of  as  the  i n t e r p r e t i v e schemas  justifying  c l e a r that the  activity  sense of  for  ideology—  I claimed  of patient behavior  reasonableness  p r o b l e m o f p r o v i d i n g an i.e.,  adult  treating this  two  understanding,  w e r e now  ideology  reviewing  concluded  not  a resource.for  uncooperativeness, reader  a puzzle  to provide  the  viewing  By  I t h e n w e n t on  competence and  Having presented of  first  are  ideology  explanations  document i t w o u l d be  provide  me  interaction.  o f knowledge.  that there  adult  of  o f my  some p a t i e n t s w e r e d i s c h a r g e d ,  dealing with  by  i n terms o f managing c o n v e r s a t i o n s  ideology  demonstrating  was  c h i l d r e n shared  reasonableness  realization  a source  t h a t what e n a b l e d  adult-child  i n t e r p r e t i v e schema. as  t o be  instances-of-a-pattern-of-behavior.  instances  f o r the  five  setting's rationality  t h e r a p i s t ' s corpus  to  only  as  as  i t continued  not.  i n chapter  account  Hence,  of  the  use  ideology.  ideology  practical  the  accounts.  setting, The  I  197 i d e o l o g y was a n i n t e r p r e t i v e account  of the setting  atric  schema.  then,  but only  of  schema t h a t e n a b l e d  and as such  i s n o t t o be c o n f u s e d  I had not acquired discovered  me t o p r o v i d e  the psychiatric  t h a t I had a resource  psychiatric  responsive  t o very  preparing  the  adequacy o f t h i s  ities  interpretive  different  and  a dissertation  tasks,  schema  f o r making adequate  report).  explanation).  i.e., treating  I t i s this  sense  adult  ideology There  'discovery' time.  enabled  I would  One c a n f i n d  enon—thinking  just  like  i n the s o c i a l  about t h e tasks  t o make s e n s e o f t h o s e  may s a t i s f y  t h e i r patients while the  We  can consider  (religious  h i spractical  problem  this  at this  can replace produces  t h e members o f t h a t c u l t u r e  lives,  To see e v e n t s , behavior,  by  s c i e n c e s o f t h i s phenom-  t h e a n t h r o p o l o g i s t who  While  o f their, everyday  doings.  explore,  schema a s a s c i e n t i s t  ethnography o f a ' f o r e i g n ' c u l t u r e .  etc.)  t h e r a p i s t s t o make  t o mention, r a t h e r than  t h a t one's i n t e r p r e t i v e  pattern-of-behavior  activ-  (description,  u n s e t t l i n g i m p l i c a t i o n s suggested  many i n s t a n c e s  s c h e m a o f t h e members.  going  i n practical  any account  schema e n a b l e d  judging  me t o make s e n s e o f t h e t h e r a p i s t ' s a c t i v i t i e s .  a r e some p o t e n t i a l l y that  were  c h i l d r e n on t h e one hand  embededness  i n understanding  The p s y c h i a t r i c  ideology  (Or f o r t h e r e a d e r ,  sense o f (see i n s t a n c e s - o f - a - p a t t e r n - o f - b e h a v i o r )  are  interpretive  schema and t h e a d u l t  on t h e o t h e r .  t h a t must be c o n s i d e r e d  report,  an  the psychi-  therapist's actions, reports, explanations, e t c . The  the  with  an adequate  the s c i e n t i s t  i s trying  e t c . , as i n s t a n c e s - o f - a -  property  relations,  (and h i s c r i t e r i a  ethnicity,  o f adequacy) b u t  2 it  may n o t r e f l e c t Similarly,  t h e s c h e m a o f t h e member p r o d u c i n g while  Durkheim produced  r a t e s which  saw t h o s e  not  t h e scheme o f t h o s e  reflect  an adequate  those  events, e t c .  account  of suicide  r a t e s as instanees-of-a-pattern-of-behavior who  'commit'  s u i c i d e n o r o f those  this who  may  198 'produce' of  suicides.  3  Finally,  some members o f o u r s o c i e t y  while  to.become p o l i c e m e n  instance-of-a-pattern-of-behavior) those  members make t h e i r  sensitive If to  there  t a s k s we may b e a c c u s e d  i s n o way t o make c l a i m s a b o u t this  accomplishment  i s no c l a i m a b o u t  setting  then.  There  that  the adult  tion  so presented  interpretive  etc.  i n the setting o f having  (an  f o r how  One h a s t o b e  r e p o r t be seen  are simply  a solipsistic  the world.  t o s o l v e my p r o b l e m  responsive  methodology—  In beginning  as having  o f the a c t i v i t i e s i n the play setting  a practical  behavior  may n o t b e a r e p l a c e m e n t  being the discovery o f occasioned accounts  account  There  that  see t h e d e c i s i o n  o f accounts.  t h e two s c h e m a s i d e n t i f i e d  however I s u g g e s t e d first  this  may  as 'class'  choice appear reasonable,  to the location  different  criminologists  this  chapter  two t h e m e s , t h e  which concluded  that the  p r e s e n t e d h e r e i n be seen  as  i n an adequate f a s h i o n .  t h e e x p l a n a t o r y power o f t h e i d e o l o g y i n t h i s  i s a c l a i m however, and t h i s  i s the second  ideology i s a feature o f the s o c i a l world i s a contribution  s c h e m a w h i c h we,  t o our understanding  a s c u l t u r a l members,  share.  theme,  and t h e o f an  explica-  omnipresent  199 Footnotes  See, f o r example, D. Lawrence Wieder, The C o n v i c t Code: A Study o f a Moral Order as a P e r s u a s i v e A c t i v i t y . Unpublished D o c t o r a l D i s s e r t a t i o n , UCLA, 1969; Ken S t o d d a r t , E n c o u n t e r i n g F i e l d w o r k : P e r s p e c t i v e s on the S o c i o l o g i c a l Ethnography. Unpublished D o c t o r a l D i s s e r t a t i o n , U n i v e r s i t y o f C a l i f o r n i a , Santa B a r b a r a , 1975; Bruce K a t z , The P r o d u c t i o n o f an Ethnography. Unpublished D o c t o r a l D i s s e r t a t i o n , U n i v e r s i t y of B r i t i s h Columbia, 1975. 2  . . F o r an i n t e r e s t i n g d i s c u s s i o n o f t h i s see M i c h a e l Moreman, "Accomplishi n g E t h n i c i t y , " i n R. Turner (ed.) Ethnomethodology, Penguin Books, 1974, pp. 54-68. T h i s n o t i o n i s taken from James W i l k i n s , "Producing S u i c i d e s , " American B e h a v i o r a l S c i e n t i s t 14 (1970) 185-202.  200 BIBLIOGRAPHY A l l e n , F.  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