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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., Univ e r s i t y of Saskatchewan, 1961 M.A., University of Saskatchewan, 1970 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY In the Department of .Anthropology and Sociology We accept t h i s thesis as conforming to 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 that 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 my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shal not be alowed without my written permission. Department of ANTHROPOLOGY & SOCIOLOGY The University of British Columbia Vancouver 8, Canada 6 ABSTRACT The 'topic' f o r t h i s thesis was formulated a f t e r many months of doing f i e l d work-in a c l i n i c o f f e r i n g play therapy to disturbed children. I was struck by the f a c t that the organization of a c t i v i t i e s , the therapy t a l k , and the therapist's explanations appeared from the beginning to be common-sensical, transparent, reasonable. I take t h i s reasonableness as the 'topic' and ask how i t was possible f o r me, on the basis of t a l k heard i n the s e t t i n g , to discover and describe the r a t i o n a l i t y of the s e t t i n g — see events, etc., as instances-of-a-pattern-of-behavior, and concomitantly how therapists were able to make t h e i r work appear r a t i o n a l . The data consists of my experience i n the s e t t i n g and more s p e c i f i c a l l y of the t a l k located i n that s e t t i n g . This formulation c l e a r l y locates t h i s t hesis i n an emerging body of l i t e r a t u r e which tre a t s the researchers achievement of making sense as the subject of inquiry. I t i s a study of p r a c t i c a l reasoning, by which I mean to emphasize that psychotherapy accounts were t i e d to the everyday p r a c t i s e s of thera-p i s t s i n ways that are not captured by i d e a l i z a t i o n s of t h e o r e t i c a l accounts, etc. An overlooked feature of those accounts are background expectancies, i . e . , those taken-for-granted views of the world that enable us to see the adequacy of accounts, reasonableness of explanations, etc. It i s proposed that i t i s our taken-for-granted views of 'children' as s o c i a l actors which accomplishes t h i s i n the f i e l d s e t t i n g . This i s re f e r r e d to as an adult ideology of childhood and t h i s notion i s explicated i n r e l a t i o n to the therapy a c t i v i t y . Considerable d e t a i l i s given on the use of one feature of the ideology, the relevance of fam i l i e s i n r e l a t i o n to c h i l d r e n . The adult ideology i s offered as an i n t e r p r e t i v e schema which allows adult actors to continuously make sense of, manage, organize f o r , t a l k to ch i l d r e n . I t i s claimed that t h i s i s an omni-present schema i n the se t t i n g , that, i n f a c t , i t supports what i s re f e r r e d to as 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. I t i s demonstrated that i t i s not simply used to explain patient behavior but i t i s a device f o r managing rel a t i o n s h i p s (showing competence), handling conversations (saying what has to be s a i d ) , explaining relapses and therapy decisions, and so on. It i s then proposed that the adult ideology be seen as a solu t i o n to my p r a c t i c a l t a s k — i t enabled me to make sense of the actions, accounts, explanations of the therapists. 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 allows therapists to make sense of patients. The two schemas are not substitutes for one another then but are responsive to d i f f e r e n t tasks i n the s e t t i n g . We are looking at occasioned a c c o u n t s — t r e a t i n g c h i l d r e n , and understanding t h e r a p i s t s . The claim f o r the explanatory power of the adult ideology i n the s e t t i n g i s then withdrawn. I t i s s t i l l claimed however that the adult ideology i s a feature of our s o c i a l world and the ex p l i c a t i o n offered here should be seen as a substantive 'discovery 1. TABLE OF CONTENTS ACKNOWLEDGMENTS v i PREFACE ' v i i CHAPTER 1 INTRODUCTION: THE SEARCH FOR A PROBLEM 1 C h i l d Therapy as a Puzzle 1 My Induction to the Setting 7 T y p i c a l Sights and Sounds 19 Footnotes. 42 2 THE PSYCHIATRIC'INTERPRETIVE SCHEMA 45 Footnotes 78 3 'NORMAL'CHILDREN AND THE THERAPIST'S CORPUS OF KNOWLEDGE . . . .81 Footnotes 91 4 THE 'FAMILY' AS A RESOURCE FOR PRACTICAL REASONING 93 Patients as Family Members 94 Bringing Notions of 'Mom' and 'Dad' to Therapy 98 Family Structure and Making Sense 105 'Constructing' the 'Family' 110 Making the Motivational Accounts Problematic 115 Family Talk as Management 117 Misbehavables and Permissibles 132 Footnotes 139 i v 5 REASONABLENESS AND THE ADULT IDEOLOGY •. 141 My Discovery of the Ideology 154 Features of the Ideology 156 The Ideology as a Source of Explanations of Patient Behavior • . 163 Consequentiality of the Ideology 166 Footnotes 172 6 THE STATUS OF THE IDEOLOGY 176 Footnotes 192 7 CONCLUSION 193 Footnotes 199 BIBLIOGRAPHY 200 v ACKNOWLEDGEMENT I would l i k e to thank Matthew Speier who i n i t i a t e d my i n t e r e s t i n 'children' as a topic of inquiry and influenced the d i r e c t i o n of my i n t e l l e c t u a l development. A s p e c i a l thanks to Roy Turner f o r keeping me going and leading me to an understanding of analysis without which t h i s document would not have been p o s s i b l e . I would also l i k e to acknowledge the f i n a n c i a l assistance of the Canada Council which made my graduate studies and therefore t h i s research p o s s i b l e . v i PREFACE These remarks are to be taken as " i n s t r u c t i o n s " on how to read the following document. This thesis has the structure of a developing argu-ment and consequently p o s i t i o n s are taken at points only to be abandoned l a t e r . This development coincides i n a d i r e c t way with my development as an observer of the scenes depicted i n the e a r l y chapters. At one l e v e l then, the document i s an autobiographical d e s c r i p t i o n of changes i n the observer over the course of many months i n which I attempted to make some-thing of therapy a c t i v i t y f o r the p r a c t i c a l purpose of producing t h i s d i s s e r t a t i o n . While the substantive i n t e r e s t pursued i s the play therapy events which occur i n a community work s e t t i n g i t i s to be seen as an examination of p r a c t i c a l reasoning. The focus i s on member's accounting procedures which accomplish the e s s e n t i a l task of making a c t i v i t i e s , events, conver-sations, etc., appear reasonable, l o g i c a l , appropriate, etc. I t i s then a study of accounts and t h e i r l o c a t i o n i n the field-work s e t t i n g . While consideration i s i n i t i a l l y given to the accounts of t h e r a p i s t s , the report i s r e f l e x i v e i n that i t s preparation and reading are also seen as worthy of examination. v i i CHAPTER 1 INTRODUCTION: THE SEARCH FOR A PROBLEM Ch i l d Therapy as a Puzzle E a r l y i n my graduate student career I became in t e r e s t e d i n c h i l -dren's t a l k , p a r t i c u l a r l y i n the way i n which adults t a l k to c h i l d r e n . 1 My i n t e r e s t i n t h i s subject prompted me to contact the d i r e c t o r of an outpatient service f o r disturbed c:children and t h e i r f a m i l i e s . P r i o r to resuming my graduate studies, I had worked as a researcher i n the mental health f i e l d and had had some involvement with c h i l d psychotherapists. However, my choice of a f i e l d s e t t i n g was determined p r i m a r i l y by the need fo r a place where I would be able to observe frequent encounters between adults and c h i l d r e n . I n i t i a l l y , I had hoped to be able to discover and describe some of the procedures that adults use when t a l k i n g to c h i l d r e n . The f a c t that t h i s t a l k was to take place during "therapeutic" encounter was not consid-ered important. That i s to say, I f e l t that the procedures that I was looking f o r would occur regardless of the function of the contact. I also suspected that a s e t t i n g which included p r o f e s s i o n a l psychi-a t r i s t s , s o c i a l workers and psychologists working with disturbed c h i l d r e n would present obvious problems f o r a 'layman 1. I was n a t u r a l l y appre-hensive about how I would explain my s o c i o l o g i c a l i n t e r e s t i n therapy and, more importantly, how I would be able to make sense of the procedures and 'professional t a l k ' which I expected to encounter. I t seemed appropriate to expect a s p e c i a l i z e d s e t t i n g to include knowledge, vocabulary and 1 2 s k i l l s which the 'layman' would be unfamiliar with. Therefore, and i n order to prepare myself for my f i r s t meeting with the d i r e c t o r , I attempted to learn something about psychotherapy with c h i l d r e n . I returned to an i n v e s t i g a t i o n of t h i s l i t e r a t u r e over the following weeks and months as I became acquainted with the c l i n i c and i t s a c t i v i t i e s . These f i r s t explorations of the how-to-do psychotherapy manuals d i d l i t t l e to r e l i e v e my anxiety as I repeatedly found the warning that psycho-therapy with 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 under-taking, something which even a f u l l y trained p r o f e s s i o n a l should approach with care. For example: Even a highly t r a i n e d c l i n i c i a n with many years of experience i n adult therapy 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 to engage i n c h i l d therapy unless he has had supervised preparation f o r work with c h i l d r e n . 2 And: Psychotherapy with ch i l d r e n i s , i n many respects even more d i f -f i c u l t than therapy with adults, and requires extensive study and considerable supervision to master.3 Or: Students often f i n d that work with c h i l d r e n r a i s e s issues and t e c h n i c a l problems which never occurred i n t h e i r contacts with adults.^ And i n t e r e s t i n g l y : You may have to have been a c h i l d within your own conscious mem-ory to be able to t a l k comfortably with a c h i l d . ^ Thus, while I believed that there were c e r t a i n things to be discovered i n therapeutic encounters—as i n any other a d u l t - c h i l d c o n t a c t — i t was with some unease that I embarked on my f i r s t v i s i t to the children's c l i n i c . For one thing, I feared that I might well have to be a 'therapist' i n order to make proper sense of the events which I wanted to study. Before t a l k i n g about my induction to the therapy s e t t i n g , I would 3 l i k e to r e l a t e some of the advice that I discovered i n the l i t e r a t u r e , and discuss some of the d i f f i c u l t i e s that I had i n l o c a t i n g that l i t e r a t u r e . Since I knew l i t t l e about the s e t t i n g , I f e l t that I should under-take an examination of the l i t e r a t u r e i n order to improve my forthcoming presentation. This examination proved i n t e r e s t i n g . I began with the common-sense notion that I would f i n d the material I wanted indexed under "psychotherapy - c h i l d r e n " . My search d i d not prove f r u i t f u l u n t i l I discovered that most of the information that I wanted was to be found under "children -psychotherapy". I f one looks under psychotherapy, 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 of materials relevant to adults. S i m i l a r l y , i f one looks at textbooks of psychiatry, he w i l l t y p i c a l l y f i n d only passing references to the s p e c i a l problems associated with c h i l d psychiatry. The l i t e r a t u r e r e f l e c t s a set ^  which i s made up of psycho- therapy and c h i l d psychotherapy, psychiatry and c h i l d psychiatry. Con-' t r a s t t h i s with a set of psychotherapy-adult, c h i l d ; or adult psychother-apy and c h i l d psychotherapy. In retrospect t h i s 'discovery' appeared to r e f l e c t the way other aspects of our world are organized, i . e . , there i s 6 the world and there are ch i l d r e n . My f i r s t examination of the l i t e r a t u r e also revealed a number of d i s t i n c t p e r s p e c t i v e s — p s y c h o a n a l y t i c descriptions of psychotherapy, b e h a v i o r i s t i c descriptions of problems, theory and advice f o r doing play therapy, general advice on how to t a l k to and interview c h i l d r e n , e t c . A f t e r my f i r s t v i s i t , I received some i n s t r u c t i o n s on how to process these d i f f e r e n t perspectives. I learned that the c l i n i c p a r t i c i p a t e d i n a s p e c i a l form of therapy c a l l e d "play therapy". In subsequent weeks I learned that t h i s was also r e f e r r e d to as " r e l a t i o n s h i p " or "non-directive" therapy, and that some of the respected 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 , 8 R. Moustakas, 9 and H. G i n o t t . 1 0 These i n s t r u c -tions were not given s t r i c t l y as " i n s t r u c t i o n s " , but references to these authors and others occurred i n the construction of explanations, d e s c r i p -t i o n s , etc. I f e l t safe i n assuming that there was some r e l a t i o n between reference to these authors, "theories", and the organization of the l i t e r a t u r e . I t i s a common occurrence that an author w r i t i n g about psycho-therapy with c h i l d r e n sets up the process as problematic because of the f a c t that the p a t i e n t i s a ' c h i l d ' , ( i . e . , i s not an a d u l t ) , and goes on to l i s t some of the s p e c i a l problems which he sees and, by 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 , to o f f e r solutions for them. The psychotherapist may suggest that: A primary diffe r e n c e between adults and c h i l d r e n must be recognized. This i s that a c h i l d requires much wooing and g i v i n g . The examiner must use many words expressing reassurance, i n t e r e s t , and p r a i s e . For example, he might say, "What a t a l l b u i l d i n g you have made"; "You got that r i g h t on the t a r g e t " . H I t seems reasonable to p r a i s e , humor and encourage the c h i l d , and to t r y to make h i s a c t i v i t i e s appear to be successful. I was to see t h i s frequently i n the form of p r a i s i n g the c h i l d ' s appearance and h i s play a c t i v i t i e s , a s s i s t i n g him with a c t i v i t i e s to insure success, or, perhaps, not keeping score i n dart games, etc. In a s i m i l a r manner, another author suggests that: Interviewing young chi l d r e n usually requires a good deal of verbal a c t i v i t y on the part of the t h e r a p i s t . Adults, a f t e r a b r i e f introduction to an i n i t i a l interview, w i l l commonly t a l k for long periods, twenty to t h i r t y minutes not being unusual; c h i l d r e n may say only a sentence or two spontaneously.-'-2 I observed t h i s i n d i f f e r e n t strategies designed to get the c h i l d to t a l k ; common among these was something l i k e , "can we make up a story about the general", or "what's going to happen next?" 5 In terms of therapy techniques we are informed that: ... play a c t i v i t y i s the c h i l d ' s native t ongue—his natural way of showing how he f e e l s about himself and the s i g n i f i c a n t persons i n h i s l i f e . The t h e r a p i s t must be able not only to comprehend play language but also to communicate h i s understanding c l e a r l y to the c h i l d . 1 3 I am c e r t a i n that the reader i s not surprised to f i n d that play i s a form of therapy or that i t i s used and recognized as a s p e c i f i c therapeutic technique. As parents and adults we know that a s p e c i a l r e l a t i o n e x i s t s between the c h i l d and h i s play. While the l i t e r a t u r e suggests that some parents are upset because they f e e l that t h e i r c h i l d r e n are coming to the 14 c l i n i c " j u s t to play", they can reportedly be s a t i s f i e d with an account which shows how the c h i l d e i t h e r uses play to work out problems from h i s past by r e p e t i t i o n , or by constructing a microcosm of h i s world anti c i p a t e s h i s worries. While I d i d not witness a parent making' t h i s p a r t i c u l a r 'complaint', therapists t o l d me that i t d i d i n f a c t happen. One t h e r a p i s t was even i n s t r u c t i n g a parent i n how to make p s y c h i a t r i c sense of h i s c h i l d ' s p l a y — w h i l e the parent observed h i s c h i l d from behind a one-way mirror. In a s i m i l a r fashion, s o c i o l o g i s t s since the work of G. H. Mead have taken i n t o account the function of play i n the emergence of the c h i l d ' s ' s e l f ' . " - ^ This i s s t i l l a strong t r a d i t i o n i n the s o c i a l sciences as witnessed by the recent writings of people l i k e N. Denzin 1^ and B. Sutton-17 Smith. The play of c h i l d r e n i s seen as such a strong and c o n s t i t u t i v e feature of childhood that i t i s a resource which can be examined by 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 , etc. In terms of understanding the patient 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 adult point of view and yet, from the c h i l d ' s frame of reference, he i s communicating something of 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 literal-minded 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 ordering i t i n t o adult meaningfulness might well be l o s t at times.^ 8 and: The world which the c h i l d constructs between the ages of four and eight i s dynamic, menacing, animistic and governed by i r r a t i o n a l c a u s a l i t y . Inanimate things are not only a l i v e and f u l l of con-sciousness, but they are also motivated and able to punish. I t i s a world i n which moral laws are exacting and s e v e r e . ^ Or: Well-established mature adults who have put c h i l d i s h things once and for a l l behind 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 other points of view. Not only i s the content often b i z a r r e , but the thoughts are frequently jumbled together and juxtaposed, and non-sequitur i s a normal part of speech. This q u a l i t y of syncretism can be extremely di s t u r b i n g and lead to a great deal of confused understanding on the part of the a d u l t . ^ u These pieces of advice appeared reasonable to me, as I am sure they do to the reader, and i t became apparent that t h i s reasonableness had something to do with our subscription to a model describing the 'normal c h i l d ' . Although the i n s t r u c t i o n s above t e l l us how to deal with d i s -turbed patients, a large part of those i n s t r u c t i o n s are framed i n terms of children we a l l know—the normal c h i l d . These accounts sound reasonable to us because, as members of the c u l t u r e , we a l l share some knowledge of what chi l d r e n are l i k e . I s h a l l conclude t h i s review of what how-to-do-psychotherapy manuals sai d about making sense of the c h i l d - a s - p a t i e n t with a couple of points which demonstrate that t h i s advice also included information on how to t a l k to c h i l d r e n . I t i s not j u s t a matter of knowing how 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 addition to t h i s , a large part of the advice t e l l s the reader how to handle and manage them. For example: Most chi l d r e n should be given several minutes notice that the end of the session i s coming.2-'-7 And: Some c h i l d r e n l i k e t h e i r words sounded back to them without change, l i k e an echo. 2 2 Or: When the the r a p i s t meets the c h i l d f o r the f i r s t time, he greets him with a b r i e f h e l l o , dispensing with formal introductions and s o c i a l amenities. He does not comment about the weather or about how nice i t i s to get acquainted. He does not describe to a t e a r f u l c h i l d the wonderful toy room, nor does he ask him i f he would l i k e to come to the play-room. The th 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 leading the c h i l d to the room by saying to the mother, "Johnny and I are now going to the playroom". He extends h i s hand to the c h i l d and o f f they go. . . . Some of the gambits used i n play therapy are undesirable because they convey hidden accusation and threats to c h i l d r e n . The question, "do you know why you are here?" may imply to the c h i l d , "You would not be here i f there were not something wrong with you". . . The statement, "I wish you would t e l l me what bothers you" does not make sense to the c h i l d . . . . The statement, "Don't you have some questions you want to ask me about why you are here?" w i l l most probably bring a b r i e f "no" and an end to the conversation. When chi l d r e n do not know the th e r a p i s t they have no reason to t r u s t him, eit h e r with questions or with answers. 2^ Now that I have given the reader a b r i e f introduction to the 'problems' of c h i l d psychotherapy (as formulated by members of the profes-sion) , and a sample of some of the advice on how to handle the problems which someone who works with c h i l d r e n i n a therapeutic environment might have, I would l i k e to give an account of my induction to the s e t t i n g . My Induction to the Setting The c l i n i c i s a sprawling array of governmental buildings surrounded by spacious lawns and large wooded areas. From the parking l o t a small play area i s v i s i b l e and, upon approaching t h i s , one can make out a sign reading "Children's C l i n i c " . As I was to discover l a t e r , the children's c l i n i c i s only a small part of the programs conducted at t h i s complex. Upon entering the c l i n i c one approaches a r e c e p t i o n i s t who i s located so as to control access to the o f f i c e and the program area of the b u i l d i n g . Next to the r e c e p t i o n i s t ' s desk i s a waiting area which i s 8 equipped with l i g h t reading material including, as might be expected, a s e l e c t i o n of c h i l d - r e a r i n g pamphlets. A waiting room obviously equipped for the use of c h i l d r e n i s situated behind the r e c e p t i o n i s t ' s desk, and ahead of 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 with many doors. Over some of these doors were e l e c t r i c signs saying "do not enter" (which, as i t turned out, were never used). Other doors were marked "observation room", " k i t ( r e f i l l ) supplies", and "toy storage room". I t would be a common experience for a v i s i t o r to see adults carrying toys from one room to another, p u l l i n g a wagon f u l l of toys, pushing a sand tray across the f l o o r , or escorting a c h i l d i n or out of one of these rooms. One would often see c h i l d r e n playing i n the c o r r i d o r s with guns and h o l s t e r s buckled on, r i d i n g a t r i c y c l e , pushing a d o l l carriage, crying, running, t a l k i n g to the r e c e p t i o n i s t , or p a t t i n g a dog. I was to become very f a m i l i a r with t h i s area over the next year. This was the main play therapy area. I: w i l l have more to say about i t l a t e r . Upon a r r i v a l I presented myself to the r e c e p t i o n i s t who checked to see that my name was i n the d i r e c t o r ' s appointment book and then announced me to h i s secretary. I was d i r e c t e d to a waiting room on the second f l o o r . As I proceeded to the second f l o o r waiting room I gained the impression that the c l i n i c was very quiet. There were many empty o f f i c e s and my only company i n the waiting room consisted of a few toys, back issues of T.V. guide and some children's magazines. At t h i s point I had not seen even one c h i l d . Upon our meeting the d i r e c t o r suggested that we tour the f a c i l i t i e s . During our tour he talked about the c l i n i c and I talked about my i n t e r e s t i n the c l i n i c . I t happened that the p r o v i n c i a l minister of health was also scheduled to make h i s f i r s t tour of the f a c i l i t i e s that day (this 9 may have accounted f o r the absence of children) and t h i s became both a point of discussion and a ve h i c l e f o r t a l k i n g about the future of the c l i n i c , about governmental attitudes towards i t , and so on. I learned that t h i s service complex was known as the B r i t i s h Columbia Youth Development Center and was a community service f o r ch i l d r e n and adolescents ( i . e . , those under the age of 17) with psychological, s o c i a l and learning problems. The core of the program can be traced back to a C h i l d Guidance C l i n i c which was started i n Vancouver i n 1932. While r e t a i n i n g some of the structure, the present c l i n i c appeared to be 24 involved _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 large program areas. Each of these enjoys a great deal of autonomy and each has i t s own d i r e c t o r . The programs consist of (a) a r e s i d e n t i a l u n i t which provides intensive psycho-l o g i c a l treatment f o r up to 45 adolescents; (b) a psychological education c l i n i c f o r chi l d r e n and adolescents .who are doing poorly i n school because of emotional, behavioral or perceptual problems and need a s p e c i a l i z e d school s e t t i n g and/or extensive psychological examination; and (c) a family and children's c l i n i c which operates b a s i c a l l y as an out-patient service f o r c h i l d r e n and f a m i l i e s . I t was the d i r e c t o r of the Children's C l i n i c that I was t a l k i n g to and i t was t h i s service that I was to be involved with over the next year. Henceforth I w i l l use the term " c l i n i c " to r e f e r to only the Family and Children's C l i n i c . The c l i n i c provides a wide range of se r v i c e s . Its services include speech therapy, diagnostic and consultation s e r v i c e s , a preschool centre, a team which t r a v e l s to areas of the province without youth services, a community team of s o c i a l workers operating out of a community health centre, 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 service f o r 10 community service personnel, a family therapy program, a treatment program for c h i l d r e n , and even a summer camp. I t was the apparent decreasing p r i o r i t y given to d i r e c t treatment services that stimulated the i d e n t i t y c r i s i s f e l t by some s t a f f members, and throughout the course of my f i e l d work, there was much t a l k about the p o s s i b i l i t y that the c l i n i c might be 25 turned i n t o a s t a f f t r a i n i n g centre. I explained to the d i r e c t o r that I was i n t e r e s t e d i n learning about how adults t a l k to c h i l d r e n . Tentatively, I proposed that c h i l d r e n could be and are seen as " 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 that t h i s may represent an i n t e r a c t i o n a l problem for - 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 discover some solutions i f I could examine t h e i r t a l k . This proposal was met with'understanding and enthusiasm for the d i r e c t o r i n t e r -preted my i n t e r e s t as a concern with the features of communication. He saw 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 that i f one could discover the properties of "therapeutic communication", these properties could be taught to parents and to teachers and t h i s might decrease the chances that these adults would undo the b e n e f i t s which the ch i l d r e n derive from therapy. Like the psychotherapy manuals, he appeared to suggest that there are 'good' ways and 'bad' ways to t a l k to c h i l d r e n , and that psychotherapists have, out of necessity, developed a 'good' way of t a l k i n g to them. He appeared interested i n , saw as problematic, and saw me pursuing these features and t h i s prompted me to return to the psycho-therapy manuals to determine what therapists see as problems i n t a l k i n g to c h i l d r e n and what advice they have to o f f e r . I also intended to f i n d out what the therapists i n the c l i n i c saw as t h e i r problems, and to look at how they a c t u a l l y talked of t h e i r p a t i e n t s . If I could discover the features of t h e i r t a l k that were s p e c i f c a l l y designed for c h i l d r e n , I f e l t 11 that I would have something. The d i r e c t o r gave me complete access to the c l i n i c . I was able to become involved with the s t a f f i n the d i r e c t service program, and I decided to concentrate on those therapy settings that included c h i l d r e n who were o l d enough to be reasonable speakers (and could thus be heard and recorded). I wanted to p a r t i c i p a t e i n the therapy i n a way that would cause as l i t t l e d i s r u p t i o n as p o s s i b l e . One of the play rooms was equipped with a one-way mirror and with audio-recording equipment and I was given access to t h i s area. I t turned out that the a m p l i f i e r and tape recorder were not functioning properly and the d i r e c t o r undertook to have the equipment improved. L i t t l e regular use had been made of the o l d equipment, but others used the observation room more frequently a f t e r I a r r i v e d . During my f i r s t v i s i t the d i r e c t o r helped me to get started on my f i e l d work. He introduced me to another s t a f f member who was a c t i v e l y involved i n play therapy with c h i l d r e n . She was excited about her work and showed great enthusiasm at the prospect of having someone observing her at work, and was anxious to t a l k about the s k i l l s involved i n therapy, about c h i l d r e n , about problems, etc. She soon became my greatest source of information. The d i r e c t o r also i n v i t e d me to observe a diagnostic session that he had scheduled with a new. patient f o r the following week. This c h i l d was involved i n another c l i n i c program and the d i r e c t o r had been asked to see him i n order to provide advice for other s t a f f members. I t happened that the play room which was attached to the observation room was not a v a i l a b l e the following week so the t h e r a p i s t suggested that I simply s i t i n the play room i t s e l f . He i n s t r u c t e d me to s i t i n a corner, f a r enough away to be removed from the centre of 12 a c t i v i t y but not so f a r that i t might appear that I was hi d i n g . This was my f i r s t experience with a the r a p i s t t a l k i n g to a pa t i e n t . I have reproduced some of the f i r s t minutes of that session so the reader can share my experience. I. 1 1. T: ( ) a man who works with me sometimes. 2. R: Hi. 3. C: Hi. 4. T: That's Gary, t h i s i s Franz. ((pause)) Would you l i k e to keep your jacket on or would you l i k e to take i t o f f ? 5. C: ( on ) 6. T: You w i l l leave i t on, sure. What I thought we would do i f we could spend a l i t t l e time together and we would play together and then when we spend some time I could take you back to your classroom. 7. C: Okay. 8. T: Do you go back home at lunchtime? ((pause)) Do you have lunch here? 9. C: No. 10. T: Where do you go f o r lunch? I I . C: I don't know. 12. T: Do you, where do you usually go for lunch. ((pause)) Do you go home? 13. C: No. 14. T: No. ((pause)) Well we can ask Mrs. ( ). I'm interest e d to know what you have done to your head. ((pause)) What happened? 15. C: Don't know. 16. T: ( ) would you l i k e to have a look through t h i s to see what we've got 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 cars. ((said i n enumerative voice)) 17. C: I'm going to play with t h i s . 13 18. T: Okay. That's a truck. ((pause)) I think I ' l l get a l i t t l e c h a ir and s i t down. ((pause)) Maybe I can help you with some of the toys. ((long pause)) What else can we see. ( ( c h i l d i s s t a r t i n g to take toys out of the box.)) 19. C: I don't know. ((pause)) I can see t h i s . 20. T: That's a red car. ((long pause while c h i l d plays with car)) 21. T: I t ' s stuck i n the, stuck i n the sand. ((pause)) Is i t ? 34. C: ( ) I'm going to get t h i s . 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 are dead i t takes (you) at the h o s p i t a l . 39. T: When a guy i s dead i t takes them to the h o s p i t a l . ((long pause)) What's i t going to do here? 50. T: Now I wonder what t h i s i s . 51. C: Don't know. ((pause)) What i s t h i s ? 52. T: I t ' s the same sort of thing as t h i s . ((points to ambulance)) but i t ' s one that's used by the army, by the s o l d i e r s . 53. C: ( ) 54. T: These men can bend. 55. C: ( ) What's th i s ? 56. T: What do you think i t might be? 57. C: Don't know. 58. T: We can guess can't we. 59. C: A ship. 60. T: A ship. ((pause)) itmThmmm (+) 75. T: What i s t h i s , do you know? 76. C: Po l i c e car. 77. T: Yea, but 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 getting 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. ((said s o f t l y ) ) 143. T: Have you got a car? 144. C: Yea. 145. T: Can you t e l l me about your car? 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 color i s i t ? 152. C: I've got a whole bunch. 153. T: A whole bunch of, 154. C: Cars. 155. T: Cars. 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 h i s toys.)) Before showing how the ther a p i s t was able to use t h i s t a l k to construct a diagnosis, or at l e a s t to formulate a problem, I want to make 15 one observation that I think the reader w i l l appreciate. That i s , the conversation above does not sound strange or e s o t e r i c , rather i t sounds very much l i k e an adult t a l k i n g to a c h i l d . Although we may be strangers, we can follow the session and make some sense of i t — i t sounds reasonable. Perhaps I should also point out that i t i s possible to see a number of the points which were r e f e r r e d to i n the l i t e r a t u r e operating i n t h i s short t r a n s c r i p t . A short time a f t e r observing t h i s play session I joined the thera-p i s t as he t r i e d to make some observations about the c h i l d that would be suit a b l e f o r a report. I Used t h i s opportunity to discover what sense he had been able to make of the c h i l d ' s play and t a l k . The following 2 6 then are some observations the the r a p i s t reported to me. 1.2 R: I see, he was going through the box the whole time, sort of that same old thing of taking out toys and, T: That's r i g h t . There's no sort of, there's no exploration of the room. He s e t t l e d down to t h i s p a r t i c u l a r task f o r the whole time without much reference to anything else going on around him. Now whether your presence was l i m i t i n g or not I don't know. Uh, maybe to some extent. But compared with the sort of behavior which most seven year olds show when, i f they came in t o t h i s room, for example, i s c e r t a i n l y a wider range of s t y l e s i n the playroom. But, there'd be much more looking around and exploring, and asking questions. 'Gee look at t h i s ' , or some surprise or excitement. R: Even on the i n i t i a l v i s i t to the room? T: Yea, r i g h t . Oh yea. . . . And I'd r e a l l y rate t h i s k i d as being quite f a r along the i n h i b i t e d scale, 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 think he may be depressed--at t h i s t i m e — t h i s k i d . And there are one or two clues here; the theme of gett i n g stuck, the stuck f e e l i n g , with the need f o r some rescue, and the odd l i t t l e thing l i k e the ambulance, the reference to the dead, where the guy then takes him to h o s p i t a l . There was something else I think. Maybe i t ' s j u s t these few clues. Ah, the so r t of thing that t h i s play wasn't going anywhere. There was no, there was very l i t t l e l i f e to i t . I t was p a r t l y , well we'll come to that, i t ' s p a r t l y the r e c i t a t i o n , i t was the naming process. Perhaps t h i s may be another problem altogether 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 the moment but with the p o s s i -b i l i t y that the i n h i b i t i o n may be part of the depression. This gives an i n d i c a t i o n of my f i r s t involvement with a therapy session. I f e l t that some important discoveries might be made i f only I could get . behind the surface l e v e l of t h i s t a l k so I returned to the manuals i n an attempt to learn what sorts of things therapists attend to when t a l k i n g to ch i l d - p a t i e n t s . Having been granted access to the c l i n i c , I approached some of the members of the s t a f f who were using the play rooms on a scheduled basis. I observed and taped therapy sessions on a regular basis and often talked with the therapists about t h e i r work. I also learned a great deal on occasions such as coffee breaks, i n post session conferences during which the therapist would report on what happened that day, i n conversations p r i o r to a session i n which I would be i n s t r u c t e d by the s t a f f on what to look f o r , and on those occasions on which I overheard a member of the s t a f f g i v i n g descriptions or accounts of problems, pa t i e n t s , or procedures to another member. In addition to these, there were scheduled contacts during which I asked questions about play 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 , t h e r a p i s t ' s actions, etc. I attended the c l i n i c on a f a i r l y regular basis f o r a period of 18 months and, during that time, I observed over 50 therapy sessions. These were usually conducted by s o c i a l workers but often included a p s y c h i a t r i s t and/or student t h e r a p i s t s . T y p i c a l l y , I would v i s i t the c l i n i c once a week i n order to follow a p a r t i c u l a r patient through a therapy program. However, I would also t r y to observe other sessions, v i s i t with t h e r a p i s t s , read case f i l e s , etc., during my v i s i t . I encountered two major methodological problems. Although both of 17 these are common problems i n 'observational' studies they should perhaps be noted here. The f i r s t of these was the l i m i t a t i o n s that were placed on my a c t i v i t i e s as a r e s u l t of the way i n which my r o l e i n the s e t t i n g had been defined. I n i t i a l l y I had described my p r o j e c t i n terms of the 'talk' that occurred i n the therapy room, and the s t a f f had interpreted t h i s as an i n t e r e s t i n communication. Much l a t e r i n the study, I decided that I would l i k e to observe a wider range of a c t i v i t i e s and expressed some c u r i o s i t y about how the intake committee di d i t s work. I wondered how r e f e r r a l s were made to the centre, how the intake committee judged a p p l i -cants as to s u i t a b i l i t y , etc., and how applicants were s l o t t e d i n t o an appropriate program. The d i r e c t o r agreed that I should be allowed to attend a meeting of the intake committee (of which he was a member). Although I was only s l i g h t l y acquainted with some of the members on t h i s committe, they a l l had some idea of who I was and what I was doing i n the c l i n i c . They expressed some bewilderment about my 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 could not see how t h e i r doings here were r e l a t e d to 'communication'. I sat through one meeting but my presence caused so much tension that I decided not to attend any more meetings. I f e l t that to have continued would have required a r e d e f i n i t i o n of my research i n t e r e s t s . On another occasion, my r o l e became r e s t r i c t e d because of thera-peutic necessity. During the f i r s t few observation sessions, the t h e r a p i s t made i t a point to inform the patient a week i n advance that he or she was going to be observed. He then followed t h i s up by introducing me to the patient on the day on which the f i r s t observation was to take place. This procedure allowed the c h i l d to f e e l secure that I was not a policeman or parent. The c h i l d was also shown the play room from my 18 vantage point behind the one-way mirror so that he would know exactly what I was able to see. The f i r s t p a t ient that I observed continued to perform for me for a few weeks, to ask about me, and to t r y and look through the mirror. As a r e s u l t of t h i s , the t h e r a p i s t suggested I avoid the c h i l d i n the h a l l s whenever poss i b l e . This meant a r r i v i n g e a r l y and leaving the observation room a f t e r I was sure that the p a t i e n t had departed for home. Eventually I was forced to.discontinue observing t h i s c h i l d because of the p o t e n t i a l for interference with h i s therapy. While t h i s d i d not appear to be a problem with future p a t i e n t s , I continued to avoid them outside of the therapy room. Both the t h e r a p i s t and researcher assumed that i f the p a t i e n t d i d not see me he would not be reminded that someone was behind the mirror. I t was also assumed that the c h i l d would not have a category structure a v a i l a b l e to him that could provide a safe i d e n t i t y f or me. Without ch a r a c t e r i z i n g the p a t i e n t as 'paranoid' i t was taken that the c h i l d could only conceive of the person behind the mirror as someone there to check up on him. Since I never knew when a c h i l d who I was observing might be i n the h a l l s , I found that I was unable to observe the c h i l d r e n i n areas outside 27 of the therapy room. To have done so may have jeopardized my welcome. While these may be construed as l i m i t a t i o n s , they are also pertinent examples of the problem of managing one's r o l e i n the construction of an 28 ethnography. Much l a t e r , I expressed a desire to t a l k with some of the patients or with an ex-patient i n order to discover something about the children's own conceptions of therapy. I was discouraged from doing the former because i t might i n t e r f e r e with the therapeutic process. I was also t o l d not to attempt the l a t t e r because of the danger of " r e a c t i v a t i n g " the 19 c h i l d ' s problem at a time when he would have no one to help him though i t . This was not s t r i c t l y speaking fear of a 'relapse', but rather a concern that the c h i l d might " r e l i v e " the therapy experience and then re-experience his anxieties, worries, fears, etc. were he to be engaged i n such a con-versation . Although I continued to see my problem as that of the 'talk' that goes on between the th e r a p i s t and patient, I continued to accumulate a great deal of information about the operation of the 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 conversations with the th e r a p i s t s . Without r e a l l y knowing why, I continued to t r y to make as much sense as possible out of the larger s e t t i n g . This non-therapy-room material was to prove i n s t r u -mental i n the r e d e f i n i t i o n of my problem at a time when most of my f i e l d work was over. T y p i c a l Sights and Sounds In t h i s section I would l i k e to introduce the reader to some of those things that 'anyone' might hear, see, understand, i f they spent even a short time i n the c l i n i c . Drawing on my experience, I w i l l report what I take to be t y p i c a l sights and sounds of the therapy s e t t i n g . While I was waiting to see the d i r e c t o r one afternoon, h i s secretary/ 29 r e c e p t i o n i s t began to t e l l me about the patient who was being seen. His v i s i t was 'reportable' because of the way he had come to have an appoint-ment on t h i s p a r t i c u l a r afternoon. The c h i l d had telephoned the centre and asked to see the doctor. This was apparently a regular p r a c t i c e f o r t h i s patient. The t e l l e r and the researcher saw t h i s as a 'reportable' event because i t stood i n marked contrast to the regular procedure by which patients appeared at the c l i n i c . The unusual nature of t h i s event gave i t a q u a l i t y of being 'cute'. This drew my attention 20 to the procedures by which patients t y p i c a l l y came to the c l i n i c . Children do not make themselves p a t i e n t s . Their parents or guardians, usually on the advice of teachers, courts, or doctors act as intermediaries. Parents arrange for r e f e r r a l s , v i s i t the c l i n i c to explain the problem-with-their-child, make appointments, and see that the c h i l d appears, and sometimes they become patients themselves. Unlike most adult patients, the c h i l d i s not a voluntary p a t i e n t . I n t e r e s t i n g l y , i n contrast to a caseload of adults, the chil d r e n d i d not appear to miss appointments. Those chi l d r e n who claimed that they d i d not want to enter 30 the play room were simply l e d or on occasion c a r r i e d i n t o i t . R e f e r r a l i s made to the centre through a doctor or a community agency which requests a p a r t i c u l a r s e r v i c e . A j o i n t intake committee which consists of the Family and Children's C l i n i c and the Psychological Education C l i n i c reviews the case and, i f i t i s accepted, i t i s assigned to a program d i v i s i o n and, t y p i c a l l y , to a s p e c i f i c t h e r a p i s t . Because of the decline of d i r e c t treatment, few ch i l d r e n appeared to be accepted s o l e l y f or play therapy. Instead, most candidates f o r therapy came from some other program within the centre, e.g., the preschool centre. For many pa t i e n t s , therapy was simply a part of the time that they spent at the centre and they appeared to see i t as a routine part of t h e i r 31 school experience. These c h i l d r e n are usually met by the th e r a p i s t a f t e r class and led or c a r r i e d to the play room. Other patients t y p i c a l l y a r r i v e with a parent on t h e i r f i r s t few v i s i t s but, f o r the remainder of t h e i r program, they often come to the centre by t a x i or with a volunteer d r i v e r . On one occasion the ther a p i s t h e r s e l f picked the c h i l d up at her home and returned her a f t e r the hour. I seldom saw parents waiting i n the waiting area, although at l e a s t one parent appeared to wait f o r h i s c h i l d i n h i s car. Those chi l d r e n coming to the c l i n i c s p e c i f i c a l l y f o r play therapy usually entered the b u i l d i n g alone and were greeted by the r e c e p t i o n i s t . She would recognize them and frequently engaged them i n conversation u n t i l the therapist a r r i v e d . I t was uncommon for the c h i l d to s i t i n the waiting area. Sometimes the patient would enter the therapy room which was adjacent to the waiting area and play with the toys u n t i l he heard the t h e r a p i s t coming. I t was not uncommon to f i n d c h i l d r e n roaming about the h a l l s and adults would approach them to discover t h e i r reason f o r being there. They might, for example, be over-extending t h e i r v i s i t away from the school complex. The presence of unattended c h i l d r e n appeared to provide the r a t i o n a l e f or locking doors; three doors were cons i s t e n t l y locked, namely, the observation room, the toy storage room, and the k i t r e f i l l room. The Play Room: Play therapy requires a c e r t a i n amount of preparation by the the r a p i s t . These preparations can be thought of as (a) administrative or t e c h n i c a l , and (b) therapeutic. F i r s t , l e t us consider the former. Unlike most verbal therapies, play therapy i s c a r r i e d out i n a s p e c i a l s e t t i n g , i . e . the 'play room', and, since there are a l i m i t e d number of these s p e c i a l s e t t i n g s , i t . i s necessary that the s t a f f work out a 32 schedule f o r t h e i r occupancy. The t h e r a p i s t usually reserved a room through the r e c e p t i o n i s t . Patients were seen once or twice a week, usually at the same time of day and i n the same room. I t appeared that each the r a p i s t had a preference for a p a r t i c u l a r s e t t i n g and scheduling was seldom problematic. The c l i n i c has a number of rooms a v a i l a b l e f o r therapy a c t i v i t i e s ; two of these are used for group a c t i v i t i e s , two are small play rooms with 22 observational f a c i l i t i e s , (these were only used once or twice to my knowledge and then only because the other rooms were occupied), two large rooms without observation rooms which were used almost e x c l u s i v e l y as play rooms, and two large rooms f u l l y equipped as play rooms. One of the two latter-mentioned rooms i s set up to provide f o r occasional family groups and contains a sofa and arm chair as well as play equipment. The other room was the most f u l l y equipped and appeared to be the most heavily used. Unlike the others i t had a c h i l d ' s washroom, a blackboard, a sink, as well as a bench which extended around a l l of the a v a i l a b l e walls. This was the room that most observations were made i n . While scheduling of the rooms d i d not appear to be a problem, i t frequently happened that the patient thought "his room" had been v i o l a t e d . Children were t y p i c a l l y t o l d that the play room was " t h e i r s " for the hour and that they could do what ever they l i k e d with i t (within reasonable l i m i t s of course). On one occasion the t h e r a p i s t and pa t i e n t had gone upstairs f o r a few minutes and, upon returning, found two c h i l d r e n from the waiting area i n the room. This appeared to be a s i g n i f i c a n t event and the the r a p i s t t o l d the c h i l d that he had a r i g h t to be annoyed at t h i s i n t r u s i o n . Later, both of them agreed that they should lock the room whenever they had to leave i t i n the future. 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 to enter another c h i l d ' s room. A c h i l d who proposed t h i s kind of v i o l a t i o n was t o l d : 1.3 T: No, playrooms are very s p e c i a l places Tanya. Your playroom i s a very s p e c i a l place, and no other people, no other c h i l d r e n come i n i t when you're i n i t , and no other c h i l d should go i n t o any other c h i l d ' s play room. 23 I t was also not uncommon for the c h i l d to expect to f i n d the room the way he had l e f t i t three days, or even a week previously. For instance, consider the following 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: Well I ' l l t e l l you what Nick, i t ' s your turn now and you can do with i t what you want, (deal). This may have been one reason why therapists would attempt to remove obvious traces of the former 'owner' when preparing f o r a next session. For example, one c h i l d was allowed to paint on the walls during her hour. This necessitated the immediate bringing together of other inter e s t e d p a r t i e s at the end of the session who would then view the pic t u r e so i t could be washed o f f i n readiness f o r the next p a t i e n t . On one occasion, a photographer was c a l l e d i n so that the production could be preserved f o r the record. S i m i l a r l y , the sand tray scenes would be dismantled and toys would be replaced i n the box. A major consideration i n removing the traces of former occupants was that the new pa t i e n t would be influenced by the work of the previous c h i l d and thus f a i l to provide a 'free' sampling of h i s own play. Some features of the play room were p h y s i c a l l y reconstructed f o r each play session. Each t h e r a p i s t has a large toy box which contains a vast assortment of small toys, e.g., animals, human f i g u r e s , trees, guns, cars, trucks, fences, caps, balloons, etc. This i s stored i n the thera-p i s t ' s o f f i c e or i n the play room. This c o l l e c t i o n of toys i s placed i n the play room p r i o r to each session and the toys may or may not be taken 24 out of t h e i r box before the session begins. There are also several large items which can be moved from one room to the other. These include two sand trays, a p a i n t i n g easel, a miniature house, and a c h i l d - s i z e d table and chair set. In addition there i s a storage room with a large assort-ment of toys, 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 animals, baby carriage, d o l l s , models, paints, paper, crayons, t r a i n s , puppets, and t o o l s . The t h e r a p i s t , i n preparation f o r a therapy session, w i l l a r r i v e early and arrange the room i n response to the p a r t i c u l a r p atient that w i l l be seen. This s e l e c t i o n and arrangement of objects has been r e f e r r e d to as therapeutic preparation. I f the c h i l d i s being seen for the f i r s t time the arrangement may be geared to what we may c a l l the 'normal c h i l d ' with the i n t e n t i o n of 'sampling' h i s play. This means that the t h e r a p i s t must provide a wide range of objects and note what the c h i l d does with them. One t h e r a p i s t who was preparing for a newcomer placed h i s toy box i n the room but d i d not open i t . He then arranged some paper and crayons, and placed both of the chairs at a safe distance facing one another. Later, the t h e r a p i s t t o l d me that the c h i l d was i n an age group i n which he could be a 'talker' or a 'player', that i s , the c h i l d was o l d enough to be able to t a l k to the t h e r a p i s t without the medium of the toys. However, because of the nature of the s i t u a t i o n , he might w e l l want to 'regress' to the safety of playing with toys. With the toy box closed, the choice would be. up to the patient rather than the t h e r a p i s t . When one c h i l d who was described as "psychotic" and was reportedly hyperactive was scheduled to use the play room, the t h e r a p i s t would remove as many things as p o s s i b l e from the room. A symptom of her psychosis was "perseveration" which was displayed i n her i n a b i l i t y to stop taking things 25 from the toy box u n t i l i t was completely empty, or to pour sand out u n t i l i t was a l l gone, etc. In order to manage t h i s c h i l d , the t h e r a p i s t would reduce the s t i m u l i to a minimum. Normally, however, there were a large number of toys i n the room. The arrangement was kept consistent f o r each p a r t i c u l a r c h i l d from one week to the next and he was provided with those resources needed to work out ( i . e . , play out) h i s problems. Although t h i s i s not the place to go into d e t a i l , i t became evident from the therapist's t a l k that there was some supposed r e l a t i o n s h i p between 'toys' and 'problems'. Some 33 examples of the therapeutic s e l e c t i o n of toys follows. A c h i l d who was seen as having "dependency needs", that i s , a c h i l d who d i d not receive enough love and attention and was s t i l l s t r i v i n g to s a t i s f y those needs, should have access to resources that allow him to "regress". For example, h i s play room would include a baby b o t t l e f i l l e d with water, d o l l s , mud, etc. A c h i l d who was assumed to harbour a great deal of pent up anger would be given cap guns, swords, punching clowns, w i l d animals 34 (e.g., a s t u f f e d bear), puppets of f i e r c e looking animals, darts, etc. A c h i l d with a s p e c i f i c anxiety w i l l be given toys r e l a t e d to that anxiety. For example, a c h i l d who was concerned about a h o s p i t a l v i s i t would be given the opportunity to play with medical toys, a c h i l d with a fear of f l y i n g would be encouraged to play with balloons, toy airplanes, feathers, etc., a c h i l d with an apparent sexual m i s i d e n t i f i c a t i o n may be permitted to play with l i p s t i c k , eyeshadow, bubble bath, etc., one with repressed f e e l i n g s about h i s parents or s i b l i n g would be given a d o l l family, and so on. While the s e l e c t i o n of appropriate toys was not always as obvious as the examples given above, there were s i m i l a r j u s t i -f i c a t i o n s a v a i l a b l e which governed the s e l e c t i o n of most items. 26 Because play therapy i s e s s e n t i a l l y a non-directive a c t i v i t y , these toys were not given to the patient but were placed i n the room so that they could be used (or avoided) as he wished. An exception to t h i s was an occasion on which a t h e r a p i s t had acquired a new toy (padded clubs) and urged the patient to use them f o r two sessions. Before concluding t h i s b r i e f d e s c r i p t i o n of the sights and sounds of the therapy s e t t i n g I w i l l give the reader some sense of what takes place during the therapy hour i t s e l f . As explained e a r l i e r , the th e r a p i s t t y p i c a l l y arranges the room p r i o r to the patient's a r r i v a l and, at the appointed time, e i t h e r c o l l e c t s the c h i l d from h i s classroom or waits to be n o t i f i e d of h i s a r r i v a l . There i s often a display of pleasure, by the ther a p i s t , on seeing the c h i l d again. To the observer some of these greetings were of a form that one would normally 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 or from people who had met a f t e r a long absence from each other. For example, the th e r a p i s t would often greet the pa t i e n t by c a l l i n g out h i s f i r s t and l a s t names i n a loud, exaggerated voice. A f t e r a greeting the p a i r would usually go to the play room, however, sometimes there were other a c t i v i t i e s that had to be taken care of f i r s t . For example, the th e r a p i s t might have to attend to some business.that was not r e l a t e d to the patient whom he was seeing. He might have to make a telephone c a l l of drop something o f f at the o f f i c e . In the l a t t e r case, the c h i l d would often go with the the r a p i s t to the o f f i c e and then return with him to the play room. The t h e r a p i s t ' s o f f i c e was given a s p e c i a l accent by both the the r a p i s t and patient although i t was not used for play therapy. On one occasion a c h i l d brought a flower f o r the th e r a p i s t and they went to h i s o f f i c e to place i t i n a vase. The o f f i c e was also used as a place to 27 display some of the productions that c h i l d r e n had created during therapy, and each o f f i c e contained at l e a s t one of the children's paintings on the wa l l . The o f f i c e was also used as a space to store some of the toys that a patient wants to t r e a t as h i s own, s p e c i a l property. Since a l l of the patients use the same toys and the rules do not allow a c h i l d to take anything home, the th e r a p i s t would often agree to put c e r t a i n toys away i n a cupboard u n t i l the next session. Even though the d e t a i l s of the play room have been arranged i n advance, some therapists would allow patients to s e l e c t t h e i r own toys from the toy storage room. This was a device f o r gathering information about the pa t i e n t . • That i s , the c h i l d ' s s e l e c t i o n of toys was an index of h i s fe e l i n g s , problems, needs, etc. For example, one patient enjoyed putting a p a r t i c u l a r model together during the session. I t was s i g n i f i c a n t that he repeatedly selected a dinosaur, thereby demonstrating the need of an i n h i b i t e d , good c h i l d to be v i o l e n t , angry, monstrous, etc. Conversely, i t was also useful to see what toys the pa t i e n t avoided. This s e l e c t i n g time was not seen as part of the therapy hour, but was regarded as a pre-session a c t i v i t y . One the r a p i s t became concerned with the increasing amount of time that a p a r t i c u l a r patient took to make h i s s e l e c t i o n . Each week he took longer and- longer. The th e r a p i s t r e f e r r e d to i t as "shopping" and explained that the lengthening of the "shopping time" was a device f o r avoiding the play session i t s e l f . Upon entering the play room, the the r a p i s t closes the door and s i t s down. The the r a p i s t spends the majority of h i s time i n the play room s i t t i n g i n a c h i l d ' s chair or on a low bench. Varying amounts of time may be spent i n a c t i v i t i e s l i k e mixing paints, reaching things from a high cupboard, playing an action game, or i n managing an active c h i l d . Some 28 therapists may spend most of the hour s i t t i n g i n the same l o c a t i o n , while others w i l l move about i n order to stay r e l a t i v e l y close to 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 during 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 of the play a c t i v i t y , e.g., he might engage i n a sword or a cap gun f i g h t , take command of a regiment of s o l d i e r s , or move some of the toys about. Sometimes h i s p a r t i c i p a t i o n w i l l be of a more i n d i r e c t nature. He might a s s i s t the c h i l d i n h i s play by mixing paints, g e t t i n g water, reading 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, etc. Whatever the form of 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 to d i r e c t h i s attention to the patient at a l l times. The c h i l d i s free to do whatever he wishes and t y p i c a l l y e l e c t s to play. On some occasions, however, he w i l l "avoid" the toys and t a l k with the t h e r a p i s t instead. The play a c t i v i t y may be the expected ones of playing games, playing with d o l l s , b u i l d i n g i n the sand tray, drawing, painting, etc., or may include undressing and climbing i n t o the sink, handcuffing the t h e r a p i s t and locking him i n the bathroom, using a water p i s t o l to attack the t h e r a p i s t who i s t r y i n g to get i n t o a raincoat, exploding two or three r o l l s of caps at a time, throwing a punching clown against the walls, p a i n t i n g on the walls, throwing darts at a drawing of h i s teacher, etc. Although the play sessions were usually confined to the play room, i t was not uncommon for the t h e r a p i s t and patient to go outside for a swim, to play i n the gymnasium, to play on the trampoline, or to go to the park. The play sequence may consist of 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 a model, i t may consist of many play a c t i v i t i e s , such as drawing, playing darts, b u i l d i n g i n the sand, or i t may consist of one or more play a c t i v i t i e s broken by periods of conversation. In more or le s s verbal 29 sessions, the t a l k may be connected to the play or i t may focus upon other concerns. The therapy sessions were scheduled to l a s t f o r one hour but could be shortened i f the p a t i e n t was anxious to go and could not be encouraged to engage i n any further play or t a l k . A session could also run over the hour i f the c h i l d was too 'worked up' or refused to stop p l a y i n g . Almost without exception the t h e r a p i s t attended to the time and, towards the end of a session he would frequently t e l l the patient how many minutes were l e f t i n the hour. This helped to prepare the c h i l d f o r the termination of the hour and encouraged him to f i n i s h h i s play. Further, the t h e r a p i s t would sometimes terminate an a c t i v i t y which he did not f e e l was worthwhile i n order to move on to something e l s e . Since the term "play therapy" invokes the idea of playing and, as we have seen, play i s indeed a c e n t r a l focus here, one might well assume that these sessions produced a minimum of conversation a c t i v i t y and often included long periods of s i l e n c e or periods where the c h i l d simply "talked to himself" i n and over the course of h i s play. However, t h i s was not the case. Instead, the hour almost i n v a r i a b l y had the appearance of a 'con-versation' with the p a r t i c i p a n t s taking regular and orderly turns at t a l k i n g . Much of t h i s t a l k was oriented to the play a c t i v i t y . The following t r a n s c r i p t s were taken from a session with a patient who was approaching the end of a treatment program which had l a s t e d for several months. The p a r t i c i p a n t s had j u s t returned to the play room a f t e r searching f o r a key for a toy t r a i n . 1.5 1. C: I t i s , ( ) I ' l l j u s t put my ( ) i n there and I might forget i t , i f I forget i t you can always remind me. 2. T: Mmhhmmm, okay. ((2.0)) Oh Dana", I ' l l // t e l l you what. 30 3. C: ( ) get 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 out the door)) 4. T: Well, I ' l l t e l l you, we ' l l , we'll get i t l a t e r okay. 5. C: Unn. ((annoyed)) 6. T: Dana. 7. C: ( ) r i g h t away. 8. T: Yea. 9. C: Anyways I don't know how much money I've got i n here. 10. T: Yea. We've got, only, ((closes door)) about eight minutes l e f t , so you can go a f t e r the session and get i t , okay. 11. C: Five, oh, oh. ((12.0)) Huh. 12. T: Yea, here's one that's a l l i n t a c t . ( ( r e f e r r i n g to the new t r a i n that has been brought back to the playroom)) 13. C: No I don't have 16 e i t h e r . I don't even have 16 cents. 14. T: What do you have? 15. C: 15. 16. T: 15? Well that's j u s t what you need i s n ' t i t . 41. C: Hey, something came o f f , of the extra t r a i n . Oh i t came o f f the back thing, the blue thing. The wheels are s t i l l on i t , s t i l l on the blue thing. 42. T: You have another car here too. 43. C: I know. ((4.0)) Oh drat, the red thing and the blue thing don't have one on i t . ( ) missing. 44. T: I ' l l t e l l you something about that Dana, you have to be quite gentle with i t or the hooks come o f f . 45. C: They do? 46. T: Quite e a s i l y , yea. ((2.0)) That's one thing that you have to t r y and be quite patient with or i t doesn't work. 47. C: ( ) but i t came o f f . 48. T: Right. 31 49. C: ( ) 50. T: Do you know why i t came o f f ? 51. C: Nope. 52. T: Have any idea why i t came o f f ? ((2.0)) Well, I think i t was because you had to r e a l l y be i n such a hurry to get i t out of the box. 53. C: Ahhh. ((scoff)) 54. T: Hmmm? 55. C: That's not why i t came o f f . 56. T: You don't think so? 57. C: Nope. 58. T: I think so. 59. C: I don't. 60. T: Mmrnmhmm ((+)) 61. C: Hey // 62. T: Well f i r s t of a l l i t ' s not made very well but, secondly when things aren't made very w e l l I guess you have to be more c a r e f u l . ((7.0)) I think sometimes we kind of wreck things for ourselves at times. 63. C: ( ) now I got the thing back 64. T: Did you get i t ? 65. C: Yep. 66. T: Good for you. Good f o r you. 67. C: 1 f i x e d i t . 81. C: Oh, oh, now t h i s things thing come o f f . The red things. And I didn't even f o o l around rough with i t . 82. T: No, okay. ((1.5)) So sometimes things break j u s t because they're not made very sturdy, not very strong, and other times I think things get broken because we handle them roughly because we're i n such a hurry to get them going. ((As the session ends the patient s t a r t s "throwing" the t r a i n back i n t o the box)) 32 91. T: Really f e e l i n g kind of mad at those things huh. 92. C: Yea e s p e c i a l l y f o r breaking. 93. T: Okay, maybe kind of mad at me too, f o r , saying i t had something to do with what you were doing. 94. C: I'm not mad at you. 95. T: No. 96. C: I f I am mad at you I'm mostly mad at the t r a i n s . 97. T: irmhnunm (+) 98. C: ( ) can of pop. 99. T: Yep, you can go and get the pop now. On another occasion, the th e r a p i s t t r i e d to turn the play a c t i v i t y i n t o data by encouraging the patient to elaborate on her a c t i v i t y . In the following 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 that object. The the r a p i s t regarded t h i s p atient as a sp e c i a l case because of the seriousness of her problem. At one point he had s a i d that there was the strong p o s s i b i l i t y that the patient might be psychotic. 1.6 1. T: I wanted to s i t down. ((pulled up a chair)) Who i s that? 2. C: I don't know. 3. T: mmm / 4. C: I dont' know. 5. T: You don't know who / Is i t a man or a lady? 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. 33 10. C: He has no wings. 11. T: No wings. Was he t r y i n g , what's he doing up there i n the sky? Is that, i s that the sky up there? 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. So bad things are happening to the 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 kinds of things d i d the monster do? 20. C: He sa i d ( l i k e t h a t ) . 21. T: He said go away r a i n . 22. C: Yes, and, and, and he, and he, rained a l l day a l l night. 23. T: inmhmm, so the monster s a i d go away r a i n but the r a i n j u s t kept on coming down, huh. 24. C: Yes. ((pause)) And, and, there a moon. 25. T: A moon. 26. C: I t s dark. 27. T: And i t s dark outside. 28. C: Yes. 29. T: And there i s no sunshine. 30. C: NO. 31. T: So i t s dark night 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 there i s a thunder storm. 35. T: Thunder. 34 36. C: Yes. 37. T: Wowww. 38. C: On h i s , on hi s foot. 39. T: On his foot. 40. C: Yaa, and he says ouch, ouch, ouch, l i k e that. 41. T: Ouch, ouch, ouch. 42. C: Yes. ( ) In other cases, we can hear that the t h e r a p i s t i s t r y i n g to get the c h i l d to t a l k about his f e e l i n g s . The following patient had been i n play therapy for a long time and was about to be discharged when he appeared to have a relapse. Here, the c h i l d has a p a i r of boxing gloves on and has been 'mock h i t t i n g ' the t h e r a p i s t . I. 7 1. T: Yep. Ah, would you l i k e to pop me one i n the nose with those. (H i t t i n g yourself?) ((pause)) You must be f e e l i n g p r e t t y awful hmm? ((pause)) Feeling kind of angry at yourself f o r // 2. C: Watch t h i s . 3. T: For disappointing Mum. 4. C: ouch, uunhnn (-) I don't do that. 5. T: Don't you? 6. C: Unnhnn .'(-) 7. T: Angry at yourself f o r , cause you think you're stupid? 8. C: Nope. 9. T: Or that you're retarded? 10. C: Nope. I I . T: Or mental? 12. C: Nope. 13. T: mmm? 35 14. C: Nope. 15. T: I think so. ((pause)) Well Tim, 16. C: Guess what? 17. T: What? 18. C: ( ) 19. T: I think, I think you're j u s t a r e a l l y f i n e fellow. Talk i s frequently b u i l t around the topic of "what kind of room the play room i s " , with numerous comparisons to the home or classroom. Consider the following three examples. I. 8 1. T: You know // what? 2. C: ( . . . t e r r i b l e ) 3. T: John. 4. C: mmm ((tone of recognition)) 5. T: I want to t a l k to you for a sec. 6. C: (What?) 7. T: Sometimes we can have these kinds of explosions here i n the play room, hey? 8. C: Yea. 9. T: When there i s flames come out of the caps and s t u f f , 10. C: Yea. II . T: But, the play room i s a d i f f e r e n t from home i s n ' t i t ? 12. C: Yea. 13. T: And we don't want a l l . . . . . 1.9 1. T: Hmmm. ((pause)) Sometimes I bet you even swear. 2. C: No I don't swear. 36 3. T: Hmm? You know, one place where i t i s r e a l l y good to swear i s r i g h t here i n the play room. 4. C: I know. 5. T: That's r i g h t . ((pause)) Why you can even say fuck and a l l those things, r i g h t here. 6. C: ( you want to the darts ) 7. T: Hmm? ((pause)) At home though I think i t sometimes bugs Mom i f you swear. 8. C: (Watch this) ((throwing a b a l l around)) 9. T: Oh wow. 10. C: Watch t h i s . 11. T: I missed i t . 12. C: ( ) 13. T: Yep r i g h t here i n the o l d play room, that's a good place to, l e t i t a l l out. You can swear ((loud noise)) y e l l , and a l l those things. ((pause)) Wowee. 14. C: The kick o f f . 15. T: But r e a l l y though, Mum sometimes get up t i g h t when kids swear at home. But i f you swore i n the play room you know I wouldn't even be shocked. You know that? 16. C: ( ( s l i g h t laugh)) Come back here. 17. T: Whoops. Heyy, beauty, beauty shot. 18. C: ( ( s l i g h t laugh)) 19. T: I think you'd l i k e to take that b a l l and heave as hard as you could. ((pause)) Good one. i t as f a r and 20. C: Ahhh 21. T: Ohhhh. For a minute I thought you were going to wear the garbage can. ((pause)) Go man go. Wow. 37 I. 10 This t r a n s c r i p t involved the 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 session, occurring at what the researcher heard as the e a r l i e s t opportunity f o r the th e r a p i s t to get i t i n . 1. T: You know Dana, ((an i n t e r e s t i n g tone of voice)) 2. C: What? 3. T: I was r e a l l y thinking about the l a s t time you were here, and I think I must have been sounding l i k e a, a naggy o l d , Mom or Dad. 4. C: Unnhnn (-) 5. T: Huh? 6. C: Unnhnn (-) 7. T: I think so. 8. C: You weren't. 9. T: I was thinking that 10. C: (noise) II. T: that I wasn't r e a l l y being quite f a i r to you. 12. C: ( two men . . . tanks . . . ) 13. T: mmmhmm (+) 14. C: ( ) // 15. T: For a long time Dana I have been t e l l i n g you that you should be able to do things you want to do i n the play room, v 16. C: I know. 17. T: -and I've been t e l l i n g you that i t ' s okay to get angry, and s t u f f l i k e that. 18. C: I know. 19. T: Well and then l a s t week when you came and you wanted to do some things, that you r e a l l y wanted to do and I sa i d you couldn't do them. Do you remember? ((2.0)) Like you wanted to get some pop, kind of early i n the day. 20. C: mmhmm (+) These p a r t i c u l a r samples of therapy t a l k have not been selected to 38 demonstrate any p a r t i c u l a r points, but are offe r e d as examples of t y p i c a l therapy hours. This chapter has presented some of the observations that 'anyone' who placed himself within the s e t t i n g f o r a reasonable length of time could have made. The materials i n t h i s chapter were selected because of t h e i r t y p i c a l i t y and are intended as descriptions of the work that i s done i n a p a r t i c u l a r section of the centre. Although I had embarked upon my research at the c l i n i c with some uncertainty, I was surprised to f i n d that I could e a s i l y see the reasonable-ness of the a c t i v i t i e s that went on there. That i s , they made sense to me. Later, t h i s was followed by a lengthy period during which I doubted the reasonableness of my observations. The former impression was that the happenings that went on i n t h i s s e t t i n g would have made sense to anyone ( i . e . , whether they were or were not members of the s e t t i n g ) . As lay members, we may assume that some of the a c t i v i t i e s reported would (or could) have been done i n other ways, but I would suggest that any competent c u l t u r a l member would have no problem i n seeing the reasonableness of these a c t i v i t i e s . By saying the s e t t i n g would make sense to anyone, I am point-ing to the common-sensical organization of the s e t t i n g , e.g., to the use of play, to the greeting structures, to the family intermediaries, etc. I would l i k e to point as well to the apparent v i s i b i l i t y of the patient's motives, to the awareness of the c h i l d as a developing being, to the common sense procedure of getting c h i l d r e n to t e l l s t o r i e s , to the o v e r a l l reasonableness of the thera p i s t - p a t i e n t t a l k , etc. While we may wonder how ther a p i s t s are able to account f o r t h i s t a l k as therapeutic, we do not doubt that i t i s an adequate and appropriate way to t a l k to ch i l d r e n . While we may know l i t t l e about psychotherapy, we are able to provide adequate motivational accounts for why the s e t t i n g appears the way i t does, 39 of what the th e r a p i s t i s t r y i n g to do i n the play a c t i v i t y , of the selec-t i o n of toys, and so on and so f o r t h . We can also provide adequate (and "adequate" always means adequate-for-all-practical-purposes) motivational accounts f o r what the p a r t i c i p a n t s are doing. That i s not to say that we would a l l agree on these matters, however, because we are competent members of the society, we can produce reasonable accounts. As members, we constantly provide accounts f o r . a l l kinds of actors and actions i n the spontaneous and routine p u r s u i t of our d a i l y a f f a i r s . I f we attend to the cautionary remarks given at the beginning of the chapter, i . e . , those concerning the " d i f f i c u l t issues and t e c h n i c a l prob-lems" which are to be expected i n working with c h i l d r e n , we could now argue that these are not actual problems and suggest instead that our ordinary and uninformed understanding of what i s going on here i s s u f f i c -i e n t f o r a l l intents and purposes. I found myself a s s a i l e d by questions of t h i s nature. While these observations appear to be reasonable, we must remember that these occasioned impressions represent something that i s supposed to be and i s r e f e r r e d to as "therapy" or "treatment". For the adults of t h i s s e t t i n g , the occasions c i t e d above are not simply an opportunity to meet and talk, to c h i l d r e n , rather, they are supposed to add up to making disturbed c h i l d r e n better. Our observations should be given an organiza-t i o n a l r e l e v a n c e — t h a t i s , they should be j u s t i f i a b l e i n terms of the organizational goal of therapy. While we could provide many adequate accounts, we must wonder whether or not they would be p s y c h i a t r i c a l l y relevant. While we can make sense of the observations, what sense do the members of the s e t t i n g give to them? What do they see going on? How do they a t t r i b u t e motivations? In short, what i s the r a t i o n a l e which makes 40 these sights and sounds p s y c h i a t r i c a l l y relevant? Further, how can we get beyond the immediate sense of reasonableness to occasioned reason-ableness? I doubted that there would, or should, be a correspondence between my accounts and those of the therapist. E s s e n t i a l l y , I f e l t that any sense that I could make out of the s i t u a t i o n was not the same sense that the t h e r a p i s t was making but was instead rooted i n my own inadequacies. The themes of 'reasonableness' and 'doubt' were recurring ones f o r me during the actual f i e l d work and during the numerous times when I sat down and t r i e d to make sense out of the data that I had c o l l e c t e d . They . continue to be e s s e n t i a l f o r the remainder of t h i s paper. These two themes provided me with my i n i t i a l problem. While I had entered the s e t t i n g to search f o r the properties of a d u l t - c h i l d conversation, I found I was spending a great deal of time thinking about the a c t i v i t i e s (including t a l k ) . t h a t went on i n the s e t t i n g i t s e l f . Even when thinking about and discussing the conversations, I found myself engaged i n constructing the actors' motivations. My i n t e r e s t then s h i f t e d to a concern with how I was able to make sense of the s e t t i n g , i t s 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 a b i l i t y to make sense of the a c t i v i t i e s , I attempted to discover the r e a l s i g n i f -icance to t a l k , events, etc. In summary, I have presented c e r t a i n impressions of a work s e t t i n g which "any" observer might have made. I have also emphasized our a b i l i t y to perceive the 'reasonableness' of a c t i v i t i e s and events without having any s p e c i a l knowledge about t h e i r organizational relevance. In an e f f o r t to discover the r e a l s i g n i f i c a n c e of events, we s h a l l now proceed to examine how the therapists themselves see these doings as something which 41 adds up to 'therapy'. I was a s s i s t e d i n t h i s undertaking by the accounts and explanations of f e r e d by the the r a p i s t s . In chapters two, three and four we w i l l look at the organizational r a t i o n a l e as discovered within the s e t t i n g and at the corpus of knowledge the therapists employ i n the i n t e r p r e t i v e work of making sense. 42 Footnotes ""This i n t e r e s t arose from a seminar with Matthew Speier. 2 H. Ginott. Group Psychotherapy with Children. New York: McGraw-H i l l , 1961, p. 125. 3 J . Schulman, J . C. Kaspar and P. Barger. The Therapeutic Dialogue. S p r i n g f i e l d : Charles C. Thomas, 1964, p. 134. 4 M. R. Haworth. C h i l d Psychotherapy: Practice and Theory. New York: Basic Books, 1964, p. 35. 5 . J. Anthony. "Communicating Therapeutically with the C h i l d " . C h i l d  Psychiatry, 3 (1964), p. 115. 6 For an example of t h i s 'location' of the l i t e r a t u r e , examine the following b i b l i o g r a p h i e s : United States Department of Health, Education and Welfare, Research i n Individual Psychotherapy: A Bibliography, 1969; and E. D. Driver, The Sociology and Anthropology of Mental I l l n e s s : A  Reference Guide, Un i v e r s i t y of Massachusetts Press, 1965. The l a t t e r piece, although i t i s supposed to be a comprehensive survey, contains only one reference to ch i l d r e n . 7 See p a r t i c u l a r l y Dibs i n Search of S e l f , Boston: Houghton M i f f l i n , 1964. 8 See Childhood and Society, New York: Norton, 1950; or "Studies i n the Interpretation of Play",. Genetic Psychology Monograph, 22 (1940), 557-671. 9 See Children i n Play Therapy, New York: McGraw-Hill, 1953; or, E x i s t e n t i a l C h i l d Therapy, New York: Basic Boos, 1966. Op. c i t . ~""S. L. Werkman. "The P s y c h i a t r i c Diagnostic Interview with Children". American Journal of Orthopsychiatry, 35 (1965), p. 767. 12 J. Schulman, et a l . , Op. c i t . , p. 138. 13 H. Ginott, Op. c i t . , p. 176. E a r l i e r Ginott had said , "to a considerable extent the c h i l d ' s play i s h i s t a l k and the toys are h i s words." p. 51. 14 See f o r example, H. Ginott. "Play Therapy: The I n i t i a l Session", American Journal of Psychotherapy, 15 (1961), 73-88. 1 5 C h a r l e s W. Morris, (ed.) Mind, S e l f and Society. Chicago: Univers-i t y of Chicago Press, 1934, pp. 135-226. 43 1 6"The Work of L i t t l e Children", New Society, 17 (1971) 12-14. 17 "Child's Play: Very Serious Business", Psychology Today, Dec. 1971, 66-69. 18 V. Axline, "Play Therapy Procedures and Results", American Journal  of Orthopsychiatry, 25 (1955) p. 623. 19 J. Anthony, Op. c i t . , p. 108. 20 Ibid ., p. 109. 21 S.L. Werkman, Op. c i t . , p. 769. 22 H. Ginott. Group Psychotherapy with Children, p. 91. 23 H. Ginott. "Play Therapy: The I n i t i a l Session", American Journal  of 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 of s o c i a l workers and a l e s s e r number of psychologists working under him. 25 During the w r i t i n g of t h i s report the children's service was i n f a c t discontinued and s t a f f members were d i s t r i b u t e d among other e x i s t i n g community services. 26 The t h e r a p i s t had contacted me to see i f I had made a t r a n s c r i p t of the e a r l i e r session since he had not made notes at the time. 27 I could frequently witness t h e i r a r r i v a l and overhear t h e i r conver-sations through the open door of the therapy room. 28 For a more thorough examination of t h i s aspect of ethnographic studies see Gerald Berreman, "Behind Many Masks: Ethnography and Impres-sion Management i n a Himalayan V i l l a g e " , Society f o r Applied Anthropology, #4, 1962. 29 In addition to administrative duties, the d i r e c t o r had a few regular patients and saw others on a consultative basis. 30 Those who take the i n t e n t i o n a l permissiveness of the s e t t i n g very s e r i o u s l y argue that c h i l d r e n should have the freedom to refuse therapy. 31 A t h e r a p i s t reported the following episode. Due to some unusual circumstance, he had to drive a patient home a f t e r therapy. At the patient's house they met some of the neighborhood ch i l d r e n and the patient introduced the the 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 large o f f i c e to enable him to use i t as a play room. " 44 The examples that follow are from f i e l d notes. . An elaboration of t h i s may be found i n H. Ginott, "A r a t i o n a l e for s e l e c t i n g toys i n play therapy", Journal of Consulting Psychology, 24 (1960) 243-246. 34 'Aggression' and 'dependency' were the two c e n t r a l emotional states ascribed to patients. They were t y p i c a l l y r e f e r r e d to as a u n i t , i . e . , one gets 'angry' because of unmet 'dependency' needs. CHAPTER 2 THE PSYCHIATRIC INTERPRETIVE SCHEMA Although the scenes portrayed i n Chapter 1 appeared eminently reasonable and obvious they could not remain so for me as a s o c i o l o g i s t . This was not simply a 'play' session, 'disturbed' ch i l d r e n were present for the purpose of becoming 'better', and the adults were performing a task r e f e r r e d to as therapy. For them therapy was work—work re q u i r i n g considerable s k i l l and t r a i n i n g . In short, I took i t that there was some organizational s i g n i f i c a n c e to those sights and sounds. As a s o c i a l s c i e n t i s t I f e l t obligated to r e j e c t the reasonableness of my f i r s t view-ing and search f o r something behind the scenes that would make them  eventful. I di d not know what my search was for but I d i d f e e l I would have to discover how the therapists made sense of these scenes. Although I was able to a t t r i b u t e meaning to what I saw, surely that would not 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 to them. That i s to say, I assumed that there 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 ther a p i s t to understand events i n another way. A great deal of my time i n the f i e l d was spent searching f o r the ways i n which therapists managed to make sense out of things that I as a layman found to be mundane and uneventful. Most of the material that I gathered was the r e s u l t of my i n i t i a l e f f o r t s to make myself a competent member of the s e t t i n g rather than any deliberate e f f o r t to uncover the p s y c h i a t r i c s i g n i f i c a n c e of the s i t u a t i o n . I found that I could conduct myself as a competent p a r t i c i p a n t by asking appropriate questions, 46 o f f e r i n g adequate solutions, seeing the relevance of accounts given me, etc. In short, I took i t that I had begun to see a c t i v i t i e s i n much the same way as the therapists saw them. On the basis of my experience at the c l i n i c , I was able to construct a r a t i o n a l account and 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 of the happenings i n the play room. The recon-s t r u c t i o n of t h i s data occurred l a t e r when I developed a more c l e a r l y defined i n t e r e s t i n occasioned accounts. I t i s the i n t e n t i o n of t h i s chapter to show how I was able to make sense of scenes such as those depicted i n Chapter 1. F i r s t l e t me indicate how t h i s was p o s s i b l e . Not only d i d I observe therapy sessions, I was often a party to t a l k about the sessions that I witnessed, and about the c h i l d and the problems involved. These conversations occurred before or a f t e r a therapy session, at coffee time, at meetings, during informal t a l k s , etc. Not s u r p r i s i n g l y , people who play with c h i l d r e n on a regular basis have standardized ways of t a l k i n g about t h e i r a c t i v i t i e s . This came out i n informal accounts or explanations of the childrens' behavior rather than i n our more formal discussions about psychiatry, psychopathology, etc. This provided me with a way to make sense of the sessions that I had observed, that i s , I looked for the r e l a t i o n s h i p between the t a l k that I had heard and the events that took place i n the therapy room. Psychotherapy, l i k e other professions ( i . e . , i n contrast to occupations) i s a theory-governed act i v i t y . " " The enterprise i s r e l a t e d to and embedded i n e x p l i c i t (and sometimes diverse) f a c t s and/or assump-tions about human nature, the etiology and development of diseases ( i . e . problems), p e r s o n a l i t y development, the source or sources of problem 47 solving, etc. While most members of the profession p a r t i c i p a t e i n the actual doing of therapy alone, a handful of people devise, elaborate upon and communicate the t h e o r e t i c a l structures of the p r a c t i c e . As I reported e a r l i e r i n t h i s study, I embarked upon a study of the relevant l i t e r a t u r e during the i n i t i a l part of my research at the c l i n i c and, l a t e r , members of the s e t t i n g afforded me with further references to p a r t i c u l a r authors and to pieces of l i t e r a t u r e . I took i t that one could, and should, see the relevance of t h i s l i t e r a t u r e to the on-going, p r a c t i c a l a c t i v i t i e s at the s e t t i n g . The r e l a t i o n between the two should run something l i k e t h i s : "See the actual a c t i v i t y as an expression or document of the pertinent t h e o r e t i c a l materials". On a few occasions I was drawn in t o discussion about the differences between various models of behavior. The therapists to whom I talked would often contrast t h e i r methods with, for example, the work of other members of the c l i n i c who pr a c t i c e d behavioral modification. I soon came to r e a l i z e that 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 sets of theories. That i s , i t was not only that some members accomplished t h e i r therapy i n d i f f e r e n t ways but there 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 -ture which governed t h e i r actions. On the other hand, although I was able to discover some differences i n the ways i n which the therapists with whom I was involved p r a c t i s e d play therapy, I d i d not see any contradictions here. Instead I saw these differences as differences i n pe r s o n a l i t y or s t y l e rather than as in d i c a t i o n s that they subscribed to d 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 chapter I w i l l . o c c a s i o n a l l y make references to the l i t e r -ature. This can be seen as a further aspect of my search f o r an account 2 of the r a t i o n a l i t y of the s e t t i n g . I found that I was able to see the 48 a c t i v i t i e s at the c l i n i c as a document of the l i t e r a t u r e , and I f e l t that i t was appropriate to do so. I sometimes noted discrepancies between what therapists a c t u a l l y d i d and what the l i t e r a t u r e claimed that they should do. On one occasion, I t o l d a th e r a p i s t that something she d i d appeared to be a con t r a d i c t i o n 3 of what Axline had written. She d i d not question the f a c t that I saw the relevance of Axline's work to her a c t i v i t y , but explained that she d i d not agree with the point i n question. As an observer, I had access to (a) actual sessions of play therapy, (b) therapists remarks and discus-sions about these events, and (c) t h e o r e t i c a l explanations and accounts which resembled and seemed to bear upon the sessions that I witnessed. I found that the l a t t e r two allowed me to make p s y c h i a t r i c sense out of the former, i . e . out of the actual sessions that I witnessed. This chapter then i s a b r i e f report on how I started with my f i r s t experience of play therapy and constructed an account and d e s c r i p t i o n of  the r a t i o n a l i t y of the s e t t i n g and i t s a c t i v i t i e s . - I was looking 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 of happenings and I take my account and des c r i p t i o n to be a version of 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. The status of t h i s schema i s unclear since i t was never e x p l i c i t l y r e f e r r e d to i n the s e t t i n g nor treated systematically. Rather i t i s my accomplish-ment based on member's t a l k , etc. While I am suggesting that to some degree what I report i s how therapists make sense of events I would not argue that what I present i s a l l they make of the episodes reported. I t i s always possible that therapists w i l l suggest that they meant more than what I understood. The following material i s organized around a serie s of puzzles experienced as I f i r s t witnessed play therapy. As I became more f a m i l i a r 49 with the s e t t i n g these puzzles were replaced with a " p s y c h i a t r i c account" which made eventful what was previously uneventful. I w i l l begin to present t h i s i n t e r p r e t i v e schema (rationale) by looking at what I f i r s t experienced: the patient playing with toys and the th e r a p i s t watching, p a r t i c i p a t i n g i n , commenting on that play. The following t r a n s c r i p t i s from a session with a patient I had been observ-ing f o r some time and who had been i n therapy f o r several months before I a r r i v e d . He was playing i n the sand tray with some veh i c l e s . 2.1 1. T: You know that sometimes people get 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 get stuck? 3. T: Well, I think that sometimes people have things that bug 'em, problems that bother them/ 4. C: Mmhmmm (+) 5. T: and sometimes they get stuck with them and they don't know how to get out of them, they don't know how to stop doing the things that bother other people. ((pause)) 9. T: But you know that j u s t l i k e you can help a t r a c t o r to get unstuck that's the way i t i s with people sometimes too. 10. C: That wasn't the t r a c t o r that was stuck. 19. T: Oh I see. ((pause)) So, sometimes people can be helped to get unstuck too so they know how to cope with the things that are, ( )// 50 20. C: I think I'm going to r o l l my sleeves up. 35. T: imThinmm (+) ((pause)) John, why do you think you come to the c l i n i c ? 36. C: mmmm ((pause)) Just to get out of doing my work at school. 37. T: Just to get out of doing work at school? 38. C: mmhmmm (+) 39. T: Is that what i t f e e l s l i k e to you? Mmmm? ((pause)) Well, there are. some other reasons that you come to the c l i n i c too. 40. C: Why? 41. T: Well because we kind of think that, you weren't f e e l i n g too happy insi d e yourself. Why Are You Here? The f i r s t puzzle for me was that of discovering what was 'wrong' with the patients whom I observed. A number of issues contribute to t h i s puzzle and we can perhaps best begin to appreciate them i f we consider the 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 the session from which t h i s t r a n s c r i p t was taken to be 'reportable' (by t h i s I mean that I saw i t as d i f f e r e n t enough from other sessions that i t seemed to warrant some comment). In contrast to the permissive and non-4 d i r e c t i v e stance that I had come to expect i n play therapy i t seemed obvious here that the ther a p i s t was pushing the pat i e n t and confronting him with h i s problems. The th e r a p i s t later.agreed that t h i s was true, but that he f e l t that they had been coasting long enough. Although the th e r a p i s t does not believe the patient when he claimed that he comes to the c l i n i c (U36) " j u s t to get out of doing my work at school", but chooses to see t h i s as an evasion instead, we might ask how i t i s that a patient can spend several months i n therapy without t a l k i n g about why he i s there. However, remember that the c h i l d i s not a 51 voluntary patient; as the th e r a p i s t says i n U41, "... we kind of think that you weren't f e e l i n g too happy ins i d e yourself". I t i s t y p i c a l that c h i l d r e n are not voluntary patients. Most adults would agree with Ginott when he t e l l s us that: The decision to receive or r e j e c t psychotherapy, l i k e decisions concerning medications and vaccinations, should not be l e f t to the c h i l d but to 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 choices i n matters that are beyond t h e i r ken. 5 The c h i l d does not usually come to therapy with "something to t a l k about". Although i t i s assumed the c h i l d knows that he has a problem i t i s usually assumed that he. i s not capable of a r t i c u l a t i n g i t . Thus i t becomes incumbent upon the t h e r a p i s t to discover why the 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 interes t e d i n the noticeable absence of a problem topic and r e a l i z e d that the c h i l d ' s status as a'child'may account f o r t h i s absence, I also noted a further absence here. 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 suggests that the i n i t i a l interview i n adult psycho-therapy sessions should, i d e a l l y , proceed through several stages. He c a l l s the f i r s t of these the "formal inception". This stage begins with the f i r s t contact and may consist minimally of a the r a p i s t greeting a patient by name, i n v i t i n g him in t o the o f f i c e , and o f f e r i n g him a seat. I t i s recommended that the th e r a p i s t then opens up the session by s t a t i n g why he thinks that the patient has come to see him. This stage i s terminated when the patient begins to provide some ideas about himself and his problems. The p a r t i c i p a n t s i n t h i s instance are immediately account-able to one another i n s o f a r as they must demonstrate some relevant and appropriate reason f o r the v i s i t . Not only i s the c h i l d t h e r a p i s t frequently advised to avoid t h i s 52 kind of t a l k during the ea r l y sessions but the same sense of accountabil-g i t y does not apply. Neither of the p a r t i c i p a n t s can be c i t e d or rebuked for f a i l i n g to mention the reason f o r the v i s i t . Not only d i d I note an absence of t a l k about the reason f o r the v i s i t but further, any sense of stages seemed to be absent. One session seemed much l i k e the others except f o r the f a c t that the the r a p i s t and the c h i l d became more f a m i l i a r with each other. Now, consider t h i s excerpt from a f i r s t session with a c h i l d . 2.2 1. T: . . . a man who works with me sometimes. 2. R: Hi. 3. C: Hi. 4. T: That's Gary, t h i s i s Franz, ((pause)) Would you l i k e to keep your jacket on or would you l i k e to take i t o f f ? 5. C: ( on ) 6. T: You w i l l leave i t on, sure. What I thought we would do i f we could spend a l i t t l e time together and we would play together and then when we have had some time I could take you back to your classroom.^ I t i s taken f o r granted that a c h i l d w i l l be anxious enough when coming int o a new or strange s e t t i n g and should not be pushed to worry about why he i s i n that s e t t i n g . Thus, treatment programs may proceed f o r quite a long time without any mention of the reason f o r the v i s i t . As Ginott points out, "the c h i l d ' s conceptualization of the meaning of therapy can come only from experience, not from verbal explanations".""^ I f , a f t e r a lengthy time, the patient continues to di s p l a y a lack of concern or understanding f o r the "why" of h i s v i s i t s , the t h e r a p i s t may attempt to focus upon t h i s issue. (As i n t r a n s c r i p t 2.1) Here, the the r a p i s t r e l i e s upon the patient's i n t u i t i v e a b i l i t y to understand why 53 he i s i n here and to act upon t h i s i n s i g h t . The sequence above d i d not appear to constitute an unusual opening. This r e l a t i v e absence of d i r e c t t a l k about problems contributed to one of my f i r s t impressions of play therapy, i . e . I found that i t was d u l l and lacked any noteworthy events. F i e l d notes for an e n t i r e hour might consist of comments such as "played with toy s o l d i e r s " , "had a game of darts", "asked what time i t was", etc. Very l i t t l e appeared to be happening. Remember that i t was the directness of the th e r a p i s t ' s remarks that made the session reported i n t r a n s c r i p t 2.1 unusual. While one might expect an adult patient to t a l k about many personal matters, the t y p i c a l c h i l d p a tient reveals extremely l i t t l e about h i s l i f e outside of the play room. Many hours of c h i l d therapy appear to be j u s t play which i s going nowhere. However, t h i s raises a c r u c i a l question, s p e c i f i c a l l y , How do the p s y c h i a t r i s t s make sense out of t h i s apparently mundane and uneventful a c t i v i t y ? For the stranger t h i s r a i s e s the very question the t h e r a p i s t has asked the patient, that i s , "Why do you think you come to the c l i n i c ? " Although most chi l d r e n are re f e r r e d to the c l i n i c because of behavioral problems such as bed wetting, anxiety, temper tantrums, doing poorly i n school, s t a r t i n g f i r e s , e tc., therapists tend to regard such offensive behaviors as symptoms of some deeper problem. The r e a l problem i s assumed to l i e somewhere i n the c h i l d ' s self-conception, h i s f e e l i n g tone, hi s p e r s o n a l i t y , or h i s pattern of development. In short, i t i s a problem which i s not e a s i l y located or d e s c r i b e d . ^ While we could a l l recognize a broken leg or a fever as a genuine medical problem t h i s i s not the case with 'disturbance' used as a gloss f o r intrapsychic problems. 54 One of my e a r l i e s t discoveries was the discovery that patients appeared to be normal ch i l d r e n and I was able to recognize t h e i r play sequences and other doings as documents which pointed to some underlying problem only when I l i s t e n e d to the t h e r a p i s t s ' reports. Thereby, I decided that the process of becoming a competent observer e n t a i l e d acquir-ing the a b i l i t y to turn the mundane world of a c h i l d ' s play i n t o something which had p s y c h i a t r i c s i g n i f i c a n c e . As I soon discovered t h i s was not a problem for me alone. Groups of students from the s o c i a l work school were often allowed to witness sessions of play therapy and students frequently remarked that they could see nothing wrong with the c h i l d r e n . Although they could see that some-thing was wrong with severely disturbed 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 frequently f a i l e d to see any problem with c h i l d r e n who had a desire to f l y , talked about dead b i r d s , refused to h i t the punching clown, took a d o l l f or a walk i n the hall,, and so on. Instead they seemed to f i n d such 12 things to be reasonable and expectable instances of behavior. I t i s never assumed that c h i l d r e n are p a r t i c i p a t i n g i n play therapy by accident or by chance, instead there i s always the e x p l i c i t assumption that the p a t i e n t suffered from some disturbance. This assump-t i o n of disturbance came out i n many ways. However, i t became e s p e c i a l l y clear through a popular joke which suggested that members of the s t a f f were reluctant to bring t h e i r own c h i l d r e n to the c l i n i c Christmas party because they feared that other therapists would discover something problem-a t i c i n t h e i r behavior. This seems to have many i n t e r e s t i n g implications f o r us. Over the course of my study, I found that I was i n c r e a s i n g l y able to make p s y c h i a t r i c sense out of the children's a c t i v i t i e s i n the 55 play room. I see t h i s accomplishment as the c e n t r a l issue here. I suggest that we can begin to look at t h i s accomplishment i n terms of (a) the nature and consequentiality of children's play, (b) through the various meanings that can be assigned to a c h i l d ' s reasons f o r s e l e c t i n g p a r t i c u l a r toys and a c t i v i t i e s , and (c) through a conception of the c h i l d as an actor i n a common-sense s o c i a l structure. However, there i s a previous point which needs some c l a r i f i c a t i o n . I suggested that play sessions appeared to be d u l l , routine and uneventful. As i t turned out, these were r e l a t e d to the very objectives of therapy. Dr. Weininger, speaking about c h i l d ' s play and therapy, described the objective of play therapy and claimed that t h i s objective could be and was achieved, i n the following way. (It seems that 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 safe f o r the c h i l d to begin to explore some of the f e e l i n g s that he has, and he can only explore them i n the context of the r e l a t i o n s h i p that e x i s t s between himself and the t h e r a p i s t . What he does i s make use of c e r t a i n kinds of play materials, these may be d o l l s or these may be other kinds of things, they may be animals, they may be bows and arrows, they may be paper and p e n c i l , but he makes use of these materials to begin to explore the problems he has. Gradually, as he has the r e l a t i o n s h i p between himself and the t h e r a p i s t , the freedom permits him to explore them i n greater depth and experience some of the anxiety that he a c t u a l l y has which.in f a c t he.is defending against experiencing. The play therapy permits him, allows him to experience the anxiety because there i s t h i s safe person, there i s t h i s person 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, begins to explore them; . . . In other forms of therapy there 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 given the freedom and helped by r e f l e c t i o n of some of the things he i s doing, to begin to extend h i s play so i t becomes a ve h i c l e through which he can explore the prob-lems, but p r i m a r i l y through which he can go back on, i f there i s such a thing, h i s own track of development, and have more adequate r e l a t i o n s with other kinds of people, so he i n f a c t no longer has a problem.13 How d i d I come to see t h i s as a r a t i o n a l way to accomplish therapy? As a s t a r t i n g point, I discovered that therapists of other t h e o r e t i c a l persuasions often c i t e d the 'dullness' that I have already r e f e r r e d to and thought of t h i s as a "strange" way to do therapy. We can ask how i t i s that 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 play therapy 'work' when nothing extraordinary appears to happen. I had to learn not only how to make sense of the patient's play, but also to see the implications of the therapy technique. That i s , I had to learn to see play therapy as a good and r a t i o n a l way of making ch i l d r e n with behavioral problems better. Again, the therapist's t a l k provided me with i n s t r u c t i o n s on how to accomplish t h i s . I t seemed to involve, at l e a s t i n part, some understanding of the c h i l d ' s emotional development, of the ways i n which r e l a t i o n s h i p s within the family 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 love, acceptance, understanding, and so on are i n t r i n s i c parts of t h i s development. I had to learn too, that the c h i l d would only be free to change within the appropriate 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 allowed him to express h i s pent up emotions. I began to see the r a t i o n a l i t y of t h i s i n the following way. Later, t h i s allowed me to locate numerous other documents of i t i n the therapy events. 2.3 1. T: Janet? 2. C: What? 3. T: I can't r e a l l y see from here, do you think I should move closer? 4. C: Do you want to t r y and see a l l the boats? 5. T: Yea, do you want me to? 6. ' C: Yea. 7. T: Okay. ((therapist moves closer)) Here, I was puzzled as to why the t h e r a p i s t had asked the c h i l d ' s 57 permission to move closer to the sand tray i n order to see what was going on. A f t e r the session, the the r a p i s t explained that c h i l d r e n are under the constant s u r v e i l l a n c e and control of adults, however, the pa t i e n t i n play therapy should f e e l free of these r e s t r i c t i o n s . That i s , the c h i l d should be made to f e e l an equal partner i n the r e l a t i o n s h i p which obtains between him and the th e r a p i s t . I w i l l provide some further instances of the r a t i o n a l i t y of the r e l a t i o n s h i p ^ f o r instance, i n the following incident. Since the r e l a t i o n s h i p was to do some of the work of 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 , therapists attempted to stimulate a high degree of rapport, t r u s t , s e c u r i t y , and confidence so that the pa t i e n t could begin to experiment with h i s own actions and f e e l i n g s . The importance of t h i s r e l a t i o n s h i p can be sensed i n the s a t i s f a c t i o n which i s evident i n the following statement. The patient had expressed her t r u s t i n the ther a p i s t and, soon a f t e r the session was over, the th e r a p i s t s a i d to me: 2.4 T: That's a tremendous t r i b u t e you know. I don't often get that .kind of thing, where kids say you have my d o l l and I ' l l have yours. Because ah, w e l l , i t ' s got a l l kinds of, probably a l l sorts of sexual overtones, or undertones, but simply the recognition that t h i s i s something I can t r u s t you with, that i s I'm coming back, and i t ' s going to be safe. And I think that she was g r a t e f u l to me for having begunv.to deal with her concerns. This short excerpt points to the importance of t r u s t and i t s r e l a t i o n s h i p to and importance i n therapy and gives us some important ideas about how we f i n d i n d i c a t i o n s as the therapy progresses. Since the c h i l d can deal.with her concerns without any d i r e c t confrontation, i t i s always d i f f i c u l t to ascertain whether or not the c h i l d has s u f f i c i e n t confidence i n the the r a p i s t to be able to sense that he can act out and deal with h i s problems. 58 Or consider the following between a the r a p i s t and a student: 2.5 T: So that's the mo-, yea so the other things i s that she hasn't r e a l l y gotten anything from the mother, the father r e l a t e s to her, the father r e l a t e s to her and mum r e a l l y doesn't, and mother handles her now by l i t e r a l l y chucking her out of the house anytime of the day or night. S: ( ) T: Yea. So that t h i s i s the thing you see ( ). She f e l t the anger, she f e e l s the rage and she can't express i t i n the classroom, and that's okay, but you know what I think the teacher i s doing i n the classroom i s to say "look I know you've been ( ). S: mmhmmm (+) T: I think f o r the k i d who's so, who.'s been getting so much h e l l as a re s u l t of ( ) she needs to know that somebody knows that ( ) i t ' s understandable you know. The t h e r a p i s t i s explaining why p a s s i v i t y and tolerance are c a l l e d f o r i n sit u a t i o n s that would normally evoke some active response from an adult. I t was through instances such as these that I began to see that the therapist's actions, h i s p a s s i v i t y , tolerance, and acceptance, were inten-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 to and had consequences f o r the ch i l d ' s actions. I t i s obvious that such constraints present c e r t a i n problems f o r the the r a p i s t . Some of these were obvious to me from the outset since the ta l k which I heard often appeared to be very strange. For example: 2.6 C: I'm putting, I'm putting a model together today. T: You're going to put a model together today hey. C: The one you gave me. 2.7 C: I want to go away. T: Hmmm/ 59 C: I want to swim i n the pool (at gym). T: You wanted to go away from me. I started to notice various kinds of repeat sequences and re f e r r e d to them 14 c o l l e c t i v e l y as the echo technique. I t was not uncommon f o r an exchange of several utterances to follow a pattern i n which the th e r a p i s t simply restated what the c h i l d had said. (For an example of t h i s see t r a n s c r i p t 1.6). In contrast, a the r a p i s t showed me how the following conversation was inappropriate i n terms of the o v e r a l l design of play therapy. I t went: 2.8 C: I guess i t ' s tough on grandfathers i s n ' t i t ? T: Tough on grandfathers? C: Yea. T: How i s i t tough on grandfathers? C: I dont' know why. T: But i t ' s tough on grandfathers huh? C: ( ) T: Thank you Terry. Is i t tough on grandfathers to work? C: mmhiruxim (+) T: Grandfathers b u i l d roads? ((pause)) Humm? She explained that: 2.9 T: . . . (this) l e f t me spinning. I, I was r e a l l y puzzled because he, usually when he's been b u i l d i n g roads I've been saying "what kind of road i s i t ? " and today I thought well h e l l I've been through that route, you know, so I'd just be quiet. And then he comes out with that 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 grandfathers" and you know i t was r e a l l y b i z a r r e . R: I forget what you did, you d i d make, you d i d t r y and say, you j u s t said " I t ' s tough f o r grandfathers?" hoping he would carry on. 60 T: Yea, and nothing happened. And a t one point I s a i d " i t ' s tough f o r grandfathers b u i l d i n g roads?" and he sa i d yea. But that was, that was bad t h e r a p e u t i c a l l y on my part because I l e d him into that,'you know. I set him up with an answer. Whereas I would have been better o f f to say, l i k e I say, I t r i e d once though, I said " i t ' s tough f o r grandfathers?" hoping he would embellish but nothing happened. But I should have said again, "how i s i t tough?" Axline makes the following point about saying the c h i l d ' s words r i g h t back to him. She. points out that t h i s i s often the correct proce-dure; had the the r a p i s t s a i d instead: "You are a f r a i d and your mother doesn't pay attention to your fears and that scares you s t i l l more", she i s getting ahead of the c h i l d and i n t e r p r e t i n g h i s remarks. Perhaps the i n t e r p r e t a t i o n i s cor-r e c t , but there i s the danger of thru s t i n g something at the c h i l d before he i s ready f o r it.15 1 So f a r , I have emphasized how the observer comes to see an order or r a t i o n a l i t y i n a strange or e s o t e r i c s e t t i n g . Although the c e n t r a l issue has been that of making sense of the c h i l d ' s a c t i v i t i e s i n the play room, i t i s also e s s e n t i a l that we see how the therapist's a c t i v i t i e s , as motivated accomplishments complement and i n some way account f o r the ch i l d ' s doings during the session. The f a c t that I was able to under-stand what the th e r a p i s t was doing was e s s e n t i a l for my conception of what was going on i n the episodes that I have reported. I take i t that the discovery of r a t i o n a l i t y amounts to the a b i l i t y to provide adequate accounts of events. In t h i s case, I am t r y i n g to show how events may be s a i d to contain some importance f o r t h e r a p i s t s . Let us now return to our c e n t r a l problem, i . e . , that of making sense of the patient's actions and a c t i v i t i e s . While I do not claim to have acquired the competence that a the r a p i s t would display i n making sense out of these events, I gained some understanding of how children's play can be made in t o p s y c h i a t r i c a l l y relevent data. There are many instances i n which adults use play with c h i l d r e n to 61 mask other tasks. A school nurse might paint a face on the c h i l d ' s arm p r i o r to g i v i n g him an innoculation, or the photographer often gives toys to c h i l d r e n as a way to capture t h e i r attention so that he can take t h e i r photographs. However, i t was not the case that the t h e r a p i s t uses play i n order to mask some other more serious a c t i v i t y , rather, the play i s i t s e l f the therapy. This became c l e a r when parents ask: "Why does my c h i l d come here to play?" Therapists do not answer t h i s question implying that they are using play to keep the c h i l d busy so that he won't r e s i s t the cure which they have designed for him. Rather, they talked about the ways i n which a c h i l d communicates h i s problems v i a h i s play and uses play as a resource f o r r e s o l v i n g h i s problems. -" In short, although the l a y -man might see the c h i l d ' s actions as "nothing but play", the person who was trained to see i t as therapy could do so. This understanding i s e s s e n t i a l i f we are to make these sessions meaningful. Anthony, who i s the mentor of one of the therapists at the c l i n i c , says that play therapy i s grounded i n the f a c t that i t provides a t r a n s i e n t , i l l u s i o n a l transformation whereby the c h i l d i s no longer a helpless homunculus i n an overwhelmingly large world, 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 malleable, non-resistant universe.17 , The c h i l d often finds that he cannot cope with'his adult-made environment and resorts to the non-resistant world of toys where he finds and makes f o r himself a manageable r e p l i c a of that larger world. This provides him with the opportunity to f i n d himself through h i s adventures. E. Erikson c a l l s the play room and i t s c h a r a c t e r i s t i c toys the c h i l d ' s microcosm. I t i s a world he can manage and i s not swept along by forces that he cannot c o n t r o l . Since the c h i l d ' s play i s fashioned a f t e r h i s image of the 'r e a l world', i t i s possible for the observer to discover the ' r e a l ' c h i l d i n and by way of h i s pretend a c t i v i t y . Erikson says further: What i s i n f a n t i l e play then? . . . i t i s not the equivalent of adult play. That i t i s not recreation. • The playing adult steps sideward in t o another r e a l i t y ; the playing c h i l d advances forward to new stages of mastery. I propose the theory that the c h i l d ' s play i s the i n f a n t i l e form of the human a b i l i t y to deal with experience by creating model s i t u a t i o n s and to 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 to be fantasy, pretence or make beli e v e , Erikson i n s t r u c t s us to see that, i n h i s apparent suspension of r e a l i t y , the c h i l d i s recreating h i s world and h i s r e a l f e e l i n g s , etc. I take t h i s to mean that, i n a developmental sense, the c h i l d has the capacity to express himself, i . e . , to communicate h i s f e e l i n g s , to show h i s understanding of the world, and to reveal h i s wishes, wants, and fears, through h i s r e l a t i o n s h i p to toys. Therapists*refer to t h i s as the c h i l d ' s n a t u r a l mode of expression. An important r e a l i z a t i o n i n the h i s t o r y of psychotherapy was that the techniques and to o l s used i n adult psychotherapy, however successful they might be i n that context, d i d not ne c e s s a r i l y work as well when used with c h i l d r e n , for they are fundamentally d i f f e r e n t creatures from.adults and often cannot be treated i n the same way that adults are treated. Hug-Hellmuth was the f i r s t to use play i n t r e a t i n g disturbed c h i l d r e n , but i t was M. K l e i n who r e a l i z e d that spontaneous play could be used as a d i r e c t substitute f o r the verbal free association used so s u c c e s s f u l l y by 19 -.' Freud i n the treatment of adults. However, i t should be noted that Freud, i n t r e a t i n g " L i t t l e Hans", used Hans' play as a resource i n order to gain i n s i g h t s i n t o h i s problems. The technique of observing a c h i l d ' s play as a method f o r discovering h i s underlying problems has been g r e a t l y elaborated and a v a r i e t y of d i f f e r e n t approaches have been developed. In 63 a l l of these, however, there i s assumed to be a r e l a t i o n s h i p between what the c h i l d does with the toys i n the play room and the state of a f f a i r s i n which the c h i l d w i l l f i n d himself when he leaves. As a stranger, I became aware of the s i g n i f i c a n c e of toys and play through a number of d i f f e r e n t i n cidents. For example, I saw that the room did not contain simply a random s e l e c t i o n of toys. Rather the t h e r a p i s t selected s p e c i f i c toys and positioned them i n the room. I t was apparent that the s e l e c t i o n that she made was r e l a t e d to her understanding of the c h i l d and h i s or her problem. For example, when preparing f o r a c h i l d who was over anxious about a h o s p i t a l stay and surgery, the t h e r a p i s t spent considerable time i n looking for some medical toys. She found a doctor's bag with some instruments i n i t and placed i t i n the room which the c h i l d would be using. I t might occur to the reader that t h i s i s s i m i l a r to what a con-cerned parent who wished to show a c h i l d what ho s p i t a l s were l i k e might do. The parent might encourage the c h i l d to play with a 'doctor bag' i n order to assure him, and to make things 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 not what the the r a p i s t had i n mind i n the above mentioned episode. As soon as the medical toys were placed i n the room a l l of the c h i l d ' s actions became consequential f o r the th e r a p i s t . I f she chose not to play with them, she was seen to avoid them and to demonstrate her anxiety; i f she played with them only towards the end of the session, t h i s could be seen as progress; playing,with them i n spurts could repre-sent ambivalence; and, i f she played with them c r e a t i v e l y , t h i s could ind i c a t e that she was working through her anxiety i n a r e a l i s t i c way. Note that, i n t h i s instance, the medical toys became a c e n t r a l and important part of the i n t e r a c t i o n a l environment i n a way that other objects d i d not. For 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 attached to the f a c t that the c h i l d d i d not draw on the board or d i d not f i n d the rubber b a l l i n the bottom of the toy box. Over the course of my observations at the c l i n i c , very few sing l e objects came to assume the importance that the medical k i t had held f o r t h i s p a t i ent, however, every toy can be assumed to be as important under some circumstances. Thus, one way of providing an adequate explanation of the patient's behavior then i s to 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 objects are inescapably r e l a t e d to the patient i n important ways. I f a c h i l d i s angry but does not play with the punching clown, i t can be assumed that he i s d e l i b e r a t e l y avoiding not only the clown but h i s anger. I t i s also possible to locate a c h i l d ' s problems by watching how he reacts to the toys i n the play room, e.g., i f he avoids the wi l d animals and plays with the domesticated ones instead, we could assume that he was avoiding h i s anger. However, before attempting to provide an account of the patient's reactions to the toys, the th e r a p i s t w i l l attempt to gauge h i s emotional l e v e l f o r h i s actions are to be interpreted i n l i g h t of t h i s . My second naive observation was r e l a t e d to the observation above. During the ea r l y stages of my f i e l d work, I often became annoyed with the therapists because they appeared to be trapping the c h i l d . That i s , I f e l t that the c h i l d had no escape because whatever he d i d was seen as s i g n i f i c a n t . Therapists made (or t r i e d to make) p s y c h i a t r i c sense out of a l l of h i s actions a l l of the time. On the other hand, I: often thought that perhaps the c h i l d was t i r e d , that he had to go to the bathroom, or that he didn't have that p a r t i c u l a r toy at home, and so on. That i s , i n contrast to the the r a p i s t , I often t r i e d to provide a normal motivation for h i s actions. 65 What we have here i s a c l a r i f i c a t i o n o f what an " o c c a s i o n e d adequate e x p l a n a t i o n " amounts t o , i . e . , i n o r d e r t o be adequate i t must be p s y c h i -a t r i c a l l y adequate. I t may be p e r f e c t l y adequate f o r a p a r e n t t o a c c o u n t f o r h i s c h i l d ' s b e h a v i o r by a p p e a l i n g t o the f a c t t h a t he i s t i r e d , r e s t -l e s s , hungry, 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 f o r the o c c a s i o n o f 20 t h e r a p y . T h i s became c l e a r f o r me i n t h e f o l l o w i n g i n s t a n c e . C h i l d r e n o f t e n p a i n t e d w i t h w a t e r c o l o u r s a t a l a r g e e a s e l and the p a i n t would o f t e n run down t h e paper w h i l e t h e c h i l d was p a i n t i n g . The f i n i s h e d p i c t u r e would be t r e a t e d as 'data' by the t h e r a p i s t . I p r o p o s e d t h a t perhaps the f i n i s h e d p r o d u c t was as much t h e r e s u l t o f the way t h a t the p a i n t r a n down the e a s e l as a gu i d e t o the p a t i e n t ' s i n t r a p s y c h i c l i f e . A l t h o u g h t h e t h e r a p i s t acknowledged t h a t t h e f l o w o f the p a i n t a f f e c t e d the f i n a l shape o f the p i c t u r e , he c l a i m e d t h a t w i t h each s t r o k e t h e p a t i e n t was making a c h o i c e — e v e n i f . i t was an u n c o n s c i o u s c h o i c e . D i d he, f o r example, t u r n i t i n t o an a n g e l o r a monster, a c a t o r a t i g e r ? d i d he f i n i s h i t o r not? d i d he i n c o r p o r a t e t h e d r i p o r l e a v e i t as a mess? e t c . Thus, we can see t h a t any adequate account o f the p l a y a c t i v i t y i s b u i l t upon n o t i o n s o f t h e i n t e n t i o n a l i t y o f the a c t i o n . A competent t h e r a p i s t would n o t c l a i m t h a t the i n t e r p r e t a t i o n s made were n e c e s s a r i l y the c o r r e c t , o r even t h a t t h e r e was o n l y one c o r r e c t i n t e r p r e t a t i o n . R ather, i n t e r p r e t a t i o n s a r e 'guesses', d e s i g n e d t o h e l p the t h e r a p i s t move towards a b e t t e r u n d e r s t a n d i n g o f the p a t i e n t . They can be p r o v e d wrong and r e c o n s i d e r e d , o r th e y can be c o n f i r m e d . The t h e r a p i s t ' s competence does n o t seem t o r e s t upon h i s a b i l i t y t o i n t e r p r e t , any 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 t o see the p a t t e r n b e h i n d the whole range o f a c t i o n s . Thus I r e a l i z e d t h a t the way i n which some p a r t i c u l a r a c t i o n was judged i n and o f i t s e l f was f a r l e s s i m p o r t a n t t h a n 66 i t s p l a c e i n the l a r g e r p a t t e r n . As one t h e r a p i s t s a i d : T: . . . you g e t a p a t t e r n do you see, emerging, so t h a t a f t e r I g e t something l i k e t h i s , um, i t makes i t , and a f t e r a few times 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 what's g o i n g on. I want t o emphasize a g a i n how each and e v e r y one o f t h e c h i l d ' s a c t i o n s i s 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 w i l l now b r i e f l y d e s c r i b e the t h e r a -p i s t ' s i n t e r p r e t i v e schema. As was s u g g e s t e d above, the t h e r a p i s t r e l i e s upon t h e f a c t t h a t a c h i l d ' s r e a c t i o n t o the t o y s i n h i s environment can be used as a r e s o u r c e i n i n t e r p r e t i n g h i s h i d d e n f e e l i n g s and problems. Many o f the t o y s were r e a d i l y c a t e g o r i z e d . F o r example', guns were seen as i n s t r u m e n t s o f v i o l e n c e , w i l d a n i m a l s were seen as p o s s e s s o r s o f a g g r e s s i o n , ambulances o r p o l i c e c a r s r e p r e s e n t e d p e o p l e who want t o h e l p o t h e r s . However, o b j e c t s l i k e drawing 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 f o r t h e t h e r a p i s t o n l y a f t e r he c o u l d see what the c h i l d d i d w i t h them. (However, i t i s a l s o p o s s i b l e t o see p a i n t i n g as an a c t i v i t y which a l l o w s the c h i l d t o a v o i d the 'angry' t o y s ) . I take i t t h a t p a r t i c u l a r t o y s were s e l e c t e d by the t h e r a p i s t i n the f i r s t p l a c e because t h e y communicated t h e s e k i n d s o f meanings. As G i n o t t s a y s : 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 and f e c e s o f e v e r y messy s u b s t a n c e , sand, water, 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 and 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 complete o r adequate w i t h o u t such 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 water, e n c o p r e t i c c h i l d r e n , mud and brown 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 s h o u l d f i n d i n t h e p l a y room 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 and s e r v i n g as means t o s u b l i m a t e o r a l needs, 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 bags, t a r g e t s and guns t o s u b l i m a t e a g g r e s s i v e d r i v e s . . . . 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 anger by p u n c h i n g d o l l s and 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 growth i n the r e p e r t o r y o f s e l f -e x p r e s s i o n . 2 1 While the t o y s a r e m e t h o d i c a l l y chosen by th e t h e r a p i s t t o r e l a t e 67 t o t h e c h i l d i n a s p e c i a l way, t h e p a t i e n t ' s own s e l e c t i o n o f them as p l a y o b j e c t s i s then seen t o be m o t i v a t e d by th e n a t u r e o f h i s problems and h i s s t a t e o f mind. G i n o t t makes t h i s c l e a r : A p p r o p r i a t e t o y s make i t e a s i e r f o r the t h e r a p i s t t o u n d e r s t a n d the meaning o f the c h i l d ' s p l a y , thus f o r example, c h i l d r e n u s u a l l y p l a y out f a m i l y scenes 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 s i b l i n g . In the absence o f such d o l l s , a c h i l d may s y m b o l i c a l l y p l a y o u t f a m i l y themes by u s i n g b i g and l i t t l e wooden b l o c k s . But the e x a c t meaning may escape the t h e r a p i s t . . . . However, when a f a t h e r d o l l i s p u t on t o p o f a mother d o l l , the t h e r a p i s t has l e s s room f o r m i s i n t e r p r e t a t i o n . 2 2 In s e a r c h i n g f o r the m o t i v a t i o n b e h i n d a p a r t i c u l a r s e l e c t i o n , i t i s p o s s i b l e t o b u i l d upon the c h a r a c t e r o f the o b j e c t t h a t i t i s a s u b s t i -t u t e f o r . I t i s i n t e r e s t i n g t h a t most t o y s ar e m i n i a t u r e r e p l i c a s o f r e a l o b j e c t s — g u n s , a n i m a l s , p e o p l e , v e h i c l e s , c a r r i a g e s , baby c l o t h e s , baby b o t t l e s , t r e e s , f e n c e s , e t c . ( E x c e p t i o n s appears t o be monsters and games). I f a p a t i e n t t a k e s a d r i n k from a baby b o t t l e i t i s n o t t a k e n t o be assumed t h a t he i s s i m p l y t h i r s t y , b u t t h a t he i s p r e t e n d i n g t o be a baby h a v i n g a d r i n k , i . e . , he i s a c t i n g o u t o f dependency needs. T h i s c h a r a c t e r i z a t i o n o f o b j e c t s became c l e a r i n the f o l l o w i n g con-v e r s a t i o n between a i i t h e r a p i s t and "myself. 2 ."10 T: Yea, I remember, i t happens o f t e n t h a t we're d o i n g d i n o s a u r s . I t ' s funny l i k e , John p e r s i s t e n t l y chooses d i n o s a u r s . R: And t h e r e a r e o t h e r t h i n g s t o choose from? T: Oh yea, t h e r e ' s c a r s , and b o a t s , and p l a n e s . R: Yea. T: 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 t h i n g s , you know, l i k e d i n o s a u r s a r e u s u a l l y thought o f as n o t , . . . t h e y ' r e m o s t l y t h e most f e r o c i o u s , dangerous c r e a t u r e s t o walk t h e f a c e o f t h e e a r t h , . . . I t r y t o use t h a t , . . . So I t r y , I t r y and t e n d t o k i n d o f see "okay, d i n o s a u r s , now d i n o s a u r s a r e f e r o c i o u s b e a s t s maybe we can g e t i n t o John's anger a b i t . " In t h i s excerpt, we see how i t i s also possible to characterize the choice of an object as eventful according to the frequency with which i t was chosen. While i t i s poss i b l e to achieve some degree of understanding by attending to the patient's i n i t i a l choice, one must also attend to the ongoing pattern of h i s playing. I w i l l , point out a few of the things that made t h i s apparent to me. Consider the following: -2.11 T: Now that's the sort of thing where you've got a seven year o l d who simply p u l l s toys out and puts them in t o the tray, un, and ignores r e l a t i o n s h i p s so no grouping occurs or very l i t t l e grouping occurs, you know you may bring out a horse, and may bring out another horse, and yet the two horses have no r e l a t i o n s h i p to each other. That sort of thing happens i n only very young c h i l d r e n who are j u s t at the sort of object naming stage, c h i l d r e n who are retarded, some chi l d r e n who are br a i n damaged, uh, who often a c t u a l l y go through the whole thing very quickly. The reference i n the above t r a n s c r i p t s i s to a pa t i e n t who spent the whole session taking the toys from the box, naming them, and then p l a c i n g them i n the sand tray. For the the r a p i s t t h i s kind of a c t i v i t y was note-worthy because of the patient's age. What i s eventful i s the f a c t that the c h i l d paid no attention to the structure of the sand tray placement, that i s , what resu l t e d from the 'play' was a random assortment of toys which bore no obvious r e l a t i o n s h i p to one another. The toys the c h i l d 2 3-was playing with were a part of Lowenfeld's "world p i c t u r e technique" miniature r e p l i c a s of people, animals., fences, etc. The resultant miniature 'world' created by the patient reveals the degree of h i s disturbance and gives some suggestions as to what the disturbance i s . In t h i s context, the above mentioned c h i l d ' s world view i s chaotic, confused, etc. 6 9 T h i s i n c i d e n t took p l a c e i n the f i r s t t h e r a p y s e s s i o n t h a t I w i t -n e s s e d and I s t r o n g l y f e l t t h a t t h e c h i l d ' s "naming game" c o u l d be e x p l a i n e d by examining the i n t e r a c t i o n s between the t h e r a p i s t and him. An e x a m i n a t i o n o f the t r a n s c r i p t w i l l show t h a t the t h e r a p i s t i n i t i a t e d t h i s naming ("what's t h i s ? " ) , and i t . i s p o s s i b l e t h a t the p a t i e n t t h ought t h a t he was t o c o n t i n u e . The t h e r a p i s t r e j e c t e d t h i s a c c o u n t and p r o v i d e d an e x p l a n a t i o n i n terms o f the i n t r a p s y c h i c l i f e o f t h e c h i l d . Many o t h e r k i n d s o f r e l a t i o n s h i p s were p o i n t e d o u t t o me as w e l l . P l a c i n g t h e p a r e n t s i n the house and l e a v i n g the baby o u t s i d e ; b u i l d i n g a f e n c e around a s o l i t a r y p e r s o n and t h e n making the ocean s p l a s h danger-o u s l y near; engaging the w i l d a n i m a l s and th e tame a n i m a l s i n a b a t t l e ; b u i l d i n g a f e n c e around the w i l d a n i m a l s ; g e t t i n g one o f the v e h i c l e s s t u c k ; and so on. A l l o f t h e s e were c o n s i d e r e d t o be s i g n i f i c a n t . F u r t h e r , i t was assumed t h a t th e p a t i e n t always i d e n t i f i e d w i t h one o f the o b j e c t s i n t h e s e s c e n e s . These comments r e f e r e s s e n t i a l l y t o the c o n t e n t o f the c h i l d ' s p l a y b u t i t was always n e c e s s a r y f o r th e t h e r a p i s t t o a t t e n d t o more than t h i s . F o r example, he would note the s t y l e o f t h e p l a y and whether i t was t i d y , o r d e r l y , p e r s o n a l , i m p e r s o n a l , e t c . He would a l s o note the e f f e c t t h a t t h e p l a y had on t h e p l a y e r . D i d t h e c h i l d become i n v o l v e d , r e l u c t a n t , e x c i t e d e t c . Even the f l o w o f t h e a c t i v i t y was m e a n i n g f u l f o r him. As a n o v i c e o b s e r v e r I s i m p l y saw l a r g e b l o c k s o f p l a y a c t i v i t y and was s u r p r i s e d t o f i n d t h a t t h e t h e r a p i s t c o u l d d i s c o v e r many m e a n i n g f u l p a t t e r n s h e r e . The e s s e n t i a l problem seemed t o be t h a t o f l e a r n i n g t o see what counted as a u n i t o f a c t i v i t y . One way o f u s i n g t h e f l o w o f a c t i v i t y went l i k e t h i s . S i n c e the c h i l d ' s p l a y i s t a k e n t o have elements o f r e a l i t y i n i t , i t f o l l o w s t h a t h i s f e a r s and a n x i e t i e s w i l l i n t e r s e c t 70 w i t h the p l a y a t some p o i n t s . P l a y scenes may h e i g h t e n the c h i l d ' s a n x i e t y and one c o u l d t h e n d i s c o v e r something about h i s p r o b l e m by examin-i n g t h e c o n t e n t o f the p l a y a t t h a t p o i n t . T h i s was made c l e a r t o me i n t h e f o l l o w i n g scene. The p a t i e n t ' s immediate problem was e x p r e s s e d as extreme a n x i e t y r e l a t e d t o a n t i c i p a t e d eye s u r g e r y and the t h e r a p i s t was o b l i g e d t o h u r r y the t h e r a p y s i n c e t h e o p e r a t i o n c o u l d n o t be postponed. Thus, i n s t e a d o f a l l o w i n g the c h i l d enough time t o work out h e r f e e l i n g s and f e a r s , he had t o t r y and b r i n g t h o se a n x i e t i e s t o the s u r f a c e so t h a t they c o u l d be d e a l t w i t h . The normal p r o c e s s had t o be speeded up. One s t r a t e g y which I have a l r e a d y mentioned was t h a t o f p l a c i n g a m e d i c a l bag i n t h e p l a y room. An o t h e r was t o mention eyes o r s e e i n g w h i l e the c h i l d was p l a y i n g . He might say, "Are you h a v i n g t r o u b l e s e e i n g t h a t ? " He c o u l d then see i f h e r a n x i e t y l e v e l r o s e by l o o k i n g f o r any d i s j u n c t u r e i n t h e p l a y a c t i v i t y , i . e . , d i d she move on t o a n o t h e r a c t i v i t y ? d i d h e r motions become more e r r a t i c ? and so on. A t the mention o f a s e n s i t i v e a r e a ( i . e . , f e e l i n g s o f anger o r r e j e c t i o n ) the p l a y a c t i v i t y may be d i s r u p t e d . Both o f t h e s e examples r e f e r t o s i t u a t i o n s i n which the s o u r c e o f d i s r u p t i o n i s l o c a t e d o u t s i d e o f the a c t i v i t y i t s e l f , i . e . , i n a comment by the t h e r a p i s t . However, i t i s a l s o p o s s i b l e t o see t h e d i s r u p t i o n coming from the a c t i v i t y i t s e l f . T h a t i s , one c o u l d l o o k f o r e v i d e n c e o f the d i s r u p t i o n i n t h e c o n t e n t o f th e p l a y . A t h e r a p i s t n o t e d t h a t a p a t i e n t was making ' p r o g r e s s ' f o r h e r p r e v i o u s s e s s i o n had c o n t a i n e d t h e l a r g e s t p e r i o d o f c r e a t i v e p l a y t h a t he had seen so f a r . In an e a r l i e r s e s s i o n he had d e s c r i b e d h e r p l a y as f o l l o w s : 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 she can d e a l w i t h h e r a n x i e t y v e r y c r e a t i v e l y i n t h a t she's you know p r e p a r e d t o adopt a v e r y c l o s e i m i t a t i o n o f r e a l i t y . R: mmhmm T: And t h e n , a t th e (worst) she goes back t o the 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 . I t ' s f a i r l y t y p i c a l I suppose i n a p l a y t h e r a p y s e s s i o n t o g e t t h i s , t h e s e swings are v e r y marked. Here, however, the t h e r a p i s t saw the c h i l d ' s c r e a t i v i t y , h e r r e l a t i o n t o r e a l i t y , and h e r r e g r e s s i v e t e n d e n c i e s . Taken as a whole, t h e s e i n d i c a t e t h a t she i s making p r o g r e s s . The c h a r a c t e r i z a t i o n r e l i e s upon t h e sym-b o l i s m o f t h e p l a y o b j e c t s and upon a r e c o g n i t i o n o f t h e k i n d s o f p l a y t h a t she was engaged i n , i . e . , ' c r e a t i v e ' and ' r e g r e s s i v e ' . T h i s sequence o f changes from c r e a t i v e t o r e g r e s s i v e was seen as normal s i n c e i t i s assumed t h a t th e c h i l d works out c u r r e n t c o n c e r n s i n p l a y a c t i v i t y . I t i s t o be e x p e c t e d t h a t the c h i l d w i l l be a b l e t o cope w i t h h i s problems f o r a w h i l e and t h e n w i l l r e g r e s s t o an e a r l i e r s a f e r s t a g e . P r o g r e s s i s e v i d e n t as the r e g r e s s i v e p e r i o d s d i m i n i s h . In c o n c l u s i o n , t h e r e a r e two more p u z z l e s t h a t I would l i k e t o mention. I i m m e d i a t e l y n o t e d t h a t t h e r e appeared t o be a s p e c i a l s e t o f r u l e s f o r the p l a y room. One t h e r a p i s t t o l d a c h i l d : 2.13-T: and, and you can a l s o swear i n t h e p l a y room even i f y o u wanted t o do t h a t . C: Why? T: Cause t h i s i s a p l a c e where k i d s can do p r e t t y much what t h e y want t o . 2.14, T: Sometimes I b e t you even swear. C: No I don't swear. T: Hmrnm? You know, one p l a c e where i t ' s r e a l l y good t o swear i s r i g h t h e r e i n the p l a y room. C: I know. T: T h a t ' s r i g h t . ((pause)) Why you can even say f u c k and a l l t h o s e t h i n g s , r i g h t h e r e . C: ( you want t o the d a r t s ) T: Hmmm? ((pause)) A t home though I t h i n k sometimes i t , bugs mom i f you swear. C: ( watch t h i s ) T: 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 o u t . You can swear, y e l l , and a l l t h o s e t h i n g s . ((pause)) Wowweee. C: The k i c k - o f f . Other c h i l d r e n were a l l o w e d t o p a i n t on t h e w a l l s , t o shoot t h e t h e r a p i s t w i t h a water p i s t o l , t o make 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 b o t t l e s , t o throw d a r t s a t a drawing o f a t e a c h e r o r t h e t h e r a p i s t , e t c . Some o f t h i s p e r m i s s i v e n e s s c a n now be seen as t h e r e s u l t o f t h e i d e a t h a t a c h i l d s h o u l d be g i v e n the freedom t o e x p l o r e and e x p e r i e n c e h i s emotions. I t i s i m p o r t a n t t h a t r e s t r i c t i o n s be h e l d t o a minimum s i n c e t h e c h i l d makes p r o g r e s s by (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 t o l e r a n t r e l a t i o n s h i p , and (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 e m o t i o n a l d e v e l -opment w i t h i n the s a f e t y o f t h a t r e l a t i o n s h i p . The r e d u c t i o n o f r e s t r i c -t i o n s h e l p s the r e l a t i o n s h i p t o d e v e l o p . G i n o t t p u t s i t n i c e l y when he s a y s : Many c h i l d r e n have been s c o l d e d o r spanked f o r messing w i t h mother's t y p e w r i t e r , f o o l i n g w i t h b r o t h e r ' s f l a s h l i g h t , o r p l a y i n g w i t h f a t h e r ' s t o o l k i t . N o t h i n g conveys p e r m i s s i v e n e s s t o t h e s e c h i l -d r e n as much as t h e p r e s e n c e o f such m a t e r i a l s f o r t h e i r own use. 73 Noisemaking toys such as drums, pegboards, xylophones, a i r r i f l e s , and cap guns serve the same purpose. They communicate loud and cl e a r the adult's basic s p i r i t of tolerance.'24 Therapists also take i t that there are some a c t i v i t i e s that r e l a t e to the c h i l d ' s problem. I t i s often p r o f i t a b l e to allow the c h i l d to do and f e e l things that he has not been able to do i n other s e t t i n g s . I once questioned a the r a p i s t about a c h i l d ' s actions. .2.15 R: Well how do you think the k i d , what's going on for the k i d when he throws darts at the balloons, and sometimes pretending the balloons are you? T: Well, I don't know, I think he can get in t o i t , you know, that i s , that he can r e a l l y kind of act out the fe e l i n g s of anger he has towards me. And I think that's kind of a r e l i e f i n a sense. ( ) ((pause)) I think for Chris too i t might make him f e e l rather brave and daring. And I think he can get some s a t i s f a c t i o n from that. Some of the assumptions here should be pursued. I t ' s a " r e l i e f " f o r the c h i l d to express h i s anger with the ther a p i s t because he was not allowed to experience anger i n other r e l a t i o n s . Perhaps when he got angry with h i s parents, as a l l c h i l d r e n do, he was not permitted to express h i s fee l i n g s but was made to f e e l g u i l t y f o r being angry with h i s parents i n the f i r s t place. A c h i l d with too many r e s t r i c t i o n s of t h i s sort may become timid, manipulative or many other things. However, i f he i s allowed to vent h i s f e e l i n g s i n the play room, he may come to see himself i n a d i f f e r e n t way (e.g., 'brave', and- 'daring'), and learn to keep up t h i s image outside of the therapy session. This r e l a t e s d i r e c t l y to my f i n a l puzzle. As an observer, I saw the patient's problems and gained an understanding of them only by p l a c i n g the c h i l d i n a family context. While I have not talked about the patient's family to t h i s point, I do not mean to suggest that i t was not seen as an 74 i m p o r t a n t f a c t o r . Without e x c e p t i o n , t h e t a l k about a p a t i e n t i n c l u d e d t a l k about the s i t u a t i o n o f h i s f a m i l y , the c h i l d ' s s i b l i n g p o s i t i o n , h i s f a t h e r ' s o c c u p a t i o n , the f a m i l y ' s t h e o r i e s about c h i l d r e a r i n g , traumas i n the f a m i l y , and so f o r t h . I assumed, t h a t none o f t h e s e f e a t u r e s were i n c i d e n t a l b u t were r e l e v a n t i n d i c a t i o n s o f what might be t h e m a t t e r w i t h the c h i l d . C h i l d r e n ' s p r o d u c t i o n s o f t e n r e l a t e d t o t h e i r f a m i l y s i t u a -t i o n s . As a t h e r a p i s t t o l d me, one p a t i e n t t y p i c a l l y p r o d u c e d p a i n t i n g s w i t h a c l e a r dichotomy i n d i c a t e d by c o n t r a s t i n g c o l o r s ( r e d and b l a c k ) and o f t e n h i s t a l k s u g g e s t e d t h a t c o n t r a s t i n g p e o p l e i n h a b i t e d t h e s e two r e g i o n s . T h i s made p s y c h i a t r i c a l l y r e l e v a n t sense and c o u l d be seen as a symptom o f t h e p a t i e n t ' s p roblem o n l y when i t was seen as a document o f h i s f a m i l y ' s s t r i c t r e l i g i o u s b e l i e f , h i s s t r u g g l e w i t h the n o t i o n s o f 'good' and ' e v i l ' , and h i s co n c o m i t a n t need t o be naughty o r m i s c h i e v o u s , ( i . e . , e v i l ) . Here i s some o f t h e t h e r a p i s t ' s t a l k about t h a t c h i l d : 2.16 T: . . . come 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 ( ) you c a n ' t do t h i n g s because you would 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 s e l f l e s s about the whole t h i n g and do i t f o r the 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 m otive, a t home I s u s p e c t . C e r t a i n l y from o b s e r v i n g him i n t h e p l a y room one would g e t t h a t i m p r e s s i o n . There i s a c o n s t a n t attempt by t h e r a p i s t s t o see the p a t i e n t ' s a c t i o n s as outcomes o f h i s everyday l i f e and t o g i v e p s y c h i a t r i c s i g n i f i c -ance t o them. There i s a g r e a t d i f f e r e n c e between assuming t h a t a c h i l d i s a m a n i p u l a t o r and assuming t h a t h i s b e h a v i o r i s t h e r e s u l t o f t h e problems t h a t he has i n h i s f a m i l y . T h i s p r o v i d e s us w i t h some i n s i g h t i n t o h i s r e a l problem. That i s , g i v e n t h a t the c h i l d i s m a n i p u l a t i v e , we can assume t h a t t h e r e i s some problem i n h i s home l i f e . 75 T h i s k i n d o f e v i d e n c e i s u s e f u l not o n l y i n c a s e s where the c h i l d ' s problems were vague, b u t a l s o i n c a s e s where the p roblem appeared, a t f i r s t g l a n c e , t o be o b v i o u s . F o r example, a g i r l who t a l k e d o f growing w h i s k e r s and o f c h a n g i n g h e r name t o John c o u l d e a s i l y be seen t o have a sex i d e n t i -f i c a t i o n problem. However, t h e s e symptoms were g i v e n a d i f f e r e n t s i g n i f -i c a n c e when i t was d i s c o v e r e d how t h e y made sense i n terms o f h e r f a m i l y s i t u a t i o n , s p e c i f i c a l l y i n terms o f the d i f f e r e n t i a l a t t e n t i o n g i v e n t o h e r b r o t h e r s , h e r p o s i t i v e f e e l i n g s towards h e r f a t h e r and n e g a t i v e f e e l i n g s towards h e r mother. Now, we have q u i t e a d i f f e r e n t p i c t u r e o f t h i n g s . I began t h i s c h a p t e r by s e a r c h i n g f o r t h e p s y c h i a t r i c r e l e v a n c e o f e v e n t s i n the t h e r a p y s e t t i n g and have p r o v i d e d a d e s c r i p t i o n o f t h e r a t i o n a l i t y o f t h e s e t t i n g . I was a b l e t o do t h i s because I was a l r e a d y ( a l t h o u g h u n w i t t i n g l y ) a competent p a r t i c i p a n t t o t h e s e t t i n g . In summation, I made the f o l l o w i n g o b s e r v a t i o n s : 1. I found t h a t a l l o f t h e e v e n t s i n th e p l a y room were open t o a p s y c h i -a t r i c t i n t e r p r e t a t i o n . T h i s p r o d u c e d the f o l l o w i n g t r a n s f o r m a t i o n s f o r me. (a) I moved from a p o s i t i o n w h e r e i n I saw p a t i e n t s as normal c h i l d r e n t o one i n which I c o u l d see t h a t t h e y had problems. (b) I n s t e a d o f s e e i n g t h e r a p y hour^as d u l l and r e p e t i t i v e , I began t o see i t as a s y s t e m a t i c programme d e s i g n e d t o h e l p d i s t u r b e d c h i l d r e n . (c) I no l o n g e r saw t h e c h i l d ' s a c t i v i t i e s m erely as p l a y , b u t as documents o f problems, as w e l l as o f t r u s t , p r o g r e s s , e t c . (d) To some e x t e n t , I began t o make the same sense o f e v e n t s as the t h e r a p i s t s . T h at i s , I began t o a c q u i r e a p s y c h i a t r i c r a t i o n a l i t y o f my own. 76 2. I also learned that i t was not s u f f i c i e n t to explain a patient's behavior i n terms of the nature of pa i n t , the time of day, body urges, etc. Rather, p s y c h i a t r i c accounts i n v a r i a b l y lead the t h e r a p i s t to features of the patient's l i f e outside of the play room (or to h i s intrapsychic functioning). These explanations 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 actions were the r e s u l t of i n t e n t i o n a l (even when unconscious) choices. 3. To achieve p s y c h i a t r i c understanding one had to provide adequate motivational statements with respect to those choices. This was done i n many ways, but the most frequent and most i n t e r e s t i n g were accounts framed i n terms of the 'family'. A l l c h i l d r e n are family members and consequently t h i s provides an ubiquitous set of circum-stances i n which to f i n d the motivations f o r the patient's play room behavior. 4. Thus we have moved from our i n i t i a l i n t e r e s t i n p s y c h i a t r i c relevance to a consideration of mundane knowledge about c h i l d r e n , f a m i l i e s , problems, etc. As I became more f a m i l i a r with the therapist's accounts, I became more d i s s a t i s f i e d with my new understanding of the s e t t i n g . This d i s -a f f e c t i o n stemmed from two sources. F i r s t , while there was a claim that the structure of p s y c h i a t r i c accounts was supported by a body of theory, t h i s was never made e x p l i c i t f or me. Consequently, I f e l t that I could never acquire an adequate understanding of how p s y c h i a t r i s t s make sense out of the events of the play room. Secondly, I became in c r e a s i n g l y aware of, 25 and i n t r i g u e d by the set of membership categorization devices that appeared i n t h i s s e t t i n g . One could, for example, naively assume that the occasioned categories of 'patient' and 'therapist' would be adequate 77 f o r c a t e g o r i z i n g the p a r t i c i p a n t s . However, I found the members were f r e q u e n t l y r e f e r r e d t o as ' a d u l t s ' and ' c h i l d r e n ' and, f u r t h e r , t h a t n e i t h e r the c a t e g o r y o f ' p a t i e n t ' nor the a c t i v i t y o f 'therapy' were e v e r 2 _ mentioned t o the ' c h i l d 1 . R e l a t e d t o t h i s was t h e o b s e r v a t i o n t h a t t h e r a p i s t s o f t e n t a l k e d about t h e p o s s i b i l i t y o f sounding l i k e a p a r e n t and h a v i n g t h e p a t i e n t r e s p o n d l i k e a ' c h i l d ' . T h i s l e d me t o see t h a t 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 a c c o u n t s was one t h a t c o n t a i n e d a g r e a t d e a l o f common sense r e a s o n i n g — s o m e t h i n g t h a t I s h a r e d w i t h t h e t h e r a p i s t s . T hat i s : p s y c h i a t r i c t h e o r y • common sense and r e l e v a n c e knowledge T h i s b r o u g h t me back t o where I had begun. I had s t a r t e d w i t h o b s e r v a t i o n s on the r e a s o n a b l e n e s s o f what I saw and h e a r d , doubted t h i s r e a s o n a b l e n e s s , and s e a r c h e d f o r i t s p s y c h i a t r i c r e l e v a n c e . A t t h i s p o i n t , we have come f u l l c i r c l e t o a new awareness about the embededness o f common sense i n t h i s s e t t i n g . T h i s r a i s e s some s e r i o u s q u e s t i o n s about t h e n a t u r e o f 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, b u t b e f o r e t u r n i n g t o t h e s e , I want t o examine some o f the f e a t u r e s o f t h e t h e r a p i s t ' s corpus o f knowledge about c h i l d r e n and f a m i l i e s . T h i s corpus i s c o n s t r u c t e d from a c c o u n t s p r o v i d e d by t h e r a p i s t s and I want t o emphasize the e s s e n t i a l r e a s o n a b l e n e s s o f t h i s e x p l a n a t o r y s t r u c t u r e . Up t o t h i s p o i n t I have p r e s e n t e d a r a t h e r b r o a d 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 t h e s e t t i n g . The n e x t two c h a p t e r s w i l l p r o v i d e more d e t a i l . 78 Footnotes ""For a b r i e f introduction to t h i s l i t e r a t u r e see R. M. Pavalko, Sociology of Occupations and Professions, (Itasca: F. W. Peacock Publishers Inc.) 1968. 2 By " r a t i o n a l i t y " I would l i k e to employ Cicourel's usage: " . . . r a t i o n a l i t y means the observer's model of how the actor decides-what i s 'reasonable', 'proper', ' l o g i c a l ' , 'acceptable', ' l e g a l ' , and so f o r t h during the course of action." As an observer, I was constantly engaged i n the construction of a 'model' of what seemed reasonable, proper, l o g i c a l , expected, usual, acceptable, etc. i n t h i s s e t t i n g . This was based on the t a l k of others i n the environment. I am t a l k i n g about the background expectancies that made events reasonable, etc. See, A. C i c o u r e l , The  S o c i a l Organization of Juvenile J u s t i c e , John Wiley and Sons, 1968, p. 46. 3 . V. Axlme i s one of the major advocates of play therapy and her work i s held up as an example of 'good' ( i f unattainable) therapy. 4 This kind of therapy i s sometimes r e f e r r e d to as 'non-directive therapy'. That t h i s choice i s theory governed i s evident i n the following statement by Ginott: "The diff e r e n c e between the two schools of 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 of permissiveness. According to one approach, permissive means the acceptance of a l l behavior as i t appears i n the (therapy) group. . . according to the other approach, per-missiveness means the acceptance of a l l symbolic behavior as i t appears i n therapy. . ..." "The Theory and Practice of Therapeutic Intervention i n C h i l d Treatment", Journal of Consulting Psychology, 23 (1959), p. 160. ^H. Ginott, "Play Therapy: The I n i t i a l Session", American Journal of  Psychotherapy, 15 (1961) p. 74. Compare t h i s to a recent l e t t e r to Ann Landers. Dear Ann: I am 35. My husband i s 40. We are both very busy with careers. I'm beginning to 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 -year-old c h i l d won't have a brother or s i s t e r unless we get busy. My husband doesn't care one way or the other. I frankly don't l i k e the idea of going back to diapers 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 brother or s i s t e r and s e t t l e i t once and f o r a l l ? - ??? Answer: Adults who would allow an eight-year-old to make such a decision sound downright f o o l i s h to me. I think you have more than you can handle r i g h t now. Vancouver Sun, Aug. 20, 1974. On the basis of a survey J . Goodman and J . Sours report: "Only three c h i l d p s y c h i a t r i s t s indicated that they believed preschool and e a r l y latency c h i l d r e n could carry on a meaningful problem-oriented discussion". The C h i l d Mental Status Examination, New York: Basic Books, 1967, p. 15. 7 The P s y c h i a t r i c Interview, New York: W. W. Norton and Co., 1954. 79 8 F. Swanson advises: "Since t e c h n i c a l l y the c h i l d i s the patient, the the r a p i s t might begin by asking him what brought him to the c l i n i c — w h a t are some of the things he and h i s parents worry about. R e l a t i v e l y few chi l d r e n can verb 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 are c l e a r l y aware of t h e i r problems only while the problems are happening. . . Besides, young children have r e l a t i v e l y l i t t l e perspective about behavior, l i f e , f a m i l i e s . They have l i t t l e basis f o r comparison. To them, 'this i s the way l i f e i s ' . " Psychotherapists and Children: A Procedural Guide, Pitman Publishers Co., 1970, pp. 30-31. Schulman, et a l , who c r i t i c i z e t herapists f o r thinking of chi l d r e n as "immature, dependent, r e l a t i v e l y helpless and to be protected", suggests: "our interview, therefore begins with an explanation of the ro l e of the th e r a p i s t . This merges in t o a discussion of problems i n general and s p e c i f i c problems which the c h i l d i s experiencing". The Therapeutic Dialogue, p. 146. 9 A continuation of t h i s can be found i n t r a n s c r i p t 1.1. 10 H. Ginott, Group Psychotherapy with Children, p. 87. 1 " _ i n o t t says, "The aim of a l l therapy. . . i s to e f f e c t basic changes i n the intrapsychic equilibrium of each patient". Group Psychotherapy with  Children, p. 2. 12 This i s a common occurrence. For example, L. J. Redlinger i n h i s research i n a r e s i d e n t i a l treatment centre for disturbed c h i l d r e n pointed out that some members of the treatment s e t t i n g " t r e a t as problematic the o f f i c i a l view of the chi l d r e n as sic k , and i n some cases r e j e c t the diag-nosis". "Making Them Normal", American Behavioral S c i e n t i s t , 14 (1970) pp. 237-253. 13 From a t a l k given on C.B.C. Radio. 14 Schulman, et a l , f o r example r e f e r to t h i s as a "simple continuing response". Op. c i t . , pp. 93-94. 15 V. Axline, Play Therapy, New York: Ballantine Books, Inc., (revised edition) 1969, p. 99. " ^ A l l therapists can provide an account of the function of play f o r chi l d r e n . For example, "play a c t i v i t y i s the c h i l d ' s native t o n g u e — h i s natural way of showing how he f e e l s about himself and the s i g n i f i c a n t persons and events i n h i s l i f e " . Ginott, Group Psychotherapy with  Children, p. 176: "Play, the c h i l d ' s most na t u r a l medium of expression. Since i t i s e s s e n t i a l to provide the c h i l d with the opportunity to use h i s natural tools and modes of expression, we see at once that play a c t i v i t y i s an important factor i n therapeutic work with c h i l d r e n " . F. A l l e n , Psycho- therapy with Children, New York: W. W. Norton and Co., 1942, p. 122. 17 J. Anthony, "Communicating Therapeutically With The C h i l d " , C h i l d  Psychiatry, 3 (1964) p. 107. 18 ' E. Erikson, Childhood and Society, New York: W. W. Norton and Co., 1950, p. 222. 80 """For an account of t h i s development see S. M i l l a r , The Psychology of  Play, Penguin Books, 1968. 20 "Whatever the c h i l d does or says i s always used by the examiner to r e l a t e to the problem for which the c h i l d was brought by the parent". H. R. Beider, " P s y c h i a t r i c Diagnostic Interviews with Children", Journal  of American Academy of C h i l d Psychiatry, 1 (1962) , p. 658. 21 "A Rationale f o r the Selection of Toys", Journal of Consulting  Psychology, 24 (1960), p. 246. 22 Ibid ., p. 243. 23 A technique made ava i l a b l e by Lowenfeld i n 1939, see, M. Lowenfeld, "The World Picture of Children", B r i t i s h Journal of Medical Psychology, 18 (1939), 65-101. 24 Op. c i t . , p. 244. 25 The notion of 'membership categorization device' i s taken from Harvey Sacks, see, "An I n i t i a l Investigation of the U s a b i l i t y of Conver-s a t i o n a l Data f o r Doing Sociology", i n D. Sudnow (ed.) Studies i n S o c i a l  Interaction, New York: Free Press, 1972, pp. 31-74. .'•'••26 When asked about the h e s i t a t i o n i n the following the t h e r a p i s t s a i d she never used the term "therapy" with a c h i l d patient. T: 'Cause I think you r e a l l y l i k e to take a piece of our ther- our session home with you. ((pause)) You l i k e to have something to remind you of our time together, huh. CHAPTER 3 'NORMAL' CHILDREN AND THE THERAPIST'S CORPUS OF KNOWLEDGE C h a p t e r s 3 and 4 a r e a f u r t h e r e x p l o r a t i o n and d e s c r i p t i o n o f t h e r a t i o n a l i t y o f the t h e r a p y s e t t i n g . T h a t i s , t h e y t e l l how I came t o see the t h e r a p i s t s ' a c t i v i t i e s as m e a n i n g f u l e v e n t s , o r as r e a s o n a b l e , p r o p e r , l o g i c a l , a c c e p t a b l e , e t c . 1 My disenchantment w i t h ' p s y c h i a t r i c t h e o r y ' drew my a t t e n t i o n t o a p r i m a r y and fundamental p r o p e r t y o f p r a c t i c a l r e a s o n -2 i n g , t h a t i s , t o "background e x p e c t a n c i e s " . The n o t i o n o f background e x p e c t a n c i e s i s v i t a l f o r us i f we w i s h t o answer the q u e s t i o n : "How do o b s e r v e r s d e c i d e t h a t a c counts a r e adequate f o r u n d e r s t a n d i n g what i s t a k i n g p l a c e ? I t i s c l e a r t h a t a c t o r s i n the w o r l d o f d a i l y l i f e n o t o n l y do t h e p r o p e r t h i n g b u t make i t app a r e n t t h a t they have done so and a r e o b l i g a t e d t o do t h i s . T h e r a p i s t s as members o f t h e l i f e - w o r l d , a r e c o n t i n u a l l y engaged i n the p r o c e s s o f making and showing t h a t t h e i r a c t i o n s and under-s t a n d i n g s are adequate. Thereby, I would l i k e t o o u t l i n e some o f t h e background e x p e c t a n c i e s t h a t make t h i s adequacy v i s i b l e . On the one hand, c h i l d r e n who a t t e n d the c l i n i c a r e seen as d i s t u r b e d c h i l d r e n o r as c h i l d r e n who have problems. On t h e o t h e r hand, and a t the same time, t h e y a r e a l s o seen as c h i l d r e n who a r e more o r l e s s normal. I found t h a t our n o t i o n s o f n o r m a l i t y a r e e s s e n t i a l f o r making sense o f the b u s i n e s s o f t h e r a p y . S p e c i f i c a l l y , I mean t h a t a l t h o u g h we may l a b e l the p a t i e n t s 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 " , we w i l l a l s o r e c o g n i z e t h a t t h e y a r e c h i l d r e n and, as such, have and d i s p l a y many o f those q u a l i t i e s 81 82 which we would e x p e c t any c h i l d t o have. In what f o l l o w s , I w i l l g i v e some examples o f how n o t i o n s o f n o r m a l i t y i n r e g a r d t o c h i l d r e n come t o have s i g n i f i c a n c e i n the p l a y room. One o f the f i r s t t h i n g s t h a t an o b s e r v e r might n o t i c e i s t h a t w h i l e the c l i n i c d e a l s w i t h d i s t u r b e d c h i l d r e n , much o f what happens here i s r e l e v a n t t o and f o r the normal c h i l d . T h i s i s made e v i d e n t i n two i m p o r t a n t ways. F i r s t , t h e r a p i s t s o f t e n make sense o f phenomena by com-p a r i n g and c o n t r a s t i n g them t o some s t a n d a r d p a t t e r n o f b e h a v i o r . Thus th e y might say, f o r example, t h a t some p a r t i c u l a r a c t i o n i s "a normal and e x p e c t a b l e t h i n g f o r a s i x y e a r o l d t o do", o r , c o n v e r s e l y t h a t "normal s i x y e a r o l d s d o n ' t do t h a t " . S e c o n d l y , t h e r a p i s t s u s u a l l y saw t h e i r p a t i e n t s as normal c h i l d r e n . T hat i s , the p a t i e n t s were n o t c o n s i d e r e d t o be d i s t u r b e d i n e v e r y a s p e c t o f t h e i r b e h a v i o r . On the c o n t r a r y , most o f what th e y s a i d and d i d c o u l d be and was thought o f and t r e a t e d as normal. L e t ' s c o n s i d e r t h e l a t t e r p o i n t made above. I t i s c l e a r t h a t the way i n which c o n t a c t was made w i t h the c l i n i c ( i . e . how appointments were made, i n t r o d u c t i o n s t o the p l a y room and t h e r a p i s t were managed, e t c . , ) has n o t h i n g t o do w i t h the p a t i e n t s ' problems b u t i s o r i e n t e d i n s t e a d t o p a t i e n t s as c h i l d r e n . T h i s i s o f t e n made c l e a r i n p s y c h o t h e r a p y manuals and i n t h e r a p i s t s ' remarks on how t o manage p a t i e n t s . A l l o w me t o e l a b o r -a t e . G i n o t t b e g i n s an a r t i c l e on h a n d l i n g the f i r s t i n t e r v i e w by s a y i n g : the 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 many t e c h n i c a l problems t h a t c a l l f o r immediate d e c i s i o n s . 4 He t h e n goes on t o o f f e r the f o l l o w i n g a d v i c e . 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 problem: how t o l e a d a c h i l d t o t h e p l a y room w i t h a minimum o f s h e d d i n g o f b l o o d , sweat, 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 the 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 , . . . H e a n t i c i p a t e s w i t h sympathy t h e scene o f s e p a r a t i o n between mother and c h i l d , . . . He knows t h a t the 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 mother, d e c l i n e t o 83 enter the play room, or demand that mother comes with them; or that mother may cry. . . . When the t h e r a p i s t meets the' c h i l d f o r the f i r s t time, he greets him with a b r i e f h e l l o , dispensing with formal i n t r o -ductions, and s o c i a l amenities. . . . He extends h i s hand to the c h i l d and o f f they go.-' Concomitantly, occupational resources abound with information on how to get children's cooperation, what chi l d r e n l i k e to do and what they don't l i k e to do, how to tal k to them, and so on.^ Throughout the emphasis i s upon chi l d r e n . This attention to patients as ch i l d r e n i s seen most c l e a r l y i n the use of toys as therapy devices. As suggested e a r l i e r , t h i s i s not based upon the expectable features of patients, but upon our ideas about what a l l c h i l d r e n are l i k e . Although therapists make a kind of sense out of the c h i l d ' s play that the lay member normally would not, the acts of providing fo r that play and of seeing a r e l a t i o n s h i p between the c h i l d ' s play and other things appear to be quite reasonable. I suggest f o r example, that i t i s no d i f f e r e n t than the way i n which a parent may see h i s c h i l d ' s future career i n the kinds of toys that he s e l e c t s , or i n h i s i n t e r e s t i n 7 or a b i l i t y to use p a r t i c u l a r toys. S i m i l a r l y , i t appears reasonable to use toys i n the playroom. The therapist's s e l e c t i o n of toys, while apparently j u s t i f i a b l e on therapeutic grounds alone, appears to be based 8 l a r g e l y upon ideas about what a l l c h i l d r e n l i k e to do. Furthermore, t h i s « se l e c t i o n takes age and sex differences i n t o account. In the following instance, we see how age differences r a i s e consid-erations f o r the th e r a p i s t . 3.1 T: If. I go downstairs ((to the day care centre)) and there's a l i t t l e four or f i v e year o l d playing with some puppets, and i f I say, "who i s i t ? " , t h e y ' l l say "mommy or daddy". Ah, they get r i g h t i n t o i t . But f o r some one l i k e Chris or John ((older children)) i t would be very hard f o r them to t e l l you that that was mommy or daddy they were jus t pounding with the hammer. 84 T h i s f o l l o w s from the n o t i o n t h a t yoking c h i l d r e n a r e h o n e s t and have n o t y e t l e a r n e d t o mask t h e i r f e e l i n g s , o r have not y e t l e a r n e d about what i n f o r m a -t i o n can 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 . I n a s i m i l a r manner some t h e r a p i s t s s u g g e s t t h a t h a v i n g a young c h i l d i n f a m i l y t h e r a p y i s b o t h b e n e f i c i a l and tends t o speed up t h e p r o c e s s because the c h i l d i s so 9 h o n e s t . Attendance t o the age o f the p a t i e n t was d i s p l a y e d by a n o t h e r t h e r a ^ p i s t i n the f o l l o w i n g way. He was s e e i n g a p a t i e n t f o r t h e f i r s t time i n what was t o be a d e m o n s t r a t i o n s e s s i o n f o r a v i s i t i n g group o f p u b l i c h e a l t h n u r s e s . I o b s e r v e d him p r e p a r i n g the room and was a b l e t o d i s c o v e r h i s i n t e n t i o n s . He p r e p a r e d a s m a l l room which c o n t a i n e d a t a b l e and two c h a i r s . Some pa p e r and w r i t i n g m a t e r i a l s were p l a c e d on the t a b l e and one o r two l a r g e t o y s were s e t i n the room. The t h e r a p i s t ' s t o y box was a l s o p l a c e d i n the room a l t h o u g h i t was n o t opened. The t h e r a p i s t e x p l a i n e d t h a t the c h i l d was o f such an age t h a t he might want e i t h e r t o t a l k o r t o p l a y . I f the t o y s were made to o o b v i o u s the c h i l d may have f e l t o b l i g a t e d t o p l a y a l t h o u g h w i s h i n g t o t a l k . Some o b j e c t s were n e c e s s a r y however, (drawing m a t e r i a l s ) t o p r e s e n t a space t h a t would l o o k l e s s t h r e a t e n i n g . There were numerous o t h e r i n s t a n c e s i n which t h e r a p i s t s spoke o f age a p p r o p r i a t e b e h a v i o r . F o r example: 3.2 T: I'm r e a l l y i m p ressed w i t h Tanya as a c h i l d t o work w i t h . R: Yea, ah, I'm n o t s u r e what i t i s b u t she seems v e r y u n u s u a l , I mean a s i d e from t h e k i n d o f t h i n g s t h a t maybe seem b i z a r r e , o r , T: Yea, I t h i n k she seems q u i t e p r e c o c i o u s . R: Yea, she seems t o know what's g o i n g on. T: More so than say some o f the e l e v e n y e a r o l d s I'm s e e i n g . 85 R: Yea, a n o t h e r t h i n g t h a t s t r u c k me today was t h e way she would s t a n d and l o o k a t t h i n g s . T: Yea. R: I t d o e s n ' t seem t o me t o be t y p i c a l o f f i v e y e a r o l d s t o c o n t e m p l a t e . The c o n v e r s a t i o n above concerns a v e r y d i s t u r b e d f i v e y e a r o l d who i s n e v e r t h e l e s s d e s c r i b e d as p r e c o c i o u s , — a c a t e g o r y t h a t l a y a d u l t s u s u a l l y r e s e r v e f o r c h i l d r e n who a r e 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 'grown-up' manner than one might e x p e c t g i v e n t h e i r age.1® These examples demonstrate how r e f e r e n c e t o t h e age o f t h e p a t i e n t p r o v i d e s an adequate acc o u n t o f h i s a c t i o n s . F o r example, i t can be c l a i m e d t h a t the d i f f e r e n c e between c h i l d r e n who w i l l admit t h a t t h e y h a t e t h e i r p a r e n t s and those who w i l l n o t i s o f t e n due t o a d i f f e r e n c e i n age. We can see t h e a p p r o p r i a t e n e s s o f t h e way i n which the t h e r a p y room i s a r r a n g e d because o f our u n d e r s t a n d i n g o f c h i l d r e n . I t s h o u l d be n o t e d t h a t t h ese assumptions about n o r m a l i t y a r e always p s y c h i a t r i c a l l y (or o r g a n i z a t i o n a l l y ) r e l e v a n t . - _ T h i s p r a c t i c a l r e l e v a n c e i s seen i n the c h o i c e o f p l a y as a t h e r a p y d e v i c e and has o t h e r consequences as w e l l . F o r i n s t a n c e , i t i s c o n s e q u e n t i a l f o r what w i l l happen t o the c h i l d i n t h e r a p y . Our i d e a s about n o r m a l i t y a r e t y p i c a l l y used as a s t a n d a r d f o r d e c i d i n g which b e h a v i o r p a t t e r n s a r e u n u s u a l , and w i l l be g i v e n a p s y c h i a t r i c s i g -n i f i c a n c e . The a b n o r m a l i t y i s a document o f the p r e s e n t i n g p r o b l e m (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 . F o r example, a t h e r a p i s t i n d e s c r i b i n g a p a t i e n t who p e r s i s t e n t l y chose t o c o n s t r u c t a model o f a d i n o s a u r t o l d me t h a t : 3.3 T: . . . Most k i d s w i l l choose one, you know, maybe t h e y ' l l do one d i n o s a u r and then ( ) i t ' s a b o r e . You've seen one d i n o s a u r , you've seen them a l l . 8 6 The f a c t t h a t most k i d s g e t b o r e d w i t h t h i s a c t i v i t y i s a document o f t h i s c h i l d ' s n o n - c o n f o r m i t y . T h i s i n t u r n becomes t r a n s l a t e d i n t o an under-s t a n d i n g l i k e the f o l l o w i n g : s i n c e he p e r s i s t e n t l y chooses t o b u i l d d i n o s a u r s , t h e r e must be something which a t t r a c t s him t o d i n o s a u r s i n the f i r s t p l a c e . As the t h e r a p i s t s a y s : T: I t r i e d t o see, okay d i n o s a u r s , now d i n o s a u r s a r e f e r o c i o u s b e a s t s , maybe we can g e t i n t o John's anger a b i t . The t h e r a p i s t d e c i d e d t h a t i t i s the angry n a t u r e o f d i n o s a u r s t h a t a t t r a c t s John's a t t e n t i o n and t h i s now st a n d s as a document o f h i s anger ( i . e . o f h i s p r o b l e m ) . E v e r y t h i n g now makes a new sense. The b e h a v i o r a t hand, t h e p a t i e n t ' s p roblem and even the c o u r s e o f t r e a t m e n t a l l f i t t o g e t h e r . There a r e many o t h e r i n s t a n c e s i n which the p a t i e n t s a r e compared t o t h e i r age c o h o r t s . The f o l l o w i n g d e s c r i p t i o n s a l l r e f e r t o the same p a t i e n t . T: T h a t ' 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 the 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 g o i n g on around him. . . . But compared w i t h the 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, 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 w i d e r range o f s t y l e s i n the p l a y room. 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 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, yea, uh, t h e k i d ' s language i t s e l f i s p e c u l i a r h i s s y n t a x i s a b i t shaky which i s the most t h a t had been n o t i c e d i n the c l a s s r o o m t o t h i s p o i n t , which i s n ' t so now, uh, sentence 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. He's g o t some f a i r l y good 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 " , "There go a c a r , a wheel, two wheels, who don't g o t some wheels". So you know i t s p r e t t y immature s o r t o f sy n t a x . 87 Or: 3.7 T: I t h i n k the 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 -t i o n i n t h i s c h i l d ' s b e h a v i o r . What's he s i x o r seven I guess? Seven. The range o f language, the range o f f a n t a s y , t h e range o f p l a y , uh, the range o f p l a y room b e h a v i o r , i s q u i t e narrow, uh, compared w i t h o t h e r c h i l d r e n . T h e r a p i s t s , l i k e t h e r e s t o f us, d o n ' t see b e h a v i o r i n a vacuum b u t see a c t i o n s as a p p r o p r i a t e o r i n a p p r o p r i a t e f o r a c h i l d o f a p a r t i c u l a r age ( s t a g e ) . Thus, i t ' s n o t j u s t t h a t t h e p a t i e n t mentioned above uses d i f -f e r e n t o r i n c o r r e c t v e r b forms, r a t h e r h i s speech p a t t e r n i s h e a r d as immature and the c h i l d i s t h e r e b y c h a r a c t e r i z e d as ' c o n s t r i c t e d ' , ' i n h i -b i t e d ' and 'depressed'. We l o o k a t c h i l d r e n as a d u l t s - i n - t h e - m a k i n g and r e c o g n i z e t h a t i t i s a d u l t members who g u i d e the c h i l d ' s development. We r e a l i z e , t o o , t h a t t h e p r o c e s s o f development may go a s t r a y a t any moment. Here, age and s t a g e a p p r o p r i a t e n e s s i s a p o w e r f u l r e s o u r c e f o r making sense o f p a t i e n t s ' a c t i o n s . While we have been c o n s i d e r i n g i n s t a n c e s when 'deviance' from age-s t a g e a p p r o p r i a t e n e s s was r e l e v a n t i n terms o f the s e t t i n g , t h e i d e a o f age-stage c o n f o r m i t y i s a l s o u s e f u l i n t h e c o n s t r u c t i o n o f t h e r a p y s t r a t -e g i e s . There i s an a n t i c i p a t i o n and r e c o g n i t i o n o f the c h i l d ' s a c t i o n s as b e i n g m o t i v a t e d by age c h a r a c t e r i s t i c s . T h i s i s s i m i l a r t o r e c o g n i z i n g t h e n o r m a l i t y o f p a t i e n t ' s b e h a v i o r i n terms o f h i s f a m i l y ' s r u l e s , t r a d i -t i o n s , and so on. Both o f t h e s e assumptions p r o v i d e ways o f making sense o f ^ p l a n n i n g f o r , and managing, p a t i e n t s . C o n s i d e r the f o l l o w i n g examples. A t h e r a p i s t , r e p o r t i n g h i s t r e a t m e n t a c t i v i t i e s t o a c o l l e a g u e and m y s e l f , e x p l a i n e d why he had had the p a t i e n t smash b o t t l e s a g a i n s t the w a l l . He e x p l a i n e d t h a t t h e b o t t l e b r e a k i n g a c t i v i t i t y was a procedure, f o r g e t t i n g the c h i l d t o e x p r e s s h i s anger o v e r t l y and thus h i s anger, h a v i n g been 8 8 r e l e a s e d i n t h i s way, would n o t be e x p r e s s e d i n d i r e c t l y i n h i s eve r y d a y r e l a t i o n s . The t h e r a p i s t made r e f e r e n c e t o t h i s as a p a r t i c u l a r l y good c h o i c e o f a c t i v i t y because i t i n v o l v e d much " n o i s e , d e s t r u c t i o n , and p h y s i c a l a c t i v i t y " . T h i s a c t i v i t y was s a i d t o be a p p r o p r i a t e f o r a c h i l d because c h i l d r e n o f t e n l i k e t o break t h i n g s and make a g r e a t n o i s e . T h e r e f o r e , i t b o t h a c c o m p l i s h e d i t s t h e r a p e u t i c o b j e c t i v e and was f u n f o r the c h i l d . T h i s a l s o a c c o u n t e d f o r why p a t i e n t s were a l l o w e d t o s p i l l water, p a i n t on the w a l l s , swear, and so many o t h e r t h i n g s which we would no t r o u t i n e l y a l l o w 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 t h i s same t h e r a p i s t t o l d how he o f t e n took one o f h i s p a t i e n t s t o the swimming p o o l . The p a t i e n t was i n h i b i t e d , and a document o f h i s i n h i b i t i o n was h i s a n x i e t y about the water. The t h e r a p i s t s a i d t h a t i t was good f o r c h i l d r e n t o work out t h e i r a n x i e t y about some dangerous a c t i v i t y w h i l e away from t h e i r p a r e n t s . Somewhat r e l a t e d t o t h i s assumption a r e ac c o u n t s o f how the p a t i e n t w i l l t e s t t h e l i m i t s o f e v e r y new s i t u a t i o n , e i t h e r t o see j u s t how much t h e y can g e t away w i t h b o t h now and i n t h e f u t u r e , o r i n o r d e r t o f i n d o u t about t h e n a t u r e 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 . F o r example: 3 . 8 T: She's v e r y i n t e r e s t i n g , she's been t e s t i n g me, ah ( ) and, l a s t day 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 she c o u l d do, you know whatever your i m p u l s e s a r e . S: Yea. T: And some k i d had been and p a i n t e d on t h a t w a l l o v e r t h e r e . S: Oh dear. T: So I 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 t h a t e i t h e r , and t h a t was okay. So a h a l f - h o u r l a t e r she s a i d , "next week I'm g o i n g t o p a i n t " , and she s a i d , "on the w a l l " ( ( l a s t p h r a s e s a i d i n a s o f t v o i c e ) ) S: ( ( l a u g h s ) ) Yea. 89 The c h i l d ' s r e q u e s t i s n o t t o be h e a r d s i m p l y as a r e q u e s t t o p a i n t on t h e w a l l , b u t as a 'method' f o r f i n d i n g o ut i f she c o u l d r e a l l y do so w i t h o u t b e i n g p u n i s h e d . I t i s one o f the c h i l d ' s methods f o r d i s c o v e r i n g t h e 12 parameters o f the r e l a t i o n s h i p and/or s e t t i n g . However, t h i s type o f t e s t i n g i s time-bound. That i s , i t o n l y 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 a r e new f o r the c h i l d . I f a p a t i e n t c o n t i n u e s t o engage i n " t e s t i n g " i n the e a r l y s t a g e s o f t h e r e l a -t i o n s h i p , i t may be seen as an attempt t o annoy o r m a n i p u l a t e o t h e r members o f the s e t t i n g . On a n o t h e r o c c a s i o n , a s t u d e n t s p e a k i n g t o a t h e r a p i s t about one o f h i s p a t i e n t s , t o l d him: 3.9 S: I t h i n k she r e a l l y wanted you t o t a k e away the f e a t h e r s , she d i d n ' t r e s i s t t o o much. In t h i s case, t h e p a t i e n t had taken some f e a t h e r s and h i d d e n them i n h e r c l o t h i n g a f t e r t h e t h e r a p i s t had t o l d h e r t h a t she c o u l d n o t t a k e them home. As the s e s s i o n drew t o an end, the t h e r a p i s t was f o r c e d t o " f i n d " t h e f e a t h e r s and ask h e r f o r them. How does the s t u d e n t ' s statement come o f f as adequate p s y c h i a t r i c r e a s o n i n g ? I n v o l v e d i n s e e i n g the p a t i e n t ' s d e s i r e t o have the f e a t h e r s t a k e n away i s an assumption about how t o i n t e r p r e t c h i l d r e n ' s b e h a v i o r , i . e . c h i l d r e n l i k e t o be t o l d what t o do. They l i k e t o be g i v e n r u l e s o r b o u n d a r i e s and t o have them e n f o r c e d because they d e r i v e a sense o f s e c u r i t y from knowing where t h e y s t a n d . Even when t h e c h i l d i s r e s i s t i n g d i s c i p l i n e we can see an u n d e r l y i n g need and d e s i r e t o have t h e a d u l t e n f o r c e the r u l e s . In r e f e r e n c e t o such l i m i t s G i n o t t s a y s : 9 0 Both i n t h e r a p y and i n l i f e , c h i l d r e n need 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 . They f e e l s a f e r when they know the 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 . T h e r e f o r e , l i m i t s s h o u l d be d e l i n e a t e d i n a manner t h a t l e a v e s no doubt i n the c h i l d ' s mind as 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 conduct i n t h e p l a y room. 1^ Many o f the a c t i v i t i e s i n the p l a y room appear t o be adequate, a p p r o p r i a t e , r e a s o n a b l e , e t c . , o n l y because we can use our background e x p e c t a n c i e s o f and f o r normal c h i l d r e n as a r e s o u r c e f o r d e t e r m i n i n g t h e i r adequacy. I w i l l r e f e r t o the k i n d s o f accounts t h a t we have been l o o k i n g 14 a t as examples o f p r a c t i c a l p s y c h i a t r i c r e a s o n i n g . A f e a t u r e o f p r a c t i c a l p s y c h i a t r i c r e a s o n i n g i s the r e a s o n a b l e n e s s , t r a n s p a r e n c y o r common-senseness o f i t s u n d e r s t a n d i n g s o f c h i l d r e n . I would l i k e t o f u r t h e r c l a r i f y i t s s t a t u s . We can assume t h a t t h e r a p i s t s have some methods f o r d e c i d i n g i f a p a t i e n t ' s b e h a v i o r i s a p p r o p r i a t e , r e a s o n a b l e , e t c . As an o b s e r v e r , I f e l t I was g r a d u a l l y a c q u i r i n g some degree o f s k i l l i n u n d e r s t a n d i n g and u s i n g t h i s r e a s o n i n g . I found t h a t o u r , n o t i o n o f normal c h i l d r e n as r e p o r t e d i n t h i s c h a p t e r i s a s p e c i f i c f e a t u r e o f p r a c t i c a l p s y c h i a t r i c r e a s o n i n g and, as such, i s a p a r t o f t h e t h e r a p i s t ' s corpus o f knowledge. In making sense o f a p a t i e n t ' s a c t i o n s , i n o r g a n i z i n g f o r , and i n r e s p o n d i n g t o them, t h e r a p i s t s f r e q u e n t l y a p p e a l t o our common sense i d e a s about what normal c h i l d r e n a r e l i k e . The n e x t c h a p t e r i s a f u r t h e r e x p l o r a t i o n o f the p r a c t i c a l r e a s o n i n g o f the t h e r a p i s t , and w h i l e c e n t e r i n g on one o f the most i m p o r t a n t f e a t u r e s o f t h a t r e a s o n i n g , namely our i d e a s about the f a m i l y , i t w i l l uncover s u r p r i s i n g ways i n which i t comes t o be used as a r e s o u r c e . 91 Footnotes ~"I want to draw attention to the f a c t that psychotherapy reports and accounts are t i e d to the everyday p r a c t i c e s of the working th e r a p i s t i n ways that are not captured by the i d e a l i z a t i o n s of textbooks, theories, etc. I am attending to psychotherapy as p r a c t i c a l reasoning. 2 See Schutz, Collected Papers 1: The Problem of S o c i a l R e a l i t y . The Hague: Martinus N i j h o f f , 1962. See, too H. Garfinkel's "Studies of the Routine Grounds of Everyday Action", i n Studies i n Ethnomethodology, Pr e n t i c e - H a l l , 1967, for a d e t a i l e d discussion of background expectancies. By background expectancies I r e f e r to those sets of taken-for-granted ideas that permit the interactants to i n t e r p r e t these remarks as adequate accounts i n the f i r s t place. For example, that which i s taken-for-granted i n seeing the adequacy of the therapist's statement, "What's he s i x or seven I guess?" 3 I w i l l return l a t e r to a s i m i l a r question: How does the reader decide that the accounts I provided of therapy and therapy sessions were adequate? 4 "Play Therapy. The I n i t i a l Session", American Journal of Psycho- therapy, 15 (1961), p. 73. 5 Ib i d . , p. 75. (emphasis added) ^Some further examples of t h i s are: "Some chil d r e n are so accustomed to being asked questions by r e l a t i v e s and friends that they have ready answers, designed to please or annoy". F. Swanson, Psychotherapy with  Children: A Procedural Guide, Pitman Pub., 1970, p. 34. "Talking slowly and d e l i b e r a t e l y i s one of the f i r s t r e q u i s i t e s of interviewing c h i l d r e n . , Children tend to hear verbs more acutely than other parts of speech". J. Goodman, J. Sours, The C h i l d Mental Status Examination. New York: Basic Books, 1967, p. 38. "Children can e a s i l y be influenced by sugges-t i o n " . I b i d . , p. 33. In every case, the t h e r a p i s t i s i n s t r u c t e d to see hi s patients as c h i l d r e n . 7 For an example of how t h i s i s used i n everyday l i f e consider the following l e t t e r to Ann Landers. Dear Ann: Our f i v e - y e a r - o l d son loves to put on my c l o t h i n g , high heels and makeup and pretend he i s "Mama". Jimmie i s a b e a u t i f u l boy, with a f u l l head of c u r l s and he p r e f e r s p l a y i n g with d o l l s to the rough-and-tumble games of boys. Last Christmas I gave him a dump truck and a tea set. He never played with the dump truck but loves the tea set. I used to think i t was cute, the way Jimmie got him-s e l f up l i k e a lady, but I'm beginning to wonder i f perhaps h i s l i t t l e game might turn i n t o something serious, and permanent. Can you advise me. Answer: Very young chi l d r e n often cross-dress, but by the time a boy i s f i v e or s i x he should be pretty well over that sort of thing. The most revealing clue was your subconscious encouragement. Why would a mother give a boy of ANY age a tea set? I suggest that you discuss t h i s with a counsellor, learn 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 to turn 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 for example, V. S a t i r , Conjoint Family Therapy, Science and Behavior Books, Inc., 1964. "^Precociousness i s usually seen as a p o s i t i v e q u a l i t y . " I f on the other hand", as Swanson points out, "the c h i l d t a l k s s e r i o u s l y of h i s worries, expresses a sincere wish f o r help for himself and concern f o r the welfare of the r e s t of h i s family, the chances are that he's burdened, depressed, too serious, and taking family r e s p o n s i b i l i t i e s prematurely". F. Swanson, Op. c i t . , p. 31. "^Notions of normal chi l d r e n appear i n many other organizational prac-t i c e s . For example, Emerson i n h i s study of Juvenile Court r e f e r s to "normal delinquents". "In contrast, delinquencies that give an impression of unplanned spontaneity and impulse suggest normal character. I f the act appears as the product of a whim, of an i n a b i l i t y to r e s i s t temptation, normal character i s generally assessed. . . . In general, adolescents are assumed normally to engage i n a c e r t a i n amount of i l l e g a l a c t i v i t y " . Judging Delinquents. Aldine, 1969, pp. 117-118. 12 See for example, H. Ginott on children's interviewing techniques i n "Play Therapy: The I n i t i a l Session", Op. c i t . , p. 80. 13 "The Theory and Practice of Therapeutic Intervention", Journal of  Consulting Psychology, 23 (1959) p. 162. 14 For a discussion of p r a c t i c a l reasoning see H. G a r f i n k e l "What i s Ethnomethodology", i n Studies i n Ethnomethodology. P r e n t i c e - H a l l , 1967, pp. 1-34; and Roy turner, Ethnomethodology, Penguin Books, 1974, p a r t i c u -l a r l y the section on " p r a c t i c a l reasoning", pp. 83-194. CHAPTER 4 THE FAMILY AS A RESOURCE FOR PRACTICAL REASONING T h i s c h a p t e r i s a f u r t h e r e x a m i n a t i o n o f the ways i n which t h e r a -p i s t s 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 as t h e r a p e u t i c e v e n t s . A t the end o f Chapter 2 I s u g g e s t e d t h a t knowledge o f and assumptions about the p a t i e n t ' s f a m i l y were an i m p o r t a n t p a r t o f the i n t e r p r e t i v e schema by which good p s y c h i a t r i c sense can be made out o f h i s a c t i o n s i n the p l a y room. I d i s c o v e r e d t h a t I had t o r e l y h e a v i l y on what I l e a r n e d about c h i l d r e n ' s f a m i l i e s i n o r d e r t o u n d e r s t a n d them. F o r example, w h i l e I c o u l d g i v e b e h a v i o r a l d e s c r i p t i o n s o f a c h i l d and h i s problems, I had t o see t h e s e t h i n g s i n the c o n t e x t o f t h e c h i l d ' s f a m i l y b e f o r e t h e y became s i g n i f i c a n t f o r me. Thereby, I began t o r e a l i z e t h e e x t e n s i v e n e s s o f the ' i n s t r u c t i o n s ' t h a t I had r e c e i v e d on t h e f a m i l y . I began t o l o o k f o r what th e s e i n s t r u c t i o n s d i d and why they were i m p o r t a n t and, c o n s e q u e n t l y , came t o see t h e r o l e o f t h e ' 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 - a t r i c r e a s o n i n g . In t h i s c h a p t e r I w i l l show the r e a d e r why I c o n s i d e r t h i s t o be the most i m p o r t a n t a s p e c t o f the t h e r a p i s t ' s corpus o f knowledge. The r e a d e r who i s f a m i l i a r w i t h the l i t e r a t u r e on p s y c h o p a t h o l o g y w i l l know t h a t t h e o r e t i c i a n s o f t e n i n v o ke the f a m i l y as an e t i o l o g i c a l f a c t o r i n e x p l a i n i n g the o n s e t o f e m o t i o n a l d i s t u r b a n c e . 1 While t h e f a m i l y was used i n t h i s way i n the c l i n i c , i t was a l s o a much b r o a d e r r e -s o u r c e . I w i l l d i s p l a y how the f a m i l y (and t h e term i s a g l o s s f o r a wide ass o r t m e n t o f r u l e s , r e l a t i o n s h i p s , e x p e c t a t i o n s , e t c . ) was used as a r e s o u r c e i n making p s y c h i a t r i c sense o f the c h i l d ' s b e h a v i o r , i n managing 93 94 a t h e r a p y s e s s i o n , and a l s o f o r p r o v i d i n g 'adequate' a c c o u n t s o f the even t s o f the p l a y room. P a t i e n t s as F a m i l y Members An e s s e n t i a l f e a t u r e o f the t h e r a p i s t ' s c o r p u s o f knowledge i s an u b i q u i t o u s awareness o f p a t i e n t s as f a m i l y members. T h i s i s a c o n s t i t -u t i v e f e a t u r e o f the c a t e g o r y ' c h i l d ' . While one may have p a t i e n t s 2 w i t h o u t f a m i l i e s , one does n o t have c h i l d r e n w i t h o u t p a r e n t s . I s h a l l b e g i n by o u t l i n i n g some o f the ways i n which I found the ' f a m i l y ' t o be a u s e f u l r e s o u r c e i n u n d e r s t a n d i n g the c l i n i c . An e x a m i n a t i o n o f the f o l l o w i n g innocuous c o n v e r s a t i o n between two t h e r a p i s t s w i l l demonstrate t h a t the c o n n e c t i o n between the p a t i e n t and h i s f a m i l y i s n o t always (or even f r e q u e n t l y ) a d i r e c t one. The f o l l o w -i n g statement f o l l o w e d i mmediately upon the d e p a r t u r e o f a p a t i e n t . I t was d i r e c t e d toward a c o l l e a g u e who had j u s t come t o the p l a y room t o say h e l l o : 4.1 T: He asked me, he s a i d "do you go 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 and he s a i d " s i n n e r , s i n n e r " . . . . Yea, I'm r e a l l y , t h a t ' s , now I'm r e a l l y done, I'm f i n i s h e d . The statement was made i n a j o k i n g manner, b u t i t r e v e a l s some i n t e r e s t i n g t h i n g s about the s e t t i n g . In o r d e r t o make sense o f the c h i l d ' s s tatement, one must know t h a t h i s f a t h e r was a m i n i s t e r i n a f u n d a m e n t a l i s t s e c t . F u r t h e r , t h e f a m i l y was seen t o be v e r y s t r i c t , t h a t i s , they p r a c t i c e d what they p r e a c h e d . A l t h o u g h t h e c h i l d was n o t seen as r e l i g i o u s , h i s problem a r o s e from the c o n s t r a i n t s and t e n s i o n s which a r e e x p e c t a b l e i n such a s t r i c t f a m i l y . We do n o t t y p i c a l l y t h i n k o f c h i l d r e n as b e i n g r e l i g i o u s and, i f we d i d , we would l i k e l y t ake i t as p r e c o c i o u s n e s s . 95 The j o k e t h e n i s n o t t h a t a r e l i g i o u s p a t i e n t would n o t t o l e r a t e an ' a t h e i s t ' (a non-church-goer a t any r a t e ) but t h a t the f a m i l y i s t h e m e d i a t o r o f t h i s i n f o r m a t i o n . The f a m i l y can be a m e d i a t o r i n two ways. F i r s t , a c h i l d i s t y p i c a l l y assumed t o have i n t e r n a l i z e d h i s f a m i l y ' s v a l u e s . As a r e s u l t he need n o t t h i n k f o r h i m s e l f . R ather, h i s f a m i l y becomes a s e t o f ready made re s p o n s e s t o r o u t i n e s i t u a t i o n s . As a t h i r d p a r t y one can a n t i c i p a t e t h i s response and r e c o g n i z e when a member o f a f a m i l y i s t a k i n g the f a m i l y - l i n e . T h i s e x p l a n a t i o n makes f o r a c l o s e f i t between the c h i l d ' s b e h a v i o r and what we know o f h i s f a m i l y . A l t e r n a t i v -e l y , the c h i l d might r e l a y the t h e r a p i s t ' s answer t o h i s p a r e n t s who c o u l d then h i n d e r t h e r a p y by d i s c r e d i t i n g t h e t h e r a p i s t . In e i t h e r c a s e, we see c l e a r l y t h a t the p a t i e n t i s n o t seen as m e r e l y a c h i l d b u t a l s o as a member o f a f a m i l y . Upon e n c o u n t e r i n g a c h i l d , one can w a r r a n t a b l y l o o k f o r a f a m i l y who manages him, i s r e s p o n s i b l e f o r him, i n f l u e n c e s h i s b e l i e f s and v a l u e s , has c o n t r i b u t e d t o h i s . p r e s e n t problems, e t c . S i m i l a r l y , one may a t t e n d t o what sense the f a m i l y a t t r i b u t e s t o t h e a c t i v i t i e s o f one o f i t s members. The p a t i e n t i s , and must be seen as, a member o f a f a m i l y . I w i l l r e t u r n t o the : c e n t r a l q u e s t i o n o f how t h e t h e r a p i s t uses the f a m i l y as a r e s o u r c e f o r u n d e r s t a n d i n g the c h i l d i n a moment, b u t f i r s t I would l i k e t o g i v e some f u r t h e r i n s t a n c e s o f ways i n which t h e r a p i s t s a t t e n d t o how what t a k e s p l a c e i n the p l a y room may g e t back t o the f a m i l y . I o b s e r v e d t h a t c h i l d r e n o f t e n d i d t h i n g s i n t h e p l a y room t h a t one would n o t e x p e c t t h a t they would be a l l o w e d t o do a t home and I wondered what t h e i r p a r e n t s would make o f t h i s , f o r i t seems l o g i c a l t o assume t h a t whatever happens i n the t h e r a p y s e t t i n g w i l l be t r a n s m i t t e d t o t h e c h i l d ' s p a r e n t s . I asked a t h e r a p i s t about t h i s . 96 4 . 2 R: I t would be i n t e r e s t i n g t o f i n d o u t , o r maybe you know, what the p a r e n t s do w i t h what he b r i n g s home from the t h e r a p y , because he must go home and t a l k about i t . T: Yea. ((pause)) I don't know. I t ' s s u r p r i s i n g , I t e l l you i t ' s 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 about t h e i r t h e r a p y s e s s i o n s a t 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 and say "what's g o i n g on i n t h e r e ? " ( ) Some o f the more d i s c r e t e p a r e n t s w i l l say "I don't ask him about i t because I know he never t a l k s about i t and I never ask cause I f e e l t h a t ' s h i s time". . . . Ah, one time I remember i t was q u i t e s h o c k i n g , ah, ( ) had drawn a p i c t u r e o f t e a c h e r on the b o a r d and sho t a t i t w i t h pop guns. So, John r e a l l y t hought t h a t was f a n t a s t i c so he went r u n n i n g d o w n s t a i r s and t h e f i r s t t h i n g he d i d t o mum was say "hey mum we j u s t s h o t the pop gun a t Mrs. Jones". And l i k e t h e mother l o o k e d you know, k i n d o f t a k e n aback, b u t she j u s t dropped i t . Thus, t h e r e a r e o c c a s i o n s when the t h e r a p i s t sees t h a t some f a c t o r i n c i d e n t might be r e p o r t e d t o a c h i l d ' s p a r e n t s and has r e a s o n t o hope t h a t the f a m i l y w i l l show some d i s c r e t i o n i n h a n d l i n g the ma t t e r . P a r e n t s u s u a l l y e x p e c t t h a t t h e r e w i l l be some r e p o r t a b l e e v e n t s and, i f th e y do n o t r e c e i v e any 'news' from t h e i r c h i l d , t h e y o f t e n ask d i r e c t q u e s t i o n s about what"<s g o i n g on i n t h e p l a y room. Some p a r e n t s h e s i t a t e t o ask s i n c e they f e a r t h a t the c h i l d may be r e v e a l i n g m a t t e r s which the f a m i l y 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 . And, as the f o l l o w i n g shows, o t h e r p a r e n t s t h i n k t h a t t h e r e i s some i n f o r m a t i o n which t h e y must know about. 4 . 3 T: In f a c t we have one mother who s a y s , " y o u ' l l t e l l me won't you i f he runs o v e r me w i t h a t r u c k " . ( ( l a u g h s ) ) T h a t ' s a p r e t t y a s t u t e mother. The f a c t t h a t i n f o r m a t i o n from the t h e r a p y s e s s i o n w i l l r e a c h the f a m i l y can a l s o be p s y c h i a t r i c a l l y r e l e v a n t i n o t h e r ways. F o r i n s t a n c e , i t g i v e s the t h e r a p i s t a r e a s o n t o hope f o r a change i n t h e home e n v i r o n -ment. T h i s t y p e o f communication between the t h e r a p i s t and the home ne v e r 97 seemed t o t a k e t h e form: " T e l l y our p a r e n t s t h a t . . . ", b u t o c c u r r e d i n much more s u b t l e ways. T h e r a p i s t s o f t e n hope t h a t , because the p a t i e n t has changed h i s p r e v i o u s d i s t u r b e d b e h a v i o r , the p a r e n t s w i l l t h e r e f o r e come t o t r e a t him i n a d i f f e r e n t manner. I t i s assumed t h a t , i n many c a s e s , the c h i l d ' s p roblem o r i g i n a t e d i n the home and t h a t i t i s p o s s i b l e t o t r e a t t h e f a m i l y by changing the c h i l d so t h a t t h i s i n f o r m a t i o n w i l l be communicated and r e f l e c t e d i n the b e h a v i o r o f the p a r e n t s . Thus, i t i s p o s s i b l e t o d e a l w i t h the f a m i l y w i t h o u t h a v i n g t o c o n f r o n t them i n a more d i r e c t way. N e e d l e s s t o say, t h i s approach does n o t work a l l the t i m e . H i s t o r i c a l l y , t h e r e have been a l t e r n a t i o n s between the i d e a l o f t r e a t i n g f a m i l i e s and t h a t o f t r e a t i n g c h i l d r e n . In the l a t t e r , t h e o b j e c t i v e i s t o change the c h i l d and hope he can t h e r e b y come t o cope i n and w i t h h i s f a m i l y . Here t h e r a p y c o n s i s t e d i n the a c q u i s i t i o n o f c o p i n g mechanisms. While f a m i l i e s were seldom p a r t o f the t h e r a p y program a t the c l i n i c , t h e r e was always the hope t h a t th e p a r e n t s would r e l a t e t o and r e f l e c t changes i n the c h i l d ' s a t t i t u d e s and b e h a v i o r i n a p o s i t i v e manner. Many t h e r a p i s t s f e l t t h a t i f t h e r a p y were t o be s u c c e s s f u l , t h e p o s i t i v e i n v o l v e m e n t o f the f a m i l y was e s s e n t i a l . I w i l l d i s c u s s t h i s l a t e r . The r e l a t i o n s h i p between the p a t i e n t and a t h i r d p a r t y (the ' f a m i l y ' ) i s o r g a n i z a t i o n a l l y i m p o r t a n t i n the f o l l o w i n g sense. I f o t h e r members o f the f a m i l y become p a t i e n t s , , an e f f o r t was made t o a s s i g n them t o a t h e r a -p i s t o t h e r than t h e one who was t r e a t i n g the c h i l d . S i n c e i t i s t a ken t h a t f a m i l y members may have t o r e p o r t on each o t h e r , i t i s seen as a p p r o p r i a t e t h a t , a t l e a s t on the s u r f a c e , t h e r e s h o u l d n o t be a c h a n n e l from p a r e n t t o c h i l d t hrough the t h e r a p i s t . I n t e r e s t i n g l y enough, i t i s f e l t t h a t t h i s may be a more s i g n i f i c a n t p r oblem f o r the c h i l d s i n c e , n o t knowing a n y t h i n g about p r o f e s s i o n a l ' e t h i c s , the c h i l d w i l l assume t h a t 98 3 the a d u l t s a r e t a l k i n g about him. However, t h i s i s n o t always a major s o u r c e o f c o n c e r n . Indeed I o b s e r v e d a t h e r a p i s t and p a r e n t t a l k i n g about t h e p a t i e n t , h e r p r o g r e s s , and t h e i r w o r r i e s w h i l e the c h i l d p l a y e d i n the sand t r a y w i t h i n easy h e a r i n g d i s t a n c e o f them. Through t h i s n o t i o n o f ' r e p o r t a b l e e v e n t s ' , we can b e g i n t o see how the p a t i e n t i s c o n s t a n t l y a t t e n d e d t o as a member o f some f a m i l y 4 s t r u c t u r e . T h i s l e a d s us t o see how e v e n t s take on t h e c h a r a c t e r o f ' r e p o r t a b i l i t y ' t hrough an i n t r i n s i c f e a t u r e o f p r a c t i c a l r e a s o n i n g , namely t h a t o f background e x p e c t a n c i e s . I t i s background e x p e c t a n c i e s which a l l o w us t o see a joke i n t h e t h e r a p i s t r e m arking t h a t she "was f i n i s h e d " a f t e r h a v i n g a p a t i e n t t e l l h e r t h a t she was a s i n n e r . C o n t a i n e d i n t h a t r e p o r t i s t h e assumption o f a f a m i l y . Background e x p e c t a n c i e s a l s o p r o v i d e the l o g i c o f s e p a r a t i n g p a t i e n t s i n the same f a m i l y , t h e a p p r o p r i a t e n e s s o f a t t e n d i n g t o c o n c e r n s o f the f a m i l y , e t c . Indeed, t h e y a r e e s s e n t i a l t o any u n d e r s t a n d i n g which we may have as members o f s o c i e t y . B r i n g i n g N o t i o n s o f 'Mom' and 'Dad' t o Therapy In t r a d i t i o n a l p s y c h o t h e r a p y , w i t h f o l l o w e r s o f S. F r e u d o r M. K l e i n f o r example, t h e r e i s a t e c h n i q u e r e f e r r e d t o as " t r a n s f e r e n c e n e u r o s i s " . T h i s i s a k i n d o f n e u r o s i s which i s g e n e r a t e d by t h e t h e r a p y s i t u a t i o n . I t a l l o w s and encourages t h e p a t i e n t t o t r a n s f e r any deep-s e a t e d f e e l i n g s t h a t he has about a phenomenon o u t s i d e o f the t h e r a p y room (such as h i s p a r e n t s ) onto the t h e r a p i s t . T h i s p e r m i t s b o t h him and t h e t h e r a p i s t t o work on t h o s e f e e l i n g s w i t h i n the c o n t e x t o f the t h e r a p y r e l a t i o n s h i p . 5 There has been a l o n g s t a n d i n g debate i n c h i l d p s y c h i a t r y about the f e a s a b i l i t y o f u s i n g t h i s t e c h n i q u e w i t h c h i l d r e n s i n c e the 99 p a t i e n t i s a c t u a l l y l i v i n g w i t h h i s p a r e n t s r a t h e r than remembering them. The f o l l o w i n g c o n v e r s a t i o n f o c u s e s on t h i s i s s u e . 4.4 T: But most p e o p l e f e e l t h a t t r a n s f e r e n c e n e u r o s i s does happen. 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 u n n e c e s s a r y i n most cases t o use i t , i n t r e a t m e n t . What happens b e f o r e t h a t , sure i t i s a v e r y s t r o n g tendency t o see f a m i l i a r t h i n g s i n the r e l a t i o n -s h i p . Which i s n o t s u r p r i s i n g . Ah, o r t o t r y and c r e a t e f a m i l i a r t h i n g s , ah, such as 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 ah, "What make i s your c a r ? My daddy's g o t a Chev." T r y i n g t o g e t some s i m i l a r i t i e s as a p o i n t o f c o n t a c t ; o r ah, 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 deeper l e v e l , e x p e c t i n g me t o behave i n a way t h a t a p a r e n t would. I had one c h i l d , a n i n e y e a r o l d , who, the one.I t o l d you about who runs a l l o v e r the p l a c e , and spends most o f the time on the t r a m p o l i n e , ah she has pushed me time and time a g a i n t o t h e p o i n t where I have t o say no. " I want t o ta k e t h i s . I want t o ta k e t h a t . I want f o u r boxes o f candy". When I say i t ' s time t o f i n i s h she wants t o go and do something e l s e . So she's c o n s t a n t l y p u s h i n g me t o say no. Ah, now i t t u r n s o u t t h i s i s the t h i n g she f i n d s most d i f f i c u l t t o t ake 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 about her.' And the y r e s p o n d v e r y h a r s h l y , so 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 about t h i s and she g o t t o the p o i n t where she 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 than mommy's 'no'. E x c e p t on o c c a s i o n s when I s a i d 'no', and she s a i d , "That's a Mommy's no". R: She used t h a t p h r a s e ? T: Yea, and we had a loo k a t i t t o see what the f e e l i n g was, maybe i t was the way I s a i d i t o r maybe i t was the t o p i c we were t a l k i n g about, o r maybe i t was the way she was r e c e i v i n g i t . But she had a tendency t o r e p e t i t i o n and ( ) and she's g o i n g t o r e c r e a t e s i t u a t i o n s h e r e v e r y much l i k e the s i t u a t i o n s she 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 she's f a m i l i a r With. And t h i s i s o f t e n o f co u r s e the f i r s t ( ) t h a t o c c u r s t o the c h i l d t h a t we don't behave, I don't behave l i k e h e r f a t h e r , o r mother, w i t h b e h a v i o r t h a t she b r i n g s home. But t h e r e ' s the expec-t a t i o n , t h e r e ' s the statements o f f a m i l i a r i t y . You do t h i s l i k e Dad o r Mom, o r you l o o k l i k e Dad or.Mom. Ah, then t h e e x p e c t a t i o n , oh yea, and 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 , even though i t ' s an u n c o m f o r t a b l e one, o r one t h a t ' s g i v e n them problems, g i v e n them p a i n . So ah, i n th o s e s e n s e s , I haven't worded i t w e l l , b u t i n those senses t h e r e 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 the r e a l i t y may be d i s g u i s e d by t h e c h i l d ' s work on i t ; what the c h i l d ' s p e r c e i v i n g may not c o r r e s p o n d w i t h what a c t u a l l y i s , because o f t h e e x p e c t a t i o n s , t h e i n n e r e x p e c t a t i o n s t h a t 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 and she sa y s "you're mad a t me". And I'm n o t aware o f b e i n g mad n o r o f h a v i n g an angry e x p r e s s i o n on my f a c e . And ah, "Sh a r r o n , I'm not aware o f b e i n g angry w i t h you". S o r t o f l o o k s a b i t c l o s e r ; "No maybe you're n o t " . But she's e x p e c t i n g 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 from me. The p s y c h i a t r i s t i s s a y i n g i n e f f e c t t h a t , w h i l e t h e r a p i s t s a c c e p t the n o t 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 t i s n o t always n e c e s s a r y i n p l a y t h e r a p y s i n c e the p a t i e n t can r e a d i l y be seen t o be t r e a t i n g him l i k e "mom" o r "dad" and does so w i t h o u t any encouragement. T h i s i s a v a i l a b l e t o us n o t o n l y i n d i r e c t s t a tements l i k e " t h a t ' s a mommy's no", b u t a l s o i n the c h i l d ' s demands. T h a t i s , t h e r e a r e eve n t s t h a t t a k e p l a c e i n the p l a y room which can e a s i l y 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 even t s i n the c h i l d ' s home. F o r i n s t a n c e , t h e above mentioned p a t i e n t ' s c o n t i n u e d r e q u e s t s a r e n o t seen s i m p l y as q u e s t i o n s b u t as i n s t a n c e s o f her attempts t o "push t h e t h e r a p i s t " i n o r d e r t o r e c r e a t e the p a r e n t - c h i l d r e l a t i o n s h i p which o b t a i n s o u t s i d e o f t h e p l a y room. Thus, e x p e c t a n c i e s about t h i s c h i l d as a member o f t h e f a m i l y p r o v i d e us w i t h a r e s o u r c e f o r u n d e r s t a n d i n g h e r q u e s t i o n s i n a more r e a s o n a b l e and t h o r o u g h - g o i n g way than would o t h e r w i s e be p o s s i b l e . The t h e r a p i s t a n t i c i p a t e s t h a t some.things a r e g o i n g t o be seen and hea r d by t h e c h i l d as i n s t a n c e s o f p a r e n t - l i k e b e h a v i o r . T h i s , t o o , f u r t h e r shows how the p a t i e n t i s and must be seen as a f a m i l y member. The t h e r a p i s t u s u a l l y t r i e s t o a v o i d sounding l i k e the c h i l d ' s mother o r f a t h e r f o r t h e r e i s an e f f o r t t o c o n s t r u c t an atmosphere t h a t c o n t r a s t s t o home. The p a t i e n t must be made t o f e e l t h a t t h e r e l a t i o n s h i p t h a t he has w i t h h i s t h e r a p i s t i s e s s e n t i a l l y d i f f e r e n t than t h a t which he has w i t h h i s p a r e n t s . T h i s r e l a t e s back t o the r a t i o n a l e o f t h e environment and th e t h e r a p e u t i c r e l a t i o n s h i p . I n c o n s t r u c t i n g t h i s r e l a t i o n s h i p t h e t h e r a p i s t can use h i s common-sense knowledge about what p a r e n t s a r e l i k e 101 and about what t h i n g s might sound o r l o o k l i k e the a c t i o n s o f a p a r e n t as a r e s o u r c e . A t h e r a p i s t was r e c o u n t i n g some o f the d i f f i c u l t i e s i n v o l v e d here and r e f e r r e d t o a case where a p a t i e n t f i l l e d h i s hands and p o c k e t s w i t h c o o k i e s and began t o e a t as i f he were v e r y hungry. (Candies and c o o k i e s were r o u t i n e l y a p a r t o f the p l a y room s u p p l i e s and were u s u a l l y p l a c e d i n the p l a y room a l o n g w i t h the t o y s . T h i s was n o t done i n a l l c a s e s , o r f o r a l l p a t i e n t s , b u t i t seemed t o be a r u l e r a t h e r than an e x c e p t i o n ) . The c h i l d had been p e r m i t t e d t o go i n t o the s u p p l y room and t a k e as many c o o k i e s as he wanted. ( T h i s p a r t i c u l a r t h e r a p i s t a l l o w e d t h e c h i l d r e n t o s e l e c t t h e i r own t o y s ) . She s a i d t h a t t h i s had annoyed h e r and, conse-q u e n t l y , she f o r m u l a t e d a r u l e s a y i n g t h a t the c h i l d c o u l d o n l y t a k e t h r e e c o o k i e s . However, h a v i n g s a i d t h i s t o t h e c h i l d , she the n r e a l i z e d t h a t i t sounded l i k e a " p a r e n t ' s r u l e " and revoked i t . I t a k e i t t h a t t h e t h e r a p i s t r e a l i z e d t h a t t h e h e a r i n g t h a t she gave t o the 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 and she revoked h e r d e c i s i o n because o f t h i s . I t i s n o t t h a t the t h e r a p i s t s i m p l y has some n o t i o n s about what p a r e n t s a r e l i k e and t h e r e b y a v o i d s i m i t a t i n g them, r a t h e r , a t any on g o i n g moment, she can a t t e n d t o t h e p o t e n t i a l h e a r i n g t h e p a t i e n t may g i v e t o some account. S i m i l a r l y , c a n c e l l a t i o n o f the r u l e i s n o t t o be h e a r d merely as a change o f mind b u t as a document o f the f a c t t h a t she i s n o t l i k e the p a t i e n t ' s p a r e n t s . On a n o t h e r o c c a s i o n a p a t i e n t was p l a y i n g i n t h e wet sand t r a y , an a c t i v i t y which i s always p o t e n t i a l l y messy. A l t h o u g h I d i d n o t f e e l t h a t she was b e i n g h e s i t a n t :or o v e r l y c a u t i o u s i n h e r p l a y , t h e t h e r a p i s t s a i d : 4.5 T: I t h i n k mom won't mind us p l a y i n g w i t h the mucky sand and water. T h a t ' s okay w i t h h e r . ' 102 The i s s u e here i s n o t whether the c h i l d was d i s p l a y i n g a c o n c e r n about t h e p o s s i b l e consequences o f h e r a c t i o n . ^ R a t h e r we s h o u l d n o t e t h a t one can w a r r a n t a b l y e x p e c t c h i l d r e n t o worry about what t h e i r p a r e n t s are g o i n g t o say o r do. That i s n o t t o say t h a t t h e y always worry about such t h i n g s b u t t h a t such a d e s c r i p t i o n i s a v a i l a b l e t o us as an accou n t o f t h e i r c onduct. (I have a l s o seen t e a c h e r s reprimand c h i l d r e n f o r p l a y i n g i n the mud on the way home from s c h o o l , r e m i n d i n g them- t h a t "mother has t o wash those you know".) I t i s always p o s s i b l e t o see a c h i l d as f a i l i n g t o show enough c o n c e r n , as showing t o o much c o n c e r n , o r as showing the a p p r o p r i a t e c o n c e r n about i t s p a r e n t s . However, a l l o f th e s e p o s s i b i l i t i e s i n v o k e the i d e a o f the c h i l d as a member o f the f a m i l y . Numerous i n s t a n c e s o f t h e r a p y t a l k d i s p l a y e d t h e t h e r a p i s t ' s a t t e n -t i o n t o the c h i l d ' s c o n c e r n f o r what h i s o r he r p a r e n t s might say. F o r example: 4.6 C: Yea, and he swears a l o t . T: Does he swear a l o t ? C: Yea. T: Hmm. ((pause)) Sometimes I b e t you even swear. C: No I don't swear. T: Hmmm? You know one p l a c e where i t ' s r e a l l y good t o swear i s r i g h t h e r e i n t h e p l a y room. C: I know. T: T h a t ' s r i g h t . ((pause)) Why you can even say f u c k and a l l t h o s e t h i n g s , r i g h t h e r e . C: ( you want t o p l a y d a r t s ) T: Hmm? ((pause)) A t home though I t h i n k i t bugs mom i f you swear. I w i l l say more about p e r m i s s l b l e s l a t e r , b u t a p o s s i b l e i n t e r p r e -103 t a t i o n o f the mention o f "mom" i n t h e l a s t u t t e r a n c e i s as f o l l o w s . The t h e r a p i s t has been e n c o u r a g i n g the c h i l d t o swear i n the p l a y room and a t t e n d s t o th e p o s s i b i l i t y t h a t t h e c h i l d i s t h i n k i n g something l i k e : "Here i s someone s a y i n g t h a t i t i s a l l r i g h t t o swear. Now I know my p a r e n t s don't say t h a t . What am I t o do?" The t h e r a p i s t p r o v i d e s f o r t h i s assumed c o n c e r n by r e c o g n i z i n g the p a r e n t a l s a n c t i o n , i . e . , "At home though I t h i n k i t bugs mom i f you swear", and uses i t as a d e v i c e t o d i s p l a y an e s s e n t i a l d i f f e r e n c e between home and the p l a y room. I t a k e t h i s t o be an adequate a c c o u n t o f what was g o i n g on i n t h a t c o n v e r s a t i o n . I had never h e a r d any r e f e r e n c e which would i n d i c a t e t h a t t h i s c h i l d had a swearing problem. I n s t e a d , I t a k e i t t h a t the t h e r a p i s t was a b l e t o use h e r common sense knowledge i n o r d e r t o d e c i d e b o t h t h a t t h e c h i l d m i ght l i k e t o swear and t h a t the mother might o b j e c t t o i t . By f o r m u l a t i n g the p a t i e n t as f a m i l y member, the t h e r a p i s t i s a b l e t o say what she f e e l s has t o be s a i d : t h a t t h i s i s one p l a c e where you can be ' e v i l ' . F u r t h e r , she i s a b l e t o show the p a t i e n t what t h e r a p y i s about. C o n s i d e r the f o l l o w i n g : 4.7 C: Here, P a u l a . T: So t h a t ' s my c o o k i e ? C: Yeaa. T: Do you know t h a t I ' l l l i k e you even i f you don't g i v e me t h i n g s ? Mmm? 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 . What i s a t i s s u e here i s a n o t i o n o f s h a r i n g . T h i s i s an a c t i v i t y which p a r e n t s and o t h e r a d u l t s encourage c h i l d r e n t o p e r f o r m . T here a r e numerous ways t o c h a r a c t e r i z e someone who d o e s n ' t share b u t , f o r the 104 offender, the penalty may be the loss of f r i e n d s . Here, the t h e r a p i s t i s demonstrating that t h e i r friendship does not depend on forced sharing. Another t h e r a p i s t complained about a patient who c o n t i n u a l l y asked permission to do inconsequential things. This was seen as a document of the patient's c o n s t r i c t i o n . Permission i s t y p i c a l l y given to c h i l d r e n by parents and the c h i l d who asks f o r permission to do things that don't t y p i c a l l y require permission can be assumed to have a troubled r e l a t i o n s h i p with hi s parents. The following i s a f i n a l example of how notions of 'mom' and 'dad' are brought i n t o the therapy room. We have been looking at one of the ways i n which therapists i n t e r p r e t patient's actions, i . e . as motivated by the underlying idea that the t h e r a p i s t i s l i k e the c h i l d ' s parents. Therapists a n t i c i p a t e many of the motives that patients may ascribe to them on the basis of the standardized 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 . In the instances 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 to encourage the c h i l d to play i n  the mud, to swear, etc., i n order to accomplish the objectives of therapy. Consider: 4.8 T: You know Dana, ( ( i n t e r e s t i n g tone of voice)) C: What? T: I was r e a l l y thinking about the l a s t time you were here, and I think 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. C: You weren't. T: I was t h i n k i n g t h a t // C: ( ( n o i s e ) ) T: t h a t I wasn't r e a l l y b e i n g q u i t e f a i r t o you. The t h e r a p i s t went on t o say t h a t , i n s p i t e o f h a v i n g g i v e n i n s t r u c t i o n s about the freedom t o do your own t h i n g i n t h e p l a y room, t h e r e were o c c a s i o n s on which she would have t o appear demanding o r u n f a i r so t h a t they c o u l d make the b e s t p o s s i b l e use o f t h e t h e r a p y hour. The t h e r a p i s t i s s u g g e s t i n g t h a t w h i l e i t may appear t h a t t h e c a t e g o r y o f "naggy o l d mom o r dad" goes w i t h the a c t i v i t y the p a t i e n t h e a r d l a s t week (b e i n g u n f a i r ) , and i t i s a p p r o p r i a t e t o have h e a r d i t t h a t way, t h e r e i s a more r e l e v a n t c a t e g o r y — ' t h e r a p i s t ' . A l t h o u g h h e r f o r m u l a t i o n o f a p r o p e r h e a r i n g f o r the p a t i e n t sounded l i k e an apology, we s h o u l d a t t e n d t o i t s i n t e r a c t i o n a l consequence. To p u t t h e f o r m u l a t i o n i n terms o f a f a m i l y c a t e g o r y ( i . e . , a naggy o l d mom o r dad), makes what the t h e r a p i s t i s d o i n g r e l e v a n t f o r t h e c h i l d and a l l o w s h e r t o e x p l a i n t h a t t h e r e a r e good r e a s o n s f o r t h o s e k i n d s o f a c t i o n s . To have couched the e x p l a n a t i o n i n terms o f the r o l e o f t h e t h e r a p i s t and the g o a l s o f t h e r a p y would have been i n a p p r o p r i a t e . T h i s would have i n v o l v e d terms and c o n c e p t s t h a t a c h i l d c o u l d n o t be e x p e c t e d t o u n d e r s t a n d . To my knowledge, such e x p l a n a t i o n s were n e v e r used i n the p l a y room. F a m i l y S t r u c t u r e and Making Sense I would now l i k e t o l o o k a t how the p a t i e n t ' s f a m i l y was i n v o k e d f o r making sense o f p a t i e n t ' s b e h a v i o r . I s h a l l b e g i n by d e s c r i b i n g how I o f t e n l e a r n e d about p a t i e n t ' s f a m i l i e s i n the c o u r s e o f t h e r a p y - r e l a t e d 106 discussions. For instance, I was a p a r t i c i p a n t to a conversation between a th e r a p i s t and a v i s i t i n g student-therapist i n which the pa t i e n t who was to be observed i n a few minutes was being described. The c h i l d ' s problem was that she d i d not want to be a g i r l . The following t a l k transpired. 4.9 1. T: So, and then i n an (ethnic group) family to have a g i r l , i s okay, to have a l i t t l e g i r l who's a burden and says ((pause)) 2. S: Yea, i t ' s a l i t t l e b i t f a r out. 3. T: So I think f o r her she would rather not be a g i r l at a l l . 4. S: Oh r e a l l y . ((tone and expression of recognition)) 5. T: and ah, ah, 6. S: Is there anything ( ) when she does that? 7. T: Yea she does, she a l o t of things l i k e , she she would l i k e whiskers, ah, a l l sorts of things l i k e , ah, I'm looking f o r something to put water i n , ah, and mother hasn't given a great deal to her I don't think. 8. S: How many ch i l d r e n are there? * 9. T: Three i n the family. 10. S: And she's the oldest? 11. T: She's the youngest. 12. S: The youngest. 13. T: And there's two older brothers. 14. S: Ahhh. ((again a voice of recognition)) 15. T: Who are very nice, very p o l i t e , ( ). I f the problem i s with the c h i l d we might naively wonder what a l l of 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 to grow whiskers and t h i s i s surely evidence of some intrapsychic rather than family problem. However, i t i s clear that both the th e r a p i s t and the student 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 the c h i l d ' s family 107 and the diagnosis of her problem. This i s made cl e a r for us i n the recognition a c t i v i t i e s done by the student-therapist (utterances 4 and 14). Let us look at these two acts. I take i t that utterance four ("oh r e a l l y " ) i s the r e s u l t of a sudden r e a l i z a t i o n on the part of the student. P r i o r to t h i s excerpt, she had been informed of the c h i l d ' s d i f f i c u l t i e s and i s now beginning to make some new or better sense of that information. Utterance one contains an assumption about the family's attitudes towards boys and g i r l s — a t t i t u d e s which are accentuated by the ethnic background of the family. This i s an ethnic group that i s s a i d to attach more value to having sons than daughters so that when t h e i r expectations f o r a g i r l are not met, t h e i r tolerance for that c h i l d i s further reduced. Not only i s the behavior i t s e l f c r i t i c i z e d , , but the c h i l d ' s status as a g i r l i s also c a l l e d to account. Because of the prevalence of these attitudes and responses i t i s assumed that the c h i l d w i l l f e e l that her family's reactions to her are r e l a t e d to her sex. And i t i s probably for these reasons that she does not want to be a g i r l . This account provided by. the t h e r a p i s t i s not the r e s u l t of some information which the parents had given, him. Rather, the warrant f o r making these statements rests i n h i s common-sense knowledge about how members of that ethnic group view children plus some personal knowledge of the family which indicates that they are representatives of that group, i . e . , they are t y p i c a l . I t should also be added that the t h e r a p i s t has only been involved i n t h i s case for a short time so that what we are hearing are her own discovery procedures. There follows an e f f o r t by the student-therapist to discover other features of the patient's family that may be relevant. Thus, i n utterance 108 e i g h t , he a s k s , "How many c h i l d r e n a r e t h e r e ? " . The s t u d e n t ' s guess t h a t the p a t i e n t i s the o l d e s t o f the t h r e e ( u t t e r a n c e ten) i s , I s u g g e s t , r e a s o n a b l e , g i v e n the p r e v i o u s t a l k . S i n c e t h i s f a m i l y p u t s more v a l u e on boys than on g i r l s , i t f o l l o w s t h a t t h e f i r s t b o r n may b e a r the w eight o f t h i s e x p e c t a t i o n i n a way t h a t o t h e r c h i l d r e n would n o t . T h a t i s , the p a r e n t s might be e s p e c i a l l y d i s a p p o i n t e d i f t h e i r f i r s t c h i l d was a g i r l . Thus h i s q u e s t i o n seems p e r t i n e n t . C o n s i d e r the consequences had t h e s t u d e n t asked i n s t e a d ' "She's the second (or t h i r d , o r f o u r t h , e t c . ) i n the f a m i l y ? " No immediate r e l e v a n c e would have been a t t r i b u t e d t o t h a t f o r m u l a t i o n . T hat i s , i t would not be seen as r e l e v a n t . However, as m a t t e r s s t a n d , we can see t h a t the s t u d e n t ' s " e r r o r " shows t h a t she under-s t o o d the s i t u a t i o n p r o p e r l y i n the way t h a t a c o r r e c t guess would n o t have shown.^ Her second r e c o g n i t i o n ( u t t e r a n c e f o u r t e e n ) seems t o i n d i c a t e t h a t she now sees some r e l a t i o n s h i p between the p a t i e n t ' s p r o b l e m and h e r s i b l i n g p o s i t i o n . That i s , p a r e n t s o f t e n respond t o a c h i l d ' s i n t o l e r a b l e b e h a v i o r by comparing the c h i l d t o h i s o r h e r s i b l i n g s . F o r t h e p a t i e n t t h i s amounts t o w i s h i n g t h a t she were a boy. The t h e r a p i s t c o n f i r m s t h i s by p r o v i d i n g a f u r t h e r d e s c r i p t i o n o f the b r o t h e r s as "... v e r y n i c e , v e r y p o l i t e " . One can now imagine t h e p a r e n t s s c o l d i n g t h e p a t i e n t w i t h some-t h i n g l i k e , "Why don't you behave l i k e y our b r o t h e r s " , which becomes, "We w i s h we had t h r e e boys". T h i s a l l o w s the p a t i e n t t o i d e n t i f y " s e l f -worth" w i t h sex r o l e s . Of c o u r s e , i t a l s o p r o v i d e s the t h e r a p i s t s w i t h a p o s s i b l e e x p l a n a t i o n f o r the p a t i e n t ' s b e h a v i o r . I want t o emphasize t h a t t h i s t a l k i s n o t j u s t s m a l l t a l k p r i o r t o a t h e r a p y s e s s i o n , i t i s a m e t h o d i c a l l y c o n s t r u c t e d exchange i n which the p a t i e n t ' s f a m i l y s i t u a t i o n i s scanned f o r c l u e s t o t h e p a t i e n t ' s problem. ) 109 F u r t h e r , i t p r o v i d e s n o t o n l y a p o s s i b l e b u t a r e a s o n a b l e and adequate u n d e r s t a n d i n g o f the p a t i e n t and h e r problem. Whenever t h e r e i s a c h i l d , t h e r e i s a f a m i l y and one can e x p e c t e d l y d i s c o v e r a r e l a t i o n s h i p between the c h i l d and h i s / h e r f a m i l y s t r u c t u r e . T h e r a p i s t s see more t h a n j u s t p l a y o r b e h a v i o r i n t h e i r p a t i e n t s , t h e y a l s o see problems. O f t e n t h e y do so w i t h o u t any knowledge about t h e p a t i e n t ' s a c t u a l f a m i l y . T hat i s , the r e a l i z a t i o n t h a t c h i l d r e n a r e f r i g h t e n e d , angry, have s e x u a l i d e n t i f i c a t i o n problems, and so on can come about independent o f any knowledge o f the c h i l d ' s f a m i l y . However, h a v i n g found such problems, t h e t h e r a p i s t t h e n l o o k s a t t h e c h i l d ' s f a m i l y . T h i s a c c o m p l i s h e s s e v e r a l t h i n g s . F i r s t , i t p r o v i d e s a r e a s o n a b l e a c c o u n t o f t h e o f f e n d i n g b e h a v i o r and h e l p s t o t r a n s f o r m i t from a ' t r o u b l e ' i n t o a t h e r a p y problem. Such f a m i l y - r e l a t e d a c c o u n t s a r e o r g a n i z a t i o n a l l y r e l e v a n t . T h i s can be seen c l e a r l y i n i n s t a n c e s where the c h i l d i s removed from h i s home, where t h e p a r e n t s a r e t o l d t o e n t e r t h e r a p y , and so on. C o n c o m i t a n t l y , i t a l l o w s t h e t h e r a p i s t t o make sense o f t h e c h i l d ' s 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 s o u r c e t o i t . I t shows, to o , t h a t the p a t t e r n e d a c t i o n s o f t h e p a t i e n t f o l l o w from an u n d e r s t a n d -a b l e c o u r s e o f r e a s o n i n g . That i s , i t p r o v i d e s adequate m o t i v a t i o n a l a c c o u n t s f o r t h e p a t i e n t ' s d o i n g s . F u r t h e r , i t p r o v i d e s the t h e r a p i s t w i t h some i d e a s about what i s i m p o r t a n t t o t h e p a t i e n t and how he can b e s t s o l v e h i s problem. In a d d i t i o n t o such c o n s i d e r a t i o n s , i t p r o v i d e s a w a r r a n t f o r i n t e r v e n t i o n i n t o t h e l i f e o f the c h i l d . In an immediate sense, such a wa r r a n t i s a v a i l a b l e t o us i n the p r e s e n c e o f the c h i l d a t the c l i n i c , however, a f u r t h e r w a r r a n t may be r e q u i r e d . C i c o u r e l , i n h i s stu d y o f 110 the juvenile j u s t i c e system found that the fam i l i e s of offenders who were going to be charged with a crime were l a b e l l e d much more severely than the fami l i e s of youths who were not going to be charged. Given the r e l a t i o n -ship 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 necessary to provide a warrant i n terms, of some problem i n the family. I suggest that t h i s has something to do with our idea that f a m i l i e s , and f a m i l i e s alone, are or should be responsible f o r t h e i r c h i l d r e n . Constructing the Family Although therapists use t h e i r knowledge about a patient's family to inform t h e i r diagnosis, the reverse also holds true, that i s , given the actions of the patient i t i s possible to construct an appropriate family f o r him. Consider the following statement. 4.10 T: You know l i k e , so I kind of f e e l given the family s i t u a t i o n and what he i s , he might have, to, h i s b a t t l e s might be manipulative. ((pause)) He can't openly express; that he'd l i k e to do something (deviant). He has to do i t kind of manipulatively. . . .He comes on sounding very good, and I guess that's the way i t i s at home. , I would guess from the way he's i n t e r a c t i n g i n the play room that at home, that you can't do things because you: would pr e f e r , you have to be rather s e l f l e s s about the whole thing and do i t for the good of somebody e l s e . You know, i t ' s not legitimate i f i t has a s e l f i s h motive, at home I suspect. C e r t a i n l y from observing him i n the play room one would get that impression. I do have other kids who say, "I don't want to.do t h i s anymore, I'm t i r e d of blowing them up". . . . So I r e a l l y get the f e e l i n g at l e a s t at home, the message he gets at home i s that you think of the other guy f i r s t and. then you have to act l i k e that. In t h i s case the th e r a p i s t d i d not know what kinds of messages the c h i l d received at home but was able to construct a possible d e s c r i p t i o n of the family by observing h i s p a t i e n t . In the l a s t play session the th e r a p i s t had been manipulated i n t o blowing up some balloons. The c h i l d would not admit that he d i d not want to do t h i s . (The very seeing of t h i s act as manipulation required more information than the act i t s e l f provided, e.g., I l l I d i d n o t see i t ) . T h i s was seen as a f u r t h e r i n s t a n c e o f the c h i l d ' s problem, i . e . t h e c h i l d always wanted t o appear i n a good l i g h t and, a l t h o u g h he needed t o e x p r e s s anger, f r u s t r a t i o n , e t c . , he c o u l d n o t a l l o w h i m s e l f t o do so. The d e s c r i p t i o n o f the f a m i l y g i v e n i n t h e t r a n s c r i p t above seems t o be c o n s i s t e n t w i t h t h i s s e e i n g . Here, the a c t , t h e p r o b -lem, and t h e f a m i l y cannot be s e p a r a t e d , i n s t e a d , each has i m p l i c a t i o n s f o r the o t h e r . I o b s e r v e d a n o t h e r s e s s i o n i n which the abovementioned p a t i e n t was g i v e n a xylophone. V e r y e a r l y i n the s e s s i o n t h e c h i l d r e l u c t a n t l y made a few n o i s e s w i t h i t and the t h e r a p i s t encouraged him t o c o n t i n u e . F i n a l l y , i n o r d e r t o keep him p l a y i n g , she a g r e e d t o accompany him on t h e drum. I was s u r p r i s e d t o f i n d t h a t the t h e r a p i s t a l l o w e d the whole s e s s i o n t o be s p e n t i n t h i s n o i s y a c t i v i t y , e s p e c i a l l y s i n c e she had e a r l i e r c o mplained o f c o a s t i n g w i t h t h i s p a t i e n t . L a t e r , she s a i d t h a t t h e xylophone p l a y i n g had been good f o r the p a t i e n t . I t was c l e a r t h a t t h e s u c c e s s o f th e s e s s i o n was due t o t h e f a c t t h a t t h e c h i l d had been a l l o w e d t o do something which would n o t have been done 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 . The c h i l d might be t o l d t h a t he was t o o n o i s y o r , p e r h a p s , t h a t he was a poor musi-c i a n . Remember t h a t the t h e r a p i s t had i n t e n t i o n a l l y p l a c e d t h e xylophone i n the room. T h i s appeared t o be r e a s o n a b l e even though I knew n o t h i n g about the f a m i l y . F u r t h e r , I s u s p e c t t h a t t h e t h e r a p i s t d i d n o t know i f the p a t i e n t had a c t u a l l y been s a n c t i o n e d f o r making to o much n o i s e o r had been t o l d t h a t he was a p o o r m u s i c i a n . Nor was I a b l e t o t e l l i f the s e s s i o n had been a good one. I t became c l e a r t h a t , on the b a s i s o f the f a m i l y ' s c h i l d -r e a r i n g a c t i v i t i e s , c e r t a i n c o n s t a n t f e a t u r e s c o u l d be assumed. T h a t i s t o say, i f the p a r e n t s respond t o a c t i o n A i n a known way, t h e y w i l l r e a c t 112 t o the c l a s s o f a c t i v i t i e s o f which A i s a member i n the same way. F o r example, i f the c h i l d cannot make a mess a t home, i t can be assumed t h a t he i s n o t p e r m i t t e d t o swear. I s h a l l g i v e two more examples o f how I came t o see the r e l e v a n c e o f f a m i l i e s f o r u n d e r s t a n d i n g 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. The f i r s t o f t h e s e i n s t a n c e s r e f e r s t o t h e p a t i e n t mentioned above. The c h i l d f r e q u e n t l y engaged i n p a i n t i n g and many o f h i s p i c t u r e s c o n t a i n e d some o b j e c t t h a t was c l e a r l y d i v i d e d i n t o two s e c t i o n s which were p a i n t e d d i f f e r e n t c o l o r s . While the t h e r a p i s t was a b l e t o see a g r e a t d e a l o f s i g n i f i c a n c e i n t h e c h i l d ' s . c h o i c e o f c o l o r s and even i n the ges-t u r e s t h a t he made when p a i n t i n g , I c o u l d n o t even see why p a i n t i n g was a s i g n i f i c a n t a c t i v i t y . How can one f i n d i n d i c a t i o n s o f t h e p a t i e n t ' s p r o b -lem i n t h e se p r o d u c t s ? How can one b e g i n t o i n t e r p r e t t h e s e p a i n t i n g s ? The "how" o f the t h e r a p i s t ' s f i n d i n g s was based upon h e r knowledge o f the p a t i e n t ' s f a m i l y , as I was soon t o d i s c o v e r . I t was seen as r e l e v a n t that- the p a t i e n t ' s f a m i l y was a c t i v e l y i n v o l v e d i n a f u n d a m e n t a l i s t r e l i g i o n . Because o f t h i s i t was p o s s i b l e t o see the c h i l d ' s p a i n t i n g s as r e p r e s e n t a t i o n o f good and e v i l . They c o u l d be t a k e n as an i n d i c a t i o n o f h i s s t r u g g l e w i t h the r e l i g i o u s t e a c h -i n g s o f h i s f a m i l y and o f h i s own, w i s h t o do e v i l . We can now see t h a t h i s p a i n t i n g s might w e l l r e p r e s e n t , the dichotomy between h i s f e e l i n g s and t h o s e e x p r e s s e d by h i s f a m i l y . A t t h a t p o i n t , i t i s p o s s i b l e t o t a l k about the p a t i e n t ' s p r o b l e m a p a r t from h i s f a m i l y , and t o f i n d a s o l u t i o n f o r them. However, i t was o n l y w i t h such i n s t r u c t i o n s t h a t I was a b l e t o see t h e p a i n t i n g as a document o f the c h i l d ' s problem. I take i t t h a t the t h e r a p i s t chose t o t e l l me t h e s e f a c t s about the f a m i l y because she thought t h a t t h e y were c o n s e q u e n t i a l . T h a t i s , she 113 saw them as p r o v i d i n g an 'adequate' a c c o u n t o f how she made sense o u t o f t h e p a i n t i n g . I take i t t h a t t h e r e a r e a number o f ways t o make sense o f the p a i n t i n g . One c o u l d l o o k a t i t i n terms o f i t s a r t i s t i c q u a l i t i e s , the p a t i e n t ' s former a r t . l e s s o n s , i t s c h e m i c a l c o m p o s i t i o n , and so on. However, the p roblem h e r e i s t h a t t h e m o t i v a t e d a c c o u n t t h a t one chooses t o a s s i g n i t has t o have r e l e v a n c e t o t h e o c c a s i o n o f t h e r a p y . The a c c ounts o f the f a m i l y as given, above are adequate f o r such an i n t e r p r e t a -t i o n . I t i s o b v i o u s t h a t n o t j u s t any p i e c e o f i n f o r m a t i o n about the p a t i e n t ' s f a m i l y i s used i n the t e l l i n g , i n s t e a d , some s e l e c t i o n i s done. I t i s p o s s i b l e t h a t a l m o s t any i n f o r m a t i o n about the p a t i e n t ' s f a m i l y can become r e l e v a n t b u t t h e adequacy o f any p a r t i c u l a r p i e c e o f i n f o r m a t i o n depends upon i t s r e l e v a n c e t o a p a r t i c u l a r a c t i v i t y . What the t h e r a p i s t (and student) was d o i n g i n t h i s work o f making sense was p r o v i d i n g m o t i v a t e d a c c o u n t s o f the c h i l d ' s a c t i o n s and t h e s e a c c o u n t s were framed i n a p s y c h i a t r i c a l l y r e l e v a n t f a s h i o n . You w i l l r e c a l l t h a t , i n my e a r l i e r o b s e r v a t i o n s , I f r e q u e n t l y attempted t o frame s i t u a t e d m o t i v a t i o n a l a c c o u n t s , t h a t i s , I l o o k e d f o r m o t i v a t i o n i n t h e p a t i e n t ' s immediate environment. In c o n t r a s t , t h e power o f p s y c h i a t r y l i e s i n i t s a b i l i t y t o d i s c o v e r m o t i v a t i o n a l s t r u c t u r e s o u t s i d e o f the immediate environment, t h a t i s , t o see a c t i o n s as i n f l u e n c e d by e x t e r n a l p r o c e s s e s . T h i s does n o t deny t h a t - t h e p l a y room and the immediate r e l a t i o n s h i p a l s o p r o v i d e m o t i v a t i o n f o r a c t o r s , however, i f t h i s were a l l t h a t was t o be d i s c o v e r e d p s y c h o t h e r a p y would take on a d i f f e r e n t c h a r a c -t e r . In c h i l d p s y c h o t h e r a p y a g r e a t many, o f t h e s e p s y c h i a t r i c a l l y r e l e v a n t m o t i v a t i o n a l a c c o u n t s make r e f e r e n c e t o t h e f a m i l y . L e t me p r o v i d e one more e x p e r i e n c e which demonstrates how t h e f a m i l y i s used as a r e s o u r c e i n t h e r a p y . I was making a v i d e o - t a p e f o r a s t u d e n t -114 t h e r a p i s t who advisedme p r i o r t o the s e s s i o n t h a t the c h i l d r e n whom we were about t o ob s e r v e were v e r y a g g r e s s i v e and e s p e c i a l l y d i f f i c u l t t o manage i n group t h e r a p y . I took t h i s as a warning about t h e chaos which I c o u l d be e x p e c t e d t o see. D u r i n g the v i e w i n g however, I n o t e d t h a t t h e c h i l d r e n d i d n o t seem t o be so bad a f t e r a l l . I assumed t h a t t h e t h e r a p i s t was a l s o aware o f t h i s . A t the end o f t h e hour, the s t u d e n t - t h e r a p i s t began t o t a l k about some o f t h e p a r t i c i p a n t s and how th e y had behaved d u r i n g t h e f i r s t s e s s i o n . (The s e s s i o n we had j u s t watched was t h e t h i r d ) . I took t h i s t o mean t h a t a l t h o u g h 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 a f t e r a l l , i t was n o t t o be seen as a t y p i c a l s e s s i o n . I was t o l d t h a t one o f the p a r t i c i p a n t s had sworn d u r i n g most o f t h e f i r s t s e s s i o n . T h i s a c c o u n t i n c l u d e d something t o the e f f e c t t h a t t h i s was a c h i l d who c o u l d n o t swear a t home so t h a t he had t o l e t . i t a l l o u t i n t h e t h e r a p y room. I f we see t h i s i n terms o f what i t does on the o c c a s i o n i n which i t i s t o l d , we can see once more how t h e f a m i l y i s b r o u g h t i n t o p l a y . I d i s c o v e r e d l a t e r t h a t t h e p e r s o n who gave t h i s a c c o u n t knew n o t h i n g o f t h e c h i l d ' s f a m i l y and t h e r e f o r e d i d n o t know t h a t he c o u l d n o t swear a t home. However, a t h i r d p a r t y can e x p e c t c e r t a i n b e h a v i o r s t o o b t a i n i n a f a m i l y — a f a m i l y b e i n g a s e t o f s t a n d a r d i z e d r e l a t i o n s h i p s . F o r example, a s t r a n g e r can e x p e c t a p a r e n t t o be r e s p o n s i b l e f o r h i s c h i l d and, i f t h i s i s n o t so, then i t i s a w a r r a n t a b l e absence. In a s i m i l a r manner, one can e x p e c t ( a t l e a s t i n m i d d l e c l a s s f a m i l i e s ) t h a t p a r e n t s w i l l d i s c o u r a g e t h e i r c h i l d r e n from swearing. We can see common-sensically t h a t an e q u a l l y p l a u s i b l e a c c o u n t o f the c h i l d ' s s w e a r i n g i s t h a t h i s f a m i l y swears f r e q u e n t l y so t h a t what happens i n the p l a y room i s no d i f f e r e n t from what happens a t home. H i s swea r i n g might then t a k e on t h e c h a r a c t e r o f 'so what'. While t h i s would 115 be an e q u a l l y p l a u s i b l e a c c o u n t , i t would n o t be adequate on t h i s o c c a s i o n s i n c e i t would n o t be seen as r e l e v a n t t o the c h i l d as a problem. I t 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 i n s o f a r as i t would s e r v e as e v i d e n c e o f the f a m i l y ' s poor o r improper c h i l d - r e a r i n g p r a c t i c e s . However, the acco u n t g i v e n by the s t u d e n t - t h e r a p i s t t r a n s -forms the c h i l d ' s b e h a v i o r t o a problem because we can see swe a r i n g as a way o f d e s c r i b i n g an a g g r e s s i v e c h i l d . Knowing t h a t s w e a r i n g i s a s a n c t i o n a b l e a c t i v i t y f o r a c h i l d , and n o t i n g t h a t t h i s c h i l d swears i n the p r e s e n c e o f those who c o u l d p r o p e r l y e n f o r c e t h i s s a n c t i o n , we can e a s i l y h e a r i t as a s i g n o f d i s r e s p e c t , h o s t i l i t y , a g g r e s s i o n , e t c . I take i t t h a t c h i l d r e n see s a n c t i o n s about s w e a r i n g n o t j u s t as something t h a t i s o f c o n c e r n t o t h e i r p a r e n t s b u t t o a d u l t s i n g e n e r a l . The r e s e a r c h e r has no t e d on many'occasions t h a t when c h i l d r e n a r e i n h i s own house and a v i s i t i n g c h i l d swears one o f the c h i l d r e n o f t h e house might say something l i k e , "My dad's u p s t a i r s you know". T h i s i s i n t e r e s t -i n g i n l i g h t o f e a r l i e r d i s c u s s i o n about t h e r a p i s t s s o u nding l i k e 'mom' o r 'dad'; perhaps i t i s i n e s c a p a b l e . The d e s c r i p t i o n o f the f a m i l y i n the l a s t example was n o t meant th e n t o be a c l a i m about t h a t f a m i l y b u t was an a p p e a l t o f a m i l i e s , and c h i l d r e n i n f a m i l i e s , i n o r d e r t o p r o v i d e f o r the r e a s o n a b l e n e s s o f t h e a c c o u n t o f a g g r e s s i v e b e h a v i o r and by i t s r e a s o n a b l e n e s s demonstrate the s t u d e n t ' s u n d e r s t a n d i n g o f t h a t p a t i e n t . Making M o t i v a t i o n a l Accounts P r o b l e m a t i c As we have seen, m o t i v a t i o n a l a c c o u n t s s t a t e d i n terms o f the f a m i l y appear t o be r e a s o n a b l e and t o be based on our common- sense knowledge as members o f s o c i e t y . However, i t was some time b e f o r e I began t o see 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. ' I f i r s t became i n t e r e s t e d i n them when I chanced t o q u e s t i o n the r e a s o n a b l e n e s s o f a p a r t i c u l a r a c c o u n t . My e x p e r i e n c e was i n f o r m a t i v e and I s h a l l r e p o r t i t f o r the b e n e f i t o f t h e r e a d e r . A c h i l d who was i n the e a r l y s t a g e s o f what b o t h t h e t h e r a p i s t and I knew would be a l o n g t r e a t m e n t program, d e l i g h t e d i n an e x t e n s i v e program o f a c t i v i t i e s t h a t appeared t o be d e s i g n e d t o annoy t h e t h e r a p i s t . He c o n t i n u e d t o ask f o r t h i n g s when i t had been e s t a b l i s h e d t h a t he c o u l d n o t have them, he d e l i b e r a t e l y s p i l l e d t h i n g s , and so on and so f o r t h . These 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 , they occuped the whole s e s s i o n . While t h e r e s e a r c h e r was a b l e t o p r o v i d e a c h a r a c t e r i z a t i o n o f the a c t i v i t y as an attempt t o annoy t h e t h e r a p i s t , he d i d n o t know why the p a t i e n t was d o i n g i t . The t h e r a p i s t s a i d t h a t t h e p a t i e n t was n e g l e c t e d and was n o t g e t t i n g much l o v e from h i s mother and t h e r e f o r e had e s t a b l i s h e d a m a n i p u l -a t i v e approach t h a t would g e t a t t e n t i o n from h i s mother and a l l o w him t o e x p r e s s h i s anger i n d i r e c t l y . I saw t h i s as an adequate account, f o r we a l l know t h a t c h i l d r e n r e q u i r e a t t e n t i o n and l o v e and t h a t i f t h i s need i s d e n i e d t h e y w i l l attempt t o g e t i t i n whatever way t h e y can (even i f they g e t n e g a t i v e a t t e n t i o n ) . I t a l s o makes sense t h a t he would be angered a t t h i s d e p r i v a t i o n and f i n d some way o f e x p r e s s i n g h i s anger. What d i d n o t make sense, however, was why the c h i l d was a c t i n g t h i s way i n the p l a y room s i n c e the t h e r a p i s t was n o t h i s p a r e n t and was showing him a t t e n t i o n . I asked the t h e r a p i s t about t h i s . However, once h a v i n g q u e s t i o n e d t h e t h e r a p i s t , I e x p e r i e n c e d a d e f i n i t e f e e l i n g o f g u i l t f o r h a v i n g asked an i n a p p r o p r i a t e q u e s t i o n and perhaps f o r s u g g e s t i n g t h a t h e r a c c o u n t had n o t been an adequate one. My q u e s t i o n a l s o r a i s e d the i m p l i c a t i o n t h a t my d e c l a r e d purpose f o r d o i n g 117 r e s e a r c h a t t h e c l i n i c had been a f a l s e one and t h a t my r e a l purpose was now i n danger o f b e i n g exposed. As i t t u r n e d o u t , t h e r e was n o t a more adequate e x p l a n a t i o n a v a i l -a b l e . However, the t h e r a p i s t d i d add t h a t t h e p l a y room b e h a v i o r c o u l d be e x p l a i n e d by a r u l e o f c o n s i s t e n c y — t h e c h i l d w i l l r e l a t e t o o t h e r a d u l t s i n much the same way t h a t he r e l a t e s t o h i s p a r e n t s . I am n o t s u g g e s t i n g t h a t i f one pushes the a c c o u n t s g i v e n by t h e r a p i s t s t h e y w i l l be found t o be i n s u p p o r t a b l e ; r a t h e r , on t h e o c c a s i o n o f t h e i r t e l l i n g , a c c o u n t s a r e framed i n terms o f 1 the p a t i e n t ' s f a m i l y and a r e adequate f o r a l l p r a c t i c a l p u r p o s e s . T h a t i s , t h e adequacy o f an a c c o u n t r e s t s n o t i n terms o f a t h e o r y o f c h i l d d i s t u r b a n c e , but i n terms o f i t s t e l l i n g . I would a l s o s u g g e s t t h a t t h e s e are w a r r a n t a b l e s a n c t i o n a b l e a c c o u n t s and t h a t t h e i r r e a s o n a b l e n e s s i s so s e l f e v i d e n t t h a t t o doubt them i s t o q u e s t i o n one's competence as a s o c i a l member. To t h i s p o i n t , we have been l o o k i n g a t how common sense n o t i o n s about the f a m i l y a r e used by t h e r a p i s t s i n c o n s t r u c t i n g r e a s o n a b l e p s y c h i -a t r i c a c c o u n t s . I have r e f e r r e d t o t h i s as p r a c t i c a l p s y c h i a t r i c r e a s o n -i n g . I would now l i k e t o l o o k a t how ' f a m i l y t a l k ' i s used' i n a somewhat d i f f e r e n t way i n t h e c l i n i c s e t t i n g . F a m i l y T a l k as Management We w i l l s t i l l be c oncerned w i t h p r a c t i c a l p s y c h i a t r i c r e a s o n i n g i n t h i s s e c t i o n . b u t I want t o show how t a l k o f t h e f a m i l y p r o v i d e s a way t o manage r e l a t i o n s h i p s . By way o f i n t r o d u c t i o n , i t might be h e l p f u l t o compare t h e t h e r a p y s e t t i n g t o t h e h a l f w a y house examined by D. Lawrence Wieder and t o l o o k a t h i s a t t e n t i o n t o the " c o n v i c t code" as a p e r s u a s i v e . . 9 a c t i v i t y . 118 There a r e two s e t s o f p a r t i c i p a n t s i n t h e h a l f w a y house, namely, the s t a f f and t h e r e s i d e n t s , and they s t a n d i n a r e l a t i o n s h i p where one s e t i s r e s p o n s i b l e f o r t h e o t h e r . T h a t i s , the former i s supposed t o be l o o k i n g out f o r t h e l a t t e r p r o v i d i n g f o r t h e i r needs, h e l p i n g them t o f i t back i n t o the community, c o u n s e l l i n g them, and, i n g e n e r a l , showing c o n c e r n f o r t h e i r w e l f a r e . While o n l y one s e t o f p a r t i c i p a n t s i s r e s p o n s i b l e f o r the o t h e r , b o t h are a c c o u n t a b l e t o each o t h e r and i n v a r i o u s ways (e.g., t o o t h e r s t a f f , t o t h e community, o r the b o a r d o f d i r e c t o r s ) . What I mean by a c c o u n t a b l e here i s t h a t t h e n a t u r e o f th e r e l a t i o n -s h i p demands t h a t one can be c a l l e d on t o r e p o r t on, j u s t i f y o r e x p l a i n h i s conduct. T h i s i s s i m i l a r t o the p a r e n t - c h i l d r e l a t i o n s h i p , w h e r e i n c h i l -d r e n are a c c o u n t a b l e f o r such t h i n g s as t h e i r absence from meals, f a i l u r e t o do h o u s e h o l d c h o r e s , e t c . While I am n o t s u r e t h a t we can say t h a t p a r e n t s a r e a c c o u n t a b l e t o t h e i r c h i l d r e n i n the same way, t h e y a r e a c c o u n t a b l e t o them th r o u g h the community and t o t h e community i t s e l f . " ' " 0 In o t h e r r e l a t i o n s o f a u t h o r i t y . a s u p e r o r d i n a t e may be p l a c e d i n a p o s i t i o n o f a c c o u n t a b i l i t y t o s u b o r d i n a t e s i f i t can be demonstrated t h a t t h e a c t i o n s o f the former j e o p a r d i z e t h e l a t t e r ' s w e l l b e i n g . C o n s i d e r how t h e r e s i d e n t s and s t a f f o f t h e h a l f w a y house a r e a c c o u n t a b l e . The r e s i d e n t s p r o v i d e t h e i r own a c c o u n t s f o r a wide range o f t h e i r a c t i v i t i e s t h a t the s t a f f , t h e r e s e a r c h e r , and o t h e r s may see as rude, a g g r e s s i v e , t r o u b l e making, a p a t h e t i c , e t c . They e x p l a i n o r j u s t i f y such a c t i o n s by a p p e a l i n g t o t h e i r r e l a t i o n s h i p t o o t h e r r e s i d e n t s o r c o n v i c t s . F o r example, t h e y o f t e n f e l t t h a t t h e y c o u l d n o t . t a l k about something t o the r e s e a r c h e r because o f the way t h a t o t h e r r e s i d e n t s might i n t e r p r e t t h i s . S i m i l a r r e a s o n s were g i v e n f o r n o t s h a r i n g a b e e r w i t h the r e s e a r c h e r , f o r f a i l i n g t o a t t e n d meetings, e t c . These were a c t i o n s f o r which t h e y were 119 a c c o u n t a b l e t o o t h e r r e s i d e n t s , e i t h e r as a f e l l o w c o n v i c t o r as a f r i e n d . S i n c e s t a f f members were 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 , t h e y were a c c o u n t a b l e f o r the way t h a t they h a n d l e d them, f o r program demands, f o r s u c c e s s o r f a i l u r e , and so on. That i s t o say, th e y had t o be a b l e t o p r o v i d e e x c u s e s , 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 the way t h i n g s were g o i n g . F o r example, the s t a f f had t o j u s t i f y the d i s c h a r g e o f a r e s i d e n t who had n o t made arrangements t o pay h i s b i l l when t h i s was c o n t r a r y t o r u l e s . In o r d e r t o p r o v i d e such a c c o u n t s , i t was n e c e s s a r y t h a t t h e y be a b l e t o make sense o f t h e a c t i o n s o f the r e s i d e n t s , i n c l u d i n g t h e i r uncoop-e r a t i v e b e h a v i o r . I t was d i s c o v e r e d t h a t the r e s i d e n t s o f t h e house had a'' body o f " r h e t o r i c " i n terms o f which t h e y framed many o f t h e i r a c c o u n t s . T h i s was c a l l e d t h e " c o n v i c t code". T h i s code was r e f e r r e d t o and t a l k e d about b o t h by the r e s i d e n t s and by the s t a f f . Because o f the r e l a t i o n s h i p which o b t a i n e d between s t a f f and r e s i d e n t s , t h i s ' c o d e was a p e r v a s i v e and p o w e r f u l f e a t u r e o f inmate l i f e (and thus o f t h e ha l f w a y h o u s e ) . C o n s e q u e n t l y , the s t a f f (and t h e r e s e a r c h e r ) had t o use i t i n o r d e r t o a c c o u n t f o r the b e h a v i o r o f t h e r e s i d e n t s and f o r t h e i r own"actions w i t h r e s p e c t t o them. The code was p e r s u a s i v e because a c c o u n t s a p p e a l e d t o s e r i o u s o b l i g a t i o n s o f a system o t h e r t h a n t h a t o f t h e s t a f f and f a i l u r e t o meet these o b l i g a t i o n s may c o s t one h i s l i f e . S i n c e the s t a f f had c o n t i n u a l l y t o demonstrate t h e i r compe-t e n c e , as w e l l as t h e i r c o n c e r n f o r t h e r e s i d e n t s , t h e y t o o a p p e a l e d t o the code. In the p s y c h o t h e r a p y c l i n i c t h e p a t i e n t i s a c c o u n t a b l e t o the t h e r a -p i s t f o r some o f h i s a c t i o n s (he may make excuses f o r b e i n g away, f o r example) a l t h o u g h the t h e r a p i s t t r i e s t o c r e a t e an atmosphere o f mi n i m a l a c c o u n t a b i l i t y . ( T h i s i s one way t o make v i s i b l e a c o n t r a s t to- the 120 patient's home). The the r a p i s t , however, i s both accountable f o r the patient and accountable to others, e.g., parents, superiors, colleagues, etc. Like the s t a f f of the halfway house, therapists are accountable f o r the progress of t h e i r p a t i e n t s . 1 1 I want to demonstrate i n t h i s section that the family serves as a resource f o r these accounts and as such we can think of 'family t a l k ' as a r h e t o r i c . Let me c l a r i f y what I mean by the th e r a p i s t being accountable f o r the progress of the patient's treatment. In an e a r l i e r section I show how some t y p i c a l features of therapy presented problems f or me. I found i t d i f f i c u l t to understand what was happening since there was a minimum of d i r e c t i n t e r -vention, the treatment was not always obvious, many chil d r e n d i d not d i s -play obvious signs of disturbance, etc.. These were not problems f o r the the r a p i s t . . However, there are many things which were and are concerns both f o r myself and for the the r a p i s t . For example, some chil d r e n were not suit a b l e f o r therapy and had to be discharged, others got worse or had a relapse, some patients made very rapid progress while, with others, pro-gress was minimal. The th e r a p i s t i s accountable f o r recognizing progress or, conversely, f o r noting i t s absence and must be prepared to take remedial action i f necessary. That i s , the the r a p i s t i s c l e a r l y accountable f o r 12 outcomes. I want to suggest that the family i s frequently used as a resource to provide such an account, e s p e c i a l l y .'in instances of f a i l u r e . This i s not to suggest that therapists are never s e l f - c r i t i c a l , they are. You w i l l r e c a l l a t r a n s c r i p t on page 60 i n which a the r a p i s t described an action as "bad the r a p e u t i c a l l y " . During my research, I witnessed numerous' occasions i n which therapists c r i t i c a l l y examined what they d i d and sought advice from supervisors and others. Neither am I suggesting that the accounts are an 121 a c t o f d e c e p t i o n o r c o l l u s i o n . ' A c h i l d whom I o b s e r v e d f o r a l o n g time was o f p a r t i c u l a r i n t e r e s t t o the c l i n i c because o f the s e r i o u s n e s s . o f h e r problem. The c h i l d was i n v o l v e d i n a day c a r e program a t t h e c l i n i c and came t o p l a y t h e r a p y s e s s i o n s t w i c e a week. A f t e r the C h r i s t m a s v a c a t i o n , d u r i n g which t h e c h i l d had not had a t h e r a p y s e s s i o n , she behaved i n a way t h a t b o t h t h e t h e r a p i s t and I thought t o be worse than t h a t which she had d i s p l a y e d the l a s t time we saw h e r . When asked about t h i s , the t h e r a p i s t r e p l i e d v e r y q u i c k l y t h a t t h e c h i l d had been home w i t h h e r mother f o r a month. How do we he a r t h i s as an e x p l a n a t i o n o f the c h i l d ' s a p p a r e n t r e g r e s s i o n ? Why i s i t an adequate a c c o u n t o f the r e p o r t e d b e h a v i o r ? I would s u g g e s t t h a t t h i s appears r e a s o n a b l e because i t f o r m u l a t e s t h e c h i l d as a member o f a r e l a t i o n s h i p p a i r ( p a r e n t - c h i l d ) which we know t o have a p o w e r f u l i n f l u e n c e o v e r one's l i f e . As p a r t o f t h i s , we know t h a t i t has the a b i l i t y t o b l o c k 13 the p o s s i b l e i n f l u e n c e o f o t h e r a d u l t s . In t h e i n s t a n c e c i t e d t h e t h e r a p i s t had n o t s p e n t the v a c a t i o n w i t h the f a m i l y n o r d i d she have a second-hand r e p o r t on how i t was spent; t h u s , i t i s n o t a f a c t u a l statement about t h e way t h e f a m i l y s p e n t C h r i s t m a s . I t i s p o s s i b l e i n s t e a d t h a t t h e y a l l had a good time and t h a t t h e c h i l d r e c e i v e d much l o v e and a t t e n t i o n . S i m i l a r l y , the t h e r a p i s t was n o t sug-g e s t i n g t h a t one can use t h i s f e a t u r e o f t h e r h e t o r i c t o p r e d i c t t h e c h i l d ' s b e h a v i o r . T h a t i s , knowing t h a t p a r e n t s i n f l u e n c e t h e i r c h i l d r e n i n ways c o n t r a r y t o the t h e r a p e u t i c i d e a l i s n o t t o say t h a t , a f t e r any l o n g absence from t h e r a p y , c h i l d r e n w i l l n e c e s s a r i l y r e g r e s s . Indeed, i t would have been e q u a l l y p o s s i b l e f o r the c h i l d (who had d e v e l o p e d a s t r o n g a t t a c h -ment t o the t h e r a p i s t ) t o have been so p l e a s e d t o be back w i t h h e r t h a t h e r b e h a v i o r would be even b e t t e r t h a n b e f o r e . 122 The account appeals to a notion of competing influences by which the work of one adult can be undermined by others- The th e r a p i s t has the c h i l d f or an hour or two every week, while the family has her for most of the remainder. This i s s i m i l a r to the discussion one hears at a PTA meeting during which some teacher i n v a r i a b l y says, "We can only do so much.if the parents don't care". The patient i s inescapably a family member and that  membership i s seen to have consequence f o r the success or f a i l u r e of the therapy. While most patients came to the c l i n i c only once a week, changes are sometimes made i n t h i s schedule. A c h i l d who i s j u s t beginning play therapy may be seen twice a week and then switched to weekly v i s i t s as things improve. On other occasions a patient may be switched to two v i s i t s a week i f problems appear to be developing. I t was not uncommon to hear therapists commenting upon the frequency of v i s i t s . 4.11 T: With l i t t l e kids I f i n d , w ell when I saw Terry remember when I f i r s t saw Terry I saw her twice a week, things seemed to go much better. R: Yea. T: Cause, from, a whole week i n between i s a very large chunk of time, but three or four 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 to them that they get involved i n i t . The th e r a p i s t appeals to a c h i l d ' s sense of time i n which a week can be thought of as a "very large chunk of time" while "three or four days i s n ' t much". In some ways t h i s account i s b u i l t around a notion of how long the influence of a therapy session can be expected to l a s t . This notion appeals to the competing influences with which a c h i l d has to cope. 123 There were also some patients for whom things weren't going so w e l l . The therapist and others f e l t they were making progress and then, for some reason, problems developed. Unlike the e a r l i e r discussion of relapses the problems were not r e l a t e d to the length of time between v i s i t s but, rather, to changes i n the patient's family. One young patient had been making such progress that he was about to be returned to regular school and have h i s weekly v i s i t discontinued. Sud-denly he appeared to get worse and these plans had to be put o f f . Thera-p i s t s attend to the fa c t that c h i l d r e n may become manipulative when they a n t i c i p a t e the end of t h e i r therapy, but t h i s was not thought to be the problem i n the above case. Rather, the therapists attended to what was happening i n the c h i l d ' s family. 4.12 T: Things aren't going well with, at Rufus'. Father i s 59, f o s t e r father i s 59, and he's l o s t two jobs i n the l a s t year due to change of operations on the job, changes of equipment or something. So he's been out of work a l o t , and apparently now he's r e a l l y depressed and the f o s t e r mother says a cloud of gloom hangs over the house. . . and what else i s happening, when father gets l i k e t h i s he overindulges Rufus and Rufus hates him for i t , and mother and father 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 things aren't very w e l l , i n f a c t we might, we might have to p u l l him out of there which I r e a l l y hate to do, cause he's been there since he was four months ol d . But they haven't done a very good job of him, you know, ( ) l i k e I could go on having him work out the anger and so on he experi-ences d a i l y but that's l i k e p u t t i n g on a bunch of bandaids. . . . Things were going well because the parents also working i n therapy for a long time, and then they were dropped, because they were doing w e l l , and because ( ) and then they kind of back s l i d , you know, so. . . when kids say and do the kinds of things Rufus does they obviously have a l o t of aggression, l o t s of anger, and the l a s t two times I had Rufus i n the play therapy room he, he's r e a l l y , r e a l l y been angry, l i k e he takes Indian c h i e f s , or one of the Indians and smashes i t i n t o a corner, l i k e r e a l l y , .'. . So we know i t ' s coming from somewhere and we think i t ' s r e l a t e d to father, and i t ' s kind of hard to p i n down why. In t h i s account there are a number of ways i n which the i n t e r p r e t i v e 124 schema o f the f a m i l y i s used, some o f which are c o n s i d e r e d l a t e r , e.g., a change i n the p a t i e n t i s i d e n t i f i e d w i t h a change i n h i s f a m i l y ' s c i r c u m -s t a n c e s ; the n o t i o n o f t r e a t i n g the c h i l d w i t h o u t g e t t i n g t o the s o u r c e o f h i s problem- i s l i k e n e d t o " p u t t i n g on a bunch o f b a n d a i d s " ; i t i s s a i d t h a t t h i n g s were g o i n g w e l l as t h e time when the f a m i l y was a l s o i n t h e r a p y ; the m o t i v a t e d n a t u r e o f the p a t i e n t ' s anger i s thought t o be found i n h i s f a m i l y r e l a t i o n s h i p s , e t c . I t i s a l s o i m p o r t a n t t o note t h a t t h i s c o n c e r n w i t h the f a m i l y i s n e i t h e r s u p e r f i c i a l nor i n c o n s e q u e n t i a l . We a r e t o l d t h a t , i f t h e f a m i l y becomes a s e r i o u s o b s t a c l e t o t h e c h i l d ' s r e c o v e r y , he may be p u t i n t o a new f o s t e r f a m i l y . A c h i l d ' s c o n d i t i o n , h i s p r o g r e s s , and h i s f a m i l y a r e i n t i m a t e l y bound t o g e t h e r . I t i s , p e r h a p s , c o n s e q u e n t i a l t h a t t h e t h e r a -p i s t made a p o i n t o f r e f e r r i n g t o the f a m i l y as a f o s t e r f a m i l y a t the b e g i n n i n g o f the c o n v e r s a t i o n . She s a i d " F a t h e r i s 59", and i m m e d i a t e l y amended t h i s t o " f o s t e r f a t h e r i s 59". L a t e r , t h i s p r o v i d e d f o r the a p p r o p r i a t e n e s s o f the o p t i o n t h a t t h e y remove the c h i l d from the home. Re l a p s e s c o u l d be t h ought o f as u n u s u a l and p r o b l e m a t i c e v e n t s which s h o u l d be e x p l o r e d . One c o u l d e x p l a i n r e l a p s e s i n terms o f the g e n e t i c make-up o f c h i l d r e n , t h e p a u c i t y o f our knowledge and the p o s s i b l e l i m i t a -t i o n s o f p l a y t h e r a p y and t h e t h e r a p i s t s , e t c . I n s t e a d , we u s u a l l y f i n d t h a t r e l a p s e s a r e r o u t i n i z e d and e x p l a i n e d i n a way t h a t p r e s e r v e s the v a l i d i t y o f the e n t e r p r i s e o f t h e r a p y , i t s u n d e r l y i n g t h e o r i e s , and the competence o f i t s p r a c t i t i o n e r s . T h e r a p i s t s i n v o k e the same r e s o u r c e s i n u n d e r s t a n d i n g each and e v e r y p a t i e n t so t h a t such t h i n g s as r e l a p s e s and l a c k 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 e v e n t s a t t r i b u t a b l e t o a s o u r c e o u t s i d e o f t h e p l a y room. 125 The D i f f i c u l t P a t i e n t The v e r y n a t u r e o f p l a y t h e r a p y ensures t h a t most c h i l d r e n w i l l f i t i n s i m p l y because the e x p e c t a t i o n s a r e so min i m a l ; however, i t i s n o t always the case t h a t t h e r a p y can even s t a r t w i t h some o l d e r c h i l d r e n . A t some p o i n t c h i l d r e n become r e s i s t a n t and can n o t be e a s i l y managed. Such c h i l d r e n can n o t become p a t i e n t s . In a l l . n o n - i n t e r v e n t i o n i s t t h e r a p i e s , the p a t i e n t can undermine the t r e a t m e n t program by f a i l i n g t o t a k e i t s e r i o u s l y , , by f a i l i n g t o c o o p e r a t e , o r a t t e n d , o r by some o t h e r means o f r e s i s t i n g . I f t h i s p e r s i s t s , t h e p a t i e n t w i l l e v e n t u a l l y be d i s c h a r g e d even though he i s s t i l l i n need o f t h e r a p y . I was a member o f a c o n v e r s a t i o n i n which a t h e r a p i s t and a s t u d e n t -t h e r a p i s t were t a l k i n g about a problem p a t i e n t . I t seemed t h a t the p r o b -lem w i t h t h e p a t i e n t was t h a t , w h i l e he had d i f f i c u l t i e s t h a t c o u l d be t r e a t e d i n p l a y t h e r a p y , he g o t b o r e d w i t h the program v e r y q u i c k l y and would w i t h o l d h i s c o o p e r a t i o n . The t h e r a p i s t s had t r i e d a number o f s t r a t e g i e s t o g e t him i n v o l v e d b u t t h e p a t i e n t r e p e a t e d l y showed a l a c k o f i n t e r e s t . The t h e r a p i s t s p o i n t e d out t h a t t h i s seemed c o n s i s t e n t w i t h h i s f a m i l y ' s way o f h a n d l i n g problems. That i s , n o t o n l y was t h e c h i l d n o t showing an i n t e r e s t i n t h e r a p y , t h e p a r e n t s were e q u a l l y u n i n t e r e s t e d . The t h e r a p i s t s s u g g e s t e d t h a t , i n o r d e r t o t r e a t the c h i l d , i t would be n e c e s s a r y t o i n v o l v e t h e p a r e n t s as w e l l even though t h e y had a l r e a d y shown t h e i r l a c k o f i n t e r e s t . The c o n v e r s a t i o n ended w i t h t h e s u g g e s t i o n t h a t an ul t i m a t u m was r e q u i r e d , t h a t i s , i f t h e p a r e n t s would not e n t e r t h e r a p y , t h e c h i l d would be d i s c h a r g e d . T h i s was a f r e q u e n t p roblem and, as one t h e r a p i s t commented: 4.13 T: I'm g e t t i n g dismayed, i n c a s e s where I'm working w i t h a k i d and 126 n o t h i n g ' s happening w i t h the f a m i l y , because you can g i v e them a l l s o r t s o f n i c e messages i n the p l a y room, i n t h a t s p l e n d i d hour a week, b u t . . . T h i s i s a c l e a r statement o f how t h e r a p i s t s see t h e i r work b e i n g i n f l u e n c e d by, made e a s i e r , o r o b s t r u c t e d by p a r e n t s . The f o l l o w i n g comments were made by a t h e r a p i s t c o n c e r n i n g a n o t h e r case i n which t h e r a p y d i d n o t seem t o b e g i n . 4.14 T: . . . i n d i c a t e s t o me anyhow, the p a r e n t s need f o r i n v o l v e m e n t . I t ' s a Japanese f a m i l y and the boy i s 11 I guess, and he, and one, two, f i v e k i d s i n the f a m i l y . There's a c o u p l e o f teenage g i r l s and a twelve y e a r o l d , and George i s the o l d e s t son, Dan's a younger b r o t h e r , Dan i s f i v e , who was born l i k e f i v e y e a r s a f t e r A r n o l d , had t h e s o l e c l a i m t o b e i n g the son and 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 and withdrawn, I'm j u s t w r i t i n g a r e p o r t on i t , he, he c o u l d n ' t p l a y w i t h a n y t h i n g . There was n o t h i n g i n t h i s whole c l i n i c t h a t was i n t e r e s t i n g , you know, e v e r y t h i n g was r i d i c u l o u s , and a waste 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 more, o r something Dan, Dan would 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 would do was models and he would complain i n t h i s v e r y a d u l t tone about 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 and the g i r l s were always f i g h t i n g and i t ' s w o r r y i n g mom and dad and i t was making the whole h o u s e h o l d upset. So he would j u s t r e a l l y i d e n t i f y w i t h the a d u l t s and have 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 went on l i k e t h a t f o r a y e a r , ah, 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 the 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 dropped 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 dropped out o f t h a t . So we c o u l d n ' t do much w i t h him, b u t we c o n t i n u e d on w i t h A r n o l d and f i n a l l y , oh yea, I had a t a l k w i t h A r n o l d about l i k e he had t h i s need t o be such a b i g boy and he c o u l d n ' t r e l a x and be a c h i l d . And he s a i d : "we don't do t h i n g s l i k e t h a t i n our f a m i l y " , you know. Which i s I t h i n k a good p i c t u r e o f what happens a t home, l i k e , and 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 , you're a b i g boy now, when you go t o bed a t n i g h t w e ' l l shake hands, . . . 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 , and, and i t comes o u t i n A r n o l d . He's a f r a i d t o be a n y t h i n g b u t the 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 keen and he g e t s e x c i t e d and then he goes home, and he's back i n t o a v e r y s t i l t e d atmosphere, and he has 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 and I don't r e a l l y know how we're g o i n g t o make i t . T h i s i s a p o w e r f u l example o f how t h e r a p i s t s see t h e r e l a t i o n s h i p between s u c c e s s i n t h e r a p y and t h e p a t i e n t ' s f a m i l y . Not o n l y do f e a t u r e s 127 o f the f a m i l y produce many o f the c h i l d ' s problems b u t , o f t e n , t h e r e a r e t h i n g s about the f a m i l y t h a t make t h e r a p y i m p o s s i b l e . A l t h o u g h the c h i l d has been i n t h e r a p y f o r a y e a r , one does n o t have the f e e l i n g t h a t any s t a r t has been made w i t h him. I t i s i n t e r e s t i n g t h a t t h e p roblem was s t a t e d i n terms o f the p a t i e n t b e i n g t o o much l i k e an a d u l t . He i s so much l i k e an a d u l t t h a t he can not p a r t i c i p a t e i n c h i l d t h e r a p y . We c o u l d n a i v e l y imagine a s i t u a t i o n i n which a t h e r a p i s t was f a c e d w i t h a c h i l d who, f o r some r e a s o n , was a d i f f i c u l t p a t i e n t and who, upon b e i n g q u e s t i o n e d by h i s s u p e r v i s o r about t h e m a t t e r , r e p l i e d "How s h o u l d I know?" T h i s would be a n a i v e s c e n a r i o i n d e e d s i n c e t h e r a p i s t s a r e t r a i n e d , e x p e c t e d and p a i d t o know, and d emonstrably do know, what i s g o i n g on w i t h a p a t i e n t . I e x p e c t t h a t one i n d i c a t i o n o f t h e s k i l l o f a t h e r a p i s t l i e s i n h i s a b i l i t y t o p r o v i d e r e a s o n a b l e d e s c r i p t i o n s and a c c o u n t s o f p r o g r e s s ( t h i s i n c l u d e s f a i l u r e ) . There was an e n d l e s s amount o f t h i s k i n d o f t a l k among c o l l e a g u e s . Sometimes t h e s e a c c o u n t s were f o r m u l a t e d i n terms o f the sex o f the t h e r a p i s t ( e s p e c i a l l y i n a c r o s s - s e x r e l a t i o n s h i p ) , o r the m i s t a k e s o f a p r i v a t e p s y c h i a t r i s t . Most f r e q u e n t l y however, an u n d e r s t a n d i n g o f why t h i n g s d i d n o t work o u t as t h e y i d e a l l y s h o u l d was f o r m u l a t e d i n terms o f the f a m i l y . T h i s membership p r o v i d e d adequate m o t i v a t i o n a l a c c o u n t s 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 and, as we can now see, i t a l s o f u r n i s h e d t h e r a p i s t s w i t h r e a s o n a b l e e x p l a n a t i o n s about the s t a t u s o f t h e t r e a t m e n t program i t s e l f . F a m i l i e s can be seen as u n c o o p e r a t i v e , u n i n t e r -e s t e d , r e l u c t a n t , d i s t u r b i n g , e t c . , a l l o f which might a f f e c t t h e p a t i e n t ' s s u c c e s s i n t h e r a p y . I have been d e m o n s t r a t i n g some o f the ways i n which t h e r a p i s t s p r o v i d e d a c c o u n t s o f how t h e y made sense o f p a t i e n t ' s b e h a v i o r , e x p l a i n e d 128 relapses, recognized problems, an t i c i p a t e d d i f f i c u l t i e s , etc., by r e f e r -ence to the c h i l d ' s family. The family appeared as a powerful resource i n the therapist's reasoning. In contrast to the halfway house where the "convict code" was a construction of the inmate and because of i t s nature was also used by the s t a f f , the family t a l k i s not a c h i l d ' s invention but an adult construction. I would l i k e to suggest that to some extent, i t i s a persuasive r h e t o r i c i n t h i s s e t t i n g . Unlike adult therapy, wherein the patient may be expected to t a l k of h i s family, the c h i l d p a tient was neither encouraged nor expected to do so. He was however, expected to demonstrate that he understood that h i s problem originated i n h i s family. I f he continued to act as i f h i s family were i r r e l e v a n t to what he was doing i n the play room, he was seen to be avoiding h i s problems. Although c h i l d r e n were never o v e r t l y challenged on t h i s point, t h i s i s how the therapists i n t e r -preted i t . Consider the following conversations i n which the the r a p i s t uses t a l k about the family to r e l a t e to the patient's problem. 4.15 C: I don't care. ( ) I don't care. That's what dad would say. Say i t exactly the same way I say i t . T: How would he say i t ? C: Exactly the way I j u s t said i t . T: Like, "I don't care". C: No. "I don't care". T: Does your dad ever get mad Simon. C: No. T: No! C: Apart from when ( ) s t a r t s a f i g h t . T: Mmhmm, and then dad gets mad? C: Yea. How do you l i k e that f o r a pi c t u r e . T: You know i t ' s okay for people to get mad Simon. And: 4.16 1. T: I f you were nice to him he would follow you a l l the way home. 2. C: Hmmm. Your mom would probably scream though. 3. T: Do you think so? 4. C: Mhmm. See a dinosaur i n your backyard. 5. T: Hmmm. 6. C: She'd probably say, "where i n the world d i d you f i n d that thing?" 7. T: There that's another l eg a l l together. 8. C: She'd probably t e l l me ( ), probably t e l l my dad to come. 9. T: What do you think your dad might do? 10. C: Come out with h i s gun, and shoot i t . But I won'd l e t Dad shoot i t . I f he shot i t , I'd get dad to shoot me i f he shot the dinosaur. 11. T: Would you? Why i s that Simon? 12. C: Cause I l i k e dinosaurs. 13. T: Okay. 17. T: So i f dad shot your pet dinosaur you'd get r e a l mad at him hey. 18. C: Mmhmmm. 19. T: and what would you do. 20. C: Get him to shoot me. 21. T: Get him to shoot you; maybe you'd f e e l l i k e shooting dad. 130 22. C: No way. 23. T: No way? 24. C: I f I d i d shoot dad, then I'd have to go to j a i l . 25. T: Hmmm. Maybe you'd get r e a l angry at dad though. The t h e r a p i s t thought that Simon was "too good". She s a i d that he was always under pressure from h i s family to behave himself. As a r e s u l t , he never admitted that he might be angry with someone or expressed h i s anger openly. There was so much c o n s t r i c t i o n from the family that he could not express h i s normal emotions, e s p e c i a l l y h i s anger, and t h i s had become a pa t h o l o g i c a l condition. The above two conversations are methodical •attempts by the therapist to get the c h i l d to express h i s anger with mem-bers of h i s family. In the f i r s t instance, she t r i e d to show Simon that i f there were occasions on which dad,got mad, then i t was a l r i g h t f o r other people (including the patient) to get mad as we l l . In the second tr a n -s c r i p t , the 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 the c h i l d could imagine that he would be angry with h i s father and asks him how he would express h i s anger. The c h i l d ' s answer, "get him to shoot me", i s a con-firmation of h i s problem—he would rather die than express h i s anger. The the r a p i s t closes t h i s attempt with a c l e a r and relevant statement: "Maybe you'd be r e a l angry at dad though". Thus, c h i l d r e n were often tested i n d i r e c t l y to determine whether they recognized how t h e i r actions and f e e l i n g s were influenced by t h e i r f a m i l i e s . Some of the t r a n s c r i p t s that have been provided make i t c l e a r that parents, too, are expected to see the r e l a t i o n s h i p between the family's circumstances and the c h i l d ' s behavior. I f they refuse to recognize t h i s r e l a t i o n s h i p , they can then warrantably be c l a s s i f i e d as problems. And, i f they do not care f o r the well being of t h e i r c h i l d , t h e i r c h i l d or 131 c h i l d r e n can u l t i m a t e l y be taken away from them. I had no r e a l c o n t a c t w i t h p a r e n t s b u t , a t one p o i n t , I o v e r h e a r d a mother e x p r e s s i n g h e r c o n c e r n about h e r a b i l i t y t o g i v e h e r c h i l d the s e c u r i t y t h a t she needed i n o r d e r t o make p r o g r e s s i n p l a y t h e r a p y . The t h e r a p i s t l a t e r c h a r a c t e r i z e d t h i s c o n c e r n f o r me as f o l l o w s : 4.17 T: You h e a r d m o t h e r 1 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 worry 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 Robin 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 ) . ( ) she's a p e d i a t r i c nurse h e r s e l f so t h a t ' s why I was making the l i t t l e j o k e w i t h her t h a t our p r o f e s s i o n a l d e f e n c e s don't work anymore. I s u g g e s t e d e a r l i e r t h a t t h e f a m i l y as an a c c o u n t i n g d e v i c e was an a d u l t c o n s t r u c t i o n r a t h e r than a t h e r a p i s t ' s c o n s t r u c t i o n because i t can be, and i s , used i n t h i s way on o t h e r o c c a s i o n s . I t i s p e r s u a s i v e l y used i n t h i s s e t t i n g however, s i n c e i t s d e n i a l by a p a r e n t can be c o n s e q u e n t i a l . A l t h o u g h i t i s p o s s i b l e t o respond, say, t o a t e a c h e r ' s q u e r i e s about one's daughter w i t h "She's n o t l i k e t h a t a t home", such a response would be most inadequate i n t h e c o n t e x t o f t h e r a p y . I take i t t h e r e may w e l l be grounds f o r the p o p u l a r c o m p l a i n t , "must the p a r e n t s always be wrong?" T h i s s e c t i o n has been concerned w i t h t a l k o f t h e f a m i l y and w i t h how such t a l k i s used as a r e s o u r c e t o p r o v i d e adequate answers t o q u e s t i o n s such as "what's g o i n g on h e r e ? " o r "Why a r e n ' t we g e t t i n g any-where?" I am c o n t e n d i n g t h a t t h e r e i s some o b l i g a t i o n upon members t o see the r e l e v a n c e o f such t a l k . As my pr o b l e m had become d e f i n e d as a t t e m p t i n g t o d e s c r i b e how t h e r a -p i s t s u n d e r s t o o d t h e i r environment and, s u b s e q u e n t l y , how I thought t h a t I had come t o u n d e r s t a n d t h a t environment, I found t h a t t h e f a m i l y , (as a g l o s s f o r the t h i n g s t a l k e d about above), was used t o make many d i f f e r e n t 132 s i t u a t i o n s appear t o be n a t u r a l , a p p r o p r i a t e , u n d e r s t a n d a b l e and so. " M i s b e h a v i o r s " and " P e r m i s s i b l e s " With some s m a l l e x c e p t i o n s , t h e examples r e f e r r e d t o have been from c o n v e r s a t i o n s between t h e r a p i s t s o r between a t h e r a p i s t and the r e s e a r c h e r r a t h e r than from a c t u a l s e s s i o n s o f t h e r a p y . I would now l i k e t o show how n o t i o n s o f t h e f a m i l y a r e a l s o e s s e n t i a l f o r an u n d e r s t a n d i n g o f t h e a c t u a l p r a c t i c e o f t h e r a p y . One o f Freud's s o c i o l o g i c a l i n s i g h t s was the u n d e r s t a n d i n g t h a t t h e r e a r e normative ways o f h e a r i n g , s p e a k i n g and s e e i n g . He s u g g e s t e d t h a t , were t h e r a p y t o be s u c c e s s f u l , i t may be n e c e s s a r y t h a t t h e p a r t i c -i p a n t s r e l a x some o f t h e s e c o n s t r a i n t s . T h i s s t r a t e g y became a s t a n d a r d f e a t u r e o f p s y c h o t h e r a p y and g i v e s i t a unique a c c e n t . Most p e o p l e have come t o a c c e p t and e x p e c t t h i s . One o f t h e ways i n which p s y c h o t h e r a p y d i f f e r s from p r o c e d u r e s f o r t r e a t i n g s t r i c t l y p h y s i c a l i l l n e s s e s i s t h a t t h e t a l k i n g t h a t o c c u r s as a f e a t u r e o f the 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 be seen as t h e t r e a t m e n t . That i s , i t i s n o t s i m p l y an a c t i v i t y which a l l o w s the d o c t o r t o g e t t o • 14 t h e t r e a t m e n t p r o p e r , e.g., w r i t i n g a p r e s c r i p t i o n . I t f o l l o w s t h a t t h i s t a l k i s t r e a t e d d i f f e r e n t l y by b o t h p a r t i e s and i s g i v e n s p e c i a l a t t e n t i o n . The e a r l y p s y c h o a n a l y s t s were w e l l aware o f the work t h a t members had t o do i n o r d e r t o make t h e i r t a l k appear as ' t h e r a p y ' . F o r example, F r e u d would a d v i s e h i s p a t i e n t s t h a t : Your t a l k w i t h me must d i f f e r i n one r e s p e c t from an o r d i n a r y con-v e r s a t i o n . Whereas u s u a l l y you r i g h t l y t r y t o keep the t h r e a d o f your 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 to o f a r from the p o i n t , here you must p r o c e e d d i f f e r e n t l y . . . say whatever goes t h r o u g h your m i n d . 1 ^ Member's con c e r n s w i t h s e q u e n c i n g and t o p i c a l i t y a r e through and t h r o u g h 133 normative and moral c o n c e r n s . F u r t h e r , c o n s i d e r Menninger's a d v i c e : 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 which he would n o t speak i n the p r e s e n c e o f any o t h e r human b e i n g . T h i s unseen 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 unexpected way i n t h a t he i s n o t r e s p o n d i n g as any o r d i n a r y human b e i n g would t o these v e r y e a r n e s t a p p e a l s . 1 ^ The t h e r a p i s t t o o , a v o i d s those normative c o n s t r a i n t s o f t o p i c a l i t y , e t c . , 17 by r e s p o n d i n g as no " o r d i n a r y human b e i n g would". One o f the e a r l y s t r a t e g i e s , namely t h a t o f " f r e e a s s o c i a t i o n " , was based on t h e s e i n s i g h t s . T h i s was i n i t i a l l y used w i t h c h i l d p a t i e n t s as w e l l as w i t h a d u l t s . When i t appeared t h a t t h i s s t r a t e g y d i d n o t work w e l l w i t h c h i l d r e n ( i n t e r e s t i n g l y , t h i s was a c c o u n t e d f o r by s a y i n g t h a t the p a t i e n t ' s s u b s c o n s c i o u s had n o t d e v e l o p e d because o f h i s g e n e r a l i m m a t u r i t y ) , an- e s s e n t i a l l y n o n - c o n v e r s a t i o n a l t h e r a p y ( p l a y t h e r a p y ) was d e v e l o p e d . We can see from M i l l a r ' s statement how p l a y i s a s u b s t i t u t e f o r f r e e a s s o c i a t i o n . When unchecked by 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 and t h i n k i n g i s m o t i v a t e d by the wishes o f th e i n d i v i d u a l . In p l a y , i n dreams, i n f a n t a s y , checks from 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 w i s h e s . 1 ^ T h i s i s c l e a r l y a v a r i a t i o n o f t h e theme o f f r e e a s s o c i a t i o n wherein t h e normative o r d e r i s e f f e c t i v e l y s u b v e r t e d by a l l o w i n g t h e c h i l d t o a c t (or p l a y o r dream) w i t h o u t t h e "demands o f o t h e r s " i n t e r f e r i n g w i t h t h i s p r o -c e s s . As w i t h a l l o t h e r p s y c h o t h e r a p i e s , t h e c o n s t r u c t i o n o f t h i s s p e c i a l -"moral accent", i s an i n t e r a c t i o n a l accomplishment t h a t has t o be m a i n t a i n e d . I t i s t y p i c a l f o r the p a t i e n t t o be t o l d d u r i n g t h e f i r s t p l a y s e s s i o n t h a t t h i s w i l l be h i s room f o r the hour and he can do whatever he l i k e s h e r e . T h i s l a t t e r i n s t r u c t i o n may be i l l u s t r a t e d and made c o n c r e t e by g i v i n g an example o f some " m i s b e h a v i o r " t h a t i s " p e r m i s s i b l e " i n the p l a y room. And t h i s comes t o s t a n d f o r a c l a s s o f a c t i o n s . Of c o u r s e , depending upon what i s known about the c h i l d , i t may be deemed n e c e s s a r y 134 t o s e t l i m i t s f o r him. These mis b e h a v e a b l e s are c l e a r l y seen as a f e a t u r e o f p s y c h o t h e r a p y . K l e i n makes t h i s c l e a r . More i m p o r t a n t s t i l l , I found 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 the 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 the p l a y room, i n d e e d the whole a n a l y s i s , i s something s e p a r a t e from h i s o r d i n a r y home l i f e . F o r o n l y under such c o n d i t i o n s can he overcome the 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 , which a r e incompat-i b l e w i t h c o n v e n t i o n , and i n t h e case 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 th e y have been t a u g h t . — - " Thus, t h e r e i s a d e l i b e r a t e e f f o r t t o e s t a b l i s h t h a t the t h e r a p y room st a n d s i n c o n t r a s t t o t h e p a t i e n t ' s home. In many c a s e s , the c o n t r a s t i s f o r m u l a t e d by the t h e r a p i s t : 4.18 T: You know what? C: ( ) T: T e r r i . C: Miranm. T: I want t o t a l k t o you f o r a s e c . C: What? T: Sometimes we can have t h e s e k i n d s o f e x p l o s i o n s here i n th e p l a y room hey. C: Yea. T: When t h e r e i s flames come o u t o f the caps and s t u f f . C: Yea. T: But the p l a y room i s d i f f e r e n t from home i s n ' t i t ? C: Yea. T: And we don't want a C: I'm gonna, my - dad i s making me a p l a y room i n the basement. Or: 135 4.19 T: Okay, you know we can p a i n t on the w a l l h e r e b u t you c a n ' t do i t a t home. C: (That's) good w a l l s . T: You c a n ' t do i t a t home, no, and you c a n ' t do i t i n the c l a s s r o o m , can you, d o w n s t a i r s ? C: No. T: No, cause i t ' s n o t good t o do i t t h e r e . And i f you d i d i t a t home i t ' l l make mom mad. C: Yea. T: But we can do i t h e r e . . . . There a r e a l s o numerous"instances when the i n s t r u c t i o n s s i m p l y say 20 what can be done h e r e . K l e i n ' s statement above t e l l s us why t h i s conduct i s p e r m i t t e d and encouraged i n the p l a y room. I would now l i k e t o make two a d d i t i o n a l p o i n t s . F i r s t , the term 'here' i s always t o be h e a r d as one end o f a s e t which i n c l u d e s ' t h i s ' s e t t i n g ( c o n t e x t , o c c a s i o n , l o c a t i o n ) , and some-where e l s e . However, the 'here' o p e r a t e s i n a more p o w e r f u l way than t h i s , s i n c e we can s u g g e s t t h a t 'here' i s o n l y m e a n i n g f u l g i v e n the under-s t a n d i n g o f some ' t h e r e ' . In r e g a r d s t o t h i s , one can l o o k a t Emanuel 21' S c h e g l o f f ' s p aper on the f o r m u l a t i o n o f p l a c e . S c h e g l o f f demonstrates t h a t 'here' i s a f o r m u l a t i o n o f l o c a t i o n which i s m e t h o d i c a l l y s e l e c t e d by the s peaker f o r the h e a r e r on t h e b a s i s o f t h e i r i d e n t i t i e s and l o c a t i o n s . Thus, g i v e n the r e l e v a n c i e s o f the c h i l d , we can see how he l o c a t e s the a p p r o p r i a t e ' t h e r e ' i n h i s f a m i l y . The c h i l d seems t o be a b l e t o do t h i s as a m a t t e r o f r o u t i n e . S e c o n d l y , the s p e c i f i c i n s t a n c e s o f " m i s b e h a v i o r s " s u g g e s t e d by the t h e r a p i s t a r e t o be seen as r e p r e s e n t a t i v e s o f the whole c l a s s o f "misbe-136 h a v i o r s " . G i v e n t h e r e l e v a n c i e s o f t h e h e a r e r , i t i s easy t o d i s c o v e r o t h e r a p p r o p r i a t e items i n t h a t c l a s s . I t i s ne v e r the case t h a t the c l a s s i s l i s t e d i n f u l l , ( i n d e e d , t h i s would be i m p o s s i b l e ) , r a t h e r , p a t i e n t s a r e a b l e t o see what k i n d o f items might appear i n such a l i s t , i . e . , t h i n g s t h a t a d u l t s , e s p e c i a l l y p a r e n t s , c o u l d be e x p e c t e d t o s a n c t i o n him f o r d o i n g . (These a r e u s u a l l y v i o l a t i o n s o f the a d u l t e n v i r o n -ment, and i n c l u d e such t h i n g s as making a n o i s e , messing t h i n g s up, d e s t r o y i n g something, swearing, and making m i s t a k e s ) . P a t i e n t s have l i t t l e t r o u b l e i n d i s c o v e r i n g t h i s c l a s s o f "misbe-h a v i o r 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 : 4.20 C: What's ya'name? T: My name i s P a u l a , what's y o u r name? C: E l l e n ' n I l i k e you. ( ( s a i d v e r y f a s t ) ) T: You l i k e me, I l i k e you t o o . You know t h a t , t h a t I ' l l l i k e you even i f y ou 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 h e r e . I f you want t o pound on t h i n g s and so on you can do t h a t , hum. C: I l i k e t o p a i n t on the w a l l . 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 s t h a t b o t h o f them a r e "misbe-h a v i o r s " . Note t h a t , by r e q u e s t i n g t o p a i n t on the w a l l , the c h i l d has demonstrated an u n d e r s t a n d i n g o f t h i s r e l a t i o n s h i p . We can e a s i l y see t h a t t h i s was the 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 a m i s b e h a v i o r i n t h e f i r s t p l a c e . We can make t h i s sound s t r a n g e by g i v i n g the f i r s t f o r m u l a t i o n an ' a d u l t ' h e a r i n g , t h a t i s , by a s k i n g what i t would be d o i n g were i t a d d r e s s e d t o an a d u l t p a t i e n t . The c h i l d ' s o p t i o n t o "pound on t h i n g s and so on" may be seen as a l i c e n s e v " t o do t h i n g s w i t h i n t h e p l a y room t h a t he c o u l d n o t do o u t s i d e o f i t w i t h o u t f a c i n g c e r t a i n s e r i o u s consequences. Such a l i c e n s e e a s i l y i n c l u d e s p e r m i s s i o n t o " p a i n t on the 137 w a l l " , etc. Some analysis of the f i r s t action must be done before a second suggests i t s e l f . Concomitantly, the c h i l d can be expected to look fo r and f i n d the r e l a t i o n s h i p between the f i r s t action and some feature or features of h i s biography. I t i s cl e a r that i n constructing the "moral atmosphere" of the play room, the ther a p i s t takes an adult's view of ch i l d r e n even while he i s attempting to appear to be d i f f e r e n t from other adults. The "misbehaviors" that he c i t e s are t y p i c a l adult concerns even i f they are given a p o s i t i v e rather than a negative connotation here. Adult notions about the family were an important resource i n the very creation of the therapy room where, through 'here' and 'there' statements, the play room i s contrasted to home, and the patient i s encouraged to perform acts that would not be acceptable i n h i s family. Further (and we must say " f o r the ad u l t " ) , t h i s appears to be a p e r f e c t l y l o g i c a l way to handle c h i l d r e n . Summary We began t h i s inquiry with a review of the everyday sights and sounds of the c l i n i c . I proposed that most of these were transparent. That i s , on some l e v e l , we already had an adequate understanding of what was happen-ing, accepted i t as reasonable, and so on. Along with t h i s , we seemed to be able to make sense out of the conversations that occurred during therapy sessions. I t was then proposed that we make matters puzzling by doubting t h e i r transparency and searching f o r t h e i r p s y c h i a t r i c relevance. During my f i e l d work, I acquired some measure of competence whereby I could see the p s y c h i a t r i c relevance of t a l k and events. That i s , I came to see therapy i n much the same way as the therapists saw i t , and I was able to do t h i s by studying the accounts that the s e t t i n g provided. Chapters,2, 3 and 138 4 a r e i n t e n d e d as a d i s p l a y o f p r a c t i c a l p s y c h i a t r i c r e a s o n i n g . C o n f r o n t e d w i t h the pr o b l e m o f u n d e r s t a n d i n g what was g o i n g on, I l o o k e d f o r and found what I have r e f e r r e d t o as the " t h e r a p i s t ' s c o r p u s o f knowledge". My 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 t a l k , and I t a k e i t t h a t t h e y under-s t a n d and i n t e r p r e t t h e e v e n t s o f the s e t t i n g i n the ways d e p i c t e d h e r e . I a l s o emphasized o t h e r e s s e n t i a l f e a t u r e s o f t h a t corpus o f knowledge, e s p e c i a l l y , (a) how background e x p e c t a n c i e s a r e n e c e s s a r y f o r p r a c t i c a l r e a s o n i n g , (b) u n d e r s t a n d i n g s o f normal c h i l d r e n and, (c) the p a t i e n t ' s f a m i l y as a r e s o u r c e . These e n a b l e d me t o make sense o f numerous e v e n t s i n much t h e same way t h a t t h e y d i d f o r t h e r a p i s t s . I would now l i k e t o l o o k a t the adequacy o f those a c c o u n t s . A l t h o u g h t h e p r e c e e d i n g i n f o r m a t i o n was p r e s e n t e d as a r e p r e s e n t a t 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, i t seemed t o be b o t h adequate and r e a s o n a b l e , i . e . , a c t i o n s appeared t o be a p p r o p r i a t e . How i s i t t h a t , a l t h o u g h t h e s e t t i n g i s o r g a n i z e d f o r and r e v o l v e s around a s p e c i a l i z e d t a s k t h a t r e q u i r e s much t r a i n i n g and knowledge, e x p l a n a t i o n s sound so r e a s o n a b l e , 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 so l o g i c a l ? T h i s w i l l be e x p l o r e d f u r t h e r i n the ne x t c h a p t e r . 139 Footnotes """In the h i s t o r y of c h i l d psychiatry one can discover a t r a n s i t i o n from a b i o l o g i c a l and genetic etiology to an environment ( i . e . , home) eti o l o g y . See, f o r example, J . L. Despert, The Emotionally Disturbed - Then and Now, New York: Grunner, 1965; or R. Crutcher, " C h i l d Psychiatry - A History for Development", Psychiatry, 6 (1943) 191-201. 2 This i s a version of Harvey Sack's notion of 'standardized 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 Investigation of the U s a b i l i t y of Conversational Data f o r Doing Sociology", i n D. Sudnow (ed.) Studies i n  S o c i a l Interaction. The Free Press, 1972. 3 Int e r e s t i n g l y t h i s separation i s also .for the'protection of the thera-p i s t . I t i s f e l t that such a sympathetic bond may develop between the r a p i s t and c h i l d that he or she may be less than understanding with the parent. 4 This was a concern shared by a l l members of the s t a f f . On one occasion i t was discovered that a parent would be a r r i v i n g e a r l y to pick up her c h i l d . The therapy session had started l a t e r than scheduled and a colleague was concerned enough to s l i p a note under the play room door to advise the thera p i s t . The the r a p i s t and patient were not i n the room and returned ' l a t e ' . The s t a f f l a t e r expressed some embarrassment about what the parent might think of the matter. 5 For an i n t e r e s t i n g discussion of 'transference neurosis' i n adult therapy see E. Schegloff, "Toward a Reading of P s y c h i a t r i c Theory", Berkeley Journal of Sociology, 8 (1963) 61-91. "Needless to say, i n t h i s p a r t i c u l a r example, the th e r a p i s t d i d not have the mother's assurance that i t was a l l r i g h t to play i n the mud. However, i t i s often the case that adults can speak f o r one another when dealing with c h i l d r e n . 7 I t should be added perhaps that the adequacy of t h i s account also requires some common sense understandings that could be characterized as 'sexist'. Q A. C i c o u r e l , The S o c i a l Organization of Juvenile J u s t i c e . John Wiley and Son, 1968. 9 D. L. Wieder, "The Convict Code, A Study of a Moral Order as a Persuasive A c t i v i t y " , Unpublished Doctoral D i s s e r t a t i o n , Department of Sociology, UCLA, 1969. ""There are many notions l i k e 'accountable', ' r i g h t s ' , 'entitlements', ' j u s t i f i c a t i o n s ' , etc. that are through and through member's notions. Such i n t e r a c t i o n a l issues are i n need of s o c i o l o g i c a l examination. There i s some material on these issues i n an a r t i c l e by M. G. Scott 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 writings of E. Goffman, H. Sacks, and A. Ci 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 the A t t r i b u t i o n of R e s p o n s i b i l i t y " , i n R. Scott and J . Douglas (eds.) Theoretical Perspectives on Deviance, Basic Books, 1972. 140 am using 'accountable 1 i n a member's sense here. On most other occasions I am r e f e r r i n g to Garfinkel's s p e c i a l usage: "When I t a l k about the accountable character of a f f a i r s or when I t a l k about accounts, I am t a l k i n g about the a v a i l a b i l i t y to a member of any ordinary arrangement of a set of located p r a c t i c e s " . "The Origins of the Term Ethnomethodology", i n R. Turner (ed.) Ethnomethodology, Penguin Books, 1974, p. 17. 12 For an i n t e r e s t i n g examination, although not supported by data, of 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. Scott, S. Lyman, Op. c i t . They also mention the use of family accounts i n non-therapy conversations. 13 As another example of t h i s consider the following excerpts from a l e t -t e r to Ann Landers. Dear Ann: As a teacher, I would l i k e to pass along a set of rules f or parents. I f followed they are guaranteed to produce a spoil e d brat who w i l l l a t e r develop i n t o a thoroughly messed-up adult. 1. I f your c h i l d has trouble with the teacher don't go to the school and t a l k to the teacher. Run d i r e c t l y to the p r i n c i p a l , to the superintendent of schools, or to the head of the school board. I t ' s always best to go s t r a i g h t to the top. 5. I f your c h i l d reports that the teacher embarrassed him i n front of the whole c l a s s f o r some l i t t l e thing he d i d , phone the school and make i t c l e a r that you w i l l not permit any teacher to d i s c i p l i n e your c h i l d because he i s very 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, et a l . , suggest that the c h i l d be given an account of the therapy enterprise which includes a reference to the t h e r a p i s t as a " t a l k i n g doctor". The Therapeutic Dialogue, S p r i n g f i e l d : Charles C. Thomas, 1964, p. 147. 15 S. Freud, "On Beginning the Treatment, The Question of the F i r s t Communications", C o l l e c t e d Works, v o l . 2, p. 355, Basic Books, 1959. 16 K. Menninger, Theory of Psychoanalytic Technique. New York: Basic Books, 1958, p. 72. 17 For a c l e a r i l l u s t r a t i o n of how therapy conversations must trade on normative hearings, see Roy Turner, "Utterance P o s i t i o n i n g as an Interac-t i o n a l Resource" i n Robert Wilson (ed.) Ethnomethodology Labeling Theory and  Deviant Behavior, Routledge & Kegan Paul, or Bruce Katz, "Conversational Resources of Two-Person Psychotherapy", unpublished M.A. Thesis, U.B.C. 1971. 18 S. M i l l a r , The Psychology of Play. Penguin Books, 1968, p. 25. 19 M. K l e i n , "The Psychoanalytic Play Technique", American J o u r n a l of  Orthopsychiatry, 25 (1955) 226. 20 For example: T: You know though that I ' l l l i k e you even i f you do something that you r e a l l y f e e l l i k e doing i n here. I f you want to pound things and so on you can do that, hum. E. Schegloff, "Notes on a Conversational P r a c t i c e : Formulating Place", i n D. Sudnow, (ed.) Studies i n S o c i a l Interaction. The Free Press, 1972. CHAPTER 5 REASONABLENESS AND THE ADULT IDEOLOGY A l t h o u g h on my f i r s t v i e w i n g the t h e r a p y s e t t i n g and a c t i v i t i e s s t r u c k me as b e i n g r e a s o n a b l e , I was t o r n between whether t o a c c e p t o r r e j e c t the adequacy o f my u n d e r s t a n d i n g . I w i l l i n g l y a s c r i b e d an e x p e r t knowledge t o t h e r a p i s t s and doubted t h a t I was making a l l t h e r e was t o make o f the e v e n t s . A l t h o u g h b o t h t h e r a p i s t and r e s e a r c h e r "understood" the p a t i e n t s , e v e n t s , e t c . , I doubted t h a t we had re a c h e d t h a t u n d e r s t a n d -i n g by the same r o u t e . F o r many months I v i s i t e d the c l i n i c a t t e n d i n g t o the p l a y room eve n t s and the t a l k t h a t t r a n s p i r e d between t h e r a p i s t s and p a t i e n t . D u r i n g t h a t time I a l s o h e a r d a g r e a t d e a l o f t a l k about p a t i e n t s , f a m i l -i e s , normal c h i l d r e n , e t c . I took a l l o f t h e s e t o be d e s c r i p t i o n s which were e x t e r n a l t o the p l a y room a c t i v i t y and t h e r e b y t o an u n d e r s t a n d i n g o f i t . F o r a l o n g time I remained p u z z l e d about t h e eve n t s t h a t took p l a c e i n the p l a y room and t r i e d t o g e t b e h i n d the scenes t o make some b e t t e r sense o f my i n i t i a l o b s e r v a t i o n s . While t a l k i n g about my e x p e r i e n c e t o c o l l e a g u e s I d i s c o v e r e d t h a t I c o u l d t a l k c ompetently about the s e t t i n g ; t h a t i s , I c o u l d a c c o u n t f o r what I saw i n ways which were adequate f o r - a l l - p r a c t i c a l - p u r p o s e s , — t h e i r m o t i v a t i o n s , e t c . F u r t h e r , I found I was a b l e t o g i v e my ac c o u n t s i n terms o f a r e s o u r c e I had f a i l e d t o take s e r i o u s l y , namely, the v e r y des-c r i p t i o n s t h a t the t h e r a p i s t s had p r o v i d e d f o r me. A t t h i s p o i n t , I began t o r e a l i z e t h a t t h e t a l k t h a t I had h e a r d about c h i l d r e n , p a t i e n t s , t h e r a p i s t s , 141 142 f a m i l i e s , e t c . , might w e l l do t h e same t h i n g f o r t h e r a p i s t s t h a t i t d i d f o r me. On the b a s i s o f t h i s i n s i g h t , I was a b l e t o c o n s t r u c t what I have r e f e r r e d t o as "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" by way o f which t h e r a p i s t s make sense o f t h e i r p a t i e n t ' s problems, p r o g r e s s , and p l a y . I hope t h a t the r e a d e r would agree t h a t t h e r e does n o t appear t o be a n y t h i n g e s o t e r i c i n the r e p o r t e d corpus o f knowledge. R a t h e r , i t t o o seems r e a s o n a b l e . Throughout t h a t a c c o u n t I have emphasized i t s adequacy, l o g i c , e t c . T h e r e f o r e , r a t h e r than t r y t o remedy t h i s r e a s o n a b l e n e s s , I s u g g e s t i t s h o u l d now become our c e n t r a l c o n c e r n . I n s t e a d o f assuming t h a t t h e r a p i s t s a r r i v e a t t h e i r u n d e r s t a n d i n g s by a d i f f e r e n t r o u t e than do laymen, I propose t h a t b o t h r o u t e s a r e the same s i n c e our v o c a b u l a r y o f m o t i v e s , our a c c o u n t s , our e x p l a n a t i o n s , a r e s h a r e d ones. I p r o g r e s s e d from d o u b t i n g the r e a s o n a b l e n e s s and t r a n s p a r e n c y o f e v e n t s and a c c o u n t s t o r e c o g n i z i n g t h a t I had a r e s o u r c e f o r making sense o f t h a t v e r y r e a s o n a b l e n e s s . T h a t i s , I began t o see t h a t t h e r e s o u r c e f o r my1 own p r a c t i c a l r e a s o n i n g about t h e r a p y e v e n t s might a l s o be t h e b a s i s o f t h e t h e r a p i s t ' s p r a c t i c a l r e a s o n i n g . I was t h e n a b l e t o t e r m i n -a t e my s e a r c h f o r something b e h i n d t h e s c e n e s . I f we l o o k back a t my accomplishment o f s e e i n g (and y o u r s o f r e a d i n g ) t h e r e a s o n a b l e n e s s o f t h a t corpus o f knowledge we w i l l f i n d t h a t , l i k e the t h e r a p i s t s , we were a b l e t o r e c o g n i z e the c o n v e r s a t i o n s as b e i n g those o f c h i l d r e n (e.g., i n i n a p p r o p r i a t e s y n t a x , n o n - s e q u i t o r s , e t c . ) ; we a l s o saw such t h i n g s as the s e n s i b i l i t y o f u s i n g p l a y as a form o f t h e r a p y , r e c o g n i z e d c h a r a c t e r i s t i c s o f the c h i l d (e.g., e m o t i o n a l s t a t e s ) i n t h e i r p l a y a c t i v i t y , a t t r i b u t e d f a m i l y - b a s e d motives t o t h e i r a c t i o n s , r e c o g n i z e d c h i l d r e n t e s t i n g the l i m i t s , u n d e r s t o o d why punishment f o r s p i l l i n g d r i n k s may n o t have been a good s t r a t e g y , saw a g e - a p p r o p r i a t e b e h a v i o r , r e c o g n i z e d s t a g e s o f growth, u n d e r s t o o d the r e a s o n a b l e n e s s o f c h i l d r e n n o t b e i n g v o l u n t a r y p a t i e n t s , a c c e p t e d the r e a s o n s f o r my n o t b e i n g encouraged t o t a l k t o t h e c h i l d r e n , e t c . The l a y p e r s o n and e x p e r t o p e r a t e i n the same manner. The b a s i s o f my own p r a c t i c a l r e a s o n i n g s k i l l i n making sense o f my f i r s t v i e w i n g was my common sense knowledge and u n d e r s t a n d i n g o f ' c h i l d r e n ' and ' a d u l t s ' as s o c i a l a c t o r s . I used a s e t o f t y p i f i c a t i o n s about t h e s e a c t o r s t h a t e n a b l e d me t o c o n s t r u c t m o t i v a t i o n a l a c c o u n t s and t o r e c o g n i z e t y p i c a l b e h a v i o r s . Thus i t was my s t o c k o f f o l k wisdom which acc o u n t e d f o r t h e t r a n s -p a r e n c y o f 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. With t h i s i n s i g h t came the r e c o g n i t i o n t h a t t h i s f o l k wisdom i s a l s o a f e a t u r e o f p s y c h i a t r i c r e a s o n i n g . I t i s i n f a c t a c o n s t i t u t i v e f e a t u r e o f t h e s e t t i n g . L e t me t r y t o d e v e l o p t h i s i n s i g h t . In t a l k i n g about t h e a c t o r ' s p r a c t i c a l i n t e r e s t i n t h e e v e n t s o f the w o r l d G a r f i n k e l s u g g e s t s : In everyday s i t u a t i o n s what he knows i s an 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 the way he knows i t , he assumes 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 as a bona f i d e member o f the group. He s a n c t i o n s h i s competence as a bona f i d e member o f the group as 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 t h e 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 g r a s p . ^ I f we s t a r t w i t h the n o t i o n t h a t what one knows i s an i n t e g r a l f e a t u r e o f h i s s o c i a l competence, and acknowledge t h a t the above r e p o r t e d r e a s o n a b l e -ness i s a r e s u l t o f what one 'knows', we can t h e n ask i n r e g a r d t o t h i s f i e l d s e t t i n g " j u s t what competence i s a t s t a k e ? " I t i s c l e a r t h a t t h e r e i s some competence i n v o l v e d i n t h e c l i n i c s e t t i n g o t h e r t h a n p r o f e s s i o n a l competence. I w i l l r e f e r t o t h i s as an a d u l t ' s competence, and contend t h a t t h e r e a s o n a b l e n e s s o f our i n i t i a l v i e w i n g o f the s e t t i n g and t h e t r a n s p a r e n c y , e t c . , o f the p s y c h i a t r i c r e a s o n i n g i s a r e s u l t o f an a d u l t ' s i n t e r p r e t i v e schema o f c h i l d r e n . 144 2 3 4 Writers such as Thorne, Leach and Sacks have suggested that a l l seeing and hearing i s normative and a v i o l a t i o n of t h i s normative order produces warrantable inferences, e.g., one doesn't know the c u l t u r e , one i s 'naive', ' f o o l i s h ' , 'stupid', etc. There are for example, normative ways to hear, see, t a l k to, organize f o r , c h i l d r e n . Our common-sense notions of c h i l d r e n being 'cute' or precocious are products of that seeing. The most c e n t r a l notion of t h i s normative order i s the adult member's notion of c h i l d r e n as s p e c i a l c u l t u r a l objects. I t i s t h i s seeing-them-as-different-from-us which produces a c h a r a c t e r i z a t i o n of 'cute' for an action that f o r other categories of actors would be uneventful or sanction-able (e.g., making your own doctor's appointment). There i s ample evidence to demonstrate that as adults we conceive of c h i l d r e n as special' c u l t u r a l objects. This was suggested i n a previous note about how information on psychotherapy with children i s placed i n the l i t e r a t u r e . The notion of children as s p e c i a l c u l t u r a l objects i s d i s -played, however, i n the very organization of services. That i s , adults see c h i l d r e n as a s p e c i a l category within the population among whom s p e c i a l needs can be i d e n t i f i e d and services developed to meet those needs. This i s not simply a reference to mental health services but applies to a wide range of a c t i v i t i e s and s e t t i n g s , e.g., s i c k children's h o s p i t a l s , c h i l -dren's d e n t i s t s , c l o t h i n g stores, l i t t l e league sports, children's books, children's movies, et c . (Although there are events described 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 kind of work than to d i f f e r e n t i a t e i t from 'childrens' movies). As analysts we can think of adults and c h i l d r e n as comprising two d i s t i n c t groups but for the adult members i t i s simply the case that there i s the world and there are c h i l d r e n . I t would seem strange for example, to think of a l l h o s p i t a l s as adult's h o s p i t a l s . 145 ( I t may w e l l be t h e case t h a t t h i s i s the way the w o r l d appears t o c h i l -d r e n , t h a t i s , t h a t t h e r e a r e a d u l t books, a d u l t movies, a d u l t h o s p i t a l s , e t c . ) F u r t h e r e v i d e n c e o f t h i s i s our b e l i e f t h a t c h i l d r e n need t o be w i t h o t h e r c h i l d r e n . A p o w e r f u l e x t e n s i o n o f t h i s f e a t u r e o f our c u l t u r e , i . e . , t h a t the c a t e g o r y o f ' c h i l d ' i s a n o r m ative c a t e g o r y , i s t h a t t h e c a t e g o r i e s o f ' a d u l t ' and ' c h i l d ' a r e o m n i - r e l e v a n t whenever t h e r e i s a c o n t a c t between t h e two. The s t r e n g t h o f t h i s n o t i o n i s a t t e s t e d t o by t h e f a c t t h a t r e g a r d l e s s o f what o t h e r c a t e g o r i e s a r e r e f e r e n t i a l l y adequate f o r the p a r t i c i p a n t s on any o c c a s i o n , e.g., t e a c h e r - s t u d e n t , c l e r k - c u s t o m e r , p r o b a t i o n o f f i c e r - p r o b a t i o n e r , the c a t e g o r i e s o f ' a d u l t ' and ' c h i l d ' w i l l c u t a c r o s s them. I t i s an i n e s c a p a b l e f e a t u r e o f t h e paramount r e a l i t y t h a t t h e s e c a t e g o r i e s w i l l n o t o n l y be r e f e r e n t i a l l y adequate b u t r e f e r e n -t i a l l y r e l e v a n t . While the w o r l d appears t o be o r g a n i z e d on the b a s i s o f one c a t e g o r y b e i n g r e f e r e n t i a l l y adequate f o r a p e r s o n on any o c c a s i o n t h i s does n o t mean t h a t on e v e r y o c c a s i o n o n l y one c a t e g o r y w i l l be r e l e v a n t . I am a r g u i n g t h a t w i t h c h i l d r e n i t i s always the case t h a t a t l e a s t t h e c a t e g o r y ' c h i l d ' w i l l be r e l e v a n t . The s i g n i f i c a n c e o f t h i s f a c t then i s t h a t n o t o n l y do we have normative ways o f h e a r i n g and s e e i n g c h i l d r e n b u t t h a t t h i s i s always a s a n c t i o n a b l e h e a r i n g and s e e i n g . T h i s f e a t u r e i s p a r t i c u l a r l y s t r i k i n g i n t a l k about c h i l d p s y c h o t h e r a p y where the p a t i e n t i s r o u t i n e l y r e f e r r e d t o as the ' c h i l d ' and the t h e r a p i s t , w i t h remarkable f r e q u e n c y , as an ' a d u l t ' . I n v o k i n g t h e c a t e g o r y ' c h i l d ' i s n o t w i t h o u t consequence. As w i t h a l l o t h e r c a t e g o r i e s i t s use p r o v i d e s s o l u t i o n s t o the b a s i c p roblem o f how an a c t o r c o n s t r u c t s h i s own a c t i o n s and u n d e r s t a n d s the a c t i o n s o f o t h e r s . I t p r o v i d e s s o l u t i o n s t o the p roblem o f making sense. S c h u t z has b r o u g h t t o our a t t e n t i o n t h e s t u d y o f the n a t u r a l a t t i t u d e as a s u b j e c t o f i n q u i r y and has g i v e n us many i n s i g h t s i n t o member's p r o c e d u r e s 5 w i t h x n t h a t a t t i t u d e . The n a t u r a l a t t i t u d e f u r n i s h e s the r e s i s t a n t o b j e c t i v e s t r u c t u r e which must be reckoned w i t h i n a p r a c t i c a l l y adequate f a s h i o n i f p r o j e c t s o f a c t i o n a r e t o be a f f e c t e d s u c c e s s f u l l y . I t appears as a m a s s i v e l y o r g a n i z e d s t r u c t u r e i n t o which the a c t o r must gear h i m s e l f . F o r members t h e n , t h e w o r l d i s e x p e r i e n c e d as a l r e a d y b e i n g o r g a n i z e d and t h i s s t r u c t u r e i s seen as h a v i n g consequence f o r what one a c c o m p l i s h e s i n t h a t w o r l d . The n o t i o n o f ' c h i l d h o o d ' i s p a r t o f t h i s o b j e c t i v e s t r u c t u r e and, f u r t h e r , i s a c a t e g o r i z a t i o n g i v e n s u b s t a n c e t h r o u g h a p r o c e s s Schutz c a l l e d " t y p i f i c a t i o n " . ~ In r e f e r e n c e t o t h i s term McKinney s a y s : " T y p i f i c a t i o n , p e r c e i v i n g the w o r l d and s t r u c t u r i n g i t by means o f c a t e g o r i c a l t y p e s , i s e v i d e n t l y an e s s e n t i a l and i n t r i n s i c 7 a s p e c t o f the b a s i c o r i e n t a t i o n o f a c t o r s t o t h e i r s i t u a t i o n s " . These f o l k t y p i f i c a t i o n s p r o v i d e members w i t h a massive amount o f knowledge about the w o r l d ; f o r example, t h e y p r o v i d e us w i t h the t y p i c a l c h a r a c t e r s o f p e r s o n s , what one can e x p e c t from v a r i o u s a c t o r s , t y p i c a l b i o g r a p h i e s , ways t o t a l k t o p e o p l e , how t o a v o i d o f f e n d i n g , t y p i c a l m o t i v a t i o n s , e t c . A l l o f t h i s p r o v i d e s us w i t h a way t o u n d e r s t a n d a c t o r s and a c t i o n s . I t i s t h i s k i n d o f knowledge t h a t we r e f e r t o as 'common-sensical', o r " s t o c k o f knowledge", and we can now show how t h i s knowledge i s used t o s o l v e t h o s e " i s s u e s and t e c h n i c a l problems" which p s y c h o t h e r a p i s t s e n c o u n t e r when c o n f r o n t e d w i t h a c h i l d - p a t i e n t . Two p o i n t s o f c l a r i f i c a -t i o n a r e n e c e s s a r y : (1) I am n o t s u g g e s t i n g t h a t t h e s e f o l k t y p i f i c a t i o n s i n some s t r o n g way r e p r e s e n t the way c h i l d r e n 'are' nor t h a t t h e r e i s complete c u l t u r a l agreement among members on the f e a t u r e s o f t h e s e t y p i f i -c a t i o n s , r a t h e r , I want o n l y t o s u g g e s t t h a t a l l members, p s y c h o t h e r a p i s t s 147 included, engage i n a great deal of 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 . For example i t provides f o r adequate accounts, demonstrations of l o g i c , instances of appropriateness, etc. (2) Further, I am not arguing that there i s no ' s c i e n t i f i c ' know-ledge about c h i l d r e n . I f we consider s c i e n t i f i c knowledge to be the product of s c i e n t i f i c r a t i o n a l i t y there are c l e a r l y such i n q u i r i e s i n t o , and accounts of, c h i l d r e n . However, the p r a c t i c e of psychotherapy 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 of psychotherapists, l i k e that of a l l members of the culture who work with c h i l d r e n , i s embedded i n the-natural a t t i t u d e and i t s notions of childhood. As a researcher and an observer my a c t i v i t y was also b u i l t on that member's understanding (or background expectancies); I, too, was geared i n t o that same massively organized structure. My awareness of my a b i l i t y to make sense of the setting's a c t i v i t y and seeing i t s reasonable-ness amounted to seeing that both myself and the t h e r a p i s t were operating as adults. I t i s our status as adults which accounts for the adequacy of what has transpired. These f o l k understandings of children.have been talked about by 9 10 Sacks and Speier as an "adult ideology of childhood" and I suggest that we use t h i s idea to further our i n q u i r y . Before examining t h e i r usage l e t me c l a r i f y what I mean by the term 'ideology'."'""'" By t h i s notion I intend to point to the normative ways adults have of seeings, (hearing, t a l k i n g to, organizing f o r , etc.) c h i l d r e n . These notions of what chi l d r e n are l i k e are deeply embedded i n the natural a t t i t u d e . This i s not to suggest however, that t h i s simply represents a body of knowledge. Rather, i t i s a schema f o r viewing the world and for making sense that i s shared by a category of actors. 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 148 v i e w i n g f o r which one can be h e l d a c c o u n t a b l e . The v i e w e r ' s s t a t u s as a competent member o f the group h i n g e s on i t . In the case i n p o i n t , one's competence as an a d u l t i s a t s t a k e . L e t me g i v e n an example. D u r i n g my o b s e r v a t i o n s I watched a p a t i e n t p l a y i n g b a s k e t b a l l u s i n g the wastebasket as a hoop. A f t e r he had made s e v e r a l u n s u c c e s s f u l a ttempts, the t h e r a p i s t p o s i t i o n e d t h e w a s t ebasket i n a way t h a t would a s s u r e s u c c e s s . He l a t e r e x p l a i n e d t h a t the c h i l d would f e e l b e t t e r a f t e r h a v i n g a c c o m p l i s h e d a s u c c e s s f u l , throw and t h i s would a l l o w him t o go on t o o t h e r a c t i v i t i e s . To have h e l p e d a n o t h e r a d u l t i n t h a t manner would have been a v e r y d i f f e r e n t m a t t e r — e v e n though a d u l t s t o o l i k e t o be s u c c e s s f u l . Not o n l y was the t h e r a p i s t ' s e x p l a n a t i o n seen as adequate, b u t i t would have been odd f o r me n o t t o have u n d e r s t o o d i t . A l t h o u g h I c o u l d have c h a l l e n g e d i t on grounds t h a t c h i l d r e n f e e l * m o r e c o n f i d e n t i f t h e i r achievements are t h e i r own, t h i s i s v e r y d i f f e r e n t from s a y i n g t o the t h e r a p i s t , "your e x p l a n a t i o n i s such t h a t i t makes no sense t o me". Both the t h e r a p i s t ' s e x p l a n a t i o n and my r e a s o n a b l e c h a l l e n g e a r e b u i l t on an u n d e r s t a n d i n g o f th e ways i n which a d u l t s a r e supposed t o l o o k a f t e r t h e c h i l d ' s development, h a p p i n e s s , e t c . L e t us now l o o k a t how t h e term " a d u l t i d e o l o g y " i s used i n the l i t e r a t u r e . Sacks and S p e i e r have b o t h drawn a t t e n t i o n t o the' a d u l t i d e o l o g y by t u r n i n g our c o n v e n t i o n a l wisdom o f c h i l d r e n on i t s head. A few y e a r s ago, Sacks d e l i v e r e d a l e c t u r e which c o n t a i n e d t h e b e g i n n i n g s o f an uncon-v e n t i o n a l way f o r f o r m u l a t i n g q u e s t i o n s about c h i l d r e n . He asked ques-t i o n s such as "where d i d ' c h i l d r e n ' come from?" o r , "As ' e x - c h i l d r e n ' , why do we know so l i t t l e about them?" He p o s e d q u e s t i o n s about the n a t i o n w i d e s p r e a d o f c h i l d r e n ' s ' c u l t u r e ' ; the c o n t r o l o f a d u l t competence by c h i l -d r e n ; the w a r r a n t a b l e consequence o f n o t t r e a t i n g c h i l d r e n l i k e c h i l d r e n ; 149 e t c . T h i s appears t o be a s t r a n g e s e t o f q u e s t i o n s because i t c o m p l e t e l y i g n o r e s a r e a s t h a t we see as c e n t r a l t o any i n q u i r y i n t o t h i s segment o f the p o p u l a t i o n , i . e . , i t i g n o r e s b o t h t h e development o f competence i n c h i l d r e n and the p r o c e s s by which t h e y become a d u l t s under the guidance o f t h e i r p a r e n t s , t e a c h e r s , e t c . As a d u l t s we a r e w a r r a n t a b l y c o n c e r n e d w i t h the fundamental problem o f how our c h i l d r e n a r e growing u p — a r e t h e y making s a t i s f a c t o r y p r o g r e s s , a r e we p r o v i d i n g t h e r i g h t k i n d o f c a r e , s t i m u l a t i o n , e t c . , i s t h e w i d e r community d o i n g a l l i t can t o a s s i s t i n the growing-up p r o c e s s , a r e we p r o t e c t i n g our c h i l d r e n from danger, e t c . How we handle t h e s e i s s u e s i s r e f l e c t e d 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 p a r e n t , o v e r - p r o t e c t i v e mother, n e g l i g e n t p a r e n t , c o n c e r n e d c i t i z e n , e t c . Sacks a l s o began t o t a l k o f the d i s t i n c t " c u l t u r e o f c h i l d h o o d " ( r a t h e r than a m i n i a t u r e v e r s i o n o f 'our' c u l t u r e ) and t h i s , l i k e t h e q u e s t i o n s t h a t he posed above, i s i n s i g h t f u l because i t c h a l l e n g e s many o f our t a k e n - f o r - g r a n t e d assumptions. F o r example, we a l l know t h a t c h i l d r e n cannot have t h e i r own c u l t u r e s i n c e t h e i r knowledge, s k i l l s , a c t i v i t i e s and a t t i t u d e s a r e j u s t c h i l d s i z e d r e p l i c a s , o r pre-competent v e r s i o n s o f a d u l t c u l t u r e . S u r e l y c h i l d r e n a r e dependent upon a d u l t s r a t h e r than t h e o t h e r way around as Sacks s u g g e s t s ! Do c h i l d r e n r e a l l y p a s s on knowledge 12 w i t h o u t t h e i n t e r v e n t i o n o f a d u l t s ? 13 The n o t i o n o f a c u l t u r e o f c h i l d h o o d i s p o t e n t i a l l y u n s e t t l i n g p a r t i a l l y because i t bypasses the u s u a l c o n c e r n s about what a d u l t s do (or s h o u l d do) t o and w i t h c h i l d r e n . T h i s c o n cept has been e x p l o r e d r e c e n t l y 14 i n a book by M. E. Goodman. Goodman i s worth l o o k i n g a t because she demonstrates the n o t i o n o f a ' c u l t u r e o f c h i l d h o o d ' w i t h o u t p o s i t i n g Sacks' n o t i o n o f an ' a d u l t i d e o l o g y ' . She b e g i n s w i t h a statement n o t u n l i k e one t h a t Sacks might make: 150 The l i t e r a t u r e on c h i l d development, inc l u d i n g a s c h o l a r l y journal published under that name, i s enormous. So i s the l i t e r a t u r e on c h i l d rearing - on s o c i a l i z a t i o n . These.and other studies report what adults see when they observe c h i l d r e n , and what adults do f o r and to c h i l d r e n . Culture of childhood studies, i n contrast, report on what chi l d r e n see as they observe the world i n which they f i n d themselves.15 Goodman goes on to proclaim the need for a science which would be a c o r r e c t i v e for the f a l l a c i o u s assumptions of adults. "Systems b u i l t upon them are l i k e l y to be f a u l t y at best and disastrous at worst," she 16 says. So, rather than attempt to discover what e i t h e r adults or 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 to the adult's problem and concerns with " c h i l d rearing and pedagogy". Goodman then looks to science and s c i e n t i f i c reasoning for solutions to these problems. While t h i s may appear to the lay reader to constitute a challenge, i t does not present a threat to the s o c i a l sciences. I n t e r e s t i n g l y enough, Speier has provided a further twis.t and ques-tions the s o c i a l s c i e n t i s t s ' concern with c h i l d r e n . For example, he says of the f i e l d of s o c i a l i z a t i o n : A set of working assumptions i s deeply engrained i n the choice of research problems and findings that r e s u l t . I would l i k e to r e f e r to t h i s set of suppositions as the c l a s s i c a l formulation of -s o c i a l i z a t i o n . I t r e a t i t as c l a s s i c a l because i t i s a formulation that i s rooted i n adult f o l k l o r e or common-sense understandings about chil d r e n . Adult professionals doing s o c i o l o g i c a l studies have oriented t h e i r work around a set of i m p l i c i t conventions. Taken together these conventions d i f f e r from lay ideology only i n so f a r as i t i s systematically working out p r o f e s s i o n a l problems and s o l u -tions that are responsive to the ideology, i . e . , how s c i e n t i f i c a l l y correct the ideology i s , how e f f e c t i v e i t might be, how could i t be remedied, e t c . 1 ^ Like Goodman, he i s t r y i n g to r a d i c a l i z e our approach to the study of c h i l d r e n but i t i s c l e a r that Goodman has not escaped the 'adult ideology'. Although i t i s impossible to escape the ideology e n t i r e l y , i t can 18 be made in t o a topic as well as a resource. That i s , one uses the 151 i d e o l o g y t o d i s c o v e r and e x p l i c a t e t h e i d e o l o g y . Thus, t h e r e s e a r c h e r who i s i n t e r e s t e d i n t h e c u l t u r e o f c h i l d h o o d can minimize the i n f l u e n c e o f the i d e o l o g y by r e f u s i n g t o f o r m u l a t e problems i n terms o f such t h i n g s as c h i l d r e a r i n g o r d e v e l o p m e n t a l models. Rather, he can choose t o examine the p r o d u c t i o n s o f c h i l d r e n i n terms o f c h i l d r e n ' s knowledge. F o r example, S p e i e r has l o o k e d a t c h i l d r e n ' s d e v i c e s f o r ' g e t t i n g t h e f l o o r ' w i t h a d u l t s p e a k e r s . T h i s approach, however, s t i l l r e q u i r e s one t o employ the i d e o l o g y s i n c e I t a k e i t t h a t S p e i e r d i d n o t have t o l e a r n a new s e t o f r u l e s f o r r e c o g n i z i n g ' c h i l d r e n ' . To b e g i n w i t h t h e n o t i o n o f a " c u l t u r e o f c h i l d h o o d " i s t o b r i n g t o l i g h t some o f the f e a t u r e s o f the a d u l t i d e o l o g y , b u t i t does n o t p r o v i d e a new way o f s e e i n g ' c h i l d r e n ' . S p e i e r ' s i n t e r p r e t a t i o n o f the a d u l t i d e o l o g y appears t o d e a l e s s e n t i a l l y w i t h the f o r m u l a t i o n o f r e s e a r c h problems even though he r e c o g n i z e s t h a t t h e r e i s a much b r o a d e r i n t e r p r e t i v e schema. He c l a i m s t h a t we have done l i t t l e more than e l a b o r a t e upon and s o l v e problems f o r m u l a t e d from w i t h i n t h e a d u l t i d e o l o g y . B e f o r e l e a v i n g t h i s t o p i c , I would l i k e t o make one c l a r i f i c a t i o n . I f one a c c e p t s my p r e v i o u s statement t h a t the c a t e g o r i z a t i o n o f ' c h i l d ' i s o m n i - r e l e v a n t (both Sacks and S p e i e r a l s o make t h i s p o i n t ) , we cannot say, as S p e i e r appears t o , t h a t "taken t o g e t h e r t h e s e c o n v e n t i o n s form an a d u l t i d e o l o g y " . A p o s s i b l e r e a d i n g o f t h i s i s t h a t t h e i d e o l o g y i s s i m p l y a s e t o f f i n i t e common-sense assumptions t h a t can be found, l i s t e d , o r escaped. However, one cannot see c h i l d r e n o t h e r than t h r o u g h t h i s i d e o l o g y . F o r the i d e o l o g y i s an i n t e r p r e t i v e schema t h a t i s c o n t i n u a l l y ad hoced t o make sense o f c h i l d r e n ' s a c t i o n s . In t h a t sense, the i d e o l o g y would be c o n t i n u a l l y employed and d i s p l a y e d . I w i l l say more about t h i s l a t e r b u t I would l i k e t o emphasize a t t h i s p o i n t t h a t I mean more by 152 ideology than a s p e c i f i a b l e way.of looking at c h i l d r e n , I mean to imply an inescapable way of looking at ch i l d r e n . In drawing attention to the " i m p l i c i t " conventions mentioned above, Speier has of f e r e d f i v e themes that he took as c e n t r a l to the ideology. These are to be seen not ju s t as features of the s o c i a l s c i e n t i s t s ideology, but of the adult ideology. They are worth l i s t i n g as an i n i t i a l view of what we mean by the ideology. 1) Children are adults-in-the-making. 2) Children get s o c i a l i z e d or 'made' into adults mainly by adults who teach 'culture', 'norms', 'values', 'roles', 'behavior systems', etc. 3) Children progressively develop i n t o competent s o c i a l members. 4) Children's development can be e i t h e r successful as they grow up through stages of l i f e or i t can be deviant anywhere along the way. 5) Children are defective 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 of precompetence at behaving p r o p e r l y . ^ 9 The implication of these conventions i s that the c h i l d i s seen as having a s p e c i a l status i n any a d u l t - c h i l d contact. The most s i g n i f i c a n t i n t e r a c t i o n a l features of the ideology are contained i n the notions of the c h i l d as a defective s o c i a l p a r t i c i p a n t and i n the idea that i t i s adults who provide c h i l d r e n with the s k i l l s and knowledge by which they are to 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 get fashioned around these resources i n order to ' s o c i a l i z e ' c h i l d r e n . (This applies p a r t i c u l a r l y i n the household but holds for other settings as w e l l ) . On the other hand, i t i s possible to learn something of the ch i l d ' s defective p a r t i c i p a t i o n by observing adult concerns with helping 20 the c h i l d to p a r t i c i p a t e i n conversations and other a f f a i r s . One can see how the ideology i s a major feature governing contact between adults and c h i l d r e n . 153 S p e i e r has begun t o demonstrate how t h i s i d e o l o g y i s r e f l e c t e d i n the p r o p e r t i e s o f c o n v e r s a t i o n s . He i s p a r t i c u l a r l y i n t e r e s t e d i n t h e i n t e r a c t i o n a l consequences o f " r e s t r i c t e d r i g h t s " o f t h e c h i l d i n h i s d e a l i n g s w i t h a d u l t s . F o r example, how does t h e c h i l d s o l v e t h e pr o b l e m o f i n i t i a t i n g 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 an a d u l t o r how does he 21 g e t t o be a speaker i n an on g o i n g c o n v e r s a t i o n . I would l i k e t o r e p e a t t h a t , w h i l e t h e s e c o n v e n t i o n s p r o v i d e a way o f c u t t i n g i n t o t h e i d e o l o g y , t h e I d e o l o g y i s n o t a d e f i n i t e o b j e c t which can be l i s t e d , l e a r n e d and used. That i s , i t i s n o t my i n t e n t i o n t o draw up a l i s t t h a t shows how a d u l t s c o n c e i v e o f c h i l d r e n . R a t h e r , i t i s o u r c l a i m 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 schema and, as such, c o n s i s t s o f a c o n t i n u o u s p r o c e s s o f ad h o e i n g by which new o c c a s i o n s , e v e n t s , a c t i o n s , and problems can be brought under i t s a u s p i c e s . R e t u r n i n g now t o my f i e l d work p u z z l e , I contend t h a t t h i s n o t i o n o f an a d u l t i d e o l o g y can be used t o acco u n t f o r , o r t o make sense o f , t h e r a p i s t s ' a c t i o n s , a c c o u n t s , e x p l a n a t i o n s , e t c . , as w e l l as f o r our e x p e r i e n c e o f t h e i r r e a s o n a b l e n e s s . W h i l e t h e r a p i s t s may p r o v i d e a c c o u n t s i n terms o f t h e r a p e u t i c 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 -graphy o f the p a t i e n t , e t c . , we would argue t h a t the a d u l t i n t e r p r e t i v e schema i s t h e f o u n d a t i o n f o r a l l o f t h e s e a c c o u n t s . The n o t i o n o f an a d u l t i d e o l o g y w i l l be used t o f o c u s on t h e i n t e r p r e t i v e schema employed by t h e members o f the s e t t i n g . The n a t u r e o f t h i s schema can be dete r m i n e d 22 t h r o u g h an e x a m i n a t i o n o f a c t i o n s i n t h e s e t t i n g . The i d e o l o g y i s o f f e r e d as a d e v i c e f o r making sense o f bo t h t h e e v e n t s and t h e o r g a n i z a -t i o n a l r a t i o n a l e . The adequacy o f a c c o u n t s , the a p p r o p r i a t e n e s s o f r e s p o n s e s , the v a l i d i t y o f r e a s o n i n g , t h e t r a n s p a r e n c y o f m o t i v e s , e t c . , — a l l a r e p r o v i d e d by the a d u l t i d e o l o g y . 154 In r e v i e w , the a d u l t i d e o l o g y i s an o m n i - r e l e v a n t d e v i c e f o r making sense o f ( c h i l d r e n ' s ) a c t i v i t i e s . Both the layman and e x p e r t s u b s c r i b e t o i t and from i t d e r i v e t h e i r s t a t u s as competent members o f the c u l t u r e . A l t h o u g h the t h e r a p i s t ' s t a l k i s on o c c a s i o n more t e c h n i c a l t h a n t h a t o f t h e l a y p e r s o n , the consequences o f t h e i r d e c i s i o n s a r e o f t e n more p r e s s i n g , and a l t h o u g h they may a p p e a l t o ' s c i e n t i f i c ' f i n d i n g s , t h e i r e x p l a n a t i o n s remain o c c a s i o n e d uses o f the a d u l t i d e o l o g y . The a d u l t i d e o l o g y p r o v i d e s a s o l u t i o n t o our e a r l y query about how i t was p o s s i b l e f o r a c t i v i t i e s ; t h a t t a k e p l a c e i n a s p e c i a l i z e d work s e t t i n g t o seem r e a s o n a b l e t o us. The t a l k , a c t i v i t i e s , e t c . a r e c o n s i s -t e n t w i t h o t h e r s i t u a t i o n s where c h i l d r e n a r e found. As a d u l t s we a r e a b l e t o u n d e r s t a n d t h o s e e v e n t s by u s i n g the same i n t e r p r e t i v e schema t h a t 23 we use i n our everyday l i f e . My D i s c o v e r y o f t h e I d e o l o g y L e t ' s l o o k a t my puzzlement and d i s c o v e r y t o see how I c o n s t r u c t e d t h e p r e v i o u s d i s p l a y o f p s y c h i a t r i c r e a s o n i n g which I now argue i s a m a n i f e s t a t i o n o f the a d u l t i d e o l o g y . B e f o r e I began my r e s e a r c h a t t h e c l i n i c , I was aware o f the n o t i o n o f an a d u l t i d e o l o g y as i t had been d e v e l o p e d by Sacks and S p e i e r , however, I f a i l e d t o a p p r e c i a t e i t s i m p l i c a -t i o n s . I t was o n l y a f t e r much time i n the f i e l d t h a t I saw t h a t I and t h e t h e r a p i s t may b o t h be u s i n g t h i s i d e o l o g y . A l t h o u g h the n o t i o n o f an a d u l t i d e o l o g y was n o t c l e a r l y f o r m u l a t e d i n the l i t e r a t u r e , I began t o t r e a t i t as a s o c i a l s c i e n c e f i n d i n g . Then, r e a l i z i n g t h a t I may be d e a l i n g w i t h an i n s t a n c e o f t h a t n o t i o n , I began t o d e v e l o p i t . I began t o see a c c o u n t s g i v e n by the t h e r a p i s t s as i n s t a n c e s o f the i d e o l o g y and t o p i e c e them t o g e t h e r t o form a p a t t e r n . T h a t i s , I r e s o l v e d my p u z z l e 155 about what was happening i n the play room and I claim that the materials presented i n the preceding chapter are an adequate account of therapy r e l a t e d concerns. Here i s an example of how I discovered a pattern i n the explanations, accounts, and actions of the therap i s t . I noted 1. A patient's t a l k about dead birds was accounted f o r i n terms of h i s father's death. 2. A patient's sex i d e n t i f i c a t i o n problem explained i n terms of family responses and structure. 3. An apparent relapse was accounted f o r i n terms of the time spent at home with mother. 4. A patient's p a i n t i n g was explained i n terms of the moral character of the family. 5. A patient's swearing was explained i n terms of the existence of a family rule sanctioning such behavior. 6. A session was s a i d to be good for the pat i e n t because i t provided an a c t i v i t y not permitted at home. 7. A patient's anger was explained i n terms of the father's employment status. 8. A patient's lack of progress was explained i n terms of the need f o r the family to be i n therapy. 9. I also found myself contributing to t h i s pattern, e.g., o f f e r i n g an explanation of a patient's apparent non-sequitor i n r e l a t i n g a rocking chair to "somebody old" by p o s i t i n g the possible existence of a grandmother who used a rocking chair. There appeared to be a rather long l i s t of instances such as t h i s . 23 Using the documentary method, I began to see events such as these 156 as a document o f the m u l t i - c o n s e q u e n t i a l n a t u r e o f the f a m i l y and was then a b l e t o use t h e i d e a o f m u l t i - c o n s e q u e n t i a l i t y t o f i n d f u r t h e r i n s t a n c e s . I f the r e a d e r l o o k s back a t the p r e v i o u s c h a p t e r s he w i l l be a b l e t o use the n o t i o n o f the m u l t i - c o n s e q u e n t i a l i t y o f t h e f a m i l y t o f i n d f u r t h e r o t h e r s uch i n s t a n c e s . . F o r example, when I reexamined my f i e l d n o t e s and t a p e s I d i s c o v -e r e d t h a t one p a t i e n t ' s a p p a r e n t e x a g g e r a t i o n o f h i s p o s s e s s i o n and s k i l l s was seen as the consequence o f the e x i s t e n c e o f an o l d e r b r o t h e r who was s u c c e s s f u l and much p r a i s e d by h i s p a r e n t s . T h i s e x a g g e r a t i o n was seen as an attempt t o appear t o be someone who he was n o t so t h a t he t o o would be a c c e p t e d . When I was i n t r o d u c e d t o the case o f a v e r y d i s t u r b e d c h i l d , I was t o l d t h a t the mother i s " c r a z y t o o " . I saw the t h e r a p i s t ' s e f f o r t t o c o n v i n c e a p a t i e n t t h a t i t was n o t i m p o r t a n t t o keep s c o r e i n t h e i r d a r t game as a s t r a t e g y t o d i s p l a y t o the c h i l d t h a t u n l i k e home, t h e r e was no p r e s s u r e t o succeed i n the p l a y room. These i n s t a n c e s a r e f u r t h e r documents o f the u n d e r l y i n g p a t t e r n . I t was c l e a r t h a t t h e se a c c o u n t s depend upon our common sense f o r t h e i r meaning and r e l i e d upon our s h a r e d u n d e r s t a n d i n g o f the ' f a m i l y ' . To t a k e t h i s f u r t h e r , l e t me d e v e l o p what I w i l l r e f e r t o as f e a t u r e s o f the a d u l t i d e o l o g y . These are a l l f e a t u r e s t h a t were c o n s t r u c t e d i n some-what the same manner as the above. To demonstrate t h a t the r e a s o n a b l e n e s s o f t h e s e f e a t u r e s a r e c o n s i s t e n t w i t h everyday happenings I w i l l a l s o p r o -v i d e some non-therapy r e l a t e d examples. F e a t u r e s o f th e I d e o l o g y 1. A l l o f the above i n s t a n c e s o f u s i n g the p a t i e n t ' s f a m i l y t o ex-p l a i n b e h a v i o r are i n s t a n c e s o f a f e a t u r e I w i l l c a l l the o m n i - r e l e v a n c e o f 157 family membership and i t s multi-consequentiality. The instances above constitute an occasioned a p p l i c a t i o n of t h i s feature and are of the same character as a parent's concern that the "public" w i l l judge the moral character of the family on the basis of t h e i r children's manners i n restaurants, or as a teacher's concern that c h i l d r e n from "deprived'' 24 f a m i l i e s need s p e c i a l attention. 2. The f a c t that the c h i l d i s an involuntary p a t i e n t (and often does not know that he has a "problem") and i s occa s i o n a l l y forced to go (and sometimes carried) i n t o therapy i s a feature of what everyone knows; i . e . , that c h i l d r e n can not be responsible for making decisions since they do not know t h e i r own emotional or p h y s i c a l states. I t i s of the same character then as the parent's a b i l i t y to see that h i s c h i l d i s t i r e d , even when he i s making a noise and running around and denying his' t i r e d -25 ness. Or, the parent who knows that a c h i l d must be hungry. 3. The therapist's c h a r a c t e r i z a t i o n of a patient as a "player" or a " t a l k e r " and h i s a b i l i t y to see the immaturity (regressiveness) of play a c t i v i t y i s an occasioned a p p l i c a t i o n of notions of age and stage appropri-ate behavior. We know that 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 d i f f e r -ent thoughts, experience d i f f e r e n t emotions, and so on, according to t h e i r age. These differences are ref e r r e d to as stages. This reasoning may be compared to that of the parent who thinks that t h e i r daughter i s now too o l d to enjoy, appreciate or play with d o l l s , or to the businessman who acknowledges that c h i l d r e n go through a stage wherein they are e s p e c i a l l y 26 l i k e l y to do some s h o p l i f t i n g . 158 4. The therapist's use of play as a form of therapy.and a b i l i t y to determine the moral character of the player, derives from the idea that there i s some s p e c i a l r e l a t i o n between ch i l d r e n and play; that i t i s i n some ways an a c t i v i t y which i s uniquely t h e i r s . This i s of the same character as i s the reasoning of the parent who i n f e r s the moral character of the c h i l d r e n i n the neighbourhood from the way that they play, or the father who sees the concerns and/or a b i l i t i e s of h i s c h i l d r e n i n t h e i r 27 "playing school". 5. The therapist's seeing of human needs (such as dependency) and the e f f o r t to help the c h i l d get back on the proper track so that he can experience such needs and work through them can be seen as an a p p l i c a t i o n of our notions about developmental derailment. We know that c h i l d r e n are creatures who go through stages of development which, at any point can be stopped or be side tracked. Derailments are t y p i c a l l y a t t r i b u t e d to c e r t a i n s i g n i f i c a n t adults whereas r e h a b i l i t a t i o n i s assumed to be the r e s p o n s i b i l i t y of a l l adults. As such., . t h i s reasoning i s of a s i m i l a r character to that of the parent who t e l l s h i s doctor that h i s c h i l d does not seem to be a normal c h i l d , or the teacher'who evaluates the emotional state of p u p i l s and advises parents on how to remedy the problems. 6. The therapist's frequent praise of patient's appearance and the frequent p h y s i c a l contact i s , i n part, an occasioned a p p l i c a t i o n of the notion that c h i l d r e n can be commented upon, evaluated, touched, etc. at any time. As such, i t resembles the actions of the sales c l e r k who admires the c l o t h i n g of a child-customer, the house v i s i t o r who praises a c h i l d ' s c o l o r i n g a b i l i t y , or the stranger who r u f f l e s the h a i r of a young 159 passer-by. 7. The therapist's s e l e c t i o n of play objects which allow the c h i l d to make a mess, to express h i s anger and aggression towards the t h e r a p i s t , to make a noise, and the approval of those 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 of the notion that c h i l d r e n are v i o l a t o r s of adult "environ-ments" and that they may have a "need" to be l i k e t h i s . As such, i t i s of the same character as the reasoning of the family that has a play room fo r t h e i r c h i l d r e n , the parental approval of play schools, and even the frequent assignment of o l d clothes to c h i l d r e n as well as the negative sanctioning of v i o l a t i o n s . Whether or not one approves or disapproves of ch i l d r e n d i s t u r b i n g the normative environment with t h e i r noise, f i g h t i n g , breaking things etc., they are r o u t i n e l y seen as creatures who can be counted on to do such things and are unable to c o n t r o l themselves. One e i t h e r punishes them, or provides s p e c i a l items, c l o t h i n g , and so on for t h e i r a c t i v i t i e s : , or ignores them. However, one i s always aware of t h e i r 29 ' presence. 8. The therapist's awareness of the patient's need to t e s t the 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 to help him discover those l i m i t s i n a healthy way i s an occasioned a p p l i c a t i o n of the assumption that c h i l d r e n always t r y to discover the l i m i t s and need to know them so s e l f - c o n t r o l i s po s s i b l e . As such, they are r e l a t e d to the reasoning of the recreation leader who "comes on strong" with h i s - followers so that they w i l l know that they cannot get away with anything with him, or the group leader who r e a l i z e s that he has l o s t c o n t r o l of the group by being too " s o f t " . 160 9. Therapists often took some patients to the gymnasium as a f i n a l part of t h e i r therapy hour and allowed them to jump on the trampo-l i n e . This was explained as a way of l e t t i n g the c h i l d " l e t o f f some steam". I t was f e l t to be e s p e c i a l l y necessary with those patients who had b u i l t up a l o t of emotion (e.g., anger) during the therapy hour but had not released i t e f f e c t i v e l y (by t a l k i n g about i t , h i t t i n g the punching clowns, e t c . ) . Rather than send the patient home i n t h i s state, the ther a p i s t gave him some exercise. This i s an occasioned a p p l i c a t i o n of the notion that c h i l d r e n are victims of t h e i r bodies and/or emotions and need p h y s i c a l a c t i v i t y to make them c i v i l . . As such, i t i s somewhat l i k e the reasoning of the recreation leader who has h i s charges run around the gym before he t r i e s to teach them the rules of a new game. 10. The therapist's assistance i n making the c h i l d ' s a c t i v i t i e s successful f o r them, for example, h i s moving the "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 scores, f a i l i n g to out perform the patient i n competitions, etc., while done f o r good p s y c h i a t r i c reasons—such as removing pressure from the c h i l d , not f r u s -t r a t i n g the patient and thereby side-tracking the session, speeding up a c t i v i t i e s which are not productive, etc.--are occasioned applications of the assumption that c h i l d r e n are pre-competent actors. As such the therapist's assistance has the same character as that of the parent who regulates a c h i l d ' s d i e t , teachers who help students with t h e i r winter boots, or the sport coach who d e l i b e r a t e l y f a i l s to h i t the b a l l . ***** * 11. While the therapist's. provision of cookies, candies, or s o f t drinks 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 that i t establishes an 161 atmosphere o f t r u s t t h a t comes through s h a r i n g , i t i s a l s o an a p p l i c a t i o n o f t h e n o t i o n t h a t c h i l d r e n can be won, p a c i f i e d , encouraged, e t c . , by g i v i n g them t r e a t s and sometimes s h o u l d be rewarded f o r no r e a s o n a t a l l . As such t h e t h e r a p i s t ' s a c t i o n s a r e somewhat a k i n t o t h o s e o f t h e s t o r e c l e r k who g i v e s t h e c h i l d a b a l l o o n , the s t r a n g e r i n the p a r k who s h a r e s h i s popcorn, o r the d e n t i s t who g i v e s h i s s m a l l c l i e n t s some t r i n k e t s (something which he would n o t do w i t h a d u l t s ) . T h i s i s n o t meant as a d e f i n i t i v e l i s t i n g , r a t h e r i t i s o f f e r e d as an example o f how t h e e v e n t s o f the t h e r a p y room a r e i n s t a n c e s o f t h e g e n e r a l f e a t u r e s o f the a d u l t i d e o l o g y . I t p r o v i d e s us w i t h some o f the n o t i o n s o f the a d u l t i d e o l o g y and shows how the t h e r a p i s t ' s r e a s o n i n g i s an o c c a s i o n e d a p p l i c a t i o n t h e r e o f . I f the r e a d e r goes back o v e r t h e d a t a he w i l l be a b l e t o f i n d innumerable o t h e r i n s t a n c e s o f t h e s e f e a t u r e s and, o f c o u r s e , t o f i n d e v e n t s which s u g g e s t d i f f e r e n t f e a t u r e s . I would sug g e s t t h a t t h a t a c t i v i t y c o u l d c o n t i n u e f o r a l o n g t i m e . What we would be d o i n g i s e x p l a i n i n g t h e e v e n t s o f the t h e r a p y room i n terms o f the u n d e r s t a n d i n g s t h a t we a l l s h a r e . As I have sug g e s t e d p r e v i o u s l y , t h i s i s the same way t h a t the t h e r a p i s t s o p e r a t e . T h i s i s because the a d u l t i d e o l o g y i s a r e s o u r c e f o r b o t h t h e l a y p e r s o n and t h e e x p e r t , and t h i s i s n e c e s s a r i l y so. Thus, the e a r l i e r d i s t i n c t i o n between l a y and e x p e r t members now t a k e s on a d i f f e r e n t c h a r a c t e r . I t i s common f o r laymen and e x p e r t s t o each see t h e i r knowledge as d i f f e r e n t from, and sometimes as i n c o m p e t i t i o n w i t h each o t h e r . E x p e r t s a r e o f t e n s a i d t o o r c l a i m t o have the t r u t h about human o r o t h e r t y p e s o f b e h a v i o r . I t i s o f t e n assumed t h a t the t a s k o f the e x p e r t , because o f h i s 162 s p e c i a l i z e d knowledge i s t o remedy the knowledge o f the layman. F o r example, our e a r l i e r mention o f t h e c h i l d r e a r i n g l i t e r a t u r e on s o c i a l i z a -t i o n and c h i l d development c h a r a c t e r i z e d i t as an e f f o r t t o c o r r e c t t h e f a l s e assumptions 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 way the t h e r a p i s t can be thought o f as someone who i s supposed t o remedy t h e m i s t a k e s made by th e l a y person.. An e x a m i n a t i o n o f t h e p r a c t i s e s o f such e x p e r t s as s o c i o l o g i s t s and c h i l d t h e r a p i s t s demonstrates t h a t e x p e r t s u l t i m a t e l y use the same r e s o u r c e s as t h e l a y p e r s o n does. Zimmerman and P o l l n e r s u g g e s t t h a t : 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 the f o r m a l and 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 seeks 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 an e m i n e n t l y f o l k d i s c i p l i n e . . . . ^ (-) While I am s u g g e s t i n g t h a t t h e s o c i o l o g i s t , l i k e t h e t h e r a p i s t , i s an a d u l t member o f th e s o c i e t y , I am n o t argui n g , t h a t t h e r e a r e no d i s t i n c -t i o n s between t h e two. The d i f f e r e n c e s l i e i n the a c t i v i t i e s t h a t t h e y do. The s o c i o l o g i s t who 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 p r a c t i c e s shows h i s e x p e r t i s e by answering q u e s t i o n s based on the v e r y r e s o u r c e s t h a t a l l a d u l t s know and share i n common. Q u e s t i o n s such as "How do c h i l d r e n become competent s o c i a l a c t o r s ? " , "Why do some c h i l d r e n become d e v i a n t s ? " , o r "What i s t h e i n f l u e n c e o f s o c i a l c l a s s on p e r s o n a l i t y developments?", r e l y upon members' common sense knowledge o f the w o r l d . S i m i l a r l y , t h e c h i l d t h e r a p i s t p r a c t i c e s h i s e x p e r t i s e by a t t e n d i n g t o problems which a r i s e from and r e l y upon t h i s same r e s o u r c e . The q u e s t i o n s t h a t he i s concerned w i t h - "How can we make the c h i l d f e e l b e t t e r ? " , "How do we remedy the c h i l d ' s s e l f - c o n c e p t ? " , "Why d i d t h i s c h i l d become d i s t u r b e d ? " , o e t c . , a r e a l s o c o n c e r n s which t h e l a y a d u l t / p a r e n t and t h e e x p e r t have i n common. R e l a t e d l y , t h e y share assumptions about c h i l d r e n b e i n g s o c i a l i z e d 163 o r made i n t o a d u l t s by a d u l t s who t e a c h them v a l u e s , r o l e s , b e h a v i o r systems, and so on. T h e r e f o r e , t h e l a y e x p e r t dichotomy i s n o t based on s p e c i a l 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 o f i t s use. F o l k w i s -dom i s a r e s o u r c e t h a t i s and must be used by e i t h e r p a r t y t o e x p l a i n such t h i n g s as the b e h a v i o r o f c h i l d r e n . L e t us ta k e a second l o o k a t what t h e a d u l t i d e o l o g y a c c o m p l i s h e d f o r t h e t h e r a p y o c c a s i o n . The I d e o l o g y 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 B e h a v i o r In a s i m i l a r f a s h i o n t o the way i n which I was a b l e t o e x p l a i n t h i s s e t t i n g t o c o l l e a g u e s and o t h e r s by r e f e r e n c e t o t y p i f i c a t i o n s o f f a m i l i e s , c h i l d r e n , e t c . , t h e r a p i s t s were a b l e t o e x p l a i n t h e b e h a v i o r o f t h e i r p a t i e n t s , and th e m s e l v e s . That i s t o say, t h e p a t i e n t s ' b e h a v i o r c o u l d be e x p l a i n e d because i t c o u l d be t y p i f i e d . 31 A s i m i l a r use o f the i d e o l o g y c o u l d be seen i n t h e " s t o r y t e l l i n g " i n which t h e t r o u b l e w i t h a p a r t i c u l a r p a t i e n t c o u l d be made f a m i l i a r by showing i t t o be an i n s t a n c e o f a p a t t e r n . F o r example t h e p a t i e n t who made un 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 , e t c . , was n o t seen t o s u f f e r from something p e c u l i a r t o him a l o n e b u t was t a k e n as an example o f a f a m i l -i a r p r oblem w i t h new p a t i e n t s and h i s b e h a v i o r was seen as " t e s t i n g the l i m i t s " . What may have appeared t o be a s p e c i a l p r oblem i s now f a m i l i a r . S i m i l a r l y , t h e p a t i e n t who swore c o n t i n u o u s l y was t r a n s f o r m e d from a unique i n t o a f a m i l i a r c ase by t e l l i n g how t h i s was t o be ex p e c t e d o f a c h i l d who c o u l d n o t swear a t home. The d i s r u p t i v e b e h a v i o r now s t a n d s as e x p l a i n e d and u n p r o b l e m a t i c ( i n terms o f u n d e r s t a n d i n g i f n o t management) s i n c e i t f i t s i n t o a known p a t t e r n . F i n a l l y , t h e p a t i e n t who has a r e l a p s e , w h i l e p r o b l e m a t i c i n t h a t t h e g o a l o f t h e r a p y i s made more d i s t a n t , does n o t 164 d i s c r e d i t the t h e r a p y program. Rather, i t becomes a n o t h e r i n s t a n c e o f a n o t h e r f a m i l i a r p a t t e r n , t h a t i s , t h a t i n f l u e n c e o f the f a m i l y has sub-v e r t e d the t h e r a p i s t ' s e f f o r t s . The f a m i l y o f the p a t i e n t i s o f f e r e d as 32 an e x p l a n a t i o n o f t h e p a t i e n t ' s behavior,, thus making i t t y p i c a l . These e x p l a n a t i o n s o f t r o u b l e s a l s o s e r v e t o make the t h e r a p i s t ' s t r e a t m e n t o f , o r response t o , them appear t o be r a t i o n a l and t h e outcome one o f d e l i b e r a t e c h o i c e . While the e x p l a n a t i o n makes the p a t i e n t ' s b e h a v i o r f a m i l i a r i t a l s o makes t h e i r response r e a s o n a b l e . F o r example, the t h e r a p i s t i s v e r y t o l e r a n t o f the d i s r u p t i v e b e h a v i o r o f th e "new" p a t i e n t and, w i t h some e x c e p t i o n s , goes a l o n g w i t h h i s demands. S i n c e t h e s e t t i n g i s supposed t o have a p e r m i s s i v e atmosphere and s i n c e t h e above b e h a v i o r has been e x p l a i n e d as " t e s t i n g " , _ t now appears r e a s o n a b l e t h a t t h e t h e r a p i s t s h o u l d go a l o n g w i t h such t h i n g s . A f t e r a l l , i t w i l l o n l y l a s t a s h o r t w h i l e and w i l l h e l p c r e a t e an open r e l a t i o n s h i p . However, when t h i s same p a t i e n t c o n t i n u e s w i t h h i s d i s r u p t i v e b e h a v i o r i t becomes t r a n s f o r m e d by the t h e r a p i s t , i n t o bugging the t h e r a p i s t , o r m a n i p u l a t i v e b e h a v i o r and, t h u s , t h e t h e r a p i s t ' s response t o i t becomes l e s s t o l e r a n t . Those t h i n g s f o r which I am u s i n g the term " a d u l t i d e o l o g y " (and the term i s i t s e l f a g l o s s ) a r e o f f e r e d as e x p l a n a t i o n s o f p a t i e n t ' s b e h a v i o r , and make t h a t b e h a v i o r s e n s i b l e o r r a t i o n a l . T h at i s , t h e y made the b e h a v i o r s appear t o be t h e - r e a s o n a b l e outcome o f some s e t o f c i r c u m s t a n c e s which the p a t i e n t was d i r e c t l y o r i n d i r e c t l y i n f l u e n c e d by. I n d i r e c t l y s i n c e i t i s n o t always t a k e n t h a t t h e p a t i e n t i s aware o f t h e r e a s o n s f o r what he i s d o i n g . I t s t r u c t u r e d t h e t h e r a p i s t ' s environment by g i v i n g meaning t o e v e n t s o r by p l a c i n g them i n the c o n t e x t o f a p a t t e r n so t h a t t h e y became an i n s t a n c e o f a " k i n d o f a c t i o n " . F o r example, the a c t i o n o f t h e p a t i e n t who s y m b o l i c a l l y p a i n t e d the 165 s t r u g g l e s o f 'good' and ' e v i l ' becomes seen as " t h a t k i n d o f a c t i o n " by v i r t u e o f t h e a c c o u n t g i v e n . T h a t i s i t i s seen as t h e a c t i o n o f a c h i l d (and 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 i s s t r u g g l i n g under a p u r i t a n -i c a l p a t r i a r c h . T h i s p r o v i d e s f o r the symbolism o f the p a i n t i n g and a p l a u s i b l e m o t i v a t i o n a l s t r u c t u r e f o r the p a t i e n t . In more g e n e r a l terms th e n , what the " i d e o l o g y " (appeal t'o f a m i l y , e t c . ) does i s s t r u c t u r e t h e t h e r a p i s t ' s environment i n such a way t h a t t h e a c t i o n s o f t h e p a t i e n t appear t o be t h e r e a s o n a b l e outcome o f a c o r r e c t (adequate) c o u r s e o f r e a s o n i n g by the c h i l d . Knowing t h a t c o u r s e o f r e a s o n -i n g e n a b l e s the t h e r a p i s t t o u n d e r s t a n d t h e p a t i e n t , t o e x p l a i n h i s a c t i o n s , t o p r o v i d e an a p p r o p r i a t e t h e r a p e u t i c r e sponse o r environment f o r him, e t c . T h i s was d i s p l a y e d i n d r a m a t i c form i n the t h e r a p i s t ' s c o n c e r n w i t h the p a t i e n t who was u n d e r g o i n g a r e l a p s e . The t h e r a p i s t e x p l a i n e d t h i s i n terms o f f a m i l y t r o u b l e s and saw t h e r e l a p s e as the outcome o f a " c o r r e c t c o u r s e o f r e a s o n i n g " by the p a t i e n t . The t h e r a p i s t a l s o saw t h a t the c h i l d might have t o be p l a c e d i n t o a new f o s t e r f a m i l y i n o r d e r t o o b t a i n t h e b e s t p o s -s i b l e r e s u l t s . S i m i l a r l y , the b e h a v i o r o f th e g i r l who "wanted t o be a boy" i s seen to. be the e x p e c t e d outcome o f the f a m i l y ' s s t r u c t u r e and v a l u e s . T h i s i s seen as an adequate e x p l a n a t i o n o r m o t i v a t i o n a l a c c o u n t o f h e r a c t i o n s and, v i a t h i s e x p l a n a t i o n , t r e a t m e n t becomes o b v i o u s and r e a s o n a b l e . ' We c o u l d l o o k a t t h e a d u l t i d e o l o g y ( t a l k o f the f a m i l y , t a l k o f normal c h i l d r e n , and o t h e r f e a t u r e s d i s p l a y e d e a r l i e r ) t h e n as s i m p l y a way t o e x p l a i n c h i l d - p a t i e n t b e h a v i o r . However, the t a l k I have o f f e r e d as a d i s p l a y o f t h e i d e o l o g y was n o t an e x t e r n a l d e s c r i p t i o n b u t was i t s e l f a c o n s t i t u t i v e p a r t o f the s e t t i n g . I t o c c u r r e d i n t a l k between t h e r a p i s t and p a t i e n t , t h e r a p i s t and c o l l e a g u e and t h e r a p i s t and r e s e a r c h e r and 166 should be examined i n terms of these r e l a t i o n s h i p s . To do so would be to suggest that the ideology i s more than an external explanatory device but, whatever i t s function, i s consequential on the occasion of i t s t e l l i n g . While I suggested e a r l i e r that the ideology was consequential f o r me while out of the s e t t i n g i t was also consequential for me and others, i n the s e t t i n g . The Consequentiality of the Ideology My own t a l k of the family etc., was consequential i n the s e t t i n g insofar as I was able to ask appropriate questions, see the relevance of explanations, actions, etc., and, through t h i s , came to be seen as a competent member of the s e t t i n g . The reader w i l l have to take my com-petence on f a i t h and I hasten to add that t h i s competence does not imply that I should be seen as (or f e e l l i k e ) a t h e r a p i s t . Rather, I was seen as some one who understood what was going on, knew something about therapy, etc. As a r e s u l t , I was seen as a person who could be asked for opinions, 33 used as a sounding board, etc. The ideology was for me then a way to manage my competence. S i m i l a r l y , as we saw i n t r a n s c r i p t 4.9, a.student-therapist could appeal to the ideology (talk of the family) to construct a set of questions about the patient which were relevant to h i s problem. On another occasion a student observer upon watching a session i n which a young p a t i e n t l e f t the play room several times during the therapy hour, commented to the t h e r a p i s t : 5.1 0: Does she say good-bye a l o t h e r s e l f ? T: No. No, nor normally, t h i s i s a separation 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 k i n d e r g a r t e n , she has been i n our day c e n t e r d o w n s t a i r s so she, O: She says good-bye a l o t around the home now t o o . Does she say goodbye t o mother? While I saw t h i s s t u d e n t ' s q u e s t i o n i n g as ' o v e r c o n f i d e n c e ' , i t was c l e a r t h a t , i n w a t c h i n g t h e d o l l p l a y i n g r o u t i n e s , he had f o c u s e d on the i s s u e a t hand, t h a t o f s e p a r a t i o n a n x i e t y . I (and presumably the t h e r a p i s t ) h e a r d h i s t a l k as a d i s p l a y o f competence. By i d e n t i f y i n g some a c t i o n and then l o o k i n g f o r an account o f i t i n the p a t i e n t ' s f a m i l y s i t u a t i o n , i t i s p o s s i b l e t o g e n e r a t e c o n v e r s a t i o n s and manage them i n such a way as t o appear t o be an adequate and competent c o l l e a g u e . How was t h i s i d e o l o g y 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 s ? By a p p e a l i n g t o c h i l d development p a t t e r n s , t o t h e i r uses o f p l a y , t o y s , f a n t a s y , e t c . , t h e i r r e s p o n s e s t o strangers,, t h e i r t e s t i n g o f l i m i t s , s i g n i f i c a n t c a t e g o r i e s f o r them (e.g., p a r e n t ) , t h e i r needs, d e s i r e s , e t c . , the t h e r a p i s t i s a b l e t o make the p a t i e n t ' s b e h a v i o r i n t h e p l a y room t h e r a t i o n a l 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 t h a t o b t a i n i n t h i s p a r t i c u l a r s i t u a t i o n . The b e h a v i o r seen as an i n s t a n c e o f a p a t t e r n which e x i s t s i n d e p e n d e n t l y o f any one p a t i e n t . T h i s e n a b l e s the t h e r a p i s t t o t h i n k i n terms o f ' p a t i e n t s ' r a t h e r than o f t h e unique p e r s o n s who e n t e r the t h e r a p y room. T h i s i s n o t t o sug g e s t t h a t t h e r a p i s t s a r e unconcerned w i t h the unique p e r s o n , t h e y a r e . However, t o t r e a t each p a t i e n t as a unique p e r s o n a l o n e would mean t h a t e v e r y t h i n g which i s known about how t o o r g a n i z e and p r e p a r e f o r a s e s s i o n , how t o . u n d e r s t a n d t h e p a t i e n t ' s t a l k and a c t i o n s e t c . , would have t o be a c q u i r e d anew on e v e r y o c c a s i o n o f t h e i r use. C o n v e r s e l y , by a p p e a l i n g 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 , t h e t h e r a p i s t ' s a c t i o n s appear t o be the r a t i o n a l outcome o f a m o t i v a t e d 168 c o n s i d e r a t i o n . To a p p e a l t o age-and-stage t y p i f i c a t i o n s i n e x p l a i n i n g why the p l a y room has been p r e p a r e d i n a p a r t i c u l a r way i s t o show how one's a c t i o n s a r e r a t i o n a l ( r a t h e r than haphazard, a c c i d e n t a l , h a b i t u a l , e t c . ) . On many o c c a s i o n s , such accounts were p r o v i d e d by the t h e r a p i s t s , b u t I a l s o came t o p r o v i d e them f o r them. That i s , I c o u l d make t h e t h e r a p i s t ' s a c t i o n s r a t i o n a l by a p p e a l i n g t o statements l i k e , " t h a t ' s a good way t o handle c h i l d r e n " , o r " I s u s p e c t you have t o do t h a t w i t h c h i l d r e n " . I made innumerable a c t i o n s o f t h e r a p i s t s r a t i o n a l outcomes o f an a p p r o p r i a t e c o n s i d e r a t i o n o f t h e n a t u r e o f t h e c h i l d - p a t i e n t . F o r t h e t h e r a p i s t , and f o r the o b s e r v e r , t h e i d e o l o g y s e r v e d t o make v i s i b l e the r a t i o n a l i t y o f the s e t t i n g . F u r t h e r , w h i l e s t u d e n t - t h e r a p i s t s c o u l d a p p e a l t o t h e i d e o l o g y i n o r d e r t o g e n e r a t e a c o n v e r s a t i o n , t h e r a p i s t s c o u l d use i t as a way t o a u t h o r i t a t i v e l y end a l i n e o f q u e s t i o n i n g . o r a t o p i c . F o r example, by p r o v i d i n g an acco u n t whose a p p r o p r i a t e n e s s and r e l e v a n c e was so t r a n s -p a r e n t t h a t t o r e q u e s t 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 one's competence. I p r o v i d e d one i n s t a n c e o f t h e 'trauma' I m y s e l f e x p e r i e n c e d from ques-t i o n i n g such an acco u n t and, i n r e t r o s p e c t , I su g g e s t t h a t t h e r e were many o c c a s i o n s on which I d i d n o t f e e l t h a t I c o u l d r e a s o n a b l y ask f o r f u r t h e r a c c o u n t i n g even though I was d i s s a t i s f i e d w i t h t h e acco u n t t h a t was g i v e n . The ' i d e o l o g y ' was a l s o u s e f u l f o r t h e t h e r a p i s t s i n t r a n s f e r r i n g t h e causes o f e v e n t s l i k e r e l a p s e s and l a c k o f p r o g r e s s from t h e i r p r a c -t i c e s t o s i t u a t i o n s e x t e r n a l t o the t h e r a p y room. As su g g e s t e d e a r l i e r , the 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 which t h e t h e r a p i s t i s r e s p o n s i b l e f o r the p a t i e n t ' s t r e a t m e n t , p r o g r e s s , e t c . T hat i s , t h e t h e r a p i s t , 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 , t r a i n i n g , knowledge, and so 169 on, i s i n a p o s i t i o n t o i n t e r v e n e i n the l i f e o f the c h i l d t o s o l v e ( t h a t i s , t o h e l p the p a t i e n t s o l v e ) h i s problems. They a r e a c c o u n t a b l e f o r knowing what i s happening w i t h t h e i r p a t i e n t s , b e i n g a b l e t o r e p o r t (add t o t h e case f i l e ) on the s t a t u s o f each p a t i e n t , t o know when i t i s appro-p r i a t e o r i n a p p r o p r i a t e t o d i s c h a r g e p a t i e n t s , b e i n g a b l e t o r e a s o n a b l y p r e d i c t the p a t i e n t ' s moods, needs, e m o t i o n a l s t a t e s , e t c . I f , f o r example, t h i n g s appear t o go wrong w i t h t h e t r e a t m e n t p r o -gram o r i f p r o g r e s s i s n o t made a f t e r a r e a s o n a b l e time, i t may be a p p r o p r i -a t e t o sug g e s t t h a t the program has f a i l e d . T h at i s , t h a t i n some way t h e t h e r a p i s t has f a i l e d . In such c a s e s t h e t h e r a p i s t w i l l t y p i c a l l y a p p e a l t o 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 a r e beyond h i s c o n t r o l and have s u b v e r t e d the t h e r a p y program. What t h i s t a l k does then i s manage the r e l a t i o n s h i p between the t e l l e r and h e a r e r ( t h e r a p i s t and r e s e a r c h e r o r c o l l e a g u e ) . An adequate ac c o u n t i s p r o v i d e d t o d i s p l a y t h a t t h e t h e r a p i s t i s aware o f what i s happening and t r a n s f e r s t h e blame t o a p l a c e o u t s i d e o f the s e t t i n g . T h i s may appear t o r a i s e q u e s t i o n s o f d e c e i t , i . e . , a l t h o u g h the t h e r a p i s t knows t h a t he i s a t f a u l t , he a c c u s e s t h e f a m i l y . However, t h i s i s n o t what I am s u g g e s t i n g . I t i s always the case t h a t a h e a r e r has t o e v a l u a t e t h e adequacy o f o t h e r s ' a c c o u n t s and, as members, we a t t e n d t o a c t i o n s such as ' p a s s i n g t h e buck', ' f a l s e a c c u s a t i o n s ' , 'incompetence', e t c . (As the t h e r a p i s t s do as w e l l ) . The a c c o u n t s we have h e a r d appeared t o be e m i n e n t l y r e a s o n a b l e and adequate. Without adequate grounds f o r t h i n k i n g o t h e r w i s e one would r i s k h i s ' s t a t u s as a competent member o f th e s o c i e t y t o suggest t h a t f a m i l i e s don't m a t t e r . I s u s p e c t t h a t t h e r a p i s t s a c q u i r e d t h e i r n o t i o n s o f t h e adequacy o f t h e s e a c c o u n t s i n the same way the r e s e a r c h e r d i d . 170 While i t i s p o s s i b l e t o r e f e r 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 an i n t e r p r e t i v e schema f o r making sense o f b e h a v i o r o f t h e r a p i s t s and p a t i e n t s , i t s h o u l d n o t be thought o f as s i m p l y a schema which i s t o be a p p l i e d t o the p l a y room scenes, e t c . I t was used i n t h a t s e t t i n g by t h e r a p i s t s , s t u d e n t s , r e s e a r c h e r , p a r e n t s , e t c . , and i t s use was conse-q u e n t i a l i n o t h e r ways as w e l l . I t was a way t o manage c o n v e r s a t i o n s , r e l a t i o n s h i p 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 . The s u c c e s s o f t h a t management work i s c l e a r l y r e l a t e d t o t h e r e a s o n a b l e n e s s o f t h e i d e o l o g y i n e x p l a i n i n g p a t i e n t b e h a v i o r . Summary S t a r t i n g w i t h a p u z z l e about my a b i l i t y t o make adequate sense o f p l a y room a c t i v i t y I c o n s t r u c t e d a r e a s o n a b l e a c c o u n t o f p s y c h i a t r i c r e a s o n i n g . I d i s c o v e r e d some o f the methods which t h e r a p i s t s use f o r a c h i e v i n g u n d e r s t a n d i n g and e x p l a i n i n g t h e i r a c t i o n s . I th e n p r o c e e d e d t o c l a i m t h a t t h e r e a s o n a b l e n e s s o f p s y c h i a t r i c r e a s o n i n g (my acc o u n t o f 34 i t ) was t o be found i n our background e x p e c t a n c i e s o r t h e a d u l t i d e o l o g y . Not o n l y i s the a d u l t i d e o l o g y adequate f o r p r o v i d i n g r e a s o n a b l e a c c o u n t s f o r t h e r a p y r e l a t e d e v e n t s , i t i s i n t e r a c t i o n a l l y u s e f u l and c o n s e q u e n t i a l f o r a l l o f the r e l a t i o n s h i p s i n t h e . s e t t i n g . I t i s i n p a r t a management d e v i c e f o r h a n d l i n g c o n v e r s a t i o n s , r e l a t i o n s h i p s , o r g a n i z a t i o n , e t c . While a l l o f the above appears t o be c o h e r e n t and a l l - o f - a - p i e c e , i . e . , the i d e o l o g y t i e s t o g e t h e r many see m i n g l y u n r e l a t e d e v e n t s , i t s h o u l d be remembered t h a t t h e acc o u n t o f t h e i d e o l o g y was t h e s o l u t i o n f o r an i n t e n s i v e p r a c t i c a l problem. T h a t i s , i t s o l v e d my p u z z l e o f d i s c o v e r i n g a way t o a d e q u a t e l y u n d e r s t a n d and d e s c r i b e the way t h a t t h e r a p i s t s o p e r a t e d i n t h e f i e l d s e t t i n g . The a d u l t i d e o l o g y s o l v e s t h e t h e r a p i s t ' s problems o f managing p a t i e n t s and i t c l e a r l y s o l v e d my problem. My c l a i m f o r the e x p l a n a t o r y power o f th e i d e o l o g y s h o u l d be seen i n r e l a t i o n t o t h e s o l u t i o n o f my p r a c t i c a l problem. L e t us r e c o n s i d e r the s t a t u s o f t h i s i d e o l o g y . 172 Footnotes "We propose to suspend conventional i n t e r e s t i n the t o p i c of members p r a c t i c a l i nvestigations and urge the p l a c i n g of exclusive emphasis on inquiry 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, lay or p r o f e s s i o n a l . The t o p i c then would consist not i n the s o c i a l order as o r d i n a r i l y con-ceived but rather i n the ways i n which members assemble p a r t i c u l a r scenes so as to provide f o r one another evidence of a s o c i a l order as o r d i n a r i l y conceived". D. Zimmerman, M. Pollner, "The Everyday World as a Phenomena", i n Jack Douglas (ed.), Understanding Everyday L i f e , Aldine, 1970, p. 80. H. G a r f i n k e l , Studies i n Ethnomethodology, P r e n t i c e - H a l l , 1967, p. 273. For a discussion of 'doubt' and the a c t i v i t i e s of 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 Rational Properties of S c i e n t i f i c and Common Sense A c t i v i t i e s " , In Studies i n Ethnomethodology, 1967. 2 J . P. Thome, "On Hearing 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. Press, 1966. 3 E. Leach, "Anthropological Aspects of Language: Animal Categories and Verbal Abuse", In E. Lenneberg, New D i r e c t i o n i n the Study of Language, M.I.T. Press, 1964. 4 P a r t i c u l a r l y lecture notes, 1966-1969. 5 The c e n t r a l notions of Schutz' work can be found i n C o l l e c t e d Papers 1. M. Natanson (ed.) The Hague: Martinus 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 , Typologies and S o c i a l Theory", S o c i a l  Forces, 1969, p. 1. Q For a discussion of 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 Rational Properties of 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 recorded lecture d e l i v e r e d i n the summer of 1968 to the conference on "Language, Society and the C h i l d " , sponsored by Department of Anthropology, Berkeley. 1(^M. Speier, "The C h i l d as Conversationalist: Some Culture Contact Features of Conversational Interaction Between Adults and Children", i n Roy Turner (ed.) S o c i a l i z a t i o n , Basic Books, forthcoming. 1 1 T h i s i s a concept with a long and d i f f i c u l t h i s t o r y and I use i t with hesitancy but i t conveys my e s s e n t i a l point 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 very d i f f e r e n t manner and I do not challenge that usage. See p a r t i c u l a r l y , "Women's Perspective as a Radical C r i t i q u e of Sociology", S o c i o l o g i c a l Inquiry 44, (1974) 7-14; and "Theorizing as Ideology", i n R. Turner, Ethnomethodology, Penguin Books, 1974. 173 12 While the e x c i t i n g work of 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 of i t . See f o r example, I. Opie, P. Opie, The Lore and Language of Schoolchildren. London: Oxford U n i v e r s i t y Press, 1959. 13 The notion of a children's culture was f i r s t brought to my attention by H. Sacks and M. Speier. See f o r example, M. Speier, "The Everyday World of the C h i l d " , i n J . Douglas (ed.) Understanding Everyday L i f e . Aldine, 1970. I t i s almost impossible to f i n d use of t h i s notion i n the s o c i a l sciences although the concept of culture has been applied to innum-erable other populations. There appears to be some recent i n t e r e s t i n the notion ' as evidenced by the work of M. Goodman, M. Speier, and more recently R. McKay; see, "Conceptions of Children and Models of S o c i a l i z a -t i o n " , i n R. Turner (ed.) Ethnomethodology. Penguin Books, 1974, pp. 180-194; and H. D r e i t z e l , Childhood and S o c i a l i z a t i o n : Recent Sociology  #5. New York, Macmillan, 1973. 14 The Culture of Children: Child's Eye Views of Society and Culture. New York: Teachers College Press, 1970. Ibid ., p. 2. 1 6 I b i d . 17 M. Speier, "The C h i l d as Conversationalist", pp. 1-2. 18 For a discussion of 'topic' and 'resource' see Don Zimmerman, M. P o l l n e r , "The Everyday World as a Phenomenon", i n J . Douglas (ed.) Understanding Everyday L i f e , pp. 80-103. 19 Op. c i t . , p. 2. 20 For examples of t h i s the reader can look back to the materials presented e a r l i e r , p a r t i c u l a r l y those pieces of advice on how to t a l k to chi l d r e n , how to greet them, etc. 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 Process i n Children'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 , Berkeley, 1969; and "The C h i l d as Conversationalist", Op. c i t . 22 The notion of 'ideology' has been used i n medical sociology to d i s t i n g u i s h between 'schools' of therapy. Strauss et a l have been able to group th e r a p i s t s i n t o three groups (somatherapy, psychotherapy, socio-therapy) by the analysis of questionnaire items they believed r e f l e c t e d the ideologies. Presumably one could do the same with c h i l d psychiatry. What t h i s notion of ideology points to i s a set of sanctionable b e l i e f s , assumptions, knowledge that supports one's membership i n some p r o f e s s i o n a l community. I t was not simply that the researchers were able to recon-s t r u c t p r o f e s s i o n a l ideologies but i t was taken that those b e l i e f s , etc. were shared, transmitted, reinforced, sanctioned, etc. by colleagues. For examples of t h i s usage see, A. Strauss, 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 Ideologies and I n s t i t u t i o n s . Free Press, 1964; or 174 M. R. Sharf, D. J . Levinson, "Patterns of 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 Residents", i n Greenblatt et a l , (ed.) The Patient and,  the Mental Hospital. Free Press, 1957, pp. 2633-285. More re c e n t l y see, P. E l l i o t t , "Professional 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 For a discussion of the documentary method see H. G a r f i n k e l , "Common Sense Knowledge of S o c i a l Structures: The Documentary Method of Interpre-t a t i o n i n Lay and Professional Fact Finding", i n Studies i n Ethnomethodol- ogy. "The focus on p r a c t i c a l reasoning emphasizes that the t a l k accomplishes scenes and t h e i r contained a c t i v i t i e s ; i t emphasizes that members are - as a condition of t h e i r competence - rendering scenes i n t e l l i g i b l e , reasonable, accountable, that t h e i r world i s a constant doing and achieving. ' P r a c t i c a l ' actors make and f i n d a reasonable world; t h e i r doing 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, "Introduction", p. 10. 24 Consider the following conversation reported by a l o c a l newspaper with a mother whose 13 year-old son had k i l l e d a store employer the night previously. "She s a i d the boy r a r e l y stayed out l a t e except when he stayed at a friend's house. Monday he l e f t to go to school at about 8:30 a.m. a f t e r leaving her a note saying he was going to see h i s father. She d i d not see or hear him again u n t i l Tuesday afternoon. 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,, that he had been staying with h i s father. U n s a t i s f i e d the mother took him to p o l i c e headquarters". Vancouver Sun, December 4, 1974. The concern of a l l readers of t h i s story was puzzlement over why a 13-year-old would murder. Although we learn that the mother and father do not l i v e together, the mother's report portrays a 'normal' family l i f e i n which she has control of her son, i . e . , she was a good mother. 25 This i s further displayed i n the treatment philosophy inherent i n juvenile delinquency l e g i s l a t i o n . 2 6 Consider the opening l i n e s of The Way to the Stars, a book for boys (and parents) i n the cub program: "cubbing i s a program for boys of 8, 9, and 10 years of age working with adults who understand and have an apprec-i a t i o n of the nature and needs of boys of t h i s age". National Council of Boy Scouts of Canada, (rev.) 1968. One can also look to Dr. Spock for descriptions of the ' t e r r i b l e twos', 'try i n g threes', etc. 27 See footnote 4 i n chapter three. 28 Consider the reader's, problem for Ann Landers. Dear Ann: We have a four-month-old baby who i s very cute. She has a d a r l i n g p e r s o n a l i t y , i s very f r i e n d l y and i s always smiling. The problem i s n ' t the baby's, i t ' s mine. I hate i t when people t r y to touch her. E s p e c i a l l y i f they appear to have a cold. Sometimes they have j u s t coughed into t h e i r hands and then they want to put t h e i r germy fingers on my c h i l d ' s face. I t drives me wild. Salespeople 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 to touch that money? He or she might have had some t e r r i b l e disease. Hands o f f . Answer: 175 Your preoccupation with germs goes beyond a mother's natural concern. . . . Please discuss t h i s with your p e d i a t r i c i a n and hopefully he can remove the k l i n k e r from your thinker. Vancouver Sun, June 11, 1974. 29 One can discover ample evidence of t h i s i n l e t t e r s to the e d i t o r where c i t i z e n s complain about the need to c o n t r o l those who occupy parks, roam i n packs, break windows, make loud,noises, etc. For example, consider 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 Slocan Park". "Night a f t e r night, 30 to 50 youths come to break things and keep the taxpayer awake. Metal garage doors with the wrinkled look, windows are non-existent, garbage cans f l a t , contents'everywhere, cats with throats cut, rocks on sun-decks". Vancouver Sun. 30 Op. c i t . , p. 82. 31 This notion of "story t e l l i n g " i s taken from D. L. Wieder, The Convict Code: A Study of a Moral Order as a Persuasive A c t i v i t y . Unpub-l i s h e d Doctoral D i s s e r t a t i o n , Department of Sociology, U.C.L.A., 1969. 32 I have also found that physiotherapists working with cerebral p a l s i e d c h i l d r e n w i l l explain the patient's lack of progress with h i s walking s k i l l s on the way the parents handle the c h i l d at home. A document on t h i s handling i s the f a c t that parents carry t h e i r c h i l d r e n from the c l i n i c to the car. 33 At one point a supervisor suggested I help her i n making a f i l m about play therapy, she appealed to my " s e n s i t i v i t y " to what transpired i n therapy sessions. 34 I t should be noted that I am not suggesting that the adult ideology has the same status the convict code does i n the halfway house as reported by Wieder. CHAPTER 6 THE STATUS OF THE IDEOLOGY In the p r e c e d i n g c h a p t e r s I showed how the a d u l t i d e o l o g y i s a r e s o u r c e f o r making sense o f t h e t h e r a p y s e t t i n g . I t a l l o w e d me t o s a t i s f a c t o r i l y t e r m i n a t e my i n q u i r i e s about what was b e h i n d t h e s i g h t s and sounds p r e s e n t e d i n the f i r s t c h a p t e r . F u r t h e r , i t p r o v i d e d the key t o the p r a c t i c a l r e a s o n i n g o f t h e t h e r a p y e n t e r p r i s e and p r o v e d t o be a c o n t i n u o u s r e s o u r c e f o r examining a n d ' e x p l a i n i n g phenomena. I t formed a g e s t a l t which e n a b l e d me t o b r i n g f u r t h e r a s p e c t s o f the a c t i v i t i e s which I o b s e r v e d i n the s e t t i n g under st u d y . Upon f i n d i n g t h a t the a d u l t i d e o l o g y a l l o w e d me t o make sense o f the s e t t i n g , I began t o t r e a t i t as a ' r e a l ' f i n d i n g . O f t e n , I found m y s e l f d e f e n d i n g i t s f u n c t i o n i n the t h e r a p y room. A l t h o u g h the members o f the s e t t i n g had n o t spoken o f the i d e o l o g y , I began t o make r e f e r e n c e s t o the " o f c o u r s e " n a t u r e o f t h e i r a c t i o n s i n d e a l i n g w i t h c h i l d r e n — " o f c o u r s e " t h e y had t o t h i n k o f , t r e a t , t a l k t o , e t c . , p a t i e n t s i n the way t h a t t h e y d i d . I had o c c a s i o n a l l y argued w i t h c o l l e a g u e s t h a t the a d u l t i d e o l o g y p r o v i d e d an a c c o u n t o f "what was r e a l l y g o i n g on". T h i s may have come thr o u g h t o t h e r e a d e r , however, we must now s t o p and c o n s i d e r the s t a t u s o f t h a t i d e o l o g y . E a r l i e r i n t h i s r e p o r t i t was s u g g e s t e d t h a t c h i l d p s y c h o t h e r a p y i s a t h e o r y - g o v e r n e d a c t i v i t y . T h at i s , t h e r e a r e b o d i e s o f t h e o r e t i c a l knowledge (e.g., t h e o r i e s o f p e r s o n a l i t y development) t h a t can be a p p e a l e d t o . I have a l s o demonstrated t h a t a major consequence o f th e t h e r a p y e n c o u n t e r i s e x p l a n a t i o n . That i s , t h e r a p i s t s a r e c o n s t a n t l y answering 176 177 'why questions' about the patient's a c t i v i t i e s i n the play room and can answer s i m i l a r questions about t h e i r own actions. For example: The th e r a p i s t must be a l e r t to r e f l e c t the unspoken wishes of the s i l e n t c h i l d . The c h i l d ' s handling of the doorknob may be s a f e l y interpreted as "you want to go out". 1 While we can see that t h i s i s an 'explanation' of the handling of the door-knob, we could ask i n what sense i t i s theory-governed. That i s , are the explanations found i n the therapy s e t t i n g the consequence of the a p p l i c a -t i o n of some s p e c i f i c theory which therapists resort to? Do events, actions, etc. follow n e c e s s a r i l y from a theory? As was the case with the adult ideology, t h i s p s y c h i a t r i c 'theory' was ever e x p l i c i t l y l a i d out for me (although reference was made to i t inso f a r as I was d i r e c t e d to the l i t e r a t u r e , i . e . , to notions of c h i l d development, etc.) During my f i e l d work I also acquired a c e r t a i n competence which allowed me to see things i n much the same way as the therapists did. I have r e f e r r e d to t h i s as 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". The reader w i l l r e c a l l that the status of t h i s schema remained a puzzle f o r me. (The puzzle which I resolved by appealing to the adult ideology). My problem with 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 the 'evidence' f o r the explanations provided i n the setting? and (2) What were i t s boundaries? Although other laymen with whom I discussed my f i e l d work pressed me to make evaluative statements about the adequacy of p s y c h i a t r i c theory and i t s effectiveness (they asked, "Does therapy r e a l l y work?"), t h i s was not my i n t e r e s t . I had trouble getting hold of the p s y c h i a t r i c schema because of d i f f i c u l t i e s i n obtaining evidence f o r i t and t h i s forced me to think about i t s status. As Hutten i n speaking about explanations says: 178 We say t h a t we have e x p l a i n e d a phenomenon i f we can 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 must p r o v i d e a t h e o r y and a law, o r s e t o f laws, by means o f which we can d e s c r i b e the phenomenon and r e l a t e i t t o o t h e r s i m i l a r , phenomena. And, second, we must be a b l e t o o b t a i n from the t h e o r y 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 the 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 as c o n f i r m e d artd we a c c e p t the t h e o r y as a v a l i d e x p l a n a -t i o n o f the phenomenon. 2 P r e d i c t i o n i s a k i n d o f e v i d e n c e because i t a l l o w s us t o e x p e c t a r e l a t i o n s h i p between d i f f e r e n t phenomena. What I d i d come t o see was a number o f i n d i v i d u a l r e l a t i o n s h i p s — r e l a t i o n s between some k i n d s o f f a m i l y s i t u a t i o n s and anger, between some k i n d s o f f a m i l y s i t u a t i o n s and depen-dency, between r e l a p s e s and new problems, between r e l a p s e s and p a r e n t s t e r m i n a t i n g t h e i r t h e r a p y , o r p a i n t i n g s and r e l i g i o u s symbolism, e t c . The p u z z l e was t h a t , h a v i n g o n l y t h e s e r e l a t i o n s h i p s , I d i d n o t know what would happen n e x t t i m e , f o r each new o c c u r r e n c e had t o be a u t h o r i t a t i v e l y e x p l a i n e d by the t h e r a p i s t . Whenever I asked, f o r example, How do you know t h a t the c h i l d ' s p l a y i n g w i t h the doorknob i n d i c a t e d a d e s i r e t o l e a v e ? t h e answer t h a t I r e c e i v e d went something l i k e , " I f you've seen i t as many times as I have you come t o know about i t " , o r o t h e r statements t h a t a p p e a l e d t o p r e v i o u s e x p e r i e n c e . G i v e n t h e e x p l a n a t i o n s t h a t I had, I was n o t a b l e t o t e l l which would work ne x t time. Even i f I had known a l l o f the 'independent v a r i a b l e s ' , I would n o t have been a b l e t o t e l l what would count as an i n s t a n c e o f an event r e l a t e d t o t h o s e v a r i a b l e s s i m p l y by w a t c h i n g the s e s s i o n s . We can r e f e r t o my p u z z l e as t h e o b s e r v e r ' s problem. T h a t i s , the o b s e r v e r must t r a n s f o r m e v e n t s ( e x p l a n -a t i o n s ) i n t o 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 . T h i s was t h e p r o b l e m which the a d u l t i d e o l o g y s o l v e d f o r me. The r e l a t i o n s h i p between ev e n t s and e x p l a n a t o r y v a r i a b l e s was n o t a p r e d i c t i v e one. B e f o r e r e t u r n i n g t o t h i s , l e t me i n t r o d u c e t h e second a s p e c t o f my p u z z l e : knowing what the b o u n d a r i e s t o the e x p l a n a t o r y schema 179 were. I s u g g e s t e d e a r l i e r t h a t I f e l t t h a t the schema was b o t h r e l e n t -l e s s and i n e s c a p a b l e , t h a t i s , e v e r y happening was a p o s s i b l e d a t a s o u r c e f o r the t h e r a p i s t and i t was n o t c l e a r what o r when something would come t o be r e l e v a n t . O b v i o u s l y , e v e r y e v e n t was n o t r e l e v a n t i n e v e r y s i t u a -t i o n f o r the t h e r a p i s t would be overwhelmed. However, some t h i n g s became i m p o r t a n t i n unexpected ways. Here i s an example o f the d e t a i l w i t h which an e n c o u n t e r c o u l d be s c r e e n e d : Even b e f o r e the i n t e r v i e w i t s e l f , much can be l e a r n e d about the r e l a t i o n s h i p between mother and c h i l d . . . •. What i s h e r manner as 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 the 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 c h i l d ? Does he swish and h i t h i s mother w i t h h i s c o a t as he t a k e s i t o f f ? Do t h e y s i t - c l o s e t o g e t h e r on the couch o r as f a r a p a r t as p o s s i b l e . . . . 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; does he l i m p , walk on h i s t o e s , o r d r a g h i s f e e t ; does he s l a p t h e f u r n i t u r e as he walks by; does he r a c e ahead, c l i n g t o h i s mother, o r l a g f a r b e h i n d . 3 N o t h i n g seems t o escape the eye o f the t h e r a p i s t . Any e v e n t c o u l d become d a t a f o r t h e i n t e r p r e t i v e schema so t h a t something c o u l d be made o f any o f t h e s e a c t i o n s . Which would become i m p o r t a n t however was n o t easy t o see. The t h e r a p i s t does n o t p r e d i c t which o f t h e s e a c t i o n sequences w i l l go w i t h which c h i l d ; i . e . , t h e t h e r a p i s t s do n o t say t h a t " t h i s c h i l d " (or "a c h i l d w i t h t h i s problem") w i l l " s l a p the f u r n i t u r e as he goes by". The t h e o r y does n o t a l l o w him t o p r e d i c t which o f the innumerable p o s s i b l e outcomes w i l l come t o p a s s . Rather, the s i g n i f i c a n c e o f t h e a c t i o n i s d i s c o v e r e d " a f t e r t h e f a c t " . R e c a l l the p a t i e n t w i t h a sex i d e n t i f i c a t i o n problem. The t h e r a p i s t d i d n o t p r e d i c t t h a t female c h i l d r e n who were the l a s t b o r n would have such problems. Rather, g i v e n a p a t i e n t w i t h a s e x u a l i d e n t i f i c a t i o n problem, i t c o u l d . t h e n be p a r t i a l l y e x p l a i n e d by r e f e r e n c e t o t h i s c h i l d ' s s i b l i n g o r d e r . S i m i l a r l y , t h e r a p i s t s d i d n o t p r e d i c t 180 t h a t c h i l d r e n who had been t r a u m a t i z e d by a death i n t h e f a m i l y would t a l k o f "dead b i r d s " . R ather, they e x p l a i n e d the t a l k o f dead b i r d s by r e f e r r i n g t o a death i n the f a m i l y . The f a c t o f a d e a t h i n t h e f a m i l y became r e l e v a n t o n l y 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 e v e n t . F i n a l l y , a p a t i e n t ' s c o n t i n u a l r e q u e s t s f o r p e r m i s s i o n t o do t h i n g s i n the p l a y 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 f e e l i n g s o f r e s p o n s i b i l i t y f o r h i s f a t h e r ' s d eath and a t h e r a p i s t c o u l d n o t have p r e d i c t e d t h a t a b e r e a v e d son would ask f o r p e r m i s s i o n t o g e t t o y s from the t o y box. 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 was n o t used p r e d i c t i v e l y , b u t was used f o r t h e p o s t hoc d i s c o v e r y 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 n t h e p a t i e n t ' s b e h a v i o r . I t was p r e c i s e l y because o f the p o s t hoc n a t u r e o f e x p l a n a t i o n s t h a t I had some d i f f i c u l t y i n u n d e r s t a n d i n g t h i s schema and coming t o terms w i t h i t . An o b v i o u s i m p l i c a t i o n i s t h a t o f i t s i n d e f i n -i t e s t a t u s whereby i t can n o t be p r e d i c t e d what i t w i l l be used t o e x p l a i n n e x t o r how i t w i l l e x p l a i n i t . These f e a t u r e s c o n t i n u e d t o make t h e s t a t u s o f the schema p u z z l i n g . I t was o n l y a f t e r a number o f months i n t h e f i e l d t h a t I d i s c o v e r e d t h a t I had a c h i e v e d a s o l u t i o n t o my " o b s e r v e r ' s problem". S p e c i f i c a l l y , I saw t h a t I d i d have a method f o r t r a n s f o r m i n g e v e n t s i n t o 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 . The a d u l t i d e o l o g y a c c o m p l i s h e d t h i s f o r me. C l e a r l y , the a d u l t i d e o l o g y a l l o w e d f o r accounts and e x p l a n a t i o n s t h a t were adequate f o r a l l p r a c t i c a l p u r p o s e s . I t a l l o w e d me t o make s a t i s f a c t o r y sense o u t o f the s e t t i n g and i t s e v e n t s and, as such, i s a d i s p l a y o f p r a c t i c a l r e a s o n i n g . Accounts a r e adequate, s a t i s f a c t o r y , e t c . , p r e c i s e l y because t h e y t r a d e on our f o l k wisdom about c h i l d r e n . F o r example, whatever the t h e r a p i s t ' s a t t r i b u t i o n o f motives t o the p a t i e n t 181 when he t o l d a p a t i e n t t h a t : T: I t h i n k mom won't mind us p l a y i n g w i t h the mucky sand and water. That's okay w i t h h e r . i t was r e a s o n a b l e t o e x p l a i n h i s statement as an e f f o r t t o r e a s s u r e the c h i l d t h a t i t was a l r i g h t t o go ahead and make a mess. We a l l know t h a t c h i l d r e n o f t e n g e t d i r t y . Perhaps t h e y e n j o y i t , b u t more o f t e n than n o t , they g e t i n t o t r o u b l e f o r i t . S i m i l a r l y , a l t h o u g h t h e t h e r a p i s t ' s e x p l a n -a t i o n 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 r e f e r r i n g t o the p a t i e n t s h a v i n g been w i t h h i s mother may have some t h e o r e t i c a l g r o u n d i n g , i t a l s o seems adequate t o s u g g e s t t h a t the t h e r a p i s t was a t t e n d i n g t o the i n f l u e n c e 4 o f p a r e n t s on the e m o t i o n a l s t a t e o f t h e i r c h i l d r e n . I t i s i n t e r e s t i n g t h a t , i n a s e t t i n g which i s t h e o r y governed and p r o v i d e s a c c o u n t s and e x p l a n a t i o n s i n terms o f t h a t t h e o r y , the a d u l t i d e o l o g y a l s o p r o v i d e s a r e a s o n a b l e a c c o u n t o f what i s g o i n g on. Regard-l e s s o f what t h e r a p i s t s say t h e y a r e d o i n g , the i d e o l o g y makes p e r f e c t l y adequate sense. T h e r a p i s t s t o o have an o b s e r v e r ' s problem and, f o r some time, I thought t h a t my d i s c o v e r y o f the a d u l t i d e o l o g y was a d i s c o v e r y o f how they s o l v e d t h e i r o b s e r v e r ' s problem. I f t h i s were so, one way t o view the a d u l t i d e o l o g y would be as a ' t h e o r y ' , f o r i t does what we e x p e c t a t h e o r y t o d o — i t e x p l a i n s t h i n g s . As a t h e o r y 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 a c c o u n t s o f what t h e y were d o i n g . They e x p l a i n e d t h e i r a c t i o n s and made i n t e r p r e t a t i o n s i n terms o f p s y c h i a t r i c o b j e c t i v e s , t h e o r y , and t e c h n i q u e s , and, as I have demonstrated, t h e s e e x p l a n a t i o n s were p o s t hoc a c c o u n t s . The ' r e a l ' e x p l a n a t i o n and i n t e r p r e t a t i o n might be based on t h e a d u l t i d e o l o g y . F o r example, w h i l e t h e r a p i s t s r e c o g n i z e t h e c h i l d ' s e m o t i o n a l s t a t e i n h i s p l a y , I have sug g e s t e d t h a t t h i s i s an o c c a s i o n e d a p p l i c a t i o n o f the 182 s p e c i a l r e l a t i o n s h i p seen t o o b t a i n between c h i l d r e n and t h e i r p l a y . Moreover, w h i l e t h e i r i n t e r p r e t a t i o n s a p p e a l t o the v a l u e s t r u c t u r e o f the f a m i l y and t o t h e psyc h o - d e v e l o p m e n t a l 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 a p p l i c a t i o n s o f the o m n i - r e l e v a n c e o f f a m i l i e s . I f we were t o t r e a t t h e a d u l t i d e o l o g y i n t h i s way, a f u r t h e r c h a r a c t e r i s t i c t h a t we c o u l d e x p e c t , i n d e e d , demand o f i t , would be p r e -d i c t a b i l i t y . T h a t i s , on the b a s i s o f t h e i d e o l o g y , one s h o u l d be a b l e t o p r e d i c t b e h a v i o r i n the t h e r a p y s e t t i n g . T h i s i s c l e a r l y n o t t h e case however. One cannot t a k e a f e a t u r e o f t h e i d e o l o g y t h a t s u g g e s t s t h a t p a r e n t a l i n f l u e n c e s on c h i l d r e n can be seen i n t h e i r e m o t i o n a l and b e h a v i -o r a l d i s p l a y s and thus p r e d i c t t h a t t h e r a p i s t s would blame a p a t i e n t ' s u n u s u a l l y d i s r u p t i v e b e h a v i o r on a p r o l o n g e d s t a y w i t h h i s mother. S i m i l a r l y one cannot assume t h a t a c e r t a i n moral environment i n t h e c h i l d ' s home w i l l a c c o u n t f o r a c h i l d s wearing i n the t h e r a p y room. To say t h a t " s i n c e he cannot swear a t home, he w i l l d e l i b e r a t e l y swear i n t h e r a p y " , o r t h a t " s i n c e everyone swears a t home, he w i l l swear as w e l l " , o r t h a t "he i s showing d i s r e s p e c t " , a l l seem adequate. F i n a l l y , w i t h r e f e r e n c e t o a p a t i e n t whom we have mentioned e a r l i e r , common sense n o t i o n s about the i n f l u e n c e o f s i b l i n g s t r u c t u r e on b e h a v i o r do n o t a l l o w one t o p r e d i c t t h a t one's f i r s t b o r n s t a t u s w i l l be used t o a c c o u n t f o r sex i d e n t i f i c a -t i o n problems. I n a p r e v i o u s t r a n s c r i p t , i t appeared t o be e q u a l l y p r o b a b l e t h a t one's f i r s t b o rn o r l a s t b o r n s t a t u s were adequate a c c o u n t s o f s e x u a l i d e n t i f i c a t i o n problems. I w i l l g i v e i t a g a i n h e r e . S: How many c h i l d r e n a r e t h e r e ? T: Three i n the f a m i l y . S: And she's t h e o l d e s t ? T: She's t h e youngest. 183 S: The youngest. T: And t h e r e ' s two o l d e r b r o t h e r s . S: Ahhh. ((tone o f r e c o g n i t i o n ) ) W h i l e t h e t h e r a p i s t may have seen the adequacy o f t h e s e two a l t e r -n a t i v e s i n terms o f a p s y c h i a t r i c t h e o r y , I found t h e i r adequacy t o be o b v i o u s . F o r example we know t h a t b e i n g a f i r s t b o r n c h i l d ( o l d e s t ) may p r e s e n t some d i f f i c u l t i e s , t h e r e f o r e the o l d e s t c h i l d a l t e r n a t i v e seems r e a s o n a b l e . The youngest c h i l d a l t e r n a t i v e a l s o makes sense because we know t h a t b e i n g a g i r l w i t h two o l d e r b r o t h e r s can make f o r a d i f f i c u l t s i t u a t i o n . The a d u l t i d e o l o g y does n o t have t h i s k i n d o f p r e d i c t i v i t y . I f we e x p e c t a t h e o r y t o a i d us i n s e l e c t i n g t h e c o r r e c t a l t e r n a t i v e from a l i s t o f competing a l t e r n a t i v e s , we s h o u l d l o o k e l s e w h e r e t o s a t i s f y t h a t r e q u i r e -ment. In the p r e v i o u s example i t d i d n o t a l l o w us t o choose between com-p e t i n g a l t e r n a t i v e s — f i r s t b o r n o r l a s t b orn. What i t does a c c o m p l i s h i s the d i s c o v e r y o f ' a p p r o p r i a t e ' b e h a v i o r , t h a t i s , g i v e n a b e h a v i o r , one can see t h a t i t makes sense, i s a p p r o p r i a t e , e t c . I t a l l o w s f o r the p o s t  hoc d i s c o v e r y o f r a t i o n a l i t y . T h at i s i t a l l o w s f o r the d i s c o v e r y o f ' r e a s o n a b l e n e s s ' , 'appropriateness'., ' l o g i c a l n e s s ' , p r o p e r n e s s ' , e t c . R a t h e r than a f i n d i n g , i t i s a method o f making f i n d i n g s . I t a l l o w s us t o see t h e adequacy o f a c c o u n t i n g f o r a s e x u a l i d e n t i f i c a t i o n problem, i n terms o f e i t h e r f i r s t b o r n o r l a s t b o r n s t a t u s , e t c . I t a l l o w s us t o see the r e a s o n s f o r a c h i l d ' s c o n s t r i c t i o n g i v e n the d e a t h o f h i s f a t h e r ; t h e adequacy o f a c h i l d ' s a n x i e t y about h o s p i t a l i z a t i o n because o f s e p a r a t i o n ; the a p p r o p r i a t e n e s s o f p r o v i d i n g c o o k i e s and pop f o r p a t i e n t s ; t h e l o g i c o f h a v i n g t r a m p o l i n e time. I t a l s o a c c o u n t s f o r the r e p o r t a b i l i t y o f the p a t i e n t who made h i s own appointments; the n e c e s s i t y f o r h a v i n g a r u l e 184 about n o t t a k i n g t o y s home; e t c . O b v i o u s l y t h i s l i s t c o u l d be extended t o c o v e r many o t h e r a c t i v i t i e s i n t h i s s e t t i n g . F u r t h e r , note t h a t the b e h a v i o r d i s p l a y e d i n the p l a y room does n o t a l l o w one t o p r e d i c t which f e a t u r e s o f t h e i d e o l o g y w i l l be used t o ac c o u n t f o r t h i s d i s p l a y . In the p r e v i o u s c h a p t e r we made r e f e r e n c e t o a number o f t h e s e f e a t u r e s . We t a l k e d about the o m n i - r e l e v a n c e o f f a m i l i e s and i t s c o n s e q u e n t i a l i t y ; the d e n i a l o f r e s p o n s i b i l i t y i n c h i l d r e n s i n c e t h e y do n o t know o r u n d e r s t a n d t h e i r body s t a t e s ; how b e h a v i o r i s seen as a p p r o p r i a t e f o r a p a r t i c u l a r age o r stag e o f development; t h e awareness o f development d e r a i l m e n t s ; c h i l d r e n ' s need t o t e s t the l i m i t s , e t c . Any p a r t i c u l a r b e h a v i o r c o u l d r e a s o n a b l y be accou n t e d f o r by a p p e a l i n g t o many o f these f e a t u r e s . F o r example, the young p a t i e n t who engaged i n p a r t i c u l a r l y d i s r u p t i v e b e h a v i o r may be seen as an i n s t a n c e o f a c t i n g o u t , as d e v e l o p m e n t a l d e r a i l m e n t , 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 , as t e s t i n g t h e l i m i t s , e t c . As a m a t t e r o f f a c t , i t was e x p l a i n e d as a r e s u l t o f h a v i n g been home w i t h mother f o r a month (the om n i - r e l e v a n c e o f f a m i l y member-shi p ) . The i d e o l o g y a l l o w s one t o s u g g e s t t h a t the d i s p l a y i s a r e s u l t o f the f a m i l y environment. Because t h e i d e o l o g y does n o t have the p r e d i c t i v e power t o s e l e c t a s i n g l e s e t o f b e h a v i o r outcomes, and because t h e f e a t u r e s o f the i d e o l o g y a r e n ot p r e d i c t a b l e on any o c c a s i o n , we can n o t t r e a t i t as a ' t h e o r y ' . ^ What then i s the i d e o l o g y ? What I am c l a i m i n g i s t h a t the i d e o l o g y formed the b a s i s o f my  p r a c t i c a l r e a s o n i n g i n the s e t t i n g and e n a b l e d me t o c o n s t r u c t a r a t i o n a l d e s c r i p t i o n o f the t h e r a p i s t ' s work and r e a s o n i n g . I t was a r e s o u r c e by which I was a b l e t o f i n d r a t i o n a l i t y i n the t h e r a p y s e t t i n g . I t p r o v i d e d a s o l u t i o n t o my o b s e r v e r ' s problem b u t n o t n e c e s s a r i l y t h a t o f t h e 185 t h e r a p i s t s . L e t us l o o k back a t how I assembled t h e i d e o l o g y . How I Put the I d e o l o g y T o g e t h e r The r e a d e r w i l l r e c a l l t h a t I p u t the i d e o l o g y t o g e t h e r a f t e r r e a l i z i n g t h a t I was a b l e t o make adequate sense o f t h e s e t t i n g , and used my common-sense u n d e r s t a n d i n g s o f c h i l d r e n t o a c c o m p l i s h t h i s . A f t e r becoming aware o f t h i s , I n o t e d t h a t t h i s r e s o u r c e had been p r e v i o u s l y 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 " . I then s t a r t e d t o l o o k f o r f u r t h e r i n s t a n c e s o f t h i s i d e o l o g y . I began t o t r a n s f o r m e v e n t s i n t o 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 . T h i s amounted t o r e c o g n i z i n g t h a t ' e x p l a n a t i o n s ' , 'accounts', . ' p r a c t i c e s ' , ' b e h a v i o r s ' , e t c . were based on common-sense u n d e r s t a n d i n g s . I sug g e s t e d t h a t t h i s a c c o u n t e d f o r the r e a s o n a b l e n e s s o f the t h e r a p i s t ' s a c c o u n t s , the s e t t i n g ' s o r g a n i z a t i o n , and so on. In o t h e r words, I saw t h a t the r e s e a r c h e r and t h e r a p i s t s s h a r e d a v o c a b u l a r y o f m o t i v e s . S t a r t i n g w i t h t h i s u n d e r s t a n d i n g , I accumulated i n s t a n c e s o f acc o u n t s whose r e a s o n a b l e n e s s was b u i l t on a normative view o f c h i l d r e n . The f i r s t and most i m p o r t a n t group o f common sense a c c o u n t s t h a t I c o l l e c t e d were t h o s e framed i n terms o f a c a u s a l r e l a t i o n s h i p between c h i l d r e n and-f a m i l i e s . That i s , I take i t t h a t i t i s a p i e c e o f f o l k wisdom t h a t t h e r e l a t i o n between p a r e n t s and c h i l d r e n i s t r a n s p a r e n t o r e a s i l y a v a i l a b l e t o us. I r e f e r r e d t o t h i s as p r a c t i c a l r e a s o n i n g and assembled a number o f i n s t a n c e s o f such r e a s o n i n g i n the t h e r a p i s t ' s work. I showed how t h e i r r e a s o n i n g was an o c c a s i o n e d a p p l i c a t i o n o f f o l k r e a s o n i n g . F o l k a c c o u n t s were o f f e r e d as an a l t e r n a t i v e t o p s y c h i a t r i c a c c o u n t s . These i n s t a n c e s were n o t assembled p r e d i c t i v e l y b u t were assembled as th e y were used. I 186 began t o see t h a t a number o f the a c counts t h a t were f o r m u l a t e d i n terms o f the f a m i l y appeared t o be r e a s o n a b l e and l o o k e d f o r and d i s c o v e r e d o t h e r such i n s t a n c e s . I d i d t h i s by n o t i n g the correspondence between a f a m i l y ' s e m o t i o n a l s t a t e and t h a t o f the c h i l d r e n , by s e e i n g t h a t a p a t i e n t ' s d i s r u p t i v e b e h a v i o r may be m o t i v a t e d by h i s h a v i n g s p e n t a month w i t h mother and so on. The f a m i l y t h e n became an environment o f m o t i v e s , and the i n s t a n c e s d i s p l a y e d were t a k e n t o be documents o f t h a t environment. S u g g e s t i n g t h a t the i d e o l o g y was 'the r e s o u r c e f o r t h i s p r a c t i c a l r e a s o n i n g , I was a b l e t o l o c a t e innumerable o t h e r documents o f t h i s — p r e v e n t i n g p a t i e n t s from c r y i n g , t h e s e l e c t i o n o f t o y s , the r e c o g n i t i o n o f age a p p r o p r i a t e b e h a v i o r , e t c . I t s h o u l d be n o t e d t h a t t h i s a n a l y s i s was n o t imposed from o u t s i d e o f the s e t t i n g , r a t h e r i t was employed w i t h i n the s e t t i n g . That i s , my d i s p l a y o f the a d u l t i d e o l o g y i n the r e a s o n i n g o f t h e t h e r a p i s t s was o f f e r e d as an a c c o u n t o f how members made sense o f the s e t t i n g . I t s use was d i s c o v e r e d i n the s e t t i n g . One way t o l o o k a t the p r e v i o u s c h a p t e r s (and the way I i n i t i a l l y saw them) i s as a r e p o r t o f r e s e a r c h f i n d i n g s . The f i n d i n g s c o u l d be i n s t a n c e s o f t h e i d e o l o g y as i t i s used i n th e s e t t i n g , o r .they c o u l d be seen as the i d e o l o g y i t s e l f . I now want t o d i s c r e d i t t h i s i n i t i a l . c o n c l u s i o n and c l a r i f y t h e r e l a t i o n o f the i d e o l o g y t o t h e s e t t i n g . I t s h o u l d be r e c a l l e d t h a t the i d e o l o g y was n o t e x t e r n a l t o my a s s e m b l i n g o f i n s t a n c e s o f p r a c t i c a l r e a s o n i n g . I used the i d e o l o g y t o d i s p l a y those i n s t a n c e s as documents o f the i d e o l o g y . I t was my own f o l k knowledge about c h i l d r e n t h a t e n a b l e d me t o see t h e r e a s o n a b l e n e s s o f a c c o u n t s and t o assemble and d i s p l a y the p r a c t i c a l r e a s o n i n g o f t h e r a p i s t s . The d i s p l a y o f the i d e o l o g y was c l e a r l y assembled w i t h i n the t h e r a p y s e t t i n g . I d i s c o v e r e d e v e n t s t h a t would count as i n s t a n c e s o f the 187 i d e o l o g y and c o u l d be used as a document o f the u n d e r l y i n g p a t t e r n (the u n d e r l y i n g p a t t e r n b e i n g the i d e o l o g y i t s e l f ) . T h i s s o l v e d my o b s e r v e r ' s problem. Having t h o s e documents o f an u n d e r l y i n g p a t t e r n , the p a t t e r n i t s e l f was t h e n used t o d i s c o v e r a d d i t i o n a l i n s t a n c e s . While I was aware o f the n o t i o n o f an a d u l t i d e o l o g y I was a b l e t o c o n s t r u c t the r e p o r t e d a c c ounts o n l y upon s e e i n g and h e a r i n g something which I was a b l e t o take as a document o f the i d e o l o g y . I found t h a t I was a b l e t o d i s c o v e r i n s t a n c e s o f the i d e o l o g y o n l y a f t e r the f a c t . A l t h o u g h the i d e o l o g y i s a p a r t o f an a d u l t ' s " s t o c k o f knowledge", i t was n o t p o s s i b l e t o p r e d i c t what would come t o count as i n s t a n c e s o f i t i n the s e t t i n g . The i d e o l o g y i s n o t p r o p e r l y a f i n d i n g b u t r a t h e r a method f o r making f i n d i n g s . The i d e o l o g y i s an i n t e r p r e t i v e schema t h a t i s open t o c o n t i n u o u s ad h o e i n g i n o r d e r t o b r i n g f u r t h e r p i e c e s o f b e h a v i o r under i t s a u s p i c e s . T h i s i s n o t t o s u g g e s t t h a t the i d e o l o g y i t s e l f i s the f i n d i n g s i n c e the f i n d i n g i s t h e a b i l i t y t o use the i d e o l o g y t o p r o v i d e adequate a c c o u n t s o f e v e n t s . I t i s t h e c o n t i n u o u s a c t o f d i s c o v e r i n g and d e s c r i b i n g r a t i o n a l i t y t h a t i s o f i n t e r e s t . While I i n i t i a l l y f e l t t h a t I was p r o v i d i n g a way t o demonstrate what the t h e r a p i s t s were d o i n g , i . e . , d i s p l a y i n g t h e i r use o f the a d u l t i d e o l o g y , i t i s now c l e a r t h a t i t i s n o t t h e t h e r a p i s t ' s work b u t my work t h a t I am d i s p l a y i n g . T h i s r e p o r t i s i t s e l f a d i s p l a y o f the a d u l t  i d e o l o g y J We might add t h a t your r e a d i n g i s i t s e l f a f u r t h e r d i s p l a y o f the i d e o l o g y . I t i s n o t the d i s p l a y i t s e l f t h a t i s o f s i g n i f i c a n c e b u t the c o n t i n u o u s a c t s o f d i s p l a y i n g ; i t i s n o t the f i n d t h a t i s o f i n t e r e s t b u t the a c t s o f f i n d i n g . The a c t s o f f i n d i n g a r e the ways the r e s e a r c h e r and r e a d e r were a b l e t o d i s c o v e r the r a t i o n a l i t y o f the s e t t i n g . F o r me, the i d e o l o g y p r o v i d e d a s o l u t i o n t o a v e r y p r a c t i c a l problem. The 188 t h e r a p i s t s t o o have immediate p r a c t i c a l problems ( i n u n d e r s t a n d i n g , manag-i n g , e t c . , ) f o r which 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 p r o v i d e s a s o l u t i o n . We now have two k i n d s o f a c c o u n t s f o r the e v e n t s i n t h i s s e t t i n g . We began w i t h the p s y c h o t h e r a p e u t i c accounts as o f f e r e d and used by members o f the s e t t i n g (or, 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). These c o n t i n u e d t o have a p u z z l i n g s t a t u s s i n c e t h e y were seldom made e x p l i c i t and appeared t o have a f l e x i b l e s t r u c t u r e which a l l o w e d them t o work f o r any and e v e r y o c c a s i o n . Because o f t h e s e p u z z l e s and the a p p a r e n t l a c k o f r a t i o n a l i t y , I attempted t o g e t b e h i n d t h o s e a c c o u n t s i n o r d e r t o f i n d o ut "what was r e a l l y g o i n g on". To a c c o m p l i s h t h i s I p r o v i d e d an a c c o u n t o f the a d u l t i d e o l o g y and t r e a t e d i t as b o t h a f i n d i n g and as a d e s c r i p t i o n o f the ' r e a l i t y ' o f the t h e r a p y s e t t i n g . As has been s u g g e s t e d i n the p r e c e d i n g p a r a g r a p h s , however, t h e s e a c c o u n t s a r e n o t t o be seen as c o m p e t i t o r s . R a t h e r , t h e y s h o u l d be seen as two a c c o u n t s o f the same e v e n t s . The a d u l t i d e o l o g y i s n o t and s h o u l d n o t be t a k e n as a r e p l a c e m e n t f o r p s y c h o t h e r a p e u t i c a c c o u n t s (and, o f c o u r s e , v i c e - v e r s a ) . I would now l i k e t o suggest t h a t t h e s e two a c c o u n t s are demonstrably s i m i l a r and have the same s t a t u s as a c c o u n t s . While one o f t h e s e a c c o u n t s made more sense f o r me, t h e y have e s s e n t i a l f e a t u r e s i n common. I t has been p o i n t e d o u t t h a t n e i t h e r o f t h e s e a c c o u n t s a r e p r e d i c t -i v e . N e i t h e r the t h e r a p i s t nor the 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 t o become an i n s t a n c e o f the schema. The t h e r a p i s t s c o u l d n o t know t h a t a c h i l d whose f a t h e r had d i e d would t a l k o f dead b i r d s , o r t h a t a c h i l d ' s a p p a r e n t r e l a p s e s would be e x p l a i n e d w i t h a r e f e r e n c e t o h i s h a v i n g been home f o r a month. In b o t h c a s e s , t h e schema e n a b l e s the u s e r t o see 189 these events as instances-of-a-pattern-of-behavior. They are both methods for the post hoc discovering of r a t i o n a l i t y , and both are resources for seeing the adequacy, appropriateness, l o g i c a l n e s s , properness, etc. of events. They c l e a r l y have the same status as accounts. Let me now 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 been suggested that my i n i t i a l puzzlement with p s y c h i a t r i c theory could be resolved by proposing that, as an i n t e r p r e t i v e schema, i t was not a p r e d i c t i v e theory but a resource for the post hoc discovery of r a t i o n a l i t y . 2. I n i t i a l l y , I terminated my search f o r an answer to t h i s puzzle when I noticed that I could provide adequate accounts of the s e t t i n g by means of the adult ideology. And t h i s was a resource that 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 that the apparent reasonableness of the s e t t i n g could be explained through the adult ideology which i s a resource that i s shared by the researcher, t h e r a p i s t s , and reader a l i k e . 4. I t was proposed that the adult ideology i s also an i n t e r p r e t i v e schema which i s used f o r the post hoc construction of r a t i o n a l i t y . In t h i s respect, both sets of accounts ( i . e . the adult ideology and the 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 adult ideology as developed here, constitutes a g d i s p l a y of my own p r a c t i c a l reasoning (rather than that of the t h e r a p i s t s ) . 6. We can now propose that the adult ideology i s r e l a t e d to the work of the therapists i n the same way as the therapist's use of the p s y c h i a t r i c theory i s r e l a t e d to the a c t i v i t i e s of the p a t i e n t s . The adult ideology allows me to make p e r f e c t l y adequate sense of the therapist's work j u s t as 190 p s y c h i a t r i c t h e o r y seems t o a l l o w t h e r a p i s t s t o p r o v i d e p e r f e c t l y adequate a c c o u n t s o f the c h i l d ' s a c t i o n s . While i t may have appeared t h a t t h e two a c c o u n t s t r u c t u r e s were i n c o m p e t i t i o n , o r t h a t I was s u g g e s t i n g t h a t t h e r a p i s t s were r e a l l y o n l y a d u l t s , we can now see t h a t t h a t i s n o t t h e c a s e . The a d u l t i d e o l o g y does n o t undermine the s k i l l s o r the t r a i n i n g o f the t h e r a p i s t s and I am n o t s u g g e s t i n g t h a t a l l a d u l t s a r e o r c o u l d be t h e r a p i s t s . T h e r a p i s t s ' s k i l l s a r e r e a l ones. The a d u l t i d e o l o g y p r o v i d e d a s o l u t i o n t o my p r oblem o f c o n s t r u c t i n g an ethnography o f the s e t t i n g and n o t f o r the problems i n v o l v e d i n t h e e n t e r p r i s e o f t h e r a p y . My t a s k , as a r e s e a r c h e r , my r e l e v a n c i e s , r e s p o n s i b i l i t i e s , c r i t e r i a o f adequacy, o r g a n i z a t i o n a l placement, and o u t p u t a l l d i f f e r from the c o r r e s p o n d i n g t a s k s o f t h e t h e r a p i s t . F i r s t and f o remost o f t h e s e i s t h a t I am i n t e r e s t e d i n con-s t r u c t i n g an ethnography; the t h e r a p i s t i n t r e a t i n g c h i l d r e n . Thus, the a d u l t i d e o l o g y i s t h e r e s e a r c h e r ' s a c c o u n t o f what happens i n t h e s e t t i n g ( i n c l u d i n g the b e h a v i o r o f the t h e r a p i s t ) and i t s a p p e a l d e r i v e s from the f a c t t h a t i t p r o v i d e s a key t o the ethnography o f the s e t t i n g . P s y c h i a t r i c t h e o r y i s a t h e r a p i s t ' s a c c o u n t o f what happens i n the s e t t i n g , i . e . , o f the emotions and b e h a v i o r s o f p a t i e n t s , and i t i s r e s p o n s i v e b o t h t o t r e a t m e n t p r o c e d u r e s and t o o r g a n i z a t i o n a l assessment. Thus, the f a c t t h a t the two i n t e r p r e t i v e schema have the same e s s e n t i a l s t a t u s does n o t make them i n t e r c h a n g e a b l e o r a l t e r n a t i v e s . To s u g g e s t t h a t t h i s was so would be t o miss the o c c a s i o n e d use o f each. T h i s i s t h e v e r y t h i n g which an ethnography i s supposed t o e x p l i c a t e . A ccounts can n o t be s e p a r a t e d from the s i t u a t i o n , i n t e n t i o n s , b i o -graphy, e t c . o f t h e i r a u t h o r . They a r e always o c c a s i o n e d . F o r example, the t h e r a p i s t i n t r e a t i n g c h i l d r e n i s p l a c e d i n an o r g a n i z a t i o n a l s t r u c t u r e , 191 and becomes r e s p o n s i b l e t o p a r e n t s , s u p e r v i s o r s , o t h e r community a g e n c i e s , e t c . F u r t h e r , he o p e r a t e s i n terms o f c r i t e r i a o f adequacy which a r e s h a r e d by h i s c o l l e a g u e s . F u r t h e r , the s o c i a l r e s e a r c h e r ' s t a s k i s t o p o r t r a y what i s g o i n g on i n a s e t t i n g . As a p a r t o f a s t u d e n t - u n i v e r s i t y system he i s r e s p o n s i b l e f o r p r o v i d i n g a s o c i o l o g i c a l s t u d y a c c o r d i n g t o a c r i t e r i a o f adequacy which i s s h a r e d by h i s academic c o l l e a g u e s . A l t h o u g h the s e t t i n g i s the same, the p r a c t i c a l t a s k s o f t h e p a r t i e s d i f f e r . A c counts must be e v a l u a t e d , u n d e r s t o o d , e t c . i n r e l a t i o n t o the p r a c t i c a l t a s k s f o r which t h e y p r o v i d e s o l u t i o n s . 192 Footnotes """H. Ginott, "Play Therapy: The I n i t i a l Session", American Journal of  Psychotherapy, 15 (1961), p. 3. 2 E. H. Hutten, "On Explanation i n Psychology and i n Physics", B r i t i s h  Journal f o r the Philosophy of Science, 7 (1956), p. 74. 3 F. Swanson, Psychotherapists and Children: A Procedural Guide. Pitman Publishing Co., 1970, pp. 27-28. 4 I am suggesting that i t i s t h i s resource which gave a sense of reasonableness to a l l of chapters one through four. 5 The 'finding' i s that the adult ideology enables one to make sense of t h i s s e t t i n g . 6 I t should be cl e a r that I have never s e r i o u s l y suggested that 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 This does not deny that one can act 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 that to check what I see against my reading of the theory simply has no relevance to the operation of the c l i n i c . Therefore, I cannot comment on the inadequacy of the theory but only on the irrelevance of my assessment of the task of therapy. ' P r e d i c t i v i t y ' i s not required fo r the task of therapy. What matters i s that t h e r a p i s t s post hoc use of the schema enables them to do whatever has to be done, said , etc. CHAPTER 7 CONCLUSION I t may have o c c u r r e d t o the r e a d e r t h a t t h i s j o u r n e y t h r o u g h the t a s k o f making sense has i n f a c t o n l y s a t i s f i e d the p r a c t i c a l p r oblem o f p r o d u c -i n g t h i s document. I t i s my c o n t e n t i o n t h a t i t does c o n s i d e r a b l y more. T h i s s t u d y i s c l e a r l y l o c a t a b l e w i t h i n an emerging body o f s o c i o l o g i c a l r e s e a r c h i n which the r e s e a r c h e r h i m s e l f i s t r e a t e d as the i n f o r m a n t and h i s own e x p e r i e n c e o f making sense i s t r e a t e d as a t o p i c worthy o f s t u d y . - What these s t u d i e s have done i s (a) d i s c o v e r and e x p l i c a t e a f e a t u r e o f t h e s o c i a l w o r l d (e.g., t h e ' c o n v i c t code', the ' a d u l t i d e o l o g y ' ) and t h e n , (b) t r e a t t h a t d i s c o v e r y and e x p l i c a t i o n as a p r a c t i c a l accomplishment. The i m p r e s s i o n was l e f t i n the p r e v i o u s c h a p t e r t h a t t h e p r o d u c t i o n o f t h e a d u l t i d e o l o g y was a l l t h e r e was and h a v i n g s a i d t h a t n o t h i n g remained, i . e . , t h e r e was no ' d i s c o v e r y ' . The s o c i a l s c i e n t i s t as 'con-man'. A l t h o u g h the p r o d u c t i o n o f t h e i d e o l o g y i s a p r a c t i c a l accomplishment t h e r e i s some f u r t h e r s o c i o l o g i c a l r e s i d u e . I t w i l l be r e c a l l e d t h a t I c l a i m e d the i d e o l o g y was a s o l u t i o n t o my p r a c t i c a l p r oblem a l t h o u g h i t may n o t have been a s o l u t i o n t o the t h e r a -p i s t ' s t a s k . What can not be r e t a i n e d i s t h e e x p l a n a t o r y power o f the i d e o l o g y i n t h i s s e t t i n g . The e x p l i c a t i o n o f t h e i d e o l o g y remains however and i s the f u r t h e r s o c i o l o g i c a l c o n t r i b u t i o n o f t h i s s t u d y . My t r e a t m e n t o f the i d e o l o g y i s n o t j u s t t h a t o f an ' a d u l t ' nor i s i t the same t r e a t m e n t t h e t h e r a p i s t s may g i v e i t . The e x p l i c a t i o n i s t h a t o f a s o c i a l s c i e n t i s t s = I would l i k e you t o t r e a t t h e e x p l i c a t i o n o f the i d e o l o g y then as a sub-193 194 s t a n t i v e ' d i s c o v e r y ' . B e f o r e c o n c l u d i n g l e t me b r i e f l y r e t r a c e t h e s t r u c t u r e o f t h i s r e p o r t . R e c a l l t h a t on my f i r s t v i e w i n g o f the a c t i v i t i e s o f the t h e r a p y s e t t i n g (and exposure t o a d v i c e , l i t e r a t u r e , e t c . ) I e x p e r i e n c e d a sense o f i t s r e a s o n a b l e n e s s . The a d v i c e on how t o g r e e t , l e a d away, manage and t a l k t o c h i l d r e n was e m i n e n t l y r e a s o n a b l e . I r e c o g n i z e d the c o n v e r s a t i o n s as b e i n g t h o s e o f a d u l t and c h i l d and f e l t i t a p p r o p r i a t e , f o r example, t o n o t t a l k i m m e d i a t e l y about why the c h i l d was i n t h e r a p y , t o use v a r i o u s s t r a t e g i e s f o r g e t t i n g the c h i l d t o t a l k , and so on. T h i s l i s t c o u l d go on and on s i n c e the f i r s t v i e w i n g was t h r o u g h and through r e a s o n a b l e , t r a n s p a r e n t , and common-sensical. I f th e r e a d e r were t o l o o k back t o c h a p t e r one t h i s t r a n s p a r e n c y would be o b v i o u s . One c o u l d r e a d the t r a n - ~ s c r i p t s t h e r e w i t h some l e v e l o f u n d e r s t a n d i n g . I n v o k i n g the c a t e g o r i e s o f ' e x p e r t ' and 'layman' I s u g g e s t e d t h a t p s y c h o t h e r a p i s t s would have an i n t e r p r e t i v e schema t o a c c o m p l i s h t h e i r work t h a t would n o t make the same sense o f e v e n t s t h a t I had. I r e c o g n i z e d t h a t t h e a c t i v i t i e s I w i t n e s s e d would have t o have more s i g n i f i c a n c e than I had i n i t i a l l y a t t r i b u t e d t o them. . A f t e r a l l , t h i s was a work s e t t i n g , the a c t i v i t y o f t h e r a p y was t h e o r e t i c a l l y grounded, and t h e p r a c t i t i o n e r s had a c q u i r e d t h e i r s k i l l s t h r o u g h t r a i n i n g . When I began my t a s k o f p r o d u c i n g an a n a l y s i s I r e a l i s e d t h a t I had a c q u i r e d a s k i l l which e n a b l e d me t o u n d e r s t a n d what the p a t i e n t s and t h e r a p i s t s were d o i n g and was a b l e t o p r o v i d e an adequate account o f t h e r a p y happenings. I took t h i s t o be a p o r t r a y a l o f 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 and r e c o n s t r u c t e d t h i s schema i n o r d e r t o show how t h e r a p i s t s t r a n s f o r m r o u t i n e e v e n t s i n t o p s y c h i a t r i c a l l y r e l e v a n t and s i g n i f i c a n t d a t a . C h a p t e r two then was p r e s e n t e d as a n o t h e r way t o l o o k a t t h e m a t e r i a l s r e p o r t e d i n t h e f i r s t 195 c h a p t e r — 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 that I could make reasonable p s y c h i a t r i c sense (but not do therapy)—presumably i n the same way therapists did—came the awareness that the accounts on which I had constructed t h i s schema made sense because they were common-sensical. I t was t h i s which enabled me to discover a pattern i n those accounts. In chapters three and four then I constructed two features of what I ref e r r e d to as the therapist's corpus of knowledge which I claimed was supported by taken-for-granted-views of chi l d r e n . Two features were continuously used to make sense of therapy happenings, namely, the notions of 1) patients as 'normal' c h i l d r e n , and 2) patients as family members. Concentrating on the second notion, I demonstrated i n chapter four that i t i s eminently reasonable to think of c h i l d r e n as family members and I show how accounts of the family are used i n the s e t t i n g . The 'family' was used i n many ways, some of which would not have been expected. I t i s a resource to construct conversations, o f f e r advice, fashion r e l a t i o n s h i p s , i n t e r p r e t children's motivations, explain relapses, propose therapy-relevant actions, etc. Although i t appeared reasonable to use the notion of patients as family members, and t h i s i s a resource we a l l share, i t was not a v a i l a b l e to me beforehand to know when or how t h i s would be used. I t was necessary to ask the following question: how was I able to construct t h i s account and d e s c r i p t i o n of the r a t i o n a l i t y of the s e t t i n g on the basis of my experience i n the setting? A l l s o c i a l actors face the problem of seeing events as instances-of-a-pattern-of-behavior, and presum-ably t h i s i s what 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 accomplishes f o r thera p i s t s . However t h i s schema was never made e x p l i c i t f o r me. What was a v a i l a b l e to me was a constant flow of accounts which I took to 196 r e p r e s e n t the p s y c h i a t r i c schema. Hence, i t c o n t i n u e d t o be a p u z z l e f o r me a l t h o u g h the scenes d i d n o t . I p r o p o s e d i n c h a p t e r f i v e t h a t what e n a b l e d me t o p r o v i d e the p r e c e d i n g a c c o u n t o f th e s e t t i n g ' s r a t i o n a l i t y was t h e a d u l t i d e o l o g y — those n o r m a t i v e ways o f s e e i n g c h i l d r e n s h a r e d by a d u l t s . T h i s a l l o w e d me t o see e v e n t s 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 . T h a t i s , I c o u l d see e v e n t s as i n s t a n c e s o f a d u l t - c h i l d i n t e r a c t i o n . I c l a i m e d t h a t t h i s p r o v i d e d f o r the r e a s o n a b l e n e s s o f my f i r s t v i e w i n g as w e l l as t h e adequacy o f the t h e r a p i s t ' s corpus o f knowledge. By t r e a t i n g t h i s s e r i o u s l y I was l e d t o the r e a l i z a t i o n t h a t t h e r e a r e n o t two i n t e r p r e t i v e schemas b u t o n l y one, i . e . , t h e a d u l t i d e o l o g y p r o v i d e s f o r , o r s u p p o r t s , 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. I t h e n went on t o examine how the i d e o l o g y was used as a s o u r c e o f e x p l a n a t i o n s o f p a t i e n t b e h a v i o r as w e l l as how i t had consequences i n terms o f managing c o n v e r s a t i o n s and r e l a t i o n s h i p s . The a d u l t i d e o l o g y p r o v i d e s a r e s o u r c e . f o r j u s t i f y i n g d e c i s i o n s , e x p l a i n i n g why some p a t i e n t s were d i s c h a r g e d , p r o v i d i n g adequate a c c o u n t s o f r e l a p s e s , d e m o n s t r a t i n g competence and u n d e r s t a n d i n g , c o n t r o l l i n g c o n v e r s a t i o n s , d e a l i n g w i t h u n c o o p e r a t i v e n e s s , and s o u nding knowledgeable. I f t h e r e a d e r were now t o go back t h r o u g h the f i r s t two c h a p t e r s o f t h i s document i t would be c l e a r t h a t t h e i d e o l o g y was employed e x t e n s i v e l y t o p r o v i d e f o r the r e a s o n a b l e n e s s o f almost e v e r y t h i n g r e p o r t e d . H aving p r e s e n t e d what I took t o be a d i s p l a y o f t h e t h e r a p i s t ' s use o f t h e a d u l t i d e o l o g y I s u g g e s t e d t h a t we examine the s t a t u s o f the i d e o l o g y . A f t e r r e v i e w i n g the a c t i v i t y o f c o n s t r u c t i n g the d i s p l a y o f t h e i d e o l o g y I c o n c l u d e d t h a t t h e i d e o l o g y was i n f a c t o n l y a s o l u t i o n t o my p r a c t i c a l p r o b l e m o f p r o v i d i n g an adequate d e s c r i p t i o n and a c c o u n t o f th e s e t t i n g , i . e . , making sense o f the t h e r a p i s t ' s d e s c r i p t i o n s and a c c o u n t s . The 197 i d e o l o g y was an i n t e r p r e t i v e schema t h a t e n a b l e d me t o p r o v i d e an adequate ac c o u n t o f the s e t t i n g and as such i s n o t t o be c o n f u s e d w i t h the p s y c h i -a t r i c schema. I had not a c q u i r e d 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 then, b u t o n l y d i s c o v e r e d t h a t I had a r e s o u r c e f o r making adequate sense o f t h e r a p i s t ' s a c t i o n s , r e p o r t s , e x p l a n a t i o n s , e t c . 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 and t h e a d u l t i d e o l o g y were r e s p o n s i v e t o v e r y d i f f e r e n t t a s k s , i . e . , t r e a t i n g c h i l d r e n on t h e one hand and p r e p a r i n g a d i s s e r t a t i o n on t h e o t h e r . (Or f o r t h e r e a d e r , j u d g i n g the adequacy o f t h i s r e p o r t ) . I t i s t h i s embededness i n p r a c t i c a l a c t i v -i t i e s t h a t must be c o n s i d e r e d i n u n d e r s t a n d i n g any acco u n t ( d e s c r i p t i o n , r e p o r t , e x p l a n a t i o n ) . The p s y c h i a t r i c schema e n a b l e d t h e r a p i s t s t o make 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 ) t h e i r p a t i e n t s w h i l e t h e a d u l t i d e o l o g y e n a b l e d me t o make sense 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 . There a r e some p o t e n t i a l l y u n s e t t l i n g i m p l i c a t i o n s s u g g e s t e d by t h i s ' d i s c o v e r y ' t h a t I would j u s t l i k e t o mention, r a t h e r than e x p l o r e , a t t h i s t i m e . One can f i n d many i n s t a n c e s i n the s o c i a l s c i e n c e s o f t h i s phenom-e n o n — t h i n k i n g t h a t one's i n t e r p r e t i v e schema as a s c i e n t i s t can r e p l a c e t h e schema o f the members. We can c o n s i d e r the a n t h r o p o l o g i s t who produces an ethnography o f a ' f o r e i g n ' c u l t u r e . While t h e members o f t h a t c u l t u r e a r e g o i n g about t h e t a s k s o f t h e i r , e veryday l i v e s , the s c i e n t i s t i s t r y i n g t o make sense o f those d o i n g s . To see e v e n t s , 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 ( r e l i g i o u s b e h a v i o r , p r o p e r t y r e l a t i o n s , e t h n i c i t y , e t c . ) may s a t i s f y h i s p r a c t i c a l p r o b l e m (and h i s c r i t e r i a o f adequacy) b u t 2 i t may n o t r e f l e c t t h e schema o f t h e member p r o d u c i n g t h o s e e v e n t s , e t c . S i m i l a r l y , w h i l e Durkheim p r o d u c e d an adequate a c c o u n t o f s u i c i d e r a t e s which saw those r a t e s as i n s t a n e e s - o f - a - p a t t e r n - o f - b e h a v i o r t h i s may no t r e f l e c t t h e scheme o f th o s e who 'commit' s u i c i d e n o r o f those who 198 3 'produce' s u i c i d e s . F i n a l l y , w h i l e c r i m i n o l o g i s t s may see the d e c i s i o n o f some members o f our s o c i e t y to.become p o l i c e m e n as ' c l a s s ' b e h a v i o r (an i n s t a n c e - o f - a - p a t t e r n - o f - b e h a v i o r ) t h i s may n o t be a r e p l a c e m e n t f o r how those members make t h e i r c h o i c e appear r e a s o n a b l e , e t c . One has t o be s e n s i t i v e t o the l o c a t i o n o f a c c o u n t s . I f the two schemas i d e n t i f i e d i n t h e s e t t i n g a r e s i m p l y 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 may be a c c u s e d o f h a v i n g a s o l i p s i s t i c m e t h o d o l o g y — t h e r e i s no way t o make c l a i m s about the w o r l d . I n b e g i n n i n g t h i s c h a p t e r however I s u g g e s t e d t h a t t h i s r e p o r t be seen as h a v i n g two themes, t h e f i r s t b e i n g t h e d i s c o v e r y o f o c c a s i o n e d a c c o u n t s which c o n c l u d e d t h a t t h e account o f the a c t i v i t i e s i n the p l a y s e t t i n g p r e s e n t e d h e r e i n be seen as a p r a c t i c a l accomplishment t o s o l v e my problem i n an adequate f a s h i o n . There i s no c l a i m about 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 s e t t i n g then. There i s a c l a i m however, and t h i s i s the second theme, t h a t t h e a d u l t i d e o l o g y i s a f e a t u r e o f the 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 so p r e s e n t e d i s a c o n t r i b u t i o n t o our u n d e r s t a n d i n g o f an omnipresent i n t e r p r e t i v e schema which we, as c u l t u r a l members, s h a r e . 199 Footnotes See, for example, D. Lawrence Wieder, The Convict Code: A Study of a Moral Order as a Persuasive A c t i v i t y . Unpublished Doctoral D i s s e r t a t i o n , UCLA, 1969; Ken Stoddart, Encountering Fieldwork: Perspectives on the S o c i o l o g i c a l Ethnography. 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 , Santa Barbara, 1975; Bruce Katz, The Production of an Ethnography. 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 B r i t i s h Columbia, 1975. 2 . . For an i n t e r e s t i n g discussion of t h i s see Michael Moreman, "Accomplish-ing E t h n i c i t y , " i n R. Turner (ed.) Ethnomethodology, Penguin Books, 1974, pp. 54-68. This notion i s taken from James Wilkins, "Producing Suicides," American Behavioral S c i e n t i s t 14 (1970) 185-202. 200 BIBLIOGRAPHY A l l e n , F. Psychotherapy with Children. New York: W. W. Norton & Co., 1942. Anthony, J. "Communicating Therapeutically with the C h i l d . 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