Milan Flashcards
Analogical Message
A metaphorical or symbolic message (process)
Circular Questioning
The therapist asks one family member to comment on the interactions of two other family members to create circularity within the system and help the therapist build a more elaborate hypothesis and have family step outside their personal experience Ex. Who do you think is closest to mom?
Counterparadox
An intervention used to unravel a family’s double-bind message by referring to their dysfunction as legitimate and necessary and as so instructing the family not to change.
Primary Contributors
Mara Selvini Palazzoli
Guiliana Prata
Luigi Boscolo
Gianfranco Cecchin
Digital Message
The content of the message (objective)
Epistemological Error
A set of beliefs that are incongruent with reality and become problematic, Ex. not believing that one is responsible for his or her own behaviors.
Epistemology
The manner in which individuals (families) make sense of the world, including their relationships to and with others
Games
Unacknowledged strategies that result in destructive interactions within families- often games are unspoken and used as attempts to control another’s behavior
Hypothesizing
Continual process of conceptualizing the nature of the family’s behavior that guide questioning and interventions
Metacommunication
communication about communication
A Learning Process
Milan Therapists viewed the use of interventions as nothing more than a learning process in which the therapists tests hypotheses and interventions through trial and error as they learn about the family.
Neutrality and Irrevernce
The therapist’s stance of being open to multiple hypotheses regarding the family’s behavior.
Paradoxical Prescription
Either prescribing the symptom or asking the family not to change
Positive Connotation
The hallmark of the early Milan Systemic School. Positive connotations illuminates upon circularity by assigning a positive motive or value to each family member’s behavior- whether it be a desirable or undesirable behavior.
Punctuation (different than structural)
The manner in which individuals attribute their behaviors as a result of another’s behavior. Ex. I only nag you because you never offer to help
Rituals
An intervention presented by a therapy team that is described in great detail, instructing various individuals within the family to carry out specific behaviors and specific times of the day for a distinct period of time. They serve to provide consistency and clarity as to the hypothesized problem within the family.
Team approach
A team of therapists that strategically hypothesize and plan interventions regarding each particular family. Often, team members will watch therapy as it unfolds behind a one-way mirror as 1 or 2 therapists work directly with the family.
The Dirty game
When parents struggle for control, they triangulate a symptomatic child who then works to defeat the parents.
Invariate Perspective
Typically during the 3rd session, the therapist will instruct the mother and father to tell their family that they have a “secret” and to then take a trip together away from the family for a few days. They are cautioned not to tell the family anything more than they mere fact that they have a secret prior to leaving.
Time
suggesting that a family’s historical perception of a problem influences their current perspective on the problem, affecting their view of the past and present behavior. Ex. If i perceive my mother as cold, I will only recall times in the past where my mother was cold and ignore current instances of my mother demonstrating warmth and compassion.
Milan differences vs. MRI and strategic
-each session had 5 tasks
-only 10 sessions but each held one month apart
-always team approach with 1 way mirror
-emphasized epistemology as informing rules to keep families stuck
-two primary interventions - positive connotation and ritual
Later Milan Group
Palazzo and Prata
- dirty game and invariant prescription
Boscolo and Cecchin
-Circular questions (dropped paradox)
Stage 1 of Dirty Game
Marital Impasse: Relationship distress between parents
Stage 2 of Dirty Game
Child aligns with one of the parents,
Stage 3 of Dirty Game
child tries to make the other parent look good (Ex. picking mom and wanting her to put them to bed)
Stage 4 of Dirty Game
Spouse aligns with other parent after problematic behavior from child
Stage 5 of Dirty Game
Extension of maladaptive behavior because child does not feel understood (ex. problems at home now at school)
Stage 6 of Dirty Game
Parents adapt to maladaptive behavior (ex. Child is now the identified patient)
Goal of Milan
Help people recognize their influence on the family
5 Parts of therapy
- Pre-session Team discussion
- Interview with the Family
- Discussion of interview amongst the team
- Assign task at end of session
- Come up with plan for next session
