Open Dialogue as Coupling of Psychic, Social,
and Creative Systems

Takashi Iba, Masafumi Nagai, Tsuyoshi Ishida and Ayaka Yoshikawa

Abstract In this paper, we study Open Dialogue, a psychiatric program developedin Western Lapland of Finland, with the theory of autopoietic systems. Although
Open Dialogue approach is originally a psychiatric program developed, we believethat the approach can be applied not only to psychotherapy but also educational andorganizational situation as the way of collaborative problem dissolving, because itis based on philosophy of dialogism, which is not limited to psychotherapy. For
understanding the applicability, we analyse the function of Open Dialogue in higher
level of abstraction with concepts of systems theories: Social Systems Theory andCreative Systems Theory. As a result, Open Dialogue can be understood well withthe framework of the combination among chain of consciousness in psychic system,
chain of communication in social system, and chain of discovery in creative system.
To put this understanding into practice, we created a pattern language forcollaborative problem dissolving, which we call “Open Dialogue Patterns.” In thispaper, we presents the summary of each pattern of 30 patterns.

1 Introduction
Recently in Japan, one psychotherapy method is attracting a great deal ofattention, which is called Open Dialogue. Open Dialogue is originally a psychiatricprogram developed in Keropudas Hospital in Western Lapland, Finland. The
founder of Open Dialogue is Jaako Seikkula, who is a clinical psychologist andfamily therapy trainer and also a professor in the Department of Psychology at the
University of Jyvaskyla and Tromso.
Open Dialogue approaches to those involved in a crisis including significant
others in patient’s life such as families and social networks to be together and toengage in meetings (Seikkula & Olson,2003; Seikkula & Trimble, 2005; Seikkula
1

Corresponding author: xxxxxx

2& Arnkil, 2006, 2014). The aim of the meetings is to develop a dialogue, giving avoice to all concerned putting the person at the centre without strategically trying tochange them. Whereas in the old system, appointments and intervention by their
psychiatrist are the only way to seek solution. The effectiveness of Open Dialogues
measures includes number of relapses, rating of psychotic symptoms and social
functioning, employment status and hospital days.
Open Dialogue is related to so-called Narrative and Collaborative therapies. As
well as these approaches (Andersen, 1991; Anderson & Goolishian, 1988;
Anderson, 1997; Malinen, et al., 2012; McNamee & Gergen, 1992), Open Dialogue
is carried out not for problem solving (proposing solution) but for problem
dissolving by dialogue.
Although Open Dialogue approach is originally a psychiatric program
developed, we believe that the approach can be applied not only to psychotherapy
but also educational and organizational situation as the way of collaborative
problem dissolving. For us, to apply the Open Dialogue approach into educationand organization looks appropriate, because the approach is based on philosophy of
dialogism, which is discussed for wider consideration about communication andhuman relationship than psychotherapy, as the books and papers by Jaakko Seikkulashow the relation to the wider literature (Bakhtin, 1981; Bakhtin, 1990; Gergen,
1999; Holquist, 1990; Maturana & Varela, 1972; Vygotsky, 1978; Vygotsky, 1986).
For understanding the applicability, we analyse the function of Open Dialogue
in higher level of abstraction with concepts of systems theories: Social Systems
Theory (Luhmann, 1984; Luhmann, 1997) and Creative Systems Theory (Iba,2010).

2 Autopoietic Systems Theory
In the literature of Open dialogue, Humberto Maturana, Francisco Varela, andNiklas Luhmann is indeed referred (Seikkula & Arnkil, 2006). Autopoietic systems
were proposed by Humberto Maturana and Francisco Varela in biology (Maturana& Varela 1980) as a unity where the organization is defined by a particular networkof production processes of elements. Although the original area of autopoietic
systems is biology, Luhmann generalized the theory and used it to enhance histheories of social systems as autopoietic systems that include communication as anelement.
In this paper, based on these autopoietic systems theories, we suggest what
happens in dialogical meeting on Open Dialogue approach can be explained as
phenomena with coupling of Psychic, Social, and Creative Systems (Fig 1). For
reaching the conclusion, we first overview Social Systems Theory, focusing on theparts of theory to understand the function of Open Dialogue, then move to Creative
Systems Theory, which is necessary to understand another side of Open Dialogue.

3Fig. 1. Coupling of Psychic, Social, and Creative Systems.

In the social systems theory, Luhmann formulate the human mind as an
autopoietic system, which is called as a “psychic system,” where the primaryelement is consciousness; Psychic system is a nexus of consciousness, and thesystem reproduces consciousness by consciousness; The consciousness can have noduration because of its momentary operation and requirement to be reproduced
constantly. Moreover, from an operational viewpoint, such a psychic system is a
closed system as it cannot send or receive communication outside the system. Since
the psychic system is closed, so you cannot directly access to the elements ofpsychic system (psychic systems are mutually inaccessible), certain type ofcommunication is required.
In the theory, communication is considered as the element of social system andemerges between people. According to Luhmann (1984), communication is
emerged from the synthesis of three-part selection in social systems: selection of`information,’ `utterance,’ and `understanding’ (Fig 2).
Note that such a definition of communication is much different fromconventional definition that is based on a metaphor of transference. In the metaphor,a sender passes a message (information) to a receiver, and then the information
moves from the sender to the receiver. Luhmann pointed out the limitation in thisperspective because the idea is prepossessed with existence of information, andthere is a concern that the information transferred between sender and receiver isthought to be the same one. He claims that this perspective misses to understand thenature of communication as social phenomena; instead, communication should beconsidered as the social phenomena related to meaning. Furthermore, I would liketo emphasize that Luhmann’s conceptualization of communication is distinguishedfrom so-called “communicative act”. The concept of communicative act, as thename implies, is based on action theory rather than communication as mutual
selection.
Communication can have no duration because it is momentary operation, so it
must be reproduced constantly; From an operations viewpoint, such a social system
is a closed system as it cannot send or receive communication outside the system,
even from psychic systems.

4Fig. 2. Communication emerged by the synthesis of three-part selection: information, utterance,
and understanding.

In the Creative Systems Theory (Iba, 2010), a creative process is defined as an
autopoietic system where elements are discoveries; In other words, a creative
process is a reproduction network of discoveries. Each discovery is emerged only
when a synthesis of the following three selections occurs: idea, association, andfinding (Fig 3).
Fig. 3. Discovery emerged by the synthesis of three-part selection: idea, association, and finding.

3 Understanding Open Dialogue with Autopoietic Systems
TheoryWe here present how we can understand open dialogue with autopoietic systems
theory introduced in the last section, Social Systems Theory and Creative Systems
Theory.

In dialogical meeting, to understand experienced world of the people who
is annoyed with the problem to dissolve is quite important but difficult. It isbecause psychic system (chain of consciousness) is closed, as we seen in thelast section. When you are trying to understand the problem the person
concerned is facing, you may often listen to his/her stories behind the5problem from your point of view, however that may not be able to grasp
his/her experiences completely.
Therefore, in the dialogical meeting on Open Dialogue approach, youunderstand his/her way of perceiving things and use that perspective to grasp
his/her experiences, through dialogue. In other words with the term ofsystems theory, you need to understand the chain of consciousness in
psychic system the people who is annoyed with the problem through thechain of communication. It is, in principle, impossible to capture the chainof consciousness itself, but you can acquire better understanding if you
imagine the chain of consciousness behind words and body expressions.
In the dialogical meeting, generating various voices is significant,because there are many interpretations as there are people. Even if you arehaving a conversation with them one on one, that will only bring personalviews of each other; The conversation will remain deadlocked/dead end.
Their talk is based on their experienced world and it is one of perspective to
see the situation. Since the content to be drawn by the talking partner will
be decided to some extent while having conversation; especially if it is aone-on-one conversation, the range of narration becomes narrow. Therefore,
it is necessary to invite multiple people related to the person facing with the
problem into the dialogical meeting, and get a variety of perspectives on the
narrative. Each individuals should not be locked up inside of theirexperienced world but to interact with various voices surrounding ourselves
so that we can get out of a dead end of a problem situation.
In dialogical meeting, new understanding shared among participants inthe meeting are generated. This can be considered as creation of newunderstanding in creative system (chain of discovery). When you are having
meeting with members to get rid of problems, the solution to deal with the problem
and to remove it does not deal with the underlying causes and the same problem
will recur later on. As a mainstream way of thinking about dealing with problems,
we tend to identify the cause and to solve it. However, even if a solution is taken
for problems in which feelings and relationships are complicatedly affected, there
are cases where the situation does not change or it is temporary in practice.
Therefore on the Open Dialogue approach, you capture the circumstances behindthat has generated a problem, express it with words in the dialogue, and create a
new understanding dissolving the problem. Capturing experience and trauma thathas been covered up to now, and by engaging in dialogue about it, it makes it
possible to express by words. As a result it resolves problems and symptoms that
had appeared on the surface. Thus, the Open Dialogue approach offers notcollaboration for finding solution to the problem, but collaboration for co-createdunderstanding, which results on dissolution of the problem.
As we discussed above, Open Dialogue can be understood well with theframework of the combination among chain of consciousness in psychic system,
chain of communication in social system, and chain of discovery in creative system.

6This shows, on one hand, how dialogical meetings on Open Dialogue approach is
successful in psychotherapy. On the other hand, this also shows the Open Dialogue
can be considered not only as psychotherapy method, but also as a collaboration
method in more broader range of social domains, because the systems we discussed
are not limiting to psychotherapy, but considering as fundamental systems of mind,
communication, and creation.

4 Open Dialogue Patterns
We here present a pattern language for Open Dialogue. First, we overview what
is pattern language, then present a pattern language for Open Dialogue, which wecall Open Dialogue Patterns. Pattern language is a method to share such practicalknowledge among people in a target domains. Patterns in a pattern language are
written in the same format. For example, our typical pattern format comprises apattern name, an introduction, an illustration, a context, a problem, a solution, aconsequence and related patterns.
The pattern name defines the pattern with a short memorable word for easy
reference, and an introduction assists in understanding a living image of the pattern.
Pattern illustration expresses the pattern’s essence, including characters that express
human movements and feelings. The context describes situations in which thepattern should be used. Followed by the words ‘In this context’, a problem that is
likely to occur in the context is written. Then, followed by the word ‘Therefore’, asolution of the problem is presented. Finally, the consequence describes how things
can change when this pattern is put into practice.
Based on the papers and book on Open Dialogue (Seikkula, 2002; Seikkula &Olson,2003; Seikkula, J. & Trimble,2005; eikkula & Arnkil, 2006), throughdeliberate process of creating pattern language (Iba & Isaku, 2016), we got 30
patterns shown in Fig 4; sources of the contents of each patterns is shown in Tab 1.
In the top level, there are core patterns: `Experienced World,' `Various Voices,'and `Co-Created Understanding.' What these patterns mean is already discussed in
the previous section in this paper. The followings are summaries of patterns in eachcategory, with using the pattern names of Open Dialogue Patterns.
For understanding `Experienced World’: Through dialogue, understandhis/her way of perceiving things and use that perspective to grasp his/herexperiences. Through dialogue, understand his/her way of perceiving things and usethat perspective to grasp his/her experiences. Find out his/her way of perceiving theworld and behind stories to those perspectives through dialogue. After so, listen to
his/her experiences and events based on those perspectives in order to elicit morestories. Specifically, do not let labels and expertise stop you from being `As a Living
Person.’ This also means recognizing others `As a Living Person’ too. It is
important to have a `Deep Listening’ to their pace of thoughts and utterance as well
as choice of words so that you can have an `Adaptation of Words.’ During the7dialogue, questions should not have a Yes/No answers, but practice question thatwill allow us to answer in own bare words such as `Open Question.’ Also, make a`Pause for Thinking’ so that person you are in a dialogue with can have a time tothink about what they want to say. When he/she has finally answered to yourquestion, make sure you also `Respond to What is Said.’ In order to understandhis/her `Experienced World,’ use not only your own point view but also his/her`Inner Frame.’ Sometimes there may be strong emotional expression though that isa great opportunity to put those experiences into words he/she couldn’t before
through `Tunnel of Emotion.’ In case of those situation, make sure you settle a`Respectful Mind’ towards dark and tough experiences he/she have had faced in thepast.
For generating `Various Voices’: Invite multiple people related to the person
facing with the problem into the dialogical meeting, and get a variety of perspectives
on the narrative. Each individuals should not be locked up inside of their`Experienced World’ but to interact with `Various Voices’ surrounding ourselves sothat we can get out of a dead end of a problem situation. First of all, we must haveour `Significant Others’ to join in and have everybody `Working as a Team.’ Then,
have those members gather in one place and `Sitting in the Circle.’ As for dialogue,
send out `Invitation for Utterances’ from the beginning and ask them questions.
Rather than trying to quickly summarize the story, it is important to proceed with
`Slow-Paced Conversation’ and to create gaps that anyone can speak frankly. Make
sure to respond back to any utterance so that we can create `Chain of Responses.’Also, not only paying attention only to words, but also to the `Tiny Sign’ that each
person gives, such as a little expression and tension. Moreover, thinking that youremotional response is more natural than `As a Living Person’ participation, express
it and let `Emotional Resonance’ happen. Showing `Reflecting’ with the supporting
team members will create a gap to think for themselves and leads out a new voice.
For achieving `Co-Created Understanding’: Capture the circumstances behindthat has generated a problem, express it with words in the dialogue, and create a
new understanding dissolving the problem. Capturing experience and trauma thathas been covered up to now, and by engaging in dialogue about it, it makes it
possible to express by words. As a result it resolves problems and symptoms that
had appeared on the surface. Doing so, we will first have `First Meeting in Crisis’;a meeting from the timing when the person's emotions and speech are easy to comeup. And, because it is an unstable period, `Everyday Meeting’ and `Continuous
Engagement’ with the same members are required. It will bring psychologicalcontinuity and security. In the dialogue, we grasp and share that there are `Diverse
Ideas,’ no right or wrong. During the process you will need `Tolerating Ambiguity,’
but rather than trying to quickly summarize, it is necessary to endure the uncertain
state. By doing so, you and your `Significant Others’ will finally lead to`Construction of Meaning’ of the situation. Furthermore, important thing is to havea `Joint Decision’ where everybody on the team is asked to discuss at the meeting.
And not converging to one agreement point, continue dialogue with the image tobring `Ever-Widening Perspectives’ so that it will eventually be a `Co-Created8

Understanding.’ The experience of such a dialogue is that experience itself creates`Community of Narrative’ which will be the foundation for their future.
Fig. 4. Overview of Open Dialogue Patterns

Table 1. Sources of Problem, Solution, and Consequence statement in each pattern (page numbers)
No.

Pattern Name

Problem

Solution

Consequence

1

Experienced World

2

Various Voices

B1 (41, 42)

B1 (17, 28, 109, 119, 129), B2(95, 98)

3

Co-Created
Understanding

B1 (52), B2 (94)B1 (117, 127, 119), B2 (94, 99, B1 (66, 100, 105, 123),151)
B2 (123, 143, 151, 171)4

As a Living person

B1 (48, 118,
119)

B1 (47, 48, 94, 116), B2 (94)5

Deep Listening

B1 (121, 131,139)

B2 (94, 97, 98, 120, 121)

B1 (41, 115), B2 B1 (69, 115), B2 (123, 102, 121, B1 (115), B2 (95, 102,
(139, 143)
149)
172)
B1 (7,17,101), B2 (158,159, 164)

B1 (94)

6 Adaptation of Words

B1 (119, 139), B2 (120, 151,174)

7

B1 (68, 116), B2 (96, 120, 151,
B1 (68)152)Open Question

B1 (130), B2 (151, 174)

8

Pause for Thinking B2 (93)B1 (103), B2 (94)9Resonance to What is B1 (113, 118),
Said
B2 (132)

B1 (69), B2 (96, 121, 132, 151)

B1 (65,69), B2 (143,172)

B1 (101), B2 (123)B1 (101), B2 (164)10Inner Frame

11

Tunnel of Emotion B1 (121)B1 (122, 131), B2 (151)B1 (101)

12

Respectful Mind

B1 (70, 119)

B1 (50)13

Significant Others

B1 (59, 60, 61, 116, 119), B2(61)

B1 (59, 60, 173)

14

Working as a Team B1 (132)B1 (57, 63), B2 (89)B1 (63, 65), B2 (167,170, 171)915

Sitting in the Circle B2 (161)

B1 (67), B2 (88, 89, 161)

B1 (50, 108~109)

16

Invitation for
Utterances

B1 (118)

B1 (47, 69, 109, 119), B2 (96,151, 152, 159)

B1 (109)17

Slow-paced
Conversation

B2 (152, 165)

B1 (131), B2 (165)

B2 (102, 152, 163)

18 Chain of Responses B2 (132)B1 (112, 113, 149), B2 (132,112, 113)

B1 (120), B2 (134)19

B1 (103, 108, 131), B2 (155)Tiny Sign

20 Emotional Resonance B2 (165)B1 (131), B2 (164, 166)B1 (122), B2 (164, 166,
171)

21

B1 (148), B2 (106)

B2 (98, 155)

Reflecting

22 First Meeting in Crisis B1 (58, 59)

B1 (57, 58, 59, 62), B2 (88, 89,
B1 (58, 59, 60, 143)
117, 150)

23

B1 (65), B2 (93, 150)

B1 (65), B2 (93)Everyday Meeting B1 (65)24

Continuous
Engagement

B2 (64)B1 (57, 63, 64, 102), B2 (90,118, 150, 165)

B1 (64, 133), B2 (90)25

Diverse Ideas

B1 (38, 42, 52,
100, 102, 118),
B2 (99)B1 (41, 42, 61, 67, 100, 111,
132, 140), B2 (99, 164)

B1 (42, 100, 101, 111,132), B2 (163)B1 (143), B2(94, 154, 163)B1 (102, 115, 143), B2 (94, 151, B1 (115), B2 (101, 151,
163)
163)

26 Tolerating Ambiguity
27

Construction of
Meaning

B1 (100, 127)

B1 (66, 100, 127, 137, 143), B2
B1 (101, 137)
(95, 163)

28

Joint DecisionB1 (23, 24, 143)

B1 (23, 24, 25, 32, 63, 67, 101,
116, 138, 143, 144), B2 (90,B2 (24, 63, 101, 133,
117, 119,120, 125, 152, 155,156, 143, 144)
165)

29

Ever-Widening
Perspectives

B1 (38, 104,107)

B1 (66, 70, 104, 107, 111, 131,
B1 (100, 138)
138)

Community ofB1 (100, 123, 124, 132, 133,
B1 (133, 134)
Narrative
135, 148), B2 (126)
B1 stands for Seikkula & Arnkil (2006), and B2 for Seikkula & Olson (2003) and Seikkula &Trimble (2005)30

5 Conclusion
In this paper, we studied Open Dialogue approach as a psychiatric program withthe theory of autopoietic systems. Also, we presented a pattern language for Open
Dialogue. We anticipate that our patterns will applied not only to psychotherapy but
also educational and organizational situation.

10

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