Collective wisdom: Integrating recent developments with established models in couples treatment

Over the years I have come to realize the foolishness of absolutes. It seems that whenever I have emphatically pledged myself to or decried a certain position, my conviction has been tested and found to be faulty. This is as true in my professional journey as in the private aspects of my life. In the 1980s, I found myself fighting to establish the primacy of an Object Relations approach to couples treatment. My earlier vow to always remain curious and respectful of difference dissipated and was replaced by an almost self-righteous, exclusionary stance. I remember my arrogance and skepticism as I entered an AFTA conference meeting room to hear a presentation of some new fad by some new therapy star who promised some miraculous short term cure. The speaker was Michael White, and I never experienced the world again in the same way. Philosophers refer to paradigms as the belief systems through which we organize knowledge (Kuhn 1970). Social critics (Foucault 1969) demonstrate the degree to which our tacit assumptions define us and perpetuate the world that has defined us. This is as true with professional practice as social order, in the sense that what clinicians are taught as basic truths continue to guide their appraisal of their own practice and the new concepts they are exposed to. True growth requires that we are receptive to differences that cause us to challenge these core assumptions. Even the process through which we evaluate new information must be, from time to time, scrutinized. In an era of multiple treatment approaches and multi-discipline perspectives, this task is indeed daunting. How is it possible to comprehend and integrate all of the recent developments in the therapy arena? At one end of the spectrum, empirical research in brain imaging and neurophysiology reveal the mechanisms that best link cognitive processing and emotional response in the maturing brain. At the same time, the subjective concepts of empathy and attunement, therapeutic cornerstones that were dismissed or excluded in the evidence-based cognitive models, resurface as essential ingredients of healing. Tenets of social justice, equality and cultural competency dominate the landscape, but remain ideals rather then therapeutic goals to many clinicians. With this in mind, I asked established couples therapists to present their current approach to couples treatment. I asked them to identify the developments that most influenced and inspired their current practice, and to illustrate their use of self in their efforts to practice what they preach. The result is a volume that has the potential to expand, refine and revision how you work with couples. In my efforts to attract senior and highly respected clinicians to contribute to this volume, I reached out to Michael White. Given his travel schedule, writing and teaching commitments, I never expected him to respond, but Michael was a trained social worker with a commitment to need over prestige. I am proud but sad to include a paper that was never fully edited, as Michael died of a sudden heart attack before his paper was completed. Dulwich Publishing House has graciously allowed me to print this article that is largely based on a previously published book chapter. It came as no surprise that I was completely surprised by the ways in which his approach to working with couples had shifted, provoking me to re-consider clinical assumptions I had inherited and absorbed as tacit professional truths. J. P. Siegel (&) Silver School of Social Work, New York University, New York, NY, USA e-mail: judith.siegel@nyu.edu