Plenary given at The Pan Pacific Family Therapy Conference 2001
- Johnella Bird

Introduction
I have been told in the past that I am not theoretical enough. I've been told in the past that I'm too theoretical. Today I will attempt to walk the line, where I speak to the spirit of the work while standing alone on this stage. I'll attempt to represent the practacilities of our work while presenting the key theoretical ideas that are foundational to my work.

I'll remind myself of the love that was extended to me by my family and friends before I left Auckland, New Zealand.

I feel passionate about the work and I hope this passion is apparent as I speak with you all. The culture I will be speaking of today is the culture of therapy.

The title I have chosen for this plenary, is "To Do No Harm", which represents to me a striving or an intention. It does not represent a therapeutic model, a rule or a statement of fact. I have a striving 'to do no harm' needs to be at the forefront of the development of ways of working with people together with the subsequent critique of these ways of working. When this intention or striving is absent, we risk becoming agents of social control. When we become agents of social control we contribute (either wittingly or unwittingly) to the further marginalisation of those who are disenfranchised by the dominant group. My membership of the dominant cultural group supports me to speak directly to us about the challenges I have found and the strategies I have put in place to minimize my participation in the practices and ideas that injure and marginalise others.

I was attracted to Family Therapy in the late 70s because it promised
- ways of working that limited therapists involvement with and in people's lives.
- it had a focus on what could be changed versus what was damaged.
- and it had an inherent optimism about both people's c
I believe that throughout the 80s and 90s Family Therapists in New Zealand were at the forefront of challenging the neutrality of therapy or counselling in respect to gender and culture. We encountered exciting and painful times as we discovered individually and collectively that 'good intentions' did not protect our colleagues from the experience of injury through our neglect and ignorant assumptions.

This comment is not derogatory of either myself or of my colleagues. It is simply the way it is and was. These experiences continue to drive the passion I have for both teaching and engaging in the clinical work. It is incredibly challenging to create the conditions where we remain alert to that which we don't know. It is incredibly challenging to remain alert to our collusion in an imposition of meaning that acts to marginalise others.

I have metaphorically described my attempt to meet these challenges by reflecting that within the therapeutic work I try to stand on I turn toward other people's unique lived experience I ready myself to and for discovery, supported by what it is that I know while being ready and willing to have this knowing changed, added to or confirmed. This intention is moved into a living practice through an engagement with a linguistic strategy which I call relational externalising.

Relational externalising evolved as a consequence of the clinical work I focussed on from 1988 to 1999. Through this time I found myself addressing the effects of sexual, physical and emotional abuse with people. Many of you will be familiar with externalisation. In 1989 I began this work supported by the clinical knowledges and skills I had collected, which included the technique of externalising the problem. I discovered that the concept of identifying the problem became problematic when the identity or self was regarded or known as the problem, i.e. I'm bad, mad, dirty, wrong, responsible for the abuse, crazy, ungrateful, weak, sick, deserving of being hurt.

Consequently I evolved a practice which had an emphasis on a deconstructive exploration of the everyday language we use, which both describes and shapes lived experience. The following represents the distinctions I've drawn between externalising and relational externalising.

Overhead -Relational externalising and externalising difference
This method of languaging supports me to begin an enquiry process using the descriptions people give me of lived experience. For many people (including children), words are and have been meagre representations of their experience. When we privilege the language of the everyday through a relational externalising enquiry, therapists and clients are provided with an opportunity to negotiate and re-negotiate the language that more closely represents lived riptions that are shaping of our lives, we have an opportunity to reinvent these descriptions while exposing the benefits of one description over another for the self, others, or institutions. e.g. Trust overhead 2 Thus creating multiple linguistic possibilities versus the binary or middle way.

The process of discovery I have embarked on over the last twelve years has been guided by an emphasis on the ethics of therapeutic practice (i.e. the desire 'to do no harm'.) This emphasis promotes a relating to clinical models (which includes theoretical ideas and practices) ra model does not however mean that I endorse the notion of the eclectic. The eclectic therapeutic practice is unaccountable and potentially dangerous unless the practitioner can articulate the ethics that underpin this eclectic practice. The ethics are then available for review, reflection, challenge and change. We cannot stand in a multiplicity of places at the same time. I stand in one place while making that place available for reflection and review from time to time (e.g. reflect on how I have engaged in the movement from psychodynamic ideas to Milan systemic family therapy ideas - to including a sampling of strategic ideas to M. White's ideas, to the evolution of the ideas I've developed.

Overhead 3
Here is another example of the Relational Externalising language use
We could Re-search using a relational externalising process.
- the wanting
e.g. - what brings the wanting to push away to the forefront.
- If you put words to the wanting, what would they be?
We could Re-search
- The push away
e.g -What do you use to engage with the push away?
- What do you notice about yourself as you begin to engage with the push?
- If you were too put words to the desire to push away, what would they be?
- How does a sense of exhaustion impact on the desire to push away?
- Have you ever felt this desire to push coming and instead you have done something different?

I also want you to use the imagination to feel the effect of relational externalising.
An everyday example - think about a time that you experienced a sense that you have been misunderstood in a relationship.

i.e. I feel misunderstood by .......Answer these questions as I ask them.
a) When did you notice that this understanding was getting lost?
b) When you noticed this understanding getting lost, what did you do?
c) How do you think the other person would have made sense of this?
d) If a renewed sense of understanding had been achieved in the relationship, how would you have known this? What would have changed?
e) What would the other person now know about you or the relationship if this sense of understanding had been achieved?

- Come back to this conversation.

The understanding we are constructing is neither generated by me or by you.

It is generated by a relationship to the relationship (which carries a history, expectations, hopes and dreams).

It is generated by a relationship to the meanings constructed by the words used to faci
and,

it is generated by a relationship to the meanings made of body language/body posture and the emotional reading between the word lines.

By utilising relational externalising we move beyond the absolutes generated by the conventional use of the English language. Language where you either understand or you misunderstand or you are either understood or you are misunderstood.

Every psychological, social, anthropological and political text which is constructed with and by the English language adheres to grammatical rules that act to generate binaries and thus absolutes. These absolutes tend to create polarities that obscure the fractional, intimate and contradictory experiences of our lives. Meaning is constructed through this thereby generating the realities that we all

We know that the spectre of the professional gaze is discriminatory as it falls on the marginalised, the "other/than" the dominant cultural group. The gaze translates to language and inevitably the language of assessment, categorization and evaluation.

The power of these binaries is confirmed through the use of the pronoun you, your, my or mine. When we use the pronoun in this way we generate the conditions where definitive internal states are created. These definitive internal states are the dominant feature of self and other descriptions, i.e. 'I'm a confident, determined person,' 'She's got really high self-esteem,' 'He's a nervous man,' 'I'm depressed,' 'She's resistant to her the we create a relationship to these qualities, ideas and practices. The linguistic relationship we create has real effects, e.g. There is a significant difference between believing I am a confident person and discovering that I have relationship with the ideas and practices that are generative of this sense of confidence. This linguistic relationship allows us to re-search the implications of gender, culture, family of origin, etc., on the development and maintenance of the experience of confidence. Relational externalising supports us to identify and deconstruct the significant language that is used to reflect and generate lived experience including the taken-for-granted 'personality traits'. This languaging strategy is the principal support for an enquiry that makes the real effects of privilege apparent or visible to people
Most of us would agree with the principle of treating the people we work with, with respect. We would expect ourselves to be trustworthy. Some of us (myself included) would hope to collaborate with people. Thinking this, hoping this, speaking of this, writing about this does not generate this within the therapeutic relationship. When we construct trust, collaboration and respect through the conventions of the English language we construct absolutes.

Thus we are either trustworthy or not, respectful or disrespectful, collaborative or imposing. These binary positions construct an environment where any challenges to the constructions we hold are experienced as a challenge to our integrity. Consequently we are tempted to argue back directly or indirectly (in our heads). When the challenge comes from a member of a marginalised group and the person being challenge belongs to a dominant group then the arguing back carries the weight of our membersp within the dominant group and thus acts to exclude and/or silence the other. This challenge rarely occurs within therapeutic relationships because of the inherent power relationship that exists within this relationship. Note - J.B. to speak to this, (i.e. refer narrative literature and other literature where notions of respect are an integral part of the work versus we orientate ourselves to de-construct the relationship we have with ideas and practices that are representative of respect, i.e. as a cultural practice).
Thus - respect is not intrinsic
- respect is constituted through cultural practices
- and we relate to respectful ideas and practices.

Some therapies obscure the power relationship within therapeutic relationships with ideas r therapies argue for the therapist to use an imposition of meaning (and thus an imposition of the power relationship) for the benefit of people (clients), ie. we know and you don't. In this environment it is difficult for people who are marginalised to believe that the 'professionals' judgment is wrong or culturally or gender biased.

The 'we know, you don't' position constructs the neutral objective observer/therapist who assesses and intervenes in people's lives. This position is supported and guided by the adherence to the psychological truths which have been constructed through either so called neutral and objectivetions, i.e. (this behaviour or this interaction means the following). When we take up this position we do not consider the observer/therapist as a central determiner of meaning. We don't consider that she/he makes distinctions, carries bias or interacts actively with the information she/he receives. The information received and sought by therapists from within this environment is subsequently fitted into professional and personal known truths. Various Family therapy and psychodynamic therapeutic approaches have and do adhere to this tradition. (e.g. it takes two years to grieve adequately for the end of a relationship).

The ambiguous and the contradictory moments which fill people's lives are nullified by the power of these grand theories.Tinvisibilises the effects of privilege through gender, culture, class on people's psychological and physical well-being. In other words this position does harm by confirming universal psychological truths which relegate those people on the margins to both professional constructions of inadequacy - sickness, badness and madness together with subsequent self constructions of inadequacy, sickness, badness and madness.

In reaction to the 'we know, you don't know' position many therapists have taken up the position of 'we don't know - you know', (Note 'I do know something'). Many therapists who use the narrative metaphor to guide their work have attempted to address the power relation by the following:-
- focussing on people's competencies and strengths
- self disclosure, i.e. "I also have struggled with this".
- reflecting back to people how they have contributed
These attempts to "even up the relationship" have acted to disguise the inevitable power relation that exists in the therapeutic relationship, supervisory relationship, consultation relationship or teaching relationship while at the same time moving the therapist, supervisor, consultant, teacher into a subject position. From this position it is very difficult for the other (client, supervisee, student) to speak to a sense of discomfort or difference or an experience of the power relation. To speak in this environment is to challenge the good intentions of the other. When people experience receiving good intentions by a member of the professional classes (this includes the dominant cultural group and other classes of domination) this can create either a sense of gratefulness (i.e. "this person is really trying to understand, no-one else has ever wanted to know") or a sense of care taking (i.e. "This person is really trying, they've got it wrong but if I tell them they'len people (clients) occupy either of these positions they are forced to defer to the good intentions we hold even if these intentions act against them.

Those people who have the courage to expose the effects of the power relation in this climate of good intentions, are exposed to the risk of being labelled both by members of the professional classes and the peer group they belong to. The operation of the power relation within this climate of good intentions is thus insidious, dangerous and does harm. It risks further marginalisation of the marginalised and alienation of people from their environment of belonging.

In order to limited the possibility of harm as the result of the power relation in the therapeutic relationship, we need to be able to acknowledge, expose and negotiate the operation of power within the therapeutic relationship (e.g. permission getting - note taking, gender)

Exposure of the power relang to, the sense of being overwhelmed, challenging the panic that comes with expectations, the critical ideas that act to silence, etc. This relational entity allows us to explore contextually the experience of the relational self. In this exploration the limitations and strengths of good intentions is exposed and explored.

In the therapeutic relationship I'm suggesting that the therapist positions her/himself relationally. This relational position is maintained through a relational form of consciousness. In turn the relational form of consciousness is created and maintained by a particular way of engaging in and with language, i.e. relational externalising.