The Evolution of Family Process: Contexts and Transformations1,2

Abstract

In April 2011, Family Process celebrated its 50th anniversary with a conference attended by editors, past and present, board, advisory editors, and early career scholars in Santa Fe, New Mexico. This editorial is my keynote address from this historic gathering. Evan Imber-Black. It is a daunting responsibility to present the 50-year evolution of Family Process. Searching for field-shaping, paradigm shifting, lens changing, direction setting papers required that I pore over more than 2,000 abstracts and scores of articles to cull themes, trends, and moments of sheer brilliance. Some of our journey will be linear, decade by decade, some will be a spiral, tracing the maturation of ideas over 50 years, and some will be a surprising turn of a kaleidoscope as the new and the novel appear. What follows here, with all humility, is simply one woman's story. The year was 1961, the place—the United States. In the rear view mirror, the conformist 1950s were inexorably slipping away. Just ahead was a decade marked by soaring hope, later to be coupled with the abject pain of war and assassination. An age of youth was dawning as 70 million baby boomers became teens and young adults. Social movements that would change us all were being born—civil rights, the early women's movement, and the awakening with Silent Spring of what would become the environmental movement in later decades. We walked on the moon and everything seemed possible. It was in this cradle that Family Process came to life. Springing from the nascent emergence of what had only recently come to be called Family Therapy, the journal was conceived in 1961 by Don Jackson and Nathan Ackerman as a joint venture of the Mental Research Institute in Palo Alto and the Family Institute, later to be named the Ackerman Institute for the Family, in New York City. The first editor was Jay Haley. Family Therapy was initially an underground movement. Emanating from some of the disappointments of psychoanalysis to successfully treat people with schizophrenia, as well as to address troubled adolescents, a handful of courageous pioneers began to see whole families, absent any theory and keeping their work a secret. Family Process would be one integral part of the coming out. The first issue of the journal appeared in March 1962, with a publication schedule of two issues a year. This issue contained 15 articles, book reviews, and abstracts from other journals. Every author was male. In an unsigned Introduction, (1962) we read: The aim of Family Process is to foster a development of a science of the family. Today, the study of behavior and the treatment of disorders of behavior is undergoing a quiet revolution.… In the purview of history, the study of the human being has gravitated to two extremes—the investigation of the isolated, individual personality, and the study of society. … The family, which is the link between the individual and his (sic) socio-cultural organization, has been curiously neglected. … We must study the person where he breathes, eats, sleeps, loves … in the intimate climate of his day by day family relationships. Many of the journal's early papers focused on bridging this gap between the individual and society via the family. Other major directions include the family as incubator of pathology, shifting the locus from a “sick” individual to a “sick” family. We read of silencing strategies, absent member maneuvers, families preventing change, and symptoms maintaining a family's balance. Papers on the exciting communications discoveries of the Bateson project inform us about levels of communication and meanings, report and command, nonverbal communication, and the ubiquitous double bind. A focus on marriage appears. Studies posed questions regarding what types of families produced what types of patients. Blame abounded—mothers and marriages were responsible for the symptoms in children, including reading problems. As a grandparent, I grew very excited when I found an early paper “The Importance of Grandparents in Family Life” (Hader, 1965)—my excitement sank when I read about pathology producing grandparents. Psychoanalytic theory was transposed to a family arena. Circularity was still somewhere over the horizon. And language, of course, reflected the times, as articles were filled with the assumptive universal “he,”“him,”“man,” men,” and “mankind.” Some ideas proved useful and some were blatantly wrong. As Chris Beels (2011, p. 8) noted in his March 2011 lead essay, “Family Process 1962–1969,”“Our theories produce a working environment, not a roadmap to actual intervention.” Of central importance is that inventive thought generated new energy, underpinned a desire to build a multidisciplinary field and sparked a spirit of curiosity that would carry the journal for half a century. Exciting trends of the sixties appeared, only to disappear until decades later. Carolyn Attneave's (1969) classic work on Network Therapy graced the journal in 1969. Not until June 2003, and coming to us from Scandinavia, do we again read of the full power of Network Therapy in “Postmodern Society and Social Networks: Open and Anticipation Dialogues in Network Meetings” (2003) by Jaako Seikkala, Tom Arnkil, and Esa Erikson—a work focused on psychotic patients and cases “stuck in the system” and their networks. This particular arc tells us about the starkly different developments of mental health systems, the values that underpin them and what is and is not possible in various countries around the world. A different theme that marked the opening years of Family Process and has evolved to the present day is that of schizophrenia and other major mental illness and the family. The first papers were searching for causation and pointing the finger at family interaction. Soon a notion of family life cycle development was added, as Haley (1969), in his final editorial, suggests that schizophrenia arises from a problematic leaving home. Only gradually did a much more sophisticated lens emerge in the twin studies of Lyman Wynne et al. (2006a, b), expressed emotion studies and the work of Carol Anderson, Michael Goldstein, Jill Hooley, David Miklowitz, David Moltz and William McFarlane, among others. Rather than blaming families, conceptual and research articles appeared, raising the question of how we can support families who are struggling with the pain and confusion of a mentally ill member. Psychoeducational multifamily groups developed with an evidence base. And in 2009 (Yu & Shim, 2009) we published an article about married couples in South Korea, in which each partner has a diagnosis of schizophrenia and where marriage, support of extended family, and a strength perspective on the part of helpers all contribute to a good outcome—a small study, highlighting family help, not family hindrance, in a country far, far away now reading and contributing to Family Process. Much of this work came under an umbrella opened early for us by Lyman Wynne. The brilliant culmination of Lyman's work, published in the journal in 2006, “I Genotype-environment interaction in the schizophrenia spectrum: Genetic liability and global family ratings in the Finnish Adoption Study” and “II. Genotype—environment interaction in the schizophrenia spectrum: Qualitative observations,” brought the journal and the field to a new and elegant appreciation of the simultaneity and complex interaction of biology and relationship. I know I join with many of you in this room to say I miss Lyman dearly—he would have loved this celebration of Family Process for which he was a steward, a guardian, a mentor, and a healer. Under Haley, the journal was truly a “mom and pop” operation, with him as the editor for 8 years and his wife as the copy editor. His work was bolstered by the editorial review board—pioneers in the field, all white and nearly all male psychiatrists. The field was so small at this time that the journal contained a section called “Family Affairs,” devoted largely to sweet gossip about those in the field—who received what grant, who was doing family therapy and where were they doing it. During this decade, at the urging of Don Bloch, who would become the 2nd editor, MRI and Ackerman sold the journal for U.S.$1,000 to what would ultimately become the Family Process Institute. Free-standing, not attached to one of the disciplinary organizations, the journal had the freedom to develop its unique niche that continues today—multidisciplinary, multimodal, iconoclastic—a home now for the best works melding scholarship and innovation, careful thinking and visionary leaps, whether that work be quantitative or qualitative research, clinical cases, theory development, or training. At the close of the 1960s, Ed Auerswald, in a paper titled “Interdisciplinary vs. Ecological Approach” (1968), calls for a new discipline, one based on Systems Theory. And in a sign that the field is growing and ready to produce a new generation, the first training paper, written by Andrew Ferber and Marilyn Mendelsohn, appears (1969). Finally, much to the relief of anyone trying to analyze 50 years of the journal, intermittent abstracts begin to appear. At the end of the 1960s, the editorship passed to Don Bloch. In his final editorial, (1969) Jay Haley warns Don Bloch, stating, “One of the tasks of the new editor of Family Process will be to help save the family field from respectability.” With prescience, he cautions that the 1970s will pose “an increasing problem of the relationship of the journal to factional struggles…” And with some degree of error, he predicts that the field will gain “prestige and power.” As the first decade of the journal closed, we had witnessed the assassinations of John F. Kennedy, Robert Kennedy, Martin Luther King, and Malcolm X. As we entered the 1970s, the Viet Nam war was strangling our spirits. The Kent State massacre, the Pentagon papers, Watergate—all led to disillusionment with government. This decade also brought Roe V. Wade, Affirmative Action, and a major Immigration Reform law that shifted the U.S. traditional favoring of European immigrants towards those from developing countries. Taboos were breaking—the first Gay Pride March was held. The first test tube baby was born in England. Smiley faces appeared, hopefully as ironic commentary, and people began to nurture pet rocks. In 1970, the journal began to publish four issues a year, surely a statement of the burgeoning knowledge available for publication. The Family Affairs section of the journal disappeared, as the field was now too large. European authors began to publish in the journal, a first step to a truly international commitment realized in the 21st century. The 1970s were a decade marked by the elaboration of models of Family Therapy: Minuchin's Structural, Haley's Strategic, Weakland, Fisch, Watzlawick, and Bodin's Brief Therapy, Bowen's—well, Bowenian, Ivan Boszormeny-Nagy's Contextual, Whitaker's Symbolic-Interactional, and Satir's Experiential—each with its own explanatory metaphors for family relationships, its own “correct” way to do Family Therapy and ideas about training reflective of the model's theory. In the larger field and on the pages of the journal, model wars ensued—often exciting, sometimes discouraging. In a 1971 article shortly before his death, Nathan Ackerman commented, “The state of affairs in family therapy today is ambiguous to say the least. … Conspicuous … is the lack of consensus on the theoretical foundations of this form of intervention. As of the present moment we are a far distance from achieving an integrated theory of family behavior and of family healing” (p. 143). It took until the end of the 1970s for a paper to appear critiquing the model wars in the field. The critical importance of Live Supervision, Family Therapy's unique contribution to training, was highlighted in a paper by Braulio Montalvo (1973). A bevvy of creative techniques were published—Papp, Silverstein, and Carter's Family Sculpting (1973), Anderson and Malloy's Family Photographs (1976), Irwin and Malloy's Family Puppet Interview (1975), and Rubin and Magnussen's Family Art Evaluation (1974)—all expanded our extraverbal repertoire. The importance of stages of family development began to appear with papers on the Family Life Cycle. Respect for varying family forms—separated, divorced, remarried—replaced the earlier focus on the two-parent nuclear family. All of the families at this point, however, were decidedly heterosexual. Gradual attention began to be paid to cultural differences and immigration, a theme that has carried forth and particularly re-emerged in the 1990s and the first decade of the 21st century. Carlos Sluzki's classic paper, “Migration and Family Conflict” (1979), led the way with a systemic view of the struggles of immigrants. Monica McGoldrick (1981) enabled us to examine experiences of specific ethnicities. In the present decade, Celia Falicov's work (2007) opens our thinking to transnationalism and the place of family therapy in the new field of Migration Studies. “Working with Transnational Immigrants: Expanding Meaning of Family, Community and Culture” amplified our knowledge of the ways 21st century immigrants maintain intense connections with their countries and extended families. We learn of the complexity of relationships that arise from transnational bonds, enabling us to do what this journal has done best—question existing discourses and push to new theory and practice. Ground-breaking research attending to the mental health needs of Latino families carried forth the journal's commitments in the special 2007 issue “Advances in Latino Family Research: Cultural Adaptations of Evidence-Based Interventions,” conceived of by my valued associate editor for research, Guillermo Bernal, and edited by Guillermo and Melanie Domenech-Rodriguez (2009). A powerful evocation of the immigrant theme recently appeared in the June 2011 issue of the journal in the work of a new generation: Ana Baumann, Melanie Domenech-Rodriguez, and Jose Ruben Parra-Cardona's courageous journey as research-practitioners with Latino immigrants enveloped in immigration raids and discriminatory practices. Combining a post-modern sensibility—one that refuses to let us stand outside—with a solid empiricism, they challenge us to painstakingly appraise the need to bend accepted hierarchical boundaries of “researcher-subject,” to listen collaboratively in order to secure local knowledge, and ultimately to take action on the side of social justice as a model for the journal and the field going forward. Shifting back to the 1970s—Marital Therapy as a separate discipline, rather than a subset of Family Therapy, made its first entry with two papers by Al Gurman, published in 1973—“Marital Therapy: Emerging Trends in Research and Practice” and “The Effects and Effectiveness of Marital Therapy: A Review of Outcome Research.” Drawing our attention to empirical and methodological issues, Gurman guided us to a new research agenda that elaborates to the present day. As the 1970s drew to a close and foreshadowing the powerful feminist critique of family therapy to come in the 1980s, Rachel Hare-Mustin (1978) gave us “A Feminist Approach to Family Therapy.” Throwing down a previously missing and much needed gauntlet, Hare-Mustin challenges us: Although family therapy recognizes the importance of the social context as determiner of behavior, family therapists have not examined the consequences of traditional socialization that primarily disadvantages women. The unquestioned reinforcement of stereotyped sex roles takes place in much of family therapy … family therapists who are aware of their own biases and those of the family can change sexist patterns through applying feminist principles to such areas as the contract, shifting tasks in the family, communication, generational boundaries, relabeling deviance, modeling and therapeutic alliances. (p. 18) A decade that began with model wars in the field and the journal was about to enter a decade marked, in part, by gender wars. In the 1980s outside of the journal, the “Me” generation was rampant; American college students avowed that they wanted status and power; people fought each other in shopping malls to get Cabbage Patch dolls; teens bought high-priced sneakers; the space shuttle exploded before our eyes; Nancy Reagan told us to “just say no”; the Viet-Nam War memorial was dedicated; the Berlin Wall fell; HIV/AIDS appeared; August Wilson's profound dramatic cycle of 20th century African-American experience began, as did the Human Genome project. In 1984, under the leadership of Carol Anderson, Froma Walsh, and Monica McGoldrick, a conference was held with 40 women leaders in Family Therapy. Popularly referred to as Stonehenge, we shared our work and our frustrations as women in the field. We made commitments to support one another's writings and presentations. And on the last day, we focused on activism. We examined the paucity of leadership roles filled by women in both the major professional organizations and the scholarly journals. A stealth movement was born dedicated to eradicating gender discrimination in Family Therapy. We counted the number of women advisory review editors. In 1984, Family Process had 15%. In 2011, 49% are women. Glorious articles on gender enriched the pages of the journal in the 1980s. Two papers by Virginia Goldner—“Feminism and Family Therapy” in 1985 and “Generation and Gender: Normative and Covert Hierarchies” in 1988—combine to question the sufficiency of systems theory. Skewering our favorite Family Therapy paradigm of over-involved mother and peripheral father, and highlighting this arrangement as the product of a centuries' old process embedded in the hidden relationship of home and work leads, at last, to an insistence on gender as a fundamental organizing principle in families. This led, in turn, to powerful work on violence towards women and child sexual abuse. During this decade Don Bloch retired as editor, and Carlos Sluzki became the new editor. During his tenure, the intellectual foundations of the field continued to deepen and systemic practices to expand. In 1983, Family Process served as midwife to a new journal, Family Systems Medicine, later re-named Families, Systems and Health. Three hardly noticed and simultaneous trends occurred: Former European contributors began to send their work to newly born journals in their own countries and languages. Authors of sparkling clinical papers turned to writing books. And the dreaded impact factor began to rank social science journals, making Family Process an increasingly welcome home for research papers. Mirroring the silence and imposed shame in the wider society, it was not until 1980 that the first article on lesbian relationships was published—“The Problem of Fusion in the Lesbian Relationship” by Joanne Krestan and Claudia Bepko, focusing on the dilemmas of committed lesbian couples seeking to define their relationship in a wider social context that disparages them. It would take 8 years before the next article dealing with homosexuality appeared in the journal, and another 8 after that for the subsequent one. From 2000 to the present, papers on gay and lesbian couples and gay and lesbian headed households appear regularly. The most recent, in the special issue, Innovations in Couple and Family Therapy Theory and Practice, September 2010, Arlene Istar Lev's“How Queer!—The Development of Gender Identity and Sexual Orientation in LGBTQ Headed Families” allows us to examine the inadvertent consequences of well-intended research showing homosexual couples raise straight kids, as we walk alongside a lesbian couple's struggle to embrace difference in their child. In the 1980s, the field was electric with new thought. The decade brought the work of the Milan team—the lead article in March 1980 was “Hypothesizing, Circularity, Neutrality: Three Guidelines for the Conductor of the Session” (1980) followed later in the decade by Gianfranco Cecchin's response to the feminist critique of neutrality, “Hypothesizing, Circularity, and Neutrality Revisited: An Invitation to Curiosity” (1987). Their work inspired many papers on using interviewing to create change—Peggy Penn's Circular Interviewing (1986) and Future Questions; and the work of Karl Tomm on interventive interviewing (1987). Solution-Focused Therapy papers and the work of Steve deShazer abounded. Papers on paradoxical techniques, therapeutic debates, therapist-team splits, Peggy Papp's Greek Chorus all created a new excitement as the clinical arm of the field turned to highly therapist scripted, and sometimes manipulative interventions. Therapist and family were conceptualized as being in a competitive relationship in which the therapist needed to be more clever. Late in the 1980s, Post-modern theory transformed this thinking. No longer was the therapist conceptualized as an outside observer operating on a family system. Pattern replaced pragmatics. The all-knowing therapist shifted to collaboration among family, therapist, and team exemplified by “Human Systems as Linguistic Systems: Preliminary and Evolving Ideas about the Implications for Clinical Theory” by Harlene Anderson and Harry Goolishian (1988) and “The Reflecting Team: Dialogue and Meta-Dialogue in Clinical Work” by Tom Andersen (1987). As theorists sought to unpack paradox, epistemology, lineal causation, and second-order cybernetics, some of our literature became unreadable. Toward the end of the decade, our British colleague, Bryan Lask, in a paper entitled “Jargon. Ambiguity, Pomposity and Other Pests,” had this to say: “How many readers of this Journal can in all honesty say that they know what ‘epistemology’ means, or worse, ‘eco-systemic epistemology’? Can they do better with ‘complementary schismogenesis’ or ‘Cybernetic metaphor’…? The current vogue in family therapy literature for writing in a style that is at best pompous and unwieldy, and at worst incomprehensible, must be challenged” (1987, pp. 396–397). I remember reading this with fondness and wanting to cheer. In the 1990s home computers and the internet galloped into our lives. In the United States and the western world, economies were booming. Simultaneously, we witnessed the horrors of so-called “ethnic cleansing,” and CNN gave us live coverage of the first Gulf War. Nelson Mandela was freed and apartheid officially ended in South Africa. Concurrently, the US furthered the civil rights agenda, passing “The Americans with Disabilities Act,” and profoundly damaged it passing “Don't Ask, Don't Tell.” In 1990, Carlos Sluzki reminded the field of its activist origins and berated our neglect of minority families and the development of people of color as professionals in the field, stating “We propose that the family therapy field actively and sustainedly address…the contribution and participation of minority colleagues, and…expand attention to minority-relevant themes in its clinical activities, professional organizations, training programs, and publications—including Family Process” (p. 1). It would take many years for this pledge to begin to be realized. The editorial review board in the 1990s had 2 people of color out of 74; the board of directors had one. Today, we have 15 out of 88 and half the board of directors are people of color. Articles reflecting this shift began to appear in the late 1990s, exemplified by “Engagement of African-American Families in Research on Chronic Illness” (1998) by Barbara Holder and colleagues, a sophisticated empirical study examining the reciprocity among family, health care team, and researchers, and “Toward an African American Genogram” by Dee Watts-Jones (1997). Here research and clinical theory coalesce in two very different papers—both addressing the critical matter of appreciating that boundaries in African-American families likely differ from those of Caucasian families, as may the definition of who is kin. Peter Steinglass became the editor in the 1990s. Two very different trends appear—a growth of empirical research and the advancement of evidence-based and evidence-informed models of treatment, and the unfolding of the Narrative Approach in Family Therapy. Two very different paradigms, belief systems, sets of assumptions, and approaches to knowledge inhabited the journal side by side. Research papers focused on developing scholarship in expressed emotion, major mental illness, and physical illness, combining physical, psychological, and interactional factors. Randomized clinical trials were reported in the journal for the first time. Beginning with Vicki Dickerson and Jeffrey Zimmerman's 1992 paper “Families with Adolescents: Escaping Problem Lifestyles,” the clinical side is filled with narrative therapy. The narrative metaphor, steeped in social constructionism, post-modern, and post-structural theory, with emphasis on multiple meanings, unique outcomes, local knowledge, and non-normative beliefs, stands far from empiricism. And while Peter Steinglass wrote in an editorial that he believed the two might ultimately find a way to join, this is one mixed marriage that never made it to the altar. For me, the resounding power of Family Process is that quantitative research, evidence-based models, and an empirical view and narrative and collaborative approaches elaborating in the past two decades can live as respectful neighbors in a field large enough to hold both. My hope is that these neighbors will meet, having graciously read and carefully considered one another's work. My message to the younger generation here is a plea that you occasionally let go of the key word method of finding only those articles that will re-enforce what you already believe, and that you dive into ones that may seem strange and exotic—we older generation might try that, too. As F. Scott Fitzgerald told us (1936): “The test of a first rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function.” The 1990s also saw the beginnings of Attachment Theory in Family Therapy. Beginning in 1994 with “Creating a Secure Family Base: Some Implications of Attachment Theory for Family Therapy,” John Byng-Hall emphasized attachment theory needed to be applied systemically and not dyadically. He affirmed decidedly that we should not create yet another new model of family therapy—I'm not sure who was listening. Near the turn of the millennium, the editorship passed to Carol Anderson, the journal's first woman editor. The journal lived now in a world of cell phones, Y2K, managed care, Harry Potter, and a completed Human Genome. The period was drastically and suddenly reshaped by the 9/11 attack on the World Trade Center. Two endless wars began. The pages of the journal and the realities of the outside world grew more in sync. During Carol Anderson's tenure, the journal became more international, with publications from Asia and the Middle East. Earlier themes deepened and connected with one another, bringing together race, gender, and major mental illness, for instance. The journal acquired a web site, and an associate editor for the web who continues with my deep appreciation to this day, Anne Bernstein. A multisystems mosaic is increasingly realized with papers examining the complex interaction of genetic and social influences. In 2001, “Genetic Probes of Three Theories of Maternal Adjustment: Recent Evidence and a Model” by David Reiss and his international research team propose a new circularity, integrating genetic factors with family interaction and our social world. This vital theme—the spiraling reciprocity of genetics, relationships, and well-being—continues in my editorship with the 2005 papers of John Rolland and Janet L. Williams, “Toward a Biopsychosocial Model for the 21st Century,” and Susan McDaniel, “The Psychotherapy of Genetics.” Responding to the imperative of 9/11, Carol Anderson swiftly organized an extended special section of invited essays for March 2002. As anyone familiar with journal deadlines knows, this was a feat of cooperation and dedication among authors, reviewers, and the editor. Noting our forever changed world in her editorial, Carol stated: “Our own families, and the families we work with or study, now live in a new and less certain world that will influence how we work … care for one another. … How do we help each other to be resilient … in the face of tragedy, grief, and anger? How do we learn to keep caring for one another and the world, to be optimistic in a time when there seems so much hate?” (p. 1). The essays that follow warn us with prescience of the anti-Muslim prejudice just around the corner, and beseech us to make true community. A series of sweeping and inspirational essays by Kaethe Weingarten begin at this time and continue into my editorship. Appearing in 2000, before the towers fell, “Witnessing, Wonder and Hope” provides the soon to be imperative value of self in community. In 2006, “On Hating to Hate” tells us that “Hate may be the most dangerous of all emotions for the survival of the planet,” and asks us to imagine a world without hate—for ourselves and the families with whom we work. Finally in 2010, “Reasonable Hope: Construct, Clinical Applications, and Supports” provides the fully realized therapeutic considerations of hope as a practice, as that which we do. Clinical theory, practice, and research in Couple Therapy are featured in a special issue on Marriage in the 20th Century in Western Civilization, guest edited by William Pinsof (2002). Examining new ways that we mate, separate, divorce, remarry, the issue exemplifies the growing separate field of Marital Therapy and Research, foreshadowed in the early days of the journal. Race and gender in marriage remain in separate papers, raising the critical question of how we can knit a more