Theory and Practice of Couples and Family Counseling. James Robert Bitter
Satir’s work in this cross-cultural experience was overwhelming. I came away from the month with a new dedication to experiential teaching and learning and a determination to integrate Satir’s human validation process model with the Adlerian principles I used in clinical practice (see Bitter, 1987, 1988, 1993a; Satir et al., 1988).
In 1980, I became a member of Satir’s AVANTA Network, an association of Satir-trained practitioners who used her methods and processes and were engaged in training others to do the same. For the next 9 years, until her death, I was privileged to work with Satir during three more Process Communities; to coauthor an article and a chapter with her; and to spend at least a week each year learning the newest ideas, hopes, and dreams of one of the most creative family systems therapists ever to have graced our planet.
Virginia Satir taught me the power of congruence in communication as well as the forms that metacommunications often take in relationships. She introduced sculpting to my work and gave me processes for creating transformative experiences with families. Her emphasis on touch, nurturance, presence, and vulnerability put my heart as a person and a counselor on the line, but it also opened up avenues of trust and caring that had been missing in my work before. Satir taught me how to join with families and still not get lost in them. When she died, it was as if I had lost a mother, a father, a sister, and a brother all rolled into one. I had certainly lost one of the best teachers in my life.
In the 1990s, I had two opportunities to do monthlong training programs with Erving and Miriam Polster, the master Gestalt therapists. Their emphasis on awareness, contact, and experiment in counseling fit wonderfully with the decade’s worth of knowledge I had received from Satir. The Polsters also had the same kind of great heart that Satir had. Whether working with individuals, couples, or families, both Satir and the Polsters demonstrated the importance of an authentic and nurturing relationship in facilitating change. At the heart of both models was a dedication to experiential counseling and learning through experiment and enactment. Even today, when I walk into a room to meet a family, I feel the wisdom of these great therapists with me (see Bitter, 2004).
As you can see, I have been gifted with great teachers in my lifetime. They have welcomed me into learning situations that I would not trade for anything in the world. Watching great masters at work has provided me with ideas and models for effective interventions that I never would have discovered on my own. To tell the truth, I often found myself imitating them initially in very concrete ways, sometimes using the exact words and interventions that I had seen them create spontaneously. Over time, I would begin to feel a more authentic integration of their influences in my life and work, and I let these influences inform my own creativity in family practice.
I have become fascinated by the flow and rhythms of therapeutic relationships. The two most important aspects of family practice are still the client and the practitioner, with the latter being in the best position to influence the process. I currently think in terms of four aspects of therapeutic movement: purpose, awareness, contact, and experience (Bitter, 2004; Bitter & Nicoll, 2004). You may already have noticed that the acronym for these words is PACE. In both my personal and professional lives, paying attention to purpose, awareness, contact, and experience brings a useful pace to human engagement and provides me with enough structure to support creativity in my interventions.
Purposefulness has always been a central aspect of Adlerian counseling and provides a sense of directionality and meaning to life (Sweeney, 2019). Awareness and contact are most clearly defined in the Polsters’ Gestalt practice. I consider both of these aspects to be critical to an enlivened and energized life. They make being present sufficient as a catalyst for movement and change. Awareness and contact are also essential to more fully realized human experiences. They allow both the client and the practitioner to touch the authentic within them and to find expressions that flow from their hearts. Such experiences are a natural part of Virginia Satir’s work. The therapeutic experiments and enactments common to systemic family counseling are just one form of such experiences.
Although I like the integration of thinking and practice that currently marks my own work, I began by absorbing as much of the great masters as I could, often imitating them until their processes became natural within me. I would recommend a similar process to you. If family systems theory and practice is what you want to do, find a model or set of models that seem to fit you. Then watch as many tapes and DVDs that feature your chosen approach as you can.1
Each theory chapter in Part 2 of this book has a transcript of an actual family counseling session right after the model is introduced. I have tried to pick couples or family practitioners who represent the most current development of each approach and who are still working and clinically active today. I have also created a fictitious family I call the Quests, which is a conglomerate of several real couples and families I have worked with over the years. I use this created family to demonstrate how each theoretical perspective might work with them. As you read about both the actual family and the fictitious family in each chapter, think about which approach you like best, what you would want to do or use yourself, and what you cannot imagine yourself doing. This is one way to begin to narrow down the choices to the systems perspectives that best fit you.
Thinking systemically about clients is one perspective—or I should say, set of perspectives—that provides a framework for therapeutic practice. For me, thinking systemically just fits the way I see human process and the social world in which we all live. We are social beings. We interact with others every day. We are influenced by the people in our lives, and we return that influence to them. In truth, we are very seldom alone, and even when we are, we are often thinking about and reflecting on life with others. Even the act of giving help involves at least two people, and in my mind, counselors join with even single clients to form a new system. I believe in family systems counseling because it is a reflection of the way we live. And at its best, intervening in systems increases the likelihood that when change is enacted, it will be supported and maintained.
An Overview of the Book
Family counseling was initiated in the early part of the 20th century, but it was in the latter half of that century that the practice of working with families really came into its own. That is when the masters of family theory and practice—Nathan Ackerman, Gregory Bateson, Murray Bowen, Oscar Christensen, Rudolf Dreikurs, Richard Fisch, Jay Haley, Lynn Hoffman, Don Jackson, Cloe Madanes, Monica Mc-Goldrick, Salvador Minuchin, Virginia Satir, David and Jill Scharff, Mara Selvini Palazzoli, Paul Watzlawick, John Weakland, and Carl Whitaker—developed ideas and models that would serve as the foundation for the family practice professions. After some 60 years of substantial growth and development, the field began to incorporate the postmodern, social constructionist positions of Tom Andersen, Harlene Anderson, Insoo Kim Berg, Steve de Shazer, David Epston, Kenneth Gergen, Harold Goolishian, William O’Hanlon, Michele Weiner-Davis, and Michael White. Race, culture, gender, and family life cycle development are now central considerations and assessments in family counseling.
From the last decade of the 20th century to the present, couples counseling has emerged as a distinct discipline in its own right. Although each of the family models has adapted its approach to working with couples, three new models currently dominate the field. These models, developed by John and Julie Gottman (the sound relationship house model), Susan M. Johnson (emotionally focused therapy with couples), and Harville Hendrix and Helen Hunt (imago therapy), are all based on the neuroscience that supports and confirms attachment theory (see Porges, 2017). The models fall in the realm of evidence-based practice, and given their prominence, they are addressed in separate chapters in this book.
Couples and family practitioners come in many different forms and represent similar, if distinct, orientations. There are the marriage and family therapists who receive their training in programs that are now largely autonomous and accredited by the Commission on Accreditation for Marriage and Family Therapy Education, the accrediting body of the American Association for Marriage and Family Therapy. There are couples, marriage, and family counselors who receive their training in counselor education programs, sometimes accredited by the Council for Accreditation of Counseling and Related Educational Programs, and who belong to the International Association of Marriage and Family Counselors, a division of the American