Keynoters and Invited Speakers
Healing Intergenerational Wounds: An Integrative Contextual-Neurobiological Approach
In this keynote, Dr. Fishbane will explore ways to facilitate healing and dialogue in distressed relationships between adults and their family of origin. Informed by both contextual theory and interpersonal neurobiology, she will discuss the neurobiology of intergenerational reactivity, and ways to promote emotion regulation and respect between the generations. Building on Boszormenyi-Nagy’s concepts of loyalty, multidirected partiality, and rejunctive action, Dr. Fishbane will focus on “relational empowerment”—including self-regulation, authenticity, generosity and empathy. She will offer techniques to help adult clients “wake from the spell of childhood,” relating to parents as individuals on their intergenerational journey. Relational ethics is key: helping adult clients “reach for their best self” in family relationships, balancing self-care with care and compassion for parents. Healing old intergenerational wounds often helps clients in their other relationships, as they resolve invisible loyalties and develop relational resilience.
Cultivating Resources of Trusworthiness in the Adult Intergenerational Family
Strengthening Connectedness in Close Relationships
This presentation is about a model for the application of contextual theory according to Ivan Boszormenyi-Nagy into therapy practice.
For a start, contextual theory will be briefly presented according a new order and from the perspective of the core-elements of this theory. Starting from the perspective of the contextual axiom encompassing the human innate sense of justice and care, it will be elaborated in the contextual anthropology, the contextual pathology and the contextual methodology. This reconstruction of the contextual theory may improve the accessibility of this complex theory, and facilitate the applicability of contextual theory in practice.
Thereafter, a model for applying this contextual theory into therapy practice is presented. It has been developed on the basis of an analysis of the practices of Nagy and twelve current senior contextual therapists.
In essence, this model supports the contextual therapist in enriching or restoring reciprocity by focusing on mutual giving and receiving. The contextual approach particularly considers responsible care for the other to be the source of a meaningful life and for close, trustworthy relationships. This model structures and gives direction to a contextual therapy process, without claiming to be a prescriptive model. It aims to assists family therapists and other professionals in integrating the core
element of this approach, relational ethics.
Finally, the core of this family therapy approach appears to be true to its axiom: people are interconnected because of their being human, including their innate sense of justice and care. This sense is considered the strength and resilience of people and thus ‘the motivational layer in which hope resides for repairing the hurt human justice’.
Jaap van der Meiden, MCH, PhD is senior lecturer and researcher at the Christian University of Applied Sciences Ede (CHE), and founder of the CHE Institute Contextual Approach.
Contributions of Contextual and Restoration Therapy to Psychosomatic Hospital Treatment
Inpatient psychotherapy was “invented” almost 100 years ago in Germany. After World War 2 psychiatry moved to very biological concepts, mostly based on medication, thus psychosomatics developed as an alternative way of understanding patient’s pain and problems, and relying on psychotherapy.
The first concepts were based on psychoanalysis, followed by behavioral therapy in the 70s. All concepts had to be adapted to the situation of inpatient treatment. The last 3 decades advances in systemic and trauma therapy had to be integrated. The use of theories on embodiment, neurobiology and attachment theory in our concepts will be described. The contextual approach was very helpful in helping patients with chronic pain or personality disorders, finding better ways of regulating self-representation, emotions and relationships.
Starting 1989 with 28 patients, we now have three clinics with 260 patients. Treatment teams are multiprofessional, our way of achieving integration was strongly influenced by Ivan Boszormenyi-Nagy, giving regular workshops since 1990, followed since 1998 by workshops with Terry Hargrave. Their contributions and our clinical practice will be described.
Psychotherapeutic Approaches to Depression-Understanding and Healing Pain
Worldwide, depressions are the most common psychiatric disorder. Medication is less effective, e.g. with young patients, than supposed. There are many challenges for psychotherapy as well, e.g. difficulties in the relationship patient therapist, relapses, 30% develop chronic depression. It is necessary and helpful that the therapist has different models of understanding. The most important approaches (neurobiology, analytical, behavioral and trauma theory on depression) will be discussed. Systemic and contextual approaches are very helpful in understanding the patient’s pain, finding new solutions to the pain, and ways of healing.
A Tribute to Ivan Boszormenyi-Nagy and Barbara R Krasner:
My Tale of Gratitude: How Ivan’s insight and Barbara’s intuition enlightened me and transformed my therapeutic work and family healing
I will highlight the contextual insights and convictions that most transformed my clinical work and family healing, illustrating with clinical and personal vignettes.
In my first meetings with Barbara and Ivan, I was moved by their concerns for social justice and the larger contexts of family life within cultural and national legacies.
Reading Invisible Loyalties: I labored to comprehend while I felt understood.
Ivan called inviting me onto the staff of the Family Psychiatry Department at Eastern Pennsylvania Psychiatric Institute in Philadelphia, Pennsylvania.
I was immediately expanded by multidirectional partiality, everyone counts, everyone has a side. The therapist is to be “accountable to everybody who is potentially affected” by therapeutic interventions. This challenged me to begin imagining the side and context of those with me in the therapy session and those not present but intimately related. Even when I was seeing an individual, I was accountable to consider the humanity of all who might be affected.
I was challenged to understand the roots of loyalty in indebtedness and to see the evolution of loyalty expectations generation to generation as burdens and blessings are passed forward.
I was especially liberated by the freeing of loyalty expectations and obligations from the culturally held notion of nonnegotiable, death dealing constraints, by understanding that due consideration frees entitlement to self-delineation. One’s obligation to inquiry and consideration of fairness and just due to others necessarily includes, or is balanced by, finding one’s own voice, being present with one’s own truth.
Gradually ledgers of fairness, context as “the sum total” of one’s ledgers of fairness, parentification, revolving slate, earned entitlement, destructive entitlement, consequences and particularity, earned trustworthiness, etc. became working concepts, a lens, with practical therapeutic applications.
I am amazed today that as I reread Invisible Loyalties, what was difficult to comprehend when I was 33 is now all so clear at 81.
I have received. I am indebted. I am grateful.
From Ivan I received ‘sight’ for the reality and motivational priority of relationship ledgers and their multigenerational life. My analogy is the experience of snorkeling on a coral reef. When I look down into the water, I enter another universe. Seeing contextually through Ivan’s eyes opened my vision to a whole universe of ethical relatedness, the impact which I had felt and by which I had been moved but which I had not previously seen. I shared Ivan’s passion for inclusion, for the welfare of each person and people group. He taught me to attend to the relational resources and justice essential for well-being. The beauty of his mind and heart as he followed the threads of his insights through clinical cases, corresponding philosophies and theological perspectives, awakened my imagination. He penetrated psychological and relational pathologies, revealing hidden ethical stagnation and resources, exploitation and parentification, contributions deserving credit, and the liberating potential of dialogue, of equitable give and take.
Ivan expressed his concern with imposing religious interpretations onto these ethical relational dynamics. He saw these dynamics as empirically evident, as revealing what was inherent in all relatedness. To me Ivan’s insight begged for theological expression. I was coming from inner experience of God’s living, now, presence and care. The reality of asymmetry and a relational ledger in my relationship with God, therefore, made empirical sense to me. In fact, praise and gratitude and passing forward God’s love for me do liberate entitlement for self-delineation through due consideration. What a gift of understanding.
From Barbara I received a sustained commitment to my well-being and to our mutuality. I found a deep resonance with the mystical ground of contextual work that she knew and lived. I treasure her frequent challenge to see another’s side, to view the humanity and Real (context) of another while holding my ground, tending my Real (context) and speaking my truths. Her questions expose options, potential relational actions and possibilities. I have borrowed her trust in the trust-building process of fair consideration and risking uncertain outcomes. I respond to her example and her challenge to me to consider returning to strained and stagnant relationships, to imagine the humanity, the Real (context) of another, to harvest residual trust where possible, remembering former giving and receiving, to own my dignity and then initiate attempts to rejoin.
Together we forged a friendship and partnership spanning 50 years.
Together, with Karen Krasner Allen and Greet DeBruijn, we authored a memoir of Barbara’s contextual journey, Lifeblood of Trust for Real Relationship (ACCO, 2019), and brought to fruition a long-held desire to put contextual work into everyday language.
Healing Seven Generations: Lessons from a Multigenerational Healing Journey
This workshop will illustrate the healing of seven generations of the Schoeninger-Purvis family through the application contextual work. Each of us stands in the present, between the past, the legacies received, and future generations, living and yet to be born. My task is to, “take what has been given in the past, assess its merit, and, finally, recast it into more effective modes of offering future care.” (Ivan Boszormenyi-Nagy and Barbara Krasner. 1986. Between Give and Take. New York: Brunner-Mazel. p. 145-146.)
The title, Healing 7 Generations, formed within me in July 2017 as I stood, with my four living generations on Neues Strasse in Schwabisch-Hall, Germany, at the address where my grandfather was born and raised. I was standing with my children, grandchildren, and great-grandchildren on the street where my grandfather had walked and played as a child. I was aware that here in this place he had lost his mother when he was just shy of 5 years old. Here my great-grandfather had grieved the loss of his wife, my great-grandmother, and my grandfather had felt the loneliness and lostness of missing his mother. And here I am standing with my great-grandchildren who are just shy of 5 years old. As I recounted to my children and grandchildren and great-grandchildren my grandfather’s loss of his mother, I became aware that we were healing 7 generations, the three that precede me through the three that issue from me.
Dialogue, Antidote to Disruption in Families, Societies, and Countries
This presentation, based on the 2019 biography and reflections of Barbara R. Krasner, is focused on insights and tools to repair stagnant relationships. The development of Barbara’s biography comprised a journey of 4 years dialogic writing across the ocean, along with pictures, video’s and personal stories.
Our world has no shortage of stagnant relationships on a variety of levels: divorces, issues in compound families, migration conflicts, trust gaps or e.g. fundamental differences in upbringing, culture and beliefs. Contextual thinking stipulates that a person develops, grows and becomes him or herself in a relational, intergenerational reality. Which questions and topics are essential for a good relationship? Is there reliable contact, do you and I matter, are we being heard, are we connected and is our relationship in balance? Without satisfactory answers, loneliness, depression and illness lurk around the corner. So:
How to stay connected in a world that seems to be disintegrating?
Applying Contextual Therapy to working with populations experiencing Social Injustice
In this panel discussion speakers will examine the application of contextual therapy theory to working with issues of social injustice. Through a discussion of clinical work and research on various marginalized and underserved populations, speakers will address considerations for working with: immigrant and refugee populations, those with experiences of complex trauma, transgender/gender expansive populations, and clinical supervision. The presentations will examine opportunities in and relevance of contextual therapy constructs while working from a social justice perspective.
Discussant & Moderator:
Rashmi Gangamma, PhD, LMFT
Associate Professor, Dept of Marriage and Family Therapy
1. Manijeh Daneshpour, PhD
Professor, California School of Professional Psychology
Alliant Interntational University
2. Jennifer Coppola, PhD MFT
3. Linda Stone Fish, PhD LMFT
Professor, Dept of Marriage and Family Therapy
4. Cadmona Hall, PhD LMFT FT
Associate Professor, Couple and Family Therapy Department
Are We There Yet?: Positioning Social Justice at the Heart of Therapy
Contextual Family Therapy is an effective theory for intervening justly with families. Specifically, its commitment to exploring fairness, justice, and entitlement lends itself overtly to incorporating a social justice perspective. The aim of this presentation is to discuss a framework for integrating social justice in the therapy room.
Differentiation as a Relational Process
Both contextual theory (Ivan Boszormenyi-Nagy) and Bowen Family Systems Theory (Murray Bowen) consider that the lives of individuals move in an undulating balance between freedom and lack of freedom. That is to say, every step towards emotional maturity, towards autonomy, differentiation and ultimately towards everything that implies the development of an individual who decides his own life; entails undoubtedly an encounter with antagonistic movements of autonomy vs. bonding. These dilemmas are between the accomplishments and commitments towards meeting the needs and desires of oneself, and those of other significant people with whom they are in relation. Who is one to satisfy? Themselves or the other? Can one’s satisfaction be compatible with the other? What responsibility is there to assume? How can one connect with others without losing their sense of self?
This study aimed to explore the relationship between the central constructs of both theories; Relational Ethics, and differentiation of self. Gaining a deep understanding of each theory as well as their connection is essential in order to guide people towards genuine and deep relational experiences, which play a vital role in the achievement of psychological health and the maturation of individuals.
Consequences of the Neurobiological Findings for the Healing of all Sorts of Relationships
We know that at least 95% of our behavior is automatically, subconsciously driven. Only 5% of our behavior is consciously chosen in a goal-directed way (Lipton, 2015; Szegedy-Maszak, 2005). What is fair in the relationship – over the generations and between cultures – and what we want to achieve in the direct address between people or between groups, is often biased by the triggers, attached to the amygdala (Levine, 2015). These triggers are the result of earlier misunderstandings, loss of control and trauma (Nader, 2003). During the contact people have with each other, these triggers result in subconscious fear reactions (fight, flee and freeze) which can lead to difficulties during the direct contact.
All those triggers of past traumatic events and fear reactions resonate in the actual thinking, dealing with and possible contacts between the people involved. This can be a burden for direct address, the open dialogue that is needed to build up constructive living together.
Because the addressing of the conscious mind only affects about 5% of the person’s behavior, conscious contextual counseling can be seriously enhanced by including the inhibition of the subconscious triggers (95%) that might affect the relationship(s).
During this lecture and demonstration, I will explore and demonstrate how we can inhibit the subconscious triggers. I will show what is needed to address and change the subconscious in order to erase the load people are experiencing after misunderstandings, trauma, neglect, abuse, and other loss of control. Contextual counseling can be enhanced by including the creation of subconscious impulses that generate fair giving and receiving in the relationship. Taking care of subconscious connections is an optimal preparation for direct address in partner- and family counseling.
Touchpoints for Relational Ethics with Application to Education
Contextual Therapy’s relational ethics were intended by Nagy to become part of every therapeutic modality. This presentation demonstrates how relational ethics are also applicable to the process of education whether in a supervisor/supervisee relationship, a mentor/mentee relationship, or a professor/student relationship in a formal classroom. Buber claimed that true education prepares the student for real relationship and authentic engagement. It is more than delivering knowledge to a student. When teacher and student develop trust between them, and open to one another, genuine meeting can occur and formative processes flourish. In this way, students do not simply pass exams, but grow in personhood and relational freedom. This allows them to sit in their therapy rooms or their own family contexts in new ways.
Contextual Therapy’s relational ethics will be distilled into five touchpoints and applied to the relationship between teacher and student. Results of a pilot focus group study on MFT education as dialogical engagement will delineate a process as well as share examples of the outcomes for students.