The Primacy of Discourse in the Study of Gender in Family Therapy.

Family therapists and scholars increasingly adopt poststructural and postmodern conceptions of social reality, challenging the notion of stable, universal dynamics within family members and families and favoring a view of reality as produced through social interaction. In the study of gender and diversity, many envision differences as social constructed rather than as "residing" in people or groups. There is a growing interest in discourse or people's everyday use of language and how it may reflect and advance interests of dominant groups in a society. Despite this shift from structures to discourse, therapists struggle to locate the dynamics of power in concrete actions and interactions. By leaving undisturbed the social processes through which gendered and other subjectivities and relations of power are produced, therapists may inadvertently become complicit in the very dynamics of power they seek to undermine. In this article, we argue that discourse analysis can help family therapy scholars and practitioners clarify the link between language and power. We present published examples of discourse analytic studies of gender and sexism and examine the relevance of these ideas for family therapy practice and research.

New Sexism in Couple Therapy: A Discursive Analysis.

The persistence of gender inequality in postindustrial societies is puzzling in light of a plethora of changes that destabilize it, including shifts in economy, legislation, and the proliferation of feminist politics. In family relations, such persistence manifests as a disconnect between couples aspiring to be more egalitarian yet continuing to enact traditional gender roles and hierarchies. There is an emerging consensus that gender inequality persists because of people's continued reliance on sexist ideology or gendered assumptions that constitute women as innately distinct from and inferior to men. Sexist ideology changes its form to accommodate to changing socio-economic conditions. Contemporary forms of sexism are old ways of legitimizing male power articulated in new and creative ways, often by incorporating feminist arguments. To effectively recognize and address "new sexism," scholars and practitioners require new, innovative research frameworks. Our objective in writing this article is two-fold. First, we seek to advance discursive (i.e., focused on language in use) approaches to the study of sexism. Second, we present the results of a discursive analysis of "new" sexist discourse in the context of couple therapy. The study provides preliminary evidence that, despite endorsing egalitarian norms, couples studied continue to rely on gender binaries and remain entrenched in old-fashioned patterns of gender inequality. Implications of these results for the practice of couple therapy and for future research are discussed.

Alone at the Table: Food Behavior and the Loss of Commensality in Widowhood.

OBJECTIVES: Eating alone is a known risk factor for nutritional vulnerability in later life. Widowhood often entails loss of commensality (shared meals). This article explores this experience among older widowed women in relation to food behavior. METHOD: Qualitative methods based on constructivist grounded theory were used. Interviews were conducted with 15 women living alone in the community, aged 71 to 86 years, and widowed 6 months to 15 years. RESULTS: Widowhood meant having significantly fewer opportunities for commensality. Participants attributed changes to their food behaviors to the loss of commensality, including food choice, fewer regular meals, and reduced work of meal preparation. These changes were attributed to the experienced difference between shared meals and meals eaten alone, no longer having the commitment of commensality, and having less interest in meal preparation in the absence of obligation or reward of commensality. DISCUSSION: Eating alone symbolized loss and was less enjoyable, yet the pleasure experienced with food was intact. Focusing on the pleasure of eating may help support women when they lose regular commensality late in life. Free from the commitment of commensality, some shifted away from regular meals and simplified their meal preparation strategies. This has implications for clinical and research endeavors.

Food behavior change in late-life widowhood: A two-stage process.

Widowhood is a common life event for married older women. Prior research has found disruptions in eating behaviors to be common among widows. Little is known about the process underlying these disruptions. The aim of this study was to generate a theoretical understanding of the changing food behaviors of older women during the transition of widowhood. Qualitative methods based on constructivist grounded theory guided by a critical realist worldview were used. Individual active interviews were conducted with 15 community-living women, aged 71-86 years, living alone, and widowed six months to 15 years at the time of the interview. Participants described a variety of educational backgrounds and levels of health, were mainly white and of Canadian or European descent, and reported sufficient income to meet their needs. The loss of regular shared meals initiated a two-stage process whereby women first fall into new patterns and then re-establish the personal food system, thus enabling women to redirect their food system from one that satisfied the couple to one that satisfied their personal food needs. Influences on the trajectory of the change process included the couple's food system, experience with nutritional care, food-related values, and food-related resources. Implications for research and practice are discussed.

A recipe for mealtime resilience for families living with dementia.

To date, research delving into the narratives of persons living with dementia is limited. Taking part in usual mealtime activities such as preparing food can sustain the identity of persons living with dementia. Yet if capacity for mealtime activities changes, this can put a strain or demand on the family, which must adjust and adapt to these changes. The aim of this study was to develop an in-depth story of resilience in one family living with dementia that was experiencing mealtime changes. Thematic narrative analysis following the elements of Clandinin and Connelly's (2000) 3D narrative inquiry space was used. One family's dementia journey was highlighted using the metaphor of a baking recipe to reflect their story of resilience. Developing positive strategies and continuing to learn and adapt were the two approaches used by this resilient family. Reminiscing, incorporating humour, having hope and optimism, and establishing social support were specific strategies. This family continued to learn and adapt by focusing on their positive gains and personal growth, accumulating life experiences, and balancing past pleasures while adapting to the new normal. Future work needs to further conceptualise resilience and how it can be supported in families living with dementia.

Conversation analysis of the two-chair self-soothing task in emotion-focused therapy.

OBJECTIVE: Despite an increasing recognition of the relevance and significance of self-compassion processes, little research has explored interventions that seek to enhance these in therapy. In this study, we examined the compassionate self-soothing task of emotion-focused therapy involving two-chair work, with seven clients. METHOD: Conversation analysis was used to examine client-therapst interaction. RESULTS: The analysis yielded a detailed description of interactional practices and processes involved in the accomplishment of self-soothing, drawing on Goffman's concept of the participation frame. We show how therapists and clients collaborate to move from the ordinary frame of therapeutic conversation to a self-soothing frame and back again by using various interactional practices: Therapists' instructions to clients, specific ways of sequencing actions in interaction, explanations and justification of the importance of the self-soothing task, pronouns as a way to distinguish among addressees (e.g., clients versus soothing agents), corrections of clients' talk, and response tokens (hm mm, yeah, good). These practices are used to help clients accomplish self-soothing in the form of self-praise, disclosing caring, and offering of helpful advice. CONCLUSIONS: This study offers therapists a specific account of how to respond to clients at specific junctures in self-soothing dialogues and how to structure and accomplish the self-soothing task.

Responsive persistence part I: therapist influence in postmodern practice.

Feminist and social constructionist developments in family therapy highlighted the importance of attending to therapist-client power relations and incorporating clients' understandings and preferences as a part of therapy. Significantly, less attention has been given to how postmodern therapists do use their power and influence. This is an important topic because it is therapists who have the major responsibility for guiding the interaction with clients and persisting in this so that change is facilitated. Therapist persistence in various forms and across dimensions of therapy process is examined to expand understanding of therapist influence in postmodern and collaborative work. An analysis of responsive persistence in a session with Karl Tomm as the therapist is presented to illustrate this conceptual framing.

Responsive Persistence Part II. Practices of Postmodern Therapists.

This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video-recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution-oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed.

Core competencies in social constructionist supervision?

Family therapy is moving increasingly toward evidence-based practice and competency-based training. This article explores what might seem to be an unlikely link between social constructionist supervision, which is based on dialogic and fluid processes of meaning-making, and the increasing reliance on discrete core competencies in the education and training of family therapists. We propose an alternate approach to competencies for supervision with therapists in training that, among other things, invites accountability and provides evaluative props. The approach we propose is based on a set of orientations that we hope reflect the dialogic and contextual nature of social constructionist practice and supervision. These orientations consist of reflexivity and attention to power, fostering polyphony and generativity, collaborative stance, and focus on client resourcefulness. Ideas and questions for supervisors and therapists in training to address the orientations are articulated.

Qualitative analysis of heterosexual women's experience of sexual pain and discomfort.

In this qualitative analysis, the author explored heterosexual women's accounts of the lived experience of sexual pain and discomfort. The author's aim was to expand theoretical and empirical knowledge in the area of female sexual dysfunction by providing a detailed description of the subjective experience of female sexual concerns. The author used empirical phenomenological methodology to analyze the data generated during semi-structured in-depth interviews conducted with 9 women and generated 42 themes that were woven into a common story of the experience, its preconditions, coping strategies, and aftereffects. The limitations of the study and implications for research and clinical practice are discussed.

Exploring corrective experiences in a successful case of short-term dynamic psychotherapy.

The concept of corrective emotional experience, originally formulated by psychoanalysts Alexander and French (1946), has been redefined by contemporary researchers to be theoretically nonspecific, that is, as "coming to understand or experience an event or relationship in a different or unexpected way" (Castonguay & Hill, 2011). Using postsession questionnaires, videotapes, and posttermination interviews, we explored whether (and how) a corrective experience occurred in a successful case of short-term dynamic psychotherapy (STDP; Davanloo, 1980). A 35-year-old woman suffering severe panic attacks was seen for 31 sessions by an experienced STDP therapist. The questionnaires and interviews focused on (a) perceived intrapsychic and interpersonal changes, and (b) how these changes came about. At termination, the client reported complete symptom relief, greater self-acceptance, improved relationships, and more emotional flexibility. Her corrective experience was evident in the qualitative themes, which showed that she came to understand and affectively experience her relationships with both parents differently. Moreover, the themes reflected both STDP-specific (e.g., confrontation of defenses) and nonspecific (e.g., rapport, acceptance) mechanisms of change. Conversation analysis (Sacks, 1995) of what the client described as "the 'gentle shove' of questions that make me see what I have been trying to ignore since childhood" showed, on a microlinguistic level, how she overcame resistance to strong emotional experience and expression.

Giving advice on advice-giving: a conversation analysis of Karl Tomm's practice.

In this article we challenge a common definition of therapeutic advice as a linear, one-way accomplishment, enacted by therapists toward clients. We also offer a novel conception of advice as a dialogical "performance," to which both therapists and clients contribute. We discuss the results of a conversation analysis of a family therapy session by Karl Tomm, showing sequential practices employed by a family therapist and a family as they jointly work out common ground to set the stage for the therapist's eventual offering of advice. We discuss the results of this study in light of the literature on advice provision in various contexts.