Dr Charles Fishman responds to enquiries and news about eating disorders, family and adolescent therapy

“We can’t solve problems by using the same kind of thinking we used when we created them.”
Albert Einstein

“Two things are infinite: the universe and human stupidity; and I’m not sure about the universe.”
Albert Einstein

A Pew survey revealed that Osama bin Laden’s popularity rating was more than 40 points higher than George Bush’s in Jordan, Morocco and Pakistan (Walt, 2005).

Family Therapy is a keen and powerful treatment for micro-systems and valuable for treating families in various configurations. When one considers the international drama played out between nations and social movements, we, as therapists, are certainly not at the table. Nevertheless, some of the classic thinking of Family Therapy tenets of Gregory Bateson, one of the fathers of cybernetics and information theory, becomes increasingly relevant; the ideas may indeed have significance, providing a more effective way of addressing increasingly dire international situation.

Gregory Bateson’s classic article on the cybernetics of alcoholism describes two central patterns observed in relationships - i.e. symmetrical - where behavior A is responded to by a similar response (the U.S. build a weapon and an adversary responds, in kind, by building one), and complementary - where behavior A is responded to by a reciprocal and fitting response (a teacher and a student are examples of complementary relationships). According to Bateson, functional relationships have both symmetrical, as well as complimentary patterns. He views the families of alcoholics as being caught in symmetrical relationships and that alcohol transforms the system to the extent where the alcoholic becomes complimentary when inebriated. If we take a look at the international situation, it appears that the U.S. and the insurgents are mirroring this dysfunctional situation of being locked in a pattern of symmetrical seqence. The U.S. has a major initiative to ferret out insurgents and the next week, more people than ever are killed by the insurgents. In Iraq with sabers rattled, the U.S., with a little help from Britain and meager cameo appearances from several other countries, threw themselves into Iraq with every certainty that, in no time at all, we would be liberating Baghdad and greeted with leis and warm welcomes. Indeed, we were liberating Paris again. Right! Right! Their action provoked a never ending quid pro quo of violence and destruction.

It is not news, however, that a dire scenario has ensued. Casualties in Iraq as if November 23, 2005, indicate that a total of 2096 American have died during the course of the war. Similar statistics regarding the Iraqi mortality rate are not readily available but estimates vary between 8,000 and 100,000 (Kaplan, 2004; Roberts, Lafta, Garfield, Khudhairi, & Burnham, 2003). Furthermore, by the end of September 2005, the projected military cost of the Iraqi war will be $186 billion, with future costs estimated at between $80 billion to $100 billion a year (Francis, 2005). Meanwhile, many people see this as a no-win situation, as the Nation’s Magazine’s bumper-sticker speaker states “Iraq is Arabic for Vietnam”.

Andrew Krepinevich, 2005, said “Our strategy can be summed up this way: as the Iraqis stand up, we will stand down”, describing a withdrawal plan, not a strategy. The hopeful strategy, as it were, amid the U.S., is that our military force will beat the insurgence into submission. A more promising approach, however, comes from Krepinevich (2005), a professor at George Mason University, in his article “How to Win in Iraq”. According to him, the current fight has three centers of gravity: the Iraqi people, the American people, and the American soldiers. The insurgence has recognized this, and are making them the primary target. For the U.S., the key to securing each one is winning the hearts and minds of these people. The U.S. Left has increaingly been advocating that the U.S. troops be pulled and just hope for the best. According to Krepinevich, such disengagement would likely be calamitous; insurgency could morph into a bloody civil war with the significant involvement of both Syria and Iran. Radical Islamists would see the U.S. departure as a victory, and the ensuing chaos would have dire consequences.

This brings us back to Gregory Bateson. Krepinevich (2005) suggests the following concepts: U.S. and Iraqi forces should adopt an “oil-spot strategy” in Iraq, which is diametrically opposed to the current approach. Rather than focusing on killing the insurgents, they should “concentrate on providing security and opportunity to the Iraqi people, thereby denying insurgents the popular support they need. Since the U.S. and Iraqi armies cannot guarantee security of all Iraq simultaneously, they should start by focusing on certain key areas and then, over time, broadening the effort - thereby enhancing the image of an expanding oil spot”. The practicality of this approach falls short in the fact that, while the “U.S. forces have overwhelming advantages in terms of power and mobility”, their key disadvantage is intelligence. According to Krepinevich (p. 93), “the Iraqi people are the best source of such intelligence”. Indeed, if they know where the insurgents are, they can quickly suppress them. Again, the “oil spot” calls for a complimentary, rather than symmetrical, approach to addressing the insurgency.

Take, for example, the Israelis and Palestinians. Many in the Israeli Left have seen the much applauded unilateral withdrawal from Gaza as short-sighted, and even inhumane. It is clearly a symmetrical action. Rather than providing concern and development for the Palestinians and seeking to help them rebuild their fledgling nation, they build a wall. This is akin to the Jamaican saying “not my job, Mon”. According to Tikkun magazine, this will only create an antagonism and disarray in that part of their world.

“It is at best naive, and at worst dangerous, to believe that Israel does not have a strategic national interest in how the Palestinian polity society and economy develops. Israel needs to invest serious political and economic capital in the development of a Palestinian state that is a stable and reliable peace partner, not a failed state, a war-making neighbor.”
Vradenburg, Tikkun, vol 20, no 5 p.6

Again, we return to Bateson’s concept. The worrisome part of this is that the dangerous parties’ action can lead to, what Bateson terms “schizmogenesis”, i.e. escalating sequences leading to schism - leading both situations to profound crises and tragedy (Bateson,1972).

On an optimistic day, I believe that the leaders could, at some point, be influenced to change their way of thinking. It would be an optimistic fantasy, however, in the sense that there are political exigencies that under-gird these political positions.

So, where is the humble family therapy drifting amid this colossal mess? Putting our Walter Mitty fantasies front and center, could the new way of thinking serve our leaders better? The perspective that we have, as a nation, is trapped in a symmetrical sequence - would the first step then be to step out of it?

However, the proposal, unabashedly immodest, calls for action; and these same souls, our erstwhile leaders, are, if nothing else, men (and woman) of action. With some certainty we can expect that in no time, our leaders will see their essential need of emergency Marriage and Family training. They should begin with Bateson and, afterwards, roll up their sleeves and imbibe our rich culture.

They may, perhaps, provide front-line care and George Bush could work with the families who have lost their sons or daughters to the war in Iraq. He should do more than just cram his MFT course-work. Finding the answers will be his ultimate challenge.

Afternote: From the position of clinician, there is one over arching question from my perspective: how do the ideas of family therapy come to the table? How can these powerful concepts begin to influence the ongoing debate and the gut wrenching search for answers? This column hopes to provide a forum for clinicians to formulate and present their ideas towards answering this question.

References

Bateson, G. Steps to the Ecology of Mind, New York. Ballantine Books, 1972, p. 324.

Francis, D. R. (2005). More costly than “the war to end all wars”. Economic Scene: A Weekly Column, August 29, 2005 edition.

Kaplan, F. (2004). 100,000 Dead - or 8,000: How many Iraqi civilians have died as a result of the war? Slate, October, 29, 2004.

Krepinevich, Jr. A. F. (2005). How to Win in Iraq. Foreign Affairs, September/October issue, 2005, p. 87-93.

Roberts, L., Lafta, R., Garfield, R., Khudhairi, J., & Burnham, G. Mortality before and after the 2003 invasion of Iraq: Cluster sample survey. The Lancet, 364 (9448), 1857-1864.

Walt, Steven M. Foreign Affairs, September/October issue, 2005, p. 107.

http://icasualties.org/oif/ (for Iraqi war mortality rates)