Specific therapeutic paths

Systemic therapies have developed many interventions and therapeutic strategies but, like almost all therapeutic perspectives, they have generally not differentiated them in relation to clients’ characteristics. The model of family semantic polarities opens up new ways to differentiate therapeutic interventions. The identification of the semantic that dominates the conversation in the patient’s family, helps the therapist to formulate a therapeutic path suited to the semantics of patients and their families.

“Certain therapy stories which are possible in one type of semantics – in the sense of being productive, easy to implement, boding well for change – are forbidden for another, in the sense that they are difficult to develop, incapable of making best use of personal resources, destined to encourage dropping out or dysfunctional circuits”.(Ugazio 2013/12,p.275) 

Values, definitions of oneself and others, attachment bonds and ways of relating are different in each semantic. Consequently, constraints and resources, as well as individual motivations to change are different. Furthermore, we have as many ways to construct the therapeutic relationship as the number of semantics. Therapists, dialoguing with the individual, the couple or family, inevitably, end up positioning themselves within the client’s semantics.

The semantics of freedom, of goodness, of power and of belonging build the therapeutic relationship in a different way. Expectations towards therapy, therapeutic relationship and possible fractures and dysfunctions are different in each semantic. For example, when the semantic of goodness prevails, as happens with obsessive-compulsive clients and their families, the polarity “judging / making another accomplice”, often implicitly, characterizes the therapeutic relationship. Therapists can therefore unknowingly find themselves in the inconvenient position of being judges, to whom the patient or the entire family group ask to dissolve the moral dilemmas that torment them, freeing them from guilt and restoring justice in the group. But, especially if they maintain a neutral position, by rejecting any comment or observation that may seem like a judgment, therapists may even find themselves as accomplices (Ugazio and Castelli 2015).

When the semantic of power prevails, therapists may find themselves in the uncomfortable position of competing with their clients. Feeling challenged by the asymmetry of the patient-therapist relationship, they interpret through the metaphor of power, clients can feel humiliated and consider the setting and its rules as a kind of plot by the therapists to put them at a disadvantage. However, the semantic of power offers therapists the most advantageous position as an ally. Obtaining an ally, clients can accept the therapeutic relationship. Unfortunately, “it is an alliance against someone else” (Ugazio 2013/12, p. 273).

These differences in the therapeutic relationship, in the values, in the emotions, in the bonds of attachment and in the ways of relating, require specific therapeutic approaches that the model of semantic polarities has, at least in part, already developed(Ugazio, 2019).