NOBLE ASCRIPTIONS
Anyone working with addicts' families for the first
time is impressed with the tremendous
defensiveness that most of them show. It sometimes seems as if they are just waiting for the therapist to cast even a minor aspersion so they can protest (or
perhaps abort therapy prematurely).
Consequently, the kinds of confrontation techniques that may be useful in group
therapy with drug abusers generally do not work with their families.
Instead, such approaches tend to foster massive
family resistance and counterattack, rendering the therapist impotent and denying him control of the therapy.
The tendency of therapists who treat families
strategically is generally to ascribe positive motives to clients.
Again, this is primarily because blaming,
criticism, and negative terms tend to mobilize resistance, as family members muster their energies to disown the pejorative label. This applies both in therapy and
in recruiting mem-bers for therapy
(Chapter 5). Consequently, the therapist might, for example, relabel -hostile- behavior
as -concerned interest-88 or as -a desire to get the best care possible- for
the IP. This approach has a paradoxical
flavor, as the family finds that its efforts to fight are redefined.' 9 t is also a form of reframingi and of
joining.'"0 Another facet of
this approach is that simply defining problems as inter-actional or familial stumbling blocks serves to
have them viewed as shared, rather
than loading the blame entirely on one or two mem-bers—that is a -we're all in this together-
phenomenon.'
In
his initial work with addicts' families in the early 1970s, the first author (Stanton) noted their tendency toward
defensiveness and decided to develop ways to counter it. He was partly influenced in this effort
by Ivan Boszormenyi-Nagy. Boszormenyi-Nagy often succeeds in defusing families by pointing out to them that
their behavior is adaptive for the
family group across generations; members are thus, in a sense, fulfilling a script and are absolved
of blame. They are functioning as
loyal family members. However, Boszormenyi-Nagy does not use such ascriptions for effect, but because he truly believes
The use of a nonblaming stance, that is the
avoidance of pejora-tives, is not a
new addition to the field of family therapy. Erickson, Haley, the MRI group,
Minuchin, L'Abate,8- and others have been applying it for some time. However, we are referring here to the practice of taking it a step further and assuming—or at least con-veying to the family—that -everything that
everybody does is for good reason and
is understandable.- This applies to even the most -destructive- of their behaviors.'" We have
termed such therapeutic moves as "ascribing noble intentions,- or -noble ascriptions.' This is not to say that we do not challenge families,
but that we often try to express our
points in nonpejorative ways that allow therapy to proceed more smoothly and rapidly.
The ascription of noble intentions is an effective
way for the therapist to enlist
parents as his allies. This is important, because parents seem to be among the most sensitive of
family members to being blamed for
the addict's problems. We might tell a mother, -You are just being a good mother,- or, "Nobody could
care more about their son than you
do—more parents should
feel this way,'' or -You didn't tell
your husband about your son's stealing because you cared about him and didn't want to upset him.- A father might be praised with, -People probably don't realize how concerned
you are about your son, that you
really care about him,- or,
-You got angry with your son because
you truly want him to grow up right and you know he needs to be taught a lesson so he can get on the right track,- or, -You hit your wife because maybe that was the only
way you could impress upon her how
important this thing is to you—the only way you could be sure she heard you.-
Often we
address an addict son in terms of the sacrifice he is making. We might say, -You're defending your family
like any good, loyal son
would,- or, -I guess people don't realize how much you care about your
family—how much you think about them every day,- or, -I know your father doesn't like to worry, but when
you get into trouble it does give him a way to show his concern and to occupy his thoughts
until a job comes through for him.-
Sometimes it is most effective to use an ascription
that encom-passes subsystems or the
whole family, thus placing the problem in a larger, or -meta,- context. For instance, if it is revealed and empha-sized by a family that the father has a drinking
problem, the therapist might state
directly to the addict (and indirectly to the father and the rest of the family), -By taking drugs you are
letting people know you don't want to
be better than your father, or show him up. If you weren't hooked he would be the only one in the
family with a problem, and that might
not be fair. In a way, you and Dad can be sort of close, because you each use something a lot—you know, 'Like father, like son.' Your being on drugs is a kind
of way of telling your dad he isn't
such a bad guy and you want to be like him, at least a little bit."
Such an ascription could serve, structurally, to connect father and son while not disparaging the commonality, that
they share, that is, substance abuse.
We also make use of noble ascriptions that speak to
the family tradition. One such might
be, -This family has had drinkers for generations.
Grandad was a heavy drinker; so was Great-uncle Harry and Dad's brother, Jim. Mom's stepfather used to
drink a lot, too. This family has had
a tradition of rough-and-ready guys who may have drunk too much, but it was part of being a man. And the women in
the family always took good care of their men, too. They understood. So now, Joe is using drugs instead of liquor
because drugs are more popular these
days. He is being loyal and keeping the tradition.-
Sometimes the best ascriptions are the most
metaphorical. When arriving at an
ascription we suggest that the therapist attempt to put himself not only in a nonjudgmental frame of
mind, but also in a very positive
one, so he can come up with a benevolent rationale. Thinking thoughts of "beauty,- -sacrifice,- or
-wonderfulness- may help, as well as
imagining scenes in which these qualities or tones prevail. Such a cognitive -set- or mood will also permit access to
one's more creative side, making the
emergence of a noble metaphor more likely.
It
is perhaps ironic that a family's or a member's response to a noble ascription is so often one of acceptance or
agreement. Com-monly, family members truly believe
they are being sacrificial and are relieved
that an outsider can recognize it. They see themselves as unappreciated and beset by difficulties at the
same time that they are
Obviously, noble ascriptions have a paradoxical flavor to
them. However, they are not the same as
prescribing the symptom—the kind of
tack usually associated with paradoxical interventions. In fact, we do not apply more conventional paradoxical
techniques with any regularity when
working with addicts' families.* We feel that Ha ley's66 general cautions about the use of paradoxical
interventions also apply to their
use with families of this type. There are several reasons for our position: first, these families are extremely
skillful and may foil any but the most experienced therapist in the ways they
react to the paradox. Second, there
are obvious ethical and legal problems in
prescribing that an addict take more drugs. Third, paradoxical
injunctions are not advisable during times of
crisis, 121' 159' '89 and the majority of these families enter treatment in a crisis and may have
additional crises at
different points in therapy.
While the ascription of noble intentions is
portrayed here only with addicts' families, it is obviously applicable to other
symptom groups as well. In fact, both
of us frequently employ it with a wide variety
of cases in our clinical practices.
