Ivan Böszörményi-Nagy
Encyclopedia
Ivan Böszörményi-Nagy was a Hungarian
Hungary
Hungary , officially the Republic of Hungary , is a landlocked country in Central Europe. It is situated in the Carpathian Basin and is bordered by Slovakia to the north, Ukraine and Romania to the east, Serbia and Croatia to the south, Slovenia to the southwest and Austria to the west. The...

-American psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 and one of the founders of the field of family therapy
Family therapy
Family therapy, also referred to as couple and family therapy, family systems therapy, and family counseling, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of...

. He emigrated from Hungary to the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 in 1950.

Contextual therapy

Böszörményi-Nagy developed the Contextual approach to family therapy
Family therapy
Family therapy, also referred to as couple and family therapy, family systems therapy, and family counseling, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of...

 and individual psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

. It is a comprehensive model which integrates
Integrative Psychotherapy
Integrative psychotherapy may involve the fusion of different schools of psychotherapy. The word 'integrative' in Integrative psychotherapy may also refer to integrating the personality and making it cohesive, and to the bringing together of the "affective, cognitive, behavioral, and physiological...

 individual psychological, interpersonal, existential, systemic
Systems theory
Systems theory is the transdisciplinary study of systems in general, with the goal of elucidating principles that can be applied to all types of systems at all nesting levels in all fields of research...

, and intergenerational dimensions of individual and family
Family
In human context, a family is a group of people affiliated by consanguinity, affinity, or co-residence. In most societies it is the principal institution for the socialization of children...

 life and development.

The contextual model, in its most well-known formulation, proposes four dimensions of relational reality, both as a guide for conducting therapy and for conceptualizing relational reality in general: Facts (e.g., genetic input, physical health, ethnic
Ethnic group
An ethnic group is a group of people whose members identify with each other, through a common heritage, often consisting of a common language, a common culture and/or an ideology that stresses common ancestry or endogamy...

-cultural
Culture
Culture is a term that has many different inter-related meanings. For example, in 1952, Alfred Kroeber and Clyde Kluckhohn compiled a list of 164 definitions of "culture" in Culture: A Critical Review of Concepts and Definitions...

 background, socioeconomic status
Socioeconomic status
Socioeconomic status is an economic and sociological combined total measure of a person's work experience and of an individual's or family’s economic and social position in relation to others, based on income, education, and occupation...

, basic historical facts, events in a person's life cycle, etc) Individual psychology (the domain of most individual psychotherapies) Systemic transactions (the domain covered by classical systemic family therapy: e.g., rules, power, alignments, triangles, feedback, etc) Relational ethics.
These dimensions are taken to be inter-linked, but not equatable or reducible to one another.

The contextual model proposes relational ethics - the ethical
Ethics
Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...

 or "justice
Justice
Justice is a concept of moral rightness based on ethics, rationality, law, natural law, religion, or equity, along with the punishment of the breach of said ethics; justice is the act of being just and/or fair.-Concept of justice:...

" dimension of close relationships - as an overarching integrative conceptual and methodological principle. Relational ethics focuses in particular on the nature and roles of connectedness, caring, reciprocity
Reciprocity (social and political philosophy)
The social norm of reciprocity is the expectation that people will respond to each other in similar ways—responding to gifts and kindnesses from others with similar benevolence of their own, and responding to harmful, hurtful acts from others with either indifference or some form of retaliation...

, loyalty
Loyalty
Loyalty is faithfulness or a devotion to a person, country, group, or cause There are many aspects to...

, legacy, guilt
Guilt
Guilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...

, fairness, accountability
Accountability
Accountability is a concept in ethics and governance with several meanings. It is often used synonymously with such concepts as responsibility, answerability, blameworthiness, liability, and other terms associated with the expectation of account-giving...

, and trustworthiness
Trustworthiness
Trustworthiness is a moral value considered to be a virtue. A trustworthy person is someone in whom you can place your trust and rest assured that the trust will not be betrayed. A person can prove their trustworthiness by fulfilling an assigned responsibility - and as an extension of that, not to...

 - within and between generations. It is taken to represent not just a set of prescriptive norms
Normative ethics
Normative ethics is the study of ethical action. It is the branch of philosophical ethics that investigates the set of questions that arise when considering how one ought to act, morally speaking...

, nor simply psychological
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

 phenomena, perspective
Perspective (cognitive)
Perspective in theory of cognition is the choice of a context or a reference from which to sense, categorize, measure or codify experience, cohesively forming a coherent belief, typically for comparing with another...

s, or constructions
Constructivist epistemology
Constructivist epistemology is an epistemological perspective in philosophy about the nature of scientific knowledge. Constructivists maintain that scientific knowledge is constructed by scientists and not discovered from the world. Constructivists claim that the concepts of science are mental...

. Rather, relational ethics is seen as (1) having some objective ontological
Ontology
Ontology is the philosophical study of the nature of being, existence or reality as such, as well as the basic categories of being and their relations...

 and experiential
Experiential knowledge
Experiential knowledge is knowledge gained through experience as opposed to a priori knowledge. In the philosophy of mind, the phrase often refers to knowledge that can only be acquired through experience, such as, for example, the knowledge of what it is like to see colours, which could not be...

 basis by virtue of being derived from basic needs and from real relationship
Interpersonal relationship
An interpersonal relationship is an association between two or more people that may range from fleeting to enduring. This association may be based on limerence, love, solidarity, regular business interactions, or some other type of social commitment. Interpersonal relationships are formed in the...

s with concrete consequences (i.e., as distinct from abstract
Abstraction
Abstraction is a process by which higher concepts are derived from the usage and classification of literal concepts, first principles, or other methods....

 or "value" ethics
Value (personal and cultural)
A personal or cultural value is an absolute or relative ethical value, the assumption of which can be the basis for ethical action. A value system is a set of consistent values and measures. A principle value is a foundation upon which other values and measures of integrity are based...

); and (2) as being significant explanatory
Explanation
An explanation is a set of statements constructed to describe a set of facts which clarifies the causes, context, and consequencesof those facts....

 and motivational dynamics operating - in both beneficial and destructive ways - in individuals, families, social groups
Group (sociology)
In the social sciences a social group can be defined as two or more humans who interact with one another, share similar characteristics and collectively have a sense of unity...

, and broader society
Society
A society, or a human society, is a group of people related to each other through persistent relations, or a large social grouping sharing the same geographical or virtual territory, subject to the same political authority and dominant cultural expectations...

. The construct validity and significance of relational ethics in clinical and educational contexts have been supported by a number of studies.

In a later formulation of the contextual model, Böszörményi-Nagy proposed a fifth dimension - the ontic dimension - which was implicit in the earlier formulations, but which considers more explicitly the nature of the interconnection between people that allows an individual to exist decisively as a person, and not just a self. (See also Intersubjectivity
Intersubjectivity
Intersubjectivity is a term used in philosophy, psychology, sociology and anthropology to describe a condition somewhere between subjectivity and objectivity, one in which a phenomenon is personally experienced but by more than one subject....

 and Philosophy of dialogue
Philosophy of dialogue
Philosophy of dialogue is a type of philosophy based on the work of the Austrian-born Jewish philosopher Martin Buber best known through its classic presentation in his 1920s little book I and Thou...

.)

Methodology

Multidirected partiality is the main methodological principle of contextual therapy. Its aim is to evoke a dialogue
Dialogue
Dialogue is a literary and theatrical form consisting of a written or spoken conversational exchange between two or more people....

 of responsible mutual position-taking among family members. It consists of a sequential, empathic
Empathy
Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...

 turning towards member after member (even absent members), in which both acknowledgement and expectation are directed at them. It is an alternative to the more common 'neutrality' or unilateral partiality of other approaches. It requires an appreciation of the 'ledger' from each person's point of view, even that of the current victimizer.

For example, a family comes into therapy desiring to fix their son's outbursts and oppositional defiant
Oppositional defiant disorder
Oppositional defiant disorder is a diagnosis described by the Diagnostic and Statistical Manual of Mental Disorders as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior...

 behavior. The therapist (and possibly a co-therapist where appropriate) would firstly seek basic information (including any relevant clinical or medical information), construct a genogram
Genogram
A genogram is a pictorial display of a person's family relationships and medical history. It goes beyond a traditional family tree by allowing the user to visualize hereditary patterns and psychological factors that punctuate relationships...

 if possible, and have each family member explain their side of the story (either conjointly or in individual sessions as appropriate), in order to begin to understand the problem in terms of background facts, the relational context (i.e., intergenerational, interpersonal, and systemic
Systems theory
Systems theory is the transdisciplinary study of systems in general, with the goal of elucidating principles that can be applied to all types of systems at all nesting levels in all fields of research...

), and deeper motivational factors (e.g., psychological processes, hidden loyalties and legacies, ledger imbalances, destructive entitlement resulting from real or perceived injustices, scapegoating, parentification
Parentification
Parentification is the process of role reversal whereby a child is obliged to act as parent to their own parent. In extreme cases, 'by role reversal the child, like a "living antidepressant", fills the alienating parent's emotional void'....

of the child, etc.), and not simply (as is commonly done in some other approaches) in terms of the 'behaviour', 'systemic interactions
Systemic Therapy
Systemic therapy is a form of psychotherapy which seeks to address people not on individual level, as had been the focus of earlier forms of therapy, but as people in relationship, dealing with the interactions of groups and their interactional patterns and dynamics.- History :Systemic therapy has...

', 'cognitions', or 'narratives
Narrative therapy
Narrative Therapy is a form of psychotherapy using narrative. It was initially developed during the 1970s and 1980s, largely by Australian Michael White and his friend and colleague, David Epston, of New Zealand....

' of the family and the son.

Having gained this preliminary understanding of the situation, the therapist would firstly address any issues requiring urgent attention (e.g., physical welfare, prevention of violence, etc.), especially in relation to the interests of the most vulnerable member(s), whether or not they are present at the therapy sessions. The therapist would then go further, carefully and sequentially ‘taking the side’ of each member (while seeking to maintain overall balance, but not ‘joining’ the family as occurs, for example, in structural therapy
Structural family therapy
Structural Family Therapy is a method of psychotherapy developed by Salvador Minuchin which addresses problems in functioning within a family...

), the aim being to begin a genuine dialogue of mutual accountability, to reduce the reliance on dysfunctional
Dysfunctional family
A dysfunctional family is a family in which conflict, misbehavior, and often abuse on the part of individual members occur continually and regularly, leading other members to accommodate such actions. Children sometimes grow up in such families with the understanding that such an arrangement is...

 acting-out
Acting out
Acting out is a psychological term from the parlance of defense mechanisms and self-control, meaning to perform an action in contrast to bearing and managing the impulse to perform it. The acting done is usually anti-social and may take the form of acting on the impulses of an addiction Acting out...

, and to find resources (e.g., hope, will) for rebuilding relationships through mutual acknowledgement of both entitlements and obligations, shifts in attitude and intention (but not ‘relabeling’ as in strategic or constructivist
Constructivism (psychological school)
In psychology, constructivism concerns the world of constructivist psychologies. Many schools of psychotherapy self-define themselves as “constructivist”. Although extraordinarily different in their therapeutic techniques, they are all connected by a common critique to previous standard approaches...

 approaches), fair exoneration, and redemptive or rejunctive (i.e., 'trust-building') actions, that will in turn build individual and relational maturity and integrity (i.e., self-validation and self-delineation - contextual counterparts of Bowen's
Murray Bowen
Murray Bowen, M.D., was an American psychiatrist and a professor in Psychiatry at the Georgetown University. Bowen was among the pioneers of family therapy and founders of systemic therapy...

 differentiation), and trustworthiness, which contextual therapists see as the ultimate relational resource for individual and family well-being.

The approach would be adapted - although the basic principles would remain the same - according to the particular case; for example: adults having problems with their siblings or elderly parents; couples issues
Relationship counseling
Relationship counseling is the process of counseling the parties of a relationship in an effort to recognize and to better manage or reconcile troublesome differences and repeating patterns of distress...

; conflicts
Conflict resolution
Conflict resolution is conceptualized as the methods and processes involved in facilitating the peaceful ending of some social conflict. Often, committed group members attempt to resolve group conflicts by actively communicating information about their conflicting motives or ideologies to the rest...

 associated with blended families, adoption
Adoption
Adoption is a process whereby a person assumes the parenting for another and, in so doing, permanently transfers all rights and responsibilities from the original parent or parents...

, fostering, gamete donation and surrogacy
Surrogacy
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...

; migration
Human migration
Human migration is physical movement by humans from one area to another, sometimes over long distances or in large groups. Historically this movement was nomadic, often causing significant conflict with the indigenous population and their displacement or cultural assimilation. Only a few nomadic...

 and cross-cultural
Cross-cultural
cross-cultural may refer to*cross-cultural studies, a comparative tendency in various fields of cultural analysis*cross-cultural communication, a field of study that looks at how people from differing cultural backgrounds communicate...

 issues; different mental disorders; addiction
Addiction
Historically, addiction has been defined as physical and psychological dependence on psychoactive substances which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.Addiction can also be viewed as a continued involvement with a substance or activity...

 and substance abuse
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...

; criminal behavior, domestic violence
Domestic violence
Domestic violence, also known as domestic abuse, spousal abuse, battering, family violence, and intimate partner violence , is broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, or cohabitation...

, and so on.

The contextual approach allows for the inclusion of many significant aspects of other approaches to psychotherapy and family therapy, provided that they are consistent with the overarching contextual principle of multilateral therapeutic ethical concern and accountability.

Further reading


See also

External links

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