Between 5 and 10% of cases of breast and ovarian cancer in the United Kingdom are caused by an inherited predisposition. It is estimated that carriers of BRCA1 mutations have an 85% lifetime risk of developing breast cancer, whilst their risk of developing ovarian cancer may be 60% or higher (Easton et al., 1995). At the present time women who think they may be gene carriers because they have a family history of these cancers are referred for genetic counselling, where their risks of being a mutation carrier and developing cancer are calculated and risk management options are discussed. There are two ways in which high risk women can manage their risk of developing these cancers. Firstly, they can have their body annually screened for signs of breast and/or ovarian cancer - they can have a vaginal ultrasound plus CA125 blood tests or mammography plus a breast examination, respectively. These screening options have both medical costs and benefits. The costs are complex. Firstly, there is no evidence that screening is effective in high risk groups; cancers may be missed, or occur during the interval between appointments. Secondly, some of the procedures are themselves risky, for example, there is a high false positive rate, particularly in ovarian screening, and this may result in women having to undergo unnecessary exploratory operations. Similarly, the use of x-rays in mammography carries with it a cancer risk which may be increased in certain high risk individuals. The benefits are simple, screening may pick up cancers at an early stage when the prognosis is good, thus reducing the risk of dying from cancer. The second risk management option available to these women is to take steps to decrease cancer risk by eradicating the sites where cancers may develop. These women can have prophylactic surgery - a bilateral oophorectomy or mastectomy. The benefits of this option are fairly obvious, removal of these tissues decreases the risk of cancer. However, as it is impossible to guarantee the removal of all the ovarian and breast tissues there is a residual risk of developing cancer following surgery, and at the present time nobody knows how high this is. With regard to the costs of prophylactic surgery there are medical risks associated with both procedures, such as anaesthesia, post-operative complications and problems with hormone replacement therapy or breast implants. Furthermore, and perhaps more importantly, it is widely acknowledged that there maybe psycho-social costs of adopting this form of risk management. Using data collected during an interview study of high risk women who had made or were in the process of making decisions about prophylactic surgery this paper presents an analysis of women's perceptions of the psychosocial implications of this form of risk management. The data reported below were collected during a prospective study of women attending genetic counselling because of a family history of breast and/or ovarian cancer. This is part of a larger project which explores lay explanations of inheritance and the influence of this pre-existing knowledge upon individuals' understanding of the Mendelian explanations of genetics that are provided during counselling sessions. The issue of prophylactic surgery was not one of the areas we were specifically investigating in this project, however, it often arose during discussions of women's experiences of counselling, and as the project progressed I became very interested the way these women perceived this option and the questions it raised for them. This paper is based upon data gathered in face-to face interviews with 41 women who had attended genetic counselling 6 weeks earlier, and one woman who had had a prophylactic mastectomy 18 months earlier. The mean age of the sample was 40 years (range 22-59 years). None of the participants were being treated for breast or ovarian cancers or had had cancer in the past. Only one women had attended genetic counselling for cancer before. Nineteen women had a family history of breast cancer, 13 ovarian cancer, 8 breast and ovarian cancer and 2 breast and either uterine or stomach cancer. It is supplemented by data gathered during observations of genetic counselling sessions and in semi-structured telephone interviews with 35 of the original sample 12 months after they visited the clinic. The face-to face interviews were fairly open-ended, but we made sure that the following themes were addressed: experiences of counselling, family history, risk perception, risk management, understanding of inheritance and general health behaviour. The follow-up telephone interviews were semi-structured and focused upon satisfaction with genetic counselling and risk management during the interim period. A grounded approach was used in the analysis insofar as emerging themes were identified in the women's accounts and these were subsequently refined through a process of comparison. Discussions about risk management during genetic counselling None of the participants either had or were offered genetic testing during the course of this study. Thus, risk management recommendations were based upon the counsellors' estimation of a woman's risk which was calculated on the basis of the type of family history she presented. With three exceptions all women were recommended to continue with or start screening programmes. Surgery was discussed in thirty four consultations and in nine of these women were asked to seriously consider having a prophylactic oophorectomy in the future. Discussions of mastectomy were much less directive, counsellors stressed that they could not make recommendations about this option. Risk management following counselling When we interviewed them six weeks after counselling, with one exception, all the women intended to adopt some form of risk management and seven intended to obtain a referral to discuss surgery (3 mastectomy and 4 oophorectomy). With two exceptions, all the women we interviewed twelve months later had either undergone or arranged some form of screening and four had had a prophylactic oophorectomy plus hysterectomy. Two women had talked to a breast surgeon about prophylactic surgery but had decided not to proceed any further for the present.

Women's perceptions of the surgical option? There was a difference in the way that the counsellees perceived discussions of oophorectomy and mastectomy during counselling. Reactions to the suggestion of oophorectomy were much more muted, and none of the women were surprised that this option had been discussed. Indeed, many of those who had been recommended to think about having this operation said they would consider it when they were older, once their ovaries had served their purpose. Many of the women acknowledged that there comes a time when their ovaries would cease to function, and at that time there was less reason to keep one's reproductive organs. Prophylactic mastectomy, on the other hand, was perceived as a much less obvious course of action. Many of those who had not heard of this before they came to counselling were shocked that the counsellor had mentioned it. As one thirty five year old woman said: " I thought that was quite bizarre because I would never dream of doing that. Never. I mean that to me is quite abhorrent, it really is. ... - It's like cutting your legs off in case you're going to get run over by a train, which is crazy." (GC07) Those who were aware of this option before the consultation, including those had come with the intention of discussing prophylactic mastectomy, acknowledged that it was a "big step" or regarded it as a "very drastic" or "radical" way of managing risk.

Reasons for rejecting or having prophylactic surgery For nearly half of the sample oophorectomy or mastectomy was not regarded as a viable option. These women rationalised their rejection of surgery in three ways: Firstly, - it was perceived as leading with the negative. The view that " if its not broke don't fix it" was frequently repeated. Many women said that removing healthy tissue was not acceptable or that it was tempting fate, they said they were they were healthy now but might not be as a result of surgery. Some women observed that even if one had breast cancer one would not necessarily have a mastectomy, therefore to remove healthy tissue was just overreacting.

A second contrasting theme emerged in the interviews which can be described as defeating the object of the exercise. Some women viewed cancer as ultimately uncontrollable. Thus, prophylactic surgery was perceived as a waste of time. These women did not believe that it would prevent them from getting cancer, they reasoned that following surgery the cancer would just develop somewhere else. As a twenty five year old woman said: "She did say about having my breasts taken away completely, but to be honest I think that's defeating the object if I walk round with no tits, you don't need to. ...If you're going to get it, it'll only come up somewhere else because it's one of them things. Cancer's not a thing, it's not like a cold. You've got a chance of getting it or you won't. It's either there or it's not. Now, if it don't come up in the breast and there's nowhere for it to come up, it will come up somewhere else and it won't be as easy to find." (GC26) Finally, some women talked of the social and financial costs of surgery, the fact that having an operation and the subsequent convalescence would interfere with their role as wife, mother and/or breadwinner. These women felt that their social obligations meant that they just could not, rather than would not, consider this option.

Two main reasons for undergoing prophylactic surgery were described by those women who were either currently making a decision to proceed with prophylactic surgery or who said they would seriously consider surgery in the future.

Firstly, many of the women who came to counselling talked of their obligations to others to find out about their risks and do something about them. For some women undergoing prophylactic surgery was seen as the only way of fulfilling these obligations, As a forty two year old woman who was considering a mastectomy said: " I feel a terrible sense of responsibility towards my young children and I'm virtually willing to do anything, if it really would guarantee there wouldn't be a problem" (GC 33) Secondly, the women who were willing to consider this option perceived themselves to be in great danger - they believed they would definitely develop cancer at some time thus, surgery was seen as removing the fear of cancer, as giving them more of a chance. As a 23 year old woman who was also considering a mastectomy observed: "Yes, you know, it is radical but if it takes away that fear, then that can only be a good thing. Because otherwise the fear will get you in the end." (P11) Similarly, a 36 year old woman who had a hysterectomy following genetic counselling said: "Well I knew it was a big operation, but I knew that by having it that would take away that fear, the fear of getting cancer there" (GC25) In addition, some women talked about other benefits of oophorectomy and hysterectomy namely, the fact that they would no longer menstruate or that the operation would relieve current gynaecological problems. As a twenty nine year old woman said, referring to her heavy periods, "...as far as I'm concerned I'll be glad to see the back of them". (GC29 ) The implications of prophylactic surgery Women who were considering prophylactic surgery and those who were not, talked of the negative implications or costs of this form of risk management. Firstly, when talking about mastectomy many women talked of the problems with breast reconstruction. Some were so worried about breast implants that they said that if they ever had to seriously consider this option then they would not have their breasts reconstructed.

The onset of menopause post-operatively was perceived as the main cost of oophorectomy. All women irrespective of age or parity acknowledged that because oophorectomy results in the immediate cessation of fertility it was only a viable option if a woman had completed her family, all said that the decision to have this operation would be much more difficult if that was not the case. As one thirty six year old woman said following her hysterectomy: "I think if it had been ovaries pre having the kids I'd have felt really differently, now I couldn't care less about my ovaries."(GC25) Age appeared to be an influential factor in how the other side-effects of the menopause were perceived. Women in their early to mid forties were less worried about entering the menopause. They had all completed childbearing so fertility was not an issue, and all had a greater familiarity with the effects of menopause. For this group the costs were seen as the physical side effects, for example, potential weight gain and regulating Hormone Replacement Therapy. The younger women, those in their twenties and thirties, were much more negative about the menopause. Many said that they were worried that they would age prematurely and become "an old woman " if they had an oophorectomy. In contrast to the older women younger women focused upon the psychological side effects of menopause.

Thus, the fear most frequently expressed by this group was that having this operation would have a negative effect upon their personality, many thought they would just have permanent premenstrual tension as a thirty one year old woman who had decided not to have an oophorectomy explained: "...'cos I talked with [my husband] about it and I said to him, "you know, when I'm pre-menstrual I' m a bitch, I'm such a cow, I'm awful to the kids, for 48 hours when I ovulate I'm so awful to live with - if I had to have both of my ovaries removed would you still love me while my hormone replacement was being sorted out?" And we talked for hours about that because that was one of the things that frightened me, if they took my ovaries out I would go into immediate menopause ... And that really frightened me, that I would be so difficult to live with, I would put stress and pressure on my family." (GC01)

The view that menopause resulted in personality change, or even madness, was frequently voiced by these younger women they talked of people they knew who had become "unbalanced" following the menopause as a twenty seven year old woman said: "I've seen a few people go through the menopause and some of them it's sent completely off the rails." (GC17) Finally, women talked about the implications of prophylactic surgery for gender identity and their image of themselves as a sexual being. Both breasts and ovaries were described as "womanly bits" and losing them was perceived as a threat to one's femininity. A 29 year old woman taking about the loss of one's ovaries and uterus said "...a lot of people think they're not part woman if these things happen to them " (GC22) Whilst another woman who had undergone a bilateral prophylactic mastectomy at thirty nine years said: "It felt very threatening to be a woman with no breasts, it really did I think, before I had it done." (GC47) The ovaries' role in defining gender identity was seen as bound up with their reproductive and hormonal functions - the ability to reproduce was perceived as part of being a woman. thus the feminine body was seen as related to the maternal body. A forty one year old woman described her feelings about her ovaries as follows: "I like that feeling in there. I know they're inside me, and I like it there, and I like the eggs being there. I like that, it feels very womanly." (GC47) A thirty one year old woman expressed similar sentiments : "You have your ovaries, and they are for producing eggs to make babies, and if they're wasted every month that's part of nature's cycle. But some women, when they have hysterectomies have terrible sadness because they think, oh well I'm not a full woman any more because I haven't got a uterus or a cervix or ovaries, and it does cause people emotional damage." (GGO1)

The ovaries role in producing hormones was also seen as crucial in preserving gender identity as a thirty one year old woman said about ovaries "... they give you all the hormones that you need and you are a woman...". (CO) Prior to having a hysterectomy one thirty six year old woman said "... you don't want to lose your ovaries because you think I might become a man." (GC25) The role played by the breasts in the social construction of gender identity was a frequent theme in discussions of mastectomy. As a forty one year old woman noted : "I think there's also a society thing of the way a woman's body is perceived, and I don't think men are immune from that. And the way women are looked at, like a physical thing, and the breasts are a very important part of that." (GC47) The view that breasts are public displays of one's femininity was repeated throughout the interviews and was most clearly articulated by another forty one year old woman who commented that: "Our society's vision of feminity is not tied up with what's inside, it's what's on the outside." (GC08) It was this external-internal or public-private dimension that ultimately differentiated attitudes towards the different types of surgery. Having your breasts removed was regarded as much more radical because it was public, consequently if these women had to make a choice between them then they would choose to lose the ovaries before their breasts in every case. As a 25 year old woman observed: "Your boobs you can see, and if my ovaries are still there or not makes no difference, because nobody else can see them. My boobs everyone can see and I know they're there, and if they weren't there that would be part of my sexuality gone. But my ovaries if I had my ovaries removed now, and couldn't have children well that would bother me, not as much as having my boobs removed." (GC35) A similar point of view was articulated by a thirty six year old woman before she had her hysterectomy, she said: "... when I go topless it's not really going to notice that I haven't got any ovaries, but it sure would if I didn't have any tits, wouldn't it?" (GC25) However, it wasn't just the fact that their bodies might look different to others following surgery that worried these women, for they did not just regard their breasts as things-for-others. Mastectomy constituted a threat to personal identity - removing one's breasts was perceived as losing a part of oneself in a way that removing one's ovaries was not. This was clearly related to the fact that one's breasts were external. They were visible not only to others but to the women themselves. Some women said that it had taken a long time for them to become comfortable with the fact that their body differed from representations of the idealised female body and that overcoming the fact that they looked different from the perfect woman had meant that they had developed a special relationship with their breasts - they defined their uniqueness. Many talked of how their breasts were fundamental to the image they had of themselves as a sexual being , they saw themselves as busty or flat-chested whilst others said they used their breasts to create an image of themselves for others, for example, they were known as a "cleavage person", if their breasts were removed they felt that the persona which they presented to the world would be fundamentally altered.

The role played by the breasts in defining one's identity is vividly illustrated in a forty one year old woman's account of how she had felt following her prophylactic mastectomy. "What did I feel I had lost? Um... a lot of my femininity. A part of my body. My breasts to me were a very important part of my body, very much linked with my mum and the relationship I had with my mum. .. And my breasts were something I'd only begun to like about myself in the last couple of years before I took that decision. ... yes, it's like my breasts were part of the deepest part of me, and the outwardly feminine part ..." (GC47) Following surgery this woman had a complete breast reconstruction, however, although she acknowledged that she still looked like a woman and that her reconstructed breasts were more aesthetically pleasing than the original ones, she experienced a deep feeling of loss, which was related to the fact that she felt compromised as a sexual being, she said: "I'm beginning to be very aware that if I have a new relationship, I'm not as I seem. Physically I'm not as I seem. And I'm not sure how to handle that, and there's an obvious difference in somebody who is like physically complete, and basically in some sense I'm not physically complete."

Finally, it must be noted that despite their acknowledgement of the negative implications of this form of risk management all the women who had undergone prophylactic surgery regarded it as one of the best things they had done. Although some were still suffering from the side effects of hormone-replacement therapy or menopause and the woman who had a mastectomy had lost the sense of feeling in her breasts, all those who had managed their risk in this way perceived prophylactic surgery as removing a life-threatening risk - as far as these women were concerned they no longer had dangerous bodies. In conclusion, this study raises interesting questions about the relationship between the physical body and gender identity. Analysis revealed that these women perceive the body parts associated with sexuality and reproduction (breasts and ovaries) as having a different meaning or value, insofar as they play a different role in the construction of gender identity. Ovaries were described in terms of their hormonal and reproductive functions, thus, the maternal and hormonal body were associated with gender identity in these women's accounts. Breasts, on the other hand, were described as publicly displaying one's feminity, in this case gender identity was related to the sexual body. The fact that ovaries were perceived as internal and private body parts, whereas breasts were seen as external and public, meant that removal of these different body parts was viewed as compromising gender identity in different ways.

Biographical note:

Nina Hallowell has a BSc (Hons) in Psychology from the University of Stirling and a D.Phil in General Linguistics from the University of Oxford. She was a psychology lecturer at De Montfort University from 1991 -1994. She is currently working as a Senior Research Associate at the Centre for Family Research, University of Cambridge on a research project which investigates the psychosocial implications of new genetic technologies.

nh113@cus.cam.ac.uk

Centre for Family Research

Faculty of Social and Political Sciences

University of Cambridge

Free School Lane

Cambridge, CB2 3RF

HIV infection is generally understood to present a formidable challenge to health care institutions, and to contemporary societies, in general. In fact, it is arguable that HIV control functions as a test case for the very suppositions upon which modern society and in particular, modern forms of social control, are based. This is because HIV infection is not presently controlled by way of external factors impacting upon the individual, such as the incarceration, or alternatively, the medical cure, of carriers. In consequence, ultimate responsibility for the control of the disease falls to the individual, as a matter for internal control. That this is fortuitous with respect to a new disease called HIV is why it presents a test-case for the limits of contemporary forms of social control. The increasing extent to which the individual in modern society is responsible for the control of all aspects of self, including the body, is clearly documented by Foucault. The operations for the development of individuals competent to this task are essentially psychological ones. Failures on the level of social control are therefore addressed accordingly as psychological failures. Increasingly, the management of failures in the social production of responsible citizens is therefore addressed by psychology/counselling, ultimately in conjunction with the law. In the case of HIV infection, however, society has been presented with a threat for which, in the production and re-production of individuals, it has been taken unprepared. We may have hoped that with the requisite information at his or her disposal, the individual was already sufficiently constituted to secure control over HIV disease. The extent to which the contemporary individual is ready and able to internalize this new responsibility, has however, proved limited. Instead, an almost infinite array of attempts to displace responsibility for the control of the epidemic onto others has been displayed. We have even banded together as groups again in order to displace responsibility onto other groups. Only with great effort has global society begun to succeed in relegating any further or ongoing transmission to the category of individual deviance, and in handing over any further resistance to psychology for the necessary interventions to be made.

HIV/AIDS and the care of the self.

The psychological self, or "identity" is constituted, by way of a set of culturally-specific operations, in relation to the body. This relation is, for the most part, transparent. However, any illness experience, or experience of threat to the body, brings the question of the relationship between self and body to the fore.

In contemporary western society, the responsibility of the individual for the management and care of self, both mental and physical, is heightened in direct proportion to increased gains on the level of the individual's "freedom of choice". As our relation to the world is increasingly a matter of choice, so our own well-being is increasingly our own responsibility. Territories previously conceived of as external to the self: for example, events in the mind such as dreams and events in the body such as sickness, are increasingly perceived of as being attributable to the self. To the extent that different diseases implicate aspects of the body and/or mind for which we are responsible to greater and lesser degrees, different diseases also implicate the self to differing degrees.

However, their can be little doubt that, in relation to HIV, the self is construed as being maximally responsible on a number of levels. With those exceptions fittingly identified as "innocent victims", we are ourselves responsible for getting and having it and we are responsible for keeping it (or not passing it on). We are also responsible, in the interim, for minimizing and controlling its impact upon our bodies and our selves. In fact, there is hardly any aspect of HIV infection for which the individual is not held accountable by himself and others. As a terminal disease, however, HIV/AIDS presents a particularly strong threat to that very self which is responsible for its management. The injunction for self-care, previously ever- present, is now, therefore, vastly intensified. Fight the disease with a compromised immune system, and fight it with the full force of your remaining psychological resources. Fight it until, and then prolong, the end. Thus we are invited to engage in a prolonged and heroic battle against certain defeat. The modern tragedy and the modern hero are born. The AIDS victim is no more. You are yourself the enemy, but in fighting your self-made destiny; you are redeemed.

In AIDS: A Guide to Survival, Peter Tatchell's approach to resisting AIDS is premised on an "holistic" approach to health: The idea that illness is not a problem which is localised solely in a particular part of the body, and that it is not a purely physical thing; but that the mind, body and emotions are interrelated and interdependent parts of the person which interact to cause sickness and wellness. This understanding of health corresponds with a notion of healing as a process which should treat the person, not just the disease; and treat the deep, underlying roots of the illness rather than its superficial symptoms.

Tatchell writes:

"Sickness is not simply something external that 'happens' to people as passive objects. People often participate in the process of sickness by negative attitudes, expectations and actions; by low self-esteem and self-confidence; by lack of a purpose or motivation in life; by guilt, depression and stress; and by inadequate diet, relaxation, sleep and exercise. In all these different ways, people contribute to undermining their mental and physical defences against disease. This increases the likelihood of HIV infection developing into AIDS and decreases a person's chances of resisting and surviving the AIDS syndrome and its opportunistic infections and cancers." (p54).

"Being positive is Positive".

In a book entitled "Being Positive is Positive" the author referred to simply as Elizabeth, provides us with an example of someone who has a highly developed and expanded interpretation of the inter-relation between self and disease.

In the first instance, she attributes her infection to psychological and moral, rather than physiological, origins:

"In modern society, disease is an unpleasant malfunctioning of the body which has to be overcome as soon as possible. ... But disease can also be seen as the materialization of a conflict or problem in our emotional, intellectual or spiritual "body" which we fail to recognise and treat and which later shifts to the physical level."

As a result, Elizabeth sees her HIV infection as a necessary 'warning' or internal challenge, rather than as an external threat:

"I think a disease, or the threat of becoming sick in the case of HIV-infected people, can also be seen as a great chance to reflect on our way of life, to ask whether we feel content and balanced in the important aspects of our lives or whether we would rather change something to live more happily. I have often wondered what I may have done wrong so that my body has had to warn me by threatening to become seriously sick. I haven't come up with any clear answers. I enjoy the process of becoming more aware of what I am doing and how I am doing it though."

Elizabeth proceeds to explore two aspects of her personality which she feels were implicated in her infection. The first of these was doing what other people expected from her, rather than what was best for her:

"For instance, I slept with many men without really enjoying it, just because they wanted to and I didn't have the courage to say no."

In this way, the sexual origin of HIV infection is construed as a failure on the psychological level of self-assertion, rather than understood in terms of the physiological route of HIV transmission alone. It is for this reason that Elizabeth can compare her disease to cancer:

"...typical cancer patients are those really 'nice' people who put all their energies into pleasing others instead of listening to their own needs and desires to be nice to themselves."

The other aspect of her personality which Elizabeth feels was implicated in her infection is her "intellectual" tendency to perceive the world in a negative way:

"I just didn't maintain an optimistic outlook on life and the world."

To the extent that HIV infection has facilitated these realizations, Elizabeth feels that it has had a very positive effect on her personal development. It is for this reason that she endorses the view that "Being positive is positive" and suggests that "AIDS means Accelerated Inner Development."

HIV infection also means that changing these aspects of her personality is now a matter of critical necessity for Elizabeth. She argues that whereas people who are not threatened by AIDS have the "choice" between "happiness" and "desperation", HIV- positive people do not have this choice, if they are to fight the virus effectively. In the following quotation, Elizabeth's understanding of the interrelation between happiness, psychological well-being and physical health is clearly elaborated.

"You have the choice: You can concentrate on the negative aspects of life and be desperate, or you can concentrate on the positive aspects of life and be happy. ... However, I think for a HIV - positive person it is a matter of survival. If we don't fill ourselves with positive energy, our immune system will lose its strength to fight the virus."

Here, the relation between happiness and physical health is a direct one, in so far as "positive energy" strengthens the immune system.

Paradoxically, HIV infection has, however, made "being positive" somewhat easier for Elizabeth. By forcing her to come to terms with her fears, including her fear of death, her HIV infection has made it easier for her to confront the challenges she has failed to overcome before.

"It [HIV] means that I am no longer afraid of death and that by overcoming this fundamental fear, I have become less fearful in general. Once the fear of death has lost its importance, all of the other horrors seem minor."

Counselling: The Role of Narrative in Self-Care.

According to Arendt, narratives are about acting and suffering. They are about doing something and what happens as a result. The therapeutic plot is one in which the actor must then go out to battle, so to speak, against adversity, actively incurring more suffering in a fight to overcome damage, both to himself and to his body.

It is generally assumed that the search for meaning in events is itself a coping strategy which leads to increased self-mastery over a situation.

"We make as well as tell stories of our lives and this is of fundamental importance in the clinical world. Narrative plays a central role in clinical work not only as a retrospective account of past events but as a form healers and patients actively seek to impose on clinical time."

It is for this reason that so-called "avoidance-coping" or "denial", through which the consideration of stressful events is blocked, is considered to be minimally adaptive. It is also considered self-evident that the way in which people understand events such as illness will determine both the extent to which, and the manner in which, they will cope with their disease. It is for both of these reasons that counselling is considered to be a necessary aspect of the care of people with HIV.

The extent to which psychological well-being, or coping, implicates a constructive search for meaning on the part of the HIV infected person devolves upon the extent to which HIV infection is seen to impact negatively upon an individual's identity or definition of self.

In this regard, two critical losses are incurred. Firstly, the fatality of the disease presents a fundamental threat to the continuation of the self or the projection of the self into the future. Much of the meaning of our lives is derived by deferral, and dependant upon projections into the future. Terminal illness inevitably generates a narrative loss; the task of counselling is to accomodate a new body and to create a plot in which the 'ending' towards which one strives invokes a sense of what it means to be 'healed' when one will never be 'cured', such that the central role of hope in structuring the meaning of the present can be regained.

Secondly, the representation of HIV/AIDS in society has consistently been geared towards distancing and isolating the disease as "other". When the "other" becomes salient to our definition of self, there can be little doubt that this presents a substantial threat to positive representations of self to self.

It is for this reason that the re-definition of self and a full consideration of the relation between HIV and self is seen to be required. Counselling provides the framework within which the arduous work of re-narration (negotiation, assimilation and incorporation) is effected. "History-taking" is no longer diagnostic. Rather, hearing/constructing the patient's story becomes an important aspect of therapeutic intervention. In the counselling exchange, we learn what we are like, what our experience is, how things are with us. (Taylor, 1986).

Elizabeth's narrative graphically illustrates the kind of subject which counselling constructs; one who examines herself. Silverman (1990) argues that what this ultimately suggests is that counsellors face subjects whom they themselves have constructed.

To view HIV/AIDS counselling as part of a progressive (World Health Organisation) programme of 'enablement' or 'empowernment' must not blind us to the broader cultural agenda of which it is also a part; the control or regulation of problematic behaviour by way of an incitement to speak. (Foucault, 1979).

JSTEIN@hoopoo.mrc.ac.za

AIDS Project

Centre for Health Policy

Department of Community Health

P.O Box 1038

JHB

2000

This paper examines the nature of abstract-surrealist art and proposes a conception of art involving among other beings the "embodiments of souls":. For the artist-psychologist, this means going beyond the blinds of collective mentality into the worlds of individual minds.

I realise there are several thorny points here e.g. what is the meaning of 'soul', is collective mentality knowable, are minds ever wholly individual, and is it really feasible to paint a mindscape? Added to these, what exactly is meant by abstract-surrealism? I will begin with the latter question, since it is probably the easiest to answer. In doing this it is necessary for me first to refer briefly to my experience and development as an artist.

My first three paintings were done in the early flush of adolescence (around 1936/37), oil on plywood. I had read about surrealism and seen some works of Dali, and all three of these first paintings were crudely surrealistic. I took them to the art class at school for the new art-master to see, but before he did so they were appropriated by an elder boy who really liked them and I never saw them again.

My next attempt at painting began as my first marriage was disintegrating. There was a very powerful urge within me to paint and it was this hitherto unexpressed creative impulse that led me inexorably to divorce. I could not be creative within the context of marriage. Despite being a moderately successful neuropsychologist, I had an overpowering need to paint, to get to know artists and their modes of living, and indeed to be an artist myself. I had to do this with very little money, a rented garret in Wolmarans Street in the heart of Johannesburg, and some paints, brushes and plywood. The results were exciting. The first five abstract paintings of this period which I submitted to a student's exhibition at the University of Witwatersrand were accepted.

This led to a series of exhibitions in Johannesburg and Durban and to a period of painting in South Africa, Ghana, USA and Nigeria lasting from the late fifties to the end of the seventies. It was during this time that I began to develop the style which later I would call 'Abstract-Surrealism', discovering only recently that this term was already in use. Thus John Griffiths, in his paper 'Movements in Abstract Art (see Papadakis, 1987) refers to abstract-surrealism, defining it as "searching the individual and collective unconscious for arbitrary form, eliciting forms from formless dreams, or co-operating with the essential dream work of an inchoate world". Interestingly he cited two artists - Jean Dubuffet (1901-1985) and Antoni Tapies (1923-) both of whom indirectly influenced my own development, in the sense that I saw them as painters whose work I thought important and significant.

My own definition of the work that I do is similar to that of Griffiths, but in the case of Mindscapes my painting aims to portray aspects of another person's mind through the process of interacting with that person, asking questions that I think are significant, and detecting cues pertaining to the nature of that person's mind and soul. I shall discuss these procedures in more detail shortly.

For me, abstract-surrealism serves to help understand the irrational. You can't do this by making it rational. You have to be irrational. Some people would say that this is an absurdity. It is probably a logical absurdity but logic is not what we are concerned with - which is living and experiencing the world as it really is - a kind of phenomenological transcendentalism. By observing the world of people one can understand how much of human existence is irrational in the profoundest sense. Abstract-surrealism portrays these absurdities by converting them into interrelated visual forms depicting the complex mysteries of soul and spirit.

Picasso rejected abstract art on the grounds that it is a "bag into which the viewer can throw anything he wants to get rid of" (Gilot & Lake, 1965). He believed that you cannot impose your thought on people if there is no relation between your painting and their visual habits. What he did was to present realism by simply jumbling up all the parts in order to "make it impossible to escape the questions it raises". Picasso's approach in my eyes was his realistic depiction of parts of a whole arranged in unexpected ways, a visual demonstration of relativity theory in artistic action. This is simple logic. And the interesting result of course was his incredible impact on the art world. One might now question why? The answer is simple - with extraordinary skill he fragmented everyday reality and rearranged it according to the multidemsional logic of cubism. In some senses he was a visual Einstein.

While Picasso made an incredible impact on the pre-1960 art world, obviously now the world picture is quite different. Almost everyone today knows in one way or another the prevalence of absurdity - or contradictions of logic - in the contemporary world.

The present near universal condition of poverty, war, ethnic cleansing, child rape, abuse of women, etc is a function of total irrationality, which clearly is now more fundamental than rationality. Which brings me to an autobiographic consideration of the paradigm shift in psychology which took effect in the sixties, with the collapse of neobehaviourism and the emergence of the twin streams of humanistic and cognitive psychology.

It was early in 1961 that I was attracted to Ghana to join a new research institute there. Apart from being immediately impressed by the social warmth of the many people I met, I was able to travel over most of the country, especially the southern half, conducting a variety of studies of infant and child development, helped in each town or village by a student from the university of Ghana who lived in that town or village. I do not intend here to go into details about this research, other than to comment on the resultant overwhelming impact on me of what I came to call the social intelligence of traditional Ghanaian culture (Mundy-Castle, 1968b, 1974).

Put briefly, my proposition deriving from this research, supported later by psychological research in Nigerial rural areas, was that traditional West African cultures saw the cultivation of social intelligence as more important than technological intelligence, the opposite being the case in western cultures. This difference between Euroamerican and traditional West African conceptions of intelligence seems very much to be the result of the divisive effects of literacy, yielding contrasting culturally mediated developmental scripts.

Literacy and the schooling that goes with it entails and engenders individualism, with the result that co-operation in school classes (called cheating) is inevitably penalised (Greenfield in Greenfield & Cocking, 1994). Perceptual wholism - as assessed by Gestalt Continuation test results among rural Ghanaians in the early sixties - is slowly if at all transformed into analycity by school-based literacy, suggesting that technological intelligence is analytic thinking removed from its larger social context (Mundy-Castle, 1968a, l991). This decontextualisation is at the root of the independence scripts favoured by western nations, contrasted with the interdependence scripts of many third world cultures (see Greenfield & Cocking, 1994). The former give rise to a greater emphasis on co-operative social intelligence, the latter on technological intelligence, with associated encouragement of analytic thinking, individualism and competition.

Forgive me if I seem to be straying from the mindscapes - I am not. What I am drawing attention to is that the characteristics of social intelligence favoured by traditional African and other third world cultures fits the newly emerging post-positivism paradigm far more closely that the old positivist paradigm, which so long dominated western psychology, politics and economics.

This is evident in the following characterisations, adapted from the work of

Guba and Lincoln.

POST-POSITIVIST POSITIVIST PARADIGM

(Mentalist) (Behaviourist)

Social Technological

Intersubjective Objective

Spiritual Scientific

Wholistic Fragmented

Belief-oriented Data-driven

(top-down) (bottom-up)

Undifferentiated Differentiated

Emotional Withdrawn

Cultural Philistine

Open Closed

Warm Cold

Mutually causal Linearly causal

Holographic Mechanical

Heterarchic Hierarchic

Complex Simple

Indeterminate Determinate

My reason for contrasting these two paradigms is that in my own case as I grew up in England between 1923 and 1941 I found myself quite alienated from my own culture, unable to fit into social situations, to behave in the right manner and so on, and felt somewhat like an emotional cripple, compensated by some bodily skills like running and fencing. The prevailing values of social life seemed wholly wrong. The result was a form of underground rebellion against all in authority and all that smacked thereof, resulting in being caught in and even confessing to unlawful acts with associated mental and corporal punishment. It was my perception of this unformulated paradigm of the future, reinforced by the avant garde artists and poets of that time, which ultimately convinced me that I too was an artist, and that was how I would live and act.

In this process may be seen the forward-looking nature of the artist, whose works often anticipate in a not-easy-to-understand manner what is likely to be easily understood in the future. Art goes beyond the present, and in so doing excites hostility, especially between powers in charge and those who know they (the powers) are barking up the wrong tree.

Abstract-surrealism, like other comparable artistic approaches (visual, verbal, musical, etc.) is revolutionary in the sense that it demands throwing away old preconceptions and opening oneself to the unexpected without fear, guilt or shame.

Collective Mentality, Individuals and the Soul

Recall the questions raised at the start of this paper - what is collective mentality, is anyone truly an individual, what is the meaning of soul? I will now try to give some answers so as to help understand just what the idea of a mindscape implies.

My first assertion is that mind is a process, which, so far as we are concerned, is primary in the universe. Indeed I would argue that it is inherent therein, and part of God's big bang.

Concerning collective mentality, two streams of thought are important - social representation theory, adapted by Moscovici (see Farr & Moscovici, 1984) from Durkheim's notion of the collective mind, and the work of the Russian linguistic school, notably Volosinov/Bakhtin (see Sinha, 1988; Wertsch, 1991).

Moscovici's social representations are not unlike Kuhn's (1962) notion of scientific paradigms. They are systems of values, ideas and practices which serve to establish a meaningful order within people's social and material world by providing codes for sociolinguistic exchange. Social representations are created and recreated by people in interaction with each other, especially during conversation and dialogue as well as through the media. They exist not in any individual's mind, but in the world of social discourse. They prescribe what people should talk about, how they should do so, and how they should conduct themselves according to social situations, in the same way as a scientific paradigm dictates, for example, about what and how psychologists should talk with each other and do their research. I recall the peculiar looks I was given long ago (circa 1955) in America when I said to a group of eager neobehaviourists that I wasn't all that impressed by the work of Skinner, and that anyway I believed any self-respecting psychologist would be wrong to disregard the fact of our minds.

The message of the Russian linguistic school bears similarities to that of Moscovici - social psychology is not located anywhere in the "souls" of communicating people but entirely and completely in the word, the gesture, and the act. "Individual consciousness is not the architect of the ideological superstructure, but only a tenant lodging in the social edifice of ideological signs ... the reality of the inner psyche is the same reality as that of the sign ... the subjective psyche is to be localised somewhere between the organism and the outside world ... the organism and the outside world meet here in the sign" (Volosinov/Bakhtin, 1929 - see Sinha, 1988).

Meaning is central in the sociocultural approach to mediated action. Who owns meaning? Answers range from "no one" (deconstructionist) to "particular individuals". Bakhtin's approach lies between the two, being grounded in dialogicality - there are always at least two voices (Wertsch, 1991).

The conclusion here seems to work against the idea of anyone being an individual per se. All our psyches are functions of discourse with others. Nevertheless, I believe that each of us makes our own interpretations of the collective voice - we are in one way the same, but in other ways unique. And it is on this unique quality that I try to focus when creating a person's mindscape. For me this is their individuality. This is their soul.

The mindscape on display at this conference is that of a young mother of three - Michele. I met her in 1993 and had a friendly contact with her through my partner, Bee. Before I began the painting I spent many hours observing her, questioning her and generally interacting on several levels. Part of this interaction required her to respond to a set of questions. She seemed to enjoy the whole experience and participated in each session with confidence and enthusiasm. These were the questions I asked:

1. Tell me your worst experience.

2. Tell me about the memory that gives you most pleasure.

3. What is your favourite pastime?

4. Food and drink - what kinds are favoured?

5. How important are:Sex, Security, Love, Family, Health, Looks/Appearance, Attraction Level?

6 What do you consider is your life role?

7 Are you more...

• spiritual than logical?

• orderly than disorderly?

• emotional than withdrawn?

• warm than cool?

• open to others than closed?

• complex than simple/straightforward?

  
  
  

  8 Do you prefer to operate according to your beliefs (belief-oriented) or according to facts (data driven)?

  
  
  

  9 Which of the following statements do you believe most? Give reasons.

  a. "The whole is more than the sum of its parts"

  b. "The best way to understand complex things is to analyse them into simple constituents (or parts)".

  
  
  

  10. Here are two word lists. Say the one in each pair that you like more or that you feel is more important - giving your reasons:

  similarity dissimilarity

  holistic fragmented

  cultural/artistic etc. philistine/materialistic

  social technological

  indeterminate determinate

  (not fixed in (of definite scope or

  character,. nature - limited in time,

  extent etc) space or character)

  humanist individualist.

  
  
  

  11 What is your favourite colour? What colour do you like least?

  
  
  

  12 Picture preference: (24 works of the artist were shown for sorting into 4 groups according to preference.

  
  
  

  13 Colour layouts - Two different layouts using the same colours - one orderly and fragmented, the other unitary.

  
  
  

  From her responses I sensed that Michele had a very strong personality although there were interesting contrasts. On the two word lists she was equally split between the post-positivist and positivist categories (dissimilarity, holistic, materialistic, social, determinate, individualist). When shown the two different colour layouts she chose the unitary layout, possibly because it was more wholistic and coherent.

  When she chose her picture preferences she reinforced the impression that I had already gained from a previous interview. She is very maternal - the memory that gave her most pleasure (question no. 2) was the birth of her children. She also chose pictures with bold colours, which seemed to echo her strong personality. The maternal pictures she selected are very simple line drawings, the rest full-colour, complex compositions.

  Having completed the study, I then got down to painting the mindscape. When I paint I divorce myself from the reality around me and immerse myself in the reality of the picture. It is almost like going into a trance, but I am actually observing what I am doing and monitoring it and directing it to some extent. To me it is as if I am floating in a visual stream of consciousness, directing my flow with subtle movements of my hand.

  I had wondered what reaction I would get from Michele when I showed her her mindscape. She too had wondered what would happen if she did not like it. At one point she visited my house and commented to my partner that I seemed to be abstracted. "Of course," Bee replied, "he's painting your mind!" Michele's reply to that was "I feel quite naked ... stripped bare". It was a feeling which she was not uncomfortable with (and which led to an interesting denouement later).

  Then come the unveiling, the first viewing of her mindscape. I was immensely relieved when she exclaimed "Oh wow! I love it!" and immediately telephoned her brother to come and view the painting.

  She loved the central area of light - to her it was a spiritual sign for the future. Her past was a dark blue, shaded area at the top of the painting and she recognised complexities in an area of finely detailed, interlocking lines. These complexities go back to her early twenties when she left her parents after an altercation about her lifestyle. At this time, too, the man she felt she was destined to marry died under extraordinary circumstances. She recognised the unfinished lines at the bottom of the painting as suggesting freedom of future directions in her life.

  Michele is very happy with her mindscape. She wants to "just sit and explore it". She asked me if I thought mindscapes could be a means of psychotherapy and I replied that the thought had occurred to me too. I am looking forward to discovering how she relates to it after a time. It is interesting to note in relation to her "feeling naked" comment to Bee, that at the formal handing over of her Mindscape to her at a function in her home, Michele felt the need to strip. She disappeared into an adjoining room and reappeared - minus clothes, but skilfully concealing herself by holding the painting in front of her whilst being photographed by a male friend of the family.

  My next mindscape is scheduled. This time it will be a Shona woman with a PhD in psychology. It will be interesting to see how the mindscapes differ because they are very different people.

  
  
  

  References

  
  
  

  Gilot, F. & Lake, C. (1965) Life with Picasso. London, Nelson.

  Greenfield, P.M. & Cocking, R.R. (Eds) (1994) Cross-Cultural Roots of Minority Child Development. New Jersey, Erlbaum.

  Kuhn T. (1962) The Structure of Scientific Revolutions. Chicago, University of Chicago Press.

  Mundy-Castle, A.C. (1968a) Gestalt continuation and design copying in Ghanaian children, Ghana Journal of Child Development, 1, 40 - 63

  Mundy-Castle, A.C. (1968b December) ...---... Paper presented at a workshop in social psychology, the Makerere Institute of Social Research and Syracuse University, New York.

  Mundy-Castle, A.C. (1974) Social and technological intelligence in Western and non-Western cultures, in S. Pilowski (ed), Cultures in Collision, Adelaide, Australian National Association for Mental Health. Reprinted in Universitas, Legon, University of Ghana, 1974, 4, 41-57

  Mundy-Castle, A.C. (1991, June/July) Commentary and discussion. In P.M. Greenfield and R.R. Cocking (Chairs), Continuities and discontinuities in the cognitive socialisation of minority children. Proceedings of a workshop, Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse and Mental Health Representation, Washington. D.C.

  Papadakis, A. (Ed) (1987) Abstract Art and the Rediscovery of the Spiritual, London, Academy Group Ltd.

  Sinha, C. (1988) Language and Representation. Hemel Hempstead, Harvester-Wheatsheaf.

  Wertsch J.V. (1991) Voices of the Mind: a Sociocultural Approach to Mediated Action. Cambridge, Harvard University Press

  
  
  
  
  

  Biographical note:

  
  
  

  Alastair Mundy-Castle, Professor of Psychology, graduated from Cambridge University in 1948 after serving as a flying instructor with the Royal Air Force during the 2nd World War. He went on to study electro-encephalography with the Council for Scientific and Industrial Research in South Africa and published many papers in leading international scientific journals, including Nature. In 1961 he moved to Ghana, serving as Principal Research Officer with the Academy of Sciences in Accra, working on the introduction of a total approach to health in developing countries. He moved to USA in 1967 to take up a three year research fellowship with the distinguished and versatile Jerome Bruner, then Director of the Center for Cognitive Studies at Harvard University. He later spent many years as Professor of Psychology at the University of Lagos, and is currently serving as Visiting Professor at the University of Zimbabwe. On the artistic side, Mundy-Castle has held exhibitions of his unusual paintings in South Africa, Ghana, Nigeria, America, England and Zimbabwe. He has works in private collections in all these countries as well as in Spain, Holland, Brazil, Uruguay, Australia, Scotland, Germany, Canada, Switzerland and Fiji. Here is an academic who believes that "art and science are one" and there is no doubt that his art has been influenced by his psychological background. Other significant influences on the development of his art and philosophy are artists Paul Klee, Jackson Pollock, the South African artist Douglas Portway, writers James Joyce, Samuel Beckett and Malcolm Lowry, and philosophers John Wisdom and Ludwig Wittgenstein.

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

  mundyc@esanet.zw

  49 Kent Road

  PO Chisipite

  Harare

  Zimbabwe

  
  
  

  Dialogical space, differance, and desire:

  conversations on the margins

  
  
  

  Andrew Favell

  Centaur Counselling & Consulting Services, Vancouver, Canada

  
  
  

  If one posits therapeutic conversations as a text which continuously unfolds through the process of dialogic intercourse, then the exploration of the margins of this text--as a source of knowledges as to what shapes, informs, constitutes, and restrains the spoken text--presents as a viable therapeutic exercise to deconstruct the dominance of the problem-story. Such knowledges from the margins of the spoken text are those discourses that not only specify what has been said, but--more importantly for the dissolution of problems--alludes to that which has not yet been said. By evoking conversations from the margins, differential knowledges can be brought forth in a serial deconstruction of the dominant problematic text.

  
  
  

  Let us space. The art of this text is the air it causes to circulate between its screens. The chainings are invisible, everything seems improvised or juxtaposed. The text induces by agglutinating rather than by demonstrating, by coupling and uncoupling, gluing and ungluing rather than by exhibiting the continuous, and analogical, instructive, suffocating necessity of a discursive rhetoric [Derrida, in Kamuf, 1991;p4.].

  
  
  

  1. INTRODUCTION:

  Stories of lives and/or relationships beset by problems cast a luminescent shadow - the shadow of the possibility of the problem's negation or non-existence. Even if the problem has been lifelong in its duration, a person entering therapy does so on the basis of - at the very least - the desire for her/his life and/or relationship(s) to be somehow different from how it is or has been to date. It is hence useful to invite persons into a more thorough exploration of their desire for difference, contrasting the idea of their desire-realized with the problem story, and entering these differences which make a difference (Bateson, 1979) into the overall narrative of meaning the person has of their life. Such ideas of a difference which make a difference may be little more than the possibility of a non-problem narrative, what White and Epston (1990) might call an "alternate story". The task of the therapist is to be able to straddle these lines that separate the possible from the realized, the virtual from the actual, and to move freely between and among these domains of contrasts and contradictions.

  
  
  

  2. PROTEST AND DESIRE:

  Persons enter into therapy as the advancement of a protest against a problem (or series of problems) which has to some extent negatively had impact upon their lives or their relationships. Whatever the initial concern persons present in therapy, it is not the concern per se which leads them to consult a therapist; rather, it is the desire for change, a desire for the realization of a different way of being/relating, which compels persons--as a form of protest against the presenting concern--to enter therapy. It will be advanced here that 'desire' no longer be considered in Platonic or Freudian ideas of desire as the expression of lack, but rather as the productive force that sweeps throughout all assemblages of semiotic and existential registers (Deleuze and Guattari, 1977, 1987) that "is an active, non-referential linear flow" (Perez, 1990;p54).

  There are two reasons for this. First, to conceive of 'desire as lack' is already to conceive of a state of affairs that at the time of conception does not 'exist'. However, the instant it is conceived as that which would satisfy a perceived lack (or absence) it becomes what Derrida might refer to as an 'absent presence'. This writer believes that the Deleuzean concept of the 'virtual' is a parallel idea to Derrida's 'absent presence'. Although the concepts of 'virtual-actual' and 'possible-real' will be discussed in more depth in the following section, for the sake of positioning this discussion, to conceive of an absence is to produce the possibility of that 'object' (in a loose sense) of desire. Hence desire is production (i.e. creative, constitutive, positive) in that by virtue of its terms of reference it forges a link from the absence of the present to the possible existance of an alternate present or future, thereby bringing that which is desired 'into' existence as a 'possible world'.

  Second, desire is to understood as positive in that, according to Deleuze and Guattari (1977,1987), desire is the mobile force of attraction (connection, in desiring-production, the 'connective synthesis') as well as repulsion (in desiring-production, the 'disjunctive synthesis') : "Desire constantly couples continuous flows and partial objects that are by nature fragmentary and fragmented. Desire causes the current to flow, itself flows in turn, and breaks the flows" (1977;p5). In this sense then, desire runs throughout the entirety of existence being the flow which connects all the chains of desiring-machines, which are themselves breaks in those flows that connect and are the connections which cause the flow itself to circulate and connect. Unfortunately, to more adequately explore this second positive aspect of desire will require a detour that is too far afield from the present discussion.

  We might say that persons entering therapy do so from a position of desire, in a manner analogous to Hewitt's (Hewitt, in Roussopoulos, 1986) anarchic declaration:

  ... [W]e must think and act according to this necessarily utopian ideal [of liberation]. It is a question of living creatively, of creative fictions, necessary fictions that are not divorced from the realm of rational possibility [p169. Original emphasis].

  
  
  

  3. DESIRE AS THE MARGINS OF THE ACTUAL:

  Protests against the dominance of problematic personal narratives are born from desire. We take as our starting point the description of desire as advanced by Deleuze (in Boundas, 1993); ):

  ... [T]he appetite [desire] is nothing else but the effort by which each thing strives to persevere in its being, each body in extension, each mind or idea in thought [p72. Added emphases].

  In pursuing this line of thought, when a person enters therapy they seek a change. In the language of the narrative or textual approach, a person is under the oppressive dictates of a dominant problematic discourse. We can infer that the presenting problem--as a narrative organization of a person's lived experiences--is getting in their way of being or relating in ways that are more preferable to the present status quo. Often persons have a vague idea of what things would be like once the yoke of the dominant problematic is removed, and when asked (as in the so-called 'Miracle Question') are able to construct a world wherein the problem no longer exists.

  We can say that persons have entered themselves into considering a possible world that did not pre-exist their expressive construction of it. Moreover, through the processes of relative influence questioning (White, 1989, 1995; White & Epston, 1990) this possible world becomes a non-localized space that is made use of as a perspective from which to reflect on the real effects and closures of the problem-story. White (1989, 1995; White & Epston, 1990) refers to this 'possible world' as an 'alternate story'.

  An alternate story is a vantage point that shadows the margins of the actual (problem) story. The alternate story stands to continuously deconstruct the problem's strangle-hold on 'news of a difference that makes a difference' (Bateson, 1972) by opening up the contradictions of alternate meanings generated through re-evaluations of lived experiences. We can hence determine two 'spaces': first, the closed space of the real or actual (i.e. the problem description); and second, the deconstructive possibilities of difference (i.e. the alternate story).

  Much has been written about the 'problem space' (for example, Friedman, 1993; Gilligan and Price, 1993; McNamee and Gergen, 1992), and so this will be dealt with only very briefly here. What is the central concern of this discussion is the possible world of the alternate story, since this is what is here being identified with the idea of the margins of the text.

  
  
  

  3.1. The Problem:

  As the point of departure, we can consider the problematic as a body, idea, meaning, and/or narrative which

  ... jeopardizes my cohesion, and tends to divide me into subsets, which, in the extreme case, enter into relations that are incompatible with my constitutive relation (death) [Deleuze, in Boundas, 1993;p72].

  The problems that "jeopardize cohesion" include - although are not necessarily reducible to - the entire gamut of concerns persons present in clinical settings. Such problems may be thought of as constraining and limiting the range of action options available for persons to access, options that open up space to engage in performances of meaning that do not include the problem-frame . When the problem-frame is dominant, there is a gradual diminishment in the range of differences, both qualitative and quantitative, which signify information. Life begins to seem the same, day after day, and any news of a difference that might make a difference becomes overlooked; the problem-frame begins to exclude any information that contradicts the primacy of the problem-frame, and compels persons to notice only that information which can be included within the limits it demarcates.

  This exclusionary effect of problem-frames is evident in how persons present themselves as the problem: "I'm depressed", "I'm dysfunctional/codependent/violent/an alcoholic/abusive/ anorexic", "my life is falling apart"; and in how the problem is described in absolutes: "I'm always crying/angry/sad", "nothing ever goes my way", "I keep on screwing up", and so on. Problems are therefore limitations that persons experience as somehow restraining them from doing something other than that specified by the problem-frame: "I can't leave him", "I don't know what to do", "I'm stuck/confused/lost/giving up".

  The problem-frame is very seductive: it reterritorializes hitherto established meanings arranging such meanings in problem-specified (or determined) hierarchies and juxtapositions which are self-confirming and self-supporting. Using a mathematical analogy, problems may be seen as a rogue Mandelbrot sequence (fractal formula) that replicates itself into infinity, filling all of its spaces with itself such that it begins, after a while, to overlay itself in multiple levels in precise order. Problems are specific densities of saturation. It would appear all lines of flight lead back into the nexus of the problem, such that the problem proliferates and migrates (Madigan, personal communication, August, 1993) into other, seemingly unconnected, areas of one's life and relationships. It is sometimes hard, especially for a person taken by such a proliferating problem, to see any limits to the problem's influence and presence.

  
  
  

  3.2. The Margins:

  The change that persons desire which brings them into therapy is always a change from the "real" or "imagined" embodiment of the problem-frame. The problem-frame has succeeded in bringing the person to the point of being cramped: they are tired of the homogeneity of their lives and relationships under the tyranny of the problem-frame, and desire the diversity of the non-problem-frame--what is here referred to as the 'margin'.

  Deleuze (in Hardt, 1993) provides us with a way of speaking of the margin. He introduces a term 'virtual' which is to be understood as "... a chaos of chance which impinges upon us as an imperative ... in the form of a question" (Bogue, 1989;p65). A client--even through approaching therapy as an option--is posing the question 'Can 'x' be different?' To consider, even momentarily, that circumstances could be different is to consider the world from the perspective of the virtual; it is to bring the virtual into play.

  However, the virtual is not to be mistaken as abstract and indifferent being, but rather as "... a self-differentiating difference that establishes relations of 'proximity' (or difference) between terms" (Bogue, 1989;p153). The client in considering an alternate story is considering a relation of difference--s/he considers what is not presently occurring. What is not presently occurring allows what is happening to be held out as a relation of difference, such that the two can be compared. In simple terms: if we were unable to conceive of difference, civilization (for better or for worse) would not be as we know it today. Moreover, difference is a distinction between this and that (Spencer-Brown, 1994), a way of 'framing' differences, which, as Bruner (1990) suggests, is vital to ordering the world and basic to the survival of humans as a species. The virtual may then be conceived as the relations of difference, rather than the terms that are different.

  The virtual is that which is in a process of perpetual becoming--immanent and yet, by definition, not-yet present--not an existent.

  To borrow from the language of 'schizo-analysis', the problem-frame might be phrased as the conjugation of flows which induce stoppages in these flows, "... a point of accumulation that plugs or seals the lines of flight, ... and brings the flows under the dominance of a single flow capable of overcoding them" (Deleuze & Guattari, 1987;p220). This conjugation (problem-frame as a restrained flow) is contrasted with the 'connection' of flows, which are augmentative and boost the escape of such flows (evoking alternate possibilities of arrangements).

  The margin is thus in the domain of the virtual, and waits in the wings of the stage upon which being plays out its drama. The margins of a text refer to what Bakhtin calls the "unfinalizability" of any discourse. Bakhtin (in Morson and Emerson, 1990) describes unfinalizability by advancing that

  Nothing conclusive has yet taken place in the world, the ultimate word of the world and about the world has not yet been spoken, the world is open and free, everything is still in the future and will always be in the future [p37. Original emphases].

  Desire is hence the production, the bringing forth, of the marginal, the unfinalizable, such that it exists in the realm of possibilities as an alternate to the exhaustive presence of the problem.

  The upshot of this is that problems are the exclusionary effects of the dominating actual; the actual squeezes out the recognition of other possibilities (the margin). In effect, problems retreat from--'deterritorialize'--the openness of the world (of possibilities), turning in on itself (reterritorializing), gradually becoming dry and dusty, tired and spent, and in the end, representing more of the same problem-frame experience ('overcoded'). As the person becomes increasingly captivated, held in check, by the solemn weight of the problem-frame, their hope, their joie d'vivre, diminishes and other possibilities become further beyond their reaches, even the reaches of their imagination.

  It is the recognition of the margins, the unfinalizability of the world, of all experience and meaning, that births the protest that constitutes a person's entrance into therapy. Such a recognition of difference beckons one from beyond the limits of the present, the slow death by suffocation of the problem-frame, and awakens 'news of a difference that makes a difference', eliciting a deterritorialization of the overcoded flows of the problem such that new connections can be made, and alternate stories (possibilities) enter-tain-ed.

  
  
  

  4. NEWS OF DIFFéRANCE THAT MAKES A DIFFERENCE:

  What is said is never all that can be said (Bakhtin's 'unfinalizability'). With any description there is generated the possibility (here referring to beyond the limits of the present) of other descriptions. Our mistake is to take the description as that which it describes (which is the 'Representationalist' perspective that Rorty [1979] takes to task). Descriptions fall into the category of 'language-games' , which are instruments for particular uses (Wittgenstein, 1953). To borrow Korzybski's now famous dictum "the map is not the territory", we can advance with Baudrillard (1983;p2) that:

  The territory no longer precedes the map, nor survives it. Henceforth, it is the map that precedes the territory--precession of simulacra--it is the map that engenders the territory and ... it would be the territory whose shreds are slowly rotting across the map [emphases in original. Added modification.].

  Representationalism presupposes that there is an equivalency between signifier and signified. Descriptions of experience, when taken to be the experience as described, create the traditional dichotomy of subject-object: the subject is said to experience that which s/he describes, and in this way, experience becomes an object of itself, to itself. We then end up with what Dennett (1991) describes as the "Cartesian Theatre", "... a metaphorical picture of how conscious experience must sit in the brain", a magical place "where it all comes together" (p.107).

  We are what we feel/think: the feeling/thinking does not happen apart from the descriptions thereof. The feeling/thinking does not dance on the stage of the 'Cartesian Theatre' awaiting an audience to experience it. Language does not represent events as in a commentary; rather language is the activity that it describes. We have been focused on the notion that language describes something other than itself. There are no objects of subjective scrutiny. When we go 'inwards' we experience a sensation (e.g., pain): the sensation is not separate and apart from the experience of 'it'. When we tell others of our pain, we are no longer speaking of 'our' pain, but rather of our description of pain. Heidegger (1971;p66) explains this by reference to the experience a poet undergoes with language:

  Th[e] relation [between word and thing] is not ... a connection between the thing that is on one side and the word that is on the other. The word itself is the relation which in each instance retains the thing within itself in such a manner that it 'is' a thing [Added emphasis].

  Heidegger (1993;p217) in a now famous quote, writes "[l]anguage is the house of Being. In its home man [sic] dwells". Rorty (1991;p35n18), in discussing this quote, reads this as a 'warning' "... against trying to get between language and its object, plus a further warning against trying to get between language and its user [added emphases]".

  Maturana and Varela (1992), adopting a radical constructivist position, suggest that language 'brings forth' a world, "... not because language permits us to reveal ourselves but because we are constituted in language" (pp234-35. Added emphases).

  In making use of Korzybski's dictum as a point of reference: representationalism, which gives rise to the fallacy of the 'Cartesian Theatre', is a Rylean (1949) "category mistake", in which the map is said to be equivalent to the territory that is mapped. What is being argued here is rather that the map is the description - in language - of the territory, which is itself a description of an experience. Descriptions can only ever describe themselves through reference and recourse to a meta-description, a description of a description, which falls down the slippery slope of self-referential paradoxes and infinite regress. Hence the mind is postulated as a black box, a simulacrum, which is the aggregate of signs which attest to its own existence: an image. The mind, even as a concept, is irrational: as an image, it is an image of an image which is then taken as real. However, when teased out in this way, the mind is emptied of anything but itself and, like a wanton helium balloon, floats off into the conceptual stratosphere. As Varela, Thompson, and Rosch (1991) suggest "... there is nothing extra on the side of mind or on the side of the world to know or to be known further" (p.225).

  
  
  

  4.1. Dialogue and Discourse:

  Bakhtin (cited in Morson & Emerson, 1990;p57) advances that

  A reified model of the world is now being replaced by a dialogic model. Every thought and every life merges in the open-ended dialogue [p.57. Added emphases].

  Dialogue is social. We may consider it as the circulation and distribution of conventions, traditions, perspectives of the world, and 'truths'. Dialogue is the material from which we construct our worlds (and our selves) with others. Morson and Emerson (1990;p.50) emphasize: "... dialogue is not a[n] ... act of combination but is itself the starting point".

  The descriptions of our world are drawn from sociocultural conventions - that is, descriptions (and hence all notions of a 'reality') are political in that descriptions involve the simultaneous operations of power/knowledge. Foucault (1980) spent a major part of his career attempting to answer his "... question of what governs statements, and the way in which they govern each other [p.112. Original emphasis.]."

  Descriptions are drawn from the available discourses, which specify what can and cannot be said and who can say what about what. Deleuze and Guattari (1987) write of 'order-words', which not only specify a command, but also order (arrange) relations according to the codes of the order-word. Discourses, and their offspring descriptions, are products of power. Foucault (1980;p119) clarifies that this power

  ... needs to be considered as a productive network which runs through the whole social body, much more than as a negative instance whose function is repression.

  Power specifies and constitutes the cultural discourses from which we draw the descriptions of our lived experiences. Let us not fool ourselves: such discourses are both captivating and persuasive, pervasive and yet located in no one fixed point:

  There are two kinds of restrictions on human liberty - the restraint of law and that of custom. No written law has ever been more binding than custom supported by popular opinion [Catt, in Tanner, 1970;p92. Added emphases.].

  "Custom supported by public opinion" is the 'soul' of discourse. Discourse becomes so deeply entwined with 'the way things are', that we no longer even notice its omnipresence, its all-pervasiveness. Discourse is somewhat like the water fish live in and which lives in them: just don't ask the fish to tell you about it! As Maturana and Varela (1992;p234) explain:

  [S]ince we exist in language, the domains of discourse that we generate become part of our domain of existence and constitute part of the environment in which we conserve identity and adaptation [Added emphases.].

  To consider a non-discursive world without making use of language to describe it, is to submerse oneself in an infinite regress. It may even be finally impossible to conceive of a world outside of language, and hence, the discursive practices that specify the terms of that world.

  
  
  

  4.2. Deconstruction and Différance:

  Deconstruction is a way of enabling us to expose the multiple layers, influences, constitutive and restraining effects of discourse. The movement of différance is deconstruction. Deconstruction - a term popularized by Derrida - is often easier to explain by what it is not than by what it is. Deconstruction is not an analysis, a critique, nor even a method (Derrida, in Kamuf, 1991). Deconstruction refers to a project in which, through which, and by which a word or discourse is taken into its interiority and its entire ensemble of significations are laid out as specifications of what the word refers to in its given context. Deconstruction also refers to a project by which, in which, and through which a word is taken on its exteriority, and the ensemble of what it does not signify are exposed. Hence, deconstruction provides a means of obtaining a 'vantage point', as it were, from the margins of the text. In this way, a tension between affirmation and negation are revealed as constitutive of the word in its given context. Deconstruction lays a concept open to its positioning on high tension 'fibres' that span the abyss of negation between the twin cliffs of affirmation. It submits a term to an exploration of what restrains it from becoming-other, and simultaneously what it itself restrains from becoming. This writer reads Derrida from the Nietzschean perspective that concepts are always a 'resting place' along a nonteleological journey; that is, as partial closures ('conjugations' in schizoanalytic phrasology).

  Deconstruction is evidently far more than a simple unpacking of the constitutive assumptions of a given word or discourse. It is also, importantly, a revelation of the displacements of other non-constitutive assumptions. Différance is the movement of deconstruction, the simultaneous "play of differences" (Derrida, 1981;p26) which function within a network of terms to produce meaning. It is further the deferral of any final or fixed point at which the meaning relationship with the extra-linguistic world is determined. To put this a different way, différance and deconstruction seek to lay bare the text beyond the text (that is, the margin), by confronting

  ... the actual and always self-interested use to which this meaning is put and the way it is expressed by the speaker - a use determined by the speaker's position (profession, social class, etc.) and by the concrete situation [Morson & Emerson, 1990;p359. Original emphases.].

  Meaning is as much generated by the terms themselves as by "[w]ho speaks and under what conditions he [sic] speaks: this is what determines the word's actual meaning" (Bakhtin, in Morson & Emerson, 1990;p359. Original emphases).

  To tack this back towards a therapeutic context, the politics of discourse are found in the starvation of the anorexic, in the descriptions of herself as "unworthy" if she takes up "too much space". These are descriptions that have entered into her personal narrative on the backs of such gendered discourse as the silencing of women's voices, the tentative extension into the world of men of her right to exist, the proscriptive and prescriptive directives from the patriarchy as to the form of her physical existence which governs her appearance, her weight, her energy and renders her a "docile body" subject to the patriarchal gaze. The politics of discourse are to be found when men have assaulted their female partners, such action being made permissible by the discourses that specify women as the property of men, as inferior to men, as objects upon which to transcribe their 'manly' rage, as nurses for their 'psychic' wounds who may be subjected to punishment for 'failing' to live up to such expectations. Even with such descriptions of oneself as "depressed", the politics of discourse are evident, be it through the idea that one is always to be "happy", "successful", "able to deal efficiently with one's own problems", and the like, and that hence one has somehow failed to make the grade measured (in part) by the unctuosity of the media-portrayed 'happy life'.

  If we hold fast onto the notion that our descriptions are both true statements about the way things truly are as well as the only way that such things can be spoken about, we are left with very little room to maneouver. If, however, we take what has been advanced thus far as valid - that is, that all dialogue is an unfinished attempt at describing our experience, and that such descriptions are more or less constrained or revealed by the availability of sociopolitical discourses - we can begin to explore the gaps, the contradictions, the tensions, the paradoxes of a person's dialogic world. That is, through minimizing our assumptions that we know what people mean when they advance descriptions of themselves, their relationships, and their lives as this or as that, we can begin to deconstruct the closed-endedness of the person's presenting problem-frame.

  
  
  

  5. FRAMES AND LOOPHOLES:

  It will be remembered from the earlier discussion that problem-frames tend towards closure and rigidity; they suffocate and slowly crush a person's hope and joie d' vivre, somewhat like the moving walls of the cinematic House of Horror which slowly and inexorably close in on - to the point of crushing - the intended victim.

  Through the deconstructive movement of différance we can listen to the stories persons tell of their lives, listening for both what is said (and how it is said) and for what is not said. The not-said is, like the relationship of desire to that which is desired, virtual: it marks the borders of the said; it lays a trace of the text beyond the actualized text. It is not the negation of what is said, nor is it even an affirmation. Rather it is the margin of the spoken text which simultaneously both limits and expands that which is already spoken. The not-said lies at the spaces between words: it is that realm of black boxes which are tropes, simulacra, used to stand-in for complex arrangements and assumptions, which always point back to themselves in self-referential parity. The not-said is the purlieu of the said, which when ventured into expands the domain of that which is and can be said. The not-said is the deterritorialized said. By bringing the not-said forth, we reterritorialize it, and mark "lines of flight" (Deleuze & Guattari, 1977) which leak from under the limitations of the said. Rorty (1991), in writing of Heidegger, alludes to what Bakhtin would term 'loopholes':

  Beyond the world made available by your [emphasis in original] elementary words there is the silence of other, equally elementary, words, as yet unspoken [p.46. Added emphasis.].

  These 'unspoken' words refer to the margins of the spoken text, which Derrida (in Rorty, 1991;p.92) understands as "... a weave of differences of forces without any present centre of reference". The task of therapy is to bring forth this other text, to expose "the weave of differences of forces", so as to allow such weave of differences to open space for news of a difference that may make a difference vis-a-vis the domination of the problem-frame.

  Bakhtin provides us with a useful concept--'loophole'--through which margins may be brought forth from the realm of the 'not-yet said' to the realm of the said. White (1989, 1995; White & Epston, 1990) have advanced a 'technique' that they refer to as 'externalizing' internalized discourse. It is this writer's impression that although White does not explicitly mention Bakhtin, in order to externalize a problem, one recruits ideas of 'loopholes' to undermine the singularity of the dominant story.

  In conversations with persons who require therapy, the therapist attends to not only what is being said--in terms of descriptions about the person's life, relationships, and sense of who and what they are as persons--the therapist also pays attention to what is not being said: the unspoken assumptions, the hidden closures, those tiny fragments of information and desire which--somehow--have managed to escape (or which have not been convinced by) the totalizing effects of the problem-frame.

  It is by standing at the margins of the spoken text, listening for both the spoken and unspoken texts that a "double description" (Bateson, 1979) is advanced of a person's story. The therapist listens for and to the polyphonous chorus that overlays each and every description that the person offers about her/his lived experience, paying attention to those parts of inferred experience that have evaded capture by the dominant (problem) frame of reference. The therapeutic task is to bring these fragments of inferred experience to the attention of the person concerned, inviting the person to provide meaning to these fragments and to the ability of these fragments to have avoided capture for so long. This is the process whereby the virtual is brought into a direct--and sometimes confrontational-- relation with the actual, exposing the actual as but one of a potentially infinite range of descriptions and meanings available for the person to perform. This is not limited to 'reframing', although the technique of reframing is certainly derived--at least in part--from the realization of polyphony.

  
  
  

  6. CONCLUSIONS:

  Conversations from the margins are often conversations about those aspects of one's experience and life that one tends to overlook. In the narrative literature (White, 1989, 1995; White & Epston, 1990), these marginal realms are referred to as 'alternate stories'. These marginal(ized) aspects are so often obscured by the predominance of the problem-frame that it is as if they become invisible, and all that's visible is more evidence of the problem. Problems appear to work on a specific circular logic that although tightly woven is never completely closed. The task of the therapist is to listen for what has not yet been said, the loopholes in the text and to play with the meanings persons bring with them to describe their experiences.

  Traditional therapies too often take the text not as a limit, but rather as an exhaustive totality and seek to effect therapeutic change through an investigation into the causes of the person's 'complaint' about the arrangements. Hence the person is seen as the site of change (interior structures, or systemic configurations of gender/generation, etc.). However, when we understand the 'text' of dialogue as a limit (overcoded conjugation) on the flow of possibilities, and describe this limit as a restraint, we face the infinite range of possible arrangements of the terms that constitute the text. Therapeutic questions then begin from a perspective that asks after how this particular arrangement dominates, and what such arrangements exclude. The overcoded conjugated flows (the problem, identity, reality) can only be deterritorialized from a serious attention to following the leaks, the escape lines, of the alternate stories which reterritorialize on possibilities and differences (i.e. the margins). Always we ask 'what are the connections?', 'what connections are yet possible?', and 'what stops those alternate connections from being effected?' The assumption is always that the possible (the margin) hovers around the actual (the text), marking the text as territory colonized, and inviting persons to explore the hitherto uncharted territories of the possible.

  Through bringing the margins into the therapeutic text, the limits are displaced and the organizational frames (narratives) are widened to become more inclusive. This is the opposite of the operations of the problem-frames, which tend towards closure and a centrifugal gravitational pull that codes everything according to its own significations. Indeed: "Let us space"; let us circulate air between the dusty closed blinds of the problem frame, because all that has been said is not all that can or ever will be said.

  
  
  
  
  

  References

  
  
  

  Bateson, G. 1972. Steps to an Ecology of Mind. New York: Ballantine Books.

  Bateson, G. 1979. Mind and Nature: A Necessary Unity. New York: Bantam Books.

  Baudrillard, J. 1983. Simulations. New York: Semiotext(e).

  Bogue, R. 1989. Deleuze and Guattari. London: Routledge.

  Boundas, C.V. 1993. (Ed.) The Deleuze Reader. New York: Columbia University Press.

  Bruner, J. 1990. Acts of Meaning. Cambridge, MA: Harvard University Press.

  Deleuze, G. and Guattari, F. 1977: Anti-Oedipus: Capitalism and Schizophrenia vol 1. (trans. Hurley, R., Seem, M., and Lane, H.R.). New York: The Viking Press.

  Deleuze, G. and Guattari, F. 1987. A Thousand Plateaus: Capitalism and Schizophrenia vol 2. (trans. Massumi, B.). Minneapolis: University of Minnesota Press.

  Deleuze, G. and Guattari, F. 1994. What is Philosophy? (trans. Tomlinson, H. and Burchell, G.). New York: Columbia University Press.

  Dennett, D.C. 1991. Consciousness Explained. Boston: Little, Brown, & Co.

  Derrida, J. 1981. Positions. (trans. Bass, A.). Chicago: University of Chicago Press.

  de Shazer, S. 1991. Putting Difference to Work. New York: W.W. Norton.

  Foucault, M. 1980. Power/Knowledge: Selected Interviews and Other Writings. (Ed. Gordon, C., trans. Gordon, C., Marshall, L., Mepham, J. and Soper, K.). New York: Pantheon Books.

  Friedman, S. 1993. (ed.) The New Language of Change: Constructive Collaboration in Psychotherapy. New York: The Guildford Press.

  Gilligan, S. and Price, R. 1993. (ed.) Therapeutic Conversations. New York: WW Norton.

  Goffman, E. 1974. Frame Analysis. New York: Harper.

  Hardt, M. 1993. Gilles Deleuze: An Apprenticeship in Philosophy. Minneapolis: University of Minnesota Press.

  Heidegger, M. 1971. On the Way to Language. (trans. Hertz, P.D.). San Francisco: Harper.

  Heidegger, M. 1993. Basic Writings. (Ed. Krell, D.F.). San Francisco: Harper.

  Kamuf, P. 1991. (Ed.) A Derrida Reader: Between the Blinds. New York: Columbia University Press.

  McNamee, S. and Gergen, K.J. 1992. (ed.). Therapy as Social Construction. London: SAGE Publications.

  Maturana, H.R. and Varela, F.J. 1992. The Tree of Knowledge: the Biological Roots of Human Understanding. Boston: Shambhala.

  Morson, G.S. and Emerson, C. 1990. Mikhail Bakhtin: Creation of a Prosaics. Stanford: Stanford University Press.

  Perez, R. 1990. On An(archy) and Schizoanalysis. New York: Autonomedia.

  Rorty, R. 1979. Philosophy and the Mirror of Nature. Princeton, NJ: Princeton University Press.

  Rorty, R. 1991. Essays on Heidegger and Others: Philosophical Papers vol. 2. New York: Cambridge University Press.

  Roussopoulos, D.I. 1986. (Ed.) The Anarchist Papers. Montreal, Que.: Black Rose Books.

  Ryle, G. 1949. The Concept of Mind. Harmondsworth, Middlesex: Penguin Books.

  Spencer-Brown, G. 1994. The Laws of Form. (Limited Ed.). Portland, OR: Cognizer Co.

  Tanner, L.B. 1970. (Ed.). Voices from Women's Liberation. New York: Signet Books.

  Varela, F.J., Thompson, E., and Rosch, E. 1991. The Emodied Mind: Cognitive Science and Human Experience. Cambridge, Mass: The MIT Press.

  White, M. 1989. Selected Papers. Adelaide: Dulwich Centre Publications.

  White, M. 1995. Re-Authoring Lives: Interviews and Essays. Adelaide: Dulwich Centre Publications.

  White, M. and Epston, D. 1990. Narrative Means to Therapeutic Ends. New York: W.W. Norton & Co.

  Wittgenstein, L. 1953. Philosophical Investigations. (Ed. Anscombe, G.E.M. and Rhees, R., trans. Anscombe, G.E.M.). Oxford: Blackwell.

  
  
  

  Notes:

  
  
  

  1. Often this desire for difference is vaguley formulated. One technique, the Miracle Question--developed by the Milwaukee solution-oriented brief therapy group (de Shazer, 1991)--is an approach to assisting persons to clearly define their goals (or desires). However, the elegance and efficacy of the so-called "Miracle Question" lies not so much in the peripheral effects of goal definition, "positive thinking", or self-fulfilling prophecies as it does in the entering of these desires into the sociolinguistic domain; that is, a bringing forth of the person's desire-realized into the consensual linguistic reality of the public sphere. The expression of a desire enters that virtuality into the co-constructed "form of life" of therapy in which its actualization becomes the focus of the therapeutic "language-game" (Wittgenstein, 1953).

  2. Following Bateson (1979) and White (1989,1995) and White and Epston (1990), these 'impacts' are to be considered the results of restraints. Briefly, restraints arise through a stressing of 'negative explanation' (Bateson, 1979; White, 1989) such that the focus is on 'what is prevented from occurring' and 'what prevents 'x' from occurring?' A positive explanation would emphasize 'what makes 'x' occur?' It is this writer's contention that by asking after restraints an investigator (scientist or therapist) must simultaneously hold ideas of both the realized present (the restraint) and the possibility of alternate 'world'