"It is for their emphasis on the unbalancing phase of treatment that structural family therapists take the most heat from postmodernists and the narrative school of therapy. Joining is common to all forms of therapy and elicits no criticism. Enactments are central to structural family therapy because of the focus on the couple relating in "the here and now" as opposed to reporting on their behaviour outside of the treatment. Enactments in general are not provocative to postmodernists, since in enactments a therapist is simply asking a couple to speak to each other rather than to the therapist. However, the unbalancing phase of treatment is most controversial (Anderson & Goolishan, 1988). Challenging and unbalancing a couple's preferred style of interpersonal behaviour is often labeled by postmodernists as "disrespectful," "bullying," "culturally insensitive," "hierarchical," and/or "patriarchal." We agree that all of these accusations can be true. Some therapists are guilty of imposing their own values, insensitively confronting families, and being ignorant of the cultural differences motivating others. Any therapeutic technique can be misused or abused, and all therapies share in common the injunction that a therapist always remain respectful of her clients. Respect for clients is a necessary condition that must be present in all treatments if there is to be a therapeutic alliance and any meaningful change in behaviour.
But we believe that a therapist has expertise and leverage that can be used to benefit a couple. To deny that a therapist has advanced training and expertise in the dynamics of relational systems would be pointless. Choosing how to use the power of knowledge creatively requires the therapist to be both self-aware and ethical. The therapist intervenes based upon what is observed in the session. The therapist creates intensity by labeling and confronting the family's dynamic. The unbalancing phase of treatment is based upon a belief that people change their behaviour when they reach a critical state of discomfort that becomes intolerable for both the individual and the system. Members of the family at this stage have the opportunity to take responsibility for the consequences of their behaviour." -- Couple Therapy with Gay Men by David E. Greenan & Gil Tunnell.
What I find interesting are the similarities and differences between structural and narrative approaches. In narrative therapy a key concept is that life is multi-storied, thus the therapist finds entry points to unearth some of these other stories that may describe more about client's preferred identity and personal agency. In a way this can be viewed as a type of "unbalancing" where alternative stories become more visible and known while the problem saturated story loses its grip. Perhaps the problem is not with "unbalancing" but with the approach used in achieving this.
It does take significant effort on a structural therapist's part to influence a change through modifying existing structure/patterns of interpersonal behaviour. Looking at a narrative therapist's approach, there is less focus on the therapist's ability to modify or facilitate modification but more on meaning making through dialogue. And how such meaning making can spur clients to seek solutions on their own. This roundabout path does not tackle the problem/structure/pattern/scripts directly which then allows it to be more respectful of clients.
Anderson, H., & Goolishan, H.A. (1988). Human systems as linguistic systems. Family Process, 27, 371-393.
