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Australian and New Zealand Journal of Family Therapy 2015, 36, 142154

doi: 10.1002/anzf.1099

Developing Dialogicity in Relational


Practices: Reecting on Experiences from
Open Dialogues
Tom E. Arnkil1 and Jaakko Seikkula2
1
Finnish National Institute for Health and Welfare, Helsinki
2
University of Jyvaskyla, Jyvaskyla

The paper analyses open dialogicity in psychotherapy and juxtaposes it with education in order to find common
dialogical elements in all relational practices. The core is found in unconditional respect for otherness and gener-
ating dialogical space for voices to be heard. In traditional practice, professionals are tempted to plan interven-
tions according to the goals of change informed by their methods and in team work and multi-professional
practices they may even do this between themselves, away from the clients. Pre-set categories, plans and goals,
however well founded they may seem, hinder listening. Following what others present here-and-now calls for tol-
erating uncertainty. Insight into developing dialogical family therapy opens through focusing on how therapists join
in interacting with families instead of focusing on and interpreting the interactions of families. The conclusions
provide a set of reflective questions for improving being in the present moment in psychotherapy practice.

Keywords: dialogical, education/pedagogy, psychotherapy, couple therapy, reflective, otherness, respect

Key Points

1 In psychotherapy, as well as other relational practices, it is essential to foster dialogical space instead of pur-
suing strategic interventions aiming at changing others.
2 This calls for respecting the uniqueness of the other without conditions.
3 Following what the patient/client/family member presents here-and-now and responding to it instead
of guiding the process to normative goals, enhances possibilities for the person to be heard the core of
dialogical relationships.
4 Practitioners learn from reflecting together how they managed to join the patients and families rather than
how they managed to change them.

This article is a reflection on our learning and writing a book we published last
year Open Dialogues and Anticipations: Respecting Otherness in the Present Moment (Sei-
kkula & Arnkil, 2014). Tom, a researcher in social policy, interviewed his colleague
and friend Jaakko, a family therapist and psychotherapy researcher, in order to inves-
tigate with him core elements in dialogical practices. Coming from outside the psy-
chotherapy community allowed Tom to juxtapose Open Dialogues with other
relational practices, especially education, which was familiar to him as an educator
and a researcher. Open Dialogues as a mental health treatment system was originally
developed for work around psychoses and has since developed into a variety of open
and dialogical psychiatric practices. Openness to work openly up front and dia-
logicity to create shared meanings and language in the present moment are

Address for correspondence: Jaakko Seikkula, Department of Psychology, University of Jyvaskyla,


P.O. Box 35, FI 40014. jaakko.seikkula@jyu.fi

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Developing Dialogicity in Relational Practices

important in all relational practices, however, to elaborate on this we want to travel


between psychiatry and education. We distinguish the mental health approach by
using capital letters: Open Dialogues.
The authors argue that there are two pivotal and interdependent core elements in
dialogicity: being in the present here-and-now; and having unconditional respect for
the uniqueness of the other. Being heard, the key experience in dialogical relation-
ships, calls for: acknowledging, accepting and respecting that the other is always more
than one can ever grasp; and responding to the unique other in the present moment.
Focusing on how therapists join in interacting with families instead of focusing on
and interpreting the interactions of families opens insight into developing dialogical
family therapy. At the end of the article we provide practice-oriented conclusions in
the form of a set of questions for reflecting experiences and improving being in the
present in therapy contexts.

Open Dialogues and Open Dialogicity


Open Dialogues as a mental health treatment system is a special example of open dia-
logicity. The network based practices of working with acute mental health crises in
Northern Finland are now quite well known internationally. However, the core ideas
of dialogicity and openness are not only important to acute mental health work, and
are not restricted to mental health practices. Respecting the uniqueness of every per-
son is vital in all relational practices professional or non-professional. The other is
always more than one can ever grasp, and cherishing this paves the way to mutual
genuine interest and listening.
The notion of a dialogue that is open dialogue refers to the key principle of meeting
up front. Dialogues can also take place behind the scene, and this makes a profound
difference. Professionals are tempted to plan interventions according to the goals of
change informed by their methods, and in team work and multi-professional practices
they may even do this between themselves, away from the clients. Pre-set categories,
plans and goals however well founded they may seem hinder listening; the hum of
professional convictions may become louder than the voice of clients. It is easy to be
dialogical when there are no worries. People are masters in dialogism this is what
they are born in to and most experienced in. But when worries arise, wishes to have
better control of situations arise too, and this is where one might divert from dialogism
and attempt to control how others think and act. There may be backstage dialogues
between professionals, but what is called for is face to face open dialogicity between all
those involved. Being present in the present moment is the key to mutual change.
In this article we discuss open dialogicity by reflecting upon Jaakkos experiences
in a context different to the original home ground of Open Dialogues the network
and team based system for mental health practice. His present clinical practice
includes couples therapy conducted by two co-therapists. We also juxtapose briefly
dialogical education in schools with psychotherapy in order to widen the perspective
on open and dialogical practices.

Do Not Put Your Best Tools to Work!


Conducting psychiatric treatment meetings following acute crises that were open to
patients, family members, and others close to them, led to a network-based system of

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Tom E. Arnkil and Jaakko Seikkula

care in Western Lapland, Finland. Research played a critical role right from the
beginning in developing the new practice. In one study by Professor Jukka Aaltonen
and Jaakko in the mid-1990s, the aim was to analyse the differences between the new
crises-oriented system that used mobile crisis intervention teams and the traditional
psychiatric system that took care of psychotic and other most severe mental health
problems by hospitalisation (Aaltonen, Seikkula & Lehtinen, 2011). The study
decided the main characterising phenomena of the treatment processes supporting the
optimal outcome. These seven main elements were thereafter seen as the main princi-
ples of Open Dialogue approach. They were, in brief:
1. immediate help (within 24 hours);
2. a social network perspective (always invite the patients, their families and other
key members of their social network to the first meeting);
3. flexibility and mobility (adapt the treatment offered to the specific and changing
needs of each case);
4. team responsibility (whoever on the team is contacted takes responsibility for gath-
ering the network);
5. psychological continuity (the team takes responsibility for the treatment for as long
a time as is needed);
6. tolerance of uncertainty (creating safety and trust in situations where no one yet
knows the answers); and
7. dialogicity (focusing primarily on dialogue, and only secondly on promoting
change in the patient or in the family).
Upon writing Open Dialogues and Anticipation (2014), we analysed Jaakkos pres-
ent clinical work, which takes places in a context different to the team work in Wes-
tern Lapland. Jaakkos current practice as a psychotherapist with individuals, couples
and families takes place mainly at a university psychotherapy clinic, where he acts
both as a therapist and a teacher. As part of their training in psychotherapy, Masters
students in psychology become co-therapists in therapy processes. For the most part,
the work is not acute crisis treatment; the therapists meet couples coming for treat-
ment because of depression and different types of marital problems. Our analysis
raised some important questions.
 Do the differences bring to light important aspects of open dialogicity that go
beyond the specific example of Open Dialogues?
 Do we gain more understanding of core elements common to all dialogic relational
practices?
One of the leading conclusions of Jaakko in the process of writing the book was:
Do not put your best tools for change to work, there are better things on the way!
Tolerating uncertainty and respecting otherness is a challenge when you are not work-
ing as a team, and this is certainly true when you work solo as do many couple
and family therapists. Nevertheless, not jumping to interventions is pivotal for dialog-
icity. Previous training in systemic family therapy would have afforded tested and
tried methods for change. However, powerful methods for change can also be power-
ful in closing alternative doors. Thus, instead of taking the shortcut to change-ori-
ented interventions, Jaakko would slow down, and instead of rushing into reframing
or interpretations he would follow moment by moment what the patient presented.
The task was to generate dialogical space.

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Dialogue-Unfriendly Questions in Classrooms


We can briefly consider a parallel in education. There are also pedagogical tools for
change that may also restrict instead of open up a dialogical space. Teachers gener-
ally know the answers to the questions they put forward. Why then, do they ask?
Perhaps teachers are trained to think that such drills promote learning. There are
also elements of educating in certain branches of psychotherapy, but this is not the
most important parallel. In both education and psychotherapy, there is an asymmet-
rical relationship between the expert and the less informed person. This is true
across many forms of professional help, counselling and coaching. The question is:
Is it possible to have genuine dialogue in such relationships? Yes and precisely
because of the asymmetry.
In what way would it enrich the event if I merged with the other, and instead of two
there would be now only one? And what would I myself gain by the others merging
with me? If he did, he would see and know no more than what I see and know myself;
he would merely repeat in himself that want of any issue out of itself which character-
izes my own life. Let him rather remain outside of me, for in that position he can see
and know what I myself do not see and do not know from my own place, and he can
essentially enrich the event of my own life (Bakhtin, 1990, p. 87).
As a matter of fact, all relationships are asymmetrical. As the philosopher Emman-
uel Levinas (1969/2004) emphasised, it is precisely the differences between people
that make dialogues both necessary and possible: The Other is always more than one
can grasp. In professional relationships, like those in psychiatry and social work, the
asymmetry is pronounced; the partners rarely share the life conditions and experi-
ences, but nevertheless, there is the temptation to help the patient/client to see things
the way the professional sees them and act in ways the professional sees most useful
the space for respect for otherness is at risk of being diminished.
The asymmetry is even more pronounced in education. The teacher is evidently
the more experienced partner when it comes to the cultural heritage that educational
institutions seek to pass on. However, teachers too have a lot to learn from their
pupils. Teachers do not live in the same life-situation as their pupils, nor do they
share their future. As Veli-Matti Varri (1997) points out, a pupil is, therefore, simul-
taneously familiar and foreign, an Other to whom only a dialogical relationship does
justice. Respecting otherness and asking questions that the teacher does not know
answers to querying with interest how pupils view the world and the matters at
hand from their unique points of perspective opens up space for mutual learning.
Wrong answers are not mistakes to be ridiculed, but hypotheses that went astray at
some juncture. If you do not feel safe to reveal your train of thought, you learn to
hide the path you are following. This is, unfortunately, a great portion of what is
actually learned at schools. But how do teachers help pupils feel safe? If ones unique-
ness is respected, if the pupil experiences that the teacher listens, if one feels heard
safe dialogical space emerges. Professor Paolo Perticari (2008) refers to questions that
the teacher knows the answers to as illegitimate questions. They banalise teaching
and make learning shallow. The following reflection exemplifies this.
One Monday in a primary school class at 2 Istituto Comprensivo di Brescia, Italy,
started with the children sitting in a circle on the floor with the teacher, discussing the
weekend.1 One of the pupils did not know the play that was based on a popular fairy
tale. One of the children described it with enthusiasm but did not understand the key

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Tom E. Arnkil and Jaakko Seikkula

words either. Instead of explaining the plot and the words the teacher encouraged the
children to discuss them, and one thing led to another and soon there was lively discus-
sion about word meanings, spelling, grammar and translations a lesson in Italian lan-
guage in other words. One girl in the class became obviously distressed, and started to
walk around the classroom, but this did not disturb the other children. They knew that
she liked to walk.
The teacher explained to Tom, who was observing the class, that they had discussed
what the girl was and was not able to do, and what she liked and did not like and
that this had led them to discuss whether people can know themselves if they cannot
utter their own name, which led to the question, What does knowing oneself actually
mean?
Children had been asked to fold a paper in a certain way and to write down what they
themselves could and could not do, and what they liked and disliked: this was an exer-
cise in craft as well as writing and a way to collect personal material for further dis-
cussions. All this had been set in motion by a boy snorting that all that the girl with
disabilities could do was drool, which led the teacher to respond by asking everyone if
that was actually all the girl could do.
Tom, who used to be a teacher in the 1970s, was fascinated by this school.
Instead of imposing educational subject matter onto the experiences of the children
and more or less ignoring their mental state in the here-and-now a group of teach-
ers in the school strived to generate a favourable atmosphere for learning by engaging
in dialogue with the children.
The educational themes grew like plants out of the dialogue. The music lesson had a
song about a bat as the theme. Children sang in lively canon after discussing how dif-
ferent the world looks for someone hanging upside down, and how different it looks
from a range of different viewpoints.
The group of teachers at 2 Istituto Comprensivo di Brescia who followed this
approach, called it conversational pedagogy, not dialogues; however, in Toms view
the process afforded beautiful dialogical moments. The teachers said their approach
was a kind of acrobatics tightrope walking between the possibilities opened up by
the childrens comments in the present moment, and the subject matter waiting to be
covered. The teachers gave preference to the present moment and dialogues, wasting
time in order to create a safe atmosphere where the children were not afraid to
express their thoughts.

Open Dialogues Even While Working Solo


Generating dialogical space is something that every psychotherapist can do in his/her
own practice while meeting with single clients, couples, families or larger social net-
works. Having a co-therapist, not to mention a team, enhances possibilities, but gen-
erating dialogical space can also be done working solo. Big changes in the entire
treatment organisation are not a prerequisite. Abstaining from strategic interventions
that aim at changing others makes room for dialogue in all relational practices
including everyday relationships.
Let us have a closer look at an example from Jaakkos practice in which he,
together with a female Masters student of psychology, met a multicultural couple.
Not much seemed to be happening; there were no skilful questions or neat

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interpretations, the therapists merely follow carefully the story of the clients. The wife,
Victoria, was a Swedish student who wanted to come to the session, because her hus-
band Alfonso an Israeli teacher at the university no longer wanted to speak with
her about the challenging issues in their life. Prior to their visit Victoria had been suf-
fering depression for some two years and when she started to recover, Alfonso almost
panicked when she wanted to speak about some relational issues.2 Alfonso had been a
great help to Victoria when she was depressed.
The following three episodes of dialogue3 happened in the second session. The
session started with Victoria and Alfonso filling out the Outcome Rating Scale (Miller
& Duncan, 2004), in which they evaluated in a simple way their previous week. Vic-
toria seemed to be unwilling to attend the meeting and therefore they were delayed
some five minutes from the start.
V: well, I feel differently, I did not want to come here today I am not usually like
this . . .
T1: mm . . .you didnt want to come here today . . .(44 ) for some specific reason or?
V: I think that I have just been working too much and I am tired
T1: ah-huh
V: I didnt have time to sleep or I just feel a bit sad, because this thing I dont know
why we feel so differently
T1: mm . . .you are a bit sad because of these differences or [points to the paper]?
V: No, I am happy that he feels good . . .
T1: okay, okay . . .(4) but you are sad, you feel sad.
This sequence takes place at the outset of the session while discussing how they
are. First they rated the ORS and afterwards Jaakko asked if they would like to say
something about how they felt. Alfonso first said that he felt good and then Victoria
said that she did not want to come here today. She said this with an irritation in her
voice and the opening of the session was quite tense. For therapists this means taking
care not to aggravate the situation more, in order to make collaboration possible. The
therapist answered by repeating her words and then asking her to say something more
(. . .for some specific reason . . .?). All these comments were open-ended, leaving the
possibility for the clients to speak about what they wanted to say. And once more
when she said that she felt a bit sad, the therapists repeated the answer word for
word.
In the next sequence after some 15 minutes in the session, the tension culminated
when Victoria spoke of her being overloaded by work.
V: Yes because Ive been, for the last weeks Ive been working like approximately
fifteen hours per day and I am never home and then if I am home, he is not, because
he has some friends to see or something. So mostly its my fault but not anyway like
I am away only because of work. So I feel like some evening being home its never at
the same time with him.
T1: ah-huh . . .
A: I actually dont feel like that . . .

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T1: You said never, what does it mean?


V: That I am never home?
T1: Not . . .that you said you are never home that you said that you are never
together home. When was the last time you were together home?
V: What time did I come home yesterday? Anyway before yesterday it was five days
in a row that I started working 8 in the morning and I finished between 10 and 12
because I am a student and I have this practice
T1: You have the practice . . .
V: and then I have the job where I go afterwards. So I feel like this. Yesterday I went
home after seven.
Victoria sounded very frustrated by her burden at work and not being home
and while at home, Alfonso was with his friends. The change in the atmosphere
happened when Victoria said they were never at home at the same time and when
the therapists took the words by repeating the word never in, You said never,
what does it mean? The story of the overwhelming frustration changed into a
story in which Victoria started to describe more precisely occasions and details in
their lives thus making dialogue possible. The therapists comment of asking when
they were last home together made it possible to speak of real things that had
happened instead of generalising comments that are not possible to have dialogue
about.
The first 28 minutes in the meeting were focused on unloading the extreme stress.
When the therapists then asked Victoria and Alfonso how they would like to use the
time during this session, they were both willing to speak about Alfonsos visit home
the following week, because it had been a constant load for the couple after they
sensed that Alfonsos mother did not accept Victoria. This actually seemed to have
been one aspect of Victorias depression when she realised that Alfonsos parents,
especially his mother, did not want to have to speak with her.
T1: mm . . .
V: But every time that he has been at some point or many times I have felt like that . . .
T1: uh-hm . . .you felt like?
V: That he doesnt think about me and he kind of likes to forget about me when he
is there.
T1: And what does it mean that you think . . .[points by hand to Alfonso] he would
like to forget you?
V: I feel like, I dont know . . .It doesnt make any sense to me, how can Alfonso be
so busy that he doesnt have time to think about me or send a message to me. . .that
is just something that I dont understand. I dont need a phone call. I just need to
know that you think about me
A: But I think it has never been . . .it has never been that for one whole day I didnt
send a message to you or phone call
...

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Developing Dialogicity in Relational Practices

A: (5) . . .right . . .I would send you a message during the day . . .


(7)
T2: Did I understand you correctly that you are afraid that he forgets you?
From the very first words in this sequence the therapists listened very carefully,
using the words, you felt like. It was an encouragement to Victoria to describe her
feelings in more detail. The core experience seemed to be the feeling of Victoria that
when Alfonso visits his home she becomes afraid that he forgets her entirely. This
was verified in the comments of both therapists.
During the last part of the therapy session the main issues were the relations
between Alfonso and Victoria and their relation to both parents. When at the end
they completed the Session Rating Scale to evaluate the session, they both reported
being heard and feeling like they discussed the right issues. After this session three
more sessions were organised and a big change took place in their way of having open
dialogue with each other concerning all the issues in their lives. Victoria became less
depressed and Alfonso no longer panicked when Victoria wanted to discuss relational
issues.
In this brief practice example, the therapists did not focus on the couple or family
systems style, either within the couple relationship or in relation to the extended fam-
ily. The main focus at all times was to follow their issues, and when doing so, the
most relevant themes that they felt to be problematic became the issues of the joint
sessions. The therapists guiding idea was to follow their stories and to be present in
their utterances, and this happened often by repeating verbatim, word for word, some
part of their utterance, to be sure that this was really what they meant. In such a con-
versation, the clients had possibilities to form more words to be able to speak about
their heavy and difficult experiences.
In general, seeing the family as a system can still be one way to analyse the prob-
lems. For Jaakko it would be still possible to define the family games, but he no
longer finds it interesting or helpful. So meeting the entire collections of relationships
present instead of looking at one system opens the door to a much more pro-
found shared experience between the therapists and the clients. Such an approach was
starting to open up for Jaakko and the team he joined in Tornio at the Keropudas
hospital in Western Lapland in 1981. Already during the years thereafter while devel-
oping the Open Dialogue approach it became apparent that the systemic point of
view of family should be opened up and more focus should be given to what happens
in the actual interaction between the several participants and several perspectives pres-
ent in the admitted patients social network meeting.

A Second Look at Pedagogics: Reciprocal Learning


There are three prerequisites for dialogical education as formulated drawing on the
ideas of Martin Buber (1958, see Collins, 1980): (1) listening, sensitivity to the whole
being of the child not only the childs intellectual capacities; (2) becoming aware of
the growing individuals specific needs; and (3) unconditionally accepting and respect-
ing the unique life of the child.
The third prerequisite is the most fundamental. These prerequisites are not dissim-
ilar to those for psychotherapy, social and welfare work or other forms of relational

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Tom E. Arnkil and Jaakko Seikkula

work. Asymmetrical relationships do not make reciprocal learning impossible. As


Veli-Matti Varri (1997, p. 93) points out, through the child the educator has the pos-
sibility for deeper understanding of the general prerequisites of human growth, but
will also face which is even more important the boundaries of his or her skills
and knowledge. Thanks to the experiences revealed by the educational dialogues he or
she learns what he or she can and cannot yet give.
The idea of reciprocal learning is, of course, the cornerstone of Paolo Freires
famous pedagogy of the oppressed (Freire, 1970/2006). For Friere, dialogue is essen-
tial in the struggle for empowerment, in the process where human actors can become
subjects instead of objects. In dialogue, students and teachers are simultaneously
teachers and students.
Maura, an experienced teacher in Brescia, Italy told Tom, that for her, the pupils are
the most important instructors. She gave an example. Paola is at the blackboard solving
a problem and Maura tries to assist her thought experiments via questions. The class-
mates are eager to offer suggestions. Paola appeals to Maura: Look at me, dont even
glance at the others! If you do, I become insecure and get stuck. You have to trust me
and I have trust that you help me. Always. To the end.
The teacher has to be in the present moment with and for the pupils and resist
the temptations of shortcuts to correct answers that spring from the curriculum.
Thinking together calls for suggestions and ideas from all around and also moments
for an individual to have the space to think and try in peace. However, the individual
is not constructing her utterances in a void but according to her embodied emotional
situation in the context. Or as Valentin Voloshinov (1986) points out, the speakers
always speak in a social and physical context and adapt their utterances accordingly.
A dialogical teacher makes it as safe as possible for the pupil to engage in her own
thought experiment in the classroom context and the best mentors for the teacher
are the pupils themselves.

Open Dialogues, Agency and Intersubjective Knowing


Pupils and teachers, patients and therapists, clients and social welfare workers . . .do
not share each others life situations, but they do share the once occurring moments in
which they meet. And the way they meet to share those moments are crucial for their
agency.
In dialogue, an intersubjective consciousness emerges. Our social identity is con-
structed by adapting our actions to those of others. Living persons emerge in real con-
tact with each other and adapt to each other, as in a continuous dance, not
necessarily controlling and deliberating on their behaviour verbally. They also experi-
ence how others see them and through this are afforded possibilities to learn to
know themselves. According to Bakhtin (1990) knowing myself as such is only possi-
ble by me seeing myself through the eyes of the other. I can be familiar with myself
only in the response that I receive in the eyes of the other. This response in the eyes
of the other is non-reflective since it happens immediately without any mediation
by words as tools in a split second. In this non-reflective answer from the other, I
can perceive whether and in which way I am received by him/her or not.
In dialogical relational work, practitioners respond to every utterance since, as
Bakhtin (1984) points out, for the word (and consequently for a human being) there

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is nothing more terrible than a lack of response (p. 127). Respecting the dialogical
principle that every utterance calls for a response, dialogical practitioners strive always
to answer what is said. However, answering does not mean giving an explanation or
interpretation but, rather, demonstrating in a response that one has noticed what has
been said and, when possible, opening up new points of view on what has been said.
Dialogical relational practitioners respond to the utterances of clients, families,
and pupils as fully embodied persons, with a genuine interest in what each person in
the room has to say, avoiding any suggestion that someone may have said something
wrong. They adapt to the emerging natural rhythm of the conversation. As the pro-
cess enables participants to find their voices, they also become respondents to them-
selves. For a speaker, hearing their own words repeated respectfully and responded to
widens the possibility to understand more of what they themselves have said.
Expressed in everyday language with which clients/families/pupils are familiar, profes-
sionals questions facilitate the telling of stories that incorporate mundane details and
the emotions of the events being recounted.
It is this responding that needs to happen in a dialogical meeting and actually not
very much more, because this is something that resonates with the first dialogical
experiences that we have from the first moments in our lives. Being heard is a basic
human experience as relevant to survival as breathing.

Questions for the Reective Practitioner: How Can We Improve Being in the Present
Moment
In our view, to be more dialogical means being more present, more in the here and-
now. In summarising the ideas that we have discussed, the following aspects could be
helpful in moving in this direction. Because of the emphasis on generating dialogue,
each meeting is unique and cannot be guided by pre-planned manuals for the conver-
sation. In order to foster our awareness of how we engaged with others we ask our-
selves questions like the following in retrospect.

Did I/we prefer themes of the actual conversation instead of clinging to narratives of the
past?
Each person chooses what he or she responds to in encounters. Responding to what
happens here and now between the participants opens up wide possibilities for dia-
loguing wider than aiming at reaching explanations of the past. For instance, if a
person becomes moved by the word he or she is using while speaking of emotional
issues, space is needed for that to happen instead of rushing into the next issue.
Stories that people tell of their lives provide important issues to be discussed in the
present moment, and should not be overlooked.

Did I/we follow clients stories and were we careful with our own openings?
The point of departure for dialogical practice is to take the words of the clients/
patients/pupils as the starting point, instead of proposing the practitioners themes for
the discussion. There are, of course, themes to be covered, as is evident in the field of
education. Also for those who work with families in the public sector, particularly in
areas of crisis, there are treatment plans to be made, and it is important that profes-
sional duties are taken care of. It is a challenge for dialogical skills to do this in ways
that do not take the possibilities out of dialogues, but instead, improve new resources

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Tom E. Arnkil and Jaakko Seikkula

to be mobilised. Instead of imposing themes, the dialogical practitioner alertly finds


opportune moments for building on what the clients/patients/pupils present. The
questions asked should encourage thought experiments, instead of steering the process
while giving no room for elaborating other perspectives. In responding to answers, a
useful way is to repeat verbatim, word by word, some part of the answer and then
for instance to ask people to say more about the matter.

Did I/we guarantee a response to spoken utterances?


Responses are embodied, comprehensive actions. It is advisable to have in mind the pos-
sibility of responding to every utterance in the session. This is not possible for every
detail; but perhaps the aspect of practice helps us to orient ourselves in such a way that
at all times we are alert to recognising the utterances of the participants in some way
for instance, by nodding when participants are commenting to each other.

Did I/we notice different voices, both our inner voices and those of people present?
Our utterances should recognise the words spoken, but also the unspoken reactions of
the participants. One can hear the horizontal voices of the participants, whereas the
vertical inner voices become evident in emotional movement in the middle of an
utterance. The first sign of this may not become evident as visible reactions, but
rather as an inner embodied feeling of the practitioner. If I am moved, most probably
someone else has been moved too, including some of the other participants also. This
experience of being moved is not said out in the open. The practitioners task is not
to define the emotions in words, but, for instance, to proceed more slowly in order
to have more space for them. Practitioners in psychotherapy and social welfare work
deal with difficult issues of human life that always cause emotional responses in us. It
is thus important that we listen to our own embodied responses and voices that may
be activated by the stories of the clients.

Did we take time for reflective talks between ourselves?


Working in teams, or at least as pairs, boosts possibilities for polyphonic dialogue. To
make use of these resources practitioners need to learn to have discussions among
themselves in the presence of the clients. This includes both discussions concerning
planning treatment or other relational processes, and reflective dialogues. Open dis-
cussion about the matter at hand makes the practitioners transparent, and this con-
tributes to clients gaining more agency in the process. Reflective dialogues focus more
on sharing ideas that have arisen while listening to what the clients tell. According to
Tom Andersen (1991), a reflective process means shifting between talking and listen-
ing positions. As clients listen to the professionals reflecting, they are in their inner
dialogues, which encompasses both polyphonic frames, the inner and outer, and the
vertical and horizontal.

Did I/we make our utterances dialogical: Did we invite responses, and did I speak in the
first person?
Firm, authorless statements do not generate and foster dialogues in the way that
speaking as a person in the situation does. Dialogue is only possible between embod-
ied human beings, not with categorised statements, and to invite dialogic responses it
can be helpful to say things like: In my mind, I am wondering what you think . . .,
or According to my experience, but I am not sure . . ..

152 2015 Australian Association of Family Therapy


Developing Dialogicity in Relational Practices

Did I/we proceed peacefully: Did I/we afford moments of silence to enhance the power
of dialogue?
The last point on our list may be one of the most challenging aspects. Colwyn Tre-
varthen (2012) speaks about the rhythmical co-ordination of dialogical responses of
the newborn with the adult. Dialogical rhythm between interlocutors calls for pauses
and silent moments which make it possible, not only to say aloud what one is think-
ing, but also to have space for inner dialogues where one can hear what one has said
to oneself and to others. The dialogical music of life takes place in mutual responsive
actions and attuning to each other. These silent tuning moments are needed for one
to see oneself and others at the same time.

Conclusion
Are we writing the same book? Jaakko exclaimed in the process of co-writing Open
Dialogues and Anticipations. We had come together once again to reflect upon our
experiences in fostering dialogicity. Our points of departure and practices are some-
what different, which affords rich possibilities for crossing boundaries and learning,
but at times the approaches drifted quite wide apart. Jaakkos training and experience
is mainly from psychology and the clinical context, Tom went from primary school
teaching to sociology and social policy and network muddles around families with
multiple clientships. The way to find firmer common ground was to add listening.
Jaakko had moved to new contexts of practice and it seemed helpful to analyse in
detail whether he was doing the same thing in the new setting or as it is likely that
contexts talk back if he and his co-therapists had altered the practice, perhaps
noticing some changes, maybe not aware of some. Thus, instead of making already
achieved conceptualisations the driver we tried to put practice in the drivers seat. This
called for recalling and reflecting without too much of a hurry towards conclusions
for others to read. What is our own practice trying to teach us?
The conclusions in this are, therefore, notions about how useful it is to listen care-
fully to ones own experiences and how helpful it is to do it in dialogue. The person
speaking can say nothing wrong, he or she has to have the chance to be heard, without
conditions, and the other does not necessarily have to agree. Asymmetry is not an obsta-
cle to dialogicity, unless there is a bigger need to formulate than to elaborate ideas as
we noticed ourselves in the course of writing and discussing. Each persons unique per-
spectives do not become similar through dialogue, but they can become richer.
We hope that the set of questions above is helpful in reflections upon practice and
lead to more awareness of how one actually engages with others and to evolving
practice and better reflective questions.

End Notes
1
Tom was visiting the school with his daughter Marikki, fluent in Italian, to negotiate a research
project. Marikki is presently analysing a wide body of empirical material for her PhD dissertation in
pedagogy.
2
The identification information has been changed. Some parts of the case have been analysed in Olson,
Laitila, Rober and Seikkula (2012). A book including seven different ways of looking at the process in
this particular couple therapy is forthcoming (Borcsa, M. & Rober, P., Eds.).
3
The dialogue was carried out in English, which was not the first language for anyone in the meeting.
4
The number within parenthesis, like (4) refers to the length of pause in seconds.

2015 Australian Association of Family Therapy 153


Tom E. Arnkil and Jaakko Seikkula

References
Aaltonen, J., Seikkula, J., & Lehtinen, K. (2011). Comprehensive open-dialogue approach I:
Developing a comprehensive culture of need-adapted approach in a psychiatric public
health catchment area the Western Lapland Project. Psychosis, 3, 179191.
Andersen, T. (1991). The Reflecting Team: Dialogues and Dialogues About the Dialogues. New
York, NY: Norton.
Bakhtin, M. (1984). Problems of Dostoevskys Poetics. Minneapolis, MN: University of Minne-
sota Press.
Bakhtin, M. (1990). Art and Answerability. Austin, TX: University of Texas Press.
Borcsa, M., & Rober, P. (Eds.) (forthcoming). Qualitative Research in Systemic Couple Therapy:
Multiple Readings. Springer-Verlag.
Buber, M. (1958). I and Thou. Translated by Ronald Gregor Smith. New York, NY: Charles
Scribners Sons.
Collins, P. (1980). Philosophy and alternative humanistic education: Buber and Neill in con-
trast. Journal of Thought, 15(Summer), 4762. University of Oklahoma.
Freire, P. (1970/2006). Pedagogy of the Oppressed, 30th Anniversary Edition (Original English
1970). New York, NY: Continuum.
Levinas, E. (1969/2004). Totality and Infinity: An Essay on Exteriority. Translated by Alphonso
Lingis. Pittsburgh, PA: Duquesne University Press.
Miller, S.D., & Duncan, B.L. (2004). The Outcome and Session Rating Scales: Administration
and Scoring Manual. Fort Lauderdale, FL: Author. Retrieved from http://wvu-msw-family-
group-fall-2011.wikispaces.com/file/view/DuncanAllianceManualSRSORS.pdf.
Olson, M., Laitila, A., Rober, P., & Seikkula, J. (2012). The shift from monologue to dia-
logue in a couple therapy session: Dialogical investigation of change from the therapists
point of view. Family Process, 51, 417432.
Perticari, P. (2008). La scuola che non ce . Riflessioni e esperienze per un insegnamento aperto, in-
clusivo e universalit
a . Il caso del 2 Istituto comprensivo di Brescia. Roma: Armando Editore.
Seikkula, J., & Arnkil, T.E. (2014). Open Dialogues and Anticipations: Respecting Otherness in
the Present Moment. Helsinki: THL, Finnish National Institute for Health and Welfare.
Trevarthen, C. (2012). Born for art, and the joyful companionship of fiction, in D. Narvaez,
J. Panksepp, A. Schore & T. Gleason (Eds.), Human Nature, Early Experience and the Envi-
ronment of Evolutionary Adaptedness (pp. 202221). New York, NY: Oxford University
Press.
Varri, V.-M. (1997). Hyv a kasvatus kasvatus hyv a a n. Vammala: Tampere University Press.
Voloshinov, V. (1986). Marxism and the Philosophy of Language. Translated by Ladislav Mate-
jka and I. R. Titunik. Cambridge: Harvard University Press.

154 2015 Australian Association of Family Therapy