The Association for Family Therapy 2000.

Published by Blackwell Publishers, 108 Cowley

Road, Oxford, OX4 1JF, UK and 350 Main Street, Malden, MA 02148, USA.
Journal of Family Therapy (2000) 22: 6182
01634445

Towards a common ground in psychoanalysis and

family therapy: on knowing not to know1

Glenn Larnera

In this paper a common ground between psychoanalysis and family ther-

apy is discussed in terms of postmodern theorizing in both disciplines.
Recent systemic, narrative or social constructionist thinking in psycho-
analysis and a psychoanalytic turn in family therapy offers the possibility of
a shared epistemology. This is described in terms of a critical not-knowing
stance which allows for the therapists/analysts contribution of meaning,
interpretation and knowledge in therapeutic conversation. Here the hold-
ing of not knowing and knowing together provides a narrative container
for personal meaning and thinking to develop. This knowing not to know
is what a postmodern psychoanalysis has in common with family therapy:
both are ways of being with persons to help them develop and hold their
own knowing. This therapeutic process is illustrated in a clinical vignette
of narrative child family therapy.

For what one knows does not belong to oneself.

(Marcel Proust, Remembrance of Things Past, p. 898)

Introduction
Readers of recent journal issues, particularly in Australia and
Britain, can testify to an unexpected psychoanalytic renaissance in
family therapy (e.g. Crago, 1998; Flaskas, 1997; Ingeborg et al., 1998;
Leupnitz, 1997; McFayden, 1997; Pockock, 1997; Speed, 1997).
Casting off a mantle of theoretical correctness, family therapists
have taken back what was dismissed or split off in the founding of
their discipline, namely things psychoanalytic (Byng-Hall, 1999).
This integration has followed the political, cultural and feminist

a Senior Clinical Psychologist, Child and Family Counselling Service,

Queenscliff Community Health Centre, Cnr Palm Avenue and Lakeside Crescent,
North Manly, NSW, Australia, 2093.
1 This paper will form the basis of the Journal of Family Therapy Discussion
Forum on the Internet at http://www.blackwellpublishers.co.uk/joft. Readers are
invited to take part in the ongoing discussion.

2000 The Association for Family Therapy and Systemic Practice

62 Glenn Larner
debates of the past decade, which have encouraged family ther-
apists to deconstruct their own theoretical dogmas before critiquing
other approaches to therapy, like psychoanalysis. What allows a
common ground between family therapy and psychoanalysis today
is a mellowing of foundational ideologies in both disciplines, an
approach to theory as both/and rather than either/or.
In this context of theoretical diversity and respect for difference
there is less need to maintain polarized epistemological positions;
rather, theory is grounded in the pragmatics of everyday thera-
peutic practice. Rigid theoretical boundaries between disciplines
are deconstructed by eclectic and pragmatic practitioners in the
field. As Derrida (1995) notes, conceptual or theoretical borders,
for example, of the kind, therapy is this/but not that, are codes
that we cast like nets over time and space in order to reduce or
master differences (p. 19). Contemporary psychoanalysts and
family therapists are currently less bound by the tradition of theory
and more informed by an ethic of practice as dialogue and collab-
oration in the therapeutic encounter.
In family therapy this means that a systemic or social construc-
tionist perspective does not have to exclude a psychoanalytic focus;
indeed, such a narrative of exclusion is a power hierarchy in theo-
retical discourse that itself requires deconstructing. Or, using the
terminology of Michael White (1995), the current dominant story
of family therapy is increasingly derived from social construction
theory; one way to deconstruct it is to bring out the alternative,
hidden or subjugated psychoanalytic story. This tells of the rich inner
psychological life (symbolic, unconscious and emotional) of the
person in the system and uses psychoanalytic ideas to illuminate the
intricacies of the therapeutic relationship (Flaskas, 1993, 1997).
Yet who would have believed at the close of the millennium, so
soon after the narrative revolution, we would be witnessing a
psychoanalytic turn in family therapy? Historically, family therapy
was founded in opposition to psychoanalysis, even though many
of its seminal practitioners originally trined in that discipline.
Here one could speculate on how this common origin continues
to inform and enrich family therapy, in practice if not in theory.
Also of interest is that narrative and social constructionist
approaches have encouraged family therapists to work less with
whole family systems and more with individuals. As Zimmerman
and Dickerson (1994) put it, narrative therapists focus not so
much on relationships as on a persons constructions or story

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 Common ground in psychoanalysis 63
about their relationships. This is not so far from what analysts
might do, particularly those with narrative leanings.
While respecting their differences,2 it is the recent development
of a theoretical communality between psychoanalysis and family
therapy that I am interested to explore here. This paper describes
the emergence of a postmodern narrative or relational stance
within psychoanalysis itself and the extent to which it now shares
with a more analytic-friendly family therapy a common epistemo-
logy of not knowing. At the same time it discusses the complexity
of the relationship between knowing and not knowing in therapy
which both disciplines grapple with; namely: how can therapists be
knowing in terms of imparting a professional sense of expertise,
agency, power, certainty and authority to their clients, while simul-
taneously adopting a not-knowing stance of open reflection, curi-
osity, ethical relating and collaboration in the therapeutic
conversation?
This is a dilemma of therapeutic knowledge and power common
to family therapy and psychoanalysis in a postmodern world. I pose
the psychoanalytic idea of containmentas a narrative structure for
holding therapeutic not knowing and knowing together as a know-
ing not to know. This allows for the interpretation of personal
meaning in relational contexts characteristic of both approaches.

The psychoanalytic turn in family therapy

A number of family therapists have introduced psychoanalytic ideas
into systemic family therapy. For example, John Byng-Hall (1973,
1979) heralded the important role of unconscious family mythology
in systems therapy. More recently his work has linked the psycho-
analytic concept of secure attachments in an empirical research
model to both systemic and story metaphors in family therapy
(Byng-Hall, 1995a, 1995b, 1997, 1998). This is significant not only
because it integrates the individual script into the family story, but
it also shows how a narrative is systemic. Myths, scripts, legends and
family stories all provide a way of thinking about repeating patterns

2 For example, while family therapy is usually time limited, directly addresses
the systemic-social context and focuses on the presenting problem, psychoanalysis
is a more personal exploration of symbolic and unconscious meaning over several
years in the context of an intense emotional therapeutic relationship.

2000 The Association for Family Therapy and Systemic Practice

64 Glenn Larner
of family interaction (Byng-Hall, 1995a: 136). The family narrative
articulates what is repeated in the family experience as a system or
pattern. This is a stability or repetition which none the less contains
the possibility of change and difference as the telling of a more
hopeful, integrated or coherent story.
Carmel Flaskas (1993, 1996, 1997) has also contributed signifi-
cantly to a psychoanalytic understanding of systemic therapy.
Flaskas (1993) identified the following influences to account for the
growing interest of systemic family therapists in psychoanalytic
ideas: the greater tolerance of constructivism to other ways of know-
ing, a refiguring of the relevance of emotional experience and the
therapeutic relationship in systemic work, the feminist critique of
power and the more relational emphasis of contemporary psycho-
analysis, in particular, object relations theory.
More recently Flaskas (1996, 1997) has mapped a psychoanalytic
awareness of the emotional quality of the therapeutic engagement
on to a systemic understanding of relational processes and repeti-
tive patterns of interaction in family therapy. Flaskas (1993)
presents her integrative model pragmatically, allowing psychoana-
lytic concepts and systemic perspectives to sit side by side. Hers is
a plural and discursive philosophy of therapy that is at once both
systemic and psychoanalytic, not one or the other.
Another key figure who has introduced psychoanalytic thinking
into systemic family therapy is Deborah Luepnitz (1988, 1997). Her
work utilizes object relations theory to signify gender, power and
subjectivity issues as part of a feminist critique of family therapy.
Luepnitzs (1997) reflection on psychoanalysis is telling:
Psychoanalysts, particularly contemporary writers, seemed to be
actually much more systemic than mainstream family therapists, as
they took into account the intrapsychic, intersubjective, familial and
social, while most family therapists entirely neglected to theorize
the unconscious (p. 305).
What Luepnitz suggests is that any hard distinction between family
therapy and psychoanalysis along systemic lines is tenuous. This is
not only because contemporary analysts have a relational focus but
also because the neglect of the (object relations) system in the indi-
vidual by family therapy is itself less than systemic. In other words,
while the term systemic is a political marker for distinguishing
family therapy from supposedly non-systemic approaches like
psychoanalysis, they can none the less be seen as two sides of the
same systemic coin, one turning inward, the other looking outward.

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 Common ground in psychoanalysis 65
Like Flaskas, Luepnitz challenges existing rigidities in both disci-
plines, showing how one can be held in tension to the other.
It seems that when we see psychoanalysis as one way of describing
what goes on in therapy, there is no reason why it cannot co-exist
with a systemic lens. The therapeutic events and experiences to
which systemic therapists refer can also have a psychoanalytic real-
ity. For example, both concern a story of repetition, whether at the
level of interactional relationship patterns in the family or in the
emotional life history of individuals. Psychoanalysis and systemic
therapy both capture a certain truth about the therapeutic
process, but this is by no means the whole story. Any combination
of psychoanalytic and systemic hypotheses is always open to new
possibilities of interpretation depending on what happens in the
session. What this suggests is that one or either model alone is insuf-
ficient to describe the complexities of the therapeutic encounter.
Of particular interest is the linking of psychoanalytic themes to
systemic patterns of family relationship as narrative. As I understand
it, the marking of pattern or repetition in the midst of change and
difference is common to psychoanalysis, family therapy and narra-
tive therapy. The idea of repetition finds expression in terms of
unconscious patterns of individual psychology, systemic sequences
in families and in the coherent recounting of life experience as
narrative. As Deleuze (1968) in his classic work Difference and
Repetition says: Repetition is thus in essence symbolic, spiritual, and
intersubjective or monadological (p. 106). Repetition is the stuff of
life which makes difference possible, and here it is perhaps no acci-
dent that psychoanalysis, systemic family therapy and narrative ther-
apy are all concerned with its touch.

The narrative-systemic turn in psychoanalysis

Yet what has been even more surprising and fascinating than the
psychoanalytic revisioning of family therapy is the recent voyage of
psychoanalysis into systemic, relational and narrative territory (see
e.g. Bouchard, 1995; Brodbeck, 1995; Gabbard, 1997; Goldberg,
1994; Ponsi, 1997; Rabin, 1995; Renik, 1998). Like family therapy,
psychoanalysis is also deconstructing its system of theory and prac-
tice (Barratt, 1993; Goldberg, 1998). There has been a radical shift
of psychoanalysis away from the individualist modernist philosophy
of mind that family therapy turned its systemic back on forty-odd
years ago (Cavell, 1993, 1998). Together with the influence of

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66 Glenn Larner
creative analysts like Bion and Winnicott, postmodern theorizing
has taken psychoanalysis in the direction of a more conversational
and collaborative approach. McFadyen (1997) for one, comment-
ing on the traditional divorce between psychoanalytic and family
therapy training, is hopeful of a rapprochement on the basis of recent
postmodern thinking in both disciplines, particularly the shared
emphasis on narrative, language and the therapeutic relationship.
In a classical psychoanalytic model, the analyst acts like a blank
screen, taking in the patients projections, emotions and thinking
about self in relation to significant others. Positioned outside the
patients subjectivity and the therapeutic relationship, the classical
analyst observes and interprets the clinical presentation in the
transference in terms of the there and then facts of the patients
developmental life history. Like the first-order cybernetic family
therapist, the modern analysts posture is based on positivist ideals
of neutrality, objectivity and truth, with the analyst presuming to
know the patients psychic reality in a scientific sense.
However, postmodern theoretical developments in psychoanaly-
sis have challenged this traditional one-person psychology.
Contemporary psychoanalysts describe what they do as a narrative
journey with the analysand, in which psychological facts and inter-
pretations are socially constructed in the here and now intersub-
jective experience of the countertransference relationship (Larner,
1999b). This two-person or relational psychology takes into
account the social construction and cultural relativity of all know-
ledge. Instead of privileging the analysts knowledge and power to
analyse meaning, to observe and interpret aspects of the
analysands mind, a dialogical or relational approach is more collab-
orative, introducing the analysts own psychology or subjectivity
into the observational process.
Recent issues of journals like the International Journal of
Psychoanalysis, The American Journal of Psychoanalysis and
Psychoanalytic Psychology will provide readers with a glimpse of the
narrative and social constructionist turn in psychoanalytic thinking.
Here I can only refer briefly to these fascinating developments in
psychoanalysis, which by and large mirror the postmodern move-
ment within family therapy and will limit my discussion to not know-
ing and critical knowing themes shared with family therapy. In all
of this the question what is psychoanalysis? remains a fascinating
and ongoing enquiry. As the Symingtons (1996) in their presenta-
tion of the clinical thinking of Wilfred Bion say: The progressive

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 Common ground in psychoanalysis 67
clarification of what the analytic process consists of is still taking
place (p. 32). Im sure the same can be said of family therapy.

Not-knowing themes in psychoanalysis

Epstein (1995) compares the art of psychoanalysis to Buddhist medi-
tation, in which the analyst, like the meditator, suspends critical
judgement and simply attends to what is present. He cites Freuds
stipulation to the beginning analyst: He should simply listen, and
not bother about whether he is keeping anything in mind (p. 115).
Freuds analytic posture uncannily anticipated the current interest
of psychoanalysts in Buddhist practice and its not-knowing philoso-
phy. As Rubin (1999) says: Analysts who meditate might thus hold
their theories more lightly than tightly (p. 15). Here, possibilities of
(unconscious) knowing in psychoanalysis are opened up by
moments of not knowing, of letting go cherished notions and theo-
ries about the patient3 in favour of attentive listening.
Bions approach to psychoanalysis also involved a not knowing
which created space for thought, meaning and knowing to grow in
the therapeutic relationship. As the Symingtons (1996) comment
on Bions work: Intolerance of the unknown and our need to
snatch at something that explains it smothers the opportunity of
coming to the truth (pp. 182183). The not-knowing analyst waits
until the psychological pattern of inner experience emerges and
then attempts a personal act of meaning and communicating. As
Thorner (1981) says of Bions epistemology: Side by side with the
desire for knowledge there is a resistance to knowledge (p. 593).
The psychoanalytic interest is the point where knowledge breaks
down and becomes unstable as a not knowing, which is a real know-
ing at the level of the patients unconscious emotional communica-
tion. In this sense knowledge for analyst and analysand provides a
link; it is a process of getting to know the other, to form what
Grotsein (1981) calls a thinking couple.
Casement (1985) similarly depicts the analytic process in terms
of not knowing: The experienced therapist or analyst, by contrast,
has to make an effort to preserve an adequate state of not-knowing
if he is to remain open to fresh understanding (p. 4). The analysts

3 While I prefer to talk of clients or persons in therapy, I respect the use of the
term patientin psychoanalytic discourse, which emphasizes the more intense and
prolonged emotional dependency and exploration of the analytic relationship.

2000 The Association for Family Therapy and Systemic Practice

68 Glenn Larner
capacity to know the reality of the patients emotional communica-
tion and to convey this understanding in the form of an interpreta-
tion depends on the use of not knowing, on what is learned from the
patient. The therapeutic use of not knowing refers to the analysts
capacity to learned from the patient what is significant for the analy-
sis to proceed.
Likewise for Christopher Bollas (1989), not knowing is essential
to analytic practise (p. 57). It creates a potential space for under-
standing and a taking in of the patients unconscious communica-
tions. The unknowing process is required for the patient to feel
known: Each analyst who comes to know his patient through a
coherent analytical understanding of the patient must unknow him
(p. 63). Similarly for Schafer (1997), the analysts delaying of inter-
pretation is a not knowing which allows the opportunity for mutual
emotional experience to become more concentrated, attain greater
richness and complexity, and extend deeper into the inner world
(p. 156). Again, as Hanly (1996) puts it, a narrative stance in
psychoanalysis involves a tolerance of not-knowing (p. 446), or as
Cooper (1996) says, analysts today attempt to deepen introspective
curiosity in themselves and in their patients. This is similar to what
family therapists with a narrative or social constructionist perspec-
tive have been saying for some years.

Critical not knowing in family therapy

For Anderson and Goolishian (1992), a therapeutic conversation
occurs when the therapist adopts a not-knowing stance in the ther-
apeutic relationship. This opens a space for conversation around a
problem, so new meanings and narratives can emerge. As
Anderson and Goolishian (1992) explain, it is the therapists curios-
ity to know more about what has been said (p. 29) or how the
client constructs meaning, which engages the future or not-yet
said narrative and opens up the possibility of change. To achieve
this the therapist relinquishes an objectifying stance as an expert in
favour of dialogue, a talking with the client in a mutual conversation
of new understanding.
The theoretical rationale for a not-knowing stance in therapy is
social constructionism which proposes a relational or communal
mode of knowing in which the dialogical creation of meaning is
always an intersubjective process (Anderson, 1997: 134). Here what
the therapist knows in the form of psychological facts about the

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 Common ground in psychoanalysis 69
client (psychopathology, diagnostic categories such as DSM IIV,
etc.) is less relevant than how the therapist knows. The therapists
collaborative stance in the therapeutic conversation, the desire to
know and understand more, forms a unique interpersonal-social
space for dialogue and the expression of a therapeutic narrative.
None the less, a not-knowing social constructionist perspective
has recently become controversial for contemporary therapists
because of the power ambiguities of the therapeutic context
(Larner, 1999a). In response to recent critiques of social construc-
tionism (e.g. Held, 1995), collaborative therapists must articulate
the complexities of knowledge and power involved in a not-knowing
stance. This recognizes that it is impossible for the therapist not to
participate in some hierarchy of knowledge and influence or to take
a position that is not culturally, politically or gender informed. For
the same reason critical and social construction theorists in psycho-
logy who aspire to a political engagement with society, now locate
discourse practices within a modified realist epistemology, one that
recognizes the discursive and social realities of power relationships
(Parker, 1998).
A critical not knowing acknowledges a collaborative stance as an
ethical ideal tainted by power, knowledge and social hierarchy in
the therapeutic context. The not-knowing therapist is a therapist
who still thinks and knows and intervenes, but this knowledge is not
imposed on the client in an abuse of the therapists power and influ-
ence (Larner, 1995). That is, a not-knowing stance in therapy
suggests not the erasure of expertise and knowledge but an ethical
prescription for how it is used, namely as a basis for dialogue, collab-
oration and open enquiry in the mutual exploration of constructed
meaning. The therapists knowledge is still there but deconstructed
for the sake of the clients own knowing, power and agency in the
therapeutic encounter.
Andersons (1997) own response to the critique of social
constructionism acknowledges this role of therapeutic knowledge
in a not-knowing stance: I do not challenge that therapists have
prelearned knowledge theoretical and experiential, professional
and personal. . . . A therapist cannot be a blank screen, void of
ideas, opinions and prejudices (p. 137). Again there is later an
impassioned plea: I do not want my not-knowing position to be
misperceived as knowing nothing or withholding knowledge.
Rather, it is related to what I do with what I know or think I know
(p. 247). The therapists expertise and knowing actively contribute

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70 Glenn Larner
to the therapeutic narrative in the form of further questions and
enquiry.
Not knowing is really a collaborative or critical knowing, one that is
relational and open rather than absolute or closed. It is a knowing
jointly constructed in the session. By not knowing, the therapists
knowing of the other proceeds as an interest in what and how the
client knows and interprets psychological and cultural meaning. As
for analysis, not knowing means that the therapist goes into each
session without preconception and with an open mind (Ebert,
1998). This in itself is a powerful intervention not unlike Freuds
stipulation to listen to the patient without censure in free associa-
tion (Grotsein, 1981).

On knowing not to know

Social constructionists in psychoanalysis have also recently acknow-
ledged the analysts knowledge, power, authority, guidance and
influence in the analytic relationship as inescapable (Larner,
1999b). Given the collaborative nature of psychoanalysis as an
exchange of subjectivities and stories in the session, the analyst
none the less has a guiding or knowing function in encouraging the
patient to refigure and test out unconscious fantasies and projec-
tions. The current epistemological issue in psychoanalysis is a
concern to validate the analysts expertise, such as to interpret the
transference relationship and to provide an external or objective
perspective, one different to and distinct from the patients (Cavell,
1998). While the analysts stance is not knowing, it is also knowing
in the sense of establishing an external reference point for the
interpretation and understanding of patterns of repetition and
change in the psychological narrative and therapeutic relationship
(Gabbard, 1997).
The analysts posture provides a reality check in a sea of subjec-
tivity, a knowing and thinking which helps form an interpersonal
context for the patient to know and think and develop what Caper
(1998) calls a mind of ones own. Like not-knowing family ther-
apists, this requires analysts to be knowing of reality in some objec-
tive sense. The communication of this knowing is crucial for the
patient to feel known and to participate in the analytic journey. My
understanding of this epistemological dilemma is that analysts, like
family therapists, hold knowing and not knowing together, that
subjectivity, narrative and the interpersonal construction of

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 Common ground in psychoanalysis 71
psychological meaning goes hand in hand with more objective
modes of knowing.
The analysts not knowing creates a space for the patients know-
ing to grow, which is a result of experiencing an intimate knowing
in relation to the analyst. In addition, it is by not knowing that the
analyst comes to know the patient, that meaning and understanding
is realized from the narrative material. This is a process that takes
place between analyst and analysand; their knowing and not knowing
is in the dialogic space between them. Whether in psychoanalysis or
family therapy, not knowing incorporates an intimate and true
knowing of the other which enhances the exploration of interper-
sonal and emotional space.
The interest here is the relationship between not knowing and
knowing in both therapeutic approaches. This recognizes that a
collaborative approach to therapy does not exclude the therapists
knowing and influence in therapy but enhances it. My thesis here is
the therapists knowing whether it takes the form of thinking out
loud, an interpretation of meaning, a linking of personal themes in
the life narrative or the sharing of relevant psychological informa-
tion (e.g. research about postnatal depression, issues of attachment,
vicious cycles of systemic interaction and so on) sits side by side with
a not-knowing receptivity towards the clients construction of mean-
ing. The analysts/therapists power, authority, knowledge and
expertise is expressed in a way which encourages the clients agency
and knowledge to emerge. In therapy, knowing and not knowing
co-exist as an exchange of knowledge and meaning between thera-
pist and client (Larner, 1995).
Here we can distinguish three kinds of knowing in therapy: factual
or knowing that, such as historical and autobiographical facts about
the client, psychological research findings, theoretical, experiential,
technical and professional knowledge, etc.; knowing how, which is a
relational form of not knowing as dialogical enquiry, and uncon-
scious knowing at the level of the countertransference, what the
therapist feels in the session. The point is that all these modes of
knowing can be present in therapy at one time or another; rather
than being mutually exclusive, they enrich and inform one another.
Elsewhere I have discussed this complex knowledge positioning
in terms of the paramodern, which following Derrida, holds the
modern and postmodern in tension (Larner, 1994, 1995). Rather
than one discourse violently replacing the other, there is a theoret-
ical stance of institutional humility (Larner, 1999c). This is an ethical

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72 Glenn Larner
knowing not to know which resonates with Pococks (1997) recent
statement: There is, I believe, a space between knowing and not-
knowing in which a different kind of collaborative understanding is
possible (p. 288). This identifies the persons experience of feel-
ing understood as the common ingredient of both psychoanalysis
and family therapy. Or as Mason (1993) suggests, family therapists
operate from a stance of safe uncertainty or authoritative doubt,
a position that encompasses both expertise and uncertainty (p.
192). This describes therapy as a process of mutual influence in
which therapeutic expertise or certainty goes with a collaborative
stance of uncertainty and respect for the clients knowledge and
narrative. Again for Pare (1999), this is called discursive wisdom:
The alternating between knowing and not-knowing creates the
space for the mutual co-construction of new meanings (p. 7). This
situates diverse modes of knowing and not knowing for both ther-
apist and client in the context of an ethical-collaborative therapeu-
tic relationship.

Knowing not to know as containment

Here I want to make a tentative connection between knowing not
to know and the psychoanalytic concept of containment. In psycho-
analysis, containment implies providing a safe, secure place where
meaning can be held and thought can grow. Schafer (1997) notes
that to contain means to hold for the time being, to let it be, rather
than to intervene, interpret or fill up, though this is possibly more
of a Winnicottian form of holding than containment in Bions
sense of the word. According to Alvarez (1992), containment for
Bion was not merely a balanced holding or being with the patient
in thoughtful reverie, but also an active interpretive process, in
which the meaning taken in is transformed and given back in a
more manageable form. Like a mother open to her infants needs,
the analyst takes in the uncontainable, the patients unbearable
emotions, projections, guilt and pain.
However, it is the analysts expressed or verbalized thought in an
interpretation that provides an emotional and thinking container
for the patient to bear the psychic pain which makes his or her own
knowing possible. Casement (1985) defines containment as a
taking in or holding of a persons emotional communication
through projective identification and interpretation: the best
containment is a good interpretation. That means being able to

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 Common ground in psychoanalysis 73
make sense of what a patient is saying and feeling, and able to
convey this to the patient (p. 153). It is the analysts not-knowing
receptivity as a desire to understand and be with the other and the
analysts knowing as a contribution of meaning through interpreta-
tion, which together with the patients meaning helps to construct
a narrative container in which the persons thoughts and feelings
can inhere. In containment there is both knowing and not knowing
on the part of the analyst rather than one or the other.
In psychoanalysis, interpretation contains the persons emotional
experience so that it can be thought about and understood. It is the
analysts attempt to contribute psychological meaning in response
to the narrative and to communicate this understanding as a coher-
ent statement of the patients experience. This amounts to a joining
with the persons inner world. It is as if two minds become one: the
analyst takes in the analysands meaning and thinks it, which the
analysand then responds to in the therapeutic dialogue. However,
an interpretation is not a statement of fact but the posing of a ques-
tion that only the patient can answer. As Winnicott put it: In
analytic work it is important that the analyst shall not know the
answer except in so far as the patient gives the clues (quoted in
Casement, 1985: 221).
In psychoanalysis, unlike in family therapy, the analysts interpre-
tation is significant for the patients development of understanding.
It is the analysts role to think or interpret the unconscious meaning
of the patients narrative, though analysts differ in the significance
which they give to interpretation. For example Stern (1998)
recently referred to non-interpretive mechanisms in psychoanaly-
sis, the something more than interpretation needed for therapeutic
change labelled implicit relational knowing. This comprises inter-
subjective moments occurring between patient and analyst that can
create new organisations, not only in their relationship but also in
the patients procedural knowledge, his ways of being with others
(p. 1). In contrast, for Ingram (1996): Not interpreting in psycho-
analysis is akin to not breathing (p. 431). The issue here is whether
a persons thought and knowledge in therapy can emerge dialogi-
cally, or does it have to be given to the patient by the analyst in the
form of an interpretation in the session?
In family therapy the therapists task is to encourage the client to
do his or her own interpreting/thinking and contribute the narra-
tive meaning in the therapeutic conversation. My point is that as in
psychoanalysis, the not-knowing therapists contribution of meaning

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74 Glenn Larner
or knowing need not interfere with this dialogic process, but can
enhance it in a mutual exchange of knowledge between therapist
and client. What therapy provides in both psychoanalytic and
systemic contexts is a narrative container in which meaning can
emerge, whether it is contributed by client or therapist.
None the less, how is the narrative understanding and coherence
that develops in an analytic session the same as or different from
that which emerges in a therapeutic conversation in family therapy?
This question more than any other defines what is similar and
different between the two therapies. For Bion, getting to know the
other was not a factual or objective knowledge, but a not knowing
(Thorner, 1981). Yet it is a knowing of the other in a very real sense;
that is, the others truth or emotional experience. Not knowing in
psychoanalysis involves a knowing engagement with the other, a
desire for the others knowing to grow at a cognitive and emotional
level. This is similar to the not-knowing family therapist who wants
to know what the clients meaning is.
An interpretation in therapeutic conversation in family therapy
would resemble a coherent linking and statement of themes, the
difference being that the therapist encourages the client to think
this process. The not-knowing family therapist still thinks and
knows, but this knowledge is given back to the client in the form of
another question that leads the client to interpret and think. The
not-knowing family therapist holds interpretation in, actively asking
questions that will lead the client to do her own interpreting, seek-
ing the clients knowledge.
The containment in a not-knowing therapeutic conversation in
family therapy proceeds not from the therapists interpretations so
much as from the narrative meaning that unfolds in the session. Here
it is the clients thinking that is relevant in terms of making sense of or
even feeling the emotional pain which brought them to therapy. The
family therapists knowing and expertise, like the analysts, lies in the
ability to take in and hold what has just been said and to interpret it,
the difference being that this thinking is given back to the client in
the form of another question that introduces more coherence and
understanding into the therapeutic conversation.

Narrative child family therapy

The following clinical vignette illustrates the process of knowing
not to know in narrative child family therapy (Larner, 1996). Here,

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 Common ground in psychoanalysis 75
an initial family interview, a child psychoanalytic play assessment
and the ensuing dialogue with the family all contain the
child/family problem in a therapeutic space that allows further
exploration and understanding. In Bions terms, the child interview
is an emotional container to receive the childs symbolic process as
reverie, for thought to be communicated to another person. Or in
Winnicottian terms, the therapeutic play space holds the child in a
non-purposive engagement (Ingram, 1996), so as to allow symbolic
developments that have implications for the whole family. All can be
considered as a kind of transitional object, linking the subjective
and intersubjective worlds between child and family. In a similar
fashion, Brafman (1997) applies a Winnicottian perspective, linking
the childs unconscious fantasy to the family experience.
At each stage, the therapists knowing not to know acts as a
container for the child and familys knowing to grow. Like Hermes,
the therapists role is to be a messenger, taking the childs symbolic
communication to the family. The major task is to institute an atti-
tude of openness and enquiry, a desire to understand rather than a
foreclosure on meaning in terms of the presenting problem. Put
simply, narrative child family therapy is a desire to hear the childs
story, to put aside questions of diagnosis and even the notion of a
problem for the time being, in order to listen. This curiosity opens
the possibility of a conversation that values the others voice. None
the less, the therapists not-knowing stance does not exclude know-
ing in the therapeutic conversation, whether this takes the form of
interpretations of individual and family meaning, observations in
the session, the linking of themes in family communication, a clari-
fication of systemic sequences of family interaction or channelling
the dialogue in a particular therapeutic direction.

Case example
John is a high-achieving 8-year-old referred because of anxiety,
somatic complaints stomach aches and headaches, sadness and
isolated episodes of temper outbursts at school where he throws
furniture and attacks children. In the initial interview with his
mother, Maria, I asked John to describe the anxiety feelings which
he called hotheads: Its like when I cant wait to my birthday, I just
feel sick. The feeling is the same, sometimes youre excited but
sometimes youre scared. I noted his feeling sick and unhappy
appeared to be centred more around school than home and he

2000 The Association for Family Therapy and Systemic Practice

76 Glenn Larner
agreed, saying that 90% of his hotheads are school-based: I get
them every day before school and Sunday nights because tomorrow
is school. It lasts till we get to school. At this point Maria
responded: I remember feeling sick and anxious at school, to
which John replied: like me. The remainder of the session teased
out Johns hothead experience, introducing verbal distinctions
between feeling worried, excited and angry.
In this initial session the therapists not-knowing stance provided
a dialogic structure or container for John to express in his own
language his understanding of the problem. However, this did not
preclude the therapists contribution of knowing and expertise in
the therapeutic conversation, which took the form of directly
asking John to discriminate and label worry, excitement and
anger in his hothead experience and to quantify this in relation
to school and home. While the therapists not knowing provided a
conversational space for the problem to be expressed in the
clients own language, this did not preclude therapeutic knowing
in the form of a specific interpretation of Johns hothead experi-
ence. This provided an emotional and thinking container for John
and the family to think and feel differently, to begin to form a new
narrative about the problem. The therapists knowing not to
know actively utilized the therapeutic significance of Johns apt
metaphor.
I arranged to see John for three fortnightly individual play
sessions to continue exploring his narrative about hothead feel-
ings. In the subsequent family interview Johns father, Chris, began
with the report: John has seemed heaps happier in the last few
months, his behaviour is better, he doesnt fly off the handle, quite
a transformation, hes been terrific. Maria agreed: he enjoys
school. I asked how they understood this dramatic change. For
Chris Johns mood was lighter, and for Maria he was less negative.
John said: I just drawed. With Johns permission I introduced his
drawings and stories into the session. Noting their significant angry
content I wondered how this related to the family experience. Maria
responded: He thinks when I get angry I dont love him, he gets so
upset. I then asked what happens when Maria becomes angry with
Chris and Johns worst fear in this scenario. Many children fear a
parental separation and this therapeutic knowledge prompted a
question that might connect up the angry and worried parts of
Johns hothead experience to possible parental discord and the
family experience of anger.

2000 The Association for Family Therapy and Systemic Practice

 Common ground in psychoanalysis 77
At this point John whispered to Jenny (his sister, aged 10 years)
That they might break up. Jenny also admitted this fear when her
mum and dad have the occasional argument. Both children
recounted with heightened emotional intensity the details of an
aggressive episode between their parents two years previously. Chris
had just left his job and Maria, angry about her access to their only
car blew up and told him to go away. The parents were aston-
ished that this single incident still figured so large in the childrens
experience. Over another three family sessions we discussed its
implications for Johns hothead experience, continuing to draw
finer discriminations between different kinds of worry and anger in
the home and school contexts. Chris understood this in terms of his
own anxious and depressive tendencies: A general anxiety attached
to specific things, little things become big problems, you get upset
by little things. Hes sensitive, he can see the darker side of things.
I was like that, I recognize it in John.
During these interviews I directed the conversation towards
Johns fear about a parental separation and asked whether this anxi-
ety connected in any way with his sick feelings about school. To my
surprise Jenny replied: Maybe hes scared of you guys fighting and
he wants to be there to stop you. Strangely the very thought which
directed my conversation with the family had emerged from the
thinking container provided in therapeutic conversation. From
here I explored Maria and Chris expectations of each other in
terms of the marriage. It emerged that Maria was afraid John would
turn out to be like Chris in terms of his negativity, worrying nature
and depression. As she confessed: Maybe Im worrying about it, I
dont want history to repeat itself.
My interpretation connected Johns narrative to Marias own
anxiety in the marriage concerning Chris and his dark negativity.
Maria admitted that in their twenty-five years of marriage she had
seen the latter too often, but noted: If we hadnt gone through this
process we wouldnt have put it into words and identified it
formally, his personality. I suggested that for both John and Chris
there was a difference between thinking deeply, dwelling sadly and
feeling anxious and angry. The sessions ended with a discussion of
preventive measures, strategies to assist Johns communication of
hothead feelings in the family. I asked John what he would find
helpful. Sitting on Marias lap he kissed her and said: Saying how
you feel. Chris then entreated: What about me, Ive been through
it, I could tell you some useful things. Jenny chimed in: You could

2000 The Association for Family Therapy and Systemic Practice

78 Glenn Larner
tell me as well, Im part of this family. Id like to be part of the
conversation with John as well, about when he feels unhappy. The
family felt this was a good point on which to finish.
In this case the therapists knowledge took the form of a clarifi-
cation and interpretation of Johns hothead feelings in terms of
the family experience, in particular the expression of anger and
anxiety in the marital relationship, together with a more specific
focus on management and communication strategies. Also signifi-
cant was the therapists unconscious knowing of John and his family,
my feelings in the session which no doubt led me to direct the
conversation in particular directions. My therapeutic knowing and
influence utilized clinical and professional knowledge in an inter-
personal context of a not-knowing therapeutic conversation, in
which the child and family narrative could be explored and inte-
grated. The therapists contribution of knowledge was always collab-
orative and respectful of the familys knowing and experience. In
this sense the therapists own knowing found meaning as a not
knowing, both were held in tension and, together with the family
knowing, formed an emotional and thinking container for the ther-
apeutic narrative to grow and develop.
A follow-up telephone call with Maria two months later revealed
that apart from a few incidents, the changes in Johns behaviour
and emotional life had been sustained. John still reported feeling
sick and anxious on occasions, but was learning to say excited
instead. Maria had realized that Johns problems triggered a lot of
fears from when Chris was sick with the anxiety. I had felt sad and
fearful for him at the time. I agreed that John seemed emotionally
sensitive to her reactions to Chris in the marital relationship. Maria
and Chris have begun to talk more about this issue. In a subsequent
follow-up call six months later, Chris told me John was going very
well, he was now the best academic performer in his class, he was
well behaved and enjoying school. The hothead experiences had
all but ceased, with no more complaints about feeling sick or
anxious. John was talking more in the family and appeared happy.

Conclusion
The thesis I am developing here is that psychoanalysis and family
therapy share a common process of narrative containment in the
analysts/therapists stance of knowing not to know in relation to
patients or clients. I believe this is the import both of Bions

2000 The Association for Family Therapy and Systemic Practice

 Common ground in psychoanalysis 79
contribution to psychoanalysis and Anderson and Goolishians
(1992) therapeutic conversation approach to family therapy, which
I have attempted to map together.4 It is the therapists/analysts crit-
ical knowing as a not knowing that acts as a narrative container in
which personal meaning and knowledge for all concerned can
develop in the therapeutic conversation both in psychoanalysis and
family therapy.
An interesting connection here is that the therapeutic conversa-
tional stance of the family therapist, like free-associative discourse in
psychoanalysis, encourages the client to set the therapeutic agenda
and say whatever comes to mind. Like the not-knowing psycho-
analyst, the not-knowing family therapist allows thought and coher-
ence to grow, until the client constructs a new meaning and
narrative for change in therapeutic conversation. None the less, in
both approaches the possibility of the therapists/analysts contri-
bution of critical knowing and interpretation as a not knowing
provides a narrative container for therapy. As Derrida (1999)might
say, the link between knowing and not knowing, as for all binary
opposites, is indissoluble. To be not knowing provides the container
for knowing and vice versa.
This integration of not knowing and knowing is what a postmod-
ern psychoanalysis has in common with family therapy; both are
ways of being with individuals to help them develop and hold their
own knowing. In the family therapy session, as in analysis, albeit
given different time frames and emotional intensities of experi-
ence, not knowing provides a sanctuary for individuals to develop
their own thought and understanding in a relationship space which
fosters a sense of internal coherence in the therapeutic narrative.
And here it is the therapists or analysts knowing not to know which
acts as a container or crucible for therapeutic knowing to grow.
This is one way of thinking what family therapy has in common
with psychoanalysis: both approaches provide a narrative container
for the clients and the therapists knowing and meaning to
develop. Here not knowing includes the possibility of critical know-
ing and interpretation, for the sharing of psychological meaning in

4 Of course this does not mean that analytic not knowing exactly mirrors family
therapy not knowing; one has its origins in Bions approach to object relations
theory, the other in social constructionism (Pocock, 1997).

2000 The Association for Family Therapy and Systemic Practice

80 Glenn Larner
conversational space. It is this deconstructive interplay between
knowing and not knowing which defines a therapeutic conversa-
tion, whether in a narrative or a psychoanalytic context.
What one knows is defined in terms of what is not yet known or
hidden, a knowledge which is waiting to be revealed in the narra-
tive. As Anderson (1997) says, not knowing articulates meaning in
nonmeaning, or understanding in a deeper sense (p. 115). This is
a process of thinking the unthought, saying the unsaid and explor-
ing the unknown known, what the client knows but has been unable
to express as unconscious meaning. In this sense therapy itself
becomes a form of epistemological enquiry in which the bound-
aries of the therapists and the clients knowing are deconstructed
as a knowing not to know.

References
Alvarez, A. (1992) Live Company. London and New York: Routledge.
Anderson, H. (1997) Conversation, Language and Possibilities. New York: Basic Books.
Anderson, H. and Goolishian, H. (1992) The client is the expert: a not-knowing
approach to therapy. In S. Mcnamee and K. Gergen (eds) Therapy as Social
Construction. London: Sage.
Barratt, B. B. (1993) Psychoanalysis and the Postmodern Impulse. Baltimore, MD, and
London: The Johns Hopkins University Press.
Bollas, C. (1989) Forces of Destiny: Psychoanalysis and Human Idiom. London: Free
Association Books.
Bouchard, M-A. (1995) Specificity of hermeneutics in psychoanalysis. The
International Journal of Psychoanalysis, 76: 533545.
Brafman, A. H. (1997) Winnicotts therapeutic consultations revisited. The
International Journal of Psychoanalysis, 78: 773787.
Brodbeck, H. (1995) The psychoanalyst as participant and observer in the psycho-
analytic process. Psychoanalysis And Contemporary Thought, 18: 531558.
Byng-Hall, J. (1973) Family myths used as defence in conjoint family therapy.
British Journal of Psychology, 46: 239250.
Byng-Hall, J. (1979) Re-editing family mythology during family therapy. Journal of
Family Therapy, 1: 103106.
Byng-Hall, J. (1995a) Creating a secure family base: some implications of attach-
ment theory for family therapy. Family Process, 34: 4558.
Byng-Hall, J. (1995b) Rewriting Family Scripts: Improvisation and Systems Change. New
York and London: Guilford Press.
Byng-Hall, J. (1997) Toward a coherent story in ilness and loss. In R. Papadopoulos
and J. Byng-Hall (eds) Multiple Voices: Narrative in Systemic Family Psychotherapy.
London: Duckworth.
Byng-Hall, J. (1998) Evolving ideas about narrative: re-editing the re-editing of
family mythology. Journal of Family Therapy, 20: 133141.
Byng-Hall, J. (1999) The unfashionable John Byng-Hall: a conversation on family
therapy in the millennium, subtitled Narrative, myths and attachment.

2000 The Association for Family Therapy and Systemic Practice

 Common ground in psychoanalysis 81
Interview with Glenn Larner. The Australian and New Zealand Journal of Family
Therapy.
Caper, R. (1998) Psychopathology and primitive mental states. The International
Journal of Psychoanalysis, 79: 539551.
Casement, P. (1985) On Learning From The Patient. London: Tavistock/Routledge.
Cavell, M. (1993) The Psychoanalytic Mind: From Freud to Philosophy. London: Harvard
University Press.
Cavell, M. (1998) Triangulation, ones own mind and objectivity. The International
Journal of Psychoanalysis, 79: 449467.
Cooper, S. H. (1996) Facts all come with a point of view. The International Journal of
Psychoanalysis, 7: 255272.
Crago, H. (1998) The unconscious of the individual and the unconscious of the
system. Editorial. The Australian and New Zealand Journal of Family Therapy, 19:
iiiiv.
Deleuze, G. (1968) Difference and Repetition. New York: Columbia University Press.
Derrida, J. (1995) The time is out of joint. In A. Haverkamp (ed.) Deconstruction
is/in America: A New Sense of the Political. New York and London: New York
University Press.
Derrida, J. (1999) Themes from Recent Work. Seminar, 13 August, The University of
Sydney, Australia.
Ebert, B. (1998) Psychoanalyst, Sydney. Personal Communication.
Epstein, M. (1995) Thoughts Without a Thinker. New York: Basic Books.
Flaskas, C. (1993) On the project of using psychoanalytic ideas in systemic therapy.
Australian and New Zealand Journal of Family Therapy, 14: 915.
Flaskas, C. (1996) Understanding the therapeutic relationship: using psychoana-
lytic ideas in the systemic context. In C. Flaskas and A. Perlesz (eds)The
Therapeutic Relationship in Systemic Therapy. London: Karnac.
Flaskas, C. (1997) Engagement and the therapeutic relationship in systemic ther-
apy. Journal of Family Therapy, 19: 263282.
Gabbard, G. O. (1997) A reconsideration of objectivity in the analyst. The
International Journal of Psychoanalysis, 78: 1525.
Goldberg, A. (1994) Farewell to the objective analyst. The International Journal of
Psychoanalysis, 75: 2130.
Goldberg, A. (1998) Deconstructing the dialect. The International Journal of
Psychoanalysis, 79: 215226.
Grotsein, J. S. (ed. ) (1981) Do I Dare Disturb the Universe? A Memorial to Wilfred Bion.
Beverly Hills, CA: Caesura Press.
Hanly, M. F. (1996) Narrative, now and then: a critical realist approach. The
International Journal of Psychoanalysis, 77: 445457.
Held, B. (1995) Back to Reality: A Critique of Postmodern Theory in Psychotherapy. New
York: Norton.
Ingeborg, S., Harris, P. and Rohan. J. A. (1998) Object relations family therapy:
articulating the incohate. Australian and New Zealand Journal of Family Therapy,
19: 5562.
Ingram, D. H. (1996) Discussion of On not interpreting: the metaphor of the
baby, enactment, and transitional experience. The American Journal of
Psychoanalysis, 56: 431434.
Larner, G. (1994) Para-modern family therapy: deconstructing post-modernism.
Australian and New Zealand Journal of Family Therapy, 15: 1116.

2000 The Association for Family Therapy and Systemic Practice

82 Glenn Larner
Larner, G. (1995) The real as illusion: deconstructing power in family therapy.
Journal of Family Therapy, 17: 191217.
Larner, G. (1996) Narrative child family therapy. Family Process, 35: 423440.
Larner, G. (1999a) Derrida and the deconstruction of power as context and topic
in psychotherapy. In I. Parker (ed.) Deconstructing Psychotherapy (Chapter 3).
London: Sage.
Larner, G. (1999b) The not-knowing knowing analyst. Paper submitted to The
International Journal of Psychoanalysis.
Larner, G. (1999c) Towards a critical psychology. Paper submitted to The
International Journal of Critical Psychology.
Luepnitz, D. A. (1988) The Family Interpreted: Feminist Theory in Clinical Practise. New
York: Basic Books.
Luepnitz, D. A. (1997) Feminism, psychoanalysis and family therapy: reflections on
telos. Journal of Family Therapy, 19: 303317.
McFadyen, A. (1997) Rapprochement in sight? Postmodern family therapy and
psychoanalysis. Journal of Family Therapy, 19: 241262.
Mason, B. (1993) Towards positions of safe uncertainty. Human Systems: The Journal
of Systemic Consultation and Management: 189200.
Pare, D. A. (1999) Discursive wisdom: reflections on ethics and therapeutic know-
ledge. Paper presented at the Millennium World Conference on Critical
Psychology, Sydney, Australia.
Parker, I. (1998) Social Constructionism, Discourse and Realism. London: Sage.
Pocock, D. (1997) Feeling understood in family therapy. Journal of Family Therapy,
19: 283302.
Ponsi, M. (1997) Interaction and transference. The International Journal of
Psychoanalysis, 78: 243250.
Rabin, H. M. (1995) The liberating effect on the analyst of the paradigm shift in
psychoanalysis. Psychoanalytic Psychology, 12: 467481.
Renik, O. (1998) The analysts subjectivity and the analysts objectivity. The
International Journal of Psychoanalysis, 79: 487497.
Rubin, J. B. (1999) Close encounters of a new kind: toward an integration of
psychoanalysis and buddhism. The American Journal of Psychoanalysis, 59: 524.
Schafer, R. (1997) Tradition and Change in Psychoanalysis. London: Karnac Books.
Speed, B. (1997) Editorial: Might psychoanalysis be of use to systemic therapists?
Journal of Family Therapy, 19: 233239.
Stern, D. (1998) Non-interpretive mechanisms in psychoanalytic therapy: the
something more than interpretation. The International Journal of Psychoanalysis,
79: 5.
Stolorow, R. D. (1997) Dynamic, dyadic, intersubjective systems: an evolving para-
digm for psychoanalysis. Psychoanalytic Psychology, 14: 337346.
Symington, J. and Symington, N. (1996) The Clinical Thinking of Wilfred Bion.
London and New York: Routledge.
Thorner, H. A. (1981) Notes on the desire for knowledge. In J. S. Grotsein (ed.)
Do I Dare Disturb the Universe? A Memorial to Wilfred Bion (pp. 590598). Beverly
Hills, CA: Caesura Press.
White, M. (1995) Re-authoring Lives: Interviews and Essays. Adelaide, Australia:
Dulwich Centre Publications.
Zimmerman, J. L. and Dickerson, V. C. (1994) Using a narrative metaphor: impli-
cations for theory and clinical practise. Family Process, 33: 233245.

2000 The Association for Family Therapy and Systemic Practice