Fam Proc 33:247-262, 1994

Therapy with Refugee Families: What Is a "Good" Conversation?SlSSEL REICHELT, Ph.Da

NORA SVEAASS, Ph.Db

aAssociate Professor, Department of Psychology, University of Oslo, Box 1094, Blindern, 0317 Oslo, Norway.bChief Psychologist, Psychosocial Centre for Refugees, University of Oslo, Norway.

This article addresses the question of what is a "good" conversation by analyzing "poor" conversations. During aproject on family therapy with refugee families, we often experienced what we labeled as "poor" conversations. Wepresent examples of a variety of such conversations, which we then analyze with reference to therapeutic maps andcentral concerns of the therapists. We describe four patterns of therapist/client relationships that emerged from thisanalysis. The main focus of our discussion is to clarify when "poor" conversations may be an important part of thetherapeutic process, and when and how they should be avoided. We believe that the issues we raise are central totherapeutic work in general and not just to therapy with refugee families.

This article is based on clinical experiences during a project on therapeutic work with refugee families. Particularly, wehave wanted to extend our understanding of how a choice of various approaches from the current family therapy field havecontributed to our conversations with the families. Over the recent years, influential voices in the family therapy field havemoved from cybernetics to linguistics, hermeneutics, and social constructionism, from action to reflection, and from thetherapist as a powerful interventionist to the therapist as a good conversationalist. An important part of this movement isthe emphasis on the client as expert on his or her own life and problems. The role of the therapist has changed fromdetecting what is wrong and correcting it, to participating in conversations with the client system in a way that makes itpossible for the system to find its own solutions (Tjersland, 1990).

The therapist may take a position of "not-knowing" (Goolishian & Anderson, 1992, p. 13), and move into the systemwith a concrete and naive questioning aimed at changing the languaging that maintains the problems so that new narrativesmay emerge (to use the terminology of Anderson & Goolishian, 1988; Goolish-ian and Anderson, 1992). The therapist maybring other voices into the conversations, with the option of creating new openings through nonauthoritarian impressionsand ideas from a reflecting position (Andersen, 1987). The therapist may also use questioning strategically, aiming atexpanding perspectives in the client system (Boscolo, Cecchin, Hoffman, & Penn, 1987; Tomm, 1987a,b; Tomm, 1988).And the therapist may consciously search for strengths and solutions in the client system through investigating exceptions tothe problems (de Shazer, 1988) or "unique outcomes" (White and Epston, 1990).

When we started a project with refugee families, we had these ideas in mind. We had been inspired by them for severalyears, and one of the authors (S.R.) had found them useful in a project on drug addicts, their families, and helping systems(Reichelt & Christensen, 1990). We considered the position of "not knowing" interesting because we were working withrefugee families from different countries and cultures. We assumed that it could give us a basis for a thorough explorationof phenomena unknown to us, and give the families an opportunity to be experts in relation to important aspects of theirlives. We considered the position of reflection and perspective-expanding questions to be particularly interesting because ofthe "dark tunnels" we expected many of the families to live in, enclosed by past misery and dubious expectations for thefuture. And in the same vein, we considered a solution-oriented approach useful in bringing forth strength and copingpotentials in the families.

THE CONTEXT OF OUR WORK

Literature ReviewReading through a considerable body of literature on refugee families, traumatized families, and families in cultural

transition, we were struck by the attempts to find regularities and gain knowledge about typical cultural issues and typicalfamily conflicts arising from culture and exile (Bemak, 1989; Rumbaut & Rumbaut, 1976; Sluzki, 1979). In the studies thatfocused on family therapy, the emphasis has been on problems rather than on potentialities, on conflicts and structuraldysfunctions rather than on potentialities. Also, knowledge of specific cultural features has been described as important fora therapist (Chambon, 1989). The studies are mostly related to families from specific cultures (Arreondo, Orjurla,& Moore, 1989; Hong, 1989). This literature increased our sensitivity to cultural issues and acculturation problems, and webecame aware of some important therapeutic! issues. As we worked in a context with families from many different cultures,however, our main! concern was to develop an approach that in a general sense might be useful across cultures, allowingfor cultural sensitivity without being "tailor-made" to a specific culture.

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Institutional ContextWe are two female psychologists working on the project, and the families we work with are recruited from referrals to

the Psychosocial Centre for Refugees at the University of Oslo, Norway. The Centre is rather prestigious, being a resourcecenter for consultation, education, treatment, and research. Referrals mostly come from local "helpers," for example, socialwelfare workers, general practitioners, and refugee consultants, who believe that one or more members of a family needparticularly qualified psychological/psychiatric assistance. Due to an established practice of individual therapy at theCentre, individual help for adults is usually first requested by the referral source. However, when family problems areobvious, the families have been offered participation in the project. Most of the families have lived in Norway for less than3 years, which makes cooperation with an interpreter useful in most cases.

Choice of ApproachesWe decided to try a position of "not-knowing" and an emphasis on solutions rather than problems, as well as adopting a

stance that the therapist is an expert on therapeutic conversations, rather than on understanding a problem in order to find asolution to it. In this approach, the essence of a "good" therapeutic conversation is captured in the following quotation:

Therapeutic conversation is the process through which the therapist and the client participate in the co-developmentof new meanings, new realities and new narratives. The therapist's role, expertise, and emphasis in thisconversational process is to develop a free and open conversational space and to facilitate an emerging dialogicalprocess in which "newness" can occur. [Anderson & Goolishian, 1992, pp. 13-14]

With this in mind, the realization that we were poor conversationalists soon struck us in our work with refugee families.Our questions and comments did not have the immediate impact that we expected, and it was often difficult to understandthe responses to them. The encounters were Kafkaesque: words were being bantered back and forth without making sense.We worked continuously to improve our skills and systematize our experiences. During this period, several ideas abouthow we influenced these conversations would emerge but then disappear, and we decided to take a closer look at whatactually was happening in the conversations. In this article, we will describe and give examples of some aspects of what welabeled "poor conversations," and discuss them in relation to our therapeutic maps. The project at large, including particularissues concerning interpretation, is discussed in another article (Reichelt & Sveaass, 1994).

PROCEDUREFor this article, we chose 10 families (out of 30) with whom we have worked more intensively than the rest. We have

met for four or more therapeutic sessions, and the conversations (as experienced by us) have varied from being rather poorto rather satisfactory. Conversations during the sessions were recapitulated from extensive notes or transcribed fromvideotapes. We studied the conversations in detail until we were satisfied that we had pin-pointed issues that were clearlydemonstrated in the material. The kind of knowledge we wanted to develop was primarily an extension of our intuitiveknowledge as clinicians and the theories with which we struggle. We hoped that some guidelines might emerge that wouldbe helpful to us and other clinicians struggling with similar issues in relation to different client populations. We had nopresumptions about establishing "objective" knowledge, and have drawn on our own patterns of theoretical and clinicalexperience, as organized through the many years we have spent as scientist-practitioners (Polkinghorne, 1992; Reichelt,1993).

"Good" ConversationsTrying to pinpoint the structure of what we vaguely had termed "good" and "poor" conversations, we found good

conversations especially hard to describe. As far as we have found, they also are not clearly specified in the family therapyliterature, except for the previous quote from Anderson and Goolishian (1992). The idea seems to be to create a space thatallows for mutual reflection and the emergence of new ideas: a space that is not dominated by the therapist's ideas ofproblems and solutions. The space may at times be filled with contradictory elements, but these are not made into an issue.Metaphorically, we see good conversations as a river that smoothly finds its course. The therapist follows! whateverdirection the course may take, interrupting with only unobtrusive questions and comments. These are met with a moment ofreflection, and answered in a way the therapist considers relevant. After a moment of reflection a new question or acomment that may be considered relevant by the client(s) is posed, and, if so, the river again flowsat times with a briefhalt as new information is developed, at times in a swirl as new options come to the fore. Whatever blocks the riverdissolves rather quickly in this smooth and friendly atmosphere. In these kinds of conversations, we experience theinterpreter as an asset that allows extra time for reflection.

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"Poor" ConversationsIn most of the families, however, the river hardly flows like this throughout the whole session. The river turns back on

itself; the swirl becomes an eddy or a small pool that is no longer part of what the therapist believes to be main current ofthe river, or the stream seems to be blocked by what she! experiences as huge obstacles. She continuously worries aboutnegative effects of working with an interpreter. At times she manages to remove the obstacles; at times she seems to remainstuck. These kind of conversations, however frustrating we might find them, at times proved rather constructive in the senseof bringing newness into the conversation. Thus our concepts of a "good conversation" became confused and complicated.We began to wonder whether "poor" conversations might be not as poor as we had assumed. We decided to analyze whatwe intuitively had labeled "poor conversations" and to reflect on them as a means of clarifying our concepts. In thefollowing section, we describe and exemplify aspects of poor conversations.

Parallel TalkHaron and Sara have a very difficult relationship. Haron is often violent, and Sara is considering a divorce. They have a

small child. The violence has been an issue in the last sessions. After some initial fidgeting, the session gets underway:T: Does your wife know that you want to do something about your problem?H: I have had the most terrible headaches.T: Do you think your wife knows which problem we are talking about?H: I don't remember.T: What we talked about in the last session, what to do when you feel you might loose control.H: I have tried.T: Does your wife understand that you want to change?H: I don't understand.T: Sarah, have you noticed that he tries to do something about it?S: It is worse than before.T: How is it worse?S: If I had known how bad it would be, I'd 've never had a child with him.T: If you think about how it has been since the last session?S: It was better before I had the child. Then I gave him more attention.T: He feels he gets too little attention?S: Yes, that's why he becomes so angry.T: What do you think about what she is saying, Haron?H: She is a terrible woman, spiteful and demanding.T: [Has a long conversation with Haron who insists that he has not hurt Sarah during the last month.] Sarah,

what thoughts do you have about him trying to do something about this?S: I have had such pains, particularly in my head, during the last weeks.T: You don't notice any difference?S: Maybe because I am so weak myself.T: How do you feel weak?S: I am quarreling with myself all the time.T: How do you quarrel?S: I had different expectations of life.The conversation goes on in the same vein, and we never seem to meet. In these kinds of conversations, we constantly

experience a lack of sense. Obviously, therapist and family are on different wavelengths, and have different concerns.

Tangential TalkThe Liung family is referred after an episode during which their somewhat retarded daughter (age 17) has behaved

seductively toward a friend of the family. The local helper believes that this has created communication problems in thefamily (of six members), and that they need to talk about it together. The parents insist on meeting without the children, andthe following conversation is typical:

T: [to Miung, the wife] How could we be useful to you?M: I would like to be responsible for the children myself.T: Who is responsible for the children?M: In Vietnam I am responsible. The children have changed from living in the Norwegian culture.T: So it is not just what happened with your daughter, but something that happens to all your children?M: Yes, but I am particularly afraid of rumors. If this gets out, they can't go out any more. It is important that

I can be responsible myself.

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T: What would you like to do in regard to your children?M: My age and health do not allow me to do what I want.T: But if it had been possible, what would you have liked to do for them?M: I would like to follow a course, learn Norwegian. Would like to be a real wife and mother, but I can't

handle it.L: [the husband] Norway and Vietnam are two different cultures. We would like to take good care of our

children, and she says that she wants to work and learn Norwegian. But she doesn't manage. Now weneed some social security assistance once again. It makes us feel sad and dependent.

T: And you feel that one of the ways out of this might be to learn Norwegian and work.M: I have not been able to do this.T: You have come to us to talk about things that trouble you. You are a large family living in Norway, and

have many difficulties. What would be the most useful issues to go on talking about today?L: They won't listen as in the Vietnam culture.T: Whom of your children won't listen?L: They mostly say no.T: Who is mostly saying no?M: Maybe we do something wrong? Maybe we are too old?T: Is the problem that the children still living at home are not as obedient as they ought to be?L: It is not that they don't listen, but we have been a split family for so long.In these kinds of conversations, we experience a concern, or maybe several concerns that somehow elude us. When we

try to specify the concerns, they become increasingly elusive. We concentrate on staying on the parents' ground and helpingthem by clarifying the main issues, but it seems to lead us nowhere.

Past Misery Flows OnNastara, a single mother of three, opens the session saying that she wants to spend it discussing problems in her daily

life. The therapist experiences this as a step forward, since in previous sessions Nastara has focused rather exclusively onpast misery. She goes on, however, telling a long story about a disturbing event the children had experienced before theyleft their home country (before they were re-united with their mother), a story about somebody who wanted to hurt themother:

T: Do these people still bother you?N: No, it happened a long time ago. But the children were told lies about me.T: In what way do these thoughts still bother your daughter?N: She often asks why people lie. Everything that is said about me are lies. But having a blue passport is a

problem.T: What does she think can happen?N: I often feel so ill. It is not a big problem if I die, but I am afraid of what may happen to the children. All

the time I try to help them think of the future, but they often ask about the past.T: Why do you think they ask about the past?N: They see how sad I am, and think that's why I am sad. They try to comfort me, and say that it would be

good for me to see the family. [She continues talking about sad things that have happened to her family inthe past. Asked whether it is more important for her to talk about the past than the present, she repeatsher concern with the present, but soon we are back again in the past.]

All the families we work with have experienced terrible events. How much space past misery should be given in theconversations is a dilemma for us. When we talk to the families about this, they mostly say that they want to go on with lifeand concentrate on challenges they meet in daily life, but the past soon breaks in. We have the choice of interrupting this bymetacommunicating on how it may be helpful to talk to us about this, or by giving it space. Some of our therapeutic ideastell us to give it space, while others warn us against becoming too absorbed in misery.

Repeated Demands for HelpFarah is a single mother of five, with long experience with helpers. She is very satisfied with her present local helpers

who, in the first session, had assured her that they would help the family so far as possible with all practical issues. Farah, awell-educated woman, had asked for individual therapy for several family members initially, and this was to be her firstindividual session with us:

T: What would you like to discuss today?F: Long time has passed. I feel that my psychologist [N.S.] does not feel responsible. The last month my

problems have increased, and I have felt the need to talk to my pyschologist.

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T: What is it important for you to talk about today?F: My boys have moved, and I live alone with the three youngest. It is a long distance to school and stores,

and I would like to move to a new house.T: Have you talked to your social worker about this?F: Yes, I have applied for a new apartment. I live so far away, and a car is expensive.T: What would you like to talk to me about, as a psychologist?F: You must help me with whatever you can. Can you help me to move?T: What do you think I can do concerning moving?F: I don't know.T: This is the business of the social office, and I can't do anything about it.F: The other matter is that I would like to see my mother who lives in Iran.The therapist embarks on a new turn of "who should do what," and Farah obviously has quite clear perceptions of the

difference between the psychologist and the social worker. In the next session, however, we are back to needing help withhousing and money.

Shalim came to Norway with two young daughters 3 years ago, and was reunited with her husband, Hassan, somemonths ago. Having undergone severe torture, he is in very bad shape physically and psychologically, and the family wantsto talk about the problems they experience in daily life. Local helpers are supposed to take care of medical and practicalissues, and the family tells us that the cooperation with local helpers is good:

T: And how do you think that these sessions may be useful to you?H: It is very important that our daughters adjust themselves to this new country. My nerves have to be cured,

and we need more space.S: Everything is impossible when my husband is in such a bad shape. I don't know if I can stand it any

longer. I feel very bad myself.D1: I want to forget all the bad things and live a quiet life. Our chief problem is daddy's nerves; he must be

helped. We live too isolated. He has nobody to talk to and thinks about sad things all the time.D2: We need a bigger house so that daddy can have some room for himself. His nerves are getting worse.T: Is it so that all of you think that nothing will be better until you move?H: We have to do something at once.T: What would it be important to do at once?H: I take so much medicine, and it just makes me worse. The whole family suffers.T: In what way does the family suffer?H: It is impossible for us to live together when we don't have more space.T: Do you think that you have to move before the relationship between you may improve?S: I don't know if I can stand it any more.The conversation goes on like this for half an hour, and the therapist fails in her attempts to pinpoint issues to work with.Practical and medical issues are at the forefront of most of the refugees' minds, and even if we carefully differentiate

ourselves from other helpers who are engaged in these practical matters (Sveaass & Rei-chelt, 1994), such questions arisein most conversations with more than half of the families. Again, we experience the dilemma of staying on their ground ortrying to move them to a different field.

Stuckness in PerspectiveNazrin and Hussein, a couple with two children, are supported in their urge to move further away from Hussein's family,

with whom they have considerable conflicts. We discuss how they should handle their affairs before they are able to move,which may take considerable time:

T: And what about school and work in the meantime?N: It is terrible. I may meet the brother's wife anywhere.T: How would that be?N: I don't know.T: What would happen if you met?N: I don't want to meet her.T: But if you should meet quite accidentally, what would actually happen?N: She tells lies about me to everybody.T: But if you should continue school and meet her there?N: My thoughts would be disturbed; they would nag all the time.T: They would nag at school. But what about the nagging if you stayed home?N: Why?

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T: If moving took time, and you just stayed home, wouldn't that nag too?N: That is why I have to move.When we deliberately asks questions in order to bring in new perspectives, they often are met by these kinds of replies.

Rather than opening up the conversation to new options, they seem to have the opposite effect.

Resentment at Clarifying QuestionsAmod recently came to Norway, and was reunited with his wife and three children who had been in Norway for 3 years

and had become quite socialized into the Norwegian culture. He had developed a strong religious conviction during hisyears in prison. The family was referred because of conflicts relating to cultural differences, particularly between Amod andhis young daughter. He especially condemns her style of life in Norway. Amod continuously refers to his God, and thetherapist tries to explore his thoughts about God. He has just said that his God is only love:

T: Is it because of love that you are so strict to her?A: Yes, I take my love away from her because I want her to do what is right.T: Can God take his love away from humans?A: God's love is at a different level.T: Is it so that God only gives his love to those who deserve it?A: Those who deserve love get it. God's love is like the sun: you can leave it by turning your back to it.T: Is it possible for you just to take the love for your family out of your heart?A: It is a big heart.T: What happens when you take your love out of your heart?A: God is in a broken heart, a sad heart.T: Is it possible for you to take love out of your heart?L: [wife] No, it is impossible. He asks for her every day. Is concerned every minute. If he had been able to

take her out of his heart, he would not have been that concerned.T: Maybe one problem in your family is too much love.A: You don't understand what we say.T: Could you explain to me what I don't understand?A: When I look at you, I see no feelings. You are in a frame that you have learned; you talk like out of a

book.In these kinds of conversations, the therapist explores the meaning of utterances and beliefs, and is obviously regarded as

an adversary.

General CommentsNone of the phenomena described above were unknown to us from therapeutic work within our own culture, but in this

context we have experienced them as more persistent and more difficult to resolve than we are used to. It has been afrustrating experience that we know we share with other therapists working with refugees. The frustration may be boileddown to the fact that neither the wish to understand nor the commitment to constructive maneuvers will get any immediatereinforcement. Our "good questions" are met with answers we experience as off the point. Our careful attempts to relatesensitively to cultural differences are met with responses like "Stop talking like out of a book." The smoothly flowingstream is by far more attractive.

From the beginning of the project, we had supplied our therapeutic maps with certain landmarks to which weconsciously tried to adjust. We knew that we would meet obstacles because of our perceived, prestigious position, whichwe expected would add to the differences of social status and power already existing between a therapist from the dominantculture and a refugee. We expected considerable differences in conceptions of what therapy is. We were aware that thefamilies' preferred solutions often would be practical/medical rather than psychological. We expected that past and presentmiseries would interfere with constructive problem solving. We knew that the use of an interpreter might lead tocommunication problems. Still, we were not prepared for the varieties of difficulties that arose, and the impact they had onus as experienced therapists.

Early in the project, we formulated the notion of "creating a common ground." For the first session, as a general rule, weinvited the local helpers to meet with the family, and interviewed all of them on what kinds of help might be needed andwho should be responsible for what. We took much care to present our project as dealing with psychological and familymatters (in whatever terms might seem suitable), and invited reflections on whether they thought this would be useful forthem or not. This offer was never refused, but we were often left with uncertainty about what it meant to the families. In thefollowing section, we discuss our thoughts about how our therapeutic maps may have influenced the kinds of conversationsexemplified above.

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THERAPEUTIC MAPSWe might certainly have discussed these conversations within the frame of cultural and linguistic differences mentioned

above. We found, however, that most of the literature on refugees has discussed therapeutic dilemmas in terms of specificcultural differences. So, even though we are certain that cultural and status differences between therapist and clients play asignificant role in the course of our conversations, we have chosen to reflect on how our therapeutic maps may haveinfluenced the conversations. This does not mean that we believe that our therapeutic maps are "culture-free." An analysisof how they are products of a particular culture or era might be a next, indeed very important, step. It may be that this wouldlead us to become even more skeptical about some of the most cherished features in our maps. In our work with thetranscripts and videotapes, we have tried to discern our beliefs, the cognitive and emotional elements in our approaches thatmay or may not have been explicit and conscious parts of our maps. We now briefly discuss five of these beliefs.

It Is Important to Empower ClientsIn accordance with this belief, we have emphasized the clients' responsibility to use the session in a way they think will

be helpful. When they are vague about this and/or immediately present problems that seem unsolvable within this kind ofcontext, we have metacommunicated on this by exploring why they think it is helpful to talk to us about this. We have alsobeen committed to explore their own strengths, by focusing on what they have managed previously and what they managetoday, as well as on any exceptions to the dominant complaints, and on small positive changes.

Conversational Continuity Is ImportantAll of us have many conversations with ourselves while we talk to somebody. The notion of a dialogical self is central to

us, with its "character of a decentralized, polyphonic narrative with a multiplicity of I positions" (Hermans, Kempen, & vanLoon, 1992, p. 30). We believe that, under pressure, these internal conversations tend to break into the dialogue with theother person, and to disrupt the flow of the conversation. The therapist has the choice of following the new track, toquestion it by metacommunicating on it, or to go on with the old. We have largely followed one of the last two options. Thisis because we think that continuity and some cognitive clarity is important in keeping the river flowing. In the same vein,we tend to ask for concretization and specification of vague complaints and utterances from a "not-knowing" stance. Webelieve that this also has an important function of clarifying matters for the client.

Commitment to MovementAll therapists are, of course, committed to movement. For short-term therapists who focus on helping clients to make use

of their own strengths rather than working through the pathology in order to develop new ones, this concern is more urgentthan within other traditions. In our conversations with the families, we have been highly attentive to every sign of initiativeand change, but less attentive to and patient with repetitions, seemingly pointless stories, vagueness, and so on.

Low Tolerance for DestructivenessWe believe that a low tolerance for destructiveness also is in accordance with a solution-oriented approach. Assessing

the tape recordings, however, we realized that our urge to prevent destructiveness affected our behavior in several waysthat may not have been therapeutic. What we perceive as destructiveness may be violence, "excessive" parental authority,long sequences of mutual accusation, or long tales of misery. Thus, our low tolerance may be one of the consequences ofbeing "responsible" women as well as short-term and solution-oriented therapists.

Hidden Agendas and Indirect CommunicationThis has, of course, not been a conscious part of our maps, but it seems to be involved in several of the "poor"

conversations. With respect to this point, it is difficult to avoid thoughts about culture. Our problems in detecting the hiddenagendas of the clients may be a consequence of different languaging styles, as well as problems in perceiving the mixedfeelings clients have regarding help-seeking and demands in a new country. In to this, the cognitive and specific style of thetherapists, closely following the languaging of the clients, may have contributed to a certain insensitivity to hidden agendas.We have also become more conscious of our own hidden agendas, as when we, on one level, try to help clients find theirown solutions, while on a more submerged level, we have ideas about what kind of solutions they would profit from. Ourown hidden agendas may well have been a main contribution to preventing clients' agendas from coming to the fore.

PATTERNS OF COMMUNICATIONWhen we look at what we have labeled as poor conversations in the light of our therapeutic maps, certain

communicational patterns emerge. We believe that various elements in our maps have been influential in the formation of

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these patterns. From the perspective of our communication patterns, we discern how we get stuck, but we also seemaneuvers that have tended to improve the conversations. Additionally, we see that "poor" conversations may have had aconstructive influence on later conversations. We will now explore three of these patterns and our attempts to deal withthem during sessions with several families.

A Battle of GroundsThe pattern we have labeled a "battle of grounds" is typical for several of the kinds of conversations that we have

experienced as poor. Therapist and family obviously have different ideas about what ground is most useful. Since thetherapist is committed to movement and to strengthen the client' s sense of agency, she is often rather assertive aboutmaintaining her own ground.

The glimpse of the conversation with Farah, the mother of five who wanted practical help, illustrates a rather open fightabout grounds. Her agenda is clear and open: she wants "her psychologist" to assist her in any practical matter. Thetherapist tries to establish her own ground (therapeutic matters) as the most relevant, and tries to strengthen the client'ssense of agency and responsibility through metacommunicating on Farah's moves. This is a typical sequence ofcommunication that may be repeated several times during a session, and from session to session, in many of the families. Italso creates a considerable emotional distance, probably because the therapist is so afraid of losing her ground that sheavoids confirming her own observations and accepts the concerns of the client. Clients have shown us how well-timedaffirmations may change the turn of these conversations in the direction of longer, constructive exchanges.

In one of the sessions, Farah talked extensively about the only solution she could see: her mother and brother must cometo Norway to assist her with the children and comfort her. The therapist thoroughly explored how this would make adifference, and acknowledged that she really saw Farah's point. This opened up a discussion of exactly what she felt wasdifficult to manage, and for the first time it became possible to talk about the relations between the family members living inNorway:

T: I really see how you feel that everything would be easier if your mother and brother could come to staywith you. I see you as a strong and courageous woman who has been alone for several years. You feelthat your strength at times disappears, and that support from your family would help you regain it. Whatdo you primarily need your strength for now?

F: I would like to support myself. And I have such problems with the boys.T: Is it something that you might do differently in relation to the boys?F: I would like to feel closer to them. I would like them to be better friends in spite of all the conflicts.T: Who has conflicts with whom?F: The boys quarrel with the girls.T: Should we spend the rest of this session talking about you as a mother of a strong bunch of kids?F: That's fine with me.This exchange occurred in the middle of the second session. As the session went on, Farah, if not without interruptive

complaints, seemed glad to take a closer look at current family relations. A common ground was established and provedpossible to reestablish in later sessions.

Another helpful attitude has been to give up our ground and do whatever we can to contribute to a practical solution. Thefollowing exchange occurred toward the end of the sequence with Hassan and Shalim, quoted above:

T: I understand that all of you feel that you need a larger place to live for Hassan's nerves to improve and forfamily relations to change. Is this something you think that we could help you with?

H: Maybe not, but maybe it would help if you sent a letter to the social services explaining how much thismeans to us. I would also like to get some help to quit using all the medicines.

T: We understand how much these matters mean, and we will send a letter, although we doubt that it will bevery helpful. We will also help you to rid yourself of the medicines. All of this, however, will take time.Does it make sense to meet with us and discuss your relations in the meantime, or will this be too muchof a burden?

H: We have to start to do something about our relations immediately.The rest of the family eagerly consented to this plan, and our common ground was defined as trying to lessen the distance

between father and daughters. When the family at times moved back to their old ground and began to talk about nerveproblems and housing, we would immediately ask whether it was too much of a burden to struggle with the relations. Itnever was, and our common ground was easily regained.

The battle of grounds, as exemplified above, often tended to move the conversation in a direction that we consideredconstructive. At times, however, we remained stuck. Our work with Haron and Sara, for example, illustrates this. Ourconversations continued on the same parallel paths, and we never met on common ground. When we reflect on this from

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the perspective of our maps, we believe that our low tolerance for destructiveness influenced the conversations in anegative way. We were anxious in regard to Haron's physical violence toward his wife, and also about how it might affecttheir baby. Options like physical distance or assistance from neighbors or police were refused. Haron insisted that his wifewas the problem; Sarah insisted on talking about her misery and disappointment; we insisted on highlighting the smallsigns of willingness to change and the positive changes that at times occurred. We now believe that we should have givenmore space to the miseries they both experienced.

Hide and SeekThis pattern concerns hidden agendas, at least agendas that are rather invisible to therapists. They may be invisible

because the therapist lacks sensitivity to issues that the client has difficulties voicing, or because the therapist overlooksthem because of her own agenda. In some cases, they remained invisible until we had reviewed several sessions. In theconversations with Liung and Miung, the Vietnamese couple who felt disempowered in a new country, the agenda neverquite became clear. It was obviously related to the shameful behavior of their daughter and to her future, but our attempts tospecify and clarify the issue always seemed to miss the point. Their responses continued to be tangential. Maybe theirconcern was just to talk with somebody who could listen empathically and console them in their shamefulness? If so, theywere unfortunate to meet therapists who believe in continuity in the conversations and are committed to movement.

Nastara, the single mother of three, is almost drowning in past misery and negative expectations for the future. With ourcommitment to movement and focus on strengths, we felt that we had moved a long step forward when she told us that shewanted to talk about problems in her daily life. Happy to meet with her on this ground, we related our questions to her dailylife and neglected to explore the point of the blue passport (which doesn't give her status as refugee) and the higher-statusred passport that she indirectly asked us to help her get (her hidden agenda). Thus, misery continued to flow. In latersessions we explored this theme, which was linked to shameful experiences regarding her flight to Norway. When welistened closely to her story and affirmed her strength, space was opened to explore daily struggles:

T: You know your strength and value; you know how you and your family have fought against the war andevil people to find refuge.

N: And Norwegian children fight with them today. The boys use knives, the teachers don't do anything, Ihave to stand up for them myself.

T: I know that you have been to see the teachers; you do a fine job for your children.N: I have to do even more. [Goes on to talk about plans for helping the children regarding racist behavior.]T: What you are talking about now is very important for your children, and I also see that you help them to

find pride in their home culture. All of you have brought with you strength and good experiences fromyour culture that will help you now.

When the therapist becomes insensitive to the hidden agenda, it is a great advantage to have another therapist behind themirror. For example, in one of the conversations with Hassan and Shalim, who have considerable problems as a couple,Shalim construes her situation as completely unsolvable. She needs some time for herself and she needs somebody tounderstand her; but neither her husband nor her children can help her to get time for herself or understand her, and she doesnot want any help from public welfare. The therapist tries to make her complaints more specific, but her response is that ifthe therapist understood her, she would know what she needed. This conversation stumbles on until the other therapistcomes into the room and reflects on whether Shalim's concern may be that she is disappointed because we don't do enoughto help her husband to function better. This opens the conversation, and she is able to express her frustrations and needsmuch more clearly.

The Two-Edged SwordIn our therapeutic maps, exploring and specifying questions from a "not-knowing" position are important tools. One

aspect of these tools is that they challenge previous conceptions and perspectives. The therapist may use them with anattitude of genuine curiosity so that the challenge more or less has a positive side effect, or use them with a consciousintention to challenge. These are not either/or attitudes: most therapists will stay between the extreme positions. When welook at the conversations where these kinds of questions result in stuckness in our own perspective, or meet withresentment from clients, the therapist has moved rather far toward a challenging position. She is too eager for theconversation to move in a particular direction.

When the therapist explores Nazrin's avoidance reactions to her sister-in-law, it is with the hidden agenda of helping herto see that reality is not as awful as she imagines. A central point in this hidden agenda is that the therapist, in spite of herverbal support of the plans to move, doesn't think moving is a good idea because the children are well-adjusted where theyare. The therapist is supported by Hussein, who is acting like a co-therapist in helping Nazrin to understand the sensibletherapist. When we review the tapes, we see that the most significant moves concerning Nazrin occur when the therapiststops pushing her agenda and begins to explore Hussein's points of view in a way that is supportive to Nazrin:

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T: Hussein, has Nazrin become less angry?H: Yes.T: Previously you wanted us to give Nazrin some advice so that she might react less strongly. What kind of

advice would you like us to give?H: You are the psychologists, you should know the kind of advice to give.T: Our impression is that Nazrin is not so bothered by her reactions.H: Other people may see the faults that you are blind to yourself.T: Do you think she has as strong reactions as previously?H: No, she is much less angry.T: You cooperate better concerning the children. Much is better. You have managed much all by yourselves.

Might it be that you have the advice you need in your own heads, and that you only need our assistance totalk together so that you may find your own advice? [Both nod. Nazrin looks very relieved and thanks thetherapist at the end of this session.]

When the therapist explores Amod's religious beliefs about God, it is with the hidden agenda of confronting him with thecruel consequences of what she conceives as religious beliefs gone astray. We have found that such conversations becomemuch more constructive when we move toward a position of genuine curiosity.

In the last couple of conversations with Amod and his family, the therapist became much more curious and accepting,and acknowledged Amod's difficult position as a deeply religious person in a different culture. Gradually, some challengesof a more open and direct kind were responded to in a constructive way, and toward the end of the last session Amod stated:

The comfortableness that we feel now, is a comfortableness that you also have. In the first conversations you weremy adversary; they were uncomfortable and without lightness. If you change your interpretations now, we will beback to the atmosphere of the first sessions. You have changed as much as we have.

Between Scylla and Charybdis

Several of the poor conversations exemplified above maymetaphorically expressedbe related to our difficulties insailing between the Scylla of the miseries of the families and the Charybdis of our commitment to movement andsolution-oriented preferences. Attempts to avoid being devoured by Scylla might lead us to the just as dangerousengulfment by Charybdis-like "constructive" maneuvers: at times we felt caught up in a whirlpool that did not allowforward movement. We will address this pattern on a general level because it seems closely related to our attempt tocombine concepts developed by Anderson and Goolishian (1988), de Shazer (1988), and White and Epston (1990).

As previously stated, we are attracted by the notion put forth by Anderson and Goolishian of creating a conversationalspace that allows for mutual reflections and the emergence of new ideas. To a large extent, we share their "not-knowing"stance that defines therapists as experts in conversations rather than in what is best for clients. We are, however, not certainthat the old must come to the fore in order to provide space for the new to emerge. We believe that the space may easily befilled with hopelessness and misery when such emotions are dominating therapeutic conversations and inner dialogues.Most of the refugee families have lived through terrible experiences in the past, as well as living an unsatisfactory life inexile. Conversations about mastery, possibilities, and strengths are submerged by the misery that is in the forefront of theirminds. We assume that conversations about potentialities may surface only if the therapist takes an active part in bringingthem forth. We also believe that it is good for clients that they surface during the session, even if they are not easilyavailable. On one or both of these points we may deviate from Anderson and Goolishian, whom we perceive as taking theposition of giving much space to what the clients bring to the sessions. With the help of notions of a focus on exceptionsfrom problems, positive changes, and new possibilities, described by de Shazer, we have actively tried to create space forthe clients' own solutions to be developed when this has seemed reasonable to us. With the help of notions of constructionof new narratives, developed by White and Epston, we have explored the past experiences of families with the clearambition of bringing forth helpful experiences rather than dwelling on destructive ones.

Our position has been that none of these therapeutic positions are "true" in a general sense, and that each family mustshow us how the space it needs may be created. Sailing between Scylla and Charybdis, we have tried to be sensitive towhen it is wise to stay close to Scylla for a while, listening to sadness and suffering, and when it should be avoided bymoving a bit toward Charybdis, focusing on possibilities. At times, such maneuvers have just pushed us back towardScylla: the complaints became intensified and the conversation deteriorated. At other times, the maneuvers created a turn inthe conversation and the atmosphere became more optimistic. As we discussed previously, it seemed important to stayclose to Scylla sufficiently long to be able to acknowledge that we have listened to the concerns, and also given some spacefor the experience of hopelessness. We have seen how this has created space in the conversation for movement to occur.We have also seen, however, that possibility-oriented comments, which seemed futile in the immediate conversation,

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proved useful in later sessions.In our previous discussion of three communication patterns, we pointed to certain aspects of our maps that we needed to

change or expand. We believe that this last pattern of maintaining a therapeutic position between Scylla and Charbydiscannot be analyzed in the same way. We never stayed close to Scylla long enough to know whether we actually would havebeen devoured if we had stayed longer, and we carefully maneuvered away from Charybdis when we felt in danger ofdrowning. Anderson and Goolishian, de Shazer, White and Epston probably would not have used our metaphor. Theywould have maneuvered differently at the points we labeled dangerous, as would the families responding to them. For us,this issue is still inconclusive, and we will go on sailing between Scylla and Charybdis until something convinces us of theusefulness of taking a different tack.

CONCLUDING REMARKSThe patterns that have emerged through our analysis of the conversations with refugee families have brought us some

steps forward in clarifying the concepts of "poor" and "good" conversations. We no longer picture good conversations as asmoothly flowing river, and believe that the river at times is blocked by obstacles that the therapist must navigate around orforcefully remove. We now see that some of the conversations during the sessions that we experienced as poor, asseemingly useless battles over territory or ground, and as immediate rejections when we focused on strengths and solutions,might have had a constructive effect on future conversations. We still believe that the sailing between Scylla and Charybdisis a necessary odyssey for therapists positioning themselves as we do, and that we have different obstacles to fight against intherapy with each individual family.

During our analysis of the conversations, it has struck us that good conversations, as described by Anderson andGoolishian (1988) and Goolishian and Anderson (1992), may fit some cultures better than others because they may believethat reflections are valued as a means to increased wisdom, as in middle-class cultures in different nations. However, othercultures may value authority and advice from the therapist; others may value battles over different positions; and still othersmay value clear and unambiguous statements to which they can relate.

We believe that the river runs more smoothly when the therapist takes care to affirm that sufferings are, if notunderstood, at least acknowledged. And maybe the most important landmark that has emerged through our analysis is howsensitivity to hidden agendas helps the navigation. One the one side we have the hidden agendas of the families, whichcultural differences make more difficult to perceive than the hidden agendas of families from our own culture. On the otherside we have the therapist's hidden agendas, which may be even more difficult to perceive in the swirls of the stream. Withrespect to these agendas, we see great advantages of a "not-knowing" stance. It does not mean that the therapist is free ofpreconceptions based on theory and therapeutic knowledge. It means, however, a continuous reflection on thesepreconceptions and a genuine conviction that they may not help this client in this situation.

Two different aspects of the "not-knowing" stance have become clearer to us. One concerns an acceptance of the "truth"of whatever the client states, a total acceptance of the client's premises, as when the reality of apparent delusions are takenfor granted (Anderson & Goolishian, 1992). The therapist then talks in the language of261 the client, with an emphaticaffirmation that does not challenge the client's beliefs, but creates a space where new ideas may come to the fore. The otherconcerns a "not taking for granted" that you know what the client means, such as asking for the meaning of utterances like"At times I get this depressed feeling." Even if the therapist does not have any preconceptions of what a "better languaging"may be, this aspect of the stance is much more challenging because it forces clients to reflect on their own languaging. Webelieve that positive effects of this kind of questioning presupposes the conveyance of much emphatic understanding tomake up for any lack of literal understanding.

REFERENCES

1. Andersen, T., The reflecting team: Dialogue and meta-dialogue in clinical work. Family Process, 26, 415-428,1987.

2. Anderson, H. and Goolishian, H. A., Human systems as linguistic systems: Preliminary and evolving ideas aboutthe implications for clinical theory. Family Process, 27, 371-393, 1988.

3. Anderson, H. and Goolishian, H. A., (1988). The client is the expert: A not-knowing approach to therapy (pp.25-39). In S. McNamee & K.J. Gergen (eds.), Therapy as social construction. London: Sage Publications.

4. Arredondo, P., Orjurla, E. and Moore, L., Family therapy with Central American war refugee families. Journal ofStrategic and Systemic Therapies, 8, 27-35, 1989.

5. Bemak, F., Cross-cultural family therapy with Southeast Asian refugees. Journal of Strategic and SystemicTherapies, 8, 22-27, 1989.

6. Boscolo, L., Cecchin, G., Hoffman, L. and Penn, P., (1987). Milan systemic family therapy. New York: Basic

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Books. 7. Chambon, A., Refugee families' experiences: Three family themes. Journal of Strategic and Systemic Therapies,

8, 3-13, 1989. 8. de Shazer, S., (1988). Clues: Investigating solutions in brief therapy. New York: W.W. Norton. 9. Goolishian, H. A. and Anderson, H., Strategy and intervention versus nonintervention: A matter of theory?,

Journal of Marital and Family Therapy, 18, 5-15, 1992. 10. Hong, G. K., Application of cultural and environmental issues in family therapy with immigrant Chinese

Americans. Journal of Strategic and Systemic Therapies, 8, 14-21, 1989. 11. Hermans, H.J. M., Kempen, H.J. G. and van Loon, R.J. P., The dialogical self: Beyond individualism and

rationalism. American Psychologist, 47, 23-33, 1992. 12. Polkinghorne, D. E., (1992). Postmodern epistemology of practice (pp. 17-30). In S. Kvale (ed.), Psychology and

postmodernism. London: Sage Publications. 13. Reichelt, S., (1993). From the auto-biography of a practitioner-scientist. Paper presented at an international

conference in Lofoten, Norway. 14. Reichelt, S. and Christensen, B., Reflections during a study on family therapy with drug addicts. Family Process,

29, 273-287, 1990. 15. Reichelt, S. and Sveaass, N., (1994). Developing meaningful conversations with families in exile. Manuscript

accepted, pending revision, by the British journal Refugee Studies. 16. Rumbaut, R. D. and Rumbaut, R. G., The family in exile: Cuban expatriates in the United States. American

Journal of Psychiatry, 133/134, 395-399, 1976. 17. Sluzki, C. E., Migration and family conflict. Family Process, 8, 379-390, 1979. 18. Sveaass, N. and Reichelt, S., (1993). Refugee families and their helping systems. Unpublished manuscript

available from authors. 19. Tjersland, O. A., From universe to multi-versesAnd back again. Family Process, 29, 385-397, 1990. 20. Tomm, K., Interventive interviewing: Part I. Strategizing as a fourth guideline for the therapist. Family Process,

26, 3-13, 1987a. 21. Tomm, K., Interventive interviewing: Part II. Reflexive questioning as a means to enable self-healing. Family

Process, 26, 167-183, 1987b. 22. Tomm, K., Interventive interviewing: Part III. Intending to ask circular, strategic, or reflexive questions?, Family

Process, 27, 1-15, 1988. 23. White, M. and Epston, D., (1990). Narrative means to therapeutic ends. New York: W.W. Norton.

Manuscript received June 25, 1993; Revisions submitted January 31, 1994; Accepted April 21, 1994.

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