コンテクスチュアル（文脈派）アプローチの理解と臨床例への適用

―対話の誕生とそのためのセラピストの働きかけ―

抄録

　　The purpose of this study is to introduce Contextual Theory, which was established by Boszormenyi-Nagy, as a tool of producing dialogue among family members. I present herein clinical cases which were discussed to clarify the contribution of this theory to reconstruct family relationships.

　　Loyalty, the spiritual bond connecting each family member to its own family consciously or unconsciously, is the key concept to understand the context which underlies behind Identified Patient's (IP's) symptom and their family problems. It is an inevitable question to be raised in this theory how fairness is broken down and whose loyalty is ignored in the family.

　　Therapist's multi-directed partiality to all members in the family is an important technique at the beginning of the treatment. This will encourage family members to disclose what they think and feel, and also give them good opportunities to think over other members' realities. It is also essential for each member to have a safety-feeling to talk to the therapist and a sense to be listened sympathetically by other members. This process will help the family to take a risk of reacting positively to the considerations given by others including IP. This process finally enables the entire family to dialogue with IP as well as with each other.

　　Case examples presented here suggest us that dialogue might not be a criticism but a self-controlling statement. Dialogue wiil lead the family to create a new balance of relationships which is regarded as being fair by all family members. Unfair partiality of the therapist to particular person in the family would be also useful for the treatment as far as other members follow the treatment process and listen to that person with the therapist.