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figure.jpg (30726 byte)    ’Altravisione’

            by Antonio Caruso*




I work as a psychologist and psychotherapist. I teach in Milan, in the systemic psychotherapy school of Boscolo and Cecchin and I lead a training and psychotherapy centre, called ‘Panta Rei’. A good deal of the paper originates from work in community health centres and in private practices.

My paper deals with a key word. ‘Key word’ means that a connotative word is correlated to a semantic whole. When I use a key word, but von Foester says any word or anytime I speak, my listener, my partner in conversation means a semantic set, a personal semantic whole. ‘‘altravisione’’ is my key word today. I used the word ‘‘altravisione’’ the first time with the intent to make a difference in supervision, in constructing supervision.

‘Supervision’ means, as it’s known, the partnership between two professionals, one of them more expert, with the same practice, with the same theoretical point of reference and the same model for both of them. In short, a professional who is more expert helps another one to reflect on his work.

Often psychologists or psychiatrists supervise social workers or educators and so on. They have different theoretical points of reference and different practices; they are expert but in a different way and in different fields and processes. So I have thought that it would have been more ‘politically correct’ to use the word ‘altravisione’ and I like this expression. We can render ‘altravisione’ in English as another and ulterior different way of viewing things, cases, problems and the world.

Why is the word ‘altravisione’ better? Altravisione’ is another vision in many respects; a professional with different skills often has a different theoretical perspective compared to participants. He carries out ‘altravisione’ from an eccentric position, which is external to the staff organization chart. I think , as second cybernetic, that the observer is inside the system he observes so that he co-constructs stories along with others, along with operators. Belonging to, to be part of a specific relationship system is connected, in a recursive way, to the semantic system, to the semantic set, that are used to read one’s own position in the system, to make sense and to construct one’s own position in the relationship system. One’s own premises, beliefs and theories symbolize, represent, express the individual subjective experience in the relationship system. This is the reason why I don't use the word supervision. My position in the connection to team is not a super position, an upper position; it is only another position, a different position.

E.g., for example, I give an example. When I or my associates carry on an ‘altravisione’ with home family professional educators, they tell me the story of a family, they report the story the family tells, and I introduce a different possible story about the family, in this way through questions, different ideas, reflection and so on we all construct a new point of view about the problem.

‘Altravisione’ proves useful to a team because it promotes creativity and improves problem-solving. ‘Altravisione’ work is useful because it allows us to introduce different points of view, in the sense described above. Different points of view enrich the job team and trigger a process of increase in creativity. Obviously the psychologist must also have the abilities in order to stimulate the group to increase reflection and problem solving.

As I have said before, ‘altravisione’ is a key word for me. It means a personal semantic whole. As a consequence, I began working in therapy session thinking about what I was going to do in order to construct an ‘altravisione’.

I have intentionally on purpose begun constructing, an ‘altravisione’. So I have begun choosing, selecting those actions that bring the conversation to new views, new positions, new perspectives, to different moods and feelings; I have paid attention to those actions through which the therapist can advance the new point of view in patients and in himself, new stances in relationship, new experiences.

I have begun taking action in therapy session with a new conceptual position: ‘altravisione’ , an epistemological and practical stance for the therapist.

Karl Tomm says that "a conceptual posture may be defined as an enduring constellation of cognitive operations that maintain a stable point of reference which supports a particular pattern of thoughts and actions and implicitly inhibits or precludes others".

Please, let me say I don't present anything original or new. You can say: " what's the meaning of this" " what's the big idea" "so what else is new"; however, then again, I think that the power, the force, the potency of key words is to simplify understanding, to rapidly create connections, to prompt new strategies. In this way I'm thinking of some skills, some tools I usually use in therapy and consultation session with individuals, couples, families. Hopes and dreams, self-characterization, future questions, and so on….

In this way the ‘altravisione’ is now a new guide-line along with hypothesising (1) , neutrality (2) , circularity (3) and strategizing (4).

I talk to the family thinking how I can put myself o them in the other position as regard to time, to role, to context, to rules, to beliefs, to symptoms, to space, to delirium, to therapist\client and so on. I found out that many usual actions I actually do in therapy, derive from the ‘altravisione’, seeking ‘altravisione’. I would like to give you some examples.

Alteration of time and or context:

During the first session I often ask:

-"If this session is the last session and the therapy has gone well,what would you tell me about yourself?"

- "If you had not believed in psychotherapy, what would you have done today?"

- "Do you remember when you began thinking that about your father?"

Alteration of pathological position:

"If your sister had your symptoms what would your mother do?"

Alteration of perspective:

Some time during the therapy I ask clients, individual or couple or family, the self or family characterization as designed by Kelly or as designed by various versions of original instructions. The original instructions went as follows: "I want to write a character sketch of, for example, A.C. just as if he were the principal character in a play. Write it as it might be written by a friend who knew him intimately and very sympathetically, perhaps better than anyone really could know him. Be sure to write it in the third person. For example start out by saying "A.C. is… … … "".

I use that in a social constructionist perspective. In this paper I mainly want to show the connection between ‘altravisione’.

Athena Androutsopoulou has written in issue 41 of Family Process "The altered point of view method, which means encouraging the client to talk about the self\the family from the perspective of a third person, especially a friend or relative, and looking at the self\the family from various angles through time ( for example from present to future). The latter is achieved by using the various versions of the original instructions."

Again, I often use the perspective of "hopes and dreams" as presented by Peter Lang and Elspeth McAdam . As for alteration of emotion. They say "One of the biggest changes is connected with the emotion of such conversation. The language of hopes and dreams leads to the person around whom the attention is focused, hearing themselves talked about in a different voice. They change emotionally while those who talk about them express different emotions of concern, care and desire for a positive future."

In conclusion, I have proposed may be, a principle of conducting the interview that would be coherent with the systemic and social constructionist epistemology I have adopted.


1) By ‘hypothesizing’ we refer to the formulation by the therapist of an hypothesis based upon the information he possesses regarding the family he is interviewing. The hypothesis establishes a starting point for his investigation as well as his verification of the validity of this hypothesis based upon specific methods and skills. If the hypothesis is proven false, the therapist must form a second hypothesis based upon the information gathered during the testing of the first

2) By ‘neutrality’ of the therapist we mean a specific pragmatic effect that his other total behavior during the session exerts on the family (and not his intrapsychic disposition), curiosity (Curiosity helps us to continue looking for different descriptions and explanations, even when we can not immediately imagine the possibility of another one. In this sense, hypothesizing is connected to curiosity. Hypothesizing has more to do with technique. Curiosity is a stance, whereas hypothesizing is what we do to try to maintain this stance)

3) By circularity we mean the capacity of the therapist to conduct his investigation on the basis of feedback from the family in response to the information he solicits about relationships and, therefore, about difference and change)

4) Strategizing may be defined as the therapist's - or team's - cognitive activity in evaluating the effects of past actions, constructing new plans of action, anticipating the possible consequences of various alternatives, and deciding how to proceed at any particular moment in order to maximize therapeutic utility)

 * Centre 'Panta Rei', Milan (Italy)


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