Ivan Boszormenyi-Nagy (May 19, 1920 – January 28, 2007) was a
Hungarian-American
psychiatrist
A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
and one of the founders of the field of
family therapy
Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and ...
. Born Iván Nagy, his family name was changed to Böszörményi-Nagy during his childhood. He emigrated from Hungary to the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
in 1950, and he simplified his name to Ivan Boszormenyi-Nagy at the time of his naturalization as a US citizen.
Contextual therapy
Boszormenyi-Nagy is best known for developing the ''Contextual'' approach to
family therapy
Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and ...
and individual
psychotherapy
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...
. It is a comprehensive model which
integrates ''individual psychological'', ''interpersonal'',
existential,
systemic, and ''intergenerational'' dimensions of individual and
family
Family (from ) is a Social group, group of people related either by consanguinity (by recognized birth) or Affinity (law), affinity (by marriage or other relationship). It forms the basis for social order. Ideally, families offer predictabili ...
life and development.
The contextual model, in its most well-known formulation, proposes four dimensions of relational reality, both as a guide for conducting therapy and for conceptualizing relational reality in general:
# Facts (e.g., genetic input, physical health,
ethnic
An ethnicity or ethnic group is a group of people with shared attributes, which they collectively believe to have, and long-term endogamy. Ethnicities share attributes like language, culture, common sets of ancestry, traditions, society, re ...
-
cultural
Culture ( ) is a concept that encompasses the social behavior, institutions, and Social norm, norms found in human societies, as well as the knowledge, beliefs, arts, laws, Social norm, customs, capabilities, Attitude (psychology), attitudes ...
background,
socioeconomic status
Socioeconomic status (SES) is a measurement used by economics, economists and sociology, sociologsts. The measurement combines a person's work experience and their or their family's access to economic resources and social position in relation t ...
, basic historical facts, events in a person's life cycle, etc)
# Individual psychology (the domain of most individual psychotherapies)
# Systemic transactions (the domain covered by classical systemic family therapy: e.g., rules, power, alignments, triangles, feedback, etc)
# Relational ethics.
These dimensions are taken to be inter-linked, but not equatable or reducible to one another.
[Le Goff, J.F. (2001). Boszormenyi-Nagy and Contextual Therapy: An Overview]
''ANZJFT'', 22 (3)
: 147–157.
The contextual model proposes ''relational ethics''—the
ethical
Ethics is the philosophical study of moral phenomena. Also called moral philosophy, it investigates normative questions about what people ought to do or which behavior is morally right. Its main branches include normative ethics, applied e ...
or "
justice
In its broadest sense, justice is the idea that individuals should be treated fairly. According to the ''Stanford Encyclopedia of Philosophy'', the most plausible candidate for a core definition comes from the ''Institutes (Justinian), Inst ...
" dimension of close relationships—as an overarching integrative conceptual and methodological principle. Relational ethics focuses in particular on the nature and roles of ''connectedness'', ''caring'',
reciprocity,
loyalty
Loyalty is a Fixation (psychology), devotion to a country, philosophy, group, or person. Philosophers disagree on what can be an object of loyalty, as some argue that loyalty is strictly interpersonal and only another human being can be the obj ...
, ''legacy'',
guilt, fairness,
accountability
In ethics and governance, accountability is equated with answerability, culpability, liability, and the expectation of account-giving.
As in an aspect of governance, it has been central to discussions related to problems in the public secto ...
, and
trustworthiness - within and between
generations. It is taken to represent not just a set of prescriptive
norms, nor simply
psychological
Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
phenomena,
perspectives, or
constructions. Rather, relational ethics is seen as (1) having some objective
ontological
Ontology is the philosophical study of being. It is traditionally understood as the subdiscipline of metaphysics focused on the most general features of reality. As one of the most fundamental concepts, being encompasses all of reality and every ...
and
experiential basis by virtue of being derived from basic
needs and from real
relationships that have concrete consequences (i.e., as distinct from
abstract or
"value" ethics); and (2) as being significant
explanatory and
motivational
Motivation is an internal state that propels individuals to engage in goal-directed behavior. It is often understood as a force that explains why people or animals initiate, continue, or terminate a certain behavior at a particular time. It ...
dynamics operating - in both beneficial and destructive ways - in individuals, families,
social groups
In the social sciences, a social group is defined as two or more people who interact with one another, share similar characteristics, and collectively have a sense of unity. Regardless, social groups come in a myriad of sizes and varieties. Fo ...
, and broader
society
A society () is a group of individuals involved in persistent social interaction or a large social group sharing the same spatial or social territory, typically subject to the same political authority and dominant cultural expectations. ...
. The construct validity and significance of relational ethics in clinical and educational contexts have been supported by a number of studies.
In a later formulation of the contextual model, Boszormenyi-Nagy proposed a fifth dimension - the ''ontic dimension'' - which was implicit in the earlier formulations, but which considers more explicitly the nature of the interconnection between people that allows an individual to exist decisively as a ''person'', and not just a ''self''. ''(See also
Intersubjectivity
Intersubjectivity describes the shared understanding that emerges from interpersonal interactions.
The term first appeared in social science in the 1970s and later incorporated into psychoanalytic theory by George E. Atwood and Robert Stolorow, ...
and
Philosophy of dialogue.)''
Methodology
''Multidirected partiality'' is the main methodological principle of contextual therapy. Its aim is to evoke a
dialogue
Dialogue (sometimes spelled dialog in American and British English spelling differences, American English) is a written or spoken conversational exchange between two or more people, and a literature, literary and theatrical form that depicts suc ...
of responsible mutual position-taking among family members. It consists of a sequential,
empathic turning towards member after member (even absent members), in which both acknowledgement and expectation are directed at them. It is an alternative to the more common 'neutrality' or unilateral
partiality
Impartiality (also called evenhandedness or fair-mindedness) is a principle of justice holding that decisions should be based on objective criteria, rather than on the basis of bias, prejudice, or preferring the benefit to one person over anothe ...
of other approaches. It requires an appreciation of the 'ledger' from each person's point of view, even that of the current
victimizer.
[
For example, a family comes into therapy desiring to fix their son's outbursts and oppositional defiant behavior. The therapist (and possibly a co-therapist where appropriate) would first seek basic information (including any relevant clinical or medical information), construct a genogram if possible, and have each family member explain their side of the story (either conjointly or in individual sessions as appropriate), in order to begin to understand the problem in terms of background facts, the relational context (i.e., ''intergenerational'', ''interpersonal'', and systemic), and deeper ]motivational
Motivation is an internal state that propels individuals to engage in goal-directed behavior. It is often understood as a force that explains why people or animals initiate, continue, or terminate a certain behavior at a particular time. It ...
factors (e.g., psychological processes, hidden ''loyalties'' and ''legacies'', ''ledger'' imbalances, ''destructive entitlement'' resulting from real or perceived injustices, ''scapegoating
Scapegoating is the practice of singling out a person or group for unmerited blame and consequent negative treatment. Scapegoating may be conducted by individuals against individuals (e.g., "he did it, not me!"), individuals against groups (e.g ...
'', '' parentification'' of the child, etc.), and not simply (as is commonly done in some other approaches) in terms of the 'behaviour
Behavior (American English) or behaviour (British English) is the range of actions of Individual, individuals, organisms, systems or Artificial intelligence, artificial entities in some environment. These systems can include other systems or or ...
', ' systemic interactions', ' cognitions', or ' narratives' of the family and the son.
Having gained this preliminary understanding of the situation, the therapist would firstly address any issues requiring urgent attention (e.g., physical welfare, prevention of violence, etc.), especially in relation to the interests of the most vulnerable member(s), whether or not they are present at the therapy sessions. The therapist would then go further, carefully and sequentially 'taking the side' of each member (while seeking to maintain overall balance, but not 'joining' the family as occurs, for example, in structural therapy), the aim being to begin a genuine dialogue of mutual accountability, to reduce the reliance on dysfunctional acting-out, and to find resources (e.g., hope, will
Will may refer to:
Common meanings
* Will and testament, instructions for the disposition of one's property after death
* Will (philosophy), or willpower
* Will (sociology)
* Will, volition (psychology)
* Will, a modal verb - see Shall and will
...
) for rebuilding relationships through mutual acknowledgement of both entitlements and obligations, shifts in attitude and intention (but not 'relabeling' as in strategic or constructivist approaches), fair exoneration, and redemptive or ''rejunctive'' (i.e., 'trust-building') actions, that will in turn build individual and relational maturity and integrity (i.e., ''self-validation'' and ''self-delineation'' - contextual counterparts of Bowen's ''differentiation''), and ''trustworthiness'', which contextual therapists see as the ultimate relational resource for individual and family well-being.
The approach would be adapted - although the basic principles would remain the same - according to the particular case; for example: adults having problems with their siblings or elderly parents; couples issues; conflicts associated with blended families, adoption
Adoption is a process whereby a person assumes the parenting of another, usually a child, from that person's biological or legal parent or parents. Legal adoptions permanently transfer all rights and responsibilities, along with filiation, fro ...
, fostering, gamete donation and surrogacy
Surrogacy is an arrangement whereby a woman gets pregnant and gives birth on behalf of another person or couple who will become the child's legal parents after birth. People pursue surrogacy for a variety of reasons such as infertility, danger ...
; migration
Migration, migratory, or migrate may refer to: Human migration
* Human migration, physical movement by humans from one region to another
** International migration, when peoples cross state boundaries and stay in the host state for some minimum le ...
and cross-cultural
Cross-cultural may refer to:
*cross-cultural studies, a comparative tendency in various fields of cultural analysis
*cross-cultural communication, a field of study that looks at how people from differing culture, cultural backgrounds communicate
* ...
issues; different mental disorder
A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
s; addiction
Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use can ...
and substance abuse
Substance misuse, also known as drug misuse or, in older vernacular, substance abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder, differing definition ...
; criminal behavior
In ordinary language, a crime is an unlawful act punishable by a State (polity), state or other authority. The term ''crime'' does not, in modern criminal law, have any simple and universally accepted definition,Farmer, Lindsay: "Crime, definiti ...
, domestic violence
Domestic violence is violence that occurs in a domestic setting, such as in a marriage
Marriage, also called matrimony or wedlock, is a culturally and often legally recognised union between people called spouses. It establishes r ...
, and so on.
The contextual approach allows for the inclusion of many significant aspects of other approaches to psychotherapy and family therapy, provided that they are consistent with the overarching contextual principle of multilateral therapeutic ethical concern and accountability.[Boszormenyi-Nagy, I., Grunebaum, J., & Ulrich, D. (1991). Contextual Therapy. In A. Gurman & D. Kniskern (Eds.]
''Handbook of Family Therapy, Vol 2.''
New York: Brunner/Mazel.
Bibliography
*Boszormenyi-Nagy, I., & Framo, J. (Eds.) (1965; 1985)
''Intensive family therapy: Theoretical and practical aspects.''
New York: Harper & Row. (Second edition, New York: Brunner/Mazel)
*Boszormenyi-Nagy, I., & Spark, G. (1973; 1984)
''Invisible loyalties: Reciprocity in intergenerational family therapy.''
New York: Harper & Row. (Second edition, New York: Brunner/Mazel)
*Boszormenyi-Nagy, I., & Krasner, B. (1986)
''Between give and take: A clinical guide to contextual therapy.''
New York: Brunner/Mazel.
*Boszormenyi-Nagy, I. (1987)
''Foundations of contextual therapy: Collected papers of Ivan Boszormenyi-Nagy, MD.''
New York: Brunner/Mazel.
*Boszormenyi-Nagy, I., Grunebaum, J., & Ulrich, D. (1991). Contextual Therapy. In A. Gurman & D. Kniskern (Eds.
''Handbook of Family Therapy, Vol 2.''
New York: Brunner/Mazel.
See also
References
Further reading
* Buber, M. (1957)
Guilt and guilt feelings.
''Psychiatry.'' May; 20(2): 114-29.
*Friedman, M.S. (1989)
Martin Buber and Ivan Boszormenyi-Nagy: The role of dialogue in contextual therapy.
''Psychotherapy'', 26 (3): 402-9.
*Friedman, M.S. (1998)
Buber's Philosophy as the Basis for Dialogical Psychotherapy and Contextual Therapy.
''Journal of Humanistic Psychology.'' 38(1): 25-40.
*Politi Ziter, M.L. (1990)
Family therapy and a “good” society: Fit or misfit?
'' Contemporary Family Therapy.'' 12(6): 515-527.
*Goldenthal, P. (1996)
''Doing Contextual Therapy: An Integrated Model for Working With Individuals, Couples, and Families.''
New York: W.W. Norton & Co.
*Dankoski, M.E., & Deacon, S.A. (2000)
Using a Feminist Lens in Contextual Therapy
''Family Process'', 39 (1): 51–66.
*Le Goff, J.F. (2001). Boszormenyi-Nagy and Contextual Therapy: An Overview
''ANZJFT'', 22 (3)
147–157.
*Ducommun-Nagy, C. (2002). Contextual Therapy. In F. Kaslow, R. Massey, & S. Massey (Eds.
''Comprehensive handbook of psychotherapy, Vol. 3: Interpersonal/humanistic/existential.''
New York; Chichester: Wiley.
*Ducommun-Nagy, C. & Schwoeri, L.D. (2003). Contextual Therapy. In Sholevar, G.P. & Schwoeri, L.D. (Eds.
''Textbook of Family and Couples Therapy: Clinical Applications.''
Washington, DC: American Psychiatric Publishing Inc.
*Hargrave, T.D. & Pfitzer, F. (2003)
''The New Contextual Therapy: Guiding the Power of Give and Take.''
New York: Brunner-Routledge.
*Hibbs, B. Janet with Karen Getzen (2009)
''Try to See It My Way: Being Fair in Love and Marriage.''
NY: Avery/Penguin Books.
*Adkins, K.S. (2010)
''A Contextual Family Therapy Theory Explanation For Intimate Partner Violence.''
Doctoral Dissertation: Ohio State University.
External links
from Allyn and Bacon/Longman publishing
Interview with Psychology Today on Destructive Entitlement
Are trustworthiness and fairness enough? Contextual family therapy and the good family
Boszormenyi-Nagy's response to 'Are trustworthiness and fairness enough?'
Contextual Therapy with Multiple Personality Disorder
Video excerpt: Ivan Boszormenyi-Nagy on the ethics of optimism, constructive entitlement, the welfare of posterity
Conference video: Dr Catherine Ducommun-Nagy, Brussels, Nov. 2006 (in French)
Conference video: Catherine Ducommun-Nagy, colloque CITFA Les loyautés (avril 2012) (in French)
Video excerpt: 2014 congres Loyaalleven Nederland, Peter Goldenthal on Multi-directed partiality
Video excerpt: 2014 congres Loyaalleven Nederland Barbara Krasner on Loyalty and loyalty dynamics
* [http://nl.newsbank.com/nl-search/we/Archives?p_product=PI&p_theme=pi&p_action=search&p_maxdocs=200&s_dispstring=boszormenyi-nagy&p_field_advanced-0=&p_text_advanced-0=(boszormenyi-nagy)&xcal_numdocs=20&p_perpage=10&p_sort=YMD_date:D&xcal_useweights=no Obituary: Philadelphia Daily News]
Memoriam
an
Profile
at EFTA by Tamás Kurimay M.D., Ph.D.
In Remembrance of Ivan Boszormenyi-Nagy M.D., by Margaret Cotroneo: ''Family Process'', Jun 2007.
Homage by Marlene F. Watson, Drexel University; July 2007.
Facebook page for Contextual Therapy / Ivan Boszormenyi-Nagy
{{DEFAULTSORT:Boszormenyi-Nagy, Ivan
American psychiatrists
Hungarian psychiatrists
American psychotherapists
Family therapists
Existential therapists
Relational ethics
Hungarian emigrants to the United States
Physicians from Budapest
1920 births
2007 deaths