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Circular questioning.

The plan of this paper is to explore the question: Does a model that includes the principles of double description, circularity, and coevolutionary change, all accounting for shifts in family coalitions over time and the emergence of problems in connection with these shifts, allow the family therapist to design better methods for the understanding and practice of family therapy? Concepts of double description, coevolution, and circularity from Gregory Bateson's writing and the research of other scientists describe the translation of these ideas from pure epistemology to the pragmatics of family therapy. Circular questioning developed by the Milan Associates is presented as a practice method exemplifying how these notions of circularity and coevolutionary change--especially changes in family patterns--are used during actual family sessions.

Adolescent↗

Negative explanation, restraint, and double description: a template for family therapy.

Gregory Bateson's notions of negative explanation, restraint, and double description are discussed. The difficulties that families often experience in the discovery of new solutions to problems are explained according to the terms of these notions. A map for therapy is derived that emphasizes the therapist's contribution to the therapeutic system's state of "readiness" for the discovery of new solutions. Details of therapist/family participation in the endurance of new discoveries are examined. An approach to the treatment of the context for childhood fears and obsessive/compulsive behavior demonstrates one application of this map.

Child↗

Mind-body patterns of symptom generation.

Effective ways for joining family therapy with other treatment modalities are becoming increasingly important as the efficacy of family therapy gains acceptance in the medical and mental health community. When one interfaces family therapy with medical and psychopharmacological treatments, which find the sources of symptoms within individuals, rather than interpersonal systems, careful attention must be paid to the mind and body relationships that guide interactions between family behavior and the somatic physiology of each family member. We present six mind-body patterns of symptom generation found to be particularly useful for designing multimodality treatments and for communicating the treatment rationale to medical and psychiatric clinicians or to family members. Case examples illustrate their clinical use.

Combined Modality Therapy↗

The artificial heart: how close are we, and do we want to get there?

The artificial heart appears here to stay, and it will become ever more reliable and therapeutic. In the new age of medicine, the attributes of humanity are blended with the mechanical and artificial. While we express our humanness by seeking new and more creative treatments for illness and delaying death, we are inevitably modifying what it means to be human. Ethical issues arise from the interface of the physician-patient relationship and the technologies being developed in today's laboratories. The new Luddites may well be too fearful to tackle the challenges of technology wed to humanity. But they rightly say we seem woefully unprepared to deal with human hubris and will to power.

Bioethics↗

Presynaptic receptors and autonomic effectors.

Agonist interactions with release processes do not validate autoreceptor operation. Instead, the data suggests that autoreceptors function as homoreceptors. Declining efficacy of agonist inhibition of transmitter release with increasing stimulation "intensity" is not assignable to competition with endogenous transmitter for a finite population of receptors. Heteroreceptor activation also reveals a pattern of declining efficacy with increasing intensity. Inhibition of stimulation-induced release by agonists also does not correlate inversely with that of antagonist effectiveness, as it should if both effects are linked to biophase levels of transmitter. Further, per pulse release of transmitter, in the absence of drugs, does not comply with expectations for autoinhibition. Experiments with tetrodotoxin, and study of the magnitudes of agonist and antagonist effects suggest that in the periphery putative autoreceptors may actually be homoreceptors, e.g., sympathetic nerve terminal receptors responsive to circulating catecholamines. In the central nervous system the paracrine secretion of transmitter may invoke homoreceptor activation rather than autoreceptors. Such activation may include, for example, the release of adrenaline from one set of fibers in the hypothalamus to act on dopaminergic or noradrenergic fibers or the release of noradrenaline from the terminals of some noradrenergic fibers in the cortex to activate alpha2 receptors on other cortical noradrenergic fibers, the latter with a somewhat different function in the same brain region. The action of antagonist drugs to enhance transmitter release may be direct on nerve membranes in particular on sodium channels, and often unrelated to feedback regulation. This possibility is discussed by me elsewhere in this volume. It is shown that yohimbine and a low concentration of veratridine have similar and nonadditive effects on transmitter release.

Animals↗

Antireductionism and molecular biology. Though the antireductionist thesis in unwarranted, research in classical biology may well be of value.

My general conclusion, then, is that, given the current state of biological science, there may be good heuristic reasons for not attempting in all possible areas to develop physicochemical explanations of biological phenomena, and good reasons for attempting to formulate specifically biological theories. This, however, is an argument which supports an irreducibility thesis for methodological reasons. Any attempt to twist this into a claim of real irreducibility for all time is, in the light of recent work in molecular biology, logically untenable, empirically unwarranted, and heuristically useless.

Biochemical Phenomena↗

Life's irreducible structure. Live mechanisms and information in DNA are boundary conditions with a sequence of boundaries above them.

Mechanisms, whether man-made or morphological, are boundary conditions harnessing the laws of inanimate nature, being themselves irreducible to those laws. The pattern of organic bases in DNA which functions as a genetic code is a boundary condition irreducible to physics and chemistry. Further controlling principles of life may be represented as a hierarchy of boundary conditions extending, in the case of man, to consciousness and responsibility.

Biological Evolution↗