9月に湘南社より出版されました『家族の絆とコミュニケーション』について、出版には間に合いませんでしたが、書評をオレゴン大学のジェフリー・トダール博士から頂きましたので、ＨＰにＵＰいたします。（ご本人の許可を得ています）

Marie Yoshida Book Foreword

10.19.14

All adults face personal hardships – from grief and loss due to the death of a close relative, to the trauma associated with violence in childhood, to ongoing conflict with a spouse about finances, parenting, sexual intimacy and relationship satisfaction. In these situations and others like them, many people reach out to psychiatrists for help, or consider doing so. Psychiatry is well known; it is and has been helpful for many. Though, many people have reported that psychiatric intervention did not adequately address their particular needs, or they did not seek psychiatric services due to their uncertainty about it, doubt about its usefulness, and concern about the sigma that often surrounds it.

In this important book written for the general public, Marie Yoshida introduces an alternative to psychiatry for people who are encountering personal problems. Ms. Yoshida draws on her training, extensive experience as a counselor, and her knowledge of Japanese culture as she shares her views about the usefulness of marriage and family therapy. She compares and contrasts family therapy and psychiatry and encourages the reader to consider marriage and family therapy as a useful option for support and change when faced with certain personal hardships.

The book is both theoretical and practical. Ms. Yoshida succinctly summarizes the core principles of family therapy, including systems theory, communication theory, and Bowen Family Therapy, and brings them to life with examples drawn from her clinical practice and the practice of well-known and highly regarded family therapists. A central theme of the book is that family therapy places emphasis on changing ones response in relationship patterns as a pathway toward meaningful change. She writes:

Clients [benefit from] learning a new relationship pattern based on new views of human relationships. The more they learn new relationship patterns, the more so-called symptoms disappear.

Ms. Yoshida critiques modern psychiatry, and argues that its narrow emphasis on “care for the mind” and a search for cause and pathology is a much too narrow view for supporting lasting change in many situations. This view is akin, she suggests, to “examining with a microscope” a series of problems and circumstances that are often much more likely resolved by taking a “broad view of things,” i.e., by “valuing a picture of the whole above the details.”

The goal of individual therapy, she writes, is different from the overall goal of marriage and family therapy: “The goal of individual therapy is behavioral change followed by cognitive changes. In family therapy, on the other hand, the goal of therapy is obtaining new patterns of how to relate to others based on understanding current patterns of relationship, in addition to changes in thoughts and beliefs.”

Through metaphor, examples, and clear illustrations, Ms. Yoshida helps the reader to see a picture of what marriage and family therapy looks like in practice. She does this both by summarizing research and clinical literature and by openly sharing her work, personal perspective, and reasons for believing that family therapy is a promising option for many people. This book is a wonderful first step toward considering whether family therapy is a good option for you and people in your life.

（日本語訳は後日、ＵＰいたします。）

個人療法としてのこころのケア、すなわち精神科医療、心療内科、大多数の臨床心理士が基礎としている理論と、システム論を基礎とする家族療法の人間と人間関係のケアの違いを、様々な例をあげて説明した本です。

本来の家族療法（アメリカの家族療法）は原因究明の切り口が、日本における既存の精神科診断学と異なるため、『理想の家族』『良い両親』『悪い両親』『正しい家族』といったような、概念は一切出てきません。精神科診断は、人間を『正常と異常』『良し・悪し』という二極化から導き出しています。結果として、思考の方向性は、”誰”が悪いのか、”何の性格”が異常なのか、”誰を治す”のかとなります。

しかし、家族療法は全体像と個人の両方を視野に入れて、全体と個のバランスを取りなおす事が核となります。従って、特定のターゲットとなる個人や病気を治す、という現在の精神科診断とは異なる診断を行います。

この、家族療法の基本姿勢が、既存の精神科医療の専門家やマスコミの家族理想論とは異なる視点からの介入方法となり、今現在、実際にいろいろな困難に直面していて、なおかつ既存の個人療法的視点では解決しないところまで追い詰められている方々への、希望の光になると思って書いたものです。具体的な内容は以下の通りです。

家族療法士が考える理想の家族とは・・・

問題があっても、けんかをしても、

それを乗り越えて新しい自分や新しい家族の関係や形に

変わっていこうとする力のある人の集まり

たとえ、今、仲良くしていても

問題がなかったことにしたり、問題から逃避したりするという姿は

この理想からはほど遠く、それは幸せの象徴ではなく

単にするべきことを後回しにしている姿である。

（拙著　p. 196より）