ABSTRACT
Working in an area defined in terms of ‘illness’ means that, as systemic therapists, we constantly need to position ourselves within several intersecting and often contradictory narratives. Engaging with, while not fully endorsing, a category defined as ‘parental mental illness’ means that we need to be mindful of how compelling is the medical discourse, both for families and for the professionals who work with them. While the research evidence (e.g. Rutter and Quinton 1984; Duncan and Reder 2000) clearly suggests that it is the behaviour rather than the diagnosis of parents which impacts on their children’s lives and wellbeing, nevertheless the totalising category of mental illness can constrain clinicians from the creative attention to the detail and meaning of interactions that is the hallmark of effective therapy. Additionally, when working with children within a context where child protection issues are likely to loom large and where we may be affronted by the reversal of generational tasks, by the marginalisation of children’s needs or by their involvement in psychotic worlds, there are likely to be challenges to a systemic approach that promotes positive connotation and encourages a sense of agency.
