オープンダイアログ(Becoming Dialogical : Psychotherapy or a Way of Life ?を読んで)



Seikkula, J. (2011), Becoming Dialogical: Psychotherapy or a Way of Life?. Australian and New Zealand Journal of Family Therapy, 32: 179–193. doi: 10.1375/anft.32.3.179.




Jaakko Seikkula(ヤーコ・セイクラ)

Jaakko Seikkulaをどのようなカタカナ表記にすればいいのか、もう少し調査が必要のような気がします。ドキュメンタリー映画のアメリカ人レポーターの発音では、この表記でよい気がしますが、現地の人の音ではどのようになるのかについても確認しておきたいです。

Seikkula 2010 photo

(追記: 詳しい方にお聞きしたところ日本語では「ヤーコ・セイクラ」という表記が一番違いのではないかということでした。ありがとうございます)


Finding out more about the “Open Dialogue” approach on the web


Becoming Dialogical: Psychotherapy or a Way of Life?

この論文は、Seikkula氏がAUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPYからの依頼で、どうすれば「対話的セラピスト(dialogical therapist)」になることができるのかという主題で書いています。いかに、論文で興味を引いたところをあげていきます。

1 生まれて初めて学習すること

After birth the first thing we learn is becoming a participant in dialogue. We are born in relations and those relations become our structure. Intersubjectivity is the basis of human experience and dialogue the way we live it.


2 Need-Adapted Treatment model

Seikkula氏は、オープンダイアログにつながるものとして、Need-Adapted Treatment modelについて述べています。このモデルについて概説した後で、もっとも革新的な特徴として、open treatment meetingsという考えがあったことを述べています。


The first questions are as open ended as possible, to guarantee that family members and the rest of the social network can begin to speak about the issues that are most relevant at the moment. The team does not plan the themes of the meeting in advance. From the very beginning the task of the interviewer(s) is to adapt their answers to whatever the clients say.

For the professionals this means they can comment either by inquiring further about the theme under discussion, or by commenting reflectively to the other professionals about their thoughts in response to what is being said. Most often, in those comments, specific phrases are introduced.


3 collaborative therapy & reflective team


As the reader can see, our approach in many respects is resonant with the dialog- ical, language-based family therapy of Harlene Anderson and Harry Goolishian (1988), which was later developed by Anderson (1997) into collaborative therapy. We also found a resemblance with Tom Andersen’s (1991) work on reflective team dialogues and processes. Interestingly, these approaches developed about the same time, but we only became aware of them later on, which gave us support to move in the direction we had chosen.

4 Mikhail Bakhtin on a polyphonic way of life and dialogism


According to Bakhtin (1984), the author of a polyphonic novel cannot control the action of the characters, and the only way to survive is to be in dialogue with them.


5 オープンダイアログの実績


Open dialogues has been systematically studied in Western Lapland with first episode psychotic patients (Seikkula et al., 2006; Seikkula et al., 2011; Aaltonen et al., 2011). These studies have shown favourable outcomes in psychosis. At 5-year follow-up 85 % of patients did not have any remaining psychotic symptoms and 85% had returned to full employment. Only one third used antipsychotic medica- tion. There is also some evidence that in Western Lapland the incidence of schizo- phrenia has declined during the 25 years of the open dialogue practice.

6 専門家が対話的手法を身につける難しさと、対話の力

what has surprised me is the enormous difficulty therapists with extensive experience in a particular therapeutic method have in adopting a dialogical way of working with clients. For as I see it, dialogue is not a method; it is a way of life. We learn it as one of the first things in our lives, which explains why dialogue can be such a powerful happening. Because it is the basic ruling factor of life, it is in fact very simple. It is its very simplicity that seems to be the paradoxical difficulty. It is so simple that we cannot believe that the healing element of any practice is simply to be heard, to have response, and that when the response is given and received, our therapeutic work is fulfilled (Seikkula & Trimble, 2005). Our clients have regained agency in their lives by having the capability for dialogue.

7 トム・アンダーソンの三つのリアリティ

1.‘either–or’ 2.‘both–and’ 3.‘neither–nor’


We experience something as taking place, but we do not have an exact linguistic description for it. We may say that it is neither this nor that, but I know that something is taking place.

8 Daniel Stern

Daniel Stern (2004), in emphasising the importance of the present moment, is critical of descriptions of psychotherapy and psychoanalysis that focus on clients’ narratives.




… authentic human life is the open-ended dialogue. Life by its very nature is dialogic. To live means to participate in dialogue: to ask questions, to heed, to respond, to agree, and so forth. In this dialogue a person participates wholly and throughout his whole life: with his eyes, lips, hands, soul, spirit, with his whole body and deeds. He invests his entire self in discourse, and this discourse enters into the dialogic fabric of human life, into the world symposium. (Bakhtin, 1984, p. 293)