LogiMind Review of Psychotherapies

Vol. 1 · No. 3 · November 2026 Director of publication: Édouard Alain de Boysson · Publisher: LogiMind · logimind.org ISSN: pending attribution (BnF) · Issue DOI: 10.5281/zenodo.21719267 (Zenodo) · Licence: CC BY 4.0

Editorial
FOCUS — Brief systemic therapy from Palo Alto
Brief systemic therapy from Palo Alto and new technologies
Brief systemic therapy from Palo Alto in the face of crises and disasters
In the spotlight — two practitioners
Box — Palo Alto therapy in French-speaking Africa
An emerging therapy — narrative practices
Brief systemic therapy from Palo Alto and its offshoot therapies
For further reading
The words of LogiMind

Editorial

Dear readers,

This month, we delve into the singular legacy of the Mental Research Institute of Palo Alto. A place, an era, an idea that turned the clinic inside out. The idea is of disarming simplicity: it is not the difficulties themselves that make the problem, but the attempted solutions we repeat, tirelessly, in order to resolve them. "More of the same," wrote Watzlawick, Weakland and Fisch. A logical trap, a vertigo.

We have chosen to present this approach with the rigour it deserves, without turning it into a panacea. For while its theoretical elegance is seductive, its level of evidence remains modest compared with other models. Brief systemic therapy is not a miracle method; it is a precise toolbox, born of a keen observation of human interactions and paradoxical communication. It teaches us not to add water to the sea.

In this month of reflection, we invite you to explore with us this logic of change. Not change within the system, but change of the system itself. An invitation to think differently about suffering, and about the solutions that sustain it.

FOCUS — Brief systemic therapy from Palo Alto

Landmarks — the birth of a method

The story begins with an unexpected convergence, that of anthropology and clinical practice. In the early 1950s, Gregory Bateson, an anthropologist and epistemologist — never a clinician, a decisive point — obtained a research project on communication. The atmosphere was that of a thinking laboratory, not a consulting room. Bateson gathered around him singular minds: Jay Haley, a brilliant and caustic theorist; John Weakland, a chemical engineer turned anthropologist; and William Fry. In 1954, Don D. Jackson, a psychiatrist, joined the group. It was he who brought the clinical material, the real interviews, the families. The Bateson project, which ran from 1952 to 1962, was therefore not a school of therapy: it was a fundamental research workshop on human communication, where family exchanges were recorded, observed and dissected as one might study a distant tribe.

From this workshop emerged in 1956 a founding article, "Toward a Theory of Schizophrenia", signed by Bateson, Jackson, Haley and Weakland. Its central concept was the double bind: a communication situation in which a person receives contradictory injunctions at different logical levels, with no possibility of stepping outside the frame or commenting on it. The canonical example remains that of the mother who says to her child "come and kiss me" while stiffening as the child approaches. The child is caught in a trap: obeying the explicit injunction betrays the implicit one, and any attempt at meta-communication is forbidden. This is not a theory of schizophrenia in the strict causal sense, but a hypothesis about the genesis of disorders through the pathology of communication. The idea gained ground, and it shifted the gaze: the problem was no longer located in the individual, but in the relational system surrounding him or her.

In 1958, Jackson founded the Mental Research Institute (MRI) in Palo Alto. The place became a crucible where researchers and clinicians crossed paths. Watzlawick, an Austrian trained in Zurich, arrived at the MRI in 1960 with a philosophical culture and an elegance of thought; in 1967 he would publish, with Janet Beavin and Jackson, Pragmatics of Human Communication, which systematised the axioms of human communication. Weakland, the chemical engineer turned anthropologist, brought an observational rigour unusual in psychiatry. Haley, the theorist, documented with surgical precision the strategies of therapists, notably those of Milton Erickson, whom he would make known in Uncommon Therapy (1973). Fisch, a psychiatrist, was the field man, the one who listened to patients and devised practical interventions.

In 1967, under the impetus of Richard Fisch, the Brief Therapy Center was created within the MRI. The wager was radical: the frame was limited to ten sessions. Ten sessions, not one more. This constraint was not a mere administrative measure; it was a therapeutic act. It broke with the long cure, with the idea that change requires years of exploring the depths. The hypothesis was that the problem is maintained by the attempted solutions already tried by the patient and those around him or her; it therefore suffices to interrupt these attempts for the problem to dissolve. Hence the MRI's tools: reframing, which changes the meaning of a situation; symptom prescription, which asks the patient to do voluntarily what he or she suffers; paradoxical tasks, which use resistance as a lever; and the therapist's one-down position, which avoids direct confrontation and escalation.

The final paradox is striking. On the one hand, the clinical and cultural success is considerable. The ideas of Palo Alto have irrigated family therapy, brief approaches, communication, management, education. Sister schools were born: the Milan school with Selvini Palazzoli, Boscolo, Cecchin and Prata, who published Paradox and Counterparadox in 1975; Minuchin's structural therapy; and above all, in Milwaukee, de Shazer and Insoo Kim Berg, who extended Palo Alto towards exceptions and solution-focused therapy. On the other hand, the level of evidence has remained thin. The body of randomised trials on the Palo Alto model taken in isolation is far smaller than that for CBT. The HAS, in 2010, recommended family therapies for anorexia nervosa in children and adolescents, but without extending this recommendation to systemic approaches as a whole. The success is therefore real, but it rests more on the heuristic power of the concepts and the reported clinical effectiveness than on massive experimental validation. That is perhaps the mark of great ideas: they change the way we see before even having proved their effectiveness.

How it works

The starting point of the Palo Alto model is an observation of disconcerting simplicity: what maintains a problem is often not its initial cause, but everything that those around the patient and the patient himself or herself put in place to make it disappear. Watzlawick, Weakland and Fisch, at the Brief Therapy Center, formalised this idea under the name of "attempted solutions". When these attempts fail, the natural reaction is to intensify them, to repeat them with more vigour, more constancy, more anxiety. This is what Watzlawick, Weakland and Fisch called "more of the same". Insomnia is the purest illustration: the more one strives to fall asleep, the more sleep eludes one, because the effort itself maintains wakefulness. The solution — trying to sleep — becomes the problem. The systemic therapist therefore does not seek to explore the origins of the disorder, but to map precisely what each person does to resolve it, for it is there that transformation is played out.

This distinction leads to two levels of change. First-order change is a modification within a given system: one tries something else, but according to the same logic. For the insomniac, changing herbal tea, breathing technique or bedtime remains first-order change. Second-order change is of another order: it modifies the rules of the game, the logic itself. It is no longer a matter of sleeping better, but of abandoning the struggle. Watzlawick, Weakland and Fisch, in Change: Principles of Problem Formation and Problem Resolution, show that second-order change often passes through an intervention that seems absurd in relation to the problem, because it targets the attempted solution and not the symptom. The therapist does not prescribe the opposite of the symptom; he prescribes what interrupts the loop.

Let us take a real session, as it unfolds at the Brief Therapy Center. The frame is strict: ten sessions maximum, a concrete goal defined from the first interview. The therapist begins with a simple question: "What brings you here today, and what have you already tried to remedy it?" He investigates with almost police-like meticulousness the behavioural details: what exactly does the patient do when he does not sleep? Does he get up? Does he count sheep? What does his spouse do? Each answer is a piece of the puzzle. Then comes the key question: "And does that work?" The answer is almost always negative, but the patient has never considered that his or her doggedness is the fuel of the disorder. The therapist does not say so bluntly; he makes the patient discover it through reframing.

First example: a forty-five-year-old woman, insomniac for two years. She has tried everything: melatonin, meditation, giving up coffee, reading, hot baths. Every evening she goes to bed at ten o'clock, turns off the light, and waits. She waits for sleep as one waits for a delayed train, with growing vigilance. The therapist asks her: "What goes through your mind at that moment?" She replies: "I tell myself I have to sleep, otherwise tomorrow I'll be exhausted." There is the loop. The prescription will be paradoxical: "For the next two nights, I ask you to stay awake as long as possible. Make yourself comfortable, do nothing but stay awake. Above all, do not fall asleep." The reframing is implicit: if she obeys, she stops struggling, and sleep can occur; if she disobeys and falls asleep, she has won. In both cases, the prescription dissolves the attempted solution. The therapist adds, in a one-down position: "I'm not sure this will help you, but try it, to see." This humility is not a feint: it prevents the patient from resisting an authority that is too assertive.

Second example: a fourteen-year-old adolescent, mute at home for six months. The parents have tried everything: kind questions, pleas, punishments, silence. The more they ask "What's wrong?", the more he closes up. The therapist receives the family. He does not address the adolescent directly, but the parents: "How long has it been since he last spoke to you?" Then, turning to the young man: "I bet you have a good reason not to speak. And I bet the more questions people ask you, the harder it is." The adolescent looks up, surprised. The therapist continues, addressing the parents: "I'm going to ask you something unusual. For one week, you will not ask him any questions. None. If he wants to talk to you, you will listen, but you will not interrogate him. And if he doesn't speak, that's fine too." Then, to the adolescent: "And you, I'd like you to carry on not speaking, to see if your parents can stick to this instruction." The mutism, from obstacle, becomes a test, a mission. The pressure drops. Within a few sessions, the young man begins to speak again, not because he is asked to, but because resistance no longer has any object. Reframing has transformed the symptom into a therapeutic alliance.

These two examples show the coherence of the model: the therapist does not fight the symptom, he prescribes it, redefines it, uses it. He does not seek the cause, he seeks the loop. And it is by touching the loop, not the symptom, that second-order change operates.

The course of a therapy, from the first session to the tenth

Brevity, here, is not an economy of means. It is an active therapeutic frame, a fruitful constraint that obliges therapist and patient to renounce dilution. From the first session, the tone is set: one does not talk about childhood, the past or deep hypotheses. The problem is defined in concrete, observable terms. A mother will say "my son is aggressive"; the therapist will ask: "When, precisely, does he do what, and what do you do at that moment?" This close, almost police-like inquiry aims to pin down the symptom in its interactional reality. Then comes the crucial question, the one that distinguishes the Palo Alto school: "What have you already tried to solve this problem?" The answers, almost always, reveal solutions that maintain the problem. The more one presses, the more it resists. The contract is then laid down, clear and limited: ten sessions. This figure is not a budget ceiling, it is a lever. It installs a fruitful urgency, an awareness of time that forbids wandering.

The middle sessions are the heart of the work. The therapist, in a one-down position, does not present himself as an expert who knows. He proposes, with humility, prescriptions. Sometimes a reframing: "Your son is not aggressive, he is terribly attentive to your fatigue." Sometimes a paradoxical task: "I ask you to carry on arguing, but only on Tuesdays, at a fixed time." The patient returns, often disconcerted. The symptom has changed status: it has become an object of observation, no longer an inevitability. One does not judge the success or failure of the prescription; one examines what happened, what it reveals about the rules of the family game. Each return is material for adjustment. The therapist does not seek to understand in order to explain; he seeks to act in order to unblock. The paradoxical task, for example, does not aim to suppress the symptom through willpower, but to make it voluntary, therefore absurd, therefore untenable. Change often arises from the side, by surprise, like a welcome side effect.

The final sessions consolidate. One does not celebrate the cure; one notes the differences. The therapist explicitly attributes the change to the patient: "It was you who found the flaw, not me." This attribution is not politeness; it is a weapon against relapse. A patient who feels like an actor in his or her own change does not fall back into passivity. Future difficulties are anticipated: "What will you do if the problem returns, in another form?" Responses, strategies, reflexes are prepared. Then appointments are spaced out: a fortnight, three weeks, a month. This progressive spacing is a test of reality. The patient learns to do without the therapist, to test his or her gains over time. Follow-up, finally, is not surveillance, but light watchfulness. A reminder session at three or six months often suffices to confirm that the new functioning has taken hold. Brevity, here, is not an amputation. It is a discipline that concentrates attention, mobilises resources and respects the patient's capacity to do without the therapist. It says: change is possible, rapid, and it belongs to you.

The therapist's toolbox

The reasoned catalogue of Mental Research Institute techniques unfolds like a toolbox in which each instrument aims at the same objective: to outwit the logic that maintains the problem. Reframing, first, consists in changing the meaning of a behaviour without altering its facts. A parent complains that his adolescent "plays the clown" at table; the therapist suggests seeing it as "an attempt to lighten the atmosphere". The reasoning: if the meaning changes, the emotional response changes, and the interactional circuit is thereby modified. One does not contest reality; one proposes another reading of it, more functional.

Symptom prescription, more audacious, invites the patient to produce the troublesome behaviour voluntarily. To someone who blushes and dreads it, one asks them to blush deliberately; to a couple who argue, to argue every evening at a fixed time. The reasoning is twofold: on the one hand, trying to reproduce an involuntary symptom places it under control, which dissolves performance anxiety; on the other hand, the paradoxical injunction ("I order you to be in pain") makes disobedience therapeutic — if the patient cannot manage it, the symptom disappears. Paradoxical tasks extend this principle: one prescribes failure to provoke success, or one asks the patient to simulate a relapse to test his or her mastery.

The therapist's one-down position is less a technique than a strategic posture. The clinician presents himself as ignorant, even out of his depth: "I don't know if I can help you, you seem to have tried everything." In doing so, he defuses power relations — the patient no longer has to resist an expert — and places him in a position of having to convince the therapist of his own capacity to change. The displayed humility is a lever: it reverses the usual dynamic in which the patient defends his symptom against therapeutic assaults.

The use of language, in Watzlawick and Weakland, is a matter of surgical precision. Metaphors make it possible to act on the frame of reference without confronting defences: speaking of a "traffic jam" to evoke a marital conflict opens a lateral path. Oriented questions, for their part, presuppose change: "What will you do differently once this problem is solved?" rather than "Why does this problem persist?" The reasoning: language structures perception; by orienting attention towards the after-problem, one makes change thinkable, therefore possible.

Finally, the prescription to "change nothing" is perhaps the most disconcerting. Faced with a patient who has been fighting his symptom for years, the therapist asks him to continue exactly as before, even to intensify his efforts. The reasoning is subtle: the attempted solution is the problem. By forbidding change, one interrupts the feedback loop that feeds the difficulty; the patient, deprived of his usual strategy, finds himself forced to innovate. Often, the simple fact of no longer fighting the symptom makes it abate — not by magic, but because the interactional system, deprived of its fuel, stops running idle. Each tool, as can be seen, shares the same conviction: the problem is not in the individual, but in the repetition of attempts to solve it.

For whom, in which cases

Who is this approach for? First, for those who suffer from what might be called relational dead ends. The couple going round in circles in the same reproach, the family where each person tries to help the other in a way that worsens the problem, the parent disarmed before an adolescent mired in academic failure: so many situations where repeated effort, far from resolving, crystallises. Brief systemic therapy is not interested in what people "are", but in what they do together, and what they might do differently.

Anxiety disorders and phobias find favourable ground here, provided they unfold in a relational context that maintains them. A school phobia, for example, is never only the child's affair: it involves the parents, the school, sometimes the grandparents. The work will consist in modifying the attempted solutions that fail — reassuring endlessly, excusing from classes, negotiating every morning — to open up a new space.

A particular case deserves attention: that of the person referred by a third party. The spouse who "sends" the other to consult, the parent who brings his child without the child having formulated the request, the employer who demands follow-up. Far from being an obstacle, this configuration is working material. The therapist does not pretend to ignore that the patient is not the one asking; he uses it. He may receive the third party, work with him on his own position, or welcome the "identified patient" by asking him what others expect of him, and what would need to change for him to be left alone. The request, here, is not a prerequisite; it is an object of negotiation.

With children and adolescents, the work often passes through the parents. Not by default, but by principle: the child is caught in a system whose levers the adults hold. Modifying the parental response — firmness that becomes rigidity, protection that becomes smothering — may suffice to unblock the situation, without the child needing to be "treated" himself. This is an economy of means, but also an ethic: one does not pathologise a child when one can act on what surrounds him.

Finally, this therapy suits those who want something concrete, brief, and who accept working on the present rather than on origins. It does not suit everyone: acute psychotic disorders, severe depressive states with vital risk, heavy addictions or situations of violence require other, more intensive or more containing arrangements. The reader will find the detail of these limits in the section devoted to them; let us simply say here that brevity is not an economy of means when severity demands time.

What science says

The question of evidence, as regards the Palo Alto model, first runs up against a problem of method. The randomised trial, the gold standard of evidence-based medicine, requires a fixed protocol, a standardised duration and a single, measurable outcome measure. Yet brief systemic therapy, as practised by Fisch, Weakland and Watzlawick at the Brief Therapy Center, is a tailor-made intervention, adjusted session after session to the patient's own logic and relational context. Its duration, bounded at ten sessions, is a frame, not a therapeutic norm: one does not "treat" a nosographic entity there; one attempts to unblock a communication system that maintains the symptom. The success criterion, therefore, is not the disappearance of an isolated symptom, but a change in interactions, often imperceptible from the outside and difficult to quantify. This epistemological gap does not mean that the method is ineffective; it means that it lends itself poorly to classical experimental proof. One might compare this to a musical instrument: one does not evaluate a violin by measuring the number of notes played per minute.

That said, the model is not devoid of institutional recognition. The clearest, in France, is the 2010 recommendation of the Haute Autorité de Santé concerning anorexia nervosa in children and adolescents: the HAS recommends family therapies there, without specifying a particular school, but recognising their relevance in this precise indication. Rigour is required: this is not a general label granted to "systemic approaches" in all eating disorders, nor a validation of the Palo Alto model in particular. It is a targeted recognition, based on work in which family therapies, often of structural or strategic inspiration, show real clinical value. The body of randomised trials specifically on the MRI model, taken in isolation, remains thin, far thinner than that for cognitive-behavioural therapies. This observation is a fact, not a judgement.

The ensuing debate is classic. Proponents of the model argue that the absence of solid experimental evidence is the price of an approach that refuses to cut the patient into symptoms, and that effectiveness is demonstrated in clinical practice, case by case, through sometimes spectacular and rapid changes. They recall that the double bind, described by Bateson and his colleagues in 1956, opened a path of understanding of relational paradoxes that classical experimentation does not know how to capture. Critics, for their part, retort that the absence of solid evidence cannot be indefinitely compensated for by clinical narratives, however brilliant, and that the therapist's one-down position, symptom prescription or reframing, however elegant, sometimes belong more to art than to science. Between the two, a nuanced position is called for: this model has fertilised all of family therapy, has inspired the Milan school and solution-focused therapies, and its heuristic value is immense. But its empirical validation remains to be built, or to be rethought according to criteria adapted to its interactional nature.

Limits, controversies and precautions

Beyond its intellectual elegance, the Palo Alto model carries limits that it would be dishonest to conceal. The first concerns its field of action. Faced with an acute delusional state, melancholia with major suicidal risk, or severe intoxication requiring medical detoxification, symptom prescription becomes not only inoperative, but dangerous. The ten-session frame, designed for circumscribed complaints, comes up against clinical severity here. Brief systemic therapy is not an emergency medicine; it presupposes a subject capable of reflective distance, which acute psychosis or deep depression precisely forbid. To underestimate this would be to neglect the biological or traumatic dimension of these presentations, in favour of a purely communication-based reading. Yet a delusion is not merely a paradoxical message; a severe depression is not merely a failed attempt at control.

Paradox itself, the MRI's central tool, can become counterproductive. In a context of active domestic violence, prescribing the symptom would amount to validating the intolerable. The therapist's one-down position, so fruitful for defusing resistance, becomes here a form of silent complicity. Likewise, under non-consensual treatment orders, the paradoxical task is perceived as institutional manipulation, and destroys the alliance before it has even been built. Paradox presupposes a space of freedom; it collapses as soon as the patient feels trapped by the frame itself.

The question of training is equally crucial. The Palo Alto model seduces by its apparent simplicity, but its practice demands considerable clinical finesse. A poorly dosed reframing, a clumsy prescription, and the patient feels ridiculed, even abandoned. Training cannot be limited to learning techniques; it must include work on the therapist's position, his capacity to tolerate uncertainty, and a thorough knowledge of psychopathology. A therapist who cannot recognise severe depression behind a banal request will do more damage than a therapist ignorant of paradoxes.

Finally, consent. Prescribing an apparently absurd behaviour presupposes a solid alliance and honest explanation. The patient must understand, at least partially, the logic of the work, on pain of experiencing the prescription as mockery or manipulation. Ethics requires naming the frame, explaining that one is working on attempted solutions, and leaving the door open to refusal. Without this, paradox becomes an abuse of power disguised as technique.

The body of randomised trials on the Palo Alto model taken in isolation remains thin, far thinner than that for CBT. This does not discredit the approach, but imposes humility. The HAS recommends family therapies for anorexia nervosa in children and adolescents, without extending this indication. Brief systemic therapy is a valuable tool, but one tool among others, to be wielded with discernment, training and respect for the subject.

Palo Alto therapy around the world: institutes, training, transmission

The MRI of Palo Alto was not only a place of thought, but a veritable workshop of transmission. From the 1960s onwards, its renown attracted clinicians from around the world, who came to observe behind a one-way mirror real sessions, brief, surprisingly active. Dissemination operated less through books than through this immersion: one came to see, one left with questions, and one adapted. The model spread like a craftsman's practice, through apprenticeship, before becoming a corpus.

The European rise was early and vigorous. In Italy, the graft took with particular vigour. The Centro di Terapia Strategica in Arezzo, co-founded by Giorgio Nardone and Paul Watzlawick, extended the Palo Alto heritage by radicalising it towards a highly directive intervention strategy. In the French-speaking world, assimilation was slower, more critical, but real: child psychiatry teams, social welfare services, private practices progressively integrated the notions of reframing, symptom prescription, one-down position. The French language, with its dominant psychoanalytic tradition, first offered resistance, then effected a fruitful clinical translation, particularly in the field of child protection and family therapies.

The question of transmission remains central. A model learned through supervision and direct observation, more than through manuals, poses a singular challenge. One does not become a brief systemic therapist by reading Pragmatics of Human Communication; one becomes one by watching a seasoned therapist ask a strange question, by analysing the system's responses, by being oneself supervised in action. This craft-like requirement explains the rarity of genuinely trained practitioners, and the difficulty of evaluating the quality of their practice.

For there is no unified international certification for this model. Each school, each institute issues its own attestations, with variable criteria. For the patient seeking a practitioner, the implication is concrete: the title of "systemic therapist" does not guarantee specific competence in the brief Palo Alto approach. He or she will need to inquire about the practitioner's background, ask whether the practitioner has been trained in direct observation, in supervision, whether he or she works within a time-limited frame. This absence of a single label is both a weakness — it makes verification difficult — and a richness: it preserves the diversity of practices, their local anchoring, their creative vitality. The informed patient thus becomes an actor in his or her own search, and that is perhaps a final lesson of this model: the solution does not come from an authority, but from an exploration.

In brief — ten points

Brief systemic therapy was born in Palo Alto, California, out of the Bateson project on communication (1952-1962), which Don D. Jackson joined in 1954, and not from this anthropologist alone, who was never a clinician.
The founding article "Toward a Theory of Schizophrenia" (1956), signed by Bateson, Jackson, Haley and Weakland, introduced the concept of the double bind, a paradoxical injunction with no way out that would serve as the foundation of systemic thought.
The Mental Research Institute (MRI) was founded by Jackson in 1958, and it was there that Richard Fisch launched the Brief Therapy Center in 1967, with Weakland, Watzlawick and Bodin, for an intervention limited to ten sessions.
The MRI model does not seek to explore past causes but to interrupt the repeated attempted solutions that maintain the problem, focusing on present interactions.
Its characteristic tools are reframing, symptom prescription, paradoxical tasks and the therapist's one-down position, which avoids direct confrontation with the patient.
Circular questions, often wrongly attributed to Palo Alto, in fact belong to the Milan school, founded by Selvini Palazzoli, Boscolo, Cecchin and Prata, a sister school and not a descendant of the MRI.
The Palo Alto current spread to Milwaukee with de Shazer and Insoo Kim Berg, who extended its ideas towards exceptions and solution-focused therapy.
Jay Haley, a member of the initial project, documented Milton Erickson's approach in Uncommon Therapy (1973), linking strategic hypnosis to systemic thought.
The level of evidence of the Palo Alto model taken in isolation remains thin, far below that of CBT, even though the HAS recommends family therapies for anorexia nervosa in children and adolescents (2010).
Its limits lie in this restricted body of randomised trials and in an effectiveness documented above all in specific contexts, which invites caution before any therapeutic generalisation.

Brief systemic therapy on screen and in culture

The double bind has left the scholarly journals to become an expression of everyday language, on a par with the Oedipus complex or Stockholm syndrome. It is invoked to describe a paradoxical injunction at the office, in the family, in politics, often without knowing that it was born of Bateson's observations on animal play and schizophrenics. This popularity is a victory: the general public has absorbed the idea that certain situations are untenable by construction, and that suffering is not always a defect of character. But the price paid is a formidable impoverishment. The notion, become slogan, loses its clinical precision: contradiction and paradox are confused, one forgets that the double bind requires a durable relationship, a negative injunction, a threat of punishment, and the impossibility of commenting on the trap. The shortcut flourishes, the rigour evaporates.

Likewise, the adage "the problem is the solution" has spread into self-help, where it often serves to justify a form of tranquil cynicism: if your attempts at control worsen your anxiety, stop struggling, accept, let go. The formula, detached from its systemic frame, becomes an injunction to renunciation, whereas in Watzlawick it designated a precise observation: repeated attempted solutions, because they rely on the same logic as the problem, reinforce it. The impoverishment lies in this: one retains the maxim, one forgets the method, the therapist's one-down position, reframing, symptom prescription.

Fiction, for its part, loves the therapist who prescribes the absurd. The character who asks his patient to carry on suffering, or to worsen his symptom, fascinates because he embodies a paradoxical, almost magical authority. Yet the clinical reality of the MRI is more modest: symptom prescription is a fine, demanding tool, resting on a solid alliance and meticulous observation of the patient's attempted solutions. The gap between the spectacular scene and real practice is immense. This popularity wins the model renown, a cultural recognition; it costs it its scientific credibility, for it is reduced to a conjuring trick. The Palo Alto model, already fragile on the evidence front, thus finds itself doubly betrayed: by the popularisation that simplifies it, and by the fascination that folklorises it.

Brief systemic therapy from Palo Alto and new technologies

Teleconsultation, first. The brief format of the Palo Alto model, with its constraint of ten sessions, accommodates distance remarkably well. Brevity imposes a rhythm, an economy of means that survives the screen. Nothing essential is lost: the rigour of the intervention, the precision of the prescriptions. The frame, to be sure, is transformed — but it remains. An adolescent who refuses to come in person will sometimes agree to speak from his bedroom, precisely where the conflict is playing out. Geographical distance then becomes a strategic ally: it lowers defences, allows a form of speech that face-to-face contact would inhibit.

Tracking applications, next. They extend the therapist’s work between sessions, particularly for observing attempted solutions. The patient notes, day after day, what he tries in order to solve his problem — and what these attempts produce. This digital diary makes the vicious circle objective: one sees inscribed, in black and white, the repetition of the same gestures and the constancy of the same failures. The tool does not replace the clinical conversation, but it feeds it with concrete, factual material that memory would distort.

Virtual reality, finally, finds its place in strategic protocols: it allows the patient to be progressively exposed to anxiety-provoking situations, with fine control over the degree of difficulty. Immersion then serves the prescription, making it more manageable, more easily dosed.

But the digital is also a problem. Screens today crystallise a considerable share of family conflicts. The repeated prohibition — “switch it off, that’s that” — constitutes the typical attempted solution that sustains the conflict: the more one cuts off, the more the adolescent clings, the more tension rises, the more one cuts off. The systemic therapist recognises a classic loop here and proposes something else: reframing usage, negotiating time slots, sometimes prescribing the symptom by inviting the family to observe precisely what happens in front of the screen. Digital tools are adjuncts, never a substitute for the therapist. They serve the frame; they do not replace it.

Brief systemic therapy from Palo Alto in the face of crises and disasters

Brief systemic therapy from the Mental Research Institute (MRI) in Palo Alto was not designed for situations of war, earthquake or mass displacement. Yet its central logic – it is not the difficulties themselves that create the problem, but the repeated attempted solutions that sustain it – resonates strikingly in contexts where urgency and scarcity push people towards mechanical, often counterproductive, responses.

Consider a specific humanitarian context: the 2010 earthquake in Haiti. The scenario that follows is a reasoned illustration, not a documented observation. In the weeks following a disaster of this magnitude, parents confronted with the collapse of their home and the loss of familiar bearings may multiply injunctions of calm and silence towards their children. This attempted solution – restoring order through control – produces the opposite effect: children, deprived of words to express their fear, develop sleep disorders, mutism or explosive outbursts of anger. The problem is not the earthquake, but the rigid response that locks down emotional expression. A clinician trained in Palo Alto would here have proposed a reframing: “Your child needs you to show them that fear is shared, not hidden.” The symptom prescription – allowing the child to cry at a set time – might have unblocked the situation.

The value of this approach in large-scale crisis contexts is threefold. First, it is brief: the framework of the Brief Therapy Center in Palo Alto, limited to ten sessions, adapts to the scarce resources of refugee camps or field hospitals. Second, it is pragmatic: it does not seek to heal deep trauma, but to interrupt a vicious circle observable in the present interaction. Third, it empowers local actors: a parent, a teacher, a community leader can learn to spot an attempted solution that worsens the problem, without depending on an expert.

But the limitations are real. In large-scale settings, the Palo Alto model presupposes a minimum of relational stability – a family, a couple, a carer–patient dyad. Yet in a camp where ties are broken, where people change tents every week, building a therapeutic alliance over ten sessions is a luxury. Moreover, reframing and symptom prescription require a clinical subtlety that untrained workers master poorly. Applied mechanically, these tools can be experienced as manipulation, even as an insult, in cultures where hierarchy and reserve impose other codes.

Finally, the level of evidence remains modest. The solid data on systemic therapies concern above all adolescent anorexia nervosa or family difficulties in the consulting room. No large-scale randomised trial has validated the Palo Alto model in a Syrian refugee camp or after a tsunami. Honesty requires saying so: brief systemic therapy offers an elegant toolbox, but it does not replace frontline services or approaches validated by large-scale field studies.

In the spotlight — two practitioners

Giorgio Nardone & Emanuela Muriana (Italy)

There are lineages that are passed down less through genes than through training rooms and annotated manuscripts. Brief systemic therapy, born in Palo Alto in the 1950s, has spread far beyond California; Italy, a natural home for strategic thought, has been one of its most fertile soils. Two contemporary figures illustrate this direct descent, each in their own way: one by extending Watzlawick's work with a conductor's rigour, the other by drawing from the very source of the Mental Research Institute.

Giorgio Nardone, psychologist and psychotherapist, co-founded with Paul Watzlawick the Centro di Terapia Strategica in Arezzo, Tuscany, whose school of specialisation in brief strategic psychotherapy he directs. His work focuses mainly on phobic and obsessive disorders, for which he has developed protocols of remarkably precise structure, designed for a limited number of sessions — an acknowledged inheritance from the ten-session framework of the Brief Therapy Center. His bibliography, more than forty works translated into over ten languages, testifies to a constant determination to make clinical practice legible and transmissible. To enter his œuvre, one might begin with The Art of Change (written with Watzlawick), Riding One's Own Tiger, Strategic Dialogue, Psychosolutions, or The Therapy of Panic Attacks (2016). One conviction stands out from him: change is not achieved through understanding causes, but through the active modification of the attempted solutions that maintain the problem.

Emanuela Muriana, psychologist-psychotherapist, presents a career path of rare coherence: she trained in brief strategic psychotherapy at the Mental Research Institute in Palo Alto itself, then at the Centro di Terapia Strategica in Arezzo directed by Nardone. A direct filiation, then, with the original home of the model — a detail that is by no means anecdotal, for it guarantees first-hand transmission of the founding insights. She has practised in Florence since 1990 and has taught brief strategic psychotherapy technique at the specialisation schools of Arezzo and Florence since 1994. Her works are well worth seeking out: The Faces of Depression (with Laura Pettenò and Tiziana Verbitz, Ponte alle Grazie, 2006) and Psychopathology of Love Life (with Tiziana Verbitz, Ponte alle Grazie, 2010) show how the strategic approach knows how to take hold of the great plains of ordinary suffering — melancholy, the end of love — without ever losing its surgical precision.

Two practitioners, one source. One has built a school, the other crossed the ocean to bring back the method. The curious reader now knows where to find them and what to read of theirs.

Box — Palo Alto therapy in French-speaking Africa

In regions where the provision of psychological care is patchy, the Palo Alto model has immediate practical appeal. Its contractual format of ten sessions avoids the pitfall of open-ended follow-up, which is often impossible to guarantee for lack of staff. It requires no specific equipment – no grid, no standardised questionnaire – and can be deployed in a general practice surgery, provided the practitioner is willing to shift their gaze from the individual symptom to the interaction that sustains it. This relational reading of distress, which does not pathologise the person but examines the unsuccessful attempted solutions, chimes with familiar representations in many cultures where suffering is from the outset situated within the family or community network. The central condition for dissemination remains the training of trainers: without local multipliers able to adapt clinical examples and formulations to cultural contexts, the model risks remaining a bookish import, ineffective in the field. The bet is on a lightweight conceptual toolbox, whose effectiveness rests less on technicality than on the rigour of circular causality.

An emerging therapy — narrative practices

Narrative therapy, developed in the 1980s by Michael White (Dulwich Centre, Adelaide) and David Epston (Auckland, New Zealand), shares with the Palo Alto school a radical rejection of the intrapsychic. Where the MRI interrogates the attempted solutions that freeze a problem, narrative therapy takes on the dominant story that confines it. Its best-known move is externalisation: “the problem is the problem, the person is not the problem.” A child labelled as defiant is no longer a defiant child; he is fighting against a force named “Anger” or “the No-Trap”. The question is no longer “why are you angry?” but “how has Anger pushed you to act?”. This shift of blame towards an external entity defuses shame and opens up a space for action.

The difference from Palo Alto lies in the material worked on. The MRI intervenes on present interactions, on behavioural loops. Narrative therapy digs into the life story, the account the person gives of themselves and which their culture has validated. White and Epston invite people to identify “unique outcomes” — those moments when the person acted in contradiction with the problem — and then to link them together to write a counter-story. Outside witnesses, often other patients or members of the community, are invited to recognise and celebrate this new version of the self. This device, which makes the collective a co-author, explains the remarkable spread of narrative therapy in southern Africa and Latin America, in contexts where healing passes through the group and shared speech.

Brief systemic therapy from Palo Alto and its offshoot therapies

Solution-focused brief therapy, developed by Steve de Shazer and Insoo Kim Berg at the Brief Family Therapy Center in Milwaukee in the late 1970s, is a direct heir of Palo Alto, yet it makes a decisive shift. Where the MRI focused on dysfunctional attempted solutions, de Shazer and Berg turn their gaze towards exceptions: the moments when the problem does not occur. Their emblematic tool, the miracle question (“If a miracle happened tonight and your problem disappeared, what would be different tomorrow?”), invites the patient to construct a concrete description of a future without the complaint. The emphasis is no longer on what maintains the problem, but on what might already have partially resolved it.

Strategic therapy, for its part, follows another branch. Jay Haley, who had documented Milton Erickson’s approach in Uncommon Therapy (1973), developed an interventionist model in which the therapist devises precise strategies to interrupt problematic sequences. Giorgio Nardone, co-founder with Watzlawick of the Centro di Terapia Strategica in Arezzo, extended this logic by systematising it, notably in The Art of Change, co-written with Watzlawick (1990). Here, symptom prescription and reframing remain central, but the intervention is more directive and protocol-driven.

These approaches must be distinguished from their systemic siblings, which are not offshoots of Palo Alto. The Milan school (Selvini Palazzoli, Boscolo, Cecchin, Prata) developed the counter-paradox and circular questioning within a family setting. Salvador Minuchin elaborated structural therapy, centred on family boundaries and hierarchies. Narrative practices (Michael White, David Epston) work on the re-creation of identity narratives. All share a systemic framework — the problem lies not in the individual but in the interactions — yet their tools and underlying assumptions differ profoundly. “Systemic” is not a school: it is a way of seeing.

For further reading

The cultivated non-specialist reader will find a rigorous introduction in the founding work of Paul Watzlawick, John Weakland and Richard Fisch, Change: Principles of Problem Formation and Problem Resolution (Norton, 1974; French translation Seuil, 1975). This text sets out the distinction between first-order change and second-order change, and illustrates through concrete cases how "attempted solutions" can lock a problem in place. Even more operational is The Tactics of Change by Fisch, Weakland and Segal (Jossey-Bass, 1982; French translation Seuil, 1986), which details the ten-session protocol of the Brief Therapy Center.

For a critical perspective, the LogiMind Handbook of Psychotherapies (DOI 10.5281/zenodo.21385807) devotes a chapter to brief systemic therapy, situating its contributions and its limits. It recalls in particular that the corpus of randomised trials on this model is thin, unlike that for CBT, and that the solid data concern above all family therapies in specific indications (adolescent anorexia nervosa). An honest reading, then, one that avoids all triumphalism.

The words of LogiMind

This Month's Glossary

Attempted solution — what those around the person and the person themselves do to solve the problem, and which, repeated, keeps it going.
Reframing — offering another frame for reading a situation, without changing the facts, in order to alter its meaning.
Second-order change — a change in the rules of the system itself, whereas first-order change merely shifts the problem within the same rules.
Symptom prescription — deliberately asking for what one is seeking to stop, in order to break the circle of attempted solutions.

This Month's Neologisms

Each month, the review presents three neologisms drawn from the LogiMind Dictionary of 395 Therapeutic Neologisms (Édouard Alain de Boysson, LogiMind — ISBN 9798285281467, also deposited on HAL). This month's selection, echoing the Palo Alto therapy:

Divergent syntony — the inability to attune one's emotions and thoughts to those of others despite clear intentions: the misunderstanding that repeats itself.
Autodissensus — a lasting internal disagreement between two logics of the self, reinforced by attempted resolutions.
Thymotraction — the manipulation of one's own emotions to avoid a difficulty, often at the cost of making it worse.

Colophon

LogiMind Review of Psychotherapies — Vol. 1, No. 3 (November 2026). Director of publication: Édouard Alain de Boysson. Publisher: LogiMind (registered trademark). Contact: contact@logimind.org. Open access under Creative Commons licence CC BY 4.0. ISSN: pending attribution (BnF). DOI: 10.5281/zenodo.21719267.

How to cite this issue

@article{boysson2026revue_paloalto,
  author  = {de Boysson, Édouard Alain},
  title   = {La thérapie brève systémique de Palo Alto},
  journal = {Revue LogiMind des psychothérapies},
  volume  = {1}, number = {3}, year = {2026},
  doi     = {10.5281/zenodo.21719267}, issn = {en attente}, url = {https://doi.org/10.5281/zenodo.21719267}
}