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This timely, ambitious and important book invites the reader to reconsider the philosophical constraints shaping much contemporary individual and family therapeutic practice. The author's central argument foregrounds critical realism, which he suggests (illustrating it with an Indian parable and poem about blind men's perceptions of an elephant) is a coherent philosophy of science which both expands the capacity of the therapist to become much more aware of the multidimensional, multi-layered and causally disparate nature of the therapeutic encounter and points to the value of a systemic understanding of human difficulties.
In the author's view, individual and family therapies have become progressively narrowed by an over-reliance on positivist assumptions, and that not enough attention is paid to the ways in which our ability to think about our theoretical standpoints is curtailed both by our culture and our institutions, limiting a wider systemic appreciation of ideas and systems of understanding. The author suggests that in the absence of critical reflection on theoretical assumptions, the inclusion and exclusion of ideas by training institutions can be based as much on ideology and tribalism as on clinical value. Institutional inattention to the multiple causal powers operating systemically in the outer world and the bodies of individuals poses questions around the dangers of psychological colonisation and ethical clinical practice. Against this backdrop, the book advocates for a critical realist framework as a way of reclaiming
depth, complexity and ethical seriousness in clinical thinking. For psychoanalytic psychotherapists, this is a deeply familiar concern, yet one that benefits from being articulated within a coherent philosophical structure capable of speaking to wider debates in the psychotherapy field. A strength of the book lies in its clear exposition of critical realism not as abstract philosophy, but as a way of thinking clinically. Drawing on Roy