Jennifer, your throw down reminds me a lot of some of the principles of Systemic Belief Therapy (SBT). Wendy Watson was my dissertation chair at BYU and my project involved implementing the therapy model that she developed (along with Lorraine Wright) with families with diabetes. One of the key principles in SBT is that human systems are "structurally determined". This idea comes from the Chilean biologist, Humberto Maturana. In an article, they describe how organisms and organizations become structurally determined:
"It is the individual's structure and history of interactions that determines change in his/her state or a change in his/her behaviour. It is not (clinicians) that determine or direct change. Change or learning occurs in humans from moment to moment, either as a change triggered by interaction(s) or 'perturbations' coming from the environment in which it exists or as a result of its own internal dynamics. It is the history and structure of the living system that determines which perturbations can trigger changes of state."
A metaphor they often use is of an old, comfortable shoe. At one point, every old shoe was actually a new shoe. In order to not be rejected by a foot, a new shoe needs to be a reasonably good fit for the foot-it can't be too large and floppy or too small and pinchy. If the foot accepts the shoe, they enter a relationship in which the foot will slowly cause changes in the shoe and the shoe will slow provoke changes in the foot. Overtime these "mutual perturbations" lead to a happy foot and a shoe that has filled the full measure of its existence.
This metaphor can easily be expanded to describe a behavioral counselor entering an existing medical system. As the medical system has been around for years, it is always the foot and the counselor is always the shoe. The system has clear rules and preferences that could easily reject the counselor if the change required by the counselor is too much for foot to desire. However, if the counselor comes in offering services and a communication style that fit well within the system and meet needs the system didn't even know it had, then the system will embrace the counselor. Over time, the counselor will then be able to create positive perturbations with the foot.
And finally, leaping to an entirely different metaphor, in the movie "Avatar", the Na'vi people fly around on large mammalian reptiles called "Ikran" or "Flying Banshees" (more here). The hero of the movie is taken to an Ikran rookery that exists high on a floating mountain. Once there, he asks how he will know which of the enormous fang-wielding beasts is destined for him. He is informed that he will know "because it will try to kill you". This proves to be true, but through sheer force of strength and domination, the hero is able to "break" the Ikran and eventually they are able to become an unconquerable fighting duo. I bring up this metaphor because it is monstrosity for a counselor entering an existing medical system. Remember, you are the expendable shoe, and they are the foot. Yes, the system may try to kill you, but you are NOT the blue cowboy forcing your manly will on the Flying Banshee.
