Department of Family Therapy Dissertations and Applied Clinical Projects

Date of Award


Document Type


Degree Name

Doctor of Philosophy in Family Therapy


College of Arts, Humanities and Social Sciences – Department of Family Therapy


Douglas Flemons

Committee Member

Shelley Green

Committee Member

Kara Erolin


Over the last 40 years, the Canadian psychiatrist and family therapist Karl Tomm has been a key contributor to postmodern developments in family therapy (Collins & Tomm, 2009; Strong et al., 2008; Tomm, Hoyt, & Madigan, 2001). This dissertation traces the people, ideas, and practices that have influenced Tomm's approach, providing an in- depth examination of the method he developed for putting his ideas into practice: Internalized Other Interviewing (IOI). A systemic, relational approach to the practice of postmodern family therapy uses language as a means to create change. Family therapists routinely use different types of questions to ask clients about other people in their lives. Direct, information-seeking questions privilege objectivity, whereas interpersonal perception questions privilege subjective assumptions and allow for new possibilities to arise. The IOI approach offers a third way to ask questions that "privilege subject-dependent assumptions and embodied knowledge" (K. Tomm, personal communication, August 15, 2019). By inviting clients to speak from their experience of the other, therapists gain entry to a broader base of knowledge.Grounded in social constructionism and bringforthism (Strong et al., 2008; Tomm, 1999, 2002, 2014b), IOI has remained relatively unrecognized and underutilized in clinical work. To date, the theoretical underpinnings and historical development of IOI have not been thoroughly delineated. This dissertation provides the necessary background information and detailed examples for therapists to put the practice in context.Archival information about case examples collected during and following the author's externship at the Calgary Family Therapy Centre in August 2019 have been interwoven throughout the manuscript. These case descriptions, along with Karl Tomm's reflective thoughts, are used to illustrate and illuminate the theory and practice of IOI, bringing to life Tomm's inimitable way of working systemically with individuals, couples, and families.