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ive LeadingTherapists Reveal Their

M

y HALEY& LYNN HOFFMAN

OKS

TB 5013

Techniques of Family Therapy

Techniques of Family

Therapy JAY HALEY and

LYNN HOFFMAN

Basic Books, Inc., Publishers

NEW YORK

© 7967 by Basic Books, Inc. Library of Congress Catalog Card Number: 67-11204

SBN 465-09512-7 Manufactured 85

86,

87 88 89 90

United States of America 20 19 18 17 16 15 14 13 12

in the

Introduction

In both form and content this book

is

designed to capture the excite-

ment of family therapy for people who have not yet set out upon this adventure and for others who have begun to perform therapy with families and seek experienced guides. Family therapy has existed as a distinct type of treatment for

developed about

literature has

for

and a considerable Yet the subject poses special problems

about it.

fifteen years

anyone who wishes to describe what happens

book by a

in family therapy.

particular therapist or his group tends to be parochial;

A

it is

confined to one method and does not express the variety of approaches to family treatment

which have emerged. Yet no one has

knowledge of the many family-therapy approaches to

sufficient

offer a concise

work which summarizes both practice and theory. Even defining family therapy and distinguishing it from other therapeutic approaches can be

difficult.

Some

family therapists regularly interview whole families

together, but other family therapists will focus

on

parts of families or

even work regularly with only one family member to bring about a

change in the entire family. Because of the variety of ways families are treated,

ment;

one cannot

it is

call

new way

a

family therapy simply a

new method

of treat-

of conceptualizing the cause and cure of psychi-

atric

problems. Family therapists are distinct as a group largely because

of a

common

which he

assumption:

lives

person, even

if

if

the individual

is

to change, the context in

must change. The unit of treatment only a single person

tionships in

which the person

come what

is,

is

is

interviewed;

is

it is

no longer the the set of rela-

imbedded. Out of family therapy has

perhaps, one of the major questions of this century:

Introduction

whether deviant and violent behavior by individuals

is

[

vi

adaptive to the

intimate social systems in which they currently live.

At

this

time in this rapidly emerging

field,

family therapy

is

best

number of family therapists are doing. To learn what it is they do, one must watch them at work and inquire about their actions. This book was designed to offer the reader an approximation defined as what a

of the experience of talking with skillful family therapists about their

work.

The form

of this

book

unusual;

is

it is

a series of conversations

with family therapists about specific family-therapy interviews. content of the

human family,

work deals with several mysteries: what happens in the what happens among the intimates of social deviants and

psychiatric patients, to

The

and how a

skillful therapist intervenes in

a family

produce a change.

The form

of presentation here

who

need. Psychotherapists retical discussions

was designed

to

meet a

special

write about treatment tend to offer theo-

which can be

far

removed from what

actually occurs

Yet an observer who merely watches a therapist at work and writes about what he sees can misunderstand what is happening. The conversational form offered here provides a compromise between in therapy.

The

those extremes. offers his

own

therapist describes

what he does and the observer

views within the framework of a discussion about the

actual operations in the therapeutic interview.

Five experienced family therapists were asked to cooperate in this

endeavor. Each was chosen because he had a style of working with

families

which was

sufficiently distinctive to

of the therapists have

exception

is

worked with

be a method in

families for

many

Four The one

itself.

years.

a therapeutic team which has begun to practice family

therapy relatively recently but

is

both

skillful

and

offers

an original

approach.

The selection of these particular family therapists is not meant in any way to be a reflection upon the many other family therapists who are making their contributions to the field. Concerns about availability, time, geography, and the space limitations of this work have made the

Many other family therapists who are equally and who have unique styles of their own would

selection rather arbitrary.

experienced and

skillful

have been appropriate for

this

type of presentation.

All of the family therapists were asked to choose an initial inter-

Introduction

view with a family which they to family treatment.

knew

therapist it

had

to

that

The it

felt

represented their usual approach

had

interview

would be used

be tape-recorded.

vii

[

to

have taken place before the

and

for this type of exploration,

A further requirement was that this must not

be an isolated demonstration or diagnostic interview, but an interview with a family which the therapist planned to continue with in treatment.

The

final

outcome of the treatment was not considered

in the selection

was upon how a therapist starts off family treatment. In two cases, there had been a preliminary contact with the family prior to the interview which is presented. In one case the initial of an interview; the focus

interview proved to be the only interview, at least to date, since the

family did not continue. These exceptions are discussed in the text.

When a therapist had several initial interviews which might be able,

an attempt was made to choose one which would give more variety

to the total collection. Different types of

problems as well as "patients"

of varying sex and age were sought. Part of the value of this that

suit-

it

offers

verbatim transcripts of the conversations of

types of families.

The

work

is

five contrasting

transcripts are as accurate as possible, with only

necessary changes to protect the anonymity of the families. These five family interviews are set apart in the text so that the reader can ex-

amine them separately from the conversation about them. The verbal transcript can, of course, only suggest the complexity of the interchange

between the family members as they talk with the

communication of the participants

is

When down with

an

is

initial

rich

enough

interview

is

said

The body

and so

necessarily omitted

range of vocal intonations which qualify whatever the verbal exchange

therapist.

is

the

and done. Yet

to offer a portrait of the family.

had been

selected,

the authors sat

the therapist and played the tape recording of the family

treatment session.

As

they listened, they talked to the therapist about

the family and probed into

why he

did what he did step by step through-

out the interview. This conversation was also recorded.

Many

discussion were reduced to the conversation published here.

hours of

The

thera-

were each given the opportunity to review the draft and change or edit what they said so that the final product would express fairly their pists

approaches to family therapy. The

what

is

pre-

should be emphasized that the family-therapy interview

is

pre-

final responsibility for

sented resides, however, with the authors. It

sented verbatim, but the conversation with the therapist about that

Introduction

interview

is

a creation put together

viii

[

from a vast amount of recorded

conversation.

own

All the family therapists were interviewed in their

where they could be manner, with

little

at ease.

The

interviews were conducted in a free

attempt to cover systematically scheduled points of

information. However,

many comparative

questions were asked to bring

how many

out the variety of points of view on such matters as

members

to

offices,

have in the room,

how

to handle secrecy,

family

whether sex

should be discussed in front of children, whether to take a history, and so on.

What was sought

in these interviews

was not a

collection of facts

obtained on an interview schedule. Instead, the intention was to lure out of a therapist his ways of thinking about his operations, and to

let

ideas develop which might not have been previously considered

by

either therapist or interviewers.

Because of

this

approach, there was

an excitement and an uncertainty about the inquiry as

which was

felt to

it

proceeded

be as integral a value as any information which could

be brought out. This type of interview, when successful, makes that

which was previously only implicit

at a level

which

is

often hidden

in a therapist's

when one

takes a

rational route. In this sense, these interviews can art

form than

work.

more

explicit It gets

direct

and

be seen more as an

as a scientific endeavor, just as therapy itself

can be con-

more art than science. The organizing factor in each conversation was the particular therapy interview being discussed. The tape recording of the interview has somewhat the same usefulness as a script for a play when one is

sidered

The interview memory, a base

trying to talk about the entire theatrical production.

became a reference point

camp

for forays into

for refreshing the therapist's

unmapped

territory,

and a concrete focus for

bringing the conversation back to earth.

Two

interviewers talked with the therapist, but in the text they

have been reduced to a single interviewer. Although

this "interviewer"

was felt that the reading would be simplified if the dialogue was between one interviewer and a therapist. Similarly, when a therapeutic team was interviewed, many of the statements of the group were put in the mouth of a single spokesman. One of the interviewers was experienced in family therapy, while the other was new to the field. This arrangement was essential to cover at times speaks in different styles,

it

Introduction

[

ix

questions of interest to practicing family therapists as well as other points which might be raised

In addition, to

by readers inexperienced

when experienced family

in family

work.

therapists talk together, they tend

many points unexpressed becommon view when indeed they may

speak a jargon of their own, leaving

cause they believe they share a not.

Such a

collusion, as well as

moments

broken up when a participant who has

of spurious debate, can be

background

less

in psychiatry

more explicit statements of issues. The views of these therapists about their work are, necessarily, only partially presented in this work. Each therapist must express his general style of family therapy when talking about a single opening

requires

interview for a relatively short period of time. also influenced

by

he

is

is

is

talking. It

his particular

mood and

What

the therapist says

the context within which

what the therapist

possible to argue that

a set of rationalizations, or explanations after the

offers here

fact, rather

the "real" reasons for his behavior with a particular family.

would he prefer

is

than

Not only

show his work in the best light, but many of these had taken place some time earlier and he could not

to

therapy sessions

be expected to recall precisely why he said one thing to a family rather than something

However,

else.

doubtful whether one can ever really

it is

someone does what he does, and necessarily disclose the "truth." therapist's beliefs are

what

to ask

him

From such

about his work.

know why

for his reasons does not

queries

If these

we

learn

what a

be rationalizations, that

what he teaches others and becomes the foundation of a therapeutic method. This book makes an effort to get beyond the rationale, but by using a dialectical apis

all clinical

writing

is.

This rationale

proach, not by offering an interpretation of

is

its

own. The conversations

what the therapist brought, what the interviewers brought, and what was contained in the interview material. This not are a product of

only has the advantage of a multiple view, but

freedom to make

his

own

it

gives the reader the

interpretations of the interview

or reject the various explanations with which he

is

and

to accept

presented.

Hopefully, the transcript of the interview provides the reader with

an approximation of the experience of joining a family in a treatment session. Therapists

who have not

observed them do not understand

Only by observing a deviant

down with whole families and new view of psychopathology.

yet sat this

individual, such as the schizophrenic, in

Introduction

[

x

conversation with his intimates can one discover that his strange and bizarre behavior It is like

is

meaningful and adaptive to his natural

seeing a fish in the water for the

viously only seen

him stranded on

first

time

setting.

when one has

pre-

the shore, gasping, and trying to

fly

with inadequate finlike wings.

The authors wish

to express their indebtedness to the therapists

who cooperated in this venture. Particular gratitude is expressed families who allowed this presentation of their experience.

to the

JAY HALEY

LYNN HOFFMAN August 1967

Contents

Introduction

1

2

3

No

v

[

Man's Land

3

[

An

interview with Charles R. Fulweiler

A

Family of Angels

An

interview with Virginia Satir

The Eternal Triangle An

interview with

Don

An

174

[

D. Jackson

4 The Growing Edge An interview with Carl A 5 Cleaning House

97

[

[

265

Whitaker

.

[

36

interview with Frank Pittman

III,

Kalman Flomenhaft, and Carol DeYoung

Bibliography

[

473

AUTHORS' NOTE The

tape recordings of the family interviews included in this

book have been

transcribed as accurately as possible and are presented in their entirety, with

only names changed and places omitted.

Techniques of Family Therapy

1]

No An

Man's Land

interview with Charles R. Fulweiler, Ph.D.

Int.

How did you come to see the Kane family?

:

The thirteen-year-old son, Mike, had broken into a store and had stolen some cigarettes and some loose change that was lying around. He was arrested, and since the investigating probation officer felt that this was a neurotic delinquent act and suspected some family Dr. F.

:

involvement, he referred the family to me.

was working with the

I

Guidance Clinic of the Alameda County Probation Department

at the

time.

Int.

Had the boy been in trouble before?

:

Dr. F.

:

Never. This was a bolt out of the blue. The only hints the

family had of anything that might have led up to this were the boy's rebelliousness about

had

smoking and

his general evasiveness at

home.

He

been cited a couple of times for truancy.

also

What was the family like?

Int.

:

Dr.

F.:

It

was a run-of-the-mill lower-middle-class

family.

The

parents were in their late thirties and they had a younger daughter,

though

I

never saw her in therapy. These were the sort of naive,

churchgoing people

who

are convinced that they are living a

and doing good works. The father had worked ant for a finance company.

He was made

for a rut

bad guy, but there was nothing about him free.

The mother had more

for years as

that

to her; she could

good

life

an account-

and he found

it.

Not

a

was spontaneous and

have come out of a soap

Charles R. Fulweiler, Ph.D., is Consultant in Family-Centered Psychotherapy at the Department of Psychology, University of California at Berkeley, and is also in private practice.

TECHNIQUES OF FAMILY THERAPY opera. She

had a

lot of

unexpressed flamboyance, hints of black-lace

underwear and sheer nightgowns, which didn't that.

He was

[4

with a husband like

fit

about as romantic as mashed potatoes. This couple's idea

of a big evening

was

to

go with the children to a restaurant in the

suburb where they lived and have the blue-plate special. Int.

:

Dr. F.

What was

the

boy

like?

Not a delinquent type

:

at

all.

He was

a good student, took

pride in himself, tried very hard to convey the appearance of being a

good boy, was line, really,

Int.

:

polite to his elders,

except

and so on.

He

never stepped out of

when he committed the burglary.

Had you

seen the family or spoken to them before this ses-

sion?

Dr. F.

:

No. All they knew was that they were going to come into

therapy with me. They had no idea of what family therapy was, but since the probation officer urged

it,

they were very anxious to comply.

The fact that the boy was to have therapy influenced the court to put him on probation rather than sending him to a correctional institution. Int.: So they were, in a sense, coming in under duress. Did this make them more resistant to the idea of therapy? Dr. F.: No, not these people. I've had families who literally had to be ordered into therapy by the judge. They come in with a politeness that is overwhelming, but they block and resist in every way they know how. This family was different. They weren't used to the idea of anybody in their family being in jail, and they were ready to do anything to reinstate themselves in the eyes of the community and prove themselves good, proper people. They were falling all over themselves to cooperate with me. Int.

:

I

noticed that this tape was divided into two sessions, one

short one where later

you introduce your method

one where actual therapy begins.

Dr. F.: No.

I

therapy right away.

usually I

tell

Is this routine for

people about

had some

wouldn't have broken off here.

to the family, and another

tests I

you?

my method

wanted them to

and go into take, or I

No

Kane

Introductory interview with the dr. F.

Man's Land

[

5

family

{referring to tests the family

members have

just taken)

Awful,

:

aren't they?

Mrs.

Horrible. (Laughs.)

K.:

somehow have guilt feelings (Mr. and Mrs. K. laugh) about giving these. Has Mr. Williams [the tester] explained to you what

dr. f.: I

the purpose of the testing is?

MR.

Ah,

K.:

He

to a certain extent, yes.

didn't go into

it

any

in any,

great detail.

dr. f.

Well, a major reason for this

:

into the, ah, nature

MR.

k.

...

and functioning of

what I'm doing.

that's

this point

engaged on a research

this family.

part of

It's

I'm taking only cases where

tion as well as the therapy

mr.

that I'm

.

.

.

Mmm, yeah, yeah.

:

dr. f.:

mrs.

is

itself.

.

.

my work

and

at

I,

can have a research func-

I

.

Mmm. Mmm.

k. k.:

work with me at all, but they are of great value to me, and I will ask you to, at the conclusion when we're through, to wind up by taking the same series

dr. f.

...

:

so the tests don't influence your

again, as

MRS. Int.

k.:

:

Ph.D.

(Laughs.)

What were

Dr. F.

my

bad as that sounds.

:

these tests for?

They were

part of the research I

was doing

But there was another

By

being friendly with the

tests in this

way.

family and empathizing with their problems in the to establish the fact that

my

role as

matically superior as a person. relationship, a relationship in

do so. appropriate, but when

contribution, I

Whenever

I

on

not "I

You

start

was

my

me

trying

auto-

can underline a symmetrical

which each party

I insist

tests, I

an authority didn't make

role as

is

valued for his unique

an authority where

it's

the father or mother or child has a richer ex-

perience or authority than I have, I don't hesitate to :

time for

thesis. I don't ordinarily test people.

reason for bringing up the

Int.

at the

out here by implying,

"You

sit

at his feet.

are going to help me,"

am going to help you."

Dr.

F.:

That's right.

that although they are

I

put us on an equal plane by pointing out

coming

to see

me

something important they can do for me too.

as a professional, there

is

TECHNIQUES OF FAMILY THERAPY

[

6

must surprise them, when you consider that they're in there because their kid has done something wrong and the law is involved and you're part of all that. But it's probably more necessary in Int.:

that

It

framework than Dr.

can't

F.:

work

might be otherwise.

it

Yes, although there are some frameworks where you

this

way, where you must establish your hierarchical superi-

There are people who won't respond to therapy

ority right off.

other context, very authoritarian people like Nazis

them



But these are only a small minority. Int. In other words, you adapt your approach

work with the particular patient. Dr. F. Yes. A problem, I've found, :

any therapy that

isn't

be in analysis

only they could afford

clear

worked with

too.

:

will

I've

any

in

if

from the

is

that

psychoanalytic therapy

start that

it.

is

to

what you think

many people

feel that

second best and they'd

That's partly

why

I

make

it

I'm not going to act like a classical analyst; I'm

going to enter into therapy in a direct, personal way.

By

Int.:

presenting family therapy as something very different,

you prevent possible objections along Dr. F.: That's right.

Does

Int.:

it

make

that line.

a difference for you

knowledge of psychotherapy

if

the family has

no

at all?

much

work with a naive family like this one than, say, a psychiatrist and his family. They can be the most dreadful patients that ever came down the trail, and the most resistant. Dr.

F.:

Yes. I'd

dr. f.: Ah,

it

isn't that

rather

bad

really.

There's one more

take today, which will take you just a few a hard one to take. But, ah, as

I say,

test for

more minutes.

you to It's

these don't influence

not

what

goes on here.

Dr. F. ally a

:

weird

Now

this last

test to take.

one was the Semantic Differential Test,

You had

to

rank

all

re-

these concepts as to

whether they were hot or cold, weak or strong. Mother, for example,

was she hot or cold? some of these things.

I didn't I

was being

spot, so they couldn't just take

Int.

knew

the

these people

would react to

evasive, trying to put

one look

This wasn't an effort to

:

Dr. F. I

know how

at the test

make them

and

them on the

reject

it.

feel like equals?

Not this part. Here I was manipulating like mad, because test would puzzle them. I was trying to get them to feel that :

No if I

thought

this

was simple and easy

to do,

why

Man's Land

[

7

of course they ought

to.

Did any of these

Int.:

tests give

you useful diagnostic informa-

tion?

Dr. F.

No. They were a waste of time, especially the Minnesota

:

Multiphasic Personality Inventory. tation families, both before

and

Family Unity Scale which

MMPIs

had

after treatment,

Nothing helpful came out

material.

Check

I

at

all.

done on

and

The only

I

all

my

disser-

couldn't use the

useful test

was the

developed myself, in the Interpersonal

I

List.

Now,

Mike has been into a good deal of trouble, recently, and all of you are concerned with what is the cause of this, what are the things that have led up to it and so on.

dr. f.:

Int.

I,

as I understand

When you mention this

:

it,

"trouble"

Mike has been

in,

did you

know exactly what he had done? remember whether I knew it or not. Int. Ordinarily, would you name the crime instead of leaving it general like this? It's such a gentle way of putting it. Dr. F.: It would depend on the case. If the family seemed to be trying to avoid talking about it or facing up to it, I would probably come out much more coldly. As long as they're not, there's no need to say, "Mike did this and this and this. What are you going to do about Dr. F.

:

I

don't

:

it?"

Int.

Mike's

When you

:

difficulty,

cerned, or did

Dr. F.:

you I

say that they are

did you have just

assume

assumed

it.

I

concerned with the cause of

all

some knowledge

that they

were con-

it?

expected them to be concerned. This

is

a

very powerful tool in therapy, to expect your patient to behave in the

way you wish he would behave. By a great deal of influence.

It

riding into

would take a

it

this

way, you can exert

socially blind person,

an au-

thority-blind person, to say to a therapist in Juvenile Hall, or to a therapist

anywhere, "I'm not concerned about

care what tion

made him

by doing

this,

get into this."

even force

You

my

can pull for a

lot of

coopera-

it.

The purpose of my work here is to that lead up to a youngster like Mike

dr. f.:

son's behavior. I don't

try to

remedy the things

getting into

diff-,

serious

TECHNIQUES OF FAMILY THERAPY difficulty. I

take

as a starting point that

it

when a

trouble, that the parents are not to blame, nor

blame

in

any kind

of, ah, right

home

tionships within the

Int.

Dr. R: There's a

When

this family.

these people

came

in

the child to

are confused or disturbed in

specific reason

is

or wrong sense, but that the rela-

Why do you immediately bring up the

:

is

child

[8

why

I

some ways.

question of blame?

phrased

it

this

way with

they looked like frightened

in,

They were all ready to be blamed. They had already heard, "There are no delinquent children, there are just delinquent parents." They were ready to swallow this whole hog, say mea culpa, and put on sackcloth and ashes. But this was not what I wanted. So I started out rabbits.

by trying

to get rid of the blame.

Int.

Dr.

grown up

Do you do this

:

No,

F.:

I usually

in the family

may

ever the parents

routinely?

and

feel

begin by pointing out that the child has various social experiences, and that

its

about

for the behavior of the child.

it,

the family shares

Here

I felt it

some

how-

responsibility

wise to start out by expung-

ing the idea of blame, because the parents were just bleeding. Otherwise, I didn't think they'd stay in therapy.

You

Int.:

At

start

out by relieving the parents of any specific re-

same time, you define the problem as something they've participated in. They can't really refuse to deal with that, because you're taking the blame off them by the way you're putting it. Dr. F.: That's the whole point. You hook them on this without sponsibility.

the

affronting them.

Int.:

I notice that

blame," and then not to blame," and

Dr. F. child

if

do

It

out with "The child

you

start

up

all

not to

with "The parents are

that because

it's

easier for the parents to forgive the

first.

would have been very

tell

different

if

you'd begun by saying

they were religious, God-fearing people

the minute they walked in the door. If I'd said that stirred

is

shift to the child.

boy was not to blame. Dr. F. Yes. I could :

start

shift to the parents;

they've been cleared

Int.: the

I

:

you don't

first, it

would have

their moralistic principles.

Int.: You're trying not to get stuck

on a moral

issue.

But by

saying the boy can't be criticized on moral grounds, you're implying that the parents don't have to criticize themselves either.

No Dr. F.

I'm trying to

:

wrong. You've

made

is

doing now."

you

mistakes, but

I

sometimes

didn't intend them, even

some

extent

and the

fore, I

assume that

ties, you'll

Int.

if

results

you can

bound up

child,

would have been

find out

what your

you had

different.

There-

what causes your

child's difficul-

under a

different set of

That's quite an assumption.

:

make them

Yes. I

:

responsible, but

our actions as partly determined. free ourselves

To

we can

it.

But

there's another reason I

off the parents. I feel

primary jobs in the

first

characterize

the extent that they are,

from moral judgments and go on to look

do something about

at the

we can

whys and

want to take the

very strongly that one of the therapist's

session

is

to seduce the patient into therapy.

Seduce?

Int.:

Dr. F.

:

Just that, seduce him. Create attitudes or feelings or rela-

tionships which will encourage

Any therapist who

him

to

come

into therapy

thinks he isn't playing this

You have

sad lack of patients.

him over

though

you would have done

rules than morality usually implies. I believe that

it.

9

want to change it.

Dr. F.

blame

in

explicitly say to parents, "If

known what you were doing with your differently with him,

[

the parents, "It's not that you're right or

tell

the effects of these mistakes are to child

Man's Land

game

is

and continue

going to have a

to sell the therapy to your patient,

you

to a relationship with you. If

don't,

win

you lose him, and

then he has had a failure experience and becomes less open to help of

any kind. dr. f. (cont.)

MR.

:

And

this

you will

k.:

Mm.

dr. f. (to

think that, ah, probably during the course of

I

try to

blame people,

Mr. K.): You

your wife

will try to

will try to

you

is

is

to blame, but both of

ture of absolving

them and

wife,

and

as far as I'm con-

to blame, both of

— (Sentence breaks

Int.: That's a slippery phrasing,

you

blame Mike or your

blame you or Mike, but

cerned, neither one of tributed to the

at times.

you have con-

off.)

when you

say, "Neither

you have contributed."

It's

yet, in the act of absolving

one of

again this mix-

them, including

them.

Dr. F.

:

I'm trying to present

it

so that they can see that they are

responsible for, or have contributed to, the situation, without having to

accept the burden of having done this intentionally.

TECHNIQUES OF FAMILY THERAPY Int. to you,

an interesting technique.

It's

:

can present

I

want

to get over a premise

wrapped up with another one which

it

Then you won't

acceptable.

If I

want you to

refuse the premise I

10

[

is

less

take, be-

cause you're being cleared of the unacceptable one.

Dr.

This

F.:

many

times, in

is

what I'm doing, and

exactly

guises. I

do

this

when

with love,

I

point out that people

love each other and fight and hurt each other at the it

though

as

Int. all this

people

all

Why

:

who love each

comes up many

it

same

time. I phrase

other hurt each other.

do you point out so

explicitly that there's going to

blaming?

Dr. F.

:

I'm saying to the father that

I

know that he and Mike

be ganging up against his wife, and that his wife and Mike ing

up against him.

this,

so that

to him,

it

which

Int.: first,

be

will I

It's

I

am

will

will

be gang-

exonerating the father beforehand for doing

be easier for him to forgive

when she does

his wife

knew was going to happen very quickly. the same thing you did when you forgave

it

the parents

so that they would then have to join you in forgiving the boy.

Dr.

F.:

who

Yes. The boy was the one

could do the really dread-

And

put him second.

same way here. The one I expected to have a dramatic problem with was the wife. She was carrying a load of guilt and anger and she was going to cut loose as

ful things that hurt, so I

soon as she found a safe place to do

so.

She looked to

already feeling safe, and I thought I'd better Int.

When you announce

:

blame each

Dr.

other,

F.:

is

that also to

Int.

Dr.

terrible?

me, that

They'd do

it

I

knew they

Dr. F.

up

here,

Repeatedly. So

I

am

it.

trying to provide

It's :

a

way

of giving permission for

Yes. I'm saying,

"You can

where we can deal with

it." It's

so particularly sensitive to blame that

a

little.

weren't going to

outside the therapy session

ceptance or some kind of framework within which it out their panicking or without its disrupting therapy. :

she were

my knowledge.

F.:

Int.

if

do a little preparing.

make it seem less

They've probably already done

:

as

Yes. Everybody was feeling so guilt-ridden and anxious,

to criticize each other.

and outside

me

that people in the family are going to

especially sitting there in front of

want

the

it

some kind of accan happen with-

to happen.

talk about

it.

You

can bring

it

a reassurance. This family was

I felt it

wise to desensitize them

No (cont.)

dr. f.

:

In the course of

a,

Man's Land

of marriage,

[11

for various

ah,

reasons, for the pressures of building a career, the pressures of

earning a living, the pressures of having kids needling at you and

pushing

at

you

all

the time, you build up, or tend to build up,

patterns of defense against each other.

mr.

Mm-hm.

k.:

Both of you probably know each other's problems better than

dr. f.:

do, at this point certainly, even after extensive diagnosis

I

both

know each

When you

Int.:

against each other,

other's

problems

much

better than

say that the parents have built up defenses

and implicating them because there has to be

something they are defending themselves against.

that

It's

When

That's right.

I

same

trick of

same package.

putting an acceptable and an unacceptable idea in the F.:

I.

you are both excusing them because they are only

acting in self-defense,

Dr.

you

say, "the pressures of building a

career and earning a living," I'm assuming the other part of the sentence: "which

would cause

think they miss

than

I

between you and your wife."

I

don't

it.

And

Int.:

conflict

"You know more about

the phrasing,

these problems

do," not only assumes that there are problems but

unlikely that they will deny

it,

makes

it

because you are giving them credit for

being the authorities.

Dr. course, little

F.:

Well, they are.

They know more about

somebody backed me

if

to the wall

and

the specifics.

said, "If

Of

you know so

about their problems, what are you doing treating these people?"

I

would be forced to admit that I did know more about their problems. Not what exactly caused the difficulties, but what kind of difficulties they were. Int.

It's

:

a

way

of slipping out from a position which they could

hang you on, of knowing more than you really know. Dr. F. I hadn't thought of it that way, but it's true. :

Int.

and

It's

:

let go.

a

Was

little

like playing a fish.

You

this particular shift part of

pull

and then

a routine introduction, or

were you responding to the reaction you were getting

Dr.

F.:

I

was responding

to the reaction.

It's

at the

fit

moment?

the kind of thing I

do with everybody, standard operating procedure, but ently with each group, to

let go, pull

I

the people I'm working with.

phrase

it

differ-

TECHNIQUES OF FAMILY THERAPY Int.

I'm curious to

:

know why you go

12

[

into this discussion of

mar-

riage.

Dr.

Part of

F.:

it

that I sincerely believe that marriage

is

difficult task, that it isn't all

keep bread on the

beer and

table, feed

skittles. It's

and clothe

kids.

hard to earn a

The other

part

a

is

living, is this

business of showing respect for your patients. If you treat raising a

family as something any fool can do, that doesn't

very good.

make

the patient feel

symmetrical idea again. Everyone hasn't the good

It's this

fortune to be a psychotherapist and

back and earn a

sit

lot of

money.

I

know marriage is a tough job and I try to show that I have some respect for how the job is being done, even though there may point out that

be some

I

difficulties

By

Int.:

with

it

now.

suggesting that everyone has these difficulties, you're

them a way out, so they won't feel on the spot. Dr. F. I would say that I am presenting them with a reality confrontation rather than a way out, because I believe that any man who also giving

:

has been married fifteen or eighteen years and has brought up a couple of kids

and kept

his family economically

his child is all loused up,

Int.

:

Suppose your

has run a crane

getting

still

That's a comforting

:

Dr. F.

who

he

them going

sound has done

well.

Even

if

deserves credit for trying.

way

to look at

it.

client is a forty-year-old operating engineer

all his life

and has raised four or

in the world. After

all,

that

man

five kids

and

is

has done a real job

of work. If you, a scientist, a researcher, a psychotherapist,

sit

back

in

your fancy chair and look down your nose at him,

your fancy

office in

how much

therapy can you do for him? This comes up with young

therapists all the time. They're nervous

they get some hardheaded guy like

this,

and inexperienced and when

they don't

know how

to handle

him. They've been taught to insist on keeping their professional distance.

Twelve or

fifteen years ago,

laugh and joke with your patients,

them respect

as

human

was considered inappropriate to to be friendly with them, to show

it

beings. I don't hold with that.

you protect each other too. You don't, unless you're angry and unless you're in difficulty, you don't deliberately attack each other, nor do you deliberately attack Mike where he is weakest or most sensitive, nor does he attack you unless he's angry and, ah, there's a blowup of some kind.

dr. f.

mrs.

(cont.): But

k.:

Mmm.

No Dr. F.

You

:

see,

I'm describing marital

[13

Man's Land

fights for

them. I'm read-

ing their minds, in a sense, by pointing out that they have fights in

which they use every

undermine each

dirty trick they can.

other, they find each other's

other viciously. But

when

When weak

they're angry, they

and hurt each

spots

they're not angry they tend to gloss over

and

avoid these sore spots.

you say that they don't hurt each other unless they're angry, which establishes the premise that they do hurt each other. It's almost hypnotic technique: "Would you rather go into a Int.:

trance

I notice

now

or later?"

And you

put

it

in the nice frame of protecting

each other.

Dr. F. deal with

is

to encourage

it,

I

encourage them to bring

The way you put

Int.:

them

to talk about

without due provocation."

it

You

it

implies,

it

By

without being embarrassed or ashamed.

it

recognizing

This

:

and be able to labeling

it

and

into therapy.

"You

don't attack each other

almost justify them. Then you

slip in

another exonerating phrase: "Nor do you deliberately attack Mike

where he

is

weakest or most sensitive."

Dr. F.

I

:

am

trying to

tell

them

know they won't set out on know they might destroy each a covert way attacking each

that I

purpose to attack each other where they

Of course, they are probably in other's weak places all the time. That's in there "not deliberate," it makes it more acceptable.

other.

dr. f.:

For the most part you

too.

But

if I

put

it

as

learn, or tend to learn, in the course

of marriage, to respect these sensitive areas for each other, and

kind of shy away from them.

The

that these sensitive areas get to be

a

of

it,

in

somewhat bigger and bigger

as

difficulty arises,

time goes on, and there tends to develop a pattern

of,

lot

not of shared

communication, but of disrupted, or slanted, or biased, communication.

Int.: I take

it

that this

is

partly to persuade

the things they're sensitive about and so on, but

way to

describe

Dr.

F.:

how a marriage

and

to talk about

also an interesting

develops.

The more of resentment there are in a marriage, the more the eyes of the married partners become toward

Yes. These silent areas get bigger and bigger.

suppressed feelings caustic

it's

them

critical

TECHNIQUES OF FAMILY THERAPY

14

[

each other, which means that even larger areas develop which they don't want to tread upon.

Int.

anger

is

Would you

:

better off than

Dr.

F.:

say, then, that a

one in which there

would be very

It

marriage in which there

open

isn't?

In

difficult to state this categorically.

But there are some marriages

general, yes.

is

in

which there

is

a pathologi-

cal degree of directly expressed anger substituting for things

under the

surface that aren't talked about.

Int.

In other words, this anger

:

Dr. F.

But in the majority of

Right.

:

is still

not open communication.

cases,

a problem and have an honest, angry fight about

if

the couple can meet at the time, they are

it

far better off.

Int.

An interest is

:

beginning to develop in

with each other. There

start a fight

becoming more talked about. Dr. F. This is a touchy :

isn't

much

how

to get a couple to

written about

area. In the case of

but

it,

two or three

it's

families

you permit it to happen too soon, it becomes the dominant thing and you lose the family entirely. But if you can get them to fight I've had,

if

about the appropriate thing at the appropriate time and in the appropriate place, that kind of fighting

Int.

Do

:

Dr. F. mine,

you encourage

Sure. I

:

can be most

beneficial.

that kind of fighting in your therapy?

was never so pleased

who had been

taking

it

and taking

responded to an insulting remark of

his

when a woman

as it

patient of

from her husband,

finally

by lighting into him and physi-

Then she ran sobbing to her bedroom and tried to wasn't available, so she worked it out with her husband and

cally assaulting him. call

me.

I

they had a wonderful weekend, the best sexual relationship they'd had in years.

dr. f.

(cont.):

Ah, the

real things that are

happening emotionally

to people within a family

group are very seldom discussed or

brought out, and

of

this is part

my job,

to, ah, literally

explore the pattern of relationship between that perhaps in improving

all

pry into or

three of you, so

communication generally, including

each person's understanding of the other, there will be real therapy for

mr.

k.:

dr. f.:

all

of you

.

.

.

Mm-hm. ... and

of you.

It's

I

consider

not, I'm not jusi

it

something of benefit to

working on Mike.

all,

all

three

No Int.

This

:

is

the

first

Man's Land

[15

time you've been so explicit about your role

as a therapist. I gather you're trying to help the family anticipate

what

you're going to be doing with them.

Dr. R:

do

I

with

this

my

all

patients, in differing degrees

depending on the kind of people they this family,

was obvious

it

was going to do

more acceptable when Dr. F.

:

that

fight,

ings of guilt

it

and anxiety

all

along, as

and be nosy. This

it.

was warning them it

advance

in

so that

it

be

will

We've gone through the process of recognizing that they they have problems, and I've been relieving them of feel-

that I will pry

doing

I

their sexual rela-

comes.

I

my

began to pry into

also tried to frame

this. I've

demand which them

I

and the circumstances. With

How have you done that?

Int. :

do

if

were going to panic. So

tionships, they

that I

that

are,

and

job

is

much

as I can.

Now I'm making

a

think they're better prepared for. I've deliberately said is

an attempt to disarm them.

to be nosy and to pry, they can't get

mad

at

If I tell

me

for

The word "pry" has an unpleasant connotation. It would be very different if you had used the word "explore." Dr. F.: My assumption was that this father would use these words in defending himself against me if I didn't use them first. He Int.:

would

say, "He's prying into

Why

Int.: three of

our business."

do you point out

them? This

is

that therapy

all

is

all

all patients.

designed to emphasize specifically that they are

three in therapy, not just the boy.

Int. is

This

F.:

going to be for

your second attempt to include the whole family

as patients without saying that they're

Dr.

is

the

:

Again, you label

way you

Dr. that the

F.:

it

as something beneficial. What's curious

stress "real" therapy.

I don't

know whether

What would I

was

"unreal" therapy be?

trying to dislodge the idea

boy was the only problem and that the parents were only pre-

tending to be in therapy to help him, or whether

I

was

telling

them

that

they were in actual treatment, that they weren't just being counseled or talked with. I did want to force as well as the

boy were

in therapy. This

accomplish when the child takes

put

it.

upon them

is

is

the understanding that they

one of the hardest things to

the presenting problem. Sometimes

months before the parents accept

it,

no matter how

directly

it

you

TECHNIQUES OF FAMILY THERAPY Int.

[

16

Do you usually put it that directly?

:

Dr. F.

:

At some

early point, I generally do.

But once

in a while

you get a case in which you have to encourage and preserve the myth that all of us adults are helping this poor little child. In one instance, it

was about a year before I got around they were in treatment too. But you assumed,

Int.:

to pointing out to the parents that

from the look of

just

this family, that

you

come out this flatly? Dr. F. They labeled themselves as patients when they walked in door. But that didn't mean I had carte blanche to say anything. If I

could

:

the

had affronted them instance,

in

any way,

would have been

it

I

would have

terribly inept of

gious principles or to use vulgar language.

by

this

lost

them completely. For

me

to attack their reli-

They were

that sensitive.

But

time I'm feeling that most of the seduction has been accom-

plished.

The mother's

in,

the father's

in,

and

their eagerness for help

and willingness to cooperate are quite apparent.

(addressing Mike): Boy, are you a sad-looking case today!

dr. F.

(The son has poison oak.) mrs.

mr.

K.:

He sure is.

k. :

mrs.

k.:

dr. f.

mr.

(Laughs.)

(Laughs.)

You really did it up brown. He looks just about as bad

:

k.:

today as he did the day

him (inaudible phrase). (overlapping, to Mike) You look

I

took the

picture of

dr. f.

:

a different kind

mrs.

.

.

like

you need treatment of

.

k.: Yes.

dr. f. :

mrs.

.

k.:

dr. f.

.

at this point.

Yes, doesn't he though, goodness sakes!

I'll

:

.

be very anxious to

know what you look

like

when

you're

(inaudible words).

mrs. k. (laughing):

When he looks normal.

(Laughs.)

dr. f.: That's right.

mr.

k.

Int.

Dr.

:

:

Why did you suddenly shift to the boy? was quite

had just labeled them all as psychotherapy, and before they had a chance to object, I

F.:

patients in

He sure is roughed up.

It

deliberate. I

No took them immediately

and simultaneously brought Mike

off the topic

He had

into the discussion in a friendly way.

my

timing was very important from shifts of

mood very helpful. The

Int.

I find

those abrupt

laughter relieves the tension and jumps

and mother came

more bon

vivant.

You

notice

right in immediately.

Do you often take that tone with the child?

:

Of camaraderie? Camaraderie, but you

Dr. F. Int.

The

to be seduced too.

point of view;

us up to a level where things can be a bit that the father

[17

Man's Land

:

:

Dr. F.

This

:

also insult him.

a technique of mine.

is

I

tend to

call

my good friends

bastards.

Int.

You apparently knew about the poison oak before they came

:

in.

Dr. F. cause of

Yes, because they were delayed in coming to see

:

me

be-

it.

Int.

:

Why

do you say to Mike, "You need treatment of a

differ-

ent kind"?

Dr. F.

It's

:

a play on words. I'm bringing in the idea of treatment

again, but in a comfortable, easy way. It's part of the seduction.

Int.

:

Again, you

slip in the

premise that they need treatment, by

saying that he needs a different kind.

Anyhow,

dr. f.:

this

is,

ah,

where

I start.

Now,

as far as I'm con-

cerned, the responsibility for this rests with you folks.

It's

your

job to, ah, open these areas up, to discuss, to talk, and so on.

Int. ity for

else.

:

Is that

a way of keeping them from pushing the responsibil-

therapy onto you or

Dr.

F.:

My

contention

is

It's

that therapy

an interaction

you can.

role as best

a philosophy about therapy?

a philosophy about therapy as

It's

cure people with.

is it

If

me

as anything

you use to between people and you play your is

they want to

can make a monkey out of

much

not a

lie,

scientific tool

or dissemble, or evade, they

or any other therapist. I try to win

my

patients' acceptance of the fact that the responsibility for progress in

treatment Int.

is theirs, :

not mine.

I think it's

unusual for someone to state

it

that directly to a

family.

Dr. F.

:

Well,

if

you accept the

sole responsibility,

even

implicitly,

TECHNIQUES OF FAMILY THERAPY

[

18

for treating them, in the sense of curing them, then they are going to foist

off

it

on you

every opportunity, in ways that can be highly

at

unpleasant because you won't

know what

whole background and understanding of have done together,

They come

to do.

in with a

their roles, the things they

Anyway,

their interactions over the years.

it

would

be presumptuous of you to assume that you understand everything they say or do. Ninety percent of Int. that

it's

If

:

you

it,

don't.

a family does badly in therapy, would you suggest to them

because they haven't taken enough responsibility?

Dr. F.

thought they weren't doing what they could,

If I

:

Of course, it might also be that I'm not the kind that could work with them, or I might just be grossly inept. tell

them

so.

This responsibility thing

Int.:

is

complex.

You

would

I

of person

say that they have

to help themselves, but they are then helping themselves in the context

of your helping

Dr. F.

them

to

do

so.

This runs through the whole warp and woof of therapy.

:

It

has to do with the relationship between equals which you are trying to

you are the curer, the

establish. If

your ministrations, think this Int. it

is :

it

I

don't

a valuable kind of relationship.

A lot of the process

F.:

Sure.

they are on the Int.:

and they come to you for

puts you hierarchically above them, and

of therapy seems to

possible for the patient to get out

Dr.

healer,

way

As soon

making

amount

to

you

go to

from under that.

as they are able to

tell

to

hell,

to getting well.

There's a suggestion of a time line here.

Up

to

now, you've

been clearing these people of responsibility for past mistakes. Here you imply,

"Now

that

you are

in therapy

it's

different, I

expect you to take

responsibility."

Dr. F.: Exactly.

I

in treatment. It's also a

expect them to take responsibility for working

way

of defining "treatment" with respect. If I

don't respect the treatment process and feel that else

is

it's

of value,

no one

going to.

Int.

:

It's

another of these assumptions that lead people where you

want them to go. Dr. F.: There's one other hook

I

don't want to get onto. If you

accept responsibility for curing your patients, you not only get the credit for their successes, but

personally, don't

want that

you get the blame for

responsibility.

their failures.

I,

No Int.

Man's Land

19

[

That's understandable.

:

Dr. R: There are many instances

down

which you have to play

in

However, there are other times when, based on your information about the family, your knowledge of what goes on in people, your training, and so forth, you can say, "You have

yourself

to

do

A

now."

this,

He

called for.

as the authority.

make people do what he

can't

when it's but he can come out

therapist shouldn't hesitate to say this says,

with an authoritative statement about what he thinks they should do. Int.:

knowing will

Do you

ever

make

that the patient will

that kind of authoritative statement,

do something

else,

or even ignore

do what you think he ought to do as a by-product? Dr. F. I worked with a couple some years ago to :

mended there

whom

I

it,

but

recom-

divorce twenty-five or thirty times, very strongly. Every time

was a serious

And

ings started.

there obviously to admit.

fight I told

them

to call a lawyer

every time they rejected

my

and get proceed-

advice

I

said,

"Well,

something more to your marriage than you're willing

is

Something must be keeping you together."

Did you do this because you knew they wouldn't get vorced and it was safe, or because you really thought they should Int.:

di-

get

divorced?

Dr.

had a dual motivation.

would have been very pleased if the wife had taken action, because it would have meant that whatever the problem was that was holding them together had been resolved. At the same time I knew she wouldn't, and that her not having done so would give me a lever to get at whatever was cooking with her. I've F.:

I

done the same thing with parents. your

And

until they finally

Int.: to facing

up

control, you'll have to institu-

we go on and on

in the

same pattern

understand what's happening and why.

to

of

problem and dealing with

to the

Yes.

:

There

dr. f.:

I

carry

will

come out of that

it

fice

.

.

I

to the

it

.

.

directly.

extreme end

result.

when I will ask each of you individually room with me and we'll talk over some aspect

the

think

is

unclear or that needs talking in another of-

.

.

it

be times

Mm.

k.:

dr. f.:

they don't. So

"You're not able to handle

In other words, you give them an unacceptable alternative

Dr. F.

mr.

I've said,

beyond your

child, he's obviously

tionalize him."

I

independently.

TECHNIQUES OF FAMILY THERAPY Int. talk with

:

Were you laying

groundwork here

in case

you wanted

to

them individually?

Dr.

Yes. This

F.:

therapy, and I did

it

is

something

I often

do during the course of

with this family.

Do you ever treat family members individually? Dr. F.: Oh yes. Right now, I have about ten cases where I've the families up and am seeing the various members separately. At Int.

split

the

[20

:

work together. Int.: I take it you would disagree with the opinion that it isn't family therapy unless you take the whole family as a unit. Dr. F.: I would disagree with any rule about how you treat a family. The needs of the particular case dictate what you do. When a child is the problem, I have found it more productive to treat the child this point

they can't

with his parents as a triad, rather than bring

though

I like to

gets old

the other siblings

in,

see the others at least once. That's why, in this family, I

didn't include the

younger

enough

to participate.

have small children, only to observe the

I'll

treatment. I've

girl in

by taking each child

eral families

all

in a

When

worked through

sev-

threesome with the parents as he I'm working with a couple

who

ask them to bring the kids in once, but this

way they handle

is

the children, as a help to under-

own problems. I would never see a family of more than three all through therapy. The number of interactions is too great. Int.: Is there any other reason why you single out the triad to standing their

work with? Dr.

F.:

Well,

family system, If

it

if

you accept the idea of family homeostasis, of a

doesn't matter which section of

you change the interpersonal balance of one

it

you're dealing with.

triad,

you

will affect the

whole system. Int.: feel that

if

Some

therapists concentrate mainly

there

is

a problem child, he

is

on the

parents.

They

merely a cover-up for the

marital conflict.

Dr. F.

:

I

agree with this to

some

can get something out of therapy,

when he

extent, but I feel that the child

at least in the first sessions. Later,

no longer the focus of the struggle between the parents, I let him drop out. But again, I don't have a hard and fast rule for this. Int.: When it comes to taking people out of the session and talking to them privately, how do you handle the other people who are being left

out?

is

No Dr. F.

questions or to ter

when

I

tell

each other about what went on.

a different mat-

It's

schedule separate individual sessions for husband or wife or

There they are guaranteed privileged communication.

child.

started

21

[

not supposed to be secret. People are welcome to ask

It's

:

Man's Land

just

I

working with a husband and a wife with the agreement that

what goes on between each of them and

me

never be communi-

will

cated to the other, unless they themselves choose to individual sessions are tremendously useful to

marriage

me

know what is going on, I don't have family in a much more fruitful way.

unit. I

work with the Int.

I

:

take

it

that

you don't carry the

about

tell

it.

These

working with a

in

and

to guess,

I

can

open communica-

ideal of

tion too far.

Dr. F.

hard way that one of the very important

I've learned the

:

things in marriage that there are

is

some

husband or wife

is

for the partners to respect each other's privacy,

things that

having an

it's

affair, it is

they said nothing and learned to bind their

own

wouldn't rather

I

tensions long

enough

the thing dissipate. This doesn't imply that I think infidelity

answer to marriage problems. confusion and misery to

all

I've never

a

usually hostility that prompts

a "confession." I've never seen a situation in which

let

When

better not to talk about.

known

it

is

to

any

to bring anything but

concerned. In the past,

many

psychiatrists

operated on the premise that the patient ought to free his repressed impulses, and

would even encourage people

was an extremely misguided Int.

one of your jobs

Dr.

F.:

is

feel that

this applies to the child as well. I don't

encour-

from each

I

take

it

that

other.

knew

age the child to talk about everything. If the parents really thing their children were thinking,

Int.

Some

:

:

No.

to

him

I

benefit the

dr. f.

way

to death.

of getting out infor-

the child has something he wants to say

don't use the child to pry with. This

all his life.

therapist might be able to

would

would scare them

every-

Do you?

I will listen if

about his family, but

happened

it

therapists use the child as a

mation about the family.

Dr. F.

think this

you

issue of privacy,

to protect people

Yes, and

affairs. I

interpretation of Freudian theory.

To get back to the

:

have

to

But do

that's a technical point.

this

is

what has

A more skilled

with a child in such a

way

that

it

whole family.

(cont.): There'll be other times

when

I'll

have

example, will leave the room and, ah, wait while

I

—Mike,

for

discuss some-

TECHNIQUES OF FAMILY THERAPY thing that

any of

Int.:

much more

pertinent to your relationship, and

his business or concern.

Mike

up,

is

will

When

[22 it

isn't

come

these kind of areas

not be included in the, the whole picture.

gather you don't think the children should be involved in

I

these discussions.

Dr. of

my

larly

That's right.

F.:

I

recognize that I'm at variance with

colleagues, but I don't think

many

does the child any good, particu-

it

between the ages of ten and eighteen, to be involved

com-

in the

plexities of his parents' sexual relationship.

Int.

:

Dr. F.

What reasons do you him

I tell

:

that

give the child for his going out?

some of

the problems his parents are hav-

ing are none of his business, that they're adult problems

out of

and he can stay

it.

Int.

:

You're drawing a generation

Giving him the com-

line, too.

fort of being a child.

Dr. F. adults.

:

And

giving his parents the respect

They should have some

Int.

:

Do you

F.:

from

their children.

think that in so doing you are making sex a special

area that children shouldn't

Dr.

secrets

know about?

I don't really

deal with

it

that way. I deal with

adult problem that they are not privy to yet.

because

we

and comfort of being

talk about sex in therapy, but

ents' explicit sexuality. If I bring

up the

we

It's

it

as an

not a taboo subject,

don't talk about the par-

child's sexuality, I don't try to

pry out the actual thoughts he has while masturbating, or something of this sort, in front of his parents, unless there's

really necessitates

dr. f.

is,

I

stay most of the time behind that, that screen,

—a

a mirror

remember whether whatever laughs)

that

it.

(cont.): But

that

some pathology

it

is,

I



two-way mirror I can never really a two-way mirror or a one-way mirror, it's,

one-, a

it's

can see through from the other side (Mrs. K.

and the microphone

hooked up to a tape recorder. There's a reason for tape recording these. Ah, sometimes I'll have something to say where I put the finger on one of you as having an attitude or a feeling that tainly there,

and

is

is

not clearly expressed but

in interpreting this I will

is

cer-

want to play back to

you what you've said, so you can hear and then judge for yourselves what you've said and what you, what has gone on .

.

.

No Int.

go

Here we

:

23

some time and you've got one room where the

that

it

and an adjoining room with a one-way screen and a tape

sits

And

from which you can observe.

recorder,

[

get into your method, so let's take

into that in detail. I take

family

Man's Land

that

you

alternate going

room and watching with going back into the room with the family. How did you come to develop this method? Dr. F. The way I came to it and it was the way I started working with families too was a total accident. In 1953 or 1954, when I was still working at the Alameda County Guidance Clinic, a girl was into the observation



:



me

sent to

was

because she kept getting into sexual-type delinquencies. She

in the habit of running

away from home and turning up

camps, honky-tonks, and so

places, valley towns, migratory workers'

And

on.

here she was, sweet, pretty, intelligent, blond, blue-eyed, and

100 percent American

well-to-do, the perfect stereotype of the

had

father

lots of

gave her a whole raft of

I

showed no pathology

at all, so I patted

"Go

forth, child,

and

sin

in trouble again,

and

I

Her

no more." Three weeks

gave her a

more

lot

seemed

all

sent her

back home and told her parents

of them. It

would turn out

still

right.

Then

later,

which

to

back she came,

and again she breezed

tests

such a lovely

like

tests,

her on the shoulder and said,

through

test picture that I

be nice to her and every-

me

she was sent to

a third time, and at

up

point she was in Juvenile Hall. She had been picked

this

girl.

money, and her parents repeatedly expressed nothing

but love and concern for her.

thing

in strange

in

one of

bunch of migratory workers and had been in jail down there for about a week before being sent up here. By this time I was pretty mystified, since the tests showed nothing of the central valley towns living with a

interest,

So

I

and apart from her odd behavior, nothing

asked the parents to permit

way mirror had

in

their first

meeting with the sitting in the

from Juvenile Hall and

The

them

to observe

—we had one—while they

girl

left

girl after

was.

The

room, and then

her there while

had no knowledge of

sitting

began

father

ing frown

on

a

her latest scrape.

this.

I

I

at last to see

was

why

sitting off to

one

arranged to girl

over

went behind the screen to

Well, after fifteen or twenty

the girl

this rather cru-

was behaving the way she

side of the

his face, saying nothing.

I

brought the

minutes of observing the family as they got together at cial time, I

seemed wrong.

an observation room for training in testing

have the parents watch.

me

else

room with a disapprov-

The mother and daughter were

very close together, having an animated discussion about the

TECHNIQUES OF FAMILY THERAPY price of cigarettes in Juvenile Hall in Fresno

kind of candy or

compared to Fresno. any warmth or

more out

and how the

that,

It

feeling.

"Of course

I

My

why

I said,

feeling was,

my

observ-

do you love your daughter?"

It

He

"Well, for Christ's sake, go in there and

"That

doesn't he do something about

her?" Well, he did.

As

daughter

idiot, his it,

took him ten or

I say, I is

was simply in trouble,

say something meaningful to

minutes to say "I love

fifteen

managed to get it out, the whole character of meeting changed. The girl began to cry, the mother began to cry,

you," but the

went out of

on the door, and called the father out of the room.

do."

when he

were cut here

institution clothes

her so," and I sent him back in the room.

exasperated.

this

was completely banal, completely lacking in I listened for about ten minutes and finally,

Just standing in the hall, I said, "Say,

tell

and whether she liked

of exasperation than anything else, I

ing section, tapped

said,

[24

and they

all

finally

began to talk about the things that were

her and what had led up to her running away.

I

went

really bothering

in

and called the

mother out and asked some question of her and sent her back

in,

and

I

noticed again that this produced a change in the character of the meet-

They began to talk about what possible reasons the girl might have for wanting to do what she had done, and what importance it had for her. It struck me suddenly that nothing I had done in individual therapy with a child had ever approximated the degree of change and change potential that I saw right there in front of me. It seemed a highly desirable way of working with people, so I went on in the same manner for about an hour and a half during that first session, and then set up another appointment. In the meantime, I went to the court and asked ing.





permission to keep the

weeks while Int.:

I

girl's

case off the court calendar for a couple of

continued working with the family

In that

first

know

session, did the girl ever

that

you were

observing?

Dr.

would

F.:

No.

I

had a very strong

distort the relationships

feeling that

and make

it

was observing.

later,

she did know,

it

impossible for her to behave

normally or naturally. That didn't change until nique to a colleague a year

if

and he asked

I

described the tech-

me why

had no answer; there

I didn't tell the

seem to be any legitimate reason for not telling the child, and from then on I did. Of course, once everybody knew what was going on, it then became possible to play the tape back to the family, which also turned out to be child that I

I

didn't

No very useful. Since then, I've tried working in the continuously, to see

and

how it compares

Man's Land

room with

25

[

the family

with going in and out of the room,

my strong impression is that the second method is the more effective.

The more

the therapist can be absent from the room, certainly in the

more information of a direct sort he can gain about how the family interacts. The more he is in the room, the more he distorts the very phenomena he is trying to observe. To the extent that you can remain outside of the thing, you get a closer approximation of a real life view of the patient and his family. I treated that particular family for sixteen or eighteen sessions and the girl's problems cleared up very nicely. No one at the clinic objected, but no one was particularly impressed either. The girl had, I think, four of therapy, the

initial stages

interviews with the psychiatric consultant for the clinic, and well convinced that to this day he thinks

did the trick. I

had

it

I

am

pretty

was these four meetings

that

close to thirty hours with the family, compressed

into six to eight weeks,

and

I

have the delusion that

this is

what did

it.

Had you

Int.:

ever, for

any purpose, seen the whole family

to-

gether before that?

Dr. R: Only

my

time, to

to prepare for individual testing. This

was the

first

knowledge, that the principle of psychotherapy had been

applied to treating the family unit in this country. Int.

To

:

get

back

to

your technique, granted that you have objec-

tive reasons for using the separate

rooms,

gather that you find

I

it

more

comfortable for personal reasons too.

Dr.

F.:

other because

That's true. But I can't really distinguish one from the I started this

have found that staying trainees too

Int.:

when you Dr. I

always seemed right for me.

easier

is

tiring.

My

them when they can pick up as much informa-

it is

freely. Also, I don't think that I

extremely

I

for

remain with the family.

if I

than

it

in with the family

comment on how much

go in and out tion

way, and

Do you are in the

F.:

find that

you

talk

more than you

you should

feel

room?

That's a hard question to answer, because

should under any circumstances. This

is

one of

I talk

my

more

faults as a

therapist.

Int. if it

:

Developing a method of getting out of the room sounds as

could also be a way of dealing with that.

TECHNIQUES OF FAMILY THERAPY Dr. F. acting

is. It's

a useful

way

of keeping

me from

inter-

should be therapy for the family.

it

So when you say to them that the responsibility for treatwith them, your method is a way of helping them to realize

Int.:

ment

probably

the time and continuously. It really shouldn't be Fulweiler

all

therapy,

It

:

[26

rests

that ideal.

Dr.

F.:

room with will

also a protection for

It's

and someone

the family,

starts to

If the therapist is in the

say something, that person

look to get a reaction from the therapist and then qualify differently

what he

same

With three people

says.

time,

it

all

focusing on the therapist at the

can be pretty exhausting.

ing a diagram of the three family

I

usually describe this by draw-

members and

the therapist

is

member A through

the therapist to family

I

point out that

when

is

always from family

member

B, and the same with

room, communication

in the

and put-

the therapist

between the therapist and the family.

ting a line

all

me.

the exchanges between the family.

Int.

Dr.

You're

:

like a filter.

Yes. Every communication goes through the therapist,

F.:

every single one. Even

if

people turn and look at each other, which they

don't usually do, they will be glancing out of the corner of their eyes at the therapist.

It's

were constantly saying, "You

as though they

see,

Mr.

when I try to do this and such, what he does to me." If the therapist so much as wiggles his ears, he's responding to this. When you have three people in the room with you and this is going on at both verbal and nonverbal levels, the number of interactional combinations Therapist,

is

tremendous. Another thing

which

is

much

is

easier to handle

if

the control of the countertransference,

you're behind the screen.

Are you using "countertransference"

Int.:

in the psychoanalytic

sense?

Dr. F. feelings

:

No, I'm using

it

toward your patients.

loosely to signify directing inappropriate If

you have ever been married, or have

ever been a child in a family, or have had any kind of family experience at all, these

you and

to

people will catch your problems and demonstrate them for

you and through you.

hard for you not to react as are out of the room, ling

your responses.

if

If

fresh with his parents

don't

and

room,

it's

you

this constant necessity for control-

know how many

I've

in the

these really were your problems. If

you don't have I

you are constantly

had the strong

times a kid has gotten desire to turn

him over

No

my

knee. Behind the screen I can mutter,

when

go back into the room

I

worked for

out,

it's

done.

able to handle

Int.

should think

who

is

I

Dr.

all

F.:

it's

stinker," so that it's

going to take some time

it.

this

would be

particularly true of a therapist

seem human. Being behind the screen

trying to

human

being

little

27

[

don't have to carry that with me;

I'm in the room,

If

me to be :

I

"The

Man's Land

you from

relieves

the time.

you out of a

It gets

true in a marital interaction.

lot of traps, too.

Most of

We

thoroughly biased in this area.

us,

This

particularly

is

whether we know

or not, are

it

take sides very quickly. I think

it

takes a lot of maturity in the therapist, and a lot of time, to get to the

point of recognizing that the labeled patient isn't always the victim, that it's

sometimes quite the other way round. Int.

Do you find that you tend to take sides with one sex?

:

Dr. F.

think that the biggest trap for a male therapist

I

:

thizing with the think, "If she

woman

were

married to a

just

We

for being married to such a clod.

man

like

sympa-

is

tend to

me, what a wonderful

life

she'd have." But there are other factors too. Therapists have diurnal

God one

variations between being

the

first

family in the morning I feel fresh and great, and

who

that all the people that I

minute and the Devil the next. With it's

a shame

me

are sick in this area can't be referred to

so

can cure them. Then around two o'clock in the afternoon I'm a

who

charlatan

is

taking

money under

false pretenses.

You

can be vic-

timized by this sort of thing very easily. Int.:

the

To

what

shift to the family,

effect

does your being out of

room have on them? Dr.

implicit

For one

F.:

command

to

they're just left there.

taped.

My

They

it's

an

them to talk, work, do something. After all, They know your beady little eyes are behind the

screen, watching them.

them on.

me,

thing, as a colleague pointed out to

Your

hallucinated presence

is

urging

there,

students also react to the pressure of being observed and

feel very

much under

the gun.

When

they are in the

room

with the family, they feel that they've got to produce while they're in there,

and

there's

sufficient poise to

stop

what

even a pressure of time.

be

silent if

he's saying

It's

and get an

a rare student

who has

he can't think of anything to say, or out.

students, while they are out of the

what they're doing.

It's

But the advantage

that

is

room, can consult with

just to

me

ideal setup for supervising treatment.

my

about

TECHNIQUES OF FAMILY THERAPY Int. :

It

occurs to

me that when you

started using this

were working with people who were more or

less forced to

[28

method you

come

to see

you because their children were in trouble with the law. Getting out the room would be one way for you to counteract this framework, would make

it

enforcement

officer, as

of It

hard for them to see you as a continuation of a law-

somebody who

going to

is

tell

them what to

do.

Dr. F.

confined to families with delinquents. People

isn't

expecting to be treated and cured.

office

different

up

to

from what they would do

it initially,

come

but

it

to a doctor's

ask them to do something

I

in a doctor's office.

They

usually live

it.

Int.

and

That may have been a good reason for

:

This method also keeps the family dealing with each other,

:

should think that they would tend to carry the therapy

I

home

them more than they might with methods which make them they can't talk to each other unless the therapist

Dr. F.

That's true.

:

apy situation

room

table,

at

is

with

feel that

there.

A family will frequently reestablish

the ther-

home, the seating arrangements around the dining

and so on. But

this isn't true of a couple.

In marital ther-

up that irritate them and save them for the therapy hour. The therapist becomes symbolic of their being able to talk together. This may also be because I don't go in and out of the room apy, people will store things

with couples, and they tend to depend on

my

presence for talking to-

gether.

Why don't you use this method with couples?

Int.

:

Dr.

F.:

that I

Because the number of interactions

can usually follow them without

And it's

strain.

small enough so

is

not so hard to get

a couple to talk together while you're there. Whatever the reason, I'm

more comfortable working with a two-person family in the room than I am with a three-person family. With a four-person family, I'm not even comfortable in the other room. Int.

:

There's another

way

in family therapy find that

this

method must be

one of the

first

useful. Beginners

problems they face

is just

making themselves heard. The "infernal machine" of the family grinds on and drowns them out. Your method provides a dramatic way of intervening. It signals the family

Dr. room,

it's

F.:

At

first,

and

arrests them.

yes. In the beginning,

like a pistol shot.

Everybody

when you come

stops, freezes

into the

where they

are,

No and waits for the great man

to say something.

"What

quite disconcerting to the therapist.

be that important?"

As therapy goes

I

Dead

Man's Land

29

This can be

silence.

have to

[

can

say,

really

it

along and the families feel more

comfortable, you have to bang on the table or do something startling to interrupt them. to

come

But by

this

time you have already established your right

and though you may have

in,

to

do something

to call attention

to yourself, they are not going to override you.

This

Int.:

quite a staging device;

is

complex of powerful

weaves together a whole

you are going

positions. First,

family unexpectedly and they never

it

know when

to

come

on

makes you an

problems and gives you an advantage they

their

don't have. Third, you have the tape recorder going and

back to them what they have

must seem Dr.

just said.

So when you

some kind of deus ex machina. Yes. But this machine idea could

first

you can play

come

out,

you

like

F.:

ex machina in an extremely negative sense. In

be thinking of

me

also apply to the tape

The whole setup could make me a deus

recorder in the other room.

mize

on the

that will be. Second,

you're behind the one-way mirror watching them, which objective authority

in

fact, the

family could

why I try to miniWhen I come back into

not as a god but as a devil. That's

this business of

my

being a great person.

the room, this humanizes me. Int.:

Humanizes you

On

dehumanizing you. There's a double

you take the position of one who is not with the family and run everything. At the same time, be-

effect there.

going to

after

sit

the one hand,

hind that screen, you see everything and

know

everything. There's a

framework of great power and a humbleness within ation and a human one when you come in.

Dr. F.

why me.

I try to I

make Int.:

:

It's

it,

an inhuman

situ-

a situation that can easily get out of balance. That's

counteract the fact that they are not always able to observe

a strong effort to be wholly observed as a person. In the tape, just now, you called the screen "a two-way

mirror" and then said, "I can never remember whether mirror or a one-way mirror."

You may

not have meant

it's

a

two-way

but that

slip

brings in the idea that they might be able to see you as clearly as

you

it,

see them.

Dr. F.

:

This again

is

part of

my

philosophy of treatment.

If

you

pretend to be a person without problems, without feelings, just a purely objective scientist practicing a scientific method,

you won't be a very

TECHNIQUES OF FAMILY THERAPY valuable therapist.

I

[30

believe that the patient has a right to a real experi-

ence with a real person in therapy. That means

get

I

mad,

laugh, I

I

have problems. Int.

Except when you are behind the screen.

:

Even when I'm there, the family will sometimes do somewill break them up, and I'll break up too. I don't make any

Dr. F. thing that

:

effort to hide

Int.

Can they hear you laugh?

:

Dr.

it.

Yes, but

F.:

and

generally go out

I'll

join

them laughing

rather than stay in the observation room.

Int.

That's a pleasant sort of intervention.

:

Dr. F.

No,

:

just sharing with

it's

them.

Or

if

I'm angry,

I'll

some-

times do the same thing. Int.

It's

:

you use a physical setup the human person and the

interesting that

double aspect of the therapist,

to divide this

objective per-

son.

Dr. F.

:

changes during therapy too. Toward the end of treat-

It

tend to spend more time in the

ment,

I

would

tie

patient progresses, there

Int.

him and

is

a

movement toward a more equal

relation-

the therapist.

should think that the method would require more time in

I

:

the family. This

what we've been saying about symmetricality. As the

in with

ship between

room with

room toward the end. There's a parallel here with analysis. Analysts start being more human toward the end of treatment, when they come out from behind the couch. You do the same thing by coming out from

the

behind the mirror.

It's

a

shift in the relationship

between you and the

patient.

Dr.

F.:

I

think most of the process of therapy

lies in

achieving

that shift.

Int.

them

that

:

What

effect

have you found

it

has on people

when you

tell

what they say may be played back to them?

Dr. F. Originally I thought it would inhibit them terribly, that it would be a stricture on openness and freedom of communication. But I :

haven't found that to be true in any way.

The

natural patterns of inter-

action between family

talk-

ing, the patterns

their

own

wills,

members are so strong that once they start take over. As they play their roles, almost against

they get so involved that they forget

and act the way they would

at

home.

Now there

all

about being taped

are exceptions to that.

No In one family

Man's Land

[31

men

had, the father was one of these sententious, wise

I

who had some deep comment about

anything that happened. This

wasn't because he was being recorded;

was simply

it

his response to

which he was being observed. With a family

situation in

therapeutic problem

becomes

to get the father off the

any

like this, the

profound

bit.

Did playing back what he'd been saying accomplish this? Dr. F. Somewhat. After a while, when he started off on one of his

Int.

:

:

profundities, he say,

"There

would

get halfway through, break out laughing,

go again." So

I

did work, but

it

it

and

was slow.

way

Int. : Playing back the tape sounds like a

to help the family

you can be from behind the

to be as objective about themselves as

screen.

Dr. F.

This

:

is

again part of

my

people see themselves more clearly. tion, either. I think that

I

philosophy of treatment, to help

a personal report

for getting information,

and

it

my

don't turn is

back on introspec-

a perfectly useful technique

shows respect for your patient to lend

credence to what he's saying. Always with the proviso that there

be in the background a problem which he dr. f.

(cont.):

Ah, but the work of

this and, ah, acting as

isn't

it,

aware of

other than

a kind of gadfly and

a,

at

my

may

all.

facilitating

an external con-

science maybe, ah, other than this, I will stay out of the

room

work with each other, ah, in this room here, and I'll be glad to show you the interior of that room, if you have any concerns about it. I can't talk to you from there, ah, I can hear you and see you but to talk to you I have to come in the door and and you

all will

talk with you, there's a reason for that too, this isn't (inaudible

phrase) but because

Mm-hm.

k.:

dr. f. :

mrs.

want you to keep some kind of idea that

do have a body.

I

MR.

I

I

become a disembodied voice too (Laughs.)

K.:

Dr. F.

:

That's another attempt to reduce the mystery about being

behind the screen.

I like to

show them

the tape recorder

observe each other from behind the screen.

more strongly with the therapist's where I am and what I'm doing. Int.

:

quickly.

At

the

same

To

role, so that

get

them

and

let

them

to empathize

they have a feeling of

time, saying that you're going to act as a "gad-

TECHNIQUES OF FAMILY THERAPY fly"

and an "external conscience,"

certainly points

up

[32

the disagreeable

aspects of your role.

Dr. F.

:

Where

frequently point out to people that

all roses. I will

isn't

working.

can, I like to reinforce the idea that therapy isn't

I

do

I

when people have

when

this

I

know

if it

very well that

the kind of problems

it

going to hurt,

it is

will upset

it

doesn't hurt,

them

to have un-

covered. Int.

:

Was

it

you

to use the

ily that led

way what

it

your feeling that

was a pious, God-fearing fam-

this

term "external conscience" here? From the

sounds, this family

hands folded in prayer: "Lord,

is sitting,

we do?"

shall

Dr. F.

:

I

use

it

with other families too. Part of

much

role of therapist

too seductive.

an overwhelming sense of getting out of the

his

It's

that I find the

it is

so easy for the therapist to get

own power.

It

may be

that the reason for

room, making myself "external,"

is

my own

in

per-

sonality.

Int.

You do seem

:

to

make more

an issue of trying not to be

of

omnipotent than most therapists.

Dr. F.

:

It's

an authoritarian

because

role.

know how

easy

I'm not what you'd

You sound

Int.:

I

so

when you

it

call

would be for

up

to them.

At

are dealing with this family.

an unpleasant brute who Dr. F.

:

Int.:

It's this

most has

same time you suggest

the

will stick pins in

That's quite a trick, isn't

that

helpless

try,

You

but that

you are going

to

it's

be

them.

it?

double framework that runs

all

though

this. It al-

you on. and so innocent and so naive and build you up a class, are very

to. Patients, as

They can be so

to take

a shy, retiring person.

say that you are going to do your best, that you will really

me

skillful at

leading

so easily.

And then cut you down easily.

Dr. F.

:

Int.

Why do you go on to tell this

:

family that you aren't going to

become a disembodied voice? Dr. just set

room.

I

F.:

It's

because I've been asked so

up a microphone and

talk to the family

frankly don't have the guts to

people I've worked with,

one says something to ing at the

if

me

I

many

am

do

silent for

times

why

I don't

from the observation

With some very simple too long a period and somethis.

while I'm in the other room, instead of look-

window they look

up, and I have a feeling that

am disembodied and floating around.

maybe

I really

No

Now does this meet with your understanding or

dr. f.:

mr.

.

.

[

33

.

k.: Yes.

... your interpretation mrs. k.: Mm-hm.

dr. f.

:

dr. f. {to

mr.

We

k.:

we

are,

you

of what we're facing here?

How do you feel about it?

Mr. K.):

quite sure

are most anxious to cooperate in this and I'm

are too, are

you not Mike?

Mm-hm.

mike:

MR.

Man's Land

work

(Inaudible words) try and

k.:

way nor

is it

out as a three-

must be something wrong, it's in keeping with Mike's normal activities and so forth, in keeping with the things that we know. I realize it must

deal because

not, ah,

we

this thing

realize there

be some combination of circumstances that has created

and caused him to do these things but Mike

tion

August, everything as far as

we

this year,

and

since, ah,

is,

are concerned in the, our

with Mike and so forth has been

life

this situa-

fine.

He

home

started high school

most interested in his work, so, ah, it's one of where we're just up against a stone wall and we

is

those situations

must have help from someone. Int.

Why did you bring the family in at that point?

:

was breaking up the lecture. The reference to disembodied voices was a somewhat humorous one, a kind of signal that I'm Dr.

F.:

I

through.

What does

Int.:

the father

mean when he

When was the boy arrested?

has been going so well since August?

Dr. F. the arrest

Int. that

Sometime around November, December. He's saying

:

was

totally

The

:

says that everything

that

unexpected.

them so

father brings in the three of

you have been emphasizing

this, it's still

quite

an

quickly.

Granted

explicit triangular

statement that he makes.

Dr. right,

F.:

and

This

a middle-class father

is

in a sense I

responsibility."

"Something

is

have defined what

So he follows along with

wrong with your

child

would have taken the opposite tack

is

this

who wants

to

do what

is

you taking immediately. If I had said, right as "all of

and you've got to help him," he

just as quickly. It's his

immediate

response to any kind of authority situation. Int.:

Would you have done

differently with a different type of

family?

Dr. F. erate the

:

With a

different type of family, I

problem as a three-way

affair

many

might have had to

times.

But with

this

reit-

man,

— TECHNIQUES OF FAMILY THERAPY you have him committed right from the start, and if he can simply nudge him gently and he will come right back. Int.

it

drifts off,

was

It

:

me

helped

lip service only, as I

to seduce

him

found out

later in the therapy.

and

into the therapy process,

a lever, later on, for pointing out the discrepancy between

ment and

you

Was his readiness to accept it a help to therapy?

:

Dr. F. But

[34

his actual behavior.

At

me

gave

it

commit-

this

the time he said this, he hadn't taken

any steps except the minor one of coming in to therapy. dr. f.

MR.

Good.

:

(to

k.

mrs.

... that, ah, times when it gets

dr. f.

.

.

Mrs. K.): Cigarette?

dr. f.:

k.

.

No, thank you.

k.:

mr.

out then at the start

I'd like to point

this process is .

.

not always pleasant. There are

.

We realize that.

:

.

:

.

there'll

.

be times when you will feel that I'm being nosy,

my

and kind of nasty about

ah,

nosiness,

and

my

this is

job. I

re

mrs.

Huh?

k.:

dr. f.

:

.

.

reserve the right to be nosy and impolite

.

if I

feel this is

an awful

lot to gain.

necessary.

mr.

Mm-hm.

k.:

dr. f.

Int.

Ah,

:

:

if

you

When you

really

say

want

it's

to, I

think there

going to be hard, are you responding to

the father's inordinate agreeableness, or

Dr.

F.:

I'm responding to what

relationship between the father as

it's

know

is

is this just

I

routine?

sense as the brittleness of the

and mother.

It is

going to be fine so long

kept on a very superficial level, but as soon as I begin to probe, they're going to hate

it.

I'm setting the stage for

it

I

so that they

won't then pull out of therapy. Int. this

:

When you

would make

anticipate

how

difficult

F.:

Yes, because this

this against the therapist. pist,

is

going to be,

hard for them to blame you for hurting them, be-

it

cause you've already said you're going

Dr.

everything

is

They'd

to.

the kind of family that would turn say,

"You're not being a good thera-

you're making this unpleasant and there's no necessity for

ease themselves out of therapy on these grounds. This

way

back to the

I

initial

framing and say,

all

"You remember,

I

it,"

and

can refer

suggested this

would happen." Int.:

Do you

always stress the disagreeableness of the process?

No Dr.

you

treatment, cate that lot,

No. There are times when,

F.:

can't refer to

may be

it

it

Man's Land

in order to

as family therapy,

[

35

keep a family in

you

can't even indi-

unpleasant. But I thought this family could take a

as precious as they were.

Are you more comfortable with a family with

Int. :

whom

you

feel

free to point out the unpleasant aspects?

Dr. F.

No,

:

only feel comfortable in tfoing

I

this

when

it's

appro-

priate. If a family is so fragile or lacking in resources that they can't

take any threat at ing completely.

Not only am

am

painful process, I

few cases

There are families to

I willing to

hide that this

even willing to keep

might say

I

don't feel the slightest discomfort in dissimulat-

all, I

it's

it

is

from being

going to be painful and not

whom you

have to say

this, in

going to be a painful. In a

mean

it

at all.

order to give them

embark on a very dangerous task only people with courage and maturity could achieve. Then you'd ter not do it or you'll lose them. the feeling that they are about to

You

Int.:

that

bet-

exaggerate the whole thing so that they won't be un-

pleasantly shocked.

Dr. F.: No, so that they

They

a certain amount of demand.

have committed themselves to a dangerous enterprise, and

will

they'll

will feel

be cowards

They

Int.:

if

they back out.

can't leave without conceding that they're not

up

to

it.

Dr. F.

That's right. Regardless of the fact that I'm making

:

gentle as I possibly can.

And

glorious aspects of therapy,

how

going to be,

there are other times

how

when

I

it

as

point out the

wonderful, sweet, charming

it

is

all

they are going to get to love each other so much,

understand each other so well. Int.

In

:

this

speech you

tell

the family that therapy

an ordeal, but then you quickly switch and say benefit

from

Dr. useful,

how much

My own

I try to

feelings

about therapy are that

communicate

this to people.

But

this

with the actual operation of therapy. I'd be a charlatan

same techniques Int.

:

it's

helpful and

has if I

little

to

do

applied the

to every family.

A therapist who uses the same method, no matter who comes

in the door, might feel that

whoever comes Dr.

they can

it.

F.:

and

going to be

is

F.:

I

it

was dishonest

to change the

method

for

in the door.

would consider such a

therapist dishonest himself.

It

TECHNIQUES OF FAMILY THERAPY would be strange

[36

a therapist were to treat every family in the same,

if

Or

up his own ideal and try to force it on people. He has to be open enough and flexible enough to go along with whatever comes and work with that. unvarying way, as though they were

It's

a question of effectiveness, too. If

tively

and

tremendous number of

would probably show Int.

because

I

Do

:

you

that not

if

he were to

might accomplish immediate

patients, but a two-year follow-up

the changes had lasted.

all

feel, then, that

a directive approach

effective

is less

only produces a surface change?

it

Dr. F.

Not

:

nondirective

all

at

all. I

the time.

And

would have the same

if I

were

this is true of the sessions too. If I

vary

think

I

results

approach from session to session, according to what

priate,

set

presented myself as authorita-

directively as I'd often like to, I

results with a

my

all alike.

I'll

have a higher

ratio of success than

I feel is

appro-

use the same ap-

if I

proach throughout. dr. f.:

I,

ah,

I've

worked with

As

families a great deal.

no marriage goes on

for, ah, ten,

far as I

can

tell,

twenty years without there

developing real blank spots on the map, real unexplored areas

where communication can be improved, where relationships can be improved, where people can understand each other and their roles better,

eased off at I

take

it

where resentment could be any rate, and people could

as a

fundamental premise

marrying and raising a family, I

take

it

it's

get along better together.

that, well,

my

gardless of

how much

unpleasantness

opinion, and

who do

as a kind of basic premise that people

on

not an easy job

it's

a hard job in

stay together love each other, that

eased out,

lifted and, ah,

this

kind of a basis, re-

this

may have

transpired, re-

gardless of the defensiveness of the people, regardless of sensitive the areas are, with this kind of a basis, things

and

out, positively this

with you

With

this

there's

Int.:

ment

It

no

all.

and

well, if

And

my

agree or assume

think

it's,

desire to help

ah, the

it's

so,

and

how

can work I

assume

one valid assumption.

Mike and

yourselves, I think

barrier whatsoever.

must have quite an

that people

who

been talking about so

effect to bring in this positive state-

stay together love each other, far has

problems they have, and so families?

I

we

and

when

all

you've

been the unpleasantness of therapy, the

forth.

Do you

use

this

phrasing with other

No Dr.

I do. It's

a

way

:

37

[

bond which

of saying that there's a

no matter what happens in this room. Are you easing the parents' minds about the

will persist,

Int.

Yes,

F.:

Man's Land

possibility of a

separation?

Dr. F. ties for

:

Not

at

all.

These people were bound by much too strong

such a possibility even to come up. Of course, the therapist has

to be able to recognize

separated.

But

when people would be

better off divorced or

only true in a small percentage of cases.

this is

And

if

makes such a suggestion too quickly, the people don't get divorced, they get right back together again and change therapists. Also, if you make yourself the judge on whether a marriage should or shouldn't continue, it's equivalent to making an ex-post-facto judgment the therapist

that these people should never

have gotten married

in the first place. I

think you have to have a lot of evidence before you can do that. For the

purposes of

family or any other,

this

love relationship, even though that that assumption

Int.

Dr.

:

is

proven wrong

does less damage to assume a

it

may be assuming

Right.

But with

going to have trouble.

You

If

later, that's fine.

They're innocent until they're proven

F.:

a great deal.

this particular

guilty.

couple

I

knew we were

could sense the strong feelings within the

wife and the iron defenses of the husband. I was trying to cushion against the bitterness I

knew would come

out by stressing

my

faith in

their relationship.

You

Int.:

put them in a bind by taking the lowest

nominator you could think of for

love.

Your assumption

one another because they've stayed together

them

sures

to agree with you.

don't love each other,"

together proves

Dr. F.

much you

:

But

if

you can always

is

it,

that they love

they disagree and say, "No, say,

"The

we

fact that you've stayed

it."

In

my

marriage cases,

I

frequently say, "I don't care

how

hate each other and fight each other, you've been living to-

you can

is

that

if

you work

find a better love relationship with each other than

could with anybody else." Int.:

de-

a positive one and pres-

gether for fifteen, eighteen years, and the probability at

common

When you

I

you

think that's a strong statistical probability.

say that people

who

stay together love each

you give them implicit permission to love each other, without requiring any responsibility from them. It just happened because they other,

lived together so long.

TECHNIQUES OF FAMILY THERAPY Dr. F.

It

:

also relieves

them of the

[

38

responsibility for having hated

each other. Int.

In a context in which they probably are accusing each other

:

of not loving each other,

You make

on the premise

that love

love something involuntary that comes with living together.

Dr. F.

hadn't thought of

I

:

it

that way.

work

Int.: You're really creating a climate to

suming that they hate each other and the problem

you give them a

difficulties,

Dr. F. dr. f.

Exactly.

:

(cont.)

:

It's

as

...

:

to

work out

the

So what you can

you

call

me

on

folks, the .

one .

you have,

for,

I

have

ah, be as honest

is to,

.

Mm-hm.

k.:

dr. f.

is

on which to get together. a useful kind of ground rule.

can, not to pull any, pull punches

I

Instead of as-

in.

basis

certain responsibilities to

mrs.

a voluntary thing.

is

or to evade the issues that

as possible

an objective mirror to

come

up, to be an, a, as nearly

re-, reflect

back to you the kinds

of things you seem to be saying, really. If you're rationalizing or, ah, evading the truth, or trying to put things in a

my responsibility

it's

MR. dr.

Mm-hm. f.: ... to, to see different way. And

not to be fooled by this

.

light,

then

.

k.:

Int.

Dr.

:

Where does

F.:

I

picked

through I'll

it

sledgehammer. What he patient has said but

of course

Int.

:

I

this

and to help to structure

try to fulfill that, as

much

the phrase "objective mirror"

is

reflects

that he

is

it

a

as I can.

my

criticism of

about as nondirective as a

back to the patient

is

not what the

what Rogers wants the patient to think he has

do the same

in

come from?

up from Carl Rogers. But

Rogers, after seeing him work,

And

.

good

said.

thing.

You're a selective mirror.

Dr. F.

:

Int.:

In your next statement you say that your job

Yes. I'm the one who's deciding what's objective. is

not to

let

them evade the truth. I think it's unusual for a therapist to come right out and say that. It's usually put in terms of "I'm going to help you understand," not "I'm going to

make you face the truth."

came to this as a result of an experience with one of my private patients. He was really conning me, leading me down the garden path, and I was going along with it. When it finally went too far, I called Dr. F.

:

I

No him on

and made a rather cruel summary, point by point, of

it

had been going on. The patient was so

chicaneries that

took such a turn for the better that

it

taught

me

my

of remark, "It's

job not to be fooled,"

know what you

I'm really saying, "I

going to

let

con

try to

you

get

away with

it." I

free

all

39

the

and

grateful

to succeed. This kind

intended as reassurance.

is

really are like before

so you don't have to worry about

[

something. People want

want

to be free to try to trick you, but they don't

start,

Man's Land

you even

At the same time, I'm not them from feeling guilty if they it.

me and also prepare them for being exposed. you the freedom

Int.: This gives

to say

whatever you

then on, because you've established the premise that

them on anything you think you ought Dr. F.: That's right. Int.:

Your tone here

to call

it's

like

from

your job to

call

them on.

not an accusing one. You're simply ac-

is

cepting the fact that they're going to behave this way.

Dr. F.

You know,

:

hard to get across

that's

in teaching

young

one of the things

therapists,

the difference between condoning a person's

is

behavior and understanding

it.

You

are sitting across the table from a

young

thief. It

social

change and making a protest against social inequities by stealing

hubcaps from ment. People

does him no good to pretend that he

he

cars, or that

who

is

just

is

in the

an innocent victim of

vanguard of his environ-

deal with delinquents generally go to great lengths to

avoid making the kid

feel he's

done anything bad. But

there's a differ-

ence between accusing a kid: "You're a thief!" and saying, "In other words, you're a thief." Int.:

You

call the kid

a thief but don't bring in the emotional

judgment.

Dr. F.:

I treat it as

don't imply that he be.

But

is

I don't ignore

Int.:

something he can change

It

:

his parents

Int.

:

all he'll

to. I

ever

it.

This remark about evading and cheating sounds like the

you're directing

and

he wants

labeled and pigeonholed and that's

sort of thing you'd direct to the delinquent

Dr. F.

if

Do

it

member

to the family as a whole, as

is. I

if it

:

I

were

itself

delinquent.

don't think there's any difference between the boy

on that. you think

this is true

only of a family with a delinquent

or would you say the same thing to any family?

Dr. F.

of the family. Yet

would say

it

to

any family.

TECHNIQUES OF FAMILY THERAPY Int. get

When you

:

away with

you believe in

Dr.

the family that

tell

people

some reason of expediency or because sharing with the family what you feel your function is?

much

the family as

let

things, is this for

my

Well, both. I try to share

F.:

your job not to

it's

[40

as possible. If they ask

beliefs

me

if

about therapy with

I'm a Freudian or a

them no, I'm not a Freudian or a Jungian. But part of it is that if a therapist makes a big secret of himself, or plays the wise old man, it puts too heavy a burden on him. In a sense, expediency governs all my therapy. I have no set beliefs or theories. Jungian,

I'll tell

dr. f. (cont.):

And

again, a part of

my

bias

is

that I kind of like

families. I live in one.

MRS. Int.

(Laughs.)

k.:

:

When you

say that you like families,

is this

because you

feel

you've gone too far in pointing out the uncomfortable aspects of ther-

apy?

Dr. F.

:

You

of

it.

But it's

I've

gone in a negative

also part of the seduction.

use "bias" in an odd way. In talking about the dread-

ful things the family is

tive

make when

the usual switch I

undo some

direction, to

Int.

It's

:

going to do, you present yourself as an "objec-

mirror" which will reflect these things back to them.

Now, when

you say how much you like families, you add, "But I'm biased." Dr. F.: I almost always say to a family that I have a bias regard to wanting to preserve families. That

I will

in

go perhaps further

than would be objectively desirable in trying to keep a family together. Int.:

Is this

another

way

of creating a positive base to

work

from?

Dr. F.

It's

:

really intended for families in

deeper-rooted pathology than

I

am

picking up.

which there might be a I

am

guarding against

may be something in this relationship that make it mandatory for the family to separate.

the fact that there seeing which will Int.:

If

biased in the

Dr. F. dr. f.:

it

first :

I

you can say, "I told you get you on being wrong.

turns out that way,

They

place."

Yes.

It's

can't

I'm not

I

was

calculated.

think that, ah, again, that

therapists in the

that could ever

you

folks are probably the best

world for Mike, better than any other therapist

be dredged up for him, you folks

are.

So long

as

No Mike, as things are confused or there's

you can

[41

difficulty, I don't

think

you can function in the best way as for him, so that this is what we're working toward. point has been reached, then we have had the answer.

be, but I think

therapists

When this

Why

Int.:

Man's Land

do you say

to parents

who

obviously are falling on

their noses with their kid that they are the best therapists in the

world for

him? Dr.

Because

F.:

I feel

very strongly that no outside person

capable parents.

effective substitute for enlightened, well-intentioned,

When

I

was working with adolescent delinquents,

win them over, even help them a

little,

bringing about any lasting change. If parents, this

Int.

is

I

did very

little

in the

you can help parents

way to help the child. a reason you give to somebody

I

could

way

of

to be better

the best

This

:

but

found that

I

an

is

is

else.

Why

do you

tell

the parents this?

Dr. R: I'm disclaiming any intention of

Fm

saying to the mother and father, "I'm not trying to take over your

function and

know what's best for Mike. I'm going to try do what you know is best for Mike." There's another

tell

you that

to help

you

part to

this, too.

to

coming

in

respect for

my

different cultural

job to change that.

their child to

be

want the parents

move

me, and

to feel that I

he

all this tells

:

have some

For the reasons

You take

boy

is

in

them they are

is.

I just gave, I

do believe

also trying to bolster their self-confidence. In that sense,

Int.

want the

I

in feeling like miserable failures because their

better therapists than F.:

have no intention

of giving the parents respect partly tactical?

and the man who's going to solve

difficulty,

like

I

background, a

as parents.

Is this

They must come

Dr.

not

this. I also

them

Int.:

it's

and training

know

family to

/

Each family has a

and

different ethos,

of

substituting for them.

that

back a

little bit

this.

But

I

am

it's tactical.

when you go on

to say that as

long as things are confused they can't be the best therapists for Mike.

Dr. F.

:

I'm pointing out that they are part of the process that got

Mike where he

is,

and

if

things are confused, they are obviously part of

this confusion. Until this is clarified,

they are not going to be able to

function maximally. Int. :

You

put an umbrella over their heads and at the same time

dig a hole under their feet.

TECHNIQUES OF FAMILY THERAPY Dr. F.: That's Int.

You

:

right.

also give yourself

more

rein,

because you're cutting

the possible objections they might raise along the line of

know my

[42

child as well as

do."

I

you

If

anticipate

"You

off

don't

them by saying

that

they are in a better therapeutic position than you are, they can't resist

you

as easily.

Dr. F. ple

This

:

have about their children.

my

And

deliberate.

is

it

caters to this delusion that peo-

anyone started to

If

tell

me

about

my

"Go jump in the lake, Jack. I've lived with her for fourteen years, and who are you to tell me?" I try to get around this with a family by saying, "Sure you know her better.

daughter,

immediate reaction would be,

Things are mixed up and communication straighten that out, you'll obviously be in a

Int.

much

but

if

we

better position than I."

you often refer to distorted or disrupted comavoid coming out with something that might not be ac-

notice that

I

:

distorted,

is

munication to

ceptable in plain words.

Dr. F.

:

Int.:

To go back

That's

of individual

more

of

to

work with

my expediency.

your point about the relative ineffectiveness

children,

is

it

also because

therapist has a better chance to help the child to

you

change

if

feel that

a

he can help

the family to change?

Dr.

F.:

more than

It's

you work

that. If

days a week, with an adolescent, you fortieth of the time with him.

He

exerting a continuous influence

assume

influence

this

is

is

still

hours a day,

five

five

are only working about one

exposed to other people who are

on him, and

a negative one.

if

the child

No

is

therapist

in trouble, I is

powerful

enough, with the techniques and tools he has, to counteract the

influ-

ence of a family. dr. f.

mr.

(cont.):

No,

k.:

dr. f.

mrs.

...

:

k.:

dr. f.:

I

If

No,

Do you

wrong.

.

.

of any sort? I

don't think

I

have anything.

well, of course then

we can

you have questions or you want

something (Mrs. K. laughs) Int.:

.

don't have.

you have,

time. If

have any questions or

Here again you put

feel free to,

in the

bring them up at any

to fight with

anything at

me

about

all.

assumption that you might be

No Dr.

That's because

F.:

position in which I

Int.:

had

to

would

I

find

it

very

Man's Land

difficult to

you allow them

for footwork. All through this

be free to comment against you,

to

I

Dr. F.: I'm also being

more room

you can

do.

self-protective. In the initial stages of ther-

you

the patient sees of

lot

notice that you're enlarging, at a vari-

ety of levels, everything possible that

when

be in a

uphold some ideal continuously.

because you have already anticipated them, you have a

all

43

seems to be a continuing enlargement of your range of

It

future behavior. If

apy,

[

is

a tremendous image of power, but

image begins to crumble and you become a plain human

that

being, watch out.

Int. criticize

So you

:

step

one down

to begin with

by

telling

them they can

you.

Dr.

This

F.:

is

showing respect for them, saying, "You

also

have perceptions, ways of looking

at things that will

mine." But the main point

care whether I'm one

I'm hung.

that

is

if I

don't think a therapist

I

one-down

couldn't accept a

would stay

be better than

down

or not,

in the business

position, because he

will

if

he

too often in that

is

position by virtue of his patients' progress or lack of progress alone.

They have come to you for help and you haven't helped them. That's the biggest one-down the therapist gets. Int. You mean you're one-downed if after five minutes you still :

haven't helped them?

Dr. F. I've

Or

:

five years. It

worked with every kid

three or four of them.

averted

some

As

Perhaps

:

mrs.

k.

dr. f.

:

mike: dr.

f.

:

:

how

to

my

effective

tragedies, but I don't think

we spending our money if

it

Sometimes

up.

it's

has produced any miracu-

"What

right to say,

are

for?"

they

questions,

Mm-mm. No? How

come

families,

role has been, I think

would have every

felt

that way, they wouldn't

Mike, do you have anything

Any

two or three

that. In

in serial order as they

lous results. These families

Int.

can be just

.

.

keep coming.

.

Mike?

do you

feel

about

it?

mike: Fine. (Pause.) dr. f.: Well,

we have

I

will get the

to use a session to

that out of the

— I'm

other test and ask you folks to

do

way before we

this,

but

I

start entirely

think .

.

.

it's

sorry

as well to get

TECHNIQUES OF FAMILY THERAPY mr.

[44

Mm.

k.:

dr. f.:

.

.

.

ah, to complete this

first,

of the

this last

tests, in this

pretesting period.

(Session ends with family arranging to meet after the

New

Year

holiday instead of the following week.)

Int.

:

Why did you turn to Mike so particularly?

Dr. F. Int.

Dr.

:

Because he had been

:

You get

out for a long period of time.

a response from the mother and father too.

Their response

F.:

left

a kind of acceptance of the ground

is

rules.

The ground rules? Dr. F. What we had been

Int.:

talking about.

:

from Mike,

from

I

want something

too.

What you

Int.:

ments.

And

get

from him

is

the nicest of

Now I gather that if it weren't for the testing,

all

possible state-

you would go

right

this introduction into therapy.

Dr. F.

Yes. I'd start them

:

off,

ask them to discuss their problems

or something general like that, and then get out of the room.

Second interview with the Kane family* dr. f.: Well, do

you

recall

our

last

meeting?

What we

talked about

then?

mr.

Mm-hm.

k.:

Remember

dr. f.:

that, as, essentially

we

talked about the need to

develop adequate or improved means of communication between three of you.

all

you or is

in

And my

role in this as that of kind of needling

acting as a kind of gadfly.

And

the fact that

my

interest

your discussing the real problems that are going on in your

family, ah, that's

major things

what you've given some thought

that's

going to be needed here

is

that

to.

One

you

of the

folks are

going to have to help Mike to express himself to a great extent. It's

kind of a

deal

difficult situation for

on your approach and your

sure that

maybe kind of bugs you,

him. We'll be counting a great attitude as

you express

it.

I'm

so I'm going to get out of here

and we can get started then. (Fulweiler starts to go out.) * This session takes place three

presented in

its

entirety.

weeks later than the introductory session and Names have been changed and places omitted.

is

No

Man's Land

When you ask them if they recall what went on last meeting, how much do you assume they will remember? Int. :

Dr. F.

And

I

:

don't assume they'll

remember

it

any

in

[

45

during the

specific detail.

way they remember it will be completely different from the do. What I do assume is that the session was important to them,

the

way

I

that

it

was a unique event

in their lives. This

especially true of a

is

family with a first-offender delinquent because the event that brought

them

from the routine of their ordinary life.

in stands out

Int.

When you

:

tell

the parents that

you want them

to help their

boy

to express himself, is this routine or did something about the

give

you a lead? Dr. F.

This

:

is

more

of a routine thing. Actually,

it

boy

leads to the

Most youngsters, in the presence of their families, are going to be dummied up. And most parents, to help the child express himself, will beg him to say something. Then as soon as he gets a word out, they will argue him

first

good reason for coming

down. I'm

setting

up the

in

and making an

situation so that I

what they are doing. I'm asking them

interpretation.

can come in and point out

to fall into the trap I'm setting for

them. Int.

In other words, you are

:

anticipated

It isn't

:

aging them to do

because

if

my

if

you've

a matter of anticipating

Of asking them

it.

it, it's

to start out

a matter of encour-

by making

this

mistake

students to structure this at the beginning of therapy,

they don't and the parents start to argue the child down,

they're stuck.

you can

free to point this out

it.

Dr. F.

I try to get

more

They

can't

go in and say, "Now, we've talked about

how

your child to communicate. What happened?" and

facilitate

play the tape back and point out what actually occurred. Int.:

If

you

didn't set this up,

would the family possibly do

something different?

Dr.

F.:

right away. I

Int.:

No, they'd do exactly the same want them to do

Is part of

it

it

right

thing,

though maybe not

away.

the setting they're in? After

all,

they're there

because the child has done something wrong, and you're watching them.

Dr.

F.:

Int.:

That's part of

What

you're doing

going to do anyway, as a then free to

it.

comment

on.

way

is

encouraging them to do what they're

of arranging a situation which

you

are

TECHNIQUES OF FAMILY THERAPY Dr.

F.:

That's right.

a relatively good, neutral, dramatic in-

It's

stance of family therapy, to bring

Int.

By setting it up

:

Dr. F.

:

But you

this

you want the atmosphere

talk.

The only way

do

home

to

them the process

way, you arrange your

of therapy.

intervention.

first

want the family to help the child communi-

also

cate,

to

[46

to be

this is to

express himself, so that you can

one

in

which the child

feels free to

encourage the family to help the child

show them how they

are actually doing

the reverse.

mrs.

k.:

Ah, ah, Mr. Fulweiler, we

up a conversation, or

just start

what?

you know the areas

we

we

discussed last

time and the things that have led to some of the

difficulties. If

dr. f.: Well,

you'll try to start

on them,

that, ah,

I'll

have,

help you out as you go along.

(Fulweiler goes out.)

Int.: If the mother hadn't

come

in there,

would you have gone

right out?

Dr. R: Yes. Int.

they're supposed to

Dr.

much

framing as you generally give them on what

Is that as little

:

F.:

I

do

after

you leave?

honestly don't think you can structure

without destroying what you're

taneous interaction. That's

comment Int.

why

which

after,

I try to get

is

it

for

them too

a relatively spon-

away with

as

ambiguous a

as possible.

The mother

:

Dr. F.

:

sitting in the

things that

isn't

about to

let

you.

No. She's uneasy. Most people

room

staring at each other. I

have led up to some of the

the door and getting out.

and using me, so

I

succeeded in doing

was this.

I

are,

made

when you that

leave

them

remark about the

difficulties just as I

was opening

wanted to prevent them from trapping

getting out fast. I

As soon

as

me

had one student who never

somebody

said,

"What

shall

we

do?" he would get caught in an interaction with the family. For two years, he never got out of the room.

mrs.

MR.

K.: k.:

mike:

I

(Laughs.) Well? (Laughs, long pause.) (Inaudible phrase to Mike.) don't know.

(Long pause.)

(Fulweiler knocks, enters.)

Hm.

No Int.

Man's Land

[

47

Why did you come back in so soon?

:

Dr. F.

Because

:

was obvious that they weren't going

it

to

move

them a push. Int.: You didn't assume that if you waited longer they'd ultimately get around to doing something? Dr. F. No, I felt that if I waited too long with this family there

very far

if I

didn't give



:

was an optimum waiting period feeling.

They would have



would leave them with a very bad failures and they would have become it

felt like

want to

critical of therapy. I didn't

let this

kind of negative feeling get

started.

How long do you sometimes let a family

Int.

:

Dr.

F.:

I've let

them

sit

and wait?

without saying a word for as long as

sit

twenty-five minutes.

On

Int.:

What kind

opening?

would you do

of a family

that

with?

Dr.

F.:

can't. I think I

might do

and are quite aware of wilderment, as

You

hard to say.

It's

was

it

it

just feel

with people

who

whether you can or you are ordinarily very verbal

their blocking. If a family's silence

here, I tend to help

them

is

a real be-

out. If their silence is a

hostile one, I don't.

Int.

You must have

:

Dr. F.

very quickly.

Or

know how to

read silences.

not hard to do. Their nonverbal behavior can

It's

:

to

they'll say, "I

wish he were in the room.

he come back in?" Then there they're obviously waiting for

me

to

Why

be a long, dead quiet

will

come back

in.

I

tell

doesn't

in

would

me

which

frustrate

this.

Int.

Dr. first

Even

:

F.:

if it

creates a negative reaction?

Yes, with a family that

time they break the silence,

As

structuring.

I'll

is

come back

It's

in

and give a further

a reward.

way of establishing when you want, not when they want. Int.:

a

come

the premise that you

Dr. F.: Yes. Except that there are times when the family in

with such

humor

that

I

can't help laughing

with them and then go out again. But

coming

in

on

But the

deliberately resisting.

I

and

make

I'll

it

come

in

calls

in

me

and laugh

quite clear that I'm

my own terms.

dr. f.: Suppose

which

is

you

start

then with what led up to Mike's

the reason for your being here

difficulty,

—mainly. What

do you

— TECHNIQUES OF FAMILY THERAPY think, Mike, are the things that led to

What kind mike:

your getting into trouble?

of feelings you had or attitudes you had.

any feelings

can't think of anything that,

I

[48

that

I

had.

you think of any criticisms or, or gripes you have? There's plenty of gripes you have at home. (Pause.)

dr. f.: Well, can

mike:

Do you

dr. f.:

MR.

have any insight into

this,

Mike

far as

want him

to or not. I

apparently

This

that's his

fairly recently as

smoking. He's told

me

he wants to smoke and he's going to smoke whether

that, ah,

:

concerned and

is

Mr. Kane?

come up

Well, there's one thing that has

k.:

dr. f.

don't think so.

I don't, I

is

it

a

didn't

good

have forbidden

it

at times, previously,

I

but

do any good.

starting point then, or at least a problem.

are your feelings about

it,

What

Mrs. Kane?

(Fulweiler goes out.)

Int.

Did the

:

father turn

and speak to the boy when you

first

went

out?

Dr.

F.:

Yes. They look immediately to the child to bail them

out.

Int.

By

:

turning to the child

when you come

in,

you are doing the

same thing they would do. Dr. F.: I'm recognizing what they are doing, and ing that, in point of fact, they wouldn't be there

if it

also emphasiz-

weren't for the

To evade this would be hypocritical, to the boy as well as to the parents. By joining them for this moment, I am also winning them over. Int. When you ask Mike about what got him into difficulty, is this a way of saying, "1 know you're a thief," and getting that over with? child.

:

Dr. Int.

F.:

An acknowledgment that he's the problem.

:

Dr. F. it

Yes.

:

No, that

he's the precipitating factor. I've already

framed

so that he isn't the whole problem. Int.:

It's

in that phrasing

your being here

Dr. phasis

F.:

on

It's

when you

say, "He's the reason for

mainly." the hesitation that's meaningful. I'm putting the

their being in the office rather

em-

than on the boy's being in

trouble.

Int.:

When you

then ask about any gripes he might have, you

turn the tables on the parents.

Dr.

F.:

Yes. I've joined them and

from a safer vantage

point, I think.

now I'm backing

the boy, but

No What

Int.:

you've done

is

Man's Land

[

49

by bringing up

to side with the parents

boy by asking for any criticism he might have, then you turn and ask for insight from the father. you

the boy's problem, then

It's

side with the

a rapid alternation, in a matter of seconds.

Dr.

I'm saying to the father, "Mike's criticisms of you are

F.:

come up." Then complaints. Even

important and they're going to

I

ask the father about

them. I'm setting the stage for

if

they had brought up

some

would probably sooner or

different matter, I

later

have come in

and asked for the complaints.

You

Int.: that his son

going to complain about him.

is

going to counter

Dr. F.

:

put the father on the defensive by bringing in the idea

it

almost insure that he's

by jumping on Mike.

Yes, but

I

give

Of

he, complains about.

him the chance

course, he brings

which he

feels is indefensible.

thinks

a matter on which

it's

You

I,

When

to put

is

as

what Mike, not

up a complaint

of Mike's

he mentions the smoking, he

or anyone, will unquestionably support

him, the sort of thing which will easily prove that he

Mike

it

is

a good parent and

a bad boy.

So

Int.:

you go out again.

after setting that up,

don't care what problem they discuss, so long as

Dr. F.

:

Part of

my

position

to talk about will contain within

it's

that whatever

is it

I

take

it

that

you

a problem.

problem they choose

the difficulties in the parent-child

relationship.

Int.

It's like

:

kicking a system on, or priming

it

a

little

to get

it

started.

Dr. F.

:

Int.:

Why

might

Sometimes you have to do a

just as well

Dr. F.

:

lot of priming.

did you choose gripes to prime this one with?

have

said,

That's not

You

"What's nice about your family?"

why

they're here. I will frequently point out to

people that they are in the therapy

room because

of what's wrong, not

what's right. Therapists have to be kind of carrion birds, psychologically.

Int.: I have a suspicion that

if

you had

about the family, they'd go right to something

Dr. F. mrs.

:

started with what's nice

like

smoking, anyhow.

Sure. Well,

k.:

I

think

Mike knows

that I

would prefer

that he didn't

smoke.

MR.

K.:

I

can't understand Mike's feeling that, he's going to

whether we want him to or not. (Pause.)

do

it

TECHNIQUES OF FAMILY THERAPY

[50

smoke I'd rather have him smoke at home than out on the street some place. mr. k.: Well, that's good. I agree with you there but I think he, I don't think he should smoke at all. And I think that he realizes

MRS.

Well,

k.:

that

Dr.

as he has

about

feel

F.:

to

She

been smoking,

notice the tells

it,

smoke. That she

Int.:

he's going to

if

it's

not,

it's

not habit.

How

do you

Mike?

it,

You

everything about

boy

that

not only that he can't ["stop" implied]. Certainly as

it's

much

I feel

starts

is

way

the mother

comes

in there.

Her

tone,

you immediately that she has encouraged the in conflict with the father about

it.

out with a defense before the accusation has been

made.

Dr.

what

exactly the

That's what you tag immediately. That this gal has done

F.:

she's defending herself against.

boy smoked

at

home

than out in the

she has undermined her husband.

The

When

street,

old

she says she'd rather

you know

man

that's

where

has been ranting and

raving and she has quietly undermined him.

He When

Int.:

remarks.

seems to be trying not to pick up the cues

in her

she disagrees with him, he ignores her and turns to the

boy.

Dr. wife's

F.:

and

Any husband who heard that first speech of the reply with, "Then why do you let him smoke?" is

Sure.

didn't

obtuse.

Int.

:

It also

to his wife.

Dr.

Even when he

F.:

feels powerless,

it?" to

the last thing he wants to do

is

face

up

interrogates the boy, he's pretty indirect.

hang on.

to

is

No

but he doesn't

Do you

Mike

if

That's partly because his feelings of powerlessness have

no external cues Int.:

sounds as

obvious ones.

He

feels

undermined, he

know why.

think that his question,

"How do you

feel

something he might ordinarily say, or did he pick

about it

up

from you? Dr. F.

:

I

think he picked

it

up from me.

express himself and he's doing what

is

I

told

him

to help

Mike

expected of him. In ten years,

I

bet he's never asked his wife or his son what they thought about anything.

mike: Well, how much do you have, how much do you have to smoke before

it's

a habit then? In your opinion?

No MR.

Oh

k.:

Man's Land

I

51

pack to a pack a day. Are there any, any

I'd say, half a

when you smoke?

certain times during the day

mike No, not especially. MR. k. Just when you happen to think of :

:

it.

mike: Uh-huh.

MR.

And you have the opportunity.

k. :

mike: Uh-huh.

MR.

Do you have cigarettes

k. :

with you

now?

mike: Yes.

MR.

k.

Do you smoke

:

school?

at

mike: No.

mr.

k.

Do you smoke on

:

the bus

on the way home from school?

mike: No.

mr. k. Are you allowed mike: No. :

mr.

k.:

know, I'm

don't

I

to

smoke on the bus? just asking, I don't

know. Have you had

any cigarettes today?

mike:

had one

I

MR. k.: What time? mike: Before, while MR. mrs.

mr.

k. (to

Mrs. K.)

I :

was riding

Well,

Did he smoke

I don't, I just

old boy smoking

Mom.

in the car with

you?

is

don't think the idea of a thirteen-year-

proper either

one of those things that can

to school with

Yep. (Pause.)

k.:

k.:

morning.

this

feel

about

gonna do

it.

it

As

any way

I've

at

home

or anywhere

else. It's just

been defied on completely.

want

or anything

And

I

but he's

still

far as he's concerned, he doesn't care about

my

I

to,

else,

on the subject at all. And he's expressed himself that way. Very openly and above board about it.

feelings

Int.: father

gather you wouldn't

and son. Not

Dr. F. is

I

:

I

on that interchange between

don't think so. Nothing has really happened.

enough yet

says, "I don't

in

this early.

acting like an interrogator but

destructive

come

know, I'm

it

to warrant

hasn't gone far

an intervention.

just asking," he's

The

father

enough nor

When

backing away.

If

is

it

the father

he had kept

up as though he were a trial lawyer, I would have come in, but I wanted to let it go on at this point and listen. What's interesting is the way the father disengages the mother from responsibility. He comes up and touches it and gets away from it. it

TECHNIQUES OF FAMILY THERAPY comes

Int.: She

in almost cockily,

[52

almost daring him. That

"Yep."

Dr. F.

Sure.

:

mike: Well

It's

I,

I,

defiance.

I said,

something, you take

mr.

Well

k.:

mire:

.

.

.

.

for

.

I said it

.

.

.

say

was

it

.

.

.

.

.

said, ah, that

I

.

.

what you think .

something and you, whenever

.

mr. k.: Well you, you asked mike: .

And he backs right off.

me

if I

then you're doing

was gonna smoke and then you it

just, just to spite

me.

And

I'm

not.

mr.

k.

Well, I've told you not to smoke, haven't I?

:

mike: Yes.

mr. k. That was a direct order. mike: Uh-huh. mr. k. And you have, and you say you are going to smoke. mike: Yes. mr. k. In other words, it, it's, in one sense mike (overlapping) I'm not doing it to spite you. mr. k.: ... in one sense of the word, it's, ah, because I have told you not to, it's just sheer disobedience, isn't it? mike: Yes, but it isn't spite. I'm not doing it just because you s-, you :

:

.

:

.

.

:

want Okay,

don't

me to.

mr. k.: I'll, I'll accept mike: Yes. (Pause.) mr.

that. Nevertheless, I told

And, no matter what

k.:

I

want, along those

you not

lines,

to.

you're

still

gonna do it. mike: Yes, I guess I am. (Pause.) mr. k. You know it's not good for you, don't you? mike: Yes. :

Dr. F.:

many

I

think that's a delightful interchange.

families. Parents will put

words and ideas into

mouths and then react according to ther

is

isn't. If

true,

saying here that the boy

It's

is

their

own

so typical of

their children's

interpretations.

being spiteful,

when

the

The

boy

fa-

really

kids are doing something destructive or malicious, then this

but

if

is

they are doing something which pleases them, like drinking

or smoking or going to a movie, in opposition to their parents' wishes, this isn't spite. It's rebelling, testing the limits of their parents' control.

They

are really saying, "Look, control

me if you can."

No So the father

Int.

:

Dr.

F.:

He's

lost

because spite

really lost,

is

a

flat rule,

goes on smoking, he's

the issue.

or thinks he has:

made

in the

background,

is

Once "No smoking," and the boy

another matter. But he's put himself in a very

down

isn't

53

[

because he's never taken any effective action.

Whether he could have, with the mother standing he's laid

Man's Land

difficult situation.

a fool of himself. All he can do

is

protest

it

in a futile way.

Int. to

The son

:

sits

there calmly

and

says, "Yes, I guess I

am

going

go on smoking."

Dr. F.

What makes

:

coming from a boy whose

He

good.

even more peculiar

superficial

is

that this insolence

appearance

is

is

And

making a demand

is

that of a goody-

What

really is a nice-talking, nice-acting, sweet-looking kid.

he's doing action.

it

that his father take authoritative, direct

the father can't. This reminds

me

of another family I

worked with where the father complained that his boy wouldn't go to bed when he was told. In the particular instance he was referring to, the mother was in bed already and the father started to go to bed and on his

way through

ing.

He

said,

said,

the dining

room he

"Don't you think

"No." The father

and the boy

said,

utes later he

still

said,

it's

noticed that the boy was

study-

time to go to bed now?" and the boy

"Don't you think

it's

getting pretty late?"

"Yep." So the father went to bed. About hadn't heard the boy move, so he

said something like, "Don't

still

you think

it's

fifteen

min-

came out and again

getting late?"

and got the

same response. This scene was repeated about five times and finally the father went to the mother and said, "You've got to do something about that boy, he refuses to rectly

how

go to bed." Yet

all

that time he

had never

di-

asked the boy to go to bed, just made asinine statements about

late

it

The mother was quite incensed; all she did was to get the room and say, "Damn it, get to bed." The kid picked

was.

up and go into up his things and went to bed. mr.

k.:

I

don't

know what

the answer to

it

is.

I

can't follow

you

around twenty-four hours a day. Where are you getting the money to

buy

cigarettes?

mike From my allowance. mr. k.: What? :

mike: From

my allowance.

mr. k.: I didn't give you any allowance in over a month. mike: Yes I know, and I was sick, and I had some monev

left

TECHNIQUES OF FAMILY THERAPY mr.

k.

[54

How much, how much did you have left?

:

mike: About a dollar and a half. mr. k. What are you going to do when that money runs out? :

mike:

mr.

don't know. (Pause.)

I

Well,

k.:

k.

Well,

:

you any allowances

and buy cigarettes with.

to go out

mrs.

don't feel that I'm going to give

I

money

don't think cutting his

I

off is the answer.

do work around the house and I should think I should get paid for it. Whether I'm going to buy cigarettes with it or not.

mike: Well,

I

It's just if

mr.

mike: ... thing, k.:

If

mean

I

I.

Again,

I

Dr. F.

:

Not

a comment.

come

Is there

F.:

that has been

isn't

want you

to

do somefire

me.

You work

something you would come in on.

dozen places where

think

I

I

stayed out because

some kind

little

could have it

come

seemed to

me

in

and

that the

play hadn't been acted out yet.

would need

it

I

in order to intervene.

of unit that has to take place before

you

Yes. Something that has some completion, some action

rounded

chance to round out,

out.

Sometimes

thought

if I

it

I

would intervene before

would end up

be bad or unhelpful to the family. Here, interrogation

showed

up

was going

for in the beginning.

Now,

if I

to hurt the boy, I

that he wasn't really helping

else entirely.

But

it

Mike

problem, not the

on

going to change that.

child's.

in a

way

it

would

that

had thought the

would have come

got a

father's

in

to express himself, the

and

way

I

rapidly began to look like something

right at this point, the

ents' is

.

in?

Dr.

set

.

he was your father or something.

didn't have the kinds of things I :

.

I'm not entirely sure why, because listening to

yet.

I

if

interaction wasn't complete, the

Int.

approve

[father's boss] didn't

gather this

again, I can think of a

made

If I don't

Mr. Carter

if

and so do

:

:

what would you say if he cut off your pay? Mr. Carter didn't want me to do something, he'd

mike: Well,

Int.

.

.

(overlapping)

k.

mr.

.

problem has become the par-

Nothing they can come up with from now

At what specific point here does it become their problem? Dr. F.: Where the mother says, "Well, I don't think cutting his money off is the answer." This is where she is battling her husband and using Mike as the weapon. At this point, if smoking were really the Int.:

No

Man's Land

[

55

problem, there should have been a united front on the parents' part.

The mother, by disagreeing with her husband, gave the son

the chance to

argue effectively against his father. Int. child's

Do you

:

problem

Dr. F.

is

any family situation in which the

feel that there is

not the parents' problem?

That's a hard question to answer, because there are levels

:

of causation. If a child has been reared in a family, you can't

from the

pletely disentangle the parents

have

feeling that children can

their

child's

own

problem. But

I

com-

have a

problems. There are a lot of

influences besides the parents, differences in physiological

make-up and

neurological responsiveness, different experiences with school, friends,

and so

But

forth.

in

some

sis that is tied in directly

families the child gets a kind of social neuro-

with the parents. In this family, the parents are

fighting each other through the boy, instead of fighting rectly.

Aside from

MR.

that, there's not

too

Mother and

I,

you are

di-

much wrong with him.

Well, part of that money, Mike,

k.:

each other

I

mean,

thirteen years old,

it,

ah, the thing that

we do

still

have some

you think we do. As to your comings and goings and what you do and what you don't do. control, although I sometimes doubt

You And

still

have certain obligations to

if

us,

as a thirteen-year-old.



you don't care any more about this doing things around home? Does Mother if

I,

do

I get

paid for

get paid for doing

things?

Int.: This speech of the father's

is

peculiar.

To

argue that you

should have power over somebody because he's only a thirteen-year-old is

a self-refuting statement. If he's only thirteen, you wouldn't argue

about

it

anyway.

Dr. F.

:

Int.

He's treating the boy as

:

Exactly.

could be discussed.

whom

I

The minute you put it that way, you're lost.

It's

as

if

he

if

said,

he were an adult with

F.:

this

"You're a responsible person with

can discuss the fact that you're thirteen and

Dr.

whom

still

irresponsible."

He's also encouraging him to get further out of control.

The boy probably

feels quite

panicky at

this point,

because the father

has told him, "I can't control you, you're on your own, thirteen or not." He's also depriving him of what

knowing someone

is

all

adolescents need, the security of

around who can keep him from

killing himself. It

TECHNIQUES OF FAMILY THERAPY would have been the

mat with you, Int.:

far better right

if

the father

"we," trying to

"Look, I'm going to

said,

now, unless you stop."

interesting the

It's

had

[56

make it

way

the father tenaciously sticks in that

a united front with the mother

when he knows

it

isn't

Dr. F.: You notice how he

At

facing the issue head-on.

the end of that speech, where he says,

"Do

paid for doing things around home?" he's shifting ground and

I get

going back to a point the boy has made, but tur.

maneuvers without ever

indirectly

What he's

child will

trying to

do

is

it's

a complete non sequi-

arouse a feeling of guilt in the child so the

do what he wants.

mike: No, but do

do

I,

work any place?

I

Do

you consider that, ah, you're doing those things and you're receiving pay for them, is that the way you consider it? mike: Yes. mr. k. You don't consider it just helping around, around home? mike: Well I, I should think I should get some money. {Pause.) dr. f.:

y-,

:

mr.

Well, Mike, I'm, I'm very

k.:

much

afraid that

I, I

don't agree

with you on that score.

mike: Well,

mr.

But

k.:

I

guess

if

you

don't.

you're going to spend your

don't approve of,

I

my

I

for something that

don't see any reason that I should be

you money.

If you're

going against

orders. That's

one way

I

obligated to give

and against

I,

money

an approach to the solution

that, ah,

know

would

my

wishes

of for at least

satisfy

a,

me.

{Fulweiler knocks, enters.) dr. p.:

You

haven't expressed any opinion on

you look kind of disapproving. What, what mrs.

k.:

this,

is

Mrs. Kane, but

your idea?

I've just said that I don't think, ah, cutting his

money

off is

the answer. dr. F.:

What do you

think

is

the answer? I think your opinion might

be helpful. {Fulweiler goes out.)

Int.:

Why

did you

come

in

and ask the mother for an opinion

here?

Dr. R: Well, the mother knows, and the boy knows, that the allowance is the tool the father is going to use to try to coerce the boy into giving

up smoking without ever dealing with

the

smoking

directly.

No The mother was

up

sitting there swelled

like a

Mail's

Land

57

[

poisoned toad. I was

giving her the chance to express herself before she burst.

Int.

Had the father already stopped the boy's

:

Dr. F. gesture.

Yes, and

:

He was

allowance?

what made the boy's burglary such an apt

that's

carrying the battle with his father over smoking to

"Even

logical conclusion:

if

you stop

my

allowance, you'll

its

pay for

still

my cigarettes." Int.

:

He's also bringing the community in against the parents.

Dr. F.

You can

Sure.

:

for himself but for the like this, I

right

whole family.

When

I

see a neurotic delinquent

assume that he knows perfectly well what

from wrong, but that

he's desperate to create

that will require a change at I've often

read his stealing as a cry for help, not just

"How

asked kids,

home and

some kind

of crisis

bring him closer to his parents.

did you feel

when you were caught?" and

they've answered, "I felt glad because I thought that at last

would

knows

he's doing,

somebody

me."

talk to

(Fulweiler has just gone out.)

mrs.

Well,

k.:

think that, I

MR. mrs.

.

don't really

I I

know what

think that he's entitled to

the answer

is,

some money

but

don't

I

And

to spend.

.

.

(Inaudible phrase) any

k.:

Well,

k.:

think that

I

if

way

that he sees

he's going to

don't think he should have to, ah, put

spends. If he's gonna,

should spend

it,

and

if

if

fit.

be given an allowance,

down

you're gonna give

I

every cent that he it

you're not going to give

he

to him, then it

to him, then,

okay.

MR.

Would you approve

k.:

something that you

mrs.

mr.

k.:

Well,

k.: Well,

I

mean

didn't, ah,

k.:

Well

him going out and spending

now, within reason,

.

.

it

for

approve of?

within reason,

What do you mean by mrs.

of

I

le-,

don't think he's going let's

analyze that a

.

.

little

.

bit.

within reason?

.

mr. k. Something you've forbidden him to do? mrs. k. Pardon me? mr. k.: Something you have forbidden him to do? (Pause.) mrs. K.: No. mr. k.: Well, I, I have forbidden him to smoke, should I give him :

:

money with

it.

to

go out and buy cigarettes? That's what he's going to do

TECHNIQUES OF FAMILY THERAPY MRS.

Well,

k.:

[58

don't think we're going after any, ah, ah, I think

I

we're teaching him to be deceitful.

By



money he's you, when I

cutting off his



gonna smoke, and I would rather I, I know that say this, you kind of, you say I'm evading the issue. But I would rather have him smoke, in front of me, and in front of you, and have his confidence, than know that he's out on a street corner someplace smoking a cigarette.

mr.

k.:

agree with you on that point.

I

smoke

would rather have him

I

in front of us.

Mrs. k. (overlapping) of an issue

And

:

made

being

is

think that, ah, that, ah,

I

of the smoking.

smoke now, because gonna impair his health,

that he didn't I

think

I

don't think

it's

cutting off his

it's

I

I

it's,

too

much

would much prefer

think he's too young.

to a certain extent.

something that we can control so

And

However,

that, ah,

by

money.

(Long pause.) The look on his face the other day when I walked into his bedroom and he was lying there in bed smoking

mr.

k.:

much

a cigarette. Just as

do about mrs.

k.:

him

tell

that

was gonna smoke he was

Then mr. mrs.

mr. mrs.

mr. mrs.

mr.

k.:

.

.

Well

.

k.:

k.

.

that

if,

smoke,

if

at

you wanted, that if he home, in front of you.

.

when he

did

agree with you

I

k.: k.:

.

.

to

it,

you flew

Now make up your mind

:

k.:

.

to

off,

you had a

fit.

agree with you.

I

:

k.

.

what are you going

it?"

heard you

I

as to say, "Well,

.

.

.

.

you want him

realize that.

I

.

whole thing,

I

.

.

.

.

smoke

to

at

home

or don't you?

I'm completely confused about the

don't,

I guess. I just

wish that

his, his

wants and desires

and so forth would change to the point where he wouldn't want to smoke yet. Because I don't think he's old enough. And I certainly

do agree with you that

I

don't like to see him, to see boys

out on the street corner smoking. I've seen an awful lot of in [nearby

mrs.

mr. mrs.

k.: k.:

k.

do

I .

.

.

down

town] while I've been working. .

.

and

.

it

just doesn't

(overlapping)

:

look nice at

have asked him

I

school and he has told

mr.

it

me

no, and

I

all.

if

he has been smoking

have asked him please don't.

Are there any places down there where you are allowed smoke, Mike? k.:

at

to

No

Man's Land

59

[

mike: No, not exactly allowed. (Fulweiler knocks, enters.)

Int.

What brought you

:

in?

The

father being confronted

by the

mother?

Dr. F.: No, that wouldn't have brought

and

"I wish his wants

saying,

wouldn't want to smoke." This

who

questions the child

who

child says, "I lied because I

"Why

parent says,

want

to. It's

in. It

a variation on the theme of the parent

He

lied.

knew

I'd get

says,

"Why

punished

if

I didn't."

And

in the boy's character for

a horrible bind for the child.

the choice the father wants

Was

the

The

father here

is

him

him

to

to

using this

device to try to arouse enough guilt in the boy so that the boy will

Int.:

The

did you lie?"

did you want to lie?" That question always implies

must be something awful

that there

was the father would change to where he

desires

is

has

me

make

make.

the father also responding to the mother's defense of

the boy?

Dr. isn't

No,

F.:

the kind of

then back

it

I

own

think he's responding to his

man who

can say,

"You won't do

up. So instead he leaves

it

insecurities.

He

period," and

this,

open for the boy

to decide

whether or not he's going to smoke. I'm quite sure that when he put to the

boy he structured

it

something

are no good, despicable, and

vile. If

boy. But you're perfectly free to position is

where

how

exactly

an impossible

if

like this: "If

make

you

don't,

it

you do smoke, you

you are a wonderful

the choice."

So the

child

is

in the

he smokes he's no good in the father's eyes, and that

the father controls situation.

Here

it.

Except that the father ends up in

he's given the

boy

free choice, but

when

boy chooses what's most appealing to him, as children usually do, there's no way in the world for the father not to end up looking ridicu-

the

As

lous.

the mother points out, the father has set

given the boy permission to smoke, and then

punish him for Int.: thing,"

up

when he

himself, has

does, tries to

it.

Where

would

it

the father says, "I'm confused about the whole

that be a point

where you might conceivably have come

in?

Dr. the father

down

the

some clarification. But isn't really confused. It's just a ploy. The mother has thrown gauntlet, saying, "Make up your mind," and when he says

F.:

Not

unless he genuinely wanted

TECHNIQUES OF FAMILY THERAPY

[

60

means that he's not going to give a direct answer. He's going to come around Robin Hood's barn and give a devious, subtle answer. And that's exactly what he does. He says, "I want him not to want to smoke." Int. The father talks as though he doesn't want to make an issue of it between him and the boy, as if he wishes the whole business would go away without his having to do anything about it. he's confused, this only

:

Dr.

Yes, but this

F.:

is

deceptive. He's the one

who

repeatedly

ignores the boy's plea that he isn't smoking out of spite and keeps

bringing

back

it

to a personal issue

between them.

(Fulweiler has just entered.) dr. f.: That's, ah, an important point in the session there, a part,

As I gather it, what you did originally then was to tell or put Mike more or less on his own, say, "Okay, you, ah, if you're going to smoke, I want you to smoke in front of me." Then when he did it, why you rather.

MR.

k.

dr. f.

Well, he's only done

:

He'd only done

:

And that w-,

it

.

.

.

it

once.

once then.

was quite by accident. mr. k. I found out oh, it was? mrs. k. Well, I mean, ah, wasn't it? mr. k. No, he mrs. K. (overlapping) Are you speaking of Sunday? mr. k.: Well, his, his bedroom door was open and I just, ah, he wasn't hiding it at all, were you, Mike? mike: Well, I just figured that you wouldn't walk into the room at that time, you were doing some work. mrs. k.: But he wasn't being, he wa-, didn't have the cl-, the door mrs.

k.

:

that



:

:

:

.

.

.

:

closed or, or locked or anything.

He wasn't hiding it. k. He wasn't hiding it.

dr. f.

mrs.

mr.

:

:

k.

No, he was

:

(overlapping)

dr. f.

just in his :

room, when he was smoking

.

.

.

This was according to your instructions about

that.

mr. dr.

mr.

k.: f.

:

What? This was according to your original instructions.

Why, yes. See, we didn't, ah, we didn't know apparently quite some time that he was smoking, he, he'd been smoking k.:

about a year.

for

for

No

Man's Land

[61

What do you think of your wife's point that perhaps, there's much ado about too little on this particular point?

dr. F.:

MR.

k.:

possible.

It's

How do you feel about it?

dr. f. :

mr.

k. : Well, I

.

.

.

dr. f.: See, here's a point that has gone

more or

um,

less,

doesn't get

mr.

ah,

takes the, ah, gets

much help

out of

it

.

.

on here where Mike has a bad time out of it but

.

Yeah.

k.:

That

dr. f.:

and

here,

you and your wife are

is,

gather

I



is this

the

first

in conflict about

what

time you've discussed

to

do

this this

way? mr.

Oh,

k.:

Ah, and, and compared notes? What has happened

dr. f.:

mr.

yes.

This

k.:

dr. f.:

.

.

.

.

.

.

.

.

.

what happens,

then,

when you do compare

in

this

fashion?

mrs.

k.:

Oh, we end up the same way. (Laughs.)

mr.

k.

We end up with no solution.

:

(Mrs. K. laughs.)

mrs. k. (overlapping): (Inaudible phrase) the same thing. (Laughs.) dr. f.

:

No solution.

dr.

As I say, this has been one of discussing down here. F. What? The conflict of discipline and

mr.

k.:

mr.

That's right.

k.:

:

No,

the, ah, the idea of this, of this

feelings about

dr. f.: Well,

about

and

.

.

.

smoking and how, our

.

then,

solution, I'd

when you discuss it this far, then end like to know how each of you feel

it.

Well,

K.:

it,

when you

up with no mrs.

.

.

thing that I thought

just stays

it

up

in the air, I

mean

I

still

have

my

opinion and he has his things go on. (Pause.) dr. f.:

mr.

k.:

And who

gets the short

end?

Mike. (Mrs. K. laughs.) Suppose you continue, then, a

dr. f.: Exactly. little

beyond

this point this time.

(Mrs. K. laughs.)

(Fulweiler goes out.)

Int.

:

You do

a curious thing here. First you

father's inconsistency

it.

I

up the

about the boy's smoking. Then you suddenly

switch and say that the real trouble

wife over

start to take

is

that he can't get together with his

wondered whether you did

this in

response to the conflict

TECHNIQUES OF FAMILY THERAPY between them. accident." "Oh,

Dr. F.

it

evidently in that

62

"That was by

little bit:

was?" "Well, wasn't it?"

don't know. I think I shifted in response to something

I

:

came out so

It

[

What prompts me

am observing will sometimes change quite rapidly during the time it takes me to get in the room. The father's inconsistency would inevitably cue me off, because about the mother.

it

to

go in when

stands out in the early part of this session as the

And I do

really deal with.

go back to

it.

to the father, the

mother was looking

here

I'll

it

goes again.

get

But as

snowed under by

if

here,

I

when

we

issue

first

could

I started to talk

she were thinking, "Well,

this verbal

barrage and then

I'm dead." She had an emotional point that was quite valid in dealing with Mike, but she was a voice crying in the wilderness.

I

was

think I

simply trying to take her side against the husband at a point where she

was emotionally

The

right

father always

and he was

managed

usually dead wrong.

You

logically right,

to argue her

down

and yet she was rationally, but

often see this in families where the

right.

he was

men

are

frightened of their emotions and erect these logical structures to safe-

guard and

isolate themselves.

A lot of engineers are like that, physicists,

man was. why you asked

or accountants, as this Int.:

Is that

the father

how he

felt

about the

mother's point?

Dr.

Yes. But

F.:

I

know beforehand

that

if

you ask most engi-

neers or accountants what they feel about anything, they will

what they Int.

tell

you

think. :

I

Dr. F.

him the chance to tell you. knew he was going to give some kind of complex verbal so I cut him off.

notice you didn't give

:

I

rationalization,

Int.: There are a lot of rapid switches here. After taking sides

with the mother, you bring in the idea of a conflict which

is

hurting

Mike, and so take his side against the parents. Then, instead of going

on about the

conflict,

with the conflict.

Dr. F.

:

Int.:

It's

I

It

you ask about the

it.

have for dealing

puts them on another level of discourse.

hadn't thought of

it

like that,

but

it's

true.

partly in the nature of your method, too. It puts the

emphasis not on what the problem about

rules they

When you

ask the father,

this?" the implication

is

that he

is

but on what they are going to do

"Do you and your

and

his wife never

wife ever discuss

have any meaningful

talks.

Dr. F.

:

That's right, nothing ever comes to a solution.

And

I al-

No ready have an idea that the father

not going to

is

Man's Land

let it

come

[

63

to a solu-

tion.

What

Int.:

are you doing at this point to

make them

more

talk

meaningfully?

Dr. F.

I'm trying to arouse their guilt by asking,

:

And

short end?"

indicates that she

the father says, "Mike,"

When

Int.:

gets the

and the mother laughs and

my position.

supporting

is

"Who

what

the father mentions

he's thought of talking

about in these sessions, and you come in with, "What, the conflict of

was

discipline?"

Dr. F.

that really

Heavens, no.

:

what you thought he had wanted

I

the matter of the conflict, but

was

thinking. This

you would

like

knew

I

mind?

open the door a

further to

little

what he

perfectly well this wasn't

just nondirective therapy;

is

him

to

in

you

tell

and hope that

to think he thinks,

the patient

he'll

what

begin to think

it.

Why

Int.:

do you go out

done as much as you can

Dr.

F.:

I

and rather than easy for

but what I've

me is

at this point?

in getting

Do you

assume you've

them going?

them something to work on, out and let them take over. It would be

leave because I've given

around,

sit

I

get

and go on talking about the

to stay

conflict of discipline,

me is what they make out of the interaction When I get back to the observation room, I can

important to

engaged them

in.

see what they do with

it.

(Fulweiler has just gone out.)

MR.

K.

(to

please

Mike) you

Would

:

said that

if I

please you,

it it

Would that make you feel mike: Yes,

MR.

k.:

I

guess

it

(Pause.)

still

have given

k. :

for

you

it

to

would

smoke?

I

wish

it's

I

could, but I honestly

the right thing for

you

and

to do.

my I

allowance away, you're, you're both, not

buy can't

cigarettes, or

I'm not being, I'm not

go to the show,

I

can't

.

.

.

Now, Mike, whenever you have come to me, in the last two three weeks, and asked me for money for some specific thing, it

to you.

mike: Those things

MR.

me

would,

I really don't.

able to do anything.

I

right with

it

better?

don't think

being, I'm not able to

or

presume

would.

mike: Well, by taking

k.:

all

Well, for your sake, Mike,

truly can't. I

MR.

was

I

You're

I

right.

had

to do. (Pause.)

You're

right.

TECHNIQUES OF FAMILY THERAPY

64

[

(Fulweiler knocks, enters.) dr. f.: I think

what Mike

make a

saying would invariably

is

difference to a kid, between the things he has to

big

do and has to

have money for anyhow, and things he might want to do and having a

that, yeah, there

is,

to spend, period.

Not

some

for

know dr. f.:

.

.

.

.

there

asked a ques-

a time when a kid needs money

is

to save, or to put into something worthwhile

spend and to have, you

Now that's, those are my feelings.

:

own

cash, jingling in his

pocket. But there's

a point that we can't avoid here too, Mike, and that father

is,

ah, as

he points

out,

says

you

him

up, everyone will back

is

that your

he

in control of this situation. If

The

not smoke, you will not smoke.

will

is

him

up.

He

court will back

has the say about

this.

remains, ah, a legal offense for you to be caught smoking

It still

outside. This could result in

quite a

number of

your getting picked up or anything,

Remember

things.

law down, you can work

that kind of a

you, (to parents) he can

If

just

.

some ready

.

You

take Mike's, ah, side here

I'll

specific purpose, but just to

(overlapping)

K.

to just goof with.

few minutes ago, and here

tion a

Mrs.

money

of

little bit

that it

when your dad

lays

out between each other.

smoke around you

in the

home,

it's

another matter. If Mike, (to son) you're at liberty to do that.

Ah,

there's a

that isn't so.

up

good deal of

And

license in

the, ah,

how

only

now

but outside

anyone, everyone will back your dad

in this. He's, he's the boss for

we're talking about

own home,

your

when

it

comes

to this.

are mainly, ah, the idea of,

to get this over to you, but

your family really wants, and right

what

now

really it's

is

how

What

to,

not

wanted, what

a conflict,

isn't it?

(To Mrs. K.) You want him to smoke, not that you want him to smoke, but you don't want to make an issue of it. (To Mr. K.) And you want to make an issue of it, or do you? mr.

I'd rather not

k.:

.

.

.

dr. f.: All right.

mr.

k.:

dr. f.

mr.

:

k.

:

dr. f.

.

.

.

but

I will if it's

necessary. (Laughs.)

Um, now what does that mean? Well, what I mean is I don't want to make an issue (overlapping) You don't want to make an issue of

mrs.

mr.

k.: k.:

I

mean

I can't

agree, with

do

it,

I

.

.

as long

bring myself

to, ah,

K. laughs.)

I,

Mike and, and I

.

.

honestly say.

mean

,

it

:

as he stops smoking? (Mr.

.

I

to

mean

I can't

condone

could go ahead and

tell

his

smoking.

I just can't

him, "Sure, go ahead."

No

Man's Land

65

[

Did you, did you, did you condone it, at first? mr. k.: Well, when, when he actually, flatly de-, defied me and said, "I'm going to smoke," which he did, then I told him I'd rather have him do it around home. Now he, he did, absolutely, flatly say, "I am going to smoke, whether you want me to or not." mike: I didn't say that, "whether you want me to or not." mr. k. Well, you said you were going to smoke. dr. f. :

:

mike: Yes.

mr. k.: Well, the, the rest of it was inferred, though. mike: All right, but I didn't say that.

Mr.

dr. f. (interrupting

who

K.,

before, Mike's, Mike's complaint,

Mike has more

that

kind of twist

mr.

true,

mr.

may

this

came up

be a complaint

more extreme or more, or really intend to do this.

:

Ah,

I

have,

I

may have some

have, ah,

I

believe

it is

nastier

probably

me that before.

because Mrs. Kane has told

dr. f. : This

this

Ah,

you take what he says and

frequently, that

He doesn't

it.

(overlapping)

k.

and

:

into something

it

than he intends

speak)

starts to

roots too

.

.

.

Sure.

k.:

...

dr. f.:

in the past. (Mrs.

K. laughs.)

(Fulweiler goes out.)

Int.

What were you

:

Dr. F.

:

after

when you came in?

My plan on coming in was to reinforce the father's role

as

the father, as the head of the household, and to point out that he has the right to Int.:

make demands he should be making but isn't. Then why do you start by criticizing his position on

boy's pocket

Dr. F.

:

the

money? Because the

first

person

I

perfectly right in saying that he should

want to prepare

want to support

have pocket money. But

for building the father up. If

run the risk of turning the boy

off,

Mike.

is

I

of giving

support the father

him

He

is

I also first,

I

the impression that I

have betrayed him. Int. will

:

off

the father

support him in the strong stand he

Dr. F. be a

The way you support :

is

to say that all of society

isn't taking.

I'm really saying, "If you'd stop acting like a

real father, you'd

have everyone's support."

I

say he's

Mike's allowance but that he has the right to lay

boy

do it directly. Int.: You've managed to take

if

he

down

jellyfish

wrong

and

to cut

the law to the

will only

sides with both simultaneously.

TECHNIQUES OF FAMILY THERAPY Dr.

That's right.

F.:

Int.

when your dad

ber

You

between you."

"Remem-

such a complex thing when you say to Mike,

It's

:

[66

lays

down

this

kind of law, you can work

imply that the father

is in

control,

and

it

out

same

at the

time you suggest that the son has a share in determining what the law shall be.

You're not building up an authoritarian image of

Dr.

F.:

No,

it's

this father.

an authoritative one, which gives the boy

fair

play as well as the security of knowing what the restrictions are, and

do

this in the context of

Int.

:

You

I

supporting the father's image in the family.

might alternatively have said to the father, "Stop acting

like a jellyfish."

Dr. F.

and

:

If I did that, I'd

son's eyes,

be undermining the father in his wife's

and also trying to substitute for him. He's got to retain a

degree of respect from them, and in, it

should be built up.

If I

if

he doesn't have

it

when he comes

were dealing with him individually

I

might

own home." But this would be done in a context where I have given him many indications of my appreciation of him as a person, so that he would know I wasn't tell

him, "You're an ineffective weakling in your

attacking his character but what he was doing. Int.:

There's a big difference between talking to someone face to

face and in the presence of his family.

You have

to consider

what

effect

anything you say to him will have on the others.

Dr.

F.:

This

is

what makes family therapy so

You

delicate.

pro-

ceed by a kind of condensed, synoptic interaction, in which, by the by, the actual content difference whether

You

is

relatively unimportant.

we were

talking about

wouldn't

It

make any

smoking or something

don't want anyone to leave the session feeling

else.

down because

down because you've built come in and make an interpre-

you've undercut him, or anyone else feeling the other person up. That's why,

when

tation like this, I

can be exhausted

knocking down,

forestalling, in

keep

it

I

after a

many

few minutes. I'm building up,

different directions at once, to

relatively even.

Int.:

Why

do you go on

to say that the real

problem

is

what the

family wants?

Dr.

For "family" you can read "father" there. I'm saying to Mike, "What you really want to know is what your father wants." I go F.:

on to point out that Mike

way

to go.

One way

affronts father

is

affronts

in a

mother and pleases

and pleases mother.

know which the other way

bind because he doesn't father;

No Int. that is

When you

:

you want him to

Man's Land

"You want him to smoke, smoke but you don't want to make an issue of say to the mother,

that to bring out the idea that she

is

[

67

not it,"

supporting the boy in his smok-

ing?

Dr.

No. That was a

F.:

smoke," the father could then an

light into her

you want him to smoke and smoking

evil person,

church says

"You want him to and say, "You see, you're

slip. If I'd left it as,

it's

bad."

was simply recouping

I

my

is

bad and the

mistake, or trying

to.

Int.

Why do you

:

what the boy says? Dr. F. This gets tied

to spite him. This

up

in a

them on the

issue of the father's twisting

back to where the father was

refers

:

boy smokes

leave

something that

is

knot when the father makes

insisting that the

just enrages the boy, this accusation. I

he

was

opening that one up. Int.

And siding with the boy.

:

More than

The mother had apparently made the same objection to the father many times, as the father admits. And I suspected that he had twisted the mother's words many times too. That was why I said, "This may have some roots in the past." The mother's Dr.

F.:

knowing laugh

tells

me that she got right off what I was getting

Int.: This time, as to

that.

what they are

when you

leave,

to do. I take

it

you don't give any

at.

instructions

you assume they are

sufficiently

trained.

Dr. F.

:

Yes, and

I

figure that they

have plenty to work on now.

become apparent that the father is going to come back to the smoking regardless, no matter what I do, just as a compass needle comes back to the north. These interpretations are making little nicks But

at

it's

him, but they are not getting through. Int.:

Do

you take

this steadfastness of the father's as

discourag-

ing?

Dr. F.

:

his defenses.

Heavens, no. Not in the

As

long as he's

still

at

first

it, still

session. He's got a right to

working.

(Fulweiler has just gone out.)

mrs.

you doubted him on Sunday as to where he was getting the money, and you, you asked him where he was getting the money, and he told you, and you said you didn't believe that he had spent what he had for k.:

I

don't,

Christmas.

I

think that,

if

you

recall

TECHNIQUES OF FAMILY THERAPY MR.

say

I didn't

k.:

wanted

.

I didn't believe that

[68

he had spent what he,

I just

.

.

me before that?

mike: Then why did you ask

MR. K. (overlapping) Well, I, I wanted to verify it, Mike. mike: In other words, you didn't believe that I spent that much for :

Christmas presents.

mrs.

k. (overlapping)

inferred

mr.

.

(Inaudible phrase)

you had

if

to verify

it,

you

.

All right.

k.:

mrs.

.

:

K.:

.

.

.

you

that

didn't believe he spent that

much

for Christ-

mas.

Dr. ing,

You

F.:

by saying

see, here she's following the line that I've

to the father, "You're trying to prove your

been tak-

boy a

liar."

That's just what he's done. Instead of accepting the kid's Christmas gift,

he went back and questioned

it

and

tried to find out

how much he

had spent and in the process tore up the whole idea of Christmas. Int. says,

it

:

So when you brought up the

was a

father's twisting

deliberate effort to support the

what the boy

mother into taking

it

fur-

ther.

The mother and the boy both. I also want the father to have to pay some attention to her. Did you catch her emphasis on the word "inferred"? She's repeating the father's word of a short time before, when he was speaking to the son. She's hoisting him on the same Dr.

F.:

petard.

mr.

(overlapping)

k.

for Christmas, Let's put

it

:

now

this

All right, I didn't believe he spent that

way,

to

me,

I

I didn't realize that

I, I

here? (Pause.)

he had spent that

much

me, as we went down the list could see how he had. But it didn't seem

when he

for Christmas. But

item by item, then

now where do we go from

wh-,

much

told

had forgotten about Betty and

much

Al.

(Long pause.)

mike: Well,

I

know

why

I

should ask you what you spent for everybody's Christ-

see

mas MR.

I don't

have as

authority, but

I,

I

don't

presents.

K.: Well,

Mike, that

is,

ah, that's another point. I realize that

wrong thing to do. Nevertheless there's one thing that you've got to remember, and I am very much afraid that there are times when you forget it, and that is that I am your father and when I ask you something, you that was, perhaps, in

are to

tell

me.

some ways was

the

No mike: Yes, but

mr.

it



And when I you blow off you get mad and pop off and k.

:

you

asks

at

mike: Yes,

the handle, nine times out of ten,

everything

aren't ready to

why you

my

(wavering voice), whether you're my, whether you're

why you

or not,

me

should ask

do

won't you?

guess so. But I don't see, I don't see

I

when somebody

else,

when you

a time

me on that,

think you'll agree with

I

it.

do something

to

69

[

.

.

.

Man's Land

what

I

should father

spent for your Christmas

presents.

mr. k. Forgive me, mike: All right.

I've, I've

:

mr.

All right.

k.:

done mrs.

k. :

it.

I,

.

.

.

we've been over that before.

shouldn't have

I

I'm wrong. In your eyes. (Pause.)

Well,

I feel

sometimes that

I,

of course

I

have been

.

.

.

(Fulweiler knocks, enters.)

mrs.

k.

... caught up

:

.

.

.

(To Mr. K.) What were you wrong

dr. f.: Sorry, I missed that.

about?

mr.

Well, he, ah, he says

k.:

shouldn't have

oh, one minute



he,

had spent that much and

presents. I didn't realize that he

didn't



he spent some twelve or thirteen dollars for Christ-

ah, claims that

mas

I

me

seem to

as

it

though he had. So he itemized the things

had bought. And among the things of course that he bought was my Christmas present, and he doesn't like the idea of my knowing how much he spent. that he had, ah, that he

DR. F.

mr.

:

k.:

Yeah. That's kind of legitimate, Sure

it is.

any way that

Sure I

isn't it?

agreed with him on that. There wasn't

it is. I

could find out. But

have asked him in the

I

past,

many many months ago, in trying to teach him to take, ah, care of his money and so forth, I have asked him to itemize what he has spent his money for, and he has yet to do it, in any, any detail. He did it for a couple of weeks. And then, he just doesn't like the idea of

having to account for his money.

of mine for many,

many

to have. Nevertheless,

years.

a habit that

it's

of every single penny that dr. f.: This

is

intensely

MR.

k.:

Maybe

I

feel

I

a,

been a habit

ah, foolish habit

do have and

I

keep track

spend. Every penny.

very useful, for you.

Mike would

it's, it's

It's

pushed

And to

it's

my

question just

do the same

how

thing.

He's apparently, from, from, ah, his past actions and his

little

green book that he was given and so forth, he doesn't think anything of

it

at

all.

TECHNIQUES OF FAMILY THERAPY

was you brought up the question of your dad misinwhat you said to him, taking things one way that you

dr. f.: Mike,

it

terpreting

meant

in another.

Mm-hm.

mike: dr. f.

170

What

:

else,

what other things do you have

to,

do you

cause

feel

unhappiness to the family other than this? (Fulweiler goes out.)

What cued you to come

Int.

:

Dr.

F.:

in there?

Nothing very profound, I'm

simply didn't hear what was going on.

phone or not paying

why

I

attention. This

I

is

would guess

afraid. I

may have been

talking

that I

on the

sometimes one of the reasons

enter the room.

Int.

:

Do you

ever ask them to repeat something as a tactic?

The fact that I brought them back to the father misinterpreting what Mike says shows that I didn't have anything new to offer at that point. I wasn't coming in Dr. F.

Yes, sure. But

:

this

time

I

don't think

did.

I

for a therapy purpose.

Int.

:

You

used your entrance to turn things a

still

ask about the father misinterpreting Mike, you ask,

cause unhappiness?"

Dr. F.

It's

a

much broader

bit.

"What

You

don't

other things

question.

I'm trying to get Mike to put into words what other things

:

he sees going on in the family, since he seems to be opening up a

how

I'm also trying to see will

bit.

the parents will deal with this, whether they

encourage him or shut him up. {Fulweiler has just gone out.)

MR.

You know what Mr.

(Pause.)

k.: this

this is

is,

Fulweiler said

Mike,

last time,

no man's land here, you can bring out anything you

want.*

know

(Long pause.) I guess this smoking has been most of the trouble. Um, you know, I, I kept my budget for more than two weeks

mike:

I

(Pause.)

it.

I

don't

want

.

.

.

.

mr.

k.

mike:

:

.

All right, .

.

and

to write

I

how

long did you do

was keeping

down (wavering

it

.

.

it?

in the bank, too, but I didn't

voice)

how much

I

want

spent for your

presents.

mr. *

The

k. :

father

is

All right, Mike,

now

le-, let's

forget about

what you

.

.

.

referring to a conversation not included in the tape recording of

the previous session.

No mike You mr. k.:

said

:

.

.

.

.

my

started for

mike: Well,

you on your,

Well,

k.:

book

71

much

know

detail as the

list

that

I

your bank.

in

exactly what

spent

I

it

I

didn't

for.

Remember

forget that particular item.

let's

keep

didn't

thought Christmas presents would be enough.

I

think you'd have to

mr.

You

Christmas presents.

track of the others in, as, ah, in as

had

[

.

.

spent for

.

Man's Land

the green

gave you?

I

mike: Yes. mr.

How long did you

K.:

mike:

mr.

keep that?

(wavering voice) kept

I

Well,

k.:

me, would you

tell

longer than two weeks.

for, a lot

it

tell

me

something very honestly,

were there any times when you put down on there that you spent

money for a phone call, when actually you spent it

or magazines, or something like that, for cigarettes?

mike: Yes.

mr.

Sure there was. So that, as far

k.:

as, ah, as that sort

concerned, there was no point in keeping

MRS. K. (overlapping) that

so important for

it's

where you and

mr. mrs.

k.

Well,

:

mrs.

mr.

And

:

Is

:

him

:

he going to follow

...

it.

Of

be given an allowance,

course, there's

.

k.:

.

.

don't see

I

why

it. .

he going to follow that practice

is

Now

k.: it

mr.

keep track of

disagree again.

I

he's going to

if

reason that

mrs.

to

(Talking simultaneously, inaudible phrase.)

K.:

k.

didn't.

That's right.

:

k.

k.

you

is

(Mr. K. trying to continue) can't see

I

he should have to account for

mr.

'cause

it,

of thing

.

I

had him,

I'm

him on

—simply because

.

.

The only

.

you've, have always kept track of

.

All right.

him

I started

all his life?

a

little

wasn't that

I

was

It

just, it

to try and,

training in the handling of

wanted

to

K. and Mike

(Mrs.

was merely

and ah,

money, that was

know

exactly what he spent his

start

speaking simultaneously,

to give all.

money

It

for.

inaudible

words.)

mrs.

You made him

k.:

allowance.

mr. mrs.

mr.

k.

:

k.:

.

I,

what

would resent

didn't care

I

K.:

I

.

.

.

.

it

.

.

him

his next

.

.

bitterly.

the thing it

present that before you gave

was

Ewie, I didn't, it wasn't that I wanted to know he was buying. It was just the mere fact that he

is,

that

TECHNIQUES OF FAMILY THERAPY was keeping the

Do you

record.

see,

do you

see

[72

what I'm trying

to get at?

MRS. K. (overlapping)

mr.

That.

k.:

MRS.

.

I

what you mean, but you

see

.

.

.

.

.

... made

K.:

:

him, nevertheless he

knew he was gonna

turn

account in to you before he got his next

that, that itemized

al-

lowance.

MR.

That's right.

k.:

MRS.

k.

Now I would resent it bitterly if I were made to do that.

:

mr. k. Well, I didn't know any other way to, ah, get him to do it. mike: You told me once that, that you want, that twice, I think, you told me the reason for me keeping that is because you wanted to know if I was buying cigarettes or not. mr. k. And you falsified it anyway. mike: Falsified what? mr. k. The fact that you d-do there never was an entry on there for :



:



:

cigarettes.

know. But you said to me that you just wanted to train the handling of money. You admitted, twice, at least, when,

mike: Yes,

me

in

I

when you

asked, found

me

out before, that you wanted to

know

was buying cigarettes or not. In other words, you want to know exactly what I spend my money for. whether

MR.

K.:

I

I

think that, that's right, Mike. (Pause.)

(Fulweiler knocks, enters.)

Int.

This "no man's land" the father quotes,

:

is this

a phrase you

often use?

Dr. F.

:

Yes.

and communicate Int.: It

same

It's

freely about what's

makes therapy a

on

down

their minds.

special place

which doesn't have the

rules as other places.

Dr. situation

F.:

The

corollary of this

enough not to carry over

dered by the therapy. he's

to try and encourage people to let the bars

is

to ask the family to respect the

into outside life the results engen-

If a child confesses in the

done something wrong, he

is

therapy session that

not to be punished afterward.

wife says something nasty to her husband, he

is

Or

if

a

not to get back at her

when they leave. Int.

:

I

should think

this

would be a problem as soon

as

you got

the family in therapy together.

Dr.

F.: That's

why

I

use this phrase.

It's

pretty

much

a myth to

No

Man's Land

73

[

expect the family to forgive and forget entirely, but you can hope to lay

down some ground

rules so that they won't

be

explicitly difficult with

each other later on. Int. this is

There's another thing which could happen.

:

you

If

them

tell

a "no man's land" where they can say things they might not

one of

ordinarily say,

their impulses

that reason alone they might

would be

come out with

to test

out.

it

And

things that otherwise

for

would

be kept hidden.

Dr. R: They

Of

during therapy.

against each other.

test

it

not only in the

first

session but repeatedly

course, as this father shows, they can also use

Here he

is

me and

copying

saying to the boy,

it

"Go

ahead, you can say anything," in the most helpful and considerate tone.

Then when list,

the

boy brings up the

father's unfairness over the

the father dismisses the topic

accounts.

stands out very clearly that the father

It

on the boy.

It's

know when

they are lying.

When

:

is

falsifying his

using the

list

to spy

a tribute to the fact that most of the time people don't

The

accounts, and yet he himself

Int.

and attacks the boy for

Christmas

is

the mother

mother and father

father accuses the

boy of

falsifying his

being completely dishonest.

comes in

start to quarrel, I

to take the boy's part,

take

it

that

and the

you wouldn't break

in.

Dr. F.

:

No. The mother

And the father isn't in a now would serve either a

little,

giving a

Int.:

doing very well, she's holding her own.

is

very secure position. to flatten

him or

On

duce

F.:

intervention

I

made

to flatten her. He's backing

little.

your entrance here, was

says, "I think that's right," that decided

Dr.

Any

it

the pause after the father

you to come in?

think so. Apparently the father has been trying to in-

I

guilt again.

Int. fairly,

:

the

that

It's

boy

same scene

and the father backs down and says, "I'm Each of your entrances so far has come at the end

of a version of this scene.

you are

which the father attacks the boy un-

protests,

wrong, you're right."

families

in

Do you

often find patterns like that in the

treating?

Dr. F.: Yes. But

I

wasn't seeing this as a pattern.

I

knew what

the father was doing, but I'm not sure that this ing

me

to

bringing

come

me

in. I

in so

don't think

much

it

was necessarily motivatwas the type of interaction that was

as the sense that the interaction

had reached a

TECHNIQUES OF FAMILY THERAPY terminal point.

came

thing that

come

tend to

I

in

after this scene

when a scene

gets

could have a bad

rounded

[74

Any-

out.

why

result. That's

I

intervene.

Int.

Dr. that the

What do you think could have happened here?

:

F.:

would anticipate a complete change.

I

boy would become

terribly frustrated or

I

would expect

blocked because the

up the way he did, and that they would shift to something else and come back to this later. The father would then act as though he had never said or heard any of these things before. father

had

tied things

Int.:

take

I

it

you see

that

this as the

kind of destructive cycle

that perpetuates the family's difficulties.

Dr. Int.

Yes.

F.:

Are your entrances designed

:

to

break up

this cycle, to

block

it?

Dr. F. which

To

:

block

it

be of benefit to

will

and also to all

try to

make some

sense out of

it

of them.

(Fulweiler has just entered.)

Ah, again, this have a good point

dr. f.:

how

one to learn

something, as a training device,

is

there. It's

training a kid

is

That

is,

fashion.

an excellent way of training some-

to handle their

they're spending their

money

for

money,

in order to

know what

and keep them aware of

it.

But

something, ah, perceived in a somewhat different

you've

made

a

mark on Mike,

as far as

ever be, at the end, as free and easy with

if he'll

think you

I



I

money

doubt as

he

you hadn't trained him. It sounds kind of as though your own goals got mixed up in the process, and that in addition to the training, it began to be sort of a, a, almost a spying might have been,

technique

mr.

.

.

Um-hm.

k.:

dr. f.:

mr.

.

if

.

.

.

to be darn sure he wasn't stepping out of line.

Um-hm.

k.:

from this standpoint and Mike's objection.

dr. f.: I think jection,

mr.

Um-hm. As far as

k.:

dr. f.:

objecting to

it

I

can understand your wife's ob-

as a training device, no,

it's

a very

good one. Mrs.

k.

:

I

don't object to

it

as a training device.

Even if it hurts, I think, even makes him squawk like a wounded banshee, it's

DR. f.

(overlapping)

:

if it

hurts and

still

good. But

No when you do you,

get con-,

sounds a

it

lot as

Man's Land

you get the two mixed up, you know, when though and this has come up two or three



times today, that's the kind of feeling that

I get

some way, you have

to establish control, in



is

really necessary.

reasons why. (To Mrs. K.)

why Mr. Kane

too, as to it

I

think

I

to be sure yourself

think this relates

it

feels a little out of

much more side

there's this feeling that

won-

of the

at times,

it,

and needs,

stricter

con-

closely to the, this business of

and the other the other, and

does to anything Mike

And

doing pretty well. Pretty good.

you

I

think that you can answer that one,

one of you championing one conflicting, than

And

know some

I

seems to me, to reach out and establish a firmer or

trol. I

you have

that

that you're in control, in Mike, in, in Mike's situation.

der whether this

75

[

actually doing. He's

think between the two of

I

Mr. Kane

is

has,

and

I

think he's pretty

well justified, that he's, ah, sometimes he's fighting both of

you

one (tape recording skips) and, and

may

and not

just

I

think this

be very disheartening for Mike, too, that he, that you and he are

teamed up against

his dad, in a

way, and that puts

his

dad out

in

the cold.

mrs.

Yeah.

k.:

The good

dr. f.:

things, the valuable things that

Mr. Kane could

teach are kind of lost in the family.

mrs.

Yeah.

k.:

(Fulweiler goes out.)

Int.

Dr.

some

Can you

:

Int.

I'm going after the father, but

F.:

points. :

Dr. F.

elucidate that? There's a lot in that speech.

So

It :

I

compliment him on using the

sounds as

if

you were

my own

impossible, because I don't :

list

to give

him

as a training device.

straining for that compliment.

Actually, at the time I thought that I'd like to be able to

do the same thing with Int.

want

first I

Are you using

kids, to train

know how to this

use

it

them

to use

money.

It's

myself.

genuine admiration on your part to sup-

port the father for tactical reasons?

Dr. F. Int.

:

then you turn

Dr. restore

she

is

To

him up so I can lay him low. You certainly do lay him low. You accuse him of spying. But :

F.:

Yes.

it

into

set

why he needs

to spy.

He's been making such a fool of himself that

some of

his dignity. I

do

this

by pointing out

playing a part in his loss of dignity.

to the

I

want

to

mother that

TECHNIQUES OF FAMILY THERAPY Int.

This

:

Dr. F.

the

is

Up

Yes.

:

first

[76

time you've gone after the mother.

to this time, everything I've said has

been very

supportive of Mrs. Kane. I've been coaxing her and encouraging her

and hacking away

techniques the father uses against her and

at these

the boy. But here, at the end of this speech, I turn and really give her the business. I point out that

by teaming up with Mike she

is

undermin-

ing her husband's authority. I'm also implying a destruction of their

sexual relationship.

You

Int.:

"Your husband you."

It's still

acting the

is

way he

is

because he has to

fight

both of

not a direct attack.

Dr. F.

:

Int.:

This

mother-son

don't say, "You're undermining your husband," but

not meant to be.

It's

the

is

first

time you've

What made you

coalition.

come out and

feel this

identified the

was the proper time

to

doit?

Dr.

F.:

rhythm of the conflict it

I

think

more than anything

session,

between the parents, bringing

again,

and they seem

to

it,

and now

want

I

at the

coming back to

way

this

round out the

to

between the two of you that you may not have been aware

of."

way

and

say, "Here's another fine that's tied

the father terminated that last interchange

and resigned.

It

have gone before.

that every family has

It's

of nothing

till all

Int.:

How

Dr.

F.:

I

of a

building on

a merger and a step to a

all

I

stage. I think

own rhythm and that this rhythm determines it. Some families are rapid and staccato, some rise

and

fall,

and some go through long periods

sudden there's an explosion.

think oscillating

session, all of

When

the interactions

new

would you characterize the rhythm of

have been four or

on.

its

way you work with move in a kind of gentle

the

am

was so hope-

move

suggested that they were ready to

point out the mother-son coalition, I

first

up, dropping

well. I've indicated the

it

issue

been hinting

the

Also, the

that

it

else. I've

up with

picture further

less

be taking

smoking

conflict is related to the

conflict

has to do with the rhythm of the family, the

it

up and down

five different things

this family?

rather rapidly. There

brought up in the space of

them very profound, tough

things that

this

you would

work a long time to get at in individual therapy. Int. Does it surprise you when a family can bring up this much? Dr. F. Even for a family, this one is pretty rapid. They take the :

:

interventions with less disruption of their ties than

many

families do,

No and with

Man's Land

[

77

could work quite fast with

less disruption of the session. I

them.

About

Int.:

you do a

One

great

many

things in

There are several ways of looking

it.

how she

showing her

is

make

how it would often be

interpreted.

:

Int.

You could also say that it would be very hard for the mother

:

on

It

would be

is

doing

there's

if

all

true.

and leaving her husband

this. It

would be equally hard

three of

them

at once.

You

is

the

Then you

for the

you

husband

way you manage

side with the father

boy to keep track of the money he spends

getting his

out, after

after

interview, but extremely evident here,

with

were

this

you have showed that he is contributing one other way to look at it. Running through the whole

keep on staying out

But

delightful

siding with her son

have told her she

too.

her behave differently.

Dr. F. to go

to

it.

you are

siding with her son against her husband,

is

giving her an understanding which will

This

at

you are providing some new information for Mrs. Kane. By

that

is

a very complicated one and

this interpretation, it's

is

to side

by saying that good training.

boy by suggesting that the father has used this as a spying technique. Then you side with the mother by supporting her objection to the spying. Then you side with the father again by saying side with the

that the reason

why he

feels

compelled to use such devices

mother and son are getting together and leaving him

you say

time,

this to the

mother in such a

is

that the

At the same way that it gives

out.

nice, helpful

the impression that you are siding with her in this difficult problem of

dealing with her husband and child.

Dr. F. Int.

:

:

Sounds pretty good, doesn't

Well,

it

gets better.

You

it?

also side with the parents

that this arrangement

is

good shape. You then

side with the

really hardest

on them; the boy

boy by saying

is

by saying in pretty

that the situation

him too. I suspect that you've sided with and and each pair, all within a one-minute speech.

disheartening for

each individual

Dr.

F.: There's

one point

I

other elements. I

am

If I

support one coalition,

pattern they are caught

Int.

:

I

pair,

in,

because

if

situation, I will inevitably

trying to suggest that I

am

against

think should be brought out. In a

way, I'm siding against each person or

one element in a side-taking

is

I

all

of

all

of

them the

with any

be siding against

disrupt another.

siding with

which makes

I side

But

I

think

them against the losers.

should also think that putting everybody in the right and

TECHNIQUES OF FAMILY THERAPY wrong

in the

taking sides, for the

Dr.

same time would tend

at the

moment

to cancel out the benefits of

at least.

I'm also trying to build

F.:

my

therapeutic relationship with

these people in an effort to achieve a status from which

my own

without overly blaming the others. In

can work.

I

am on

join with each of them, so that each will feel that I side,

[78

mind,

I

his or her

I see it as

the

four of us working together.

The four of you against the world. Dr. F.: At least against this abstract Int. :

"the mess you're

entity,

caught in." Int.: What's interesting swiftly,

it

you were Dr.

sounds

one reads your interpretation

this,

As

if

them "understand."

I try to stay

cause you did

if

like a rational, causal explanation for the mess.

trying to help F.:

that

is

away from

frame: "Be-

this simple, causal

your son does that."

I

people, unbalance the picture even further.

think

I try

does

all it

to let a

is

upset

meaning grow

in the context of the interaction.

When you

Int.:

you

said, "All of

There

it

were introducing your method to these people,

you have contributed, but none of you

stood as a mere verbal statement. Here

is

to blame."

translated into the

it's

actual relationships.

Dr.

F.:

would be

It

what

foolish to say that

I

did here was a

conscious and deliberate act, but as a matter of technique, to

it's

devoutly

be wished for. (Fulweiler has just gone out.)

mrs.

K.:

(Long pause.)



I've

(Pause.)

It's

I,

I

can see Mr. Fulweiler's point, in that

unfair to

How do you feel about that, mike: Int. :

I

Dr.

F.:

is

shouldn't have. (Pause.)

son? (Pause.)

making the

Do you think she has I

first

admission that she

part of

already had this thought?

I

suspect she has never thought of

One reason

I

it

as being unfair to

brought the boy in was to arouse enough

her so that she would have to acknowledge the statement

Take

is

think she has been quite aware that she gets together

with her son, but the boy.

I

don't understand.

The mother

the problem.

him and

the boy out of

it,

take this

hook out

turned on the father and fought or denied

of it.

it,

I

guilt in

was making.

and she might well have

No Int.

It's

:

Man's Land

a way of preventing them from getting into a

79

[

about

fight

it?

Dr. F.

Yes.

:

they discuss

If

it

the

wrong way

this first session,

it

can do more harm than good.

Would you say that this difference in the mother signals some kind of shift? The whole character of the session seems to change from now on. Dr. F. Yes. The mother starts working to relate the boy's behavInt.:

:

between herself and her husband.

ior to the conflict

She doesn't sound antagonistic toward him

Int.:

was ready to throw the book

earlier she

conversation,

you said

ciliatory.

though

him. In the beginning of this

you expected trouble with the

that

she not only has failed to

at

at all,

become a problem, but she

is

wife.

Now

extremely con-

How did you prevent her from blowing up?

Dr.

want her

I didn't

F.:

prevent her,

come out with

to

merely slowed her down.

I

I didn't

everything she's got against her husband in

new situation. There are a thousand little ways you can do this. One way is to turn the responsibility on her, turn it away from the husband, as I just did. Or you can calm her down by giving her emotional support, as I also did. She has given many indications of how she feels about her husband during this session, and another way to forestall her is not to hear her one

fell

until

swoop, before he's got

you are ready

chance to

to.

his bearings in the

Later on in the sessions,

I

gave her plenty of

steam, and she did. She could be an extremely vigorous

let off

antagonist.

{Fulweiler

MR.

K.

:

still

Well,

ing as

I realize,

mike:

mr.

I

k.:

I

if

adamant about your smokprobably a difficult question for you to answer, if Mother were as adamant about smoking as I

Mother were anywhere

am,

I

was, as

out.)

but

it's if,

as

am, would you quit?

don't know. It's

something I'm afraid of with Mike, and

know,

really,

think,

is

that

what the reason

Mike

is,

or

—but

has, for a long while,

Mike? Do you mike: Well, what do you expect me that,

.

.

.

to do?



I

don't

part of the problem, I I

had do you

think, has

sense of independence, far beyond his years.

about

it's

How

a,

a

feel

TECHNIQUES OF FAMILY THERAPY mr.

k.: Well, ah, haven't you, ah, haven't

know where you were and what you

to

[

80

you resented our wanting

did,

many times

.

.

.

mike: Yes. {Fulweiler knocks, enters.)

mr.

k.

.

:

mike: Yes,

mr.

k.

I

I

:

is,

Ah, a

I think.

feeling like this?

think the smoking has to

I

had to do

dr. f.: This

is

wanted to and they it

do with

didn't,

some place where they

it

think causes

too.

they didn't want

me

to,

couldn't find out about

you think, that you get away with things?

feel this

so

it.

why

probably true of other things. Have you any idea

it is,

to

What do you

How do you mean?

:

mike: Because I

definitely

Mr. K.) Mike?

mike: Well, dr. f.

it

{to

this,

was none of our business?

it

guess so.

Well,

:

dr. f.

almost feeling

.

.

independent that you'd be able

mike: No.

You

dr. f.:

with things, do you?

mike: No,

I

how

don't suppose, ah, that you've learned

to get

away

A little bit?

don't think so.

you want to do something, and you know it's something that, that your dad won't approve of? Probably won't, or you, you're afraid to ask him anyhow. mike: I don't know, I guess I either just do it and not tell him about

dr. f.: Well, what happens

it

.

.

.

if

dr. f.: Or, what else could

you

what could happen? {Long pause.

do,

To Mr. K.) Do you know what he does? Do you have a good guess?

mr.

k.

No,

:

dr. f.:

I don't.

Do you

suppose he might have, ah, learned

ends against the middle?

How

to play each of

how

to play both

you

off against

to,

a

each

other?

mrs.

k.

dr. f.:

:

It

Well, that could be.

kind of sounds

like

he might be able

know, by working the angles

correctly.

learn awful fast, and once they learn lesson they ever learn. rate so easy.

mke: No,

I

Does

that

It

it,

It's, it's

little

bit,

you

ah, something kids

probably the saddest

gets so successful, so fast,

maybe,

at

any

sound right to you, Mike?

hadn't intended to do that,

I

don't think.

DR. f.: Well, without even thinking about

entered into {inaudible phrase).

it,

do you suppose

that

it

No mike (overlapping) Well, :

it

might be, but

.

.

Man's Land

[

81

.

(Fulweiler goes out.)

Dr. F. the

This

:

boy into the Int.:

a relatively simple intervention. I'm just bringing

is

act,

pointing out something he's responsible for.

I notice that this

time

when you come

in they go right

on

talking, they don't stop.

Dr. F. the

:

Yes. I'm just part of the family now. This

is

very early in

game for this to happen. Int. Do you take this as a good prognostic sign? Dr. F. Yes. It means they're caught up in the therapy Int. Why did you come in so quickly this time? :

:

process.

:

Dr. F. saying,

I didn't like the direction the father

:

"My boy

has too

much

was going

home and

authority at

this

He was makes me

in.

feel childish."

Int.

This same scene has occurred several times, and each time

:

you've waited until

it

came

time you don't even give

Dr. F.

it

you came

in.

This

a chance.

Because he's

:

to a completion before

just going to increase the boy's feeling that

he can't control him and demean himself in the eyes of his wife and son

done

again. He's

him do

it

over and over and there

again. I've pointed out the

it

into the picture,

and now

it's

ways the

isn't

any sense

father

in letting

and mother enter

the boy's turn to be brought

in.

He's

playing mother off against father. They've set the stage for that, but I

want

to get the

him share a feel

boy

to recognize or admit his part. This will also

amount of responsibility that he has done some work too. Int.:

certain

for therapy. I

make

want him

to

notice that your phrasing doesn't implicate the parents

I

very heavily. This playing off both ends against the middle

is

an unfor-

tunate happenstance that the boy has engineered.

Dr. F.

:

Well, I'm really pointing out to the parents that the split

between them has played hand in glove with mother's coalition with the boy, because ing

them

about

off against

falling for

Int.:

if

this.

I'm weakening the

she recognizes that he

each other, she's going to be a

little

more

is

play-

hesitant

it.

So you're not only trying to get the boy to acknowledge

his

share, but you're using this to pull the parents together.

Dr. F.

:

However,

if

you

notice,

when

I try

to get the

boy to agree

TECHNIQUES OF FAMILY THERAPY with

me on

on

that fell flat

Int.

had

face. I

its

This

it.

is

an example of an interpretation

go ahead and force it.

to

wasn't something he had done in the

It

:

he denies

this,

couldn't point

room

there, so

Dr. R: Exactly. But I

forced

it,

was important

I felt it

and when he got out

to get a concession

that "Well,

it

might be,

but," I backed quickly out of the room. I wasn't going to stay

him

you

out or play back the tape.

it

out of him, so

[82

and

let

get that "but" out in contradiction.

When you

Int.:

you suggesting

use the phrase "without thinking about

that his behavior

it,"

are

something he might not have been

is

aware of?

Dr. F.

Yes. So that he can't very well refute me.

:

(Fulweiler has just gone out.)

mr.

(Pause.) Well, do you suppose that this might stem clear back

k.:

any way?

to [city] in

mrs.

mr.

(Pause.)

K.:

Back

k.:

It

could.

And

away, when Mike was so small?

when you were be, ah,

feeling

months or so

to the seventeen or eighteen

that I

in those very early

was

months,

him? That there might both in Mike and in you, to a greater or lesser degree, a of, you might say resentment, at my coming into the picso completely in charge of

ture?

wonder if that doesn't have something to do with it. mr. k.: And that was many years ago, I realize, but I've often wondered about that. There've been a few times when I, I can't think mrs.

k.

Well,

:

I

of any specific cases, but

I

seem

few times when Mike has asked I

to recall that there

me

if

have been a

he could do something and

have said no, and then he has gone and asked you. There are

times

when perhaps you might

say yes, without stopping to think

that he might have already asked me.

mrs.

k.

don't remember, ah

I

:

he did

mr. mr.

k.:

and

Do you,

k.:

mrs. k.

that,

—but

it

—was

recall

That time was when we

:

am

stopped, and that

do you ever

ah,

that I

mike (overlapping) mr.

k. :

.

.

.

that

:

.

.

to, to

pin

won't,

if

.

.

Dad

it

.

like that,

Mike?

down

to

any particu-

do you think that you've

.

won't

.

he was very small.

.

Well, yeah

Dad

.

any times

lar incident, but, ah, just in, in general,

ever had that idea

.

lived in [city],

I'm not, I'm, I'm not trying

aware of one time that

.

.

No mike:

mr.

.

k.:

but

.

.

.

.

will? I

.

mr.

I've

I just

k.:

away with

Two

mother out,

ah, won't let me, but, ah,

probably done

wonder

if

it,

but

happened when he has gotten

mind

in his

that per-

(Pause.)

interventions back you

When you come

propose the idea that the

boy against the

and the father turns the topic back

pendence."

maybe Mother

can't think of anything.

I

that has ever

getting together with the

is

83

hasn't she?

it,

which would implant that idea

it,

[

when.

[daughter] has done

haps he could.

Int.:

Dad,

that, ah,

know

mike: Well,

can't think of

I

Man's Land

in again,

father.

Then you go

to the boy's defiance, or "inde-

you

relate the boy's

independ-

ence to his playing both ends against the middle. This time when you leave, the father turns

it

back to the mother getting together with the

boy against him. Is this a way of pushing the father in the direction you want him to go by giving him a new alternative he likes less than the first?

Dr. F. though

it

I

:

wasn't consciously working at

did have the effect of turning

him go on about ally

him back

independence and so quickly.

in the

way you

suggest,

to the mother. If I'd let

the boy's independence long enough, he might eventu-

have gotten around to hinting that

more

it

forth.

However,

this

way I got not much of

This

it's

stemmed from the mother's him to deal with the mother a victory.

You

notice

how

deviously he goes about confronting her. For instance, that phrase: "in those very early months

him."

It

hangs her.

No

when you were

so completely in charge of

matter what has happened since then, she has to

And

done

in

the spirit of earnest and intelligent investigation. This kind of attack

is

take the rap for the genesis of the boy's problems.

it's all

probably a daily occurrence in their house, always under the guise of

making a helpful suggestion: "Why don't you put a little more the dust mop, doesn't it sometimes help to pick up the lint?" Int. of

them

:

in the :

problem of the boy and put That's right.

And

sponsible, since that's

way

Int.

:

all

to defend herself.

It's

The mother answers

the

blame on

her.

him of attacking responsible, the war was re-

she can't even accuse

make her entirely why he was away for

because he doesn't

has no

on

In other words, he has taken your attempt to include both

Dr. F. her,

oil

those eighteen months. She

a beautifully done thing. in such a doubtful

way.

TECHNIQUES OF FAMILY THERAPY Dr. R: Yes. She knows there are hidden see them until it's too late.

What he does

Int.:

them

one of us

is

come back

to

but she doesn't

to the boy's playing

each other. He's going in the stages you suggest.

off against

Dr. F.

next

traps,

Yes, but again he gets her. He's saying, "Mike

:

off against the other,

to think that

84

[

when he

but

it's

your

fault,

is

playing

because you never stop

asks you for something, he might already have

asked me." Int.

:

Dr.

F.:

He's

still

Sure.

This

is

why

partly

ing the mothers. thers than

most

He

could

and ask

into the kitchen all.

declining to admit his part in the situation.

I

Many

his

sit

in the living

room and hear Mike go

mother the question and never intervene

at

don't go along with the usual business of blam-

people have said

therapists,

am

I

and the reason

a lot rougher

fa-

been a kind of

that there's

is

on the

among psychotherapists for years. My contention is that the fathers are far more adroit manipulators in the home than the mothers have ever thought of being. In most cases, when you find a mother who is being bitchy, contriving, nasty, you name it, you find behind her a coldly manipulating father who is keeping himself emoI-hate-mothers cult

tionally isolated

from

his family

and making them pay for everything

they get. Int.

:

I think the

for this emphasis

weep, they can

mothers of schizophrenics are partly responsible

on mothers. These women have a range; they can

fall apart,

they can be helpless, they can be sarcastic,

they can join you, they can unjoin you.

one of these mothers,

Dr. F. satile. tics.

I

:

Watch

I

Once a

therapist has dealt with

don't think he ever forgets

think the mothers only seem

the father while the mother

is

it.

more extended, more

ver-

going through her gymnas-

He doesn't appear touched at all, but whenever he wants to produce

any of these behaviors in her, he pushes the

right button

The

father in this family isn't as worthy an antagonist as

he's

much

too childish and sensitive and

very quickly. But even at that, he's

and son

at

some

You can

it

on.

I've met;

shatter

him

putting the knife into his wife

still

every opportunity and with everything he's got.

(Fulweiler

mrs.

brittle.

and turns

k.:

still

Well,

out.) I

think as far as

I



I

have bent over backwards, ah,

not to take the authority on which

I've,

have, since

come

to the

.

No conclusion

wasn't right either, because

it

I

Man's Land

think he's entitled to

an answer from, either yes or no, from either one of Mike.) But that I'm, am, possibly unfair to

I've, in

—but

you

(To

us.

doing, in so doing, I have been

wasn't aware of

I

85

[

it,

I

was doing

it

for

you would come ask me, I would say, "Well," my answer would quite often be, "It's all right with me but you'll have to ask your father." (To Mr. K.) And of course I realize now that if you said no, then you were the stinker who

Or

you, at the time.

that



said no.

mr.

k.

mrs.

Well, that, that's true.

:

k.:

But

I

was not doing

it

would sound at the time. mr. k. You had no impression :

mrs. K. (overlapping)

What

:

with any,

.

.

I didn't realize

how, how

it

.

impression

trying not, not to take the authority

it

was making on him.

I

was

away from you.

(Fulweiler knocks, enters.) dr. f.: That's very good.

Ah, the

point, ah, being that

things that occur are not intentionally done.

meant,

Ah,

if

And

most of these this

what

is

I

very beginning session, about not blaming people.

in the

you slipped

into this kind of a trap,

you

didn't

do

it

with

your eyes wide open.

mrs. k.

No,

I didn't.

(overlapping)

dr. f.

mrs.

:

k. :

You

:

I'm aware of

dr. f.: Yeah.

it

And you

of this that

did

it

now. can see

thought might,

I

by accident. this side

of

we might

it.

There's another part

as well bring in to

out this particular picture (to Mr. K.) and this

and feeling kind of

ah, perceiving this

left

is

your

round

feelings,

out with Mike and (in-

audible phrase)

mrs. K. (overlapping)

:

I,

ah,

Mr. Fulweiler,

started. I think he, I've felt that, that

my

I

think that's where

husband

felt that

I

he was

had too much authority. dr. F.: Yeah. (To Mr. K.) You left him at how old? How old was he when you came back? mrs. K. (simultaneously): And Mike would come to me before he would go to him. mr. k. He was about twenty months when I came home. dr. f. He was twenty months when you came home. mr. k. Three months when I left. dr. f. And three months when you left. mr. k. Well, he not having, that

I

:

:

:

:

:

.

.

.

TECHNIQUES OF FAMILY THERAPY You came home

dr. f.:

mr.

to find

mrs. k.

.

mrs.

:

k.

.

and not

.

And he

was, ah

you developed that

mr.

much

of a kid

.

.

.

just a little infant. .

.

Mr. K.)

:

.

.

And

:

wondered

I

of being out of

feelings

it,

what extent

to

from having

just

.

.

Oh,

:

.

.

dr. f. (simultaneously, to

dr. f.

pretty

That's right.

:

dr. f.:

k.

a,

86

Yeah.

K.:

mr.

him

[

yes.

.

long absence.

Sure.

k.:

mrs. k.

Because he would be

:

.

.

.

(simultaneously): This just might be the root of that need to

dr. f.

reach out and control him in some ways that, that hurt him.

mrs.

Of course when he came home, he wouldn't

k.:

let his

father

even play with him, something or other had to be, something had

he would come to me.

to be done,

had a very

And

also

I

think

I

Yeah,

:

it's

I

think

I, I

have always

I

it's

not on-, only

very true with, ah, mothers and sons.

think that he and his father are very

they're inclined to be a

dr. f.

Of course

close relationship.

true with us, but

And Mike and

little

much

alike,

and

antagonistic because of this.

think we've seen them both use the

same arguments

against each other quite directly, ah (inaudible phrase).

MRS.

it

mr.

(overlapping)

k.

k.

mrs.

:

But,

um, what

trying to, to put the responsibility Shift the

:

k.

:

...

.

.

for,

started was, as I said, I did

I

on

.

.

.

.

on him.

dr. f.: Yeah.

mrs.

k.:

For, to bring you ba-, to

in, to

make him

feel that

he was being

being brought into the whole thing, and in the course of

(Mr. K. talking

in

background)

I

did

it

more harm than good.

dr. f.: Yeah, this happens sometimes.

(Fulweiler goes out.)

Int.

Let's see

:

Dr.

F.:

Ex

what brings you

in there.

post facto reasoning,

mother had taken so much on

I

think

herself, said

mea

it

was because the

culpa,

minute she would have begun to pour ashes on her head.

and the next It

was toward

the end of the session and I wanted to get her off that guilt and ease her

up, so that

Int.

:

we could end more Is this the

evenly.

time you usually end a session?

No Dr. F.

time.

I

:

:

Dr.

F.:

But

I

To

was

give her

87

"That's very good"?

same she took the blame from

some support and shut her

really pleased, too, not that

off at the

went one better on him. She points out that her

the father, but that she

trying not to take the authority

own

[

think this one had already gone on longer than usual.

Why did you say to her,

Int.

Man's Land

made him

into the "stinker." It's her

contribution.

She doesn't

Int.:

just agree with him.

She

says, "I

can find an

even better reason for blaming myself than you can."

Dr.

But she was already

F.:

beginning to be a bit uneasy about

You seem

to see

emotion, but as a better.

Here

people

if

way people

take

I

it

that

F.:

resentful

Yes.

and

sits

the

that I

was

word

"guilt."

inside a person, like an

influence other people, usually not for the

you are concerned with the

the mother feels too

Dr.

way you use

not as something that

it,

enough so

it.

There's something about the

Int.:

and

feeling guilty

much

on other

effect

guilt.

If

she feels guilty enough, she will become angry

will

begin to undermine therapy, her husband, her

son. It could be very disruptive.

Int.

:

The way you

relieve her of guilt

is

by suggesting

that these

actions are not intentional.

Dr. F.

:

Int.:

This

That's right. That they slip into habitual patterns. is

what you

up for in the introductory session. Now told you this would happen." It would give set

you have to do is say, "I you greater weight in dealing with Dr. F. Exactly. all

her, I should think.

:

was unintentional" is interesting. It's something so many therapists use. Somebody starts to blame himself and then the therapist comes in and says, "But it wasn't intentional." It's always in the intransitive; not "You didn't do it intentionally," but "Most of these things are not intentionally done." It was a happening which took place outside her awareness all by itself. I was wondering whether there might be another way you could go about relieving someone's guilt. Dr. F.: If I didn't want to give the mother an out by making it Int.: This "It

unconscious, that she

I

might praise her for her

insight,

had discovered something about

herself.

make her But

feel

pleased

that wouldn't be

nearly as effective.

Int.

:

No, that would

still

leave her to blame for the past.

And

it

TECHNIQUES OF FAMILY THERAPY would put the other people down. The "unintentional" phrasing

way

to support

one person without putting the others down.

and taking away

ture of relieving guilt

credit. If

that responsible for having caused whatever

By

her that powerful.

away

it

is

a

a mix-

It's

you make the mother

you are

it is,

suggesting that she did

88

[

also

inadvertently,

making

you take

the credit.

Dr.

F.

Credit for having too

:

much

influence,

you mean?

Int.: Yes. That undermines the father's position too, because

what he

saying to the mother

is

Dr. F.

:

is,

"You

set all this

up."

An indirect way of dealing with her guilt would be to turn

show how he is letting himself be the stinker. I believe that people ask for what they get, that there are no victims in the ordinary sense. I do turn to the father and point out that when he came home and found his wife occupied with the baby and not paying attention to him, he got his nose out of joint and as a result tried to control the boy too strictly.

it

on the

father,

You

Int.: That's right.

don't let

him

nocent bystander. But again the implication

Dr. F.

You

:

get is

away with being an

that

in-

wasn't intentional.

it

notice that the mother then points out that the father

and son have a coalition

too,

where she says that they are extremely

time

this coalition

alike.

Int.

:

Dr.

F.:

That's the That's

first

why

I

emphasize

have observed that they are

it.

alike, rather

I

has been mentioned. bring out a specific

than taking

it

way

back to

I

their

antagonism, as she does. Int.:

What

is

beginning to be impressive here

balancing that goes on.

You

side against another. If

is

the

amount of

balance one coalition against another, one

someone

starts

blaming himself, you suggest

somebody else is to blame; if someone is attacked, you support him; if somebody takes credit, you give credit to somebody else. There's an emphasis on equal participation, whatever the content. If you take a mother, father, and child in a situation in which the mother and child are getting together and the father is being left out, and you that

keep bringing the father

in as a participant, you're

they had in the direction of making

Dr. F. this

that

:

Yes, but that doesn't

point at least. is

it

added in

To

a

more equal

mean

changing the balance one.

there's a real change, not at

use a metaphor, the therapist

different proportions to

is

like

an operator

each side of an equation, so

No that

it

ends up being balanced. At

away, the original order would

this stage,

still

be

if

Man's Land

[

89

you took the therapist

there. Hopefully, at

some point

the merit value of the operator, the therapist participation, will decline

and the equation Int.

will

still

remain

in balance.

That's quite an image.

:

The

therapist going

from one

side to

another, adding weights.

R:

Dr.

Literally throwing his weight around.

The

intent

is

to

have the family experience an entirely different quality of relationships

and leave the session

for this period of time

feeling

good about what

they have achieved. Int.

did

When

:

it's

really

been the added factor of the therapist that

it.

Dr. F. identify

But

:

you hope

that's invisible, or

it is.

They never have

to

at all.

it

Int.:

should think that giving people a different experience of

I

balance would be a more effective kind of therapy than just handing

them a verbal interpretation. They can't toss it back as something you've imposed on them, and they can't escape being in it. Dr. F. Neither can the therapist. When I am engaged in therapy, :

I

am

totally involved, I

haviorally. That's

what

I

am

in the family, emotionally, physically, be-

mean when

I

sometimes say

I

"join" the fam-

fly.

Int.:

You

join

them when you

but you're attacking the balance that

Dr. F. I feel that I

Int.

am

up

exists.

them when

I

do

this.

supporting their healthy impulses.

"supporting their healthy impulses"?

I'm supporting everything that

F.:

more equal balance,

this

don't really feel that I'm attacking

What do you mean by

:

Dr.

I

:

set

will

make them

feel that

they are gocd, responsible, intelligent people. Int.:

You

could also say that when each

appropriate share in the total operation, this

Dr. F.

:

is

able to concede his

healthy.

is

That's right. Without overdoing

it

or taking too

much

of

the burden.

Int.: It wouldn't be healthy this sort of

skew

for themselves,

Dr.

F.:

that

if

you constantly

they did

I

like that. It's exactly

correct. Until they

you use your own weight

Yes.

it

to

do

it

I

want.

it

for them.

use the therapeutic relationship

the kind of family interaction

can correct

itself

to simulate

TECHNIQUES OF FAMILY THERAPY

[

90

(Fulweiler has just gone out.)

mr.

:

Well,

k.:

But

k.

mrs.

cision



it's

a complex thing.

had

if I

said, "Well, I

would have been a mr.

Mr. K.)

k. (to

stinker. "Well,

mr.

k.

my

saying, "Well

said no, then

you were the

than

if,

And

:

then

when you

Mother would have

let

me, but

me

and

I

me

talked

Well,

:

been

it's

won't."

all

right with

you

have said no, there have been times when you have come to

me and k.

Mike has asked you and

after

Dad

when you have come

Yes. Well, then there have been times

:

to

mrs.

different than

Yes.

k.:

mrs.

little

me, but ask your father."

right with

it's all

making you make the dedon't know, ask your father," it

I didn't realize that in, in

I,

I

into

it.

Do you realize that,

suppose there have been. But

too?

I, I

think

now

that

we

each ought to have the authority to say either yes or no and give

him mr.

And the other one ought to back it up. And the other one ought to back it up.

k. :

mrs.

k.

Dr.

F.:

father

is

a direct, a direct answer. (Pause.)

:

The mother does something

driving

it

in,

how

she has "forced"

quite admirable here.

him

having any authority with the boy, and she

The

into a position of never

replies,

"We

ought to get

him a direct answer, yes or no." Again, she takes says and goes further. This time she implicates him

together and give

what the father squarely.

Int.: This

parents have

is

the

time during the whole interview that the

first

shown any

other one ought to back

sign of unity. it

When

the father says,

"And

the

up," the mother comes right back and re-

peats the phrase.

Dr.

F.:

made

time she strongly,

This

this

what she always wanted, and

:

admission, on

Dr. F.

:

wasn't the last

that they should get together.

What importance

was able to agree,

it

She came out several other times, very

point.

and indicated

Int.

ment

is

did you place on the fact that this couple

for the first time ever according to their previous

how to handle their son? I

was pleased

in the initial session. I

that they were able to formulate this agree-

they weren't going to be able to that I could then refer

making promises keep, but once they had said it, it meant it in later sessions and show them how

knew

back to

it

was a matter

of

No

much

[

91

they were departing from their eminently reasonable conclusion.

The important

thing

was that they had

course, the father turns

Int.

it

right

You

That's strange.

:

there's

none of that quality

said

not me. But here, of

it,

back to the boy. could see

when

his wife earlier in the session,

tive.

Man's Land

how he would want

to avoid

she was acting so defiant. But

in her voice

now; she sounds quite suppor-

Why would he turn away from her at this point? Dr.

He

wife.

F.:

Because he's very frightened of the relationship with

around him, not

feels that she runs rings

sophistication. This has to

do with

He's bright enough to recognize that he sexually shy and untutored,

and

their sexual

where she

is

is

intellectually

his

but in

social relationships.

an awkward, obtuse person,

a warm, attractive person

wouldn't have any trouble forming relationships with

who

men much more

capable than he. She has needs that he can't meet. Int.

much

:

She was making an advance here, and

this

worried him as

as her defiance.

Dr. F.

:

That's right. If she ever got turned on, he would probably

become sexually impotent in the same way that men sometimes do when their wives reach that period, right around the menopause, when they are no longer constantly frightened of pregnancy and always refusing their husbands. Instead, they are tripping the old man up and beating him to the floor. Then the husband isn't the ever rutting stag any more, and he suffers a very real impotence.

work

man was

to get over that hurdle in marriage. This

and he was well aware that

if

his wife ever got

going to be able to satisfy her.

was

takes a lot of patient

It

someone who was

getting

He knew when

uncorked, he was not

he married her that he

better than he could have

because he was the kind of bumbling guy

who

about forty,

never had

hoped

much

for,

to

do

women. The way he made up for being this kind of inadequate man and kept his wife in line was to control the finances and the order of the home and adjudicate on moral issues. This way he kept his wife

with

within very narrow limits of behavior and himself from being proved inadequate.

(Fulweiler

MR.

k.

:

still

Does

mike:

Umm.

mr.

:

k.

Does

out.) that

seem reasonable

that

seem more

fair?

to you,

Mike?

TECHNIQUES OF FAMILY THERAPY mike: Yeah,

mr.

can see

I

Can you

k. :

that,

yeah

.

how, perhaps,

see

.

[92

.

one reason why

that's

there's been,

to a certain extent, greater or lesser extent, a resentment against

me because you might

I've

and

I've

and your

say,

things you've

always been the one to stick pins in your balloons,

wanted

ideas, the ideas that you've had,

to do, that Mother's passed the

and the

buck

me

to

been the one to say no?

mike: Um-hm.

mr.

k. :

mrs.

I

think over a period of time

But

k.:

I've, as I say,

.

.

Mickie-boy,

.

I

was not doing

it

with any,

any thought of hurting your father.

mike:

know

I

it.

You don't remember I don't think, Mike, but, but, I don't know how many weeks it was, or how many days it was, but it

mr.

k.:

was

quite a long time,

kiss that picture

MRS.

were k.

mrs.

in the apartment in [city] you'd

good night rather than

me good night.

kiss

Oh, now, you might as well have been the garbage

K.:

far as

mr.

back there

man

as

he was concerned, he didn't know you, the fact that you

his father didn't

mean

a darn thing to him.

I realize that. I realize that.

:

k.

I

:

mean, Daddy was more of a father to him than you were,

at that point.

mr.

Yeah. That's

k.:

Dr.

See

F.:

how

right. (Pause.)

the father changes the subject here to the bad

behavior of the boy and begins rubbing

him good

it

in,

how

the

boy wouldn't

kiss

when he was small. Making him feel guilty again. The sensibly calls him on this. I like the way she puts it: "You

night

mother quite

might as well have been the garbage man." Int. It's

the

:

And

then the father slumps

same put-upon tone

down and

says, "That's right."

he's used with the boy, the

same phrase

even.

Dr. F. mr.

He's quite an

:

(cont.)\

k.

and

As

artist.

I've told

I didn't care, didn't

we wouldn't be one after

all,

and we

.

.

times, Mike, if

care about you, didn't love

tenth concerned as

you are old enough now

the family reputation. this

you so many

Your

to carry,

share of

it.

much

as

we do, we are. And

you

you might

And

Mother

as

some of you know

say,

certainly

.

mrs. k. (overlapping)

:

Well, now, you can

do

it

this

way, you can do

No gonna ruin your

things that are

any, ah, feelings toward

have your

whom

own

[

93

for yourself, regardless of, of

Daddy and me. You have

your, you

reputation to consider, and, and the people with

you, you associate and

ah

lar and, and,

life

Man's Land

.

.

you, and you should be particu-

y-,

.

(Fulweiler knocks, enters.)

You've done a very good

dr. f.:

about enough for

MRS.

mr. mr.

this afternoon.

I'm enjoying

k.:

k.:

mean

I

if

we

.

.

.

can,

well as

if,

I

say,

help the family situation that in turn

Evvie it's

said, he's got his life .

.

one foot dr. f.

ahead of him.

in the grave

If,

by

golly,



if,

as if

:

Oh,

and the other on a banana peel yet yourself.

I realize

that

.

.

There's a possible chance that this

:

going to help Mike

is

not forget one important point, ah, you haven't got

let's

(laughing)

k.

whatever we can do to

if,

.

dr. f.: Well,

mr.

me now

look pretty tired to

K. laughs.)

frankly. (Mrs.

it,

Well, good, ah

:

You

{Laughs.)

K.:

dr. f.

job. All three of you. I think this is

mrs. k. (overlapping)

I think, I

:

.

.

.

.

think today he thinks he has. (Mr.

and Mrs. K. laugh.) dr. f.

Well, as

:

as

I

pointed out last time, this

for Mike,

it is

and

I

.

.

.

important for your

mr.

So

:

k.

this is

folks

under the surface

.

.

gain. .

life,

not, for years,

and finding out what causes

this is

and very

as well as for Mike.

not only, ah, good for Mike,

it's

good for you

too.

Oh, we love him dearly.

:

dr. f.: In fact,

a

it

you you to

for

Sure.

k.:

dr. f.

this conflict,

and implied, whether expressed or

getting at the root of this

mr.

much

Mm-hm.

k.:

dr. f.:

as

think there's something for

Obviously there has been

mr.

is

little

it

may

some aspects, you two might find (Mr. and Mrs. K. laugh.) Let's ad-

hurt him. In

harder to get along.

journ then until, ah, next Tuesday at three-thirty.

mr.

K.

dr. f.

mr.

The same

:

time.

Fine.

k.:

dr. f.

MRS.

:

(simultaneously): Three-thirty?

Same

K.:

station.

(Laughs.)

Thanks very much, you've done a very good people moving about.) See you, Mike. mike: Goodbye. dr. f.:

job.

(Noise of

TECHNIQUES OF FAMILY THERAPY dr. f.

MRS.

You

:

(laughing)

k.

Int.

:

I

without poison oak, old man.

was going

to say,

was

what do you think of him

(Voices fade away, tape recording ends.)

better.

What brought you in there

:

Dr. F. I

lot better

now? f.: Much, much

dr.

and

look a

to terminate?

They'd had a reasonably positive interchange.

:

and they were

tired

[94

tired. It

seemed a good time

was

It

late

end the

to

session.

Int.

Do you generally try to end on a positive note?

:

Dr. F.

:

Int.

Would you have

:

Dr. F.

Yes. Especially in the

Probably

:

end a session where

let it

so. If

first

go on longer

my schedule

I

if

was

you hadn't got

at all flexible, I

work

feelings are running high. I'd

when

another hour. There have been times next patient that

session.

couldn't see

him

I

it

out

this?

wouldn't

took

if it

have gone out and told

that day. In family therapy

my you

end within a pre-set time the way you can with individual therapy. You have to work a lot longer sometimes to weave can't always plan to

things into a relatively even state. If the family goes out feeling

the

air, this

Int.

this point, the

parents were joining together and speak-

ing to the boy as a united front for the

Dr.

in

could be detrimental to the therapy.

At

:

up

first

time.

Yes. They were handling themselves and the boy very

F.:

well. I like to

end on a note that

will

make people

pleased to

come back

the next time.

On

Int.:

enjoying

it,"

Dr.

the other hand,

you turn it

F.:

I

when

the father says so brightly, "I'm

into something a

little different.

simply took the opportunity in a reasonably positive

emotional context to reinforce the idea that they were

all

in treatment

them off the idea that they were just coming in for Mike. I wanted Mike to hear this, too. At the same time, I am serving warning on the parents that I am going to deal with their relationship more and

to get

directly

and

Int.

:

in greater

And when

depth in the future. the father says, "I love

him

dearly,"

you counter

some difficulties that may arise. Dr. F.: Yes. That was an obtuse and banal remark. Up to end of the session, he hadn't shown the slightest bit of affection for

this

boy.

with a

little

implication of

the the

No

How did the course of therapy We had about twenty-two or F.

Int.:

Dr.

:

dropped out of therapy

Man's Land

you remember

go, as

twenty-three sessions.

after eight or nine sessions.

This

initial

95

[

it?

Mike

session

comment that's been made so often about therapy, will show you all his problems in the first hour. Well,

illustrates that old

that the patient this

family did too; they laid

all their

biggest difficulty

was

responsibility for

what was going on.

he does

just as

apy, and

it

after time.

got

more

When

share, he broke

even the

to get the father to accept

through

all

problems out on the

down

My

tiniest bit of

kept ducking out from under,

was a rugged course of therwent on. I locked horns with him time

this session. It

difficult as

he

He

table.

it

finally did get to the point of

acknowledging his

He

confessed his total

completely, sobbed, cried.

inability to deal with the

major problem that was facing him, which he

admitted was the relationship between him and his wife. Int.

How far along was that?

:

Dr. F.

:

About midway. The wife had a very

and the husband objected to issue again

Int.:

close

this friendship strongly.

woman

He went

friend,

over

this

and again.

Was

he suggesting that there was something homosexual

going on?

Dr.

He

F.:

never quite said

it

dark implications. In a sense he was relationship between the

explicitly, right,

but there were a lot of

not that there was a physical

two women, but there was

this

tremendous

involvement that kept the wife emotionally and intellectually occupied.

As soon

as this

woman

called

up on the phone, the wife was

and pleasure, and she never gave any of with

this

guy; whenever she

He was

was the

point.

sexually

demanding

it

to him.

way

made an advance, he

flattened her. This

would become

that he couldn't possibly match,

that he might lose her entirely.

He

fun

She couldn't have fun

facing two threats: one, that she

in a

full of

and two,

couldn't accept what she wanted to

him and he couldn't stand her giving it anyplace else. Int. How did you try to improve their relationship? Dr. F.: Well, one specific thing I suggested was that he take her out to dinner. It turned out that they had never been out together as husband and wife, they had always gone out as a family. There was

give

:

entirely too

much

The

father

came into the terminating session and declared that had been an enormous change in the family and that things were

pened. there

togetherness. Just at the end, an amusing thing hap-

TECHNIQUES OF FAMILY THERAPY

[96

The reason he gave for this change was not the therapy but their going to hear Billy Graham. Int. How did you take this? Dr. F. I felt it was really an accolade, because I was completely out of it. He had taken all the responsibility and all the credit and pinned it on Billy Graham. I wasn't offended. The father put it quite great.

:

:

simply and naively, and of the

way very

means

that

showing.

he

is

put

If I

it

pleased me, because I

successfully.

taking too

When

much on

my weight into

If

gotten out

the therapist gets the credit, his

own

from on

it

shoulders; the wheels are

the family equation, I try to

neutral person, not as an authority Int.:

felt that I'd

do so

as a

high.

you're an authority from on high, you put too

much

weight in whatever you do.

Dr. F.

:

That's right.

The

goal

is

to

have the equation stay in bal-

ance without you. Then the job of the therapist

is

over.

2]

A

Family of Angels

An interview with

Virginia Satir,

What was

M.A., A.C.S.W.

Pope family in to see you? Mrs. Satir: They had been on a trip to Europe to visit relatives, Int.

:

and while they were

that brought the

it

traveling,

Gary, the seventeen-year-old son, began

They took him to a European psychiatrist who labeled him psychotic and recommended that he be institutionalized, so they came back to this country and put him in a hospital here. He had been in the hospital a week when I saw them. Int.: Did you know anything about the previous history of the to talk and act strangely.

family before this interview?

Mrs.

S.

Int.

How did they happen to come to you?

:

:

No, and

I rarely do.

Mrs. S.: A psychiatrist who had been in one of my training groups had seen the boy and his parents, and he told them that one of the best ways they could be helped was to be seen all together as a family. He referred them to me. They were very cooperative about the idea from the beginning.

I

took them as a demonstration family for

my

trainees.

Int. :

Mrs.

How long were they in treatment? S.

weeks. Then Int.

:

Mrs.

:

I

I treated

as a demonstration family for five or six

saw them privately

What kind S.:

them

of people

They were

for about

two years.

were they?

quiet, nicely dressed, middle-class people.

Virginia Satir, M.A., A.C.S.W., has taught family therapy at many institutes throughout the country, has published several articles on family work, and is the author of Conjoint Family Therapy (1964).

TECHNIQUES OF FAMILY THERAPY The

The

parents were in their forties.

he was rather

industrial-parts business;

handsome. The mother was pretty pretty, but there

had an

was a

Did

:

Mrs.

S.

all

was co-owner

tall,

if

in a delicate way, or could

have been

Both of them

they were walking on eggs.

the children

come

to that first session?

Yes. There was Gail, twenty-two; Gary, the labeled pa-

:

and Tim,

tient; Lois, twelve;

five.

They were

nice kids, but pale in

they weren't sure what they could or couldn't do.

spirit, as if

of a small

soft-spoken, physically

feeling of constriction about her.

air of caution, as

Int.

father

[98

The whole

family conveyed an obvious eagerness and willingness to learn, but there

same time. them or talk to them on

was a lack of spontaneity Int.

Did you see

:

at the

phone before

the

this

session begins?

Mrs. waiting

S.

No, but

:

I

had already introduced myself

room downstairs and explained

Int.

them

and so

forth.

Did you continue to see the family as a unit through

:

in the

one-way observa-

the setup, the

tion mirror, the tape recorder, the teaching setting,

to

treat-

ment?

Mrs. to see

S.

how

Yes.

:

it fits

To understand the meaning of the symptom, I have

into the family system. I believe that every piece of

behavior in a family

is

logical to that system. That's

the whole family during the different units

am

doing

first

why

meetings. Later on,

and see them separately, but

I

always

I

I

tend to see

may

make

it

take out

clear that I

within the framework of the family as a whole, and

this

never pull out any unit in terms of which

is

I

the "sickest." I usually see

the parents alone fairly early, because I believe that

where there

is

a

disturbed child, the marital relationship has been displaced onto the parent-child relationship.

Int.

If the child

:

with the

symptom

gets better,

do you leave him

out of treatment and concentrate on the parents?

Mrs.

want simply to

No,

S.:

I don't. I

have ambitious goals for therapy.

to repair the family. I

with the Pope family

{Background MRS.

s.

:

noises, people entering

Let's see

if

we'll

don't

want to focus on prevention and

accomplish an expansion of possibilities for each person.

Initial interview

I

room.)

have enough

chairs.

also

A oail (laughing)

mrs.

Tim can

gail: Well,

mrs.

Well,

s.:

..

ers

99

[

We're kind of a large family.

:

No. That's not unusual.

s.:

Family of Angels

I'll

sit

on

my

Let's see

.

.

.

lap. That's all right.

my

get another chair. This will be

The

chair.

oth-

.

gary: Well,

I

took the one out here. This (inaudible phrase) now, and

Timmie up

here.

(Everyone talking together about seating. Voices jumbled.)

mrs.

s.

Now, everybody has

:

Tim mrs.

wouldn't

s.

.

.

:

and

.

of a sudden he had two places to

all

p.:

Yes.

mrs.

s.:

... he had

places to

is

and Gary's

Gail's lap

you have a reason

sit

.

.

.

lap. (Pause.)

for saying that the

little

boy has two

sit?

Mrs. there

Do

:

looked for a minute like

.

.

mrs.

Int.

sit. It

Yes.

p.:

mrs.

.

a place to

I

S.:

begin to give out, right at the outset, a message that

a place for everybody. So

place, the chair, the place to

often notice viduation. I

sit.

always

I

do

I

this

start in

on

either

name

or

because one of the things

I

that people in dysfunctional families are lacking in indi-

is

want

to

show

timing and a thought that

that fits

I

see each person as an individual, with a

him.

wonder what, as you're all sitting here, as you're thinking about it, what is it that you expect? (Pause.) As you came here? gary: I didn't think about it. I knew I was going to come down here. But I, ah, I was kind of dubious of, that it would do any good. To mrs.

I

s.:

be frank.

mrs.

Well,

s.:

we have your

'cause you're

Int.

:

Mrs.

S.

Yes. This

:

I

Everybody

else has ideas,

here.

Do you usually start with

the idea that

some

all

contribution.

is

to

show

a formal question*?

that I'm in charge. I try to give out

have some kind of structure, something that

place, so that they can immediately begin to feel

will lead

some kind

of

hope. Int.

:

Mrs.

Why do you direct this question to all of them? S.:

I

want to firm them up

commit themselves

to

coming not

in a contract in

which they

will

in the interests of the patient but in

TECHNIQUES OF FAMILY THERAPY When

the interests of themselves.

come

they

themselves as coming on behalf of the patient.

100

they naturally see

in,

want to begin to break

I

them to see that we're working with a family system which each person is making a contribution. Int. And you do this by asking them all what they expect.

up and

this

in

[

to get

:

Mrs.

One

analysis.

Yes. This

S.:

way

also a

is

to get into the

of the other things I've found

unaware

tional families are

somebody

that

than they do. They operate on the idea, "If

is

that people in dysfunc-

might think differently

else I

communication

think

it,

then naturally you

must." They talk on behalf of other people and behave as though the

way

this

has to be. So

I

this is

ask about the expectations, to give everyone

an immediate opportunity to see that each person sees things

differ-

ently.

Int.:

I notice

the patient speaks

up

first.

Were you looking

at

him, or did he volunteer?

Mrs.

He

S.:

volunteered. I would have been looking round at

everybody, to show that they were but

him go on because

I didn't let

included.

all

I

Gary jumped

in

first,

wanted to give a chance to the

others.

Int.:

You

say,

"Everybody

here," but that doesn't really follow.

might not

Mrs.

all

S.

it,

They might be

all

all

there, but they

have ideas.

Oh,

:

everybody has ideas. There

yes,

about whether the idea

on

because you're

else has ideas,

fits

may be

a question

the occasion, or whether they can

comment

but everybody has an idea, because you cannot not have an idea. Int.:

You're saying that in

this situation

you expect them not

only to have ideas but to express them, because they've

come

for this

purpose.

Mrs. S. That's right. This is how by having everybody take part. :

ous,

gary: Funny, today this

s.:

had

ward meeting up

trolling

mrs.

I

it,

I

make

this, this, this, ah,

at the hospital,

s.:

You were

doing what?

I see.

gary: 'Cause

now

at the

time

we had

and I'm immediately con-

unfortunately. I

didn't hear.

gary: Controlling the meeting. Because people out.

mrs.

the family system obvi-

this

doctor

.

.

.

this, I sit

there and try to

draw

A MRS.

Well, that will be

s.:

gary: That's Int.

my job here.

Family of Angels

[

101

(Female laughter.)

right.

How did you receive that exchange?

:

Mrs.

S.

:

I

saw

that

saying, "I have both the

Gary was a spokesman

for the family.

burden and the joy of having

As long as he sits in him is, "You don't have

family."

that role, he's got to

to

to take the burden,

be

manage

to

So what

sick.

I'll

He was I

be directing

this

say this

ship."

Int.

Would you

:

take this remark of his as a challenge or as an

invitation to restrain him, or as a

Mrs. me,

S.

telling

:

I

took

me what

it

warning to you, or what?

as his perception of himself.

the situation

father and mother, can't

manage

them. But I'm only a child and

in this family:

is

for themselves. I

I can't

do

And

a message to

"These people,

my

have to manage for

it."

Gary is also saying, "I control situations like this one." Mrs. S. But this tells me what I have to do. I have to be in the driver's seat. Now, a therapist would get into trouble here if he received this as a threat rather than as a comment on the perception of the person's self in relation to the others. Such a therapist would be reactInt.:

:

ing to the control rather than to the

Int.

:

Mrs.

You prefer to go S.

way

along with

the self sees the

self.

it.

Yes. I'm also indicating to Gary what sort of person I'm

:

know whether I'm going to be an authoritative person who will say, "Do what I tell you to do!" or whether I'm just going to be a leader. One of the things that's all mixed up in these families is how to react to a head-sorter. Is this an authoritative person or is this somebody who just leads? My structure is that of administration, sorting, rather than telling you how you ought to be. going to be. At this point he doesn't

mrs.

So

s.:

let's

hear about the rest of you. Gary has spoken.

hear about the rest of you. 'Cause you're

let's

Now

here and you

all

have something that you expect.

MR.

p.:

Well,

we hope

that, ah,

Gary can

find his place with the rest

of the family here.

Mrs.

knew

S.

:

When

I

heard that "we" from the father,

that in this family there

is

very

little

I

immediately

differentiation

between "I"

and "you." Very often the children would be hearing "we," but the

TECHNIQUES OF FAMILY THERAPY behavior they saw would obviously have to be of different cause

it

102

[

sorts, be-

belonged to different people.

gary

(interrupting)

mrs.

s.

mr.

Excuse

:

Here's, here's part of the trouble already

:

me

just a

minute. I'm not finished. Ah, anything else?

That was, ah, that was the main, ah,

p.:

.

.

.

thing,

find the

to

hoped for before, that, ah, existed before, and find some foundation for that now. mrs. s.: O.K. Let's hear about the rest of you. (To Lois.) What about homogen-homogeneity that we, ah,

that, ah,

you? Since you're next to Dad? (Laughs.)

lois:

I

(Gary talking

don't know. Well, in

don't know, what

I

background.) Well,

I

don't

was going

know what

to expect,

really.

gary:

think

I

mrs.

it's

something new to

(to Lois):

s.

Well,

us.

why do you

We

didn't really, well

.

.

.

came?

think you

lois: 'Cause I'm part of the family. (Laughing.)

mrs.

And

s.:

if

the family has a wish,

you want

go along with

to

it.

(Pause.)

Int.: That's a pretty careful rephrasing of

what the daughter

Mrs.

do

said. S.:

tions. I take

to

That, you'll notice,

what

is

said

go some place with

me

ily."

That

what

she's thinking

tells

it.

and

if

it

is

I

in

frame which

into a

a child

my

interven-

will

enable us

who

I translate it:

you know about the

not openly announce

will

another form of "Somebody can be

feeling. It's

a spokesman for me." So that

put

something

Lois said, "I just came, I'm part of the fam-

that this

and

I

is

"What

you're saying, then,

you go along with

family's wish,

it." I

is

give

her an active function. Int.

:

Mrs. this

You phrase it S.

:

as something she wants.

That, you'll see,

kind of rephrasing

all

is

the

way my

the time. Because

sage to these people that whether they see

it

I

interventions work. I also

this

want

way

to give a

do

mes-

or not, whatever

they are doing represents a decision. Int.:

Why

you usually go

Mrs. I

choose,

Int.

S.

:

Do you

have a particular order

in? I

I label :

did you turn to Lois?

don't have a predetermined order, but whatever order it.

In this instance,

I

took

it

by position.

She was next to the father and so next

in line?

A Mrs.

Family of Angels

[

103

Or sometimes I will say, "Well, let's see, let me male first, now you're the adult female. You're the numYes.

S.:

take the adult

ber-one child, you're the number-two child."

I'm going in because

I

want

to

make

point out the order that

I

clear that there

is

no universal

formula for picking anything.

mrs.

s.

mrs.

p.:

What about

:

Well,

I

you, Mother?

think this

prayer. I feel like this

mrs.

s.:

I

is

perhaps our, our answer over here.

Tim?

tim: Well,

Int.:

I'm just looking for the answer to a

is just,

guess the same as Mother.

I

gather that since you're going round the circle, you don't

want to go further

into

what each one

says.

Mrs. S.: I want to avoid bringing out facts haphazardly. If I stopped and followed through on every lead, it would be a mishmash. Int. Did it require a little restraint for you to keep silent there? Mrs. S.: It always does. But I feel that more is accomplished by working on the structure, the structure in this case being that each is to comment, never mind about what. It's very easy for the therapist to pick up somebody's comment, get interested in the content, and bypass the :

process.

Int.

:

You

might have

said, in

some

fashion, "I'm not the answer

to your prayers."

Mrs.

S.

:

I

wouldn't do that, because

to get everybody to

it is

more important

comment. In a family with a schizophrenic,

though there were rules that people cannot comment.

I

want

me

for it is

as

to break

into that.

Int.:

Well, there are these rules that people cannot comment,

and yet you yourself are not commenting. Are you going along with their rule in that sense?

Mrs. S.: No, my rule breaks theirs, which is that nobody is to comment. I want them all to comment close enough together so that it will

be an experience of everybody speaking out. Int.:

That's

why you break

in

so

quickly

on everybody's

speeches.

Mrs.

S.:

That's right.

Int.: You're also indicating you're not going to let yourself be

TECHNIQUES OF FAMILY THERAPY provoked.

don't think

I

my

a quality in

mother had

showed

was reacting That statement might provoke some that

I

for

S.

don't have to react to anything unless

I

:

I try to discipline

it.

myself so that

something about themselves, and production about themselves. just

wanted you to

report, I

That tricky

person.

if

could sing gobbledygook, and

would thank you and move on

language,

this,

then

up

don't pick that

until

self

charge of yourself, which

is

s.

MRS.

me

:

If

God

anything? In

how you

else.

my

But

I

handle taking

another thing.

What about you, Gail? gail: Well, I hope that we can work together that we can all become a real family again.

mrs.

I

to the next

over to someone

I'm ready to deal with

if

"We're going to

how can man do

a way of giving charge of

it's

merely a

it, it's

church, God's going to take care of everything" just said to

has something to do with

in.

hear everybody's production as

I

statement of Mother's:

little

therapists to

have some use

I

I'm not ready to use

You

what the

to

you

decline the omnipotent position she seems to be putting

Mrs.

104

could have turned to the next person without

I

voice that

just said.

[

:

to find a solution so

—you

All right. So what you were talking about

s.:

are aware

some way Gary has been hurting, and you don't understand why, that there was a time when Gary didn't hurt and the that in

family

Mrs.

When

S.:

— {Gary

interrupts.)

There's one other thing

hear these people responding,

I

brings out something that

with somebody

else.

You

is

I

I get

from

this conversation.

look to see whether the person

unique to him or whether he follows along

notice that Lois doesn't

comment

and Tim goes along with Mother. That "we" of the that he goes along with Mother, too.

Now

for herself,

father's tells

me

Gail takes the same line as

the father. Int.:

"Well,

I

a remarkably ambiguous statement.

It's

hope we can work together

say the solution to what.

I

commenting on what she

said or using

been

couldn't

When

she says,

to find the solution," she doesn't

tell

at that point

what she said

whether you were

to review

what had

said.

Mrs. Int.:

S.

:

I

You

used what she said to review

it.

used what she said to reverse

it,

been implying that the family was a real family

too.

Everybody has

until the thing they

A can't

mention happened.

It is

[105

Family of Angels

Gary who has hurt them. You turn

that

by saying that it is Gary who has been hurting. By shifting the focus onto his hurt, you put him back in as a member of the human community. Mrs. S.: This is something I always try to do as quickly as possible. I call it

An

Int.: hurt,

idea of causality

is

being introduced here.

ness didn't

Mrs.

come out of the

You

S.:

"God

did

can't

it,"

air, as

Gary

is

the family likes to think.

do very much, you know, with conclusions

or with the "sick," "bad," "stupid," or "crazy"

formulation, because that usually ends right where to put

If

possibly because something happened to hurt him. His crazi-

it's

about

"taking the label off the identified patient."

into

it

some kind

it

begins.

You've got

of a frame which allows people to envision

change. If something caused Gary to hurt, something can be done to

cause him not to hurt. Int.

This

:

is

also the first time that the idea that there

lem has been introduced.

You

ask the family

why

is

a prob-

they're here.

Gary

says he's doubtful about the value of coming, since he usually controls these situations.

The

father says he hopes

the rest of the family, which that something

is

is

Gary can

find a place with

the only approximate statement in here

wrong. The mother says coming here

a prayer; Lois and

Tim go

is

the answer to

along with her; and Gail says they're going

become a real family again. What you do is to summarize their comments in such a way that you introduce Gary as the problem when nobody has been admitting he's the problem. Furthermore, you say the problem is that he's been hurting, which isn't the way they see it at all. Mrs. S. I always translate these things. I call their approach the morality play. You can't do anything with a morality play. to

work

together to find the solution so that they can

:

gary:

mrs.

I don't s.:

understand.

What do you mean by

the

word "hurt"?

Hurt. Hurt.

gary: Pain? Physical, mental, anguish?

mrs.

s.

:

Mental,

maybe physical.

gary: Are you saying that

mrs.

s.:

This

is

I

I don't

know.

am hurting?

what I'm saying the family

time when you didn't hurt. I'm checking to

now have

aren't hurting.

is

saying.

this out.

There was a

And you want

a family in which things are again, where people

TECHNIQUES OF FAMILY THERAPY Int. hurting,

That's pretty complicated, too. First you said that

:

and now you

Mrs.

shift to

I try to

S.:

do

[

106

Gary was

everybody in the family hurting.

that as quickly as possible, to get

it

into a

frame of family process. Int.

It's like

:

"You poor

saying,

flood victims," instead of,

"You

poor family with a schizophrenic."

Mrs.

S.

You

:

know

see, I

about changing behavior until

take the focus off

I

do anything the patient and put it

that I really can't begin to

onto the family.

You

gary:

mrs.

see,

it's

.

.

.

(simultaneously):

p.

inflicted the hurt,

whatever

that

it is

I

Gary. That that

we don't feel you have what we mean. We just mean

don't feel that, isn't

— (Gary

Int.: There's a flurry here

interrupts.)

and Mother and Gary

talk at once.

The mother is behaving as though you said that they were accusing him, when you haven't said this at all. Mrs. S. Yes, but the fact that one member of the family is suffering any kind of trouble, particularly craziness, is a strange phenomenon to the others. It's very hard to make an identification with the sick one. The mother is doing two things. It's her self-esteem that's operating when she attempts to say, "I am a good mother, I didn't do this." At the same time she tries to signal the idea of strangeness. Int.: The tone of her voice when she says that Gary hasn't inflicted the hurt labels him very clearly as the cause. Mrs. S. She's also the first to agree that there is a hurt. :

:

Int.:

But she does

really bypassing

it

by bringing the focus back to Gary. She's

your statement that the family

is

the problem, and

going back to where you presented the problem in terms of Gary.

Mrs.

S.

Well, she picked up that

:

have to say A, then push Int.:

It

it

first

part of

it.

Sometimes you

to C, in order to get the person to say B.

sounds as though you've made a remark that they're not

quite ready for

and they go into a flurry to try to handle it. The mother then goes back and accepts the thing you previously wanted them to

accept, in preference to this worse thing.

Mrs.

S.:

I

do

that in

many

lead ahead, and people often use

of

my

my

interviews.

I

lead ahead and

expeditions as a basis for going

A

Family of Angels

[

107

further themselves, but they usually keep a couple of sentences or

sometimes even a paragraph behind.

It's

as

if I

me

were moving the brush, and the few behind

brush, but after I'd already gone by, they could the place

I

couldn't see for the

come up and

say,

"Oh,

really cleared."

is

Some

Int.: fenses

were a pioneer and

therapists

would maintain

that in dealing with de-

you shouldn't go further than the person's ready to

would maintain

you should, because then people

that

will

go.

You

go further

than they otherwise would.

Mrs.

That's right. Sometimes

S.:

later in this interview

when

I will

move way

"Who's going

I said,

over. I did

it

to drop dead?" Their

how awful it is to be drop dead?" By the time I get

fears are about keeping safe, but I don't talk about

going in the dark;

say,

I

there, the other fear,

been reduced.

It's

"Who's going

by comparison with dropping dead, has already

way

a

to

of reducing differences. In another family

had, the father was talking about his daughter wearing lipstick.

and

to the girl

"What your

said,

This

is

that he's scared

may be

the function of the whole reductio

surdum technique in therapy. When you carry something that a moderate way doesn't seem very far at all. Mrs. S.: I've found that it's much easier for people something

dreamed

if I

can carry

turned

bed with some guy."

that you're going to get in

Int.:

father's really saying

I

I

it

much

ad ab-

far,

going

to accept

further than they in their fantasies ever

of.

gary: Well, that get to

isn't, it's

not the idea.

what you mean. At

It's

the word.

I

can't

[university] we're taught to, to

seem

to

be able

communicate with others, and to try not to let the words get in the way. The word "hurt" sort of befuddles me. I don't actually understand what you meant by that word. See, if I don't understand what you meant by the word, I don't know what you mean.

to

Int.

:

You've said that

comment about anything this

boy seems able

Mrs. not,

Int.:

You

S.:

you have

to

do

in this

kind of family nobody can

make

a

puzzling that they find in anybody else, but

it.

can do

it

if

you're an identified patient. If you're

to be careful.

He

catches you on the

word

"hurt."

One

of your aims in

therapy seems to be to get these people to drop their double talk and

TECHNIQUES OF FAMILY THERAPY how

learn

[

108

Yet you yourself use the word "hurt" in an

to report clearly.

ambiguous way.

Mrs.

S.:

do a

think I

I

different kind of

one of the messages corresponds

family. In the double talk I give out,

and the other part of

to "life out there,"

that he wasn't to

blame for the

double talk with "hurt" too, but

meaning of

is

it's

hurt, while her tone said

them

to get

to

know

also

I

acknowledge the real

and that the thing that

in a bind.

They

can't

deny that there

why

because you've already defined that as the reason

You

he was.

is

their relationships together.

You have them

:

burlesques the double talk

their situation: that they all hurt

hurting them

Int.

it

That was double talk the mother was using when she told

in the family.

Gary

double talk from the

that they won't

directly, so they'll

is

hurt,

they are there.

want to come out and point

probably want to accept your version that

Gary

to

it's

every-

body.

Mrs.

S.

Yes.

:

a bind for sickness.

Mrs.

Of

s.:

The way the family uses this kind of double The way I use it is a bind for health.

course,

and I'm glad that you are bringing

cause one of the

apy

to be sure we're

is

me what do

asked

mean by This

is

"hurt."

what

I

I

—hurt

mrs.

s.

gary:

mrs.

.

.

we

will try to

talking about the

"hurt,"

and

this out.

is

Be-

do in family ther-

same

thing.

I will tell

And Gary

him what

I

in feelings, hurt in body, hurt in emotions.

mean. still

use the word "hurt" to define hurt and

in feelings, for instance.

What would

this

be? Sadness,

.

It

:

all

mean by

Hurt

gary: Yes, but you, you or

things that

first

talk

could be sadness, or

it

could be anger.

It

could be

.

.

.

Now that's good. Now keep going along that line. ...

s.:

it

could be disappointment.

It

could be frustration.

It

could be any of these things. Int.: This exchange about the

word "hurt" seems

to

have some

of the effect of what has been called a "confusion technique" in hypnosis.

The

idea

with a clear

someone sufficiently and then come out statement about what you mean, they will be so relieved

is

that

if

you

baffle

that they'll fall right in with you.

Mrs. S. I see what you mean, but what I was most pleased about was that Gary was going to be able to insist on getting clarity from me. :

A Some

therapists

don't pick

Int.

:

Mrs.

up

would have picked

I

:

you look

at

from giving up Int.:

It's

The

it.

like

on the

in their negotiations for

a rapid

move

to a

you can get some sense out of do, you know, is to keep people

meaning.

more

it

almost makes

Someone

and

it

what you mean

seem

a class-

like

to clarify the messages they give

message into

its

Take

directions about relationships.

its

shifted

cognitive aspect of the person to

instance, I will help people to separate a

tions about content

You've

abstract level.

in the family to discussing

room problem in semantics. Mrs. S.: I do this to invite the function. I want to show people how

beef.

I

outside,

biggest thing to

by "hurt." And the way you do

For

But

resisting.

question very seriously.

from talking about the hurt

out.

Gary

109

wanted to give a message to the family that whatever a

communication sounds it if

as

[

that kind of thing in that way.

You took his S.

up

this

Family of Angels

says, "This is terrible roast beef," but really

direc-

roast

means,

"You don't love me." If it was terrible roast beef, all right. That's a comment on roast beef and what it does to your stomach and your teeth. That's content. But it is also a comment on "my idea of what you think of me." One of the things I want to do is separate these two person can distinguish between them.

things, so that the

beef

is

being used symbolically,

Int.:

sadness or

You do it

I

want

Int.

:

S.

another thing here.

could be anger," Gary says,

:

No.

You

I

go along

shift at this

the roast

to straighten this out.

When you say, "It could be "Now that's good, keep going

along that line." But you don't go along that

Mrs.

If

line.

my line.

point to disappointment, rather than keep

to the subject of anger. Is this because you don't want to get into the

question of whether Gary

Mrs. tion, as

S.

:

No,

I

angry or not?

because

it's

I

always see anger as a secondary emo-

a cover-up for hurt and as protection for the

ways of handling way.

is

hurt;

one

is

the carpet

way and

self.

There are two

the other

is

the bull

can crawl under the carpet: "I'm terribly hurt, you've stepped on

me." Or

I

can act

like

a bull and attempt to annihilate you. That's

when

you see the anger. Int.:

Then you would consider disappointment more

anger?

Mrs.

S.

:

Oh,

yes.

Much more so.

basic than

TECHNIQUES OF FAMILY THERAPY Mrs.

(cont.)

s.

—you

And

:

didn't say this. This

these are

members of your family were,

ferent

out a

I'd like to find

is

[

110

what

dif-

talking about.

I think,

And

more.

little bit

You mean, what we've said so far? mrs. s.: Um-hm. Somewhere at some point

gary:

they're feeling

You

Int.:

now. This

is

what

I gather.

don't say this time that they are feeling hurt,

that they are feeling different. Is that to

Mrs.

the family didn't feel as

make

it

just

it's

less threatening?

Yes, but I'm also attempting to help them to measure

S.:

the past by the present. Another thing I've noticed about these families is

behave as though change doesn't occur. They

that they

that everything

is

as

it

always was, even though yesterday

like to feel it

was quite

different.

Int.

By

:

slipping in the premise that things

slipping in the premise that change

Mrs.

S.

gary:

I,

ah,

I,

in

my

being with the family, just because

any

neath, I have felt pretty s.:

S.

I

:

Here

sages in this family

I

get

felt,

pretty

same

much,

at least

since ever I

I

have

under-

was born.

is

of the fact that he has not

like a little boy.

Because one of the mes-

that to

grow

He is disagreeing different now that Gary is

always have been,

probably

the

at [uni-

some confirmation

Int.:

I

much

was

think you have.

been able to stop feeling

are

have

I

I

toward the family than

different

moment, than

at this

felt,

Mrs.

possible.

Right.

:

versity], I don't feel

mrs.

is

have changed, you're

is

with the family

when

they say, "Things

so strange." He's saying, "No, I'm just as

just that

it's

to threaten.

you are noticing

it

now." Which

is

true.

Mrs.

S.:

That's right. He's also commenting on the fact that the

family has always hurt, but they haven't recognized that either.

mrs.

s.

(cont.):

other

And what

members

we're talking about are the family's, the

of the family's feelings.

Not your

feelings

toward

his feeling

toward

them.

gary: Well, mine,

it

has to be

my feeling

all

together. I

toward Mother.

I

mean,

mean

.



all .

.

A mrs.

s.

You want to know what they

:

—O.K., go

gary: No. Well

Mrs.

S.

:

are.

on.

Now that's lovely. He

said an unequivocal no.

waiting to see whether he's going to disqualify

watch for in these

families.

[111

Family of Angels

To

see

who

That's another thing

it.

no or a

gives a

Now I'm

yes,

I

and they

At this point, when he came out "No" right away, I was wondering when he'd disqualify it. Can this stand by itself? Int. He does disqualify it, almost in the same breath. Mrs. S.: The very fact that he could say no was already something. Another patient might not have commented at all, or he might have come out with a psychotic symptom. Gary could say no. But then

practically never do.

:

he had to disqualify

it.

Again, you're doing a transposition. First you were talking

Int.:

about Gary's hurting, then you talked about the way the whole family

But

hurt.

a third

this is

shift,

because

it's

not

all

of

them

hurting,

it's

the

Why do you do this?

family excluding Gary.

Mrs. S.: The identified patient always tends to try to keep the focus on himself. See, he starts out again: "my feelings." If I go along with this, then I don't get the other family members to make it clear that they hurt too. This is a subtle point. If you ever get off on this tack, particularly in the first interview, it takes forever to get back. The pahe

tient feels this as a validation of the fact that

and

feels there's

Int.:

label,

the identified patient,

on with him.

there's always this sparring going

keep on with the

is

If I let the patient

he can get crazy very quickly. Because then he

no hope.

You

a slippery sequence.

It's

what the other members of the family

"We're talking about

say,

feel."

He

says, "It has to

be

all

Then you say, "You want to know what they all feel." And that's when he says no. Mrs. S.: I think I may have been putting those words in his together."

mouth.

I

wanted to get something

members and so Int.

:

Mrs. bers.

I

may not have been hearing him

What was S.:

I

explicit in relation to the other family

it

you were trying

to get

hadn't been able to pin

You're always vulnerable

if

tribution, never

mind whether

it's

from them?

down

you don't get

must get each family member to confirm the for

quite.

memthem committed. You

the other family

fact that

he makes a con-

good or for bad. Then you've got

TECHNIQUES OF FAMILY THERAPY A

everybody committed to treatment.

from people

try to get a confession tive. is

Then

hold with either

who

it is

something

mrs.

show that the opposite approach. What you have to do is get

make

How

a production.

he

else again.

O.K. All

s.:

seems to me,

try to

each person to validate the fact that he can uses

it

112

that their productions are destruc-

there are other therapists

true. I don't

lot of therapists,

[

right.

(To Mrs. P.)

So,

now

let's

see

how

it

was, as

you think about it, when the family was all happy together. When you felt that the family was all happy together, how was it, then? mrs. p.: Well, we were all, we were all working together, and, ah, whenever anyone had anything nice happen to them, they'd come home with it and there would be enthusiasm. Ah, this, ah, this hurt, that begins, I think when we were in [city abroad] and Gary said

first

Int. there. It

:

he wanted to leave

Gary must have begun

us.

to enjoy himself independently over

sounds as though he got involved outside the family.

Mrs.

S.

He

:

when any

did. In this family the gratifications

were so nebulous

had any joy outside the home, that was already a threat. Here's a situation in which the husband and wife are really saying, "Everything's perfectly beautiful and wonderful," when that

everybody

of the children

who

lives in the family

knows

have some nice experience outside, they don't bring it's

an

affront. It's

When

that isn't so. it

back

in,

the kids

because

an affront because there's such emotional poverty

between the parents. Int. felt that

:

the family

doubt about

Mrs.

you phrase

I notice

was

all

it

to the mother,

happy together,"

as

"How was if

there

when you could be some it

that.

S.

I

:

put

it

this

way because

I

want

to give a signal to

Gary

that I hear him.

gary:

I

mrs.

p.:

never said that. Well, yes,

you

did.

gary: No, now, wait a minute. I

mrs.

brought you p.:

fruit, I

Yes.

gary: But, then

...

I

have to

tell

you

brought you roses as

my

side of the story.

gifts

.

.

.

A MRS.

[113

Family of Angels

But then you wanted to take yourself away. What good are

p.:

roses

.

.

.

—O.K.

gary: Well, now, no, no, no, no

mrs.

p.:

gary:

.

.

.

When

I

and

fruit,

had gone

without you? just for

one

have a

night, to

little

fun.

Mrs. S. With this kind of an interchange, even if I hadn't known that Gary had been in the hospital, I'd have known right now that this was a schizophrenogenic family. The mother criticizes Gary for not bringing joy home, by implication, and he says, "Look, I tried to give you flowers and everything in the hope that maybe I could get out." She rejects his presents, so that she's really saying, "It doesn't matter what you would give in return, you may not grow up." This I know would be :

the message of the schizophrenic's family. She

no way

you to do anything except give

for

invalidation of growth for the child. get anything except messages of

Her

Int.:

voice

is

is

me

also saying,

validation."

It's

is

a total

so obvious that the boy can't

It's

my

"You can

only grow in

woman

injured in love.

that of a

"There

image."

"What good

are roses and fruit without you?"

Mrs.

S.

Yes, but

:

can't talk about love with people

a feeling that they're mistake.

They

get

all

a matter of self-esteem.

this isn't love, it's

alive.

who need

This

this

where a

is

You

kind of thing just to get

lot of therapists

make a

involved in incest long before the people have

even developed to that point. This

particularly true with schizophren-

is

The ones I have observed, at least, haven't reached the point where they're making integrations at a male-female level. Int.: It's basically assumed here that if Gary left, it would be a

ics.

betrayal.

He

doesn't debate whether he has a right to leave, he debates

He knows

whether he would really be leaving.

he

isn't

supposed to

leave.

Mrs. they locked

gary:

S.:

how

it

was.

do anything bad

in

my

That's exactly

When

he started to leave,

him up. I

didn't

ably approved of everything

with two friends ing.

And

mind.

I did. I

who had been

came back

have prob-

in the

morning

I

had not been drink-

my room

for over twenty-four

drinking.

suddenly I'm locked in

You would

was well over twenty-four hours, and I could not understand this reason to be locked up. I became frustrated. I became

hours,

it

TECHNIQUES OF FAMILY THERAPY mad. fair.

And this, to And so this, I

abroad].

be locked in

this

room,

I felt,

do anything about couldn't stand to be locked up

I

didn't

it

[

114

was

unjust, un-

we

got to [city

until

like that.

And

then

I

ran, because I don't like to be locked up. If you'll understand

what

One

Int.:

phony acting

Mrs. mrs.

mean.

I

what he says

quality of

here.

It's

transcript

Well, prior to this business at [city abroad], you would never

:

them

into our

home, and

ing to talk) you brought

brought some of

I

same mrs.

the very

an oration.

have picked up two absolute strangers on the

gary:

is

That's right.

S.:

p.

you don't get from the

thing

that's the

them

my

street

and brought

same thing when (Gary

into our hotel

school friends.

is try-

room.

I felt it

was about the

thing.

School friends and strangers in a strange city are two

p.:

differ-

ent things, Gary.

gary: Well,

mrs.

s.

mrs.

p.:

Int.:

:

I

.

.

.

Could

I

stop

you now?

Yes.

Why

did you interrupt them?

Why

didn't

you

let this

go

on?

Mrs.

S.:

Because

I

saw

had uncovered another rule was putting this together in

it

becoming a useless interchange. Also,

I

in the family: strangers are not allowed. I

my

head with the rule that growth for the

self is penalized.

Int.:

By "growth

for the self"

you mean independent

activity,

don't you?

Mrs. tions.

S.:

Yes.

One was an

I

think his bringing strangers

attempt to

make a

could get out, as in the matter of the

home had two

substitute for himself so that he fruit

and the

people were on their

way

And the welcome. You

flowers.

other was to break the rule about strangers not being see, these

func-

to a foreign country to visit rela-

"We want

show our folks there that we don't have monsters for children." The mother and father were cousins and there had been dire predictions about the consequences when they married. Also, this was supposed to be a fun trip. What I didn't know

tives,

and the message was,

to

A was

until later

Family of Angels

[115

Gary broke while they were on ship-

that Lois attempted suicide just before

down. She attempted suicide the day before, board. But Lois was never labeled.

You mean

Int.:

Lois attempted suicide on shipboard, and the

next day Gary brought these strangers

Mrs.

much

Yes. Then his craziness followed. Since the identified

S.:

up

patient soaks

the pains in the family,

all

and since nobody had paid

was almost as though he was testing out for Lois was growing up to be quite a tomboy. And she was in a

attention to Lois,

Lois' sake.

home?

it

terrible bind, too.

Int.

Why aren't strangers welcome in this house?

:

Mrs. S. I got subsequent data on this. Strangers are wanted but at the same time they are dangerous. Now why are they dangerous? Because this family was a tiny, closed kind of place. The mother had two sisters who were several years older. They were like extensions of her to the children, but to her they were mother figures. The family :

never did anything except go back and forth to the the father's mother

an attempt to



it

was such a

alleviate this.

One

sisters'

house and to

The

strangers are

tightly closed unit.

of the things the mother talked about

was all her dreams for becoming acquainted with different people. So the boy was bringing something for his mother as well.

later

Int.

:

Mrs. Int.:

He was S.

trying to free her with his roses

and

his strangers.

Sure.

:

You

wouldn't think

it

would be much appreciated,

bringing in two strangers the day after his

sister's

his

attempted suicide, and

acting kind of crazy as well.

Mrs.

Of course not. But it doesn't seem very different from an incident I remember when a mother was distraught over something that had happened, and her little child came in with an old ragged doll. It

S.

:

was so obvious

tion:

"Don't

that the child

feel so

was trying

to divert the mother's atten-

bad." There's never just one thing going on, there

are several things going on.

mrs.

s.

get

(to Mrs. P.): all

the help

I

Because you obviously are coming here to

can

offer,

and

I

think



let's

say that

Gary

is

try-

ing to say something about his feeling, and you are trying to say

something about your the

Gary pointed out with me, two of you weren't communicating. And he was asking you feeling, and, as

TECHNIQUES OF FAMILY THERAPY a question which you think

somehow

was hard for you

it

didn't see

to figure out

he was saying. Just as hard as

it

was

an answer

him

for

116

because

to,

why Gary was

[

I

saying what

to figure out

why

you were saying and doing what you were doing. All right. These are some of the things, I think, that may occur with other members of the family, and not only with Gary and yourself. How does this happen between you and Dad? How does it go when you and Dad are trying to figure out something that seems you do? Suppose you go and maybe Dad didn't expect you to spend,

strange that one or the other of

spend some money that

and he thinks about

MR.

p.:

mrs.

but

it,

maybe might be kind suppose. (Mr. and Mrs.

let's

don't think we've

I

had

this situation.

P. laugh.)

(Laughing.)

Well, what kind of situations have you had where

s.:

turn out that

Dad

know

of odd? I don't

this

it

might

him

to do,

How

would

did something that you didn't expect

or you did something that he didn't expect you to do? that go?

mrs.

Well, I'm the type that blows up, you know, and then

p.:

over

and

it,

just takes

it,

am

sorry.

and

that's the

And

Father

way

it is.

is

the quiet type.

I get

mean, he

I

But we haven't had too many

blowups (laughing) fortunately, so we're very happy.

Int.

Dad if

When you

:

ask the mother,

"How

go when you and

it

are trying to figure out something that seems strange?"

you

really

trying to

Mrs.

S.

make

You

sounds as

is

close to "crazy."

Are

a parallel to Gary's craziness?

Yes. This, you see,

:

the family system. lary.

it

mean, "something that makes you angry." But instead of

"angry," you use the word "strange," which

you

does

You

start with,

is

how you

translate all behavior into

try to get the family to use a different

vocabu-

"You're crazy, insane," and you translate that into

"unexpected" or "different" or "strange," and then you get some evi-

dence in some other family member about "strange," and then you can

work back to Int.

:

the

first

"strange" again.

You make

a calculated use of "strange" to shift the symp-

tom onto the family relationships. Mrs. S.: That's right. Int.: The mother then offers something

9 that

sounds

pretty

strange; she says she's the type that blows up.

Mrs.

S.

:

You

see,

if

at this particular point I

had been

trying to

A how

get the family to talk about that

from

they get angry,

wouldn't have gotten

I

would have been too threatening. But when

her. It

[117

Family of Angels

put

I

it

in

terms of "What do you do in the case of something strange or unexpected?" then she here

when

takes

able to acknowledge

is

found out something

else

she said, "I'm the one that blows up and he's the one that just

This

it."

me

tells

that the father has given out very

what he himself thinks and by the nature of things So there

I

it.

is

will

have to be,

spokesman for the husband. husband thinks and feels that the boys

have to guess

The husband

larly the boys.

woman

about

in the family, the

a great deal that the

in the family just

and that the

feels,

little

at,

everybody

as does

else,

but particu-

labeled as good because of this, but

is

if

the

boys puzzle people, they are labeled as being crazy.

A

Int.:

how you

while back, you explained

use exaggeration to

lead people ahead. Here you rephrase anger as something milder, but the process seems to be the

same

in that

allows people to explore

it

themselves more than they might ordinarily wish

Mrs.

S.

I

:

think that's the function of

into this impression that all of

it.

to.

Here

I

was

trying to cut

them are angels except the

identified

patient, particularly the parents.

mrs.

{to

s.

Do

Mrs. P.):

you know whether your husband disap-

proves of something that you do?

mrs.

p.:

Yes,

mrs.

s.:

Well, then,

mrs.

p.:

Yes,

think

I

{Tim

sion.

much more quiet then {inaudible phrase). do you ever know then what he disapproves of?

he's, he's

I

can

tell. I

mean,

it's, it's

mostly facial expres-

talking in background.)

gary: That's a good question. That's a good question Timmie

He

picked out.

said,

opened the door? thing that he

mrs.

from

come?"

remembered

Now

see,

when we

out of the car

here he picks up some-

himself.

[city

abroad],

when you

tried to

run away

us.

Well,

s.:

How

He's thinking of

p.:

mrs.

"How come you went

just

I

don't

know

if

he

is.

I

don't know.

We'd have

to be

sure to find out.

gary:

think the reason that

I

mrs.

p.

mrs.

s.

:

I

I

ran

.

.

.

think this was the only occasion.

{simultaneously): Well, you don't know.

You

don't

know.

Here you don't say, "Does your husband ever disapprove of something that you do?" You simply assume it. Int.

:

TECHNIQUES OF FAMILY THERAPY Mrs.

S.

I

:

admit things

do

that a lot. There's

no point

118

somebody to down on their

in getting

make them

they're paining. I don't

if

[

get

knees.

That was a quick switch Gary makes from how the mother and father show disapproval to how he ran away. I notice that Gary did Int.

it

:

through the other boy.

Mrs.

Tim

That's right, through Tim.

S.:

started, almost

on cue,

make noises then. I think Tim might have been under the table. Int. What does that question of Tim's refer to? Mrs. S. I don't know what that was. I chose to let it go by because I wanted to pick up the mother's claim that she knew what Tim

to

:

:

was

talking about. She

was speaking

Tim, and

for

wanted to disabuse

I

knew what he meant. By doing that I knew that whatever was said

her of the idea that she automatically that, I

was

also saying to the patient

about him might or might not

gary:

fit.

think the reason

I

I

ran was that

Daddy

did not expect of him, by locking

because

son

I

may have been of

ble phrase]. This

my is

n-,

of

my naive,

something

perhaps more than

I

trust people,

mrs.

s.

locked

me up

should trust

God and

gullible personality [inaudi-

we have I

my

He

that he didn't have a full understanding of

I'm not overly friendly in that

I

up.

did something that he didn't expect of me, and the rea-

my personality,

and

me

did something that I

to discuss, because

I,

have a glad hand, but then, should.

I

mean,

believe in people,

I, I

and

let

I,

I

trust people

them prove

belief.

Why? Why should you

:

openly

trust,

without reason?

gary: Trust God?

mrs.

p.:

mrs.

s.:

People.

Anybody. gary: There is no reason born.

I

good,

when

Int.:

Mrs. used

tend

I, I

don't

But

this is

S.

:

Yes, because

You

might be raised?

my personality

ever since

I

was

say believe in people, believe they'll turn out

know

for sure. Sometimes.

Did you take Gary's remark

like this, I don't

Int.:

to, let's

to.

I

translated

to be in reference to people?

God

into people.

When God

is

go along with the displacement.

wouldn't worry about any religious objections that

A Mrs.

S.

No.

:

I

have a thing about

Family of Angels

that; I say, "Well,

119

[

any religion

can be used neurotically."

same time that he's telling you he does. Your saying, "Why should you openly trust, without reason?" sounds like a way to give him the chance to deny his statement that he trusts. Mrs. S.: I'm saying to him, "You don't have to mouth anything; you can talk about what you feel and think." This was a church-going family, but I learned later that none of them really wanted to go to Int.

Gary

:

you that he doesn't

telling

is

trust people at the

church, they just didn't want to hurt the feelings of the mother's older sisters.

mrs.

Then these are some of the things that we will learn about. Let's come back. Gail, how do you know when your father disapproves of something you do? Mother says she knows by his facial expression. What do you know? All right.

s.:

Oh,

gail:

mrs.

Well, what will he say? "Gail, you

s.:

that

you should have done

gail: Oh, I

me.

he'll just tell

this

that I don't think

or that"?

a way, yes. He, he'll say

in, in

know

it

don't think (laughing) I've done too

and

we'll discuss

many

and

it,

I,

(inaudible phrase).

Lately.

mrs.

s.

Do you know

:

you ever did anything

that

to get Dad's disap-

proval?

Gary: At

least that

Once

gail:

mrs.

s.

:

in a while.

He'd

And

gail:

.

How

s.:

tell

And

(Laughing.)

of.

he'd

tell

me.

you.

then I'd

and then mrs.

he knew

tell

my

him

reasons why, and then we'd discuss

it,

.

.

about you, Lois?

Do you know when Dad

disapproves

of something you do? lois:

Well, yes.

think that

I

we

just talk

about

this,

and, well

.

.

.

gary: But what have you, do you think, Lois, you ever remember anything you've done that lois: Well, ah

gary:

I

.

when we do something bad, we know that we've And we know it. We know ourselves, to ourselves, that

it.

something that nobody would disapprove

it's

s.

.

really did disapprove of?

think that

done mrs.

.

Dad

:

It

might. Let's see

how

of something she's done.

Lois decides that

of,

Dad

perhaps.

has disapproved

TECHNIQUES OF FAMILY THERAPY lois:

Well

mrs.

s.:

the

.

.

.

(Pause.)

Does he frown? You

way

120

[

his face looks.

Mother says she knows

see,

Now, does he frown,

by

this

or does he say, "No,"

or what?

He

lois:

te-,

he

me

tells

go along with what did

it,

that, well, that, well, well,

I've done,

and we

he doesn't exactly

and he says what reasons he has for disapproving of

we usually come to agreement. mrs. s.: Tim, how do you know when Dad disapproves of, he doesn't like?

why

sort of, well, I say

I

and

it,

you've done something that

tim: Nothing. (Female laughter.) Int.:

Once

again, you're going

around the family

circle

on

this

without dealing with the content of what they say.

Mrs. Int.:

That's right.

S.:

You

can hardly

ever does disapprove, or

Mrs.

S.:

I felt

if

whether the

tell

they

know it,

girls

are saying that

Dad

or anything.

quite certain that the father never disapproved of

anything openly. Never gave any clues as to what he disapproved

He's already been labeled as the quiet one. The message doesn't

show what he

stupe, or

is

of.

that he

thinks and feels, so then he can be taken for the

he can be taken for the reluctant one. Mostly he was taken for

the stupe. Later on,

we had

a very interesting interview about father's

messages of being a stupe. Int.

:

You

Mrs.

S.

gary:

I

used that word?

Sure.

:

don't think he's done anything.

I

think that actually we're

(inaudible phrase), we're actually working on sort of ficial,

superficial



worked on how we

we

relate

on a super-

we how we, how

(Lois talking in background) I think relate to

our parents,

I

think

w-, I treat the treat, well,

relate to ourselves, as, in the family group. I

members

of the family approximately

with a different feeling, but

in, in

how

a similar

that I might treat any group of individuals that raised

from

my

learned

if

between any human being, then we could find per-

how we

haps

a,

very birth.

You

to, to trust the

see,

you see what I'm

getting

family, then I've learned that

mean

would manner me up

I

at. If I've

it's

good

to

trust other people too.

MRS.

s.:

I'm not so sure there's any reason

why anybody

should trust

A anybody

know

until they

talking about here

.

.

exactly

how

[121

Family of Angels

to

do

it.

And what

we're

.

How

do you trust? mrs. s. This is what we're going to talk about. And what we are just now trying to figure out is what kind of signals does the family use

gary:

:

to find out

You

Int.:

agree that what you're

and then you don't

Mrs. This

is

some

a

S.:

way

I

of them.

going to talk about

all

is trust,

talk about trust.

say we're going to talk about

"What you have

of telling him,

and

clues

when Dad disapproves

it,

but

to say

is

I

don't say when.

useful;

it

gives us

But by not hamstringing myself,

we'll deal with it."

since I don't say when, I don't have to pick

up

all

the clues

when I'm

not ready.

mrs.

(to

s.

of you?

gary:

mrs. gary:

:

I

tell

What do you

because Well,

s.:

Mrs. that? I felt

though he,

do you know when your father disapproves

use?

a lot of times.

I can't tell.

You don't know, sometimes. know when, I know more when Mother .

.

tells

disapproves. I can

.

now what

gary: Well, she

like

How

:

I can't tell, really, s.

mrs.

Gary)

signs

do you use?

me.

Did you notice the change in Gary's voice when I asked that this was a surprise, that he would be looked upon as too, could be part of this whole process, that he could be

S.

:

everybody

else.

I

think this was the

first

time he realized that

maybe he wasn't going to be treated like a patient. Int.: You made him wait till last in this round of questioning. Was this to keep him in his place? Mrs. S. No, it was because if I went to him first, whatever he said would be received as something crazy. He wears a label. This is why I :

often leave the identified patient out, so that his contribution

is

the

till

last, after I've

got the process

seen within that framework.

Int.: Twice at least he's tried to take you off the question of the father's disapproval little

and you've come

right

back to

it.

I

think he's also a

surprised at your persistence.

Mrs.

S.:

That, by the way,

is

something you'll find

me

doing

all

TECHNIQUES OF FAMILY THERAPY

[

122

the time. I keep coming back to the thing. Later

"What do you have drop dead." But mrs.

I

to rescue your father for?

want to give the experience before the

She says words. She

s.:

on I'll interpret: He and I aren't going to interpretation.

"You're doing something

says,

don't

I

like."

gary: Well,

remember,

I

I

And

ever said anything.

time

at the

I

didn't think that I

anything wrong. No, well, twice, the time in

And

thinking of another time.

me,

tells

Mrs.

proving, and he

me

tells

And

Int.:

I really, really, I

had done

abroad]

[city

has

—I'm

then he told me. But, unless he

do not know.

See what he did there?

S.:

Dad

can only remember once when

I

ask him about Mother disap-

about Father.

when you asked about

before,

Father, he shifted to

Mother. What a good boy! mrs.

s.

gary:

O.K.

:

Now

.

do know what

I

.

.

I

can do

approve of myself, but

s.

I

cannot

tell, I

do not

I

me.

tells

mrs.

I,

know what I know unless he

and

in a situation like,

What

:

definite

I

am

work

trying to get at here, because

that

we need

out here, and to help you

way

we have some

very

to accomplish,

what I'm trying

to find

find out,

what do you use

in the

all

of clues from each other to decide

is

how

the other one

is feel-

ing about you?

At

was hearing him again take over and I was reminding him that we were here for a purpose, we had definite work to do. I often get the impression from this kind of speech that the patient thinks that what he's supposed to do is go on and on in terms of his

Mrs.

S.

:

this point I

inside self, because that's

"All right, that

may be what somebody

am really shutting him off. Int.: He was apparently about

want."

else wanted,

but

it

isn't

what

I

I

proves of in himself and give you the pists

to him,

what the therapist wants. I'm saying

would

Mrs. mrs.

disapthera-

prefer.

S.:

s.

wound up on what he breast-beating that so many

to get

That's right.

(cont.)

here,

you

:

Now

you

said that

said,

you

and Gary,

we'll use

you

as an

example

didn't often, or rather, didn't always

know

A when Dad was

You knew more

disapproving.

[123

Family of Angels

often

when Mother

was disapproving.

And I told you

gary:

mrs.

s.

him

tells

Yes, because she says so.

:

Why

Int.:

the reasons.

did you accept this boy's statement that his mother

when

explicitly

she disapproves,

when

there

is

considerable

doubt about it?

Mrs.

S.

I left it

:

so that

I

can come back and wind up the discrep-

would be so easy in this first interview to have the whole thing go on between Gary and myself. That's where a lot of therapists ancy

later. It

go wrong, because they get involved

So

I just

leave

it.

in a

war with the

identified patient.

I'm gathering information in a kind of relaxed way.

Of course.

Int.:



Now, let's find out from Gail, for instance, how do you know when you've displeased Mother? gail: Oh, I think we talk it out. I mean, she'll tell me what, what I've done, and I think the same way with my father.

mrs.

(cont.)

s.

mrs.

s.

:

:

You mean, you

see

it's

the

same kind of

thing.

That

mean,

I like

they'll

is,

you.

tell

gail: Yes. That's the

way

I

think that

I like

it.

I

to

know

when I've done something wrong, and then, again, we discuss it. mrs. s. What about you, Lois? lois: Well, when I've done something definitely wrong, well, I usually, :

well, sometimes, I

mrs.

s.

:

can

tell

.

.

We're talking about Mother, now.

And, but then, sometimes

lois:

.

quite understand.

And

there's

something

done

I've

then we'll talk about

it

that I don't

and then,

Mother doesn't like it. mrs. s.: Mother will tell you? lois: We'll sit down and talk about it, and see why say what I think and we sort of discuss it.

well, I

usually see that

Int.: That's a remarkable series of statements.

it's

You

wrong, or

I

don't get any

idea about what goes

Mrs. first,

S.:

on between mother and daughter. No, you don't. What I was trying to do was take Father

because he

isn't

By

By

the time

I

get to

that process of taking the

two

getting out the data about first one, then the other, I learn that

you

Mother, everybody

and

so dangerous to discuss.

feels

a

little freer.

can't tell anything about Mother.

TECHNIQUES OF FAMILY THERAPY And rather than comment on it

Int.: it

just accept

and go on?

Mrs.

comment

That's right. If I

S.:

of an interview feeling lost in Gestalt. That's

the

little

pieces.

what I'm gunning

for.

And

that's

Say you

if it

was

just

you

everybody sees and

way

of getting out

any other way. So

spitting,

on some

may not be know at first that

"How does

Then

only an individual one.

that

but in fact

how everybody

I ask,

I

mean when

about

Your

it.

you

yourself that

spitting

I'm doing

ting sleeping pills.

system interpretation rather than

my

to

and then

interviews, I notice that I I

build this into a meaning

were giving people

this.

In a way,

pills

without letting them

But by the time they

anxiety afterward, with

it's

as

if I

know

they're get-

realize what's happening, they

no place

to put

it.

for people, but they've got to have

mrs.

a

can't get out

have some overall meaning they can use, and so they aren't

integrate

is

so comfortable for people to accept. But they don't

very sweet-tasting sleeping

bad

I

has a relationship to what

it

feels

I listen

trivial thing,

what

don't get the

each one here get out that which he

I've got a

When

They

an interview. Well, that could look

some message about

can't say directly?"

often start off

spit in

little

So often a family goes out

all

talk about process.

on these

at this point

pieces, I can't bring out the idea of a system.

as

you

at this time,

124

[

left full

don't think that pain

I

some way

of seeing

of

is

so

how

to

it.

s.

:

What about

you,

Tim?

How

do you know when you've done

something to displease Mother?

tim

when I'm monkeying in the flour. mrs. s.: When you monkey in the flowers? tim: The flour. {General laughter and something :

Well,

that sounds like

an

explanation about a flour sack.)

gary: Monkeying in the

flour.

Oh, yeah.

I

used to do that when

I

was

a boy, Timmie.

mrs.

:

Well, you're telling

tim: No. She

mrs.

me what you

how do you know that your mother disapproves? 'Cause I don't know that everybody would disapprove of your playing in the flour. How do you know that Mother does? Does she frown at you? What does she do? s.

s.:

She

do you,

did, but

me.

tells

Now, I'd like to come back to Dad. What how do you know what the family, let's say when Gail, tells

you. O.K.

when you've done something you? (Pause.)

that

makes Gail

feel

disapproving of

A mr.

Oh,

p.:

mrs.

125

[

don't know. (Female laughter.)

I

Does

p.:

Family of Angels

that situation ever occur? (Laughs.)

We

have a pretty

unusual daddy. (Laughter.)

gary (low voice) mrs.

how he

You

:

Yes,

We really do.

p.:

Int.

:

shift

we

do.

(Laughing.)

how Dad

here from

expresses his disapproval to

finds out that others disapprove of him.

Mrs.

S.:

I

posed to look

at

Int.

do

this

anybody's disapproval.

The women

:

because there's a rule here that you're not sup-

start to

laugh and there's the remark about the

unusual daddy. Again, you can't

tell

what

they're saying about him.

And Gary comes in very quietly with that "Yes, we do." Mrs. S. When I heard Gary say this, I saw that in :

guy who has to

this family the

up to the fact that he can't comment is the father. Then I immediately saw Gary and the father and Tim together, facing very definite ideas about what males could and couldn't do. I saw that another function of Gary's symptom was to show a better way to the live

Gary used Tim

you remember, further back, how

Do

males, particularly to the father.

by picking up Tim's question? This shows the way the males here protect each other. They are all in a frame of "You can't

as a front

comment," and the females are

mrs.

s.

Well,

:

I

in the driver's seat.

go on the principle that no humans are angels.

just don't think that fine people, that

anybody

is

really

And

I

an angel. But they can be

has nothing to do with that. But I'm sure there

must have been times, Gail, when you have been disapproving of something your father did, or gary:

I

think the reason

That's

mrs.

Int.

I

s.:

:

Is

why we're think there

Gary

is

'cause I don't think there hardly ever

Int.

comes

in

S.

:

is.

sunk. is.

saying,

"One

of the reasons I'm in trouble

father doesn't act out enough, so

Mrs.

said, or looked, or acted.

That's a part of

I

have to do

it

for

is

that

my

him"?

it.

The mother came in when Gail was queried, and now Gary when the father's on the spot. It's an interesting rescue sys-

:

tem.

Mrs.

The

S.:

Rescue operations are going on a mile a minute

rationale for

it is

here.

that they've got to protect each other, they don't

TECHNIQUES OF FAMILY THERAPY want

each other's feelings, and

to hurt

for "Shut your

[

126

a reinforcement

this all acts as

mouth!" So you notice these pungent things

I

put in here

"Nobody's an angel."

like,

gail:

think the only time

I

had a

flat tire,

and that wasn't Daddy's

of whoever used

mrs.

s.

my

fault.

when

That was the

I

fault

car before. (Laughing.)

wasn't Daddy's fault.

It

:

could ever think of was one time

I

gail: No.

mrs.

Mr. P.):

(to

s.

How

do you know when Lois

is

disapproving

of something of you?

MR.

(Gail laughing):

p.

Maybe, maybe I

know. (Female laughter.)

.

.

.

little bit,

.

.

.

(overlapping): (Inaudible phrase.)

p.

Remember when you get mad and cry and go to your remember those times. Remember those times? / remem-

(to Lois)

room?

I

:

ber those times, 'cause

when

they happen,

p.:

think

MR.

as I

gone into her room and sulked a

she's, ah,

can remember when the

I, I

gary

know

think. It probably's possible

gary:

MR.

don't

I

I

it's

I

remember them,

they're very rare, but

quite a, an exper-, quite an event.

it's

happened sometimes when (name inaudible) was

in school.

gary:

remember when

I

mad

got

Gail's

way.

ther.

five,

or was

remember when

I four,

I

Daddy for not giving me a whole waffle, and I broke doll? Remember that. Now that's sort of a round-about

And

then in

a mental hospital.

[city

I

abroad] of course,

me

didn't

up.

I

want

I

ran, 'cause

I

did disap-

thought he was going to put

me

in

that, so I ran.

Why is everyone getting so excited?

:

Mrs.

was

at

prove of him locking

Int.

I

There's a rule that nobody can

S.:

But Gary

is

show disapproval

beginning to think perhaps he can trust

me

a

to fa-

little.

So

he comes out with very definite evidence about Lois. What's shaping up here comes close to an explicit statement about the presence of anger

and disagreement. That's the most

explicit

it's

been and so everybody

starts to talk.

mrs.

s.

:

All right. Then,

on, then gels,

we can

you

begin to

see, if

we

remember

start putting

that this

is

our thinking caps

not a family of an-

but a family of people in which people are going to be disap-

A

Family of Angels

proving and disappointing as well as loving.

—what do you you

do,

At

Int.:

think happens

and he doesn't

tell

when you

first,

when Dad

you about

127

[

Now, Mother,

me

tell

disapproves of something

it?

started asking

how

people show disap-

same question to the mother. Tim and Gary deflected it and you went around to all the children before getting back to the parents. Why did you think it was all right to come back to them at you put

proval,

this

this point?

Mrs.

S.:

Because

been around to everybody now.

I've

message before that showing disapproval

is

dangerous. So I've

I

got the

made

and

these cushions. I've gotten everybody to talk about everybody else, this is

now

I

approach the husband and wife

I'll

get the least defensive reaction.

a familiar kind of thing.

with this kind of cushioning so that

You

Int.:

could have said, "Dad,

disapproves of you?" That

is,

all

how do you know

you could have done

that

Mother

the other

it

way

around.

Mrs.

S.

:

I

deliberately picked the

the family system

Mother.

By

woman, because,

as I'm seeing

now, you can pick on Dad, but never, never on

asking her to acknowledge her husband's disapproval

an interesting way



—and

bound both of them. I said, "What do you know about your husband disapproving of you when he doesn't tell you he disapproves?" I'm saying that I know the messages I

think

I

put

this in

I

of disapproval in this family get across but they aren't acknowledged.

put

it

into that frame, asking her to give evidence about

proves,

when he

Int.:

You

wrong for him Mrs. S.

when he

I

disap-

doesn't let her know. get in the assumption that she's got to

do something

to disapprove of.

The way this is phrased is a subtle maneuver. She has to acknowledge, "I do something that he disapproves of," as well as, "He disapproves." Int.: You also sound as if you were going to come in with something big. You say, "Now, Mother," then you pause, and then you go :

Precisely.

ahead. I'm sure she

Mrs. a bind in

it

S.

:

felt

Well,

on the spot

I try to

there.

engineer a strategy like this so that there

for both persons, but there

mother could do. She could

say, "I

also a

is

am

way

out.

Look what

is

the

always bad, and I'm always

doing something he disapproves of." She could say,

"He always

disap-

TECHNIQUES OF FAMILY THERAPY Or

proves of everything."

she could say, "I never

proves, so I'm constantly worrying about

ways

you

to go,

see,

know when he

There are

it."

but she has to do something with

it.

all

128

[

disap-

kinds of

The choice she

makes helps me to get more information about the family system. But I try to set up every intervention so that it leaves the person a way out.

me

This also helps

You

Int.:

to see

how

up

set this

as

people get out of a threat situation. if

quite mild. I'm sure she felt she

both a feeling of that's all

something were coming, and then

was going

relief that that's all

to

it is

it's

be blamed. There must be

and an opening up because

it is.

Mrs.

S.

mrs.

p.

suppose

I

:

that's right. I

freeze

up and

and

.

.

.

he ever

.

.

.

I get quiet

Hmm.

gary:

mrs.

mr.

I'm sure

:

p.: p.:

.

.

.

and

resentful. I don't think

think you'll have to get the question rephrased again.

I

I

what you said. mrs. s. That is, when your wife knows that you disapprove of something, but you haven't said that you disapprove of it, but she knows it. Then what does she do? slipped a

little bit, just

exactly

:

mrs.

p.:

I

think that's what

I

do.

(Loud laugh by Gary, humming

sound from Tim.) gary: Ha, ha

mrs.

p.

mrs.

s.

Int.

:

Mrs. on

—we've got a game!

would hurt him with my silence. You would hurt him with a silence. I

:

:

Was Gary playing a game with Tim? S.

:

No, he was saying, "This

is

a game.

Games

like this

go

in our house."

Int. silence,"

:

The mother

and you

says very explicitly, "I

"You would

say,

hurt

would hurt him with

him with a

silence."

Was

my this

deliberate?

Mrs. niques;

S.:

I didn't

Yes,

it

want

to

talk about the various

At this point I was only getting at the techlabel them as belonging to anybody. Later on, I

was.

ways

in

which people are operating.

You didn't want to identify this technique at this point? You wanted to make it a general one? Int.:

Mrs. I'm

still

S.

:

Yes. Silence

is

used in

this family, it's

working toward the family homeostasis.

else uses silence.

I

with the mother

one of the

want to

rules.

find out

who

A Int.

Did you

:

also feel that the

Family of Angels

a pretty extreme statement, "I would hurt him with S.

asked her

answer

No,

:

I felt that

way

a

my silence." I

had

she wouldn't have been able to

of hurting, a secret way, because you

is

can't find out about

It is also

upon

usually looked

it.

whether she's saying that she

tell

whether she means that S.

You

Int.:

is

not

certainly lifted

it's it

deliberately

is

inadvertent.

it's

means

think she

I

:

a discrepancy, because silence

as something that hurts.

hard to

It's

:

Mrs.

is

way. But we have removed a few things, so that she was

able to see that silence

silent or

This

it?

she had put something together. If

this question at the outset,

this

Int.

129

mother was provoking you, saying

she was doing something bad to see what you would do with

Mrs.

[

inadvertent.

her by making

off

it

"a" silence in-

stead of "her" silence.

Mrs. all

S.

Well, in

:

my

effort to get at the rules,

the dimensions that I can get.

For one

I'm trying to put in

thing, the possessive pro-

nouns have to be redistributed, the "me's" and the "my's." that there's a conviction in these people that whatever has

ceded by "my" "your"

is

is

unique to that

unique to that

self. I

use of the pronouns, and use of the pronouns.

As

do

judge

my

how

is

reality.

All things and

come from,

are a

means

am

that I

preceded by

is

far the treatment has

people and

all

been pre-

diagnosis in a lot of ways by the

said before,

I

that whatever

one of the things

that in dysfunctional families there's

believe

Int.

I

Or

self.

found

I've

comment on "me."

ideas,

all

If

no room

I

gone by the

have come to

for

any outside

no matter where they

the tomatoes are rotten, that

not loved.

You're implying that everyone uses a kind of confused lan-

:

guage in a family with a schizophrenic, not

Mrs.

S.

just the schizophrenic.

That's right. That's what you find out

:

when you

get the

family together.

mrs.

mr.

(cont.)

s.

Well, what happens then?

when

it

p.

think, time.

I

:

mrs.

s.

MRS.

p.:

mr.

:

p.

It

it

be a minute or ten minutes or what?

(simultaneously)

p.:

this get clear,

depends on the degree of the (inaudible phrase).

hours, possibly.

mrs.

does

happens?

Well, would

:

How

Yes.

:

Oh, maybe a few hours. Probably. Few

TECHNIQUES OF FAMILY THERAPY mrs.

s.:

are

Have you ever noticed this, Gail? When Mother and Dad somehow in a silent period?

Oh! Oh,

gail:

Mrs.

130

[

At

S.:

But

sure.

made

building

up here

us

unhappy

all

What I'm

you, Gary."

is

a picture of the pain in the family.

is

had sometimes not spoken

that these parents

three days. So

was remembering the statement at the "We were happy," which said, "The thing

this point, I

beginning of the interview, that has

never for very long.

it's

what

am

I

doing

is

gradually

learned later

I

to each other for

two or

to ask Gail for a validation of the

pain.

Int.

Gail seems to be the model child in the family.

:

It's interest-

ing that you use her as the validation.

mrs.

s.:

How

have you interpreted

What

it?

did you think was going

on? gail: Oh, I interpreted

then they

mrs.

s.

:

mrs.

s.:

be quiet

just,

maybe

then, oh,

a while.

s.

:

s.:

Yes,

mrs.

I

I'll

say

:

it

I

let

blows over.

know. We'll

out their anger in other ways. this

phenomenon between your

again. It

was

ever noticed

.

my

.

.

parents?

.

.

.

when your

Have you

father

and mother are

ever noticed this?

no.

You've never noticed this? gary: No. I'm, I usually take people .

ah, like I said, naive thing,

and

Most of tion

mrs.

that.

gets angry, I suppose.

was preoccupied with

with each other?

To be frank, s.

it all

so

noticed that you were.

Have you

silent

gary:

And

few minutes, depending on

for, for a

Have you ever seen

gary: Yes,

mrs.

thing.

some-

this out.

Gary (overlapping) mrs.

on the same

we'll find out something. I don't

Gary: Some people would s.:

to eye

a couple of hours later,

Everyone

maybe

Well,

have to check

mrs.

slight disagreement, or

Do you think they're angry?

For

gail:

had a

as they

and they don't see eye

thing,

And

it

s.:

is

I've

my

and

right

of

always been busy with friends most of the time.

life is

it's

their face value, and,

gullible, so I don't notice that sort

spent with

my

peer group, but a very great por-

also spent with the family, so

Well,

on

.

.

.

already been established that, at least by Gail, any-

way, that Mother and Father have periods of silence once

in

a

A and they've established

while,

to look too,

Mrs.

S.

if

What

:

you happen

so

it,

to see

Family of Angels

guess

I

right for

what he saw and heard. What

of having to deny

you

to get the silence

between the parents validated by Gail so that Gary could get

hook

131

it.

was working toward here was

I

all

it's

[

was, "Don't trap me. I'm not sure that

it's

off the

heard him say

I

and

safe to say anything

I

maybe he

smell a trap here." But he's teetering wittf the possibility that

can comment.

gary (overlapping)

I

:

but then again,

it,

test

s.

Yes, well,

:

I



might be

if I

saw

like

it,

looked for

just

to say

all right.

But

lois:

To

Lois. )

Well,

once

by each one thinking,

in a while.

silent periods don't last

know they

But

about

it

it

and Gail has seen

think this

I

well, they think over

well, they just think

time being,

Mother and Dad have

that

They agree that they have Have you ever seen this?

I think, well,

and they,

what he wanted

just for the record, at the

periods of silence. (

might see

I

discovered an exception will prove the rule,

you have not thought and recognized

it.

it,

Freud, and he had a theory to

and so every time he got the people

them to, and he you know. Mrs.

can't see

is

what they have done,

and

usually, well, these

very long.

mrs.

s.:

I

mrs.

p.:

And they happen very,

mrs.

s.:

But when they happen, when they would happen,

mean

caused

don't.

very infrequently. it

would

would have to figure out what was going on. I'm going to ask Mother a question. When you're silent with Dad, is that because you're angry with him? mrs. p. (sighs) Well, sometimes, I mean, it happens so stupidly. It's that everybody

:

because

I

think something, and because

I

think

it,

I

think he

should follow the same line of thinking, and of course he doesn't,

my

and then

it's

phrase.)

And

disappointment in him that causes

then after

I

analyze

it

and

I

get

all

this.

(Inaudible

through going

through, everything's fine again.

mrs.

s.:

Then

mrs.

p.:

That, that's the thing.

mrs.

s.:

Well,

it

isn't

let's

anger at

all, is it?

— (To Mr.

It's just

P.)

stupidity, really.

Are you angry when you're

silent

with your wife?

Int.

:

You've got a special

to the father.

inflection in

your voice when you talk

TECHNIQUES OF FAMILY THERAPY Mrs. Int.

S.

How would you describe it?

:

Was

almost a coyness.

It's

:

this

because you

was hot and you were trying to soften it? Mrs. S. Yes, by my voice. The voice :

"Come

say,

esteem

out."

One

minute you do Int.

a

is

words

that the self-

The

easy to turn them back.

it's

you arouse defensiveness.

that,

It's

:

material

felt this

will protect while the

of the things in these families

so low in everybody that

is

132

[

herding sheep into a corral; they'll

like

little

flee if

you

move them wrong. Mrs.

S.

That's right.

:

have to keep the lowest

mr.

No. No,

p.:

I

go on the principle that to make changes

I

level of defensiveness.

think

I

the more,

it's

I

have a question of

letting

healing time take place.

mrs.

Well,

p.:

mr.

p.:

Well, sometimes, yes,

munication

is right.

communicate, let

Int.:

lack of communication, sometimes, that

isn't it

But,

think that's right.

I

mean, ah,

I



If I tried to

seem reluctant to

you think anger

is

to Father

and ask,

"Is

it

.

com-

time

can't

to

do

I

it is

to

interrupts.)

a secondary emotion, but you

people assume that anger

let

them. First you bring out the idea that

you turn

— (Gary

way

.

lack of

at that particular

so then, the, ah, the

time lapse, and then you can

I realize

The

.

it isn't

is

what's motivating

anger with Mother, then

anger?" Finally

it

ends up as a lack of

communication.

Mrs. treat

that

to say that

it is

giving

bum :

Mrs.

I see if

messages.

up before Int.

Since

S.:

I

anger as a secondary emotion, the

way

I

a person shows anger, he's hiding his hurt and

If I

put too

much emphasis on

anger,

if I

pick

uncover the hurt, then I've got more work to do.

How do you mean, you've got more work to do?

whole monkeyshine of anger. People who are giving out messages which look like anger messages can S.

:

I

have to go through

be either angry or hurt.

If

this

a person feels hurt and wants to say to some-

"Come closer," but expresses it in an angry way, the other person away. What I want to do is to get that message of hurt out first. If

body, goes I

accuse the anger, the anger always comes out in relation to the attack

on the other person, and I get into the business of blame. Then to spend more time on it than I want to.

I

have

A Int.: I assume that you don't think

what they blame each other

Mrs.

enhancing part of the Int.

133

important to bring out

it's

what

get at

I

the ego-

I call

self.

why

Right here,

:

[

for.

Yes, but that comes after

S.:

Family of Angels

are you getting the question of anger out of

their discussion?

Mrs.

S.

Because

:

want to show

in this family

that anger

is

nobody

will

acknowledge anger.

basically each one's hurt

I

and disappointment

with the other. In a sense, you're going along with the family by trying to

Int.:

get anger out of the picture.

Mrs. Int.

S.

:

No, no.

Is part of

:

want

I

in its right place.

it

by going along with the family's idea that

that

it

to put

they mustn't call anything anger, you enable

them

to speak

more

freely

about their real feelings?

Mrs.

came

S.:

That's right.

Toward

the

end of the interview, when

we could

to the question of the mother-in-law,

about anger.

By

then

I

had made

it

possible to

do

I

talk differently

There's a timing

that.

element here. Int.

That's one of the things I'm trying to get

:

Mrs. cially

S.: I

when

it is

would never

he can acknowledge :

S.:

it.

Later on,

when he

doesn't feel he'll drop dead,

it.

Is that the

Mrs.

talk about the anger at the outset, espe-

seen by the individual as something so devastating that

he can't acknowledge

Int.

at.

way you would treat every family?

Oh, no. In other

instance, I say, "It sounds to

one." I've noticed that

many

families, families with delinquents, for

me

as

if

you want to draw blood on that

therapists think there

is

something thera-

peutic about getting out anger, that there's something therapeutic about

reporting what one's emotions are, never tients

pushing to get out anger even

"Be angry!"

if

mind what. So you

they're not angry.

get pa-

You know:

Pretty soon you've got a countertransference situation in

which the poor patient has to announce that

he's angry,

going along with the beliefs of the therapist.

I

when

he's only

don't think there's any

particular growth in that.

Int.

:

There's another possibility for what

mother says that the anger agrees with

this. It

sounds

is

is

happening here. The

a lack of communication, and the father

like a

comment you would make,

it's

in your

TECHNIQUES OF FAMILY THERAPY

[

134

makes it for you. The question is whether she picked it up from what you said previously, or whether she picked it up on the outside, or whether it's been engineered so that this would come out, which is what I begin to suspect. Mrs. S.: The way I heard her, she was not talking about commulanguage, only Mother

nication but about isolation.

Int.

I'm sure she

:

isn't

using the

word

in quite the

way you would,

wonder if another therapist working with this family would get the same terminology. Mrs. S. This is something to look into. But I try not to give any messages that say, "Give me what I want," but rather, "How do you it's

just that she's got the terminology. I

:

see it?"

As

Int.: to

C

I

A

remember, you said before that you take

come up with

so that they will

and push

it

B. Insofar as you do that, they're

come up with ideas you're engineering them to have. Mrs. S.: It could be. All I know is that the families bring

going to

own pieces gary

very nicely.

(to Mrs. S.):

mrs. gary:

s.:

Yes.

I

think

and

time, he's a

Int.

:

it's

he's

little

May

I

say something about this subject?

difficult for, for

—Daddy

busy working and

more

all,

quiet than usual.

There's one thing here that

is

gary

(cont.)

You know what

:

well

this isn't

terribly

when

I

hard to find when

it's

impressive. In this short time, if

he can speak.

mean. He,

may have

he's

it's

not that,

I

don't

know

Daddy

talks, not,

not too

can't tell the difference,

maybe,

trouble because

much, and she maybe angry at her.

Well, we've had an illustration here of something. Gail has

observed

were

and so

my daddy and mommy communicate together, 'cause my affair and I usually stick to my own business. But,

but Mother

s.:

quiet quite a lot of the

That's right, he does.

S.:

how

Mrs.

is

(Female laughter.)

you've got that boy asking your permission

Mrs.

in their

this

silent

phenomenon between Mother and Dad when they

sometimes, and she concluded

angry with each other.

gary: Could we ask Tim?

And

it

was because they were

Lois has seen this

.

.

.

A mrs.

He may

mrs.

be the most observant of us

Well,

s.:

And,

s.:

Lois,

all.

ask him.

I will

gary: Ask him simply, so

mrs.

135

[

Pardon me?

s.:

gary:

Family of Angels

—you know.

you kind of concluded

going

that, ah, things are

to get to be all right.

Umm.

lois:

mrs.

s.

You're not sure whether your mother and dad are angry with

:

each other lois:

at that

time or what.

don't think they are angry.

I

to define angry, I think.

gary: Yes, you're lois:

someone

mean,

think they're just, well, it, it

.

.

it, it's

hard

.

right.

mean, on various

I

I

I

angry can mean angry over maybe

levels,

spilled a glass of milk, or something. But, ah, I think

it's

hard to define (laughing) angry.

mrs.

Yes, but you know,

s.:

if

who

they expect that person

them or to

to hit

important that

reject

we

people

someone

call

has angry feelings toward them

them or something of

understand, because

people fear there's going to be trouble. clear. Well,

else angry, then

this kind.

when anger So we have

So is

it's

very

around,

to get this

Tim, have you seen your mother and father when

they seem not to be talking?

tim: No. mrs.

s.

gary:

:

You

never saw this?

(Laughs.)

mrs.

s.:

Well, so you and

gary: We're the tive

this.

and, you know, we're more, we're not so sensi-

about things like

about Int.:

men

Gary haven't seen this.

Women

are

more

sensitive

on the whole

this sort of thing.

Gary

says,

then he finds out that

"Tim may be

Tim

the most observant of us all." But

hasn't noticed his mother

and father not

talking.

Mr.

S.

:

Well, the

men

can't

acknowledge

that.

Int.: Neither can Lois.

Mrs. S.: She was classified as a tomboy at this point. There were only two females there, the mother and Gail. All the rest were labeled males.

mrs.

s.

:

Well, we'll see. But what comes out

pens,

Mother has

is

that

whenever

a feeling of disappointment,

and

I

this

hap-

think

Dad

TECHNIQUES OF FAMILY THERAPY know

has a feeling that he doesn't

quite

how

go

to

[

until a

136

little

time goes by. Isn't that right?

MR.

That's right.

p.: s.:

You

that

when

mrs.

it

just

kind of stop and wait to see what you can do. So

this silence

p.:

has nothing to do with anger, but

s.:

Go

mrs.

p.:

But

I

:

to each other. Isn't that right?

ahead.

happens very seldom.

it

amazing. s.

way

think that's right.

I

mrs.

mrs.

it

has to do with the fact that, for that moment, you haven't been

able to find your

mr.

comes,

I

mean, we

really

know. Well, you

I

mean,

this is the thing that is

have had an amazing relationship.

see, this

has a relationship

now

to the thing

Gary was trying to get at, when he was talking about what was going on in his mind, and the behavior that he had, and then what he saw in the way in which you responded to it and his father responded to

it.

And

he wanted a chance to clarify

him something that I think you thought was did you lock him up in his room? MR.

p.

:

Well,

it

this. It

different.

wasn't really, he wasn't really locked

up

looked to

Now—why

in the

room.



The mother is emphasizing the whole family is, to some extent that there are no negative feelings and that everybody is quite happy, except possibly Gary. Your approach goes along with what the Int.:



family would like to think, that positive feelings,

it

isn't really

anger, that they have

and that they have amazingly happy

relationships.

Their desire to emphasize the positive coincides so well with your emphasizing the positive.

Mrs. S. I'm not saying there isn't any anger. I'm relabeling it as hurt and disappointment. To get people like this to comment even on :

disappointment takes a

little art.

you confronted the family with how angry they were and how miserable they were, and so on, you would Int.

:

You

said before that

if

So what you're doing

silence them.

is

accepting the positive impression

they're trying to give. You're encouraging

are within this

them

to

go on the way they

framework you're changing.

Mrs. S. I have seen nothing that contradicts my idea that people want to grow and survive and get close to others. But I don't think anybody grows under a defense. So I build very clearly and cushion :

things.

Int.

:

What

follows

all this

suddenly into the question of

cushioning

is

a confrontation.

why they locked Gary up.

You go

A Mrs.

S.

Int.:

why I do

That's right. That's

:

It's

way they do appear to be the somehow happens that things go badly,

it

just

in spite of their positive intentions,

Then

all

The

path.

the positive and the

same. They're saying that

this.

137

[

this bridge-building.

them down the garden

also kind of leading

way you emphasize

Family of Angels

of a sudden you ask,

and you seem

"Why

to

be agreeing with

him up?" You

did you lock

"How did it happen that he got locked up?" Mrs. S. You notice how far along in the interview we

don't say,

:

come what

have to give enough ego-enhancement so that

to that. I feel I is

are before I

ego-assaultive can be tolerated.

Int.: Well, there's an acceptance which they're going along with,

and

all

of a sudden there's a capper

You're behaving as

you were

if

would

p.

mrs.

s.:

when

going along with them, different

actu-

from any-

accept.

Gary: Well, as far

mrs.

and the Gestalt changes.

this

them with something very

ally you're confronting

thing they

still

on

as, I

mean, to me,

(simultaneously):

Were you

literally

We

I

could not leave. Let's say that.

were (inaudible phrase), that was

all.

locked in a room?

gary: Yes.

With the key in the door locking it? gary: No, there was no key in the door. It was just (inaudible phrase). MR. p. (overlapping) No, we were watching Gary so that he mrs.

s.

:

:

wouldn't go out by himself.

"May

go down to get a drink of water?" I would have come back, but you grabbed me like this. mrs. p. We had water right in the room, Gary. mrs. s. O.K. Now just a minute. I'm trying to look at what the facts

gary: Let's say

I

(inaudible phrase)

I

:

:

Now, the facts were, you were get out. Now, my question was are.

.

gary (overlapping)

Now,

s.:

room and you

exactly whether

the question was,

couldn't

.

(Inaudible phrase) in any way.

remember

out. I can't

mrs.

:

.

in a

"Why

it

did

I

couldn't get

was locked or

Dad do

it?"

not.

That's your

question to him, so I'm asking him.

Gary didn't put it as, "Daddy locked me up." Mrs. S. No, he put it as, "I couldn't get out."

Int.

:

:

Int.

:

You

prefer to

make

it

more

active

and to pin the

credit

on

Dad.

Mrs. Int.:

S.

:

Right.

There's quite a flurry here. Perhaps

it's

because you've

TECHNIQUES OF FAMILY THERAPY jumped so suddenly from everybody's good Gary up. Mrs.

S.

It's

:

138

[

intentions to their locking

though their good intentions carry them along, or

as

mind how they are manifested. I'm beginning to say, "All right, so you've got good intentions inside, but let's take a look at how they come out. Let's take a look at what kind of message this gives to somebody else." at least they think so, never

mr.

we what we

Well, the question, the reason at that time was, ah, ah,

p.:

Gary

couldn't trust

to, ah,

be sure that he was doing

thought was right.

mrs.

s.

Now,

:

you want to punish him?

did

No! No punishment. mrs. p.: No. mr. p.: No, we felt he was mr.

p.

:

needed mrs.

MR.

s.

p.:

Int.: saying,

this

was a way you wanted

You

won't

"Gary wasn't

"Why

"Was

it

did

really locked up,"

Dad

lock

him up?

Why

that's

did

S.:

off,

and

Yes,

play in bowling.

sliding

I try

You

we go back

of persisting

put

is

and

it?"

You come on

it

back

Here you

ask,

"Was

thing. There's a kind of

it

com-

back again. It

and

if

hit first to the nearest pin,

again.

watching

just

strong, then slide into

not to give too big a lump.

if it's

He's been

shifting

The

reminds

too much,

There

is

I

therapist has to

come back, we

a persistence in

it,

me

of a

you're successful

farther ahead; these are really like flyers. I always

stress reactions,

then

were

Dad do

with that one, the next time you try for more. little

"We

this.

not accepted, so you say,

what happened as a protective

ing out, giving

and

hook on

by himself," and you've been

off

protection?" and finally he agrees.

Mrs.

and that he

him?

to protect

the father off the

let

punishment?" and

redefining

sick,

Right.

him so he wouldn't go to,

Gary was

rest, terrifically.

So

:

sick, that

be a

watch for the

rest a

little,

and

and one of the ways

to build the context, a specific context,

which

is,

"We'll

this picture together."

Int.

:

There

is

also a considerable persistence about responsibility

here. In that statement,

"We

couldn't trust Gary," the father

taking responsibility himself, even though you almost

with

it.

He

doesn't say, "/ couldn't trust Gary."

He

is

not

drowned him

doesn't even say

A

Family of Angels

Gary up because Mother was so

that he locked

[

upset, though this

139

was

probably the case. S.:

The

fact that

Dad

lock

him up?" shows

Mrs.

"Why

did

But you're

responsibility.

would

again, I

this

he

is

To Mother

this

to

that he

is

do

would

it

I

t>e

would have

that,"

the question,

indirectly accepting the

"I don't understand 'we.' "

say,

how you people came

who answers

right about that "we." I think

checked out that pronoun. But don't understand."

the one

if I

I

were to do

would have

within the context of "I said, "I don't

understand

and to Father, "Oh, you mean that

was something you did for your wife?" Int.

:

Mrs. Int.:

He may be trying to give you S.

Yes. "I'm just a

:

Why

a clue with that "we."

pawn in this."

knew that they would deny it, or that he would. Mrs. S. I wanted to make it explicit that punishment :

what people do sometimes, and find out I

in this case I

whether what you intended to do

was again introducing the idea Int.

:

You

did you say, "Did you want to punish him?"

You knew

that they

fit

was

saying,

is

part of

"We want

what Gary got out of

to

this."

that people perceive things differently.

were going to say "no punishment."

Mrs. S.: I did know. But it had to be on knew that Gary perceived it as punishment.

the record because I

way of getting the negative things out of the picture. You don't say, "Of course, you didn't want to punish him," you say, "Did you want to punish him?" You knew you were going to Int.

:

This

is

again a

get a denial.

This also paves the

way

for a discrepancy

on. I often say in such cases, "If

you

didn't

Mrs.

S.

:

did your hand to

come

to slap his face?"

come out loud and

But

comment

later

want to punish him, how

first I

want the discrepancy

clear in front of everybody. Later I can pose the

discrepancy and ask for the explanation.

mrs.

But Gary didn't

s.:

was your MR.

p.:

Mrs.

way about

it,

but nevertheless that

intention.

Right.

S.:

that way, but

feel that

You

see, I

posed the discrepancy. "You didn't mean

Gary perceived it

as punishment.?

Int.: In view of the context of Gary's actions,

they

may have been

afraid he

it

would

try to kill himself.

it's

possible that

They might

find

TECHNIQUES OF FAMILY THERAPY it

[

140

very hard to believe that he thought they were punishing him, since

they were devoting themselves to protecting him.

Mrs.

S.

Well,

:

suppose

let's

want

I

to shake

your hand. Suppose

more weight on your hand than I may only be aware of my effort to try to reach you. You,

you're kind of far away, and I put intended. I

however, can be quite aware of your broken

you have a broken

that

finger.

Now

the facts are

You've got to do something about

finger.

how you interpret it. But how you interpret it is going to both how you feel about yourself and how you feel about the matter

anybody

person.

I

damage

to another person. It's usually

don't really believe that

As

interest of the self."

I

see

what

I call

no

affect

other

starts out deliberately to

do

"an accident in the

Gary was

the parents' behavior with

it,

it,

that kind of accident.

Int.

Your philosophy about

:

it

seems to

fit

so well with what the

family would like to hear.

Mrs. S. I was raised on the notion that you catch more flies with honey than with vinegar. The problem is how to do this in the interests of growth. If I use my technique, the honey, to tell you what you must do in order to please me, I take away from you your opportunity to :

grow.

use

If I

my

honey technique

can learn something, then

I

to attract

have used

growth. I don't think you hear

much

my

you

to a place

where you

technique in the interests of

of the usual reassurance

from me.

The reassurance comes in making things obvious. Int.: The way you make things obvious is often very reassuring. Mrs. S.: Yes, but I know therapists who tell people, "You're a good guy," and of the

that sort of thing,

most reassuring things

to say

wide open and bleeding." But wide open, and Int.

:

"You were son

You

S.:

bad

a

think one

"You know, your nose

is split

"Your nose

is split

would never

I

in. I

say,

your fault." tell this

father that

it's

his fault.

You

don't say, is,

"Your

thing."

is

again a

like to think.

way

The family

sponsible for what happened.

on how the son perceived

of going along with is

it is

what the family

very busy indicating they're not re-

"Your son perceived that you was not your intention." The empha-

You

punished him. Nevertheless, that sis

don't believe

That's right.

Int.: This

would

don't

is,

I

a bad person and did this bad thing." All you say

felt this as

Mrs.

it's all

which

a

say,

way

of playing

down

the question of

A What

responsibility.

the father did, he didn't really intend, and

son perceived, he had no control over, and ing.

Nobody

would

way

was

it

You

[

141

what the

a misunderstand-

all

responsible for what happened, which

is

like the phrasing to be.

but in a

Family of Angels

what the family

is

accept the family's view of things,

can ultimately produce a change. There's a subtle way

that

of going along with the typical pattern that

is

partly in the nature of

your method, but partly in the nature of psychotherapy in general.

Mrs. the

kill,

When

S.

:

Sometimes

I

have the feeling that I'm coming right

in for

and then suddenly, bang! Here's where the timing comes

I'm building up to a major discrepancy and moving

where I'm convinced that the

real

much

lot of writing.

quite a

lot.

sleep. I

At

And,

in, that's

change begins to take place.

gary: Well, by that night they were worried because getting too

had been doing,

I

hadn't been

end of school, a

at the

the end of final exams, and after school,

was

ah, I

in.

subtired, a

little,

but

I

was

I

wrote

able, I got,

some naps in the daytime, in the afternoon, and though I, I knew I was tired, I, after I had finally finished finals, when the final period was over, you feel a little excited, exhilarated, and this slept

was,

think, the sense of being, perhaps, too

I

much

alive,

or at

much alive, it was almost like a nervous breakdown, but it wasn't. Too much alive, that they thought perhaps, that I might be sick. And I think it was a misunderstanding. After least

appearing too

had been studying pretty hard the last four weeks, and I hadn't any communication then with the parents. I had to study hard 'cause I'd had mononucleosis and, and, ah, was, was not able to perform up to my capabilities at the beginning of the quarter. So it was just at the end that I started to get a little interested in some of the subjects, and to read them, and to get the knowledge all, I, I

I

should have gained while

was

that I



was

I

sick. Physically.

was out of

finally I

been very mean to me, and out of

this

they interpreted

Mrs. gary:

mrs. gary:

mrs.

s.

It

:

.

.

p.:

.

could be.

:

this as

I

But you didn't sleep

.

didn't sleep,

.

parents,

and

Gary.

had

I

think that this

I

think perhaps

sick. I didn't

do

.

at all

enough.

You

my

perhaps being

just

think

[university], so, so that I

We can ask.

wild things.

I slept

p.

was noticed by

I

house where a boy had

nothing to do, and just to write and have fun, and great exhilaration

Then,

when you were home.

.

.

.

TECHNIQUES OF FAMILY THERAPY gary:

I slept

mrs.

You

enough for then.

see



wait, wait.

when

that

tween

was

I

Another thing that you have to notice

would

getting over mononucleosis, I

ten, eleven, twelve, thirteen, fourteen

tim (whispering) mrs.

142

Two hours?

p.:

gary:

[

is

sleep be-

hours a night.

Wow!

:

That doesn't help you.

p.:

gary: Well, yes

does, yes

it

been getting a

it

does.

of sleep, and

lot

mean, up

I I

time

until this

really didn't

need

it

I

had

for (inaudi-

ble phrase).

mrs.

s.

gary:

mrs.

Well, what

:

All of this

:

are

.

ah, not important

It's,

s.

we

.

.

now.

over.

It's

It's

not important.

important because of the fact that

is

it

again

illus-

you want to get over a message about something about yourself, and it doesn't come over in a way which you meant it, then you wonder why did it happen. And it's quite obvious that, in this instance, your being locked in the room, from

trates the fact that if

everything you could see and everything you could like

some kind of punishment

feel, this felt

to you.

gary: No. No.

mrs.

As

s.:

far as your parents

trying to

do something

were concerned,

it

felt like

to help, at least as far as

they were

Dad was

con-

cerned.

gary:

didn't think of

I

doing something

mrs.

(overlapping)

p.

gary:

...

to

me

stand then. I

Int.

:

.

it

was, they were

I

couldn't under-

.

Overprotective.

:

that

seemed

to be unjust,

did not ever think that I

which

was being punished, which

(inaudible phrase) or being put in the hospital at the time.

Why did you let him go on at such length?

comI felt that I didn't have to respond so much to this. He was beginning to look quite withdrawn, and I wasn't quite clear what

Mrs. ment, and also

I

.

as punishment. I felt that

it

S.

I

:

remember

was happening with him. some indication.

I

was under

that he

hoped

that

if

terrible pressure to

he went on a

little bit,

I'd get

you thought the question of why they locked him up was too distressing, and were letting him take the focus on himInt.

:

I

wondered

if

self.

Mrs.

S.

:

I

don't know.

I

was

trying to get

some

things clear at this

A was

point, because there

was

quite a change in the family.

rising very high. I wasn't sure

And

where

I

[143

Family of Angels

The

tension level

was going to go with

as I

it,

remember having feelings of annoyance. Gary's voice becomes more clipped here and you can hear the agitation. recall.

Int.

:

Mrs.

I

It's

a pretty agitated speech.

S.:

When

done better

if I

I

thought back on

had continued

later, I felt that I

to relabel their locking

of a misunderstanding, to

show

have asked something

"What

like,

it

would have

him up

in terms

that he wasn't really so crazy. I could

did you think your father and mother

saw and heard that made them think that you thought that they thought you were crazy?" mrs.

Well,

s.:

all right.

Now,

let's

leave

another level of our material, which that

is,

how

now and go

into

what we need to do.

And And

all is

of this

whole family came to be

this

in the first place.

where does that start? It starts out the first time that you and you (to Mr. and Mrs. P.) ever laid eyes on each other. When was that and how? Int.

:

Mrs.

Why did you move to the family history at this point? S.

as though I've

It's

:

respiratory system

is

examined the body and

Now

not in such good shape.

out some more about the basis for the disorder.

would be wasting a

make

time that

lot of

the parents be responsible.

I

I find

I've decided to find

To go on

as I

could use better. Also,

When

I

that the

ask the question,

was then I

want

"How

to

did

you two get together?" I'm implying that they have made a selection. One of the things I want to do is give the parents an experience of

The power

choosing. that

you have Int.

topic

:

of this question

is

that

it

means

Did you make

this shift to the past

difficult to

thing.

The

understand

other

idea of continuity.

how

all

is

The

I find

the ways in which the people before

know something about

their

past runs into the present, just as though

So

me no

it fell

bring out the continuity aspect. Also, a

came to be can give the children assemsome new clues. There are many things that

the family

bled an opportunity to get

I

it

development. That's

that in families with schizophrenics there's

in out of the clear blue sky.

discussion of

select,

because you thought the

you were on was getting too upsetting? Mrs. S. I wanted to get into some of this material before.

are behaving unless I

one

you

responsibility.

:

very

that

TECHNIQUES OF FAMILY THERAPY

144

[

come out in a family life chronology. One of the critical factors here was the shadow of the first-cousins relationship of the parents. I want to find out about what I call the witches. What are the witches that are around? The shadows that are going to affect everybody. Int.

Do you

:

Mrs. illness

S.:

I

take a family history with every family you treat?

always regret

without doing

all

it

when

diagnosing an

I don't. It's like

The

therapist can always

start this

vary from family to

the appropriate tests.

be wrong in his perceptions.

Does

Int.:

the point at which

you

family?

Mrs.

S.

Yes.

:

I

more and more

find

do

that at the outset I tend to

rule analysis.

By

Int.:

do you mean an

"rule analysis,"

what the

analysis of

rules are in the family?

Mrs.

S.:

Well,

I

might ask about the rules for fighting or for

pleasing. I might say, "Well, every family has rules about all kinds of things,

and you may not have thought about these

—and

can you do

I

everybody Int.:

his

but what

you know will make so or her face?" Then I ask this of

pick out one person

and so angry," or "bring a smile on



rules,

that

in the family.

As you

did

when you asked

this family

how

they showed

disapproval?

Mrs. do

in the

S.

:

first

That was a similar kind of interview

do

you

to the conclusion that

this also to

What

I

usually try to

ask about the hurt and anger, to try to get

is

people to differentiate between them. leads

thing.

I'll

he or she

say, is

"What do you

angry?

How

see that

do you

tell?" I

focus people on the relationship between the other per-

son and themselves. Then

I

usually go into the family

life

chronology,

if

do some symptom reading first. Int. What do you mean by symptom reading? Mrs. S. In one family I interviewed, the girl was not doing well at school. She was obviously a very bright girl, and I couldn't understand it, so I said to her, "What was it that you did that said to other people that you were stupid? You know, I don't understand that." Then I

don't

:

:

I

went into the messages about stupidity and brightness.

take a look and see

obvious that in

how

this family

this

whole business got

I said,

started,

"Let's

because

it's

people have a highly developed sensitivity to

who's bright and who's stupid." That's what reading the messages that relate to symptoms.

I call

symptom reading

A mrs.

mr.

That was

p.:

in 1934. Chicago.

A

All right. We've got that.

s.:

lot of

people in Chicago, so

must have been something more than that. mrs. p.: Well, actually, I mean, ah, you have

mr.

first

cousins,

visit

and

p.

mrs.

145

[

Chicago.

p.:

mrs.

Family of Angels

We

:

p.:

.

.

.

Henry and

so, ah,

his

we

that

are

mother came back

to

.

much

hadn't seen .

.

and

know

to

it

and

the inevitable

of each other up until this time.





was nineteen and he was two twenty-one and happened. First there was a lot of protest on his I

mother's part.

mrs.

Wait, wait before you get that

s.:

far.

All right. So, you're

first

cousins. We'll put that over here.

mrs.

p.:

Mrs.

S.

Yes.

This

:

a place where some therapists would have hung

is

themselves up on this cousin business and gotten

can see a therapist coming in with the feel

about that?" All

affect,

They

but what

a part of

interested in was,

and the

else,

Were you S.

:

do here was Int.

you say

:

affect.

No,

I

"What

knew

it

did you

was loaded with

did you really react to?"

fact that they

to

happened to be cousins was only

passing over their being cousins to try to mini-

S.:

I

deal with that later.

to get at

You

this, it

Mrs.

what they saw

sounds as I

it

go back and look Int.

:

I

in

The important

if

thing

I

wanted

each other.

could have chosen not to pass over

it.

The way

make it lighter. know this has much

I

hear

you're trying to

am, because

When somebody

thing. I relabel

tells

I

me

by not treating

already

about a mixed marriage, it

I

too

much

do the same

too importantly, and later on

we can

at its consequences.

wondered, too, whether you were reacting as a representa-

tive of the scientific

see

and

fact,

"How

it?

Mrs. to

terrible question,

it.

Int.:

mize

was

was a

it

off the track. I

marry because they were cousins, they were reacting

didn't

something

I

right,

way

community, knowing that they were watching

what you'd say about a marriage between first cousins. Mrs. S. That was part of it. This can be a juicy kind of :

therapist can get sidetracked

by

it.

I've noticed that

comments on can sometimes be much more juicy than to what he finds helpful.

what a

related to

thing.

to

A

therapist

what he

finds

TECHNIQUES OF FAMILY THERAPY why

Int.: Perhaps that's

up the sessions. Mrs. S. I think

liven

I

:

tent

can get

so

many

[

146

therapists bring out sex, to

any process. The con-

just as far with

can be about tying your shoes, or eating, or anything. mrs.

What made you

s.:

You know,

think he was so nice?

after

all,

I'm sure plenty of people could meet each other and go right by, but you didn't.

mrs.

Well, actually,

p.:

such a thing, but

a

little girl.

We

had

the most beautiful

think he

I don't

mrs.

I

I

think that, ah, well,

little

felt that

ridiculous to say

had worshipped him ever since picture. He was blond, and he was

think his

it's

I

boy

in the world. (Laughing.)

Of

I

was

to

me

course,

way about me.

Well, wait a minute. We'll find out about that. Is that so un-

s.:

usual? For a

girl to

have an ideal?

And

worship an ideal?

Is that

so unusual?

mrs.

p.

Ohhhh

:

.

.

.

Gary: (Inaudible phrase.) That's

Mrs.

S.

When

:

I

just the

there

You

answers you,

Mrs.

S.

was.

"You had

a choice."

challenge the idea of the "inevitable" by saying that

was a choice. But you also go along with

was something

it

ask the mother what appealed to her in her hus-

band, I'm posing another question that says, Int.:

way

special here,

some form of

it

by implying that there

destiny, perhaps.

When

she

that's the part she picks up.

That's in the

:

same category

with,

"The wind blew and

it

came in." You are never going to get people involved in change unless you can get them to see themselves as agents of change. Int.: When you try to make it more commonplace for a girl to have an ideal, in one sense you're making it less her choice, less individual. Is this because she's she's

gone so far in having

making it a power beyond her? Mrs. S.: I'm playing on that. I'm

"Look,

kids,

inevitable.

you choose these things,"

What I'm aiming

ing charge of themselves." I

for

all

know

the

it

be exceptional that

trying to enhance the fact,

away from the idea of the time is what I call "people tak-

to get

I can't get to first

base unless

I

crack

that one.

mrs.

p.:

Ohhh,

I

don't know. There

was

ah, bench, with a big wide belt on, cutest

little

boy

in all the world.

and

And

boy lying on the, thought he was the

this little I just

of course, then,

we

visited

A them when

man

I

mrs.

knew

ever

gary: Smoked

was seven, and

I

in

his father

Family of Angels

was the most wonderful

my life.

cigars.

Well, he was completely different from

p.:

147

[

my own

father,

though.

How are you related? Brothers?

mrs.

s.

mrs.

p.:

Mothers are

mrs.

s.

Your mothers

MRS.

:

:

Yes.

p.:

Mrs.

And

sisters.

are sisters.

he was affectionate and, ah

— (Tim

interrupts.)

Later on, Gary came in smoking a cigar, and

S.:

out that the family had

all

it

turned

kinds of prohibitions about drinking and

smoking. The husband's mother couldn't stand her

own husband smok-

WCTU act. The wife's mother, who was her younger sister, had to put on the WCTU act too. Everyone on

ing cigars, and she also put

knew

own two was

mother was fun-loving, but she couldn't openly

that the wife's

announce

it.

this big

This was exactly the same bind the wife was in with her

older sisters, as

weeks

that about five

found out

I

Another

later.

after this session

Gary had another break-

down, which began while he was eating out with

on the

the condiments

table,

interesting thing

He

his father.

took

Worcestershire sauce and ketchup and

and sugar and pepper, mixed up a

cocktail,

and handed

it

all

salt

to his father

Then he went out and urinated behind a signboard and got picked up by the police. It was an obvious protest against the family's for a drink.

Victorian ideas.

tim (whispering): How old is Daddy? mrs. s.: Ask him; he'll tell you. How old you want to let him know?

is

gary: Multiply your age times

come out almost

Int.

S.

:

It

it

that

Gary was watching

was the kind of question

this family. I noticed

mrs.

Do

exactly.

had been a long time since Tim had commented, and

was already aware

really get

P.)

Why did you pick up this child's whisper?

:

Mrs. Besides,

ten. You'll

Daddy? (To Mr.

when

to see

who

I

I'd leave out.

that I felt never got answered in

I listened

back to the tape that he didn't

an answer. p.:

And

so

I

think

all

of this was built up, and so

he was handsome, and, ah, at first sight so far as I

it

just

happened.

was concerned.

I

when he came

mean,

it

was love

TECHNIQUES OF FAMILY THERAPY MRS.

s.

No,

:



know

think

I don't

it

was love

at first sight

[

148

because you didn't

you were looking at these pictures. (Laughter.) All right, so we see that. But as far as your contact with your husband was concerned, it was limited up until you were seven. Is that it? mrs.

p.

there were

all

these years that

Yes.

:

was by picture. mrs. p.: Yes, I saw him when I was seven. And then they went to [abroad] and came through and I saw them I guess when I was

mrs.

s.

Mostly

:

nine, ten?

Int.

it

Was that it?

You seem

:

more

to be

matter-of-fact in your tone than

usually are. Is this partly to cut through the cloud of love at

first

you

sight

and idealism?

Mrs. the

There are some tears around. She's near

S.:

tears, right at

moment.

mr.

'25.

p.:

mrs.

Yes, 1925. And, ah, of course, then he wasn't quite so sweet.

p.:

He was

kind of in that age where he was putting dirt on

me and

things like that.

mrs.

s.

What age was he?

:

About twelve. mrs. s. About twelve. mrs. p.: Then he was kind of pesky at that age. (Everyone talking at once.) But anyhow, when he came back, he just was everything mr.

p.

:

:

that I

mrs.

s.

mrs.

p.

had ever

.

.

And then when

:

(overlapping)

:

.

he came back

.

.

.

(Inaudible phrase) hadn't found

him any

dif-

ferent.

mrs.

mr.

s.

p.

mrs.

At what age?

:

Twenty-one.

:

p.:



Twenty

born in

mr.

p.

it

was

in

1934 and

I

was born

in '15

and he was

'12.

(simultaneously)

:

Well,

it

was 1934,

yes.

had done a lot of dating, so I mean, it wasn't that I had never seen a boy before. But Henry was everything that I ever

mrs. m.

:

So

I

looked for in a husband.

mrs.

mr.

s.

p.:

(to

Mr. P.)

:

Well, now,

how

about you?

Well, I thought she was pretty great. (Laughing.)

A mrs.

s.

Well, did you have her picture?

:

Family of Angels

Was

it

the

[

149

same kind of the

development of an ideal? gary: No.

Int.

A little boy wouldn't be that way.

Why

:

does everybody talk at once when Mother

tells

about

Father being pesky and throwing dirt?

ther, It's

Mrs. S.: There are two and the other is that you

as

rules.

One

is

that

you

can't criticize Fa-

on a romantic

ideal.

though they were trying to disguise the fact that Mother

really

makes more Int.

can't cast aspersions

toward Father than Father does toward Mother.

efforts

Why does Gary speak for the father here?

:

Mrs.

S.:

think he's making a burlesque of the father's position

I

in the family.

Int.

He's saying that

:

would be

it

better

if

Father weren't so ac-

cepting?

Mrs. mrs.

MR. MR.

s.

:

Well, I don't

No,

p.:

mrs.

That's right.

S.:

p.:

I

know about

that. Let's see.

hadn't any, ah, thoughts along that

He was mechanical-minded.

line.

(Laughing.)

(Laughs.)

(Inaudible phrase.)

p.:

gary: Ask Tim.

mrs.

mr.

s.

:

I

got lost there.

(Inaudible phrase) time in 1934. That really was the start of

p.:

was concerned. mrs. s. And then how long was the relationship before you married, one in which you were labelling yourselves as sweethearts? as far as I

it

:

mrs.

came out here to visit were married. So it was three years. p.:

mrs.

s.

mrs.

p.:

:

Well,

I

And then

We

in 1936,

all

we

in '37

people raised cain about this?

—my own mother, before she

had been writing

said that (pause, starting to cry) as far as she

was

and then

that mattered.

And my own

family

died, she

was concerned, love

felt that

way. But, ah,

Henry's mother didn't approve. (Weeping.)

mrs.

s.:

They

didn't.

And

so they

made

trouble for you?

mr. p. No. No, not trouble, but, ah, disapproved. mrs. p. (simultaneously) His father, his father died :

:

mrs.

s.:

And then how did you handle

mrs.

p.

(sighing)

:

were married,

that?

we came home to her back East, we came home

Well,

at fifty-seven.

the night that, ah,

we

to her, and, ah, she

TECHNIQUES OF FAMILY THERAPY wasn't very nice to

me

completely, because

I just

and

I'd

make every

(weeping) and

I

150

was prepared

to give,

my

husband

thought that Henry was

overture. But, ah, I

[

mean, to

this day, I really

don't think she, she really cares.

Where

Int.:

pletely," she

she

is

the mother says,

"I

was prepared

to give

com-

sounds like a bride rejected by her husband, even though

talking about her mother-in-law.

Mrs.

S.

It's

:

The mother

a matter of self-esteem again.

that she counted for anything

and wherever she could she

didn't feel

tried to get

some kind of validation of her worth, which is pushed onto Gary. What comes out here is that Gary sees that he can be useful to his parents in two ways: first, to make life worthwhile for his mother and give what the father didn't give; second, by his extreme behavior, to give his fa-

ther clues about if

how he can

live. If

he can accomplish these two things,

he can get Father to be more interesting to Mother, then Mother

perhaps can use Father instead of him. At the end of

who

a problem about

symbolically, you'll see

gary:

mrs.

think

I, I

s.:

gary: I

I

You

mrs.

going to live with the mother-in-law. Again,

is

how Gary

I see

will

the outside of this, because

think that Grannie did

I

mean, she did not mean

p.:

gary:

I

you

to hurt

mrs.

Mrs.

:

think see,

it

was

actually accidentally.

I

don't think she really

I

th-that,

mean, she was born

it.

about cousins marrying?

She had, ah,

S.:

communication

years before, and they had ideas then that this sort of thing

You mean

p.:

a sister



who

(Gary

There were a great number of

who was still

it

Grannie had, was born a long time,

very

who

much

interrupts.)

relatives here.

There were

never married, and the father's

also the mother's aunt. It

day the mother would have She was

Mother.

sort of a, just a l-lack of

the mother's two older sisters,

mother,

wasn't involved.

to.

was, they had taboos against s.

I

She loves the children. She adores the children.

many mrs.

be the rescue agent.

weren't even there. (Female laughter.)

think that,

meant

this tape, there is

was very complicated. Every

at least three calls

and maybe two

in a child relationship to all three

visitors.

women.

A

Family of Angels

Gary: She probably had been pretty well isolated in her group, and this seemed so that

it

might have been very

would be mrs.

.

.

151

Danish

out of the ordinary to her, that,

difficult for

her and she naturally

.

(simultaneously)

p.

much

little

[

:

She told

me

that

all

the children would be

born deformed.

— —

made the comment she may be naive, herself, intellectually, and when she's told there's kids at [university] that think they come out half feeble-minded. But actually, if you

You

gary:

she

see,



I've read a

book, a book, on

that says that

it

if

they come,

if

anything happens, the recessive genes are reinforced, and recessive genes

may

be good. They

blond hair and blue eyes from

Int.

The

:

patient plays

As

it is,

we

get our

same reason.

Gary was

all

—and

trying to give at least

feel

kinds of roles, rescue roles, peace-

in trying to help the so-called healthy adults,

don't notice, with their pains

this is a

very painful kind of thing.

one reason why

so bad. That was one part of

which they

his

mother wouldn't

it.

He's also the result of this marriage, so Grannie could be

Int.: right

this

be bad.

Why did Gary come to Grannie's rescue here?

:

Mrs. S. maker roles,

have to

may

about the monsters they created. He's protecting himself to some

extent.

Mrs.

mrs.

S.

s.:

There's that too.

:

Let

me

stop

you

just

What do have very much

a minute, Gary. (To Mrs. P.)

you think about Gary's comment that this didn't to do with whether or not you were acceptable in your mother-inlaw's eyes, but that

it

had something

to

do with her fears because

she was uninformed?

Int.:

Is there

a particular reason

why you stopped Gary and

in-

terpreted his statement to the mother?

Mrs.

wanted to make

Gary was trying to give the mother something to work on, something that was almost a straight message. Both the mother and the father still felt that what they had done was so terrible they had no way to look at it, and I thought that S.:

I

it

clear that

TECHNIQUES OF FAMILY THERAPY Gary was

152

[

them a clue. I wanted to rephrase it clearly to see what the mother could do with it, and I wanted to make explicit to Gary the fact that I knew he was making a contribution. I wanted to make Gary giving

appear to be able to make contributions, to be taken seriously, not to be thought crazy.

One

scapegoat position

to demonstrate

is

know what

ways to remove the patient from the

of the

contribution to make. This

whenever possible that he has a

a good opportunity for

is

just

me

because I

some validity, that the fear about this kind of thing is not supported by scientific fact. But if I let Gary go on too long, he's going to disqualify himself, so I'm going to cut him off while he's saying has

the cutting's good.

mrs.

p.:

I think

when he was MR.

p.

mrs.

was

it

fifty

partly,

(simultaneously)

p.:

.

.

.

.

fact that her

think

it

was partly

that. '33, yes, that's

and, ah, I think that almost any

.

husband died

.

I

:

and also the

girl

.

.

.

would have had

mean, she was the possessive type of mother who came down here, and took an apartment and lived with Henry when he was here at [university], and this, I mean a hard time. Because,

me,

to

mrs.

s.

mrs.

p.

mrs.

:

:

s.:

this is the

Well, here I

I

kind of thing a mother just doesn't do.

you were

.

.

.

think she did have an overpossessiveness.

Well,

we can

look.

Now

here

is

a problem here for

you

in

you were unacceptable, and how did you try to handle this? 'Cause obviously the love for the two of you was strong enough to stick together, so how did you (to Mr. P.) try to handle feeling that

this

MR.

and help Mother communicate? Well,

p.:

I tried to tell

her what

we were

doing, and, ah, she, ah,

there really wasn't any, 'cause I think her

main worry was the

fact of, ah, children.

mrs.

Int.

(overlapping)

p.

:

I

take

it

:

Children.

you think

this

mother-in-law's overpossessiveness up.

So when you

say,

"How

statement the wife makes about the is

going to get the husband's back

did you handle this?" you're not just rais-

was overpossessive, you're assuming it, so that he isn't quite in the position to deny or affirm it. Mrs. S.: That's right, I skip that problem. Trying to get some-

ing the question whether his mother

body to what I call the "confessional" is just engaging in a power and if I engaged in this kind of tactic I would lose ground.

tactic,

A Int.:

interesting that

It's

problem a power

Mrs.

S.

you wouldn't consider skipping the

not the kind that brings out defensiveness.

what you mean about the difference, but powerful maneuver to slide through on these people. Int.:

I

Mrs.

S.

see

:

Yes, because

it

doesn't engage in active war.

trouble within this kind of situation

Then

to

[153

tactic.

It's

:

Family of Angels

is

it's

a more

To assume

'congruent with the situation.

assume that not only was there trouble but the husband did

comment to him that I see that he can an ego-enhancing comment about a difficult situation. something with

Int.

it is

a

There's a lot in that speech.

:

to handle it?" It's also,

It's

not only,

"The love between

the

"How

cope.

It's

did you try

two of you was strong

enough to keep you together."

Mrs.

S.

:

That's evidenced by the fact that they're in front of

me

and haven't been divorced. Int.:

You make

a translation here. They haven't unitedly han-

dled his mother, but you're implying this by saying, "The two of you

have stuck together."

You

almost say, "stuck together on this issue/'

Mrs. S.: But I didn't say that. What I'm doing here is to say, "The two of you had something with each other, but at the same time you had terrible problems with each other." I'm beginning to see that the

woman

doesn't talk very much,

and when she does she double-

So there are many implications when I then ask him directly how he helped his wife. Since this was his mother, he probably had ways of dealing with her, and he would be the one who talks,

and he doesn't talk

would have to help Int.:

You

at all.

his wife in relation to this.

did

mean

the father's mother,

when you

said "help

Mother communicate"? Mrs. S. I meant "wife." I said it wrong. Int.: Then he might have misunderstood you where he says, "I tried to tell her what we were doing." Mrs. S.: That's right. I hadn't caught that until now. He did mis:

understand me. Int.

:

This slow hesitation might have been because he was trying

to figure out

what way you meant

that.

Mrs. S. That's right, and he couldn't ask me. I gave him a bum steer by saying "mother" when I meant "wife." Int. It's a nice problem for him about which side you're helping :

:

on.

TECHNIQUES OF FAMILY THERAPY MR.

And,

p.:

founded.

ah, so that was, I tried to convince her that that

had done some reading and so forth on

I

it

154

[

was not

to check

it

up before we did anything, and, ah mrs. p.: You and your mother didn't even talk to each other before we were married, though. I mean, they were not even speaking to each other, although they were living in the house together. mr. p. (overlapping) No yes yes. .

S.

The

:

thing

.

— —

:

Mrs.

.

beginning to crack a

is

little bit.

The parents

have been saying, "We're together on everything," and then the hus-

band

my

says, "I talked to

The

talk to her."

Int.

Int.

S.

Very much

:

Then

:

Mrs.

between them

P.:

mrs.

s.

:

:

She lived almost next door.

so.

why the wife would come

then, there

in

on

this point.

the possibility that the fault

is

could be that.

It

situation. It wasn't easy.

You

was more with,

can't say, but then, there's

possibility.

Of course

:

out.

in the picture?

was a really (inaudible phrase) No, of course it wasn't.

always that s.

come

yes.

with Grannie.

Int.

beginning to

It

And

Gary:

this is

Oh,

S.:

mrs.

mrs.

is

Was the husband's mother still

:

Mrs.

rift

mother," and the wife says, "No, you didn't

Gary has

there

just

is.

defended the grandmother and

now he comes

in to take his mother's side.

Mrs.

S.

This

:

is

around to everybody,

the

dilemma of the schizophrenic. He has

that's

why he comes

many

triangles to

out with so

much

to

go

double-

talk.

Int.

:

Mrs. Int.

:

He's got so S.:

keep the peace

in.

That's right.

If I

understand

it,

the husband's mother

moved

in with

him

while he was going to school and then they didn't talk to each other.

Was it while he was going to school that he was married? Mrs. S. He had finished school. Int.: Was the mother still living with him after the marriage? Mrs. S.: Yes. When he went to college, his mother came to live :

with him, to keep house for him. Later in

this interview

she wanted to do the same thing with Gary.

it

turns out that

A MRS.

(cont.)

s.

mother

You know,

:

p.:

s.:

And what

mrs.

p.:

Yes.

p.

— (To Mr.

P.) Is your

she

is

now? Does she

live close to

you?

She's close. She lives in [next town].

p.:

mrs.

at this

155

Yes.

mrs.

mr.

you look

[

living?

still

MR. and mrs.

as

Family of Angels

Yes, and she's with us an awful lot of the time.

:

I

mean, more

than most mothers-in-law.

At

Int.:

very

much

a part of this?

Mrs.

S.

No, but

:

I

to get at

Mrs.

find out

what may

still

all

the parents of

still

be operating;

from other family organizations.

a very quick switch to the present.

It's

I

about keeping to the family history

aren't too strict

want

want to

leftover homeostasis

Int.:

mother was

father's

quickly try to find out where

the people involved are. I

you know,

you know the

this point, did

take if

it

that

you

something you

comes up. I try to

S.:

use the family

fashion as possible. This get one. First of

all,

why

is

it

the calendar

life

chronology in as creative a

me

sometimes takes is

five interviews to

a wonderful vehicle by which you

can keep things straight and give a sense of continuity. Also, what has

happened things,

in the past is residual in the present.

and here again

mother-in-law, ily

the

all

it's

a matter of clinical judgment.

ways

which she could

in

as a scapegoating device to

have enough information for the present.

So

it

So I'm doing several saw, with the

be used by the fam-

keep the husband and wife together.

now from

will serve

still

I

the past to see

some

my treatment purposes

I

of the pieces

better here to see

what's going on in the present. Int.

Is this partly

:

ing and think this

is

because you see the end of the interview com-

a problem that ought to be dealt with? At about

you must be realizing that there is a triangle between the husband and his mother and his wife, which you could either let go and take up another time, or take up right now. Mrs. S.: I felt I could bring it in and still have a unit feeling to

this point,

my interview.

I

could see that Gary played a part as well in

of the mother-in-law and the husband and the wife, and to that too.

And

for an hour

and a

Int.

:

It's

I

thought

half; this

I

could do

it.

I

this triangle

wanted

to get

Ordinarily, I hold interviews

one was only an hour.

always a problem of judgment when something like

this

TECHNIQUES OF FAMILY THERAPY

[

156

comes up. A therapist has to decide whether to deal with it right away or to go on with the matter in hand and circle around back to it. In the earlier part of this interview, where you were going from person to person,

something

if

person. Here,

go

right to

when

came up you went

critical

on

right

to the next

comes up, you

the question of the mother-in-law

it.

Mrs.

S.:

almost never pick up anything like that at the begin-

I

ning of an interview, certainly not in an

never bring anything up

knew

I

if

I

initial interview.

work

couldn't

it

And

I

would

into a process

before the end of the interview. Int.

You

:

Mrs.

S.:

tend to think of an interview in terms of a unit?

Yes. Every interview should be like a well-done sym-

phony, complete in and of

would

again, they

still

itself.

So

that even

have something from

would be

finished, but the experience

if

people never came back

The job might not be

it.

My

unitary.

interviews almost

always have a kind of preparation period, like a prelude to a climax, but when

I

get to a climax, there's

no letdown.

with them something that's

stitches out this

shape

off,

so that the

want people to take ego-enhancing. The wound has been su-

interview has a whole lot of embracing parts to

tured and you can see that

I

it's

it.

I

going to heal. Next time

and maybe make another

cut.

Maybe

we may

we'll

one over again. But you know you won't go home

take the

even have to do all full

of mor-

phine.

mrs.

s.:

Well,

how

does this

come about

that

and your (to Mrs. P.) mother-in-law

Mrs.

S.:

Here

I feel that I

person with the idea that he

is

is

your (to Mr. P.) mother in the

house so much?

need to find ways to confront each

more

able than he thinks. I'm starting

with Mother because she has indicated that she's hopeless, helpless,

picked on. is itself

When

I

ask her,

an indication that

I

"How

come about?" the question know she has made choices about the situadoes

this

tion with her mother-in-law.

Int.

:

Mrs.

That's a complicated question. S.

:

Sure

it is.

I

question like that, because ing question.

It

rarely get

it's

someone who

can't respond to a

an ego-enhancing question, not an attack-

puts an action within a frame that implies that things

could be different.

A Int.:

attacking question

Mrs. S. how you can ing. I

if

you

said,

"Look

here,

say,

"How

did this

why

come about?"

are

it.

It

know how

could be an

you allowing

so that

it

I

don't

this?"

know

sounds attack-

like that.

This could be tactical, too.

:

give

But that wouldn't be using the same words.

:

have several questions Int.

you

think that's partly the tone

I

[157

Family of Angels

typical of all patients to say,

It's

came about." By definition, nobody's responsible for his symptoms. By asking these people, "How did this come about?" you're giving them back what they ordinarily would say. So that they're not responsible, it just came about. Mrs. S. But when they're saying it to me, they say, "It just came about." When I say to a person, "What's your idea about how it came "I don't

this

:

about?" I'm already changing things by turning the statement into a question.

Int.

The

:

fact that you're questioning the

that he's responsible to

some

person about

extent, but the phrasing

is

it

implies

such that he's

not responsible. There's a double level there.

Mrs.

S.

Int.:

happen?"

I

:

It's

see

what you mean.

very different from saying,

"How did you bring this

or,

Mrs. S. I would avoid such a the way I phrase my questions. :

Int.

Can you

:

give another

"How

could you

let this

about?"

question.

I

pay special attention

to

example of that kind of question?

"As you think of it now, how do you suppose you got into that fix?" "As you think of it now" that's the part that gives you freedom. If I just said, "Why did you let this happen?" that's a defense-producing question. If I preface it with, "As you think of it now," they can pick any point along the way to look back on whatever they did then. I'm always looking for that which makes it possible to create some distance from the self, so that the person can envision Mrs.

S.

All right.

:



change.

It's

interesting

how many

of the responses to these questions

are responses of "I see myself as a person

who

is

responsible for what I

do."

When you say, "As you think of it now," you're saying, implicitly, "Now that you're a responsible person who initiates what happens, how can you, as this person, see how you let such a thing get Int.:

beyond your control?"

Mrs.

S.

:

That's exactly right. I want

all

my

questions to have an

TECHNIQUES OF FAMILY THERAPY escape hatch, but life

I

also

want

[

158

to get across the idea that people tailor

for themselves.

Int. less

You're leaving people no out.

:

they were at that time, they're

the point of view of the present.

if

how

they talk about

help-

conceding responsibility from

still

And

If

they say they were responsible

at that time, they're taking the position that

you'd

like

them

to take

anyway.

Mrs.

But they come out with a

S.:

feeling of

ego-enhancement

rather than assault.

Int.

I

:

some kind

think what you

S.

mrs.

p.

mrs.

s.

mrs.

giving

them

do and

to

behavior openly.

That's exactly right.

:

I

:

guess I'm just kind of weak.

Well

:

I

.

.

mean,

do think

it.

mrs.

their

p.: I

is

of freedom to take responsibility for what they

acknowledge

Mrs.

mean by "ego-enhancement"

.

I just, I just

that

it's

don't, I

too much, but

I

mean, don't

I

don't like

know what

it

to

because

do about

She, she's a strong personality.

s.:

What happens when you

tell

her no?

Mrs. S.: Here she elaborates a little on this business of being weak and then says that the mother-in-law is really too much. So what I do is to reach way over here and take something functional and then pose it: "So what would happen if you said no?" Int.: You don't say, "What would." You say, "What does happen?"

You assume that

Mrs. for.

why

S.:

she does say no.

That phrasing marks over here the point we're aiming

Then, instead of relating to

how bad

things are, she has to relate to

she can't stand up for herself.

You

somebody who could, who does, tell her mother-in-law no. And you do another thing. You ally yourself with the mother against the mother-in-law. It's conceivable that you could take the other direction and say, "Perhaps you don't understand your Int.:

treat her as

mother-in-law well," or whatever.

Mrs.

S.:

Those would be

but in such a way that Int.:

It's

it

fighting words. I side with the mother,

doesn't turn out to be an alliance.

an odd form of

alliance.

exactly siding with the mother-in-law.

At

the

same

time, you're not

A Mrs.

S.

This

:

what

is

When

healthy process.

I

would

I say,

call siding

Family of Angels

159

[

with the interests of the

"What happens when you say no?"

am

I

siding with a healthy process.

Int.

Thinking of alternatives, you could say, "Let's

:

why your mother-in-law would

stand

wouldn't do

Mrs.

That would be saying

S.:

explain the fact that your mother

But

Int.:

to them,

is

to

draw

Mrs.

is

you

"Look, you

really are

not the time for that. Later

is

how do you

it,

always dropping in?" information that you have, you

at this point, with the

simply assume that

lem

it

this either.

might put some such question: "As you think about

I

under-

get so involved." I take

dopes, and you really are children." This

on

try to

an intrusive mother-in-law and that the prob-

this is

limits with her?

Yes, and being able to say no in the interests of the

S.:

self.

gary mrs.

I,

:

ah

.

.

.

know as I've ever told her "No." I mean, she has told me, I mean, we had a real rousing battle once in her apartment, when we were first, when Gail was a baby. She told me never to step inside her door again. Maybe a lot of people never would p.:

I

don't

have, but, of course,

Mrs.

Why

s.:

mrs.

when Int. his

:

mother be

Mrs.

all

out a father.

And

cannot stand

my

is

thought, as

young

that?

I listen to it

age, he has

I

don't

saying, "I see I

to

be

make

my

mad

his wife, so

at

now,

husband

is

how

What

she's also saying

me, and

as

man

I

see

have her husband I

entirely

withis,

"1

him valuing me

him and

his

mother."

somebody who cannot cope

have to do the coping for him."

There's another less attractive side to the phrasing

S.:

could

that since Henry's

been perceived as a

trouble between

he had." There's an implication that

Mrs.

She was

he was an only child.

with his mother, so that Int.:

mean by

husband

to the degree that

she

did

he had?

father died at such a

And

I

did she

My

S.:

Why

you step back? couldn't take Henry's mother away from him, it?

he had.

it's all

What

have. (Laughs.)

did you, as you think about

Because

p.:

I

if

his

mother weren't

"it's all

there, she'd

on her hands.

don't think that

fits

very well because he was practi-

TECHNIQUES OF FAMILY THERAPY cally never around. That's

mother to Int.

one of the reasons why

she's always

160

[

had

his

entertain.

Yes, but this sounds a

:

husbands to have

affairs

little

who encourage

like wives

because when they don't, they get

all

their

the atten-

tion of the husband.

Mrs.

S.

mrs.

Well, perhaps.

:

Well,

s.:

from Henry whether he worried about

find out

let's

that or not.

mr.

p.:

wasn't worried about that, particularly. But, ah, of course

I

she, she'd get very, ah,

angry

would always come back mrs.

mrs.

mr.

again.

You know, come

to

visit.

up and ask if she could buy me a something, which was ridiculous. I mean, I didn't want Well, she'd call

p.:

s.

That didn't

:

Oh,

p.:

mrs.

at situations like that, but, ah, she

p.:

her not liking you, did

think she does, but, ah

I

You know, you

loving,

Mrs.

fit

S.:

it

buy

can't

would take away

all

.

.

if just

once she would be wholly

{Starting to cry.)

it.

I'm getting ready to do some fancy footwork here.

to shake loose the idea in this family that people

tims.

So

go into a

would want mrs.

to

s.:

I

.

.

it?

want

I

.

.



of

dress or

about

real thing

how come

buy her daughter-in-law a wonder what

—Gary

I

this

have to be

unloving

I

vic-

woman

dress.

think has a

comment

that might be

of help here.

gary:

I

have been observing people,

Grannie. For instance, in

Anna

of a certain type like

I think,

Karenina, reading

this

and read-

ing a lot of books, that she has tried to be too loving. She has tried to be all-loving, tions.

my

She told me,

I told h-, I told

muscles that, oh,

and she love,

it

said, "All stifles

and therefore

it

I

stifled

the rest of her

her once while she was rubbing

had trouble communicating

takes

is

the rest of us.

to

Mother,

And yet, if, if all we have is As Anna Karenina found out, she

love."

couldn't have the love of her lover

all

the time, and therefore,

she committed suicide, on the train. But Grannie this

emo-

her god, so to speak, love, and

it's all

love,

is

trying to

and so

make

this is all

she knows, and so she's become, for this reason, she's become

narrow-minded. For instance, she comes over to our house. The only thing she can do

is

go

in the

garden and work, work, work.

A Because

this is the

only

way

Family of Angels

[

161

that she seems to be able to express

her love.

mrs.

(to

s.

about

Mr. and Mrs. P.)

You know, maybe you

:

like this, but this

it

haven't thought

has obviously been a big puzzle and

a big source of heartache, because you can't be sure whether your mother-in-law loves you or whether she doesn't love you. She does loving things. She does things that look like they're unloving.

And, how many years have you been married, now? mrs.

p.:

mrs.

s.:

Twenty-four.

Twenty-four years. (To Mr. P.)

a big puzzle, and

It's still

apparently you have seen the pain that this has brought to your wife and you can't figure

what Gary

it

out either, because

I

think

you see

There's a loving basis, but some of the behavior

sees.

doesn't match, either.

mr.

Right.

p.:

mrs.

Now,

s.:

I

wonder about Gary's explanation, and

given us something

we can

toward you

attitude

is

look

mrs.

of course,

I,

to

that

is

that

and

as

such,

think he's

your mother's

on you

it

that she

looks like she's

what you were talking about?

Yes.

p.:

gary:

Isn't that

all.

And

so completely focused

hasn't thought about herself,

smothering you

at.

I

.

.

I

was giving you a general theory.

If

you want

.

was asking you for validation as you see it, now. gary: I would not say it's smothering. No. I would say an overconcern, or a caused by her, probably from the very time she was born, trying to be all love, from some misdirection in the child mrs.

s.:

I



(inaudible phrase). Yes. (Inaudible phrase, stops, lowers voice.)

Approximately, yes.

mrs.

And

what we're dealing with, then gary: For instance, she tried, she wanted to come down and live with me this year. I mean, it's the same thing. mrs. s. Uh-huh. And how were you able to say no? 'Cause apparently you did what Father was never able to do. s.

:

so,

.

.

.

:

Int.:

Why

would you

at this point bring

up

the fact that

Gary

could do something Father couldn't do?

Mrs.

S.:

I

thought

it

was

safe to begin to rub things a

I've already put a cushion in for the father

way

of handling his mother.

Now

when

I

little bit.

said that he

had a

I'm saying that Gary could do things

TECHNIQUES OF FAMILY THERAPY from

differently

make

his father, but I'm trying to

comment on who's

thing instead of a

[

162

an individuation

it

better or best.

Were you trying to imply that Gary could do something with his own mother, that is, say no to her, too?

Int.: different

Mrs. in as a

S.

I

:

wasn't thinking of

Gary was again coming

like that.

it

peacemaker, but he was also trying to put something together

for (he mother.

was

It

was hoping

clearly. I

a

gift,

peace with a

comment on

whole situation a

to objectify this

Did you assume

Int.:

but he couldn't present

gift,

little.

that the too loving accusations

his relationship with his

own

it

were a

mother, on the way his

mother was dealing with him by being too loving?

Mrs. the

Oh,

S.:

yes, the

mother dealt with the

him, and the way people ally killing

gary:

way

the mother dealt with Gary, the

father, the insist

on

way

I

just

mrs.

s.:

It

:

when

calling this loving

never did say no, but

went down to look

I

day by day, and then

they're actu-

seemed

to

work and

was able

I

Well, now, what you're saying

is

was

.

just luck, let's

put

it,

"Well,

I said,

.

.

that I

you did not .

thought that

I

see

if I

I

can

out and

it

.

.

.

.

it

.

gary: In some ways, perhaps

1*11

and

to get into [dormitory].

you did not want, then, or feel that or even gratifying for your grandmother to be s.:

at things,

And one guy dropped

find a place in [dormitory]."

gary

the father's mother dealt with

each other. This smothering.

sort of lived

mrs.

way

could help me, or both. In other things,

would be

fitting

living with you.

could help her, or she

I

I really

want

to be with

my friends. mrs.

gary mrs.

s.:

Well, naturally.

So

want to go to [dormitory]. s. But the dilemma for you gary: At least, consciously mrs. s.: ... but the dilemma for you was how mother without hurting her feelings. :

I

really did

.

:

.

.

.

.

.

to say

no

to

Grand-

And as it turned out, just lucky. mrs. s.: And so the situation managed.

gary:

Int.

:

Mrs.

Why does he say he was just lucky? S.:

Because

that's

how

it

happened.

It's

a very interesting

sequence. His grandmother asked to live with him, but that way.

So

I

interpreted for

him

that he

was able

it

didn't turn out

to say no.

But

in this

A

Family of Angels

context he can't get the credit for saying no, because

he puts

situation. If

dent,

it's

as a series of circumstances, as luck or

it

163

fit

the

an acci-

okay.

Int.: Actually, this wasn't luck.

down

peared, but he went there,

doesn't

it

[

to the

It

dorm

was luck that a room ap-

to see

he could get a room

if

and a boy happened to be leaving.

Mrs.

You

Int.:

aged." All by

Mrs. because

S.

we

mrs.

The luck came

S.:

in that another circumstance appeared.

have a nice phrasing for

it:

"And

man-

itself.

push him too far

If I

:

in this, he'll

have to be crazy again,

haven't done enough preparation yet.

Mrs. P.)

(to

s.

so the situation

manage

this

:

Now

for you,

you

I

have to go

—sometimes

I

carefully.

guess you can

way, but you don't want to say no either because

you'll hurt her feelings.

mrs.

p.:

it.

And sometimes

gary:

mrs.

That's

p.:

we're lucky and sometimes we're not.

Yes, well, sometimes she comes in and she

starts in.

She

just

takes over.

gary: That's

mrs.

mrs.

p.:

true.

Well, then, where's

And

my place?

you had to you said no, Grandmother would be hurt. s.:

mrs.

p.

:

my

felt

let this

happen? That

if

Yes. Yes.

And

gary:

you've always

have had a dilemma, which side to pick. Should

I

mother's side or

my

grandmother's side?

And

I

take

I've sort of

been

waiting and waiting.

mrs.

s.

gary:

mrs.

:

I

Is there a side? Is this a

think

p.:

matter of sides at

all?

it is.

(Inaudible phrase.)

gary: Well, baby.

I

At



at least I

least this

is

have to see things clearer than something. At least

I

have to

I

did as a

see, ah, see

an

ace as an ace, so to speak.

As we near the end of the interview, he's becoming about his dilemma. Whose side should he take, Father's side or

Mrs. clearer

S.:

Mother's side? At

this point,

Grandmother and Father

about the same. He's taken another Int.

:

Mrs.

What S.:

step.

are you aiming for

I'm saying,

"It's

are symbolically

when you

talk

about sides?

not a matter of sides

when you

consider

TECHNIQUES OF FAMILY THERAPY your own

interests." That's

what I'm aiming

decide on whose side the power fits

lies. It

You

for.

164

[

don't have to

has to be done in terms of what

you. Int.

You're looking for an individual decision rather than a coa-

:

lition decision?

Mrs.

S.:

way

That's a good

to put

it.

somebody who

If

volved in something that refers only to him has to it

concerned other people,

mrs.

else.

s.

:

Your

mrs.

s.:

if

going to reinforce his feeling that he

He

has to continue to be victimized by

"coalition decision"

Who's the mother

gary: Of course.

a decision as

this is

can't take charge of himself.

somebody

make

in-

is

in the

is

a good

word

for that.

household? Your household.

My mother.

Yes. All right. All right.

And Grandmother

is

Grandmother.

She's not Mother.

gary: Yes. That should be

—the Bible says

there's a place,

you know,

there's places for everything.

mrs.

s.:

Now,

we'll

come back

you too have been caught in this thing, that to mother would hurt her feelings, to your mother. MR.

p.:

mrs.

That's right.

how have you

We've got one idea that Gary has used sometimes. And we know that Mother hasn't been able to do this, so she lets these things happen. Now, what s.:

Well,

have you

MR.

p.

:

tried to

concerned. s.:

do

to say

tried to

handle

it?

no?

Well, sometimes, just saying no, ah, ah, but ah, that

that, in the case

mrs.

Mr. P.) say no to Grand-

to you. Because apparently (to

Ah

.

where .

it

means anything

do

is, I'll

as far as the family

is

.

Did you know anything about Grandmother wanting

to live

with Gary, for instance? In school?

MR.

p.:

Yes. Well that, ah,

approval.

much

is,

mean, that we

I

was a question of approval or nonreally didn't, ah, didn't, ah,

have too

opinion on that, as far as what was best to do. Because

Gary had spent

quite a bit of time in the hospital here, and, ah,

breakdown, and so we thought maybe it would be helpful for him, in that case, now. (Mrs. P. and Gary

and had had

this,

ah,

talking in background.)

mrs.

s.:

Wait.

little

and

Gary and Mother making a noise) is being

got caught in crosscurrents.

young man (Tim is mouse (laughing) and Dad is

talking,

a

I

this

trying to answer.

Now

are like

look,

A what

I

asked about Dad's being able to say no to Grandmother,

his mother.

And

then

we posed

to

you didn't want her commenting?

to

vious that

MR.

just

what did he live with you, and it was oband it wasn't fitting. And you

the question about

do when Grandmother wanted were

[165

Family of Angels

And, ahhh, there are times when, ah, I just sort of let time lapse to see if, ah, how it works out, so I, ah, without trying to

p.:

create a situation.

Mrs.

(interrupting Gary,

s.

Mr. P.)

work

Till time, if

out,

I

said I

tries to

you can

let

speak): Just a minute. (To

.

.

maybe things will maybe you get a lucky

time go by,

and Gary has suggested that

break of some kind

gary:

who

if

.

was lucky.

you are lucky. Whatever. A lucky break or something. You couldn't fall back on these two things. gary: I, I get an awful feeling when Grannie comes to visit me as if there wasn't anything there. I mean, because she is all love, I mrs.

s.

Well,

:

guess she

mrs.

all right; if

stifles

the rest of her emotions.

You know,

s.:

Gary,

if

your mother and father could

really

understand, and I'm going to try to help them, because you're saying something very important, and that

is

that she

is

not the

kind of strong person that she appears to be. That actually she

wants so Mrs.

Int. derive

it

:

to be loved, and this

and Gary

What you

from what he

all talk

say there

is

what you

feel.

(Mr.

P.,

together for a few seconds.)

isn't

what Gary said

at

all.

You

could

said.

Because he's been trying to make pleas.

make my Remember when he

when Grandmother comes,

she works in the gar-

Mrs. point.

P.,

much

S.

That's what

:

said further back that

I did. I

derived

so that

it,

I

could

den, work, work, work?

Int.

:

Mrs.

He does make her sound pretty sad. S.:

That's right, and yet she's perceived by the family as a

victimizer. I'm trying to cut through this.

One

of the problems here

is

that the wife can't see herself as acceptable in the eyes of her mother-in-

law. This all.

is

really saying that she doesn't see herself as acceptable at

The mother-in-law

is

a vehicle by which this comes about.

body

in the family sees the

who

inhibits

will

them, they

have to form

all

If every-

grandmother as a victimizer or as somebody

will all

experience low self-esteem, and they

kinds of coalitions to outwit the grandmother.

TECHNIQUES OF FAMILY THERAPY Gary

is

now

intimating that the grandmother

is

pleading for

[

166

some kind

of acceptance herself. I'm going to use Gary's perception to try to take the situation out of the ego-assaultive framing the wife puts

put

in a framing

it

which

will allow her to

visits,

differently. It

and

was quite

made some changes concerning

interesting; after this interview the wife

the mother-in-law's

cope

it in,

and those changes

stuck.

She told the mother-

in-law very quietly that she would like to have her call before she

came

over.

Int. for

you

When you make

:

this shift,

to get the family to stand

it is

up

partly that

will

it

to the mother-in-law

be harder if

you go

along with the idea that she's a victimizer?

Mrs.

S.:

If I

continue to behave toward her as though she's a

and I'm not

victimizer, I'm telling these people that they are victims

helping them much.

poor teachers teacher

people

It's like

their children have. If I say,

a victimizer," then

is

who come

I

am

in

and complain what

"Yes, you're right, that

cutting off avenues for these people

to grow.

Int.: Part of the shift

is

to define the

grandmother as a victim

herself.

Mrs.

S.

Sure. I think a lot of therapists forget that

:

if

they

make

change over here, they're automatically producing a change over Int.

Were you looking

:

for

an opportunity to make

so decided to pick something from what

decide you to do

Mrs.

S.:

was the way Int.

way

I

there.

this shift

said, or did his

and

speech

it?

I

was looking

for

knew

that

was consciously thinking

of a

thought that

this

an opportunity to do

it.

I

wanted to end the interview. This strains a little, as if you were reaching.

:

Mrs.

Gary

a

I

S.:

was looking for

I

it,

yes. I

could reduce this victim-victimizer situation.

would be helpful

in getting

Gary

off the

I

hook.

gary: (Inaudible phrase) we're getting closer to her now.

mrs.

mrs. mrs.

p.: s.

:

p.:

was

You

see,

she was so young

when her husband

died.

How old was she? She was only

forty, ah, oh, forty-two, I guess. I think she

eight years younger, but she was, well, she has a marvelous

talent for nursing. She's this is

when

marvelous.

wonderful when anyone's

she's the best.

Had

When

I

sick. I

get sick, oh, then she

mean, is

just

she gone ahead and taken up nursing and had

A some

life

has no

mrs.

of her own, but she didn't, she didn't do a thing. So she

life,

except ours.

me

Let

s.:

pose something to you. Here

speak about in superlatives about her

about her

weak

that

you

When you

and you also have a feeling

else,

is



Are any of

will fall over.

(Mr. P. interrupts.)

"Are any of these things true?" what are

ask,

after?

Mrs. cies.

woman who you

You've been talking

ability.

you say no, she

if

Or

these things true?

Int.:

a

is

one way as though she were such a strong person

in

she could dominate everybody she's so

[167

Family of Angels

S.

One

:

of the things I'm after

is

up the discrepan-

to point

I'm putting the question in terms the people use, as though I'm

accepting that the mother-in-law could really be

of these contradic-

all

tory things, but by saying, '75 she any of these things?"

I

pin them

is

the thing,

down. MR.

p.

mrs.

Well, not weak, she gets very angry

:

She would get angry.

p.:

we

if

mrs.

Gary: Anger

mrs. Gary:

.

.

mrs.

s.:

mrs.

p.:



ever said no

is

often

.

:

.

:

.

this

.

.

.

.

Who

would drop dead?

from fear. Who would drop dead if Grandmother got angry? (Pause.) Nobody. And she would lose so much because she wouldn't .

come around and she wouldn't even Int.

.

would be so angry she'd probably who would drop dead?

(overlapping)

s.

we

.

said no, she

And

s.:

If

ah

if,

Do

you have a term for

this

see the children.

"Who would

drop dead" tech-

nique?

Mrs. that has I

S.:

I

use

it

rather frequently to try to

been labeled with survival significance

go back to the

literal survival effect,

which

is

is

show

that the thing

purely a delusion. So

dropping dead.

divest the victim-victimizer situation of survival significance

out the reality, which Int.:

You

is,

"How close

are

you

I try

to

by pointing

to literal death?"

take what they imply and carry

it

to

its

logical ex-

treme.

Mrs.

do this frequently. I have another question like this: "Did you ever see the cause of death on a death that you said no to somebody? I've never seen that." S.:

I

that goes certificate

TECHNIQUES OF FAMILY THERAPY mrs.

[

168

you something. Didn't she say, "You never darken my door again"? So what happened when you darkened it? She said, "I'll buy you a dress," maybe, hm? s.:

Ah,

mrs.

p.

Yes. Yes.

mrs.

s.

mrs.

p.:

No. No.

mrs.

s.

Doesn't sound like

mrs.

:

:

:

Actually,

Maybe

does

does

at all,

it

that

would back down.

that's

it fits,

it?

it?

think you have hit on something, here. Because

I

have kind

I

think

I

you know, reared up,

of,

maybe

she recognizes strength.

it.

You know,

s.:

tell

like

do think the few times

that she

mrs.

to

That doesn't sound

p.:

I

want

wait. I

after a while

it

won't even be that you have to

be so strong to overcome somebody, or you have to go and pick

them up. What's the

Here

reality?

is

a family in which you're the

mother, you're the father, you're the wife, you're the husband.

These four are your children.

How come Grandma

has something

to say about the lives of other people?

Int.: You're labelling each one's function here, but the gist of

what you're saying

is,

"How is

to say about your life?"

must put the family

Mrs. Int.

S.

:

Yet you,

as

in a curious position.

I'm not the grandmother,

You've phrased

:

some other woman has something another woman, are saying that. It

that

it

it

as,

that's

what saves

"How come Grandma

it.

has something

to say about the lives of other people," not "the lives of her family." It's

almost a paradox, because

it

implies,

"You

shouldn't

let

yourself be

influenced by an outsider like me."

Mrs.

S.

:

That's

no

my telling people that each one "Who goes to the toilet for you?"

different than

must take charge of himself.

I'll

say,



things like that.

mrs.

p.:

But how, how do you make her

four times a week

mrs.

s.

gary:

:

I

I've

Well,

you can

is

more than e-enough?

see that

.

.

c- (sighs).

haven't seen the problem because I've been at school so much.

never really seen Mother's pain.

towards p.:

mean, she

I

three or

.

(inaudible phrase). I've sort of,

mrs.

maybe

realize that

what

I

haven't really seen the

I've

done

is

shut

my

eyes

it.

Eight-fifteen. I

mean, a

planned. But there she

is

lot of times I

have something

at eleven o'clock in the

morning.

else

A

—and

Family of Angels

[169

you probably recognize, we don't have any ready-made solutions but this I can tell you. That is, that right at the outset, the two of you, certainly as far as your mother is concerned, felt in some way at a disadvantage. You wanted her to like you. You wanted her to bless this thing which was so

MRS.

s.

:

Well, I can't

much Gary

as



And

love between you.

it

didn't happen,

and

I think, as

suggested, not because she didn't love, but because she

scared and naive and didn't know.

And

you've

so,

felt

was

always at

a disadvantage ever since.

MRS.

p.:

gary:

Yes (inaudible phrase)

I feel,

guilty.

the one reason, I had

wanted her down

some

reason. I didn't

know

what,

wanted her down there is that she would be away from our family, and the family could be itself. I think if there were, there was some urge but

I

there. I think the reason I

wanted her to be down there, there was some urge that wanted her not to be down there, this was the, in my subconscious that I wanted to help the family by pulling her away. that

you had Grandmother with you, then she wouldn't be bothering Mother and Dad. She'd be, you'd have the pain of it.

mrs.

If

s.:

gary:

mrs.

I didn't

s.:

No,

think of this consciously.

it

just

came out

today.

gary: Yes,

that's right. I think,

mrs.

think you have a point.

maybe.

And what

want to say is that nobody has to be a victim of Grandmother, because I think Grandmother is somebody who's got a great deal, and I think outside people would be very surprised to hear Grandmother spoken of in this kind of way. So this means that all of you have somehow, without meaning to, gotten into some kind of a delusion s.:

I

I

with her, that can be taken care of very nicely all out.

Int.:

Why

And you

(to

when we work

it

Gary) won't have to be the rescue man.

did you keep talking about the grandmother at this

point?

Mrs.

Because in talking in

S.:

this

way about

the grandmother,

I'm giving a message to the other people that they've got something to offer. I

am

saying that

won't have to Int.

:

about her. ily,

when

they understand

all

they have to

offer,

they

feel like victims.

It's

going pretty far to say that

Is this again trying to

rather than pin

them on the

all

of

them have a delusion

spread the symptoms around the fam-

patient?

TECHNIQUES OF FAMILY THERAPY Mrs. Int.

S.

Oh,

:

Why

:

[

170

yes.

do you

say,

"An

outside person

hear Grandmother spoken of like this"?

would be surprised to

Do you

tend to bring in the

idea of what the outside world will think?

Mrs.

make

Not very

S.:

often. It fitted nicely here,

the point that the family

saw her

in a

way

from the way others on the outside would see

because

that

her,

wanted to

I

might be different

where she wouldn't

be in the same system with them. Someone outside the system can have a different experience with the person.

It's

a matter of shifting the per-

spective.

mrs.

p.

mrs.

s.

:

She

gets so

That's

:

mad at us.

all right.

gary: We've got to be

mrs.

p.:

eat,

mrs.

I

know, but

you

just

Now, especially. even when eating and she subtle.

tries to

force you to

have to say no.

You know what you do then? "Thank you, Grandmother, for thinking about me." And go right on eating what you yourself want to eat. And Grandmother will feel valued, and she will not s.

:

control you.

A

Int.:

few minutes ago you told them you had no ready-made

and yet here you give them a

solutions,

mother-in-law

is

solution.

Do you

think the

so demanding that they need practical advice at this

point?

Mrs.

S.

Yes. I'm giving the mother an illustration of

:

be done. Sometimes great the

I

do

that,

sometimes

I don't. It

how

it

depends on

can

how

and whether the people have something to work don't tell them what to do, I give them an illustration

demands

You notice I of how it could be on.

are

done. In a sense, that's being a model.

Int.: Is this something you tend to

do toward the end of a

ses-

sion?

Mrs. S. Toward the end of the session I might ask, "What has this all meant to you, what did you learn?" or I might say, "Where do we go from here?" or I might say, "During the next week it seems to me you ought to get some evidence of thus and so," or I might prescribe a symptom. There are all kinds of things I might do. Int. What do you mean, prescribe a symptom? Mrs. S. You can prescribe a symptom in one of two ways. One :

:

:

A is

them

to ask

say the ing

man

is

what they've been doing

explicitly

woman

accusing the

woman

and the

it,

do

to

of nagging,

accusing the

is

Family of Angels

man

[

171

implicitly. Let's

woman

and the

deny-

is

and not

of being passive

make them do the same things on purpose. Or I might reverse the role. One time I had a woman who was complaining about her husband spending too much money them

talking to her. I then give

directions that

and he was complaining about her

beirtg stingy, so in this instance I

asked them to reverse their procedures. She wasn't to have a single thing to

times

do with the money and he was to take care of do a

I will

little

teaching.

one another,

listen to

I'll

somebody hears you. One and the other touch?"

To

to touch

is

get

instance,

if I

to

be sure you have

him and then

ask,

it.

Some-

to

who don't make sure

his eyes in

your focus,

"Are you

feeling the

have people

them there are two ways

tell is

For

of

all

them used to a new way of asking for

attention.

Or we

might come up with a whole new aspect, vague, about one part of the mother's

or something like that, so

life,

albums around, or obituaries, to value in terms of the facts per don't have to have a cover

I

ask

they have

if

try to get the facts together.

se,

but

on any of

it

some old This

is

of

you can find out, you There is no dangerous

also says

this stuff.

information.

Gary:

What

gives

say

I

me

is

usually,

more. But

I

"No, thank you, please."

have been

insistent. I

Mrs.

I

You

then she

have tried to be

do want to be a good runner, and of the wrong thing, you're not a good runner. ent 'cause

And

if

you

eat too

insist-

much

Gary spent some time in the hospital after his second breakdown, which occurred early in treatment, but when he came out he went back to college and finished the year very well. The main thing was that he wanted to be an Olympic runner. So this little, skinny boy got himself ready for the Olympic tryouts, literally made his meek little body into Olympic material.

S.

He won

medal for

it.

:

notice this reference to being a runner.

third place in a college cross-country track

But

it

was such a

meet and got a

terrible idea to the family that

he wasn't

going to go and be a professor that they put a damper on the whole thing.

They

said,

"What do you want

to be a teacher," implying,

rations?"

And

to be a runner for? You're going

"My God, how

of course, just before the

can you have such low aspi-

Olympic

tryouts,

he had an-

TECHNIQUES OF FAMILY THERAPY

[

172

other breakdown. I had been forced to discontinue the case before

therapy was completed, and I wasn't seeing the family at the time, but I

heard that he carried the medal around with him in the hospital.

He

gold and gray medal.

and father

brought

it

out in front of everybody, mother

make arrangements

too. I tried to

A

for the family to see an-

other therapist, but that wasn't successful and they dropped out of

The

treatment altogether.

won

girls

did well. Lois blossomed at school and

moved

a scholarship to go round the world, and Gail

apartment and a job. So there were some things mrs.

s.

an

pleased about.

now we have to stop at this point, and we'll meet next week, and I think we will make great progress.

Yes. Well,

:

again

Gary: Perhaps. (Mr.

mrs.

I felt

out, got

And

s.:

I

P.,

Mrs.

want you

all

P.,

to

and Gary all talk at once.) know it was a pleasure. Father.

Lois.

Mother.

mrs.

p.:

Thank you

mrs.

s.

Tim.

:

so

much.

I've got the

wrong hand, haven't

This

I?

is

not the right

hand.

Gary:

mrs.

(Inaudible phrase.) s.:

It's

It's

good enough.

nice to see you. Gary, a pleasure. (All talk at once.)

Goodbye. (Noise of people Int.

Do

:

leaving, tape recording ends.)

you name each one to emphasize your relationship with

him, or to identify each one as separate?

Mrs.

S.

:

I

think

names are the most

direct

way

of giving a mes-

sage of individuation. Int.

Mrs. it if I

Why do you say it was all a pleasure?

:

S.:

Because

hadn't enjoyed

/ thought

Int.

it.

it

was. I enjoyed the treatment. I wouldn't say

Sometimes

it

was

:

You try to end with

I'll

say, "It

was

pretty sticky today.

pretty sticky."

something personal.

Mrs. S.: Well, I feel that none of these families have ever had somebody else in their environment giving out clear reports about them. So I do as much of that as I can. For instance, I have a perforated eardrum, and I've been wearing a paper eardrum. Sometimes the

paper eardrum

slips

and that

into a treatment hour it's

because

lems in

my

and

up a disequilibrium in my head. I'll go say, "You know, if you see me like this,

sets

I'll

paper eardrum slipped and

listening. If I

ask you to repeat,

it

this

causes

may be

me

certain prob-

because you're not

A talking loud enough, we'll find that out, but this defect I

it

Family of Angels

[173

could also be because of

have." That already says you can talk and be clear about

anything. It also says that people's behavior need not be related to expectations about whether they are acceptable, lovable, sick, bad, stu-

So

pid, or crazy.

Int.

:

Mrs.

I

do that kind of thing

With a paper eardrum! S.

:

With a paper eardrum.

too.

3]

The An

Eternal Triangle Don D.

interview with

Int. to see

What

:

did you

M.D.

Jackson,

know about

the Starbucks

when

they

came

in

you?

Dr.

J.

I

:

knew

who

they had an eighteen-year-old daughter, Sue,

had a psychotic breakdown while she was away at college. I was on an extended visit to the city where the family lived. The college psychiatrist,

whom

I didn't

had learned I

that I

know

personally, telephoned me,

was going

would consider taking the

to

be

and said that he

in that city for a while,

girl on.

He had

and asked

if

her on the acute ward and

she was suffering from paranoid delusions, was hallucinating, and so

he

forth, but

felt that

she was calm enough to be sent home.

and I

telling

me

her.

She was

still

acting pretty far out, rolling her eyes

confidentially about a servant she thought

spoke to her parents on the phone and

three of them. This :

Dr.

J.:

:

up an appointment

her.

for

all

the session we're going to talk about here.

They had

and Laura,

Int.

set

had raped

Was Sue their only child?

Int.

fifteen;

is

she

have her put on an open ward in a hospital

arrived, I arranged to

and went to see

When

three other children: Peter, seventeen; Charles,

thirteen. I didn't see

any of them

at

first.

What were the parents like?

They were wealthy, upper-class people, both in their forties. The father was a businessman. He was the one with the obvious charm, but there was something pompous and pseudo-executive Dr.

Don D.

J.:

Jackson, M.D., is Director of the Mental Research Institute, Palo Alto, California. He has published many articles on family research and therapy, is the editor of The Etiology of Schizophrenia (1960), author of Myths of Madness ( 1964), and co-author of Pragmatics of Communication ( 1967).

[175

The Eternal Triangle

about his manner. The mother was a fading beauty in cashmere and

been worn away by a

pearls. She'd

life

of psychosomatic illnesses,

you had the constant impression that she had and was tolerating you from her bed of pain. Did the parents know

Int.:

them

just

taken two aspirins

you were planning

that

and

to include

in therapy?

Dr. left it

No, and when

J.:

I

spoke to them on the phone

vague, because they had a reputation to uphold.

I

I deliberately

suspected that

the last thing they would want in that city was to be identified with psychiatric treatment of

any kind. As the tape recording begins,

you'll see

how cautiously I had to proceed.

Initial interview

with the Starbuck family

(to Sue)

dr. J.

:

Ah,

the ground rules

I

think you better

first

.

sit

down and

let

me

bring up

.

.

sue: Okay. (Laughs.)

Dr.

make

You'll notice that I

J.:

What

throughout the interview.

am

I

remark

that kind of

doing

initially is to

both jump on her and

cused on her by

is

we wouldn't

telling

for her to misbehave,

get anywhere.

her to behave.

I

So

always do

I

Sue

say to her,

"Don't make a fool of yourself, because we'll lose the ball game do." All the parents would need

to

if

you

and they'd

immediately fo-

this

with disturbed

schizophrenics because they can keep themselves so worked up in a pointless sort of way.

And



you have a chair deliberately, ah, in this room, because whenever I can I like to record family sessions. Now if it makes you nervous, we'll dispense

dr. j.

:

with

then, ah, in the

first

place I'm seeing

it.

sue: Not me. (Laughs.) dr. j.:

The reason

therapist, things are said

the tape myself

MR.

s.

.

.

(overlapping)

:

when you have three people, and a that, ah, don't become clear until I hear

that, ah,

is

.

Slowly.

... in the interim, and also there about who said what which we can, ah,

dr. j.:

it

back.

are sometimes questions settle

by actually playing

TECHNIQUES OF FAMILY THERAPY

176

Why did you make that remark about playing back the tape?

Int.

:

Dr.

J.

sarily

[

This

:

partly to

is

tell

the identified patient, "I'm not neces-

going to believe what's said against you.

understand you and vice versa, trying to put

them

it

may

on an equal

all

If

your parents don't

not be just your fault." I'm also

level,

which

is

not done by saying,

"You all have problems," but by saying, "It's all so very complicated that we have to have a tape and look into it again and then we can be objective."

You

Int.:

up to understanding matters any more than anyone else.

suggest that you're not

without a leisurely listening

Dr.

J.

Yes.

:

It

dr. J.: I think

makes me equal it's,

it's

kind of bickering sue:

a useful thing. .

.

too.

saves a lot of needless, ah,

It

.

(Sighs.)

dr. J. I,

Int.

.

:

.

.

ah, myself

Was

:

that can go on. But the other

have to

way

that a

listen to

is

the

more important,

that

it.

to engineer a conversation that wouldn't be

just bickering?

Dr.

J.:

No. This

is

surprised that I did say

ter

because

I

wouldn't usually say, and I'm

make people aware own recordings. The feel I got of

I

don't like to

them with their family over the phone must have given me the idea that the daughwas going to be accused of things that weren't so. That there was

that

the

we might

it,

something

trap

confusion. Ordinarily

mrs.

s.:

wouldn't point out future

I

difficulties.

We're used to a tape recorder. [/am//y

younger

friend's]

brother has one. dr. J.:

Good.

sue (overlapping) it

whether

it's

:

Gosh,

I

don't care,

it

doesn't bother me.

I

can say

being recorded or not.

Did that give you the idea that Sue had something she was ready to come out with? Dr. J.: Yes. I was already becoming uneasy that she was going to lay some bomb on the table. I thought that it might literally be incest, and I wasn't too far wrong. One of her delusions was that she had been raped by a servant while her mother stood by, giving him Int.:

The Eternal Triangle

was an

advice of a mechanical nature. There

[

177

when she

actual incident,

up or was just kidding her, but it was nothing much. The delusion was really based on the involvement she had with her father. It came out in a later interview that he was in the habit of walking about nude with the bedroom door open. She complained, she said it was very provocative, which embarrassed him very much. Also, she used to climb into bed between her parents on weekend mornings, even when she was in junior high was twelve or

school.

thirteen,

When they

when

a servant did feel her

locked her out, she'd go round and climb in through

know any

the window. I didn't

of this yet, but something about her

manner gave me the feel of Joe McCarthy with the 202 names in his briefcase. I was afraid she was going to blow the thing open before I could get started.

MR.

s.

It

:

would pay,

I

would

think, to

have one of us talk

at a

time

you expect to be able to read it back on the tape recorder, so let's not two of us try to talk at once. if

Ah, the reason

dr. J.:

I

wanted to get together with you

is

though Sue has a therapist of her own, ah, and although an age where

ting of

she'll be, ah,

moving on

are certain, ah, family considerations that

that al-

she's get-

in the world, there

still

come

up, ah, for

example, there's what to do with her in the next few months, for

example sue: Well,

I

.

.

.

have some ideas of

my own.

(Laughs.)

dr. J.: That's right, but these also involve your parents.

sue: Oh, necessarily they do,

I

understand

Int.:

I

was wondering why you

Dr.

:

I'll let

J.

that.

let that

statement of the father's

a lot go in the early sessions

if

I

think

it's

not lead-

ing to disaster. I think that these patterns are redundant and are going

to be repeated, so I'm not worried about missing anything.

It's

not the

word with "evenly hovering attention." What I am concerned about is that somebody will be so humiliated that they'll withdraw, or that there will be violence of some kind that will break up the group, or that somebody will be made such a fool of by a coalition of the other two that the sides will be drawn up and it will be impossible to break them down. That kind of thing old analytic idea of attending to every

I will interfere with,

even in the

first

interview.

TECHNIQUES OF FAMILY THERAPY You

Int.:

[

178

weren't worried that the father was coming in as presi-

dent of his company?

Dr.

you

J.:

couldn't care less. I'm learning something about him,

I

see. I don't

know him well enough

to say, "Oh,

come on now."

Did you have a reason for Sue's having a therapist of her own, as well as coming into family therapy? Dr. J.: I've found that most youngsters this age, since they are Int.:

half in the

house and half out of

They

sees nothing of the family.

it,

have a private therapist who

like to

feel as if that's the part of

leaving home. Otherwise they take family therapy to

are being kept as a child. This

to her therapist about certain things

me

on,

girl, later I

did.

mean

that is

that they

would complain

bitterly

She had the feeling that with

she was being treated like the daughter,

come

them

when

she was about to be-

a young lady.

What

Int.:

did you

mean when you spoke

of "family considera-

down

while she was away at

tions"?

Dr.

J.:

I

assumed

that Sue's breaking

school so that she had to

come back

solved family business, though

I

to the family

didn't

want

had

do with unre-

to

to lead her to think that this

was important. Later, when she started to go steady with a boy and got engaged and finally married him, there was a lot of friction. It showed that the family really needed her as a scape-

was

the only thing that

goat.

Int.: There's quite an edge in your voice

Sue. I gather you're

Dr.

J.:

still

keeping her in

Right. This

have to have a picture of

is

when

line.

where the nonverbal factor comes

her.

She was a very cute, very

but malicious-looking with flashing black eyes and a

was about

to say,

saying, "You're

down.

"Ask me,

still

I think this is

going. If she

kid, I've got

a daughter." But

had said

is

that you've got a

at that

Int.

:

Dr.

J.

if

she

you." So I'm right

not that you've in-

cooperation like,

game

"What's that

different interview.

How did you get her cooperation? :

I just

game now," and know.

little

moment something

sound?" you would get an entirely

tell

grin as

you notice how she backs It's

you

in;

attractive girl,

little

something to

what gives you confidence.

timidated her, the point

you're talking to

looked

at

her as

if

to say, "We're going to play this

she was willing to go along with

it.

Why,

I'll

never

The Ah, and

DR. J.:

how

there's the question if she should live at

people are going

are certain past issues ah, so that ings.

Now

Eternal Triangle

much

very

still

home, ah, of

with each other. Ah, there

to, ah, interact

which are

179

[

in her

mind, and,

think that, that there's a real reason for these meet-

I

what

with any kind

would suggest

I

that

is

and

of, ah, progress, ah,

we

if

get through this

this is shared, that

we

one then

plan to have some other get-togethers after you get back [from a

planned

trip],

basis

.

.

.

Mm-hm.

sue:

dr. J.:

.

.

from time

.

sue: Well, that's dr. j.:

.

.

lems, I

Int.:

.

because

.

mean

.

.

.

.

don't think

I

all

the family problems can be set-

therapists.

Ah, when

I

say family prob-

an attempt to commit them to coming in

is

we have

say, "If

ah

things like (pause) decisions.

gather this

I

You

.

to time,

by having individual

tled

again.

on a kind of ad hoc

ah,

progress," but

you imply, "No matter

what."

that

Dr.

J.:

and

say,

What I would do now is probably be more "If we all leave the room alive." I'd make it would be tempted to

possible so that they

fight

me by

flip

about

bad

as

not having

it

as

be

that bad.

odd phrasing: "family problems, I mean things problem isn't the same as a decision. It's a little

Int.: That's an like decisions."

deceptive, as

if

A

you wanted

going to uncover too

Dr. this

J.

many

may have been

make

it

seem

that family therapy wasn't

skeletons.

I can't explain

:

to

why

I

put

it

that way. All I

can say

is

that

part of a general attempt to seduce the parents and

not frighten them. I don't think that at this point they thought they had anything to do with Sue's that the other

Int.

:

illness,

although later on they each thought

one had a great deal to do with

What

is

it.

your rule for bringing the whole family in?

Do you

always start by seeing just the identified patient and the two parents, or

do you sometimes have everybody come

Dr.

J.:

I

don't think there should be any rule about this and

might have done a sick,

in?

little

differently here.

something active has to be done.

If

But with a

girl

would have been a very serious problem about where

Then

there

possibility that she

is

this

she didn't stay in the hospital,

there

was the

who

I

to put her.

might get shock treatment. I

TECHNIQUES OF FAMILY THERAPY

[

180

think the siblings are apt to be on the side of the parents against the

and I'm usually not prepared to deal with them

patient,

especially in a case like this. If

of I

some

think

kind, like a marital

depends on the

it

away,

a family difficulty

problem where children are involved,

therapist. It

have three more youngsters just the

more obviously

it's

right

sure.

would have slowed me down to

had enough

in there. I thought I

to

do with

mother.

Did you

Int.

:

Dr.

J.

see the other children later?

Yes. In the beginning, the two boys were away at school,

:

some of the meetings. Then Sue improved so much, started to live away from home and so forth, that it turned into marital therapy and I just saw the parents. Sue is married and doing quite well now. The younger sister got pregnant at the age of fourteen or fifteen, and I worked with her individually and she pulled out of it well. Then I took on the older boy, who was floundering around at college, no serious symptoms, but confused. I felt like a paperhanger with bad glue, running around, never organized the way but

I

I

included the

would have

them

all

liked to be.

Do you

Int.:

in

little sister

think you could have avoided this

if

you had seen

together from the start?

Dr.

was an unusual circumstance. All these children were growing up and getting to the point of leaving home. If you see the whole family as a unit, there may be some benefits, but it gets the kids reinvolved. I think you have to play it by ear. J.:

I don't

know.

It

sue: Yeah. Well, I'm, right here

think

we have an

eternal triangle.

Mmm.

dr. J.:

And

sue:

I

I

think

maybe we're

seated

wrong

for

it,

but I think

it's,

very much, there.

Mm-hm.

dr. J.:

sue

(to parents)

:

I don't

know whether

the

two of you understand

what I'm talking about.

Int.

:

What was your

private reaction

when she used

that phrase

"eternal triangle"?

Dr.

number

J.:

It

made a tremendous impression on me.

of times in talking to groups.

apt remarks that schizophrenics

I

often

come out with.

am

I've

used

it

a

impressed with the

[181

The Eternal Triangle

You

Int.

:

Dr.

J.:

I

say

this is a

Do

not me,

"It's

Dr.

I

thought this might be the

mixed reaction

Int.:

of, "Is



it

you often get an

it's all

mean

in

and

I

said,

that at

I'd

made me

been expecting.

who

says right out,

this didn't

mean

This

all.

is

a one-shot

had a patient, a schizophrenic "Mother had to get married, so

I'm here," which encapsuled a whole history

But

also

it

of us?"

who came bouncing

the obvious.

there.

or not?"

kind of ploy that has no substance. girl,

bomb

identified patient

Yes, but she doesn't

J.:

an uncertain way

in such

think Sue's remark delighted me, but

nervous, because

So

"Mmra"

I

won't go

that she could stand

into, including

up

to her

mother

or that she really understood her problems. Int.:

Sue uses the remark to implicate her parents rather than

herself.

Dr.

That's

J.:

my

impression. But

why

she said that about the

seating, I don't yet understand.

from

Int.

:

Dr.

J.

What was the

seating?

She was between her mother and father and

:

her. This has always puzzled

angle, she should not

have been

I

was across

me, because the way she saw the sitting

tri-

between her parents. She ap-

parently didn't think of herself as mediating between them, the

way

the child with the problem usually does.

Int.

:

She says

her father, "You're torn between Mother

later to

and me." Perhaps she was thinking her father should have been

in the

middle.

Dr.

J.

That must be

:

it.

In one of the later interviews, he banged

the table, red in the face, and said to the of the

two of you dragging me

into this."

women, "I'm sick and tired He was always being called

into their fights as a mediator.

Int.

Dr.

:

Then it wasn't an It all

J.:

oedipal triangle.

depends which side you stand

it

on.

were very distant with each other, and they needed the

The parents

girl as

a cross

monitor. In that sense she was in the middle, though she wasn't seeing it

that way.

mr.

s.:

Is that

a problem according to the ground rules that you're

ready to discuss now? dr. J. :

I

made my

speech, ah, so

now

I'm,

ah

.

.

.

TECHNIQUES OF FAMILY THERAPY mrs.

sue (simultaneously)

The ground

dr. j.: Oh,

up

ah

.

.

to point out that the

ground

of the material, and that, ah, secondly, that

.

.

s.

sue

Sure, so I

do think

some things to be done, it's not Sue having had some difficulty and then, let's

that, that there are

get her patched up, but there's going to be

Uh-huh. This

:

:

my

difficulty,

.

.

Dr. Jackson.

This, right here, these three.

Mm-hm.

dr. J.:

mr.

is

.

Which?

dr. J.:

sue

again, because,

am I.

simply a case of

sue

did want to intro-

I'm agreeable.

:

dr. j.:

I

.

mrs. :

do like the anonym-

rules are I

we would meet

duce early the notion that we'd,

ah

medical

.

to record, although I take responsibility for this, for ity

my

we go on?

rules just as,

wanted

I

to bring

Hmm?

dr. j. (toMrs.S.): :

me

Well, do you want

:

considerations before

s.

182

Well, what are the ground rules?

s.:

mrs.

[

s.

The, the lack of conversation, or just these three people?

:

sue: Conversation, yeah, but communication has been cut off for vari-

ous reasons, and

don't think I'm entirely to blame for

it.

Mm-hm.

dr. j.:

Int.:

I

At

up her

the beginning of this part, Sue tried to bring

medical problems. Were you trying to bypass that?

Dr.

My

J.:

by acting as

if

reaction here

was

she was about to

Sue made her parents nervous

that

come out with something.

I

thought

was more specific than it turned out to be. She had a propensity for making them nervous anyway, because they never knew what she was going to do or say next. Both the father and the mother then that

it

are saying,

"What is

out?" I'm about to not legal, reasons,

there in the ground rules to stop Sue from speaking let her,

I

use this material. I

and then

have to felt

tell

them

we were

wouldn't want publicized, and

I

names on

and says,

I

it.

I

that

I

me

that for ethical,

intended to record and

going to get into something they

wanted

take responsibility for not spreading their

occurs to

it

it

to

make

it

clear that I

around the community with

should have mentioned

it

earlier.

But the mother

are both reacting to the tone, the maliciousness, of the

"Should

I

bring up

would

my medical problems?"

way Sue

The Eternal Triangle

By

Int.:

saying

and taking the focus

Dr.

J.:

All

I

it,

though, she

is

making

183

herself the scapegoat

off the family.

can say

is

that

you don't know Sue. Her medical

problems could turn out to be quite provocative.

"How come my

say,

[

hymen's perforated?"

I

thought she might

— some "medical problem"

like that. It turned

out that she was talking about a bona fide hospital-

type question, but

couldn't

Int.

:

This

I

is

know

that beforehand.

the second time you've referred to the ground rules.

Here, by putting "meeting together as a family" in the rules, you take

something you're not sure the parents as

it

if

will agree to at all,

they had no option.

Dr.

J.:

Yes, I'm putting pressure on them, but

they indicated

knew that on a number

of occasions a fear of

know

at that point

how bad

very carefully.

didn't

I

I

they didn't want any Int.:

up

and present

more

had

I

to

proceed

the parents were upper-class people and

some kind

of leak.

a marriage they had. Naturally,

strain.

There's another thing about these rules.

at the start of the session

You

bring them

and then don't specify what you mean

except to say that you're going to record and that you want them to

come

in together.

way, or are you

Dr.

J.:

of therapy it

different,

how

it's

is

Are you using ground

just being

rules in

an idiosyncratic

ambiguous?

I'm being ambiguous. I'm warning them that different

this

kind

and I'm spelling out some of the things that make

microphones and so on.

different, the

all

very

way

If

they have

some questions about

they ask and what they ask will

tell

me

something. Int.:

Yes, but ordinarily,

you might expect him

if

someone

to say that the

lays

first

rule

down is

the ground rules,

that

everybody can

say whatever comes into his mind; the second, that certain things won't

be talked about; and so

forth. All

you say

is,

"I'm recording, and we're

going to meet again."

Dr.

J.:

With a healthier family,

family, or with one in which relatively short time, I I if

will

looks as

say with an "underachiever" if

a lot could happen in a

might structure certain things as specifically as

could, to try to save time. the parents will

it

let's

With a family

come back,

or

if

like this, since I don't

know

the girl won't go so crazy that she

have to be locked up and won't be able to come to the sessions,

I'm not sure that ambiguity

isn't

a

good

thing.

TECHNIQUES OF FAMILY THERAPY Int.: I take

you would prefer to be

that

it

[

184

unstructured

fairly

with this kind of a family.

Dr.

This family was extremely

I think so.

J.:

they only ap-

rigid;

pear unstructured.

Could you give an example of a family with

Int.:

would be Dr. trying to

specific

about the ground rules?

With couples with symmetrical match the other tit for tat, Fll say, J.

:

we won't

rules is that

week and

whom you

difficulties,

where each

"Now one

of the ground

refer to anything in the past. We'll

is

meet once a

we won't go any further back than that." I'll get that specific because they waste so much time saying, "Well, you ." With this family, I have a feeling remember in 1923 when you that if I said to the mother, "One of the ground rules is that the mother agree that

let's

.

will

have to say whatever comes to her mind," she would say to me,

"Are you implying It

.

am

that I

dishonest? I'm just trying to help Sue."

would be misinterpreted.

When

on these ground rules and asks whether or not the daughter's remark comes under them, you don't say yes or no, you just say, "I made my speech." Why don't you anInt.:

the father calls you

swer his question?

Dr. to

me

J.

Because

:

I don't think

it

really is a question. He's talking

but he's really asking whether he should answer his daughter's

statement. I'm telling him,

He

Int.:

misuses

Int.

of a conversation this

is

supposed to be.

he understands the framework completely and so I'm not going to give him any more help.

J.

it,

deal with your daughter."

a proper organization man, trying to find the frame-

is

work for what sort Dr.

"Go ahead,

:

I feel that

:

It

anything, so

sounds as

you

if

you are

deliberately trying not to structure

be free to block whatever the family

will

is

trying to

do.

Dr. they

Free, to me,

J.:

is

not to give them so

much

direction that

know how to use it against you. sue: Before

Like

first

difficult.

dr. J.:

we of

you a couple of questions? going to the bathroom is kind of

get launched, can I ask all

(lowering voice),

(Laughs.)

Hm?Oh!

sue: Going to the bathroom

.

.

.

The Eternal Triangle

[

185

dr. J.: Uh-huh.

...

sue:

Also

maybe it's tension but maybe it's something else too. don't know whether this has any connection, but I would

in that, I, I

like to try

it

without medication for a while.

dr. J.: Sure.

sue: Okay, will you

(overlapping)

dr. j.

this

is,

them

tell

Sure, uh-huh.

:

ah, usual, I

can then?

I

would

As

far as going to the

say, and,* ah

.

.

bathroom,

.

sue: Well, I'm either constipated or have diarrhea, or hard stools. (overlapping)

dr. J.

was sue: Good. cal

I

:

got a report from Dr. Smith that your physi-

just fine.

dr. j.: So, ah, nothing to worry about there.

Dr.

See, she said

J.:

saying, "I don't think that

it's

any missiles that get

Why

Int.:

"Before

it:

my

all

we

fault,"

get

launched" She also keeps

and so you pick up the idea

shot, she is going to shoot.

does she suddenly switch to

this

innocent medical

business?

Dr.

J.

I really don't

:

know, except that she may have been more

some

daring than she could tolerate. She could say things, but following

through was another story. She really never

tacked her parents in a straightforward, durable at a time.

of these devastating

way

for

at-

two minutes

She would say something, as when she accused her father of

walking about naked, and then in two minutes she would disqualify

sue: Well, an interne called Johnson did

it

it.

on me.

dr. j.: Yeah.

sue: Poked around quite a

bit.

(Laughing.) Who's Dr. Smith, by the

way? dr. j.: Dr. Smith

is

the,

is

the

woman, ah

.

.

.

sue: Oh! dr. j.:

.

.

.

in the

ward

.

.

.

sue: Oh, yes. dr. j.:

sue: dr.

mr.

.

.

.

in her forties

Um-hm. Light j.: Um-hm. s.

:

.

.

.

blond?

Do these drugs cause constipation?

sue: Well, I'm constipated anyway, I'd better

not have them



if

they do, then (laughing)

occasionally have trouble.

I,

maybe

ah,

it's,

I

TECHNIQUES OF FAMILY THERAPY think there's one thing that needs taking care of but

have the

.

:

I still

.

.

.

think

186

Mm-hm.

dr. J.:

sue

fissure

I

[

.

which

.

Ah,

dr. J.:

let's

get rid of please,

you do have a up with Dr. Brown, ah

think that, ah,

I

should take

it

one way or the other. fissure, ah, that

if

.

.

you

.

sue: Uh-huh. dr. J.:

.so

.

.

that he can give you, ah,

softens the stool and

makes

it,

makes

it

one of these things that

get well fast.

sue: Okay.

Ah,

dr. J.:

in other words,

illness, ah,

I

think

all

or physical complaints

sue (overlapping)

Well,

:

don't

I

.

problems relating to physical .

.

know simply who

to take

what

to.

him because he knows more about it than I do. I've been away from it too long. sue (overlapping) Well, yeah, I really, you know, I don't know exactly who to take what to. (Laughing.) It's just one of these

dr. J.: Yes, should go to

:

(inaudible phrase) Sure.

dr. J.:

sue

(sighs)

mr.

s.

is

.

Okay. Well,

:

let's

go.

That's a mechanical problem that

:

a positive answer to

it,

so I'm

.

.

many

people have and there

.

sue: Yes.

mr.

s.:

Dr.

.

.

.

You

J.:

the topic because

"This

no place

is

sure the medical doctor can clear that

notice that I'm I

to bring this up," because, after it

know much about

The other

there. I don't

can't without punishing her. I don't

so I'm trying to get out of "I don't

on a spot

up very

want

quickly.

to

want to

all, I let it

drop say,

happen,

with the least pain to everybody by saying, it,

thing that occurs to

up with your medical doctor." that about two years after this, the

so take

me

is

it

mother had a hemorrhoidectomy. She was a great hypochondriac, and her internist's chart was about four inches thick, without any major illness.

When

Sue takes

this

role,

it's

certainly in concert with her

mother.

sue: Okay,

that's all I

had

to say

on that

score.

Daddy, do you un-

der dr. J.

sue:

(interrupting)

Do

:

What about

you understand the

the communication?

eternal triangle in that, ah, what, ah,

how

The Eternal Triangle

187

[

know if Mother sees it the same way I do. MR. s.: Well, ah, I suspect I know what you're talking about. I was (Sue overlapping, inaudible section) don't know why it has to see

I

it

and

I,

I

don't

exist.

Dr. "I

This

J.:

know what

is

really

both data and problem. The father

you're talking about," and he sounds a

little bit

what happened almost every time Sue indicated

This

is

thing

was going on between them.

He

Int.:

pompousness

Dr.

J.

is

saying,

pleased.

that

some-

sounds both pompous and pleased. Or perhaps the

is

a protection against seeming too pleased.

Yes, some kind of mixture. But what do you do with

:

it?

Would you say to him, "Are you flirting with your daughter?" You could make a joke of it: "Ha, ha, ha, you're flirting with your daughter." Or you could say, "I'm sorry, old man, but you seem sort of pleased when your daughter makes up to you." This was one of the problems, how to get in the fact that she had a way of titillating him, without getting him on the defensive. It took quite a while before I could even get near

sue

this.

(to father):

Well, here's Mother, and here's me, and here's you,

and you come down the center and you get pulled apart decently sometimes (laughs) by

between the two of us

at

it.

some

I

pretty

think you probably feel torn

times,

and sometimes

(sighs) 1

think this has been something that's been present from just about all

Dr.

my life.

of

J.:

Just to remind you, this

is

a young

woman on

a mental

ward with seventeen other patients, who has had all these wild ideas and is still entertaining this rape thing. However, you'll notice that in certain contexts, and for short periods, she sounds not only normal but very precocious. Int.

:

If

you hadn't known

a breakdown, would you have been able to

Dr.

J.:

I

had been in a hospital for tell it from this interview?

that this girl

Of course, I had seen her in the hospital was already prejudiced. She was behaving

don't think so.

before the interview, so

I

pretty weirdly there, calling attention to herself

and

about these fantasies, hallucinations, she had. So

I

well she handles herself.

am

telling

everybody

surprised at

how

TECHNIQUES OF FAMILY THERAPY Int.

Did

:

Dr.

J.

make you hopeful about helping her?

this

most acute psychotics can be helped, and

I feel that

:

can't, the fault is usually

I

why

don't see

if

they

with the therapy. Chronic schizophrenics are

another matter. There you've got

But

188

[

all sorts

of other factors to deal with.

a breakdown in a college

of this age shouldn't

girl

have a good prognosis. mr.

s.

Is

:

sue: Oh,

MR.

s.

MRS.

think

I

Well,

:

I

it's

all

of us,

didn't feel bothered

by

I

think

it

has

to.

it.

Um-hm. Well {laughing), I'm glad you

{to father):

on a heck of a mrs.

bothering

me?

{overlapping): Well {inaudible phrase).

s.

dr. J.:

sue

bothering you or bothering

it

Well,

s.:

I

spot.

don't know, Daddy's

derstand each other and

sue: Oh,

know

I

don't, because you're

but

I

.

.

think I

my

husband and

think

I

we un-

.

come between you sometimes,

or he

comes between us to mediate, because I, I think, sometimes we have our run-ins and Daddy mediates pretty well, on one side or the other.

mrs.

{overlapping): Well,

s.

while

sue:

I

.

.

know

everybody

has

run-ins,

once

in

a

.

.

.

.

you have them with Dad too, occasionally sue: I know, but it seems that you and I {laughs) more often do than Dad and I. I'm sorry about it and I really want to change it, that's one reason why we're all here, it's 'cause I, I hate it, really I do.

mrs.

s.:

.

.

.

.

.

.

{Pause.)

Dr.

J.

:

Int.

:

She's reviewing the whole family problem.

had not been seeing enough of her to have primed her to say this. They had only had one, maybe two, get-acquainted visits, so this can't have been put in her mind by a therapist. Dr.

J.:

Sue's therapist

That's right.

Were you thinking that

Int.

:

Dr.

J.:

I

was probably

at the

thinking,

time?

"How much

handle?" and looking for a way to break in with

One

of the

analysis,

ways

which

is

in

which family therapy

how

I

was

is

of this can

humor or

different

all

something.

from individual

trained, is that in analysis

everything and you try to get the patient to say

we

you

listen to

more and more. But

in

The Eternal Triangle

family therapy that

You

much

don't want too

fact, it's often

not often the case; in

is

this privilege of saying,

or

will get in the

it

way.

"Yes, go on," while you

sit

not the case.

You

don't have

and take

do you want me to do something about you want Mother to do something about it? J. You can't do it, ah

mr.

Well,

s.:

dr.

ah,

I,

sue

(sighs)

:

It's

MRS.

s.

sue

It's

mr.

s.

it,

or

do

.

It's

not either or

You

:

can't

do

it

.

.

.

with one person.

not that simple. Well, do

us clear

sue: Well, dr. J.

:

(overlapping)

:

it all in.

not that simple.

dr. J. (overlapping)

:

.

.

:

189

[

I

it

you have some request

as to

how

you'd like to have

up?

think

.

(interrupting)

.

:

.

I don't

think that's a fair question.

sue: No. (Laughs.) dr. J.: Let

me

interrupt,

ah (to Mr. and Mrs.

S.), let's try to under-

some kind of an eloquent plea, here, and a very touching one, to be sure, and I want to know what each of you understand by it because I, I certainly don't know, I

stand. You're, you're getting

don't live in your family.

Dr.

J.:

That was a very good

aside,

if I

say so myself: "I don't

not a bad statement,

live in

your family."

after

has been said, you suddenly realize that the person

it

"Thank God."

It's

So, although

it

is

it's

not offensive, yet is

saying,

a request for information, there's a

piece of information being given as well. You'll notice too that there's

a

me

shift in

the

here.

Sue has convinced

me

that she's not going to ruin

game by taking over. She's very cautious.

Int.

:

Dr.

J.:

Cautious and well put, so

I

am

willing to relax

and

say,

now let's get at 'em." Int. You take the daughter's part very feelingly here. Dr. J.: Right. But I try and this may not be therapeutic technique, it may be just a personal bias to reward schizophrenics when they say something correctly. I make it a point to see that they get a

"O.K.,

:





boost.

Int.

:

Dr.

J.

To imply that they're not so crazy after :

all.

Yes. But there must also have been a feeling of relief in

TECHNIQUES OF FAMILY THERAPY me when

190

had her chance to burst her bomb and

realized that she

I

[

didn't.

When you

Int.:

say, "This

you're not just rewarding the

is

an eloquent and touching plea," being clear and perceptive and

girl for

well-mannered, you're also saying to the parents, "She's not as dangerous as you think."

Dr.

But

J.:

I

Up

really wasn't.

wasn't able to say that until

then

until

I

found out that she

wasn't sure what she might do. There

I

was an episode in the hospital, her first or second day there, when she walked up to one of the nurses and hit her because she thought the nurse was laughing at her. The element of craziness and violence was still

present.

What do you

dr. J.:

think of this idea that there

some block

is

in

communication? sue: There

MR.

can

Dr.

.

tell

:

You're speaking to

(Pause.)

you what the block

is.

Why did you

:

J.:

I

ask that question of the father?

always go to the father

first,

The myth is that the father is in charge knows less about what's going on and because he cultural

is

out of touch and often

more insecure about it dominated by the wife. Also, for feels

So

and, ah,

help them

make

I

know of any block in communication. Ah, many years, felt that, ah, Sue was a pretty good

don't

I

was very

her and ah

liberal with

.

.

.

Mmm. Yeah. s.:

.

.

.

her mother, to offset

extremely

strict

sue: Oh, Daddy,

MR.

:

have always, for

girl

I try to

to say worthwhile.

(laughing)

s.

I

MR.

situation.

reasons or perhaps because of the nature of therapy, the

what they have

sue:

any

in almost

of the family, but he usually

fathers are the hardest to keep involved.

MR.

me now?

No, you give your dad a chance now. (Laughs.)

dr. J.:

Int.

.

Mm-hm.

I

:

.

(simultaneously)

s.

dr. J.:

sue

is

s.

:

...

with her

now .

.

.

.

.

.

.

liberalness, ah,

.

wait a minute

and, ah, then

sue: Wait a minute

.

my .

.

.

would, ah, be

The Eternal Triangle

MR.

s.

sue:

.

.

:

there were

.

some times you

needed discipline

I

.

.

.

.

[191

.

.

You do

dr. J. (simultaneously, to Sue):

your chance (laughs) to

get

what we're looking

rebuttal, but, ah, we're getting

for.

mr. s. Two at once here. sue (overlapping) Go on. :

:

Int.

Dr.

What were you looking for?

:

J.

Evidence from the parents about the

:

You

that the daughter has started to hint about.

that kind of thing

with

and Sue can get

it,

between them

conflict

notice that I can say

but the parents don't do anything

it.

You

Int.:

ask them about a block in communication and you

way

get this evidence about the triangle. Is this a

to ask for

one thing

and get another?

Dr.

Oh, you always assume that what they

J.:

you

tell

will only

be tangentially related to the block and for a very good reason, because

who knows what the block is. Int. Then why do you use this

"block in communication"?

:

Dr.

It's just

J.:

a good ploy.

better than saying,

It's

problems," because then somebody might say, "Well, do." But

pretty hard for

it's

communication. mr.

to

I,

what

I

thought was an unnecessary degree. I realize

was

to, ah,

dr. J.: s.:

some block

is

but

Mm-hm. ... ah,

it

used

especially

a

more

little

bother

inasmuch

I

probably she

that, ah,

me considerably

think as the

.

.

.

the two girls will start

as, ah,

recriminations, neither side will accept, and shut up, after the disciplinary

ment sue:

mr.

.

.

in

ah, sometimes resented Mrs. Starbuck's discipline,

years have gone on right,

deny that there

don't think I

I

an irrefutable statement.

Ah, so

s.:

ah, to

mr.

It's

them

"You have

comments and,

ah, therefore

it

first

gets to be an argu-

.

And there you land in the middle. s.

:

.

.

.

and

that's

when

I

try to interfere, ah, and, ah, of course

that creates probably this triangle

sue: Well now, as far as

this is

which you refer

concerned

.

to.

.

.

dr. j.: Wait a minute, now, wait a minute! (Sue laughs.

Ah, you were brought mrs. s.: Well .

.

.

into this

by

.

.

.

To Mrs.

S.)

TECHNIQUES OF FAMILY THERAPY dr. J.

... by

:

Ah, do you

indirection.

feel

you need some help

making, ah, your wishes known to Sue in such a way that

more

is

odd;

Dr.

J.

it

puts

them

were three other children, between him and

all

was

it

along.

girls start

recrimina-

I've said, although there

Sue to get into bed

characteristic for

girl

was someone he could

lot.

Why

Int.

:

Dr.

J.

did

you stop Sue

Well, the father

:

sound a

little

much

too

more

of being the

is

there

not

is

all

one-sided, but he has

like the lily.

He

is

do

don't think that he can

I

made him-

taking the nicer position

don't want Sue to

I

it.

and turn to the wife?

leaning over backward to acknowledge

is

and

liberal,

not have the wife react to

he

be

on mornings when he wasn't working, and

his wife

that this matter of discipline self

two

As

they would read the funnies together. This

use a

it'll

same generation.

in the

That's what he did

:

in, in

expeditious?

Int.: This phrase of the father's, "the tions,"

192

[

come

saying something primarily about his wife and

I

this

and

in here because

think

it's

only fair

to indicate to her that she has a right to speak too.

Int.: It sounds as

one

hadn't brought her into J.

you are going around the

Would you have gone

in turn.

Dr.

if

I lost

where

I

had

raised

was. Ideally,

I

When you

turn to the wife, your whole tone changes to a

seductive one.

Dr.

Well, she

J.:

took a swipe

Do

Int.: that she will

Dr. problem

I get this all

What

I said,

"Your husband

just

do anything about it?" she the time." I'm trying to draw her out.

you going

to

I

am

doing there

is

to ask whether the

between her and the daughter or between her and the hus-

arm

I

put

of the

it

makes

Y

between herself and Sue. that they

if

you use the phrase, "Do you need some help?" hoping

Right.

band. The way first

a martyr and

deny that she needs help?

J.: is

is

at you, aren't

might say, "Oh,

that

the husband

to the wife, but especially after this kind of speech.

Int.:

more

if

to the wife next, unless they

something so interesting or heated that

would go

even

to the wife next,

each

it?

would have gone

I

:

table, taking

it

to go I

a

little

preposterous that she will pick

down, the one making

don't think that most

need help in making

their wishes

known

it

a problem

women would

feel

to their daughters.

The I'm hoping that

say the problem

she'll

Eternal Triangle

[

193

the husband's interference,

is

which, as you'll see, she does.

mrs.

s.

Well,

:

my

When

should have had. often crossed

been that

feeling has

.

.

came

it

I didn't get

to matters of discipline,

.

sue (overlapping): I'm with you there^ on mrs.

s.:

.

.

and the

.

up I I was

the backing

discipline

.

was necessary, but

discipline

.

.

—and

unfortu-

nately she's the only one of the four that that's applied to.

Int.: This

a very mixed remark. The mother picks on the

by the time

father, but

to pick

is

she's finished the sentence, she's turned

on Sue.

Dr.

As

J.:

know

I got to

the mother later,

sciously apprehensive that her social

plode.

And

so here, where she

is

life,

of living might ex-

being careful with the father,

Int.: That's a very skillful, vague

them both

she was con-

I felt

way

her

was an element of not wanting to cause

there

around

I

think

trouble.

comment

she makes. She gets

one sentence without being too hard on either one of

in

them.

Dr.

Her tone

J.:

complaining, exactly;

implies:

"Both of you are so

difficult." It isn't

a patient, put-upon tone.

it's

sue: Well, you know, Mother, I'm really with you and

something that you've had to do pretty

this is

and

I've been, I've

to learn a lot of

cry).

It's

it

needed

on

it,

I've

my own

been rugged,

it's

needed

been

and

hell,

mrs.

mr.

s.

would agree

I

:

that

:

I

sue (simultaneously)

:

It's

mr.

.

s.:

Uhh

sue:

.

.

mrs.

s.

:

MR. mrs.

s.: s.:

.

hard to say but

(starting to

think partly that's bethat

you needed.

.

.

.

it's

.

.

.

.

the truth, and I think

.

.

.

.

it's

.

(overlapping): .

weeks

think that's pretty hard to say

no condemnation of anybody The thing that was hard for me

.

.

.

would agree to that

(overlapping)

it's

I

so badly, and I've had

Daddy

was probably

(simultaneously): Well,

s. s.

it

I

feel that

much on your own

in the last three

cause you didn't get the support from

MR.

it

I

.

.

and

I

.

in this

room.

.

(Inaudible phrase) lack of experience

always knew

why Daddy

was because he loved you so much.

.

.

.

did the things he did,

it

TECHNIQUES OF FAMILY THERAPY Int.:

When

discipline,

Daddy

[

the daughter says to the mother, "I'm with you didn't support

you enough," she seems

194

on

to be taking

her mother's part.

Dr.

She could also mean, "This

J.:

one of the few things we

is

are in agreement about."

Int.

She uses

:

a curious way. She accuses

this discipline issue in

her parents of being hard on her by being too easy on her.

Dr.

Well, you can take

J.:

somebody

own

for their

both ways.

it

good, and

it's

bad

if

bad

It's

if

you don't

you

discipline

discipline

them

because you love them so much. She's got a beautiful area to be ambiguous

in.

Int.: She's also pretty ambiguous

me

haven't helped

Dr.

to discipline myself. I've

experience has taught her

it

At

:

she

tells

had to learn

them,

"You

my

own."

on

it

"Especially since I've been crazy." She says the hospital

J.:

Int.

when

same

the

when

easy on father

this,

very explicitly.

time, both

mother and daughter are busy taking

they're really ticking

loved you so much," and

"It's

him

off: "It

was because he

no condemnation of anyone

in this

room."

Dr. it

this

They've got another area of agreement. They don't see

J.:

way, but

you look

if

closely at this matter of discipline,

you see

that each pair has an area of agreement against each third person simul-

Dad

taneously. There's

control her,

protecting Sue against Mother's attempts to

Mother and Sue disapproving

Dad

of

for doing

it,

and both

parents controlling Sue so ineffectively that she had to go to a hospital.

sue (sighing)

know and

I

:

just think that

mr.

I agree. I

s.:

erything,

mr. sue

mr.

:

more

exists?

You mean my, I

.

.

:

.

I

.

.

I

think

it,

Daddy,

make

Daddy, but

I

you

governs ev-

current or recent evidence that the situation

me?

Mr.

S.):

Oh,

I

think

lack of support from .

it

or break, really.

.

mean if

life,

a lack of discipline in

(interrupting, to

s.:

dr. j.

No,

for

recently.

your whole

still

dr. J.

mr.

it, it's

Have you seen

:

condemn you

Discipline's so important,

:

s.:

s.

don't

you were a little bit blinded by it. said I was learning (Sue sighs) slowly but had pro-

gressed quite a bit

sue (overlapping)

I

.

.

.

me?

.

.

The Eternal Triangle

[

195

sue: No.

...

dr. j.:

pursue that

sue: Yeah

.

dr. J.:

.

sue:

Int.

.

.

.

.

It's

:

a trap you don't need to

way

answer

said

I

asking a genuine question.

it

I

improved?' "

can prove If I

.

.

.

.

.

no, anyway.

man

is

in a different direction, to

that I don't think the father

by the

What he I

is

am

fact that I

took the opposite tack,

an honest question." But

.

is

don't think he expects or desires the an-

I

it

and

fall into."

swer that the question seems to ask. proved, and

into

fall

is

of turning a

you don't need to

The reason

J.:

my

don't,

I, I

a nice

say, "That's a trap

Dr.

be getting yourself into

.

.

and

.

line, you'll

saying

is,

"I have im-

willing to ask,

would

say, "I

'Have

I

hope you put

think that would be a very untherapeutic

I

thing to say.

Why did you stop the argument at that particular point?

Int.

:

Dr.

J.:

I'm not sure, but in hearing

cause Sue was getting a she says

it

little

was her "whole

carried

would not hear of sue: Well, oh I

.

dr. j.:

.

.

.

.

now,

away about

I

suspect

it

was be-

when

the discipline,

life."

... we can assume

dr. j.:

it

it

that, that

people do the best they can.

otherwise, because (sighs) people

.

.

I,

.

.

try to

do the best they can so that they won't, ah, be

in

pain in any way.

Int.:

When you

say,

"I wouldn't have

taking an extremely arbitrary position.

You

it

otherwise," you're

certainly could

have

it

otherwise.

Dr.

J.:

Well, I don't have

much

tolerance for this business where

"We are all going to do "Why do we have to?" and

a therapist says,

such and such," and then

somebody says, he says, "Well, it has been shown that the best thing that can happen is for you to do this," and so on. I would much rather have it be idiosyncratic and imply that maybe I am peculiar. That way I take responsibility and say, "Be my guest."

Int.

Dr. ground

:

J.

Without giving your reasons. :

rules.

Right. So

I

can't be

The ground

rules

hung on them. But

this gets

back to the

have never been spelled out, so the

TECHNIQUES OF FAMILY THERAPY ground rules are whatever the ground for example: "I won't tolerate

you can

trying as hard as

any

come

rules

[

196

to consist of. Here,

belief other than that all of

try." I honestly believe this,

but

it is

you

are

a tactic

too.

Int.

same

a

It's

:

way

When you

time.

them

of exonerating people and implicating

at the

say that people do the best they can because

they want to avoid pain, you bring up the question of whether what's best for

them

Dr.

J.:

is

best for anyone else.

Well, they do what they do for selfish reasons. But I'm

trying to bypass the issue of blame. If there's anything that wastes time, I

think

it is

Int.

Dr.

recrimination, It's

:

efficiency

what we almost get

how

move.

little

odd, because you do have time

J.

:

I'm not thinking in terms of

how much

to use that time. It's like the crisis in

A person may be months the crisis, he'll if

if

you want

make

it.

or the other.

It's

if

he passes

not that you don't want to waste time, right,

it

it's

can be dangerous and harmful.

In other words, you want to control the timing.

:

Dr.

J.

sue:

I

Timing. That's the word.

:

won't condemn anyone,

think

mrs.

way

recovering from pneumonia, but

you don't use your time

Int.

time but in terms

pneumonia. You're build-

ing toward a certain peak where things can go one

that

into.

it.

Dr. of

this is

Yes.

J.:

Int.: That's a to take

an

partly

and

normal for him

it's

(overlapping)

s.

you, Sue, but of a sudden

:

when

.

.

I

won't

condemn anyone,

I don't, I

to be that way.

I've always felt that

the time

it

was

especially hard for

came when Dad did back me up

all

.

sue (laughing) Oh, yeah. mrs. s.: because it was you. (Laughs.) :

.

.

.

sue: Well, because

it

was

inconsistency,

it

was,

it

was very much

in-

consistency.

mr.

s.

A change of pace, with me.

:

sue (overlapping) And, ent with me and that, :

well,

those, that's

made my life a little hard. mrs. s. What do you mean by :

sue:

In,

you both have been kind of

inconsist-

one of the inconsistencies

being inconsistent towards you?

sometimes in your behavior toward me. (Pause.)

that's

The Eternal Triangle

mr.

s.

Sometimes

:

I

back you up, sometimes

[

19 7

I don't.

sue: Yeah.

mrs.

s.

Is that

:

what you mean?

sue: Yeah.

mrs.

What about me? Where have

s.:

been inconsistent? (Starting

I

to cry.)

sue

(to mother)

mrs.

But

s.:

Not

I really

When

Int.:

:

the

much

as

want

you, really.

know. (Weeping.)

to

daughter says

whether she means the mother's or the

Dr.

J.

inconsistency,

it's

unclear

it's

father's.

But she gets them again. She's already scored against her

:

Then

parents for not disciplining her properly.

if

they change sides

about discipline, or change their minds, she gets them on that too, because they are being inconsistent. Int.:

would think

She's an extremely clever

lose in debates with her.

is

girl.

You

The mother

can see

more

is

how

her mother

limited,

which

I

unusual in the mother of a schizophrenic.

Dr.

J.

Except that

:

this

mother was

not.

One

day, quite a while

afterward, the mother and Sue had an argument and the mother said,

"Now you go and Sue

said,

meanwhile holding on to Sue's

to your room,"

"But

I can't,

wrists,

made her

you're holding me." This episode

mother's contradictory tactics, the double-bind aspects, very obvious to her.

Her

therapist felt she

began to be

after that. There's a lot to this

woman

less vulnerable to

that

we

her mother

miss in the tape; her

martyred looks, her sighing, her whole mien. Int.

Dr.

:

She's perpetually hurt?

Yes. Here, for instance, she's weeping and asking sup-

J.:

posedly helpful questions,

when what she

consistent,"

you, just kick Int.

:

like, "I

me

I just

in the side

really

now

want to know where

means

is,

that I'm lying

"Tell

been

I've

me how

in-

I've hurt

on the ground."

think that in that interchange the daughter

is

a pretty

fair competitor.

Dr. a

J.:

It's

partly because you're thinking of

woman who managed

it

verbally. This

number of surgeons to operate on her would not operate for. She got them to

to get a

for conditions they ordinarily

do an exploratory laparotomy and a laminectomy for pain, and neither case did they find any pathology. Int.

:

It's

is

an interesting definition of a controlling woman.

in

TECHNIQUES OF FAMILY THERAPY Dr.

For

her.

storm

J.

It

:

was only

in direct debate that the daughter could outwit

would "lose" an argument with Sue, Sue would

instance, she

won't do

off saying, "I

198

[

and then the mother would have

it,"

three other children to relate this to and say, "Don't turn out like Sue,

know you never

oh, I this

was completely

Then

Int.:

would make the father angry, he knew

will." It

he wouldn't do anything about

it.

part of his behavior with Sue was protective,

it

unfair, although

wasn't altogether seductiveness.

Dr.

Yes.

J.:

evident that he was trying to compensate.

It's fairly

There was a grandmother

in the picture too,

During the period when Sue was

up and berated her

called her

the mother's mother.

quite crazy, the grandmother

still

She

severely.

"You're no good,

said,

made a suicide attempt, an emergency. The grandmother lived

you're killing your mother." After that, Sue

or threatened to;

was quite

it

nearby, so she was in the picture too.

still

Do you ever bring in the third generation?

Int.

:

Dr.

J.:

I

don't think

have, but I

I didn't

here. If

would have brought

I

in the

had

to

it

do over again,

grandmother. There were

a lot of relatives in the area; she was reputedly quite a matriarch. don't

know whether I could have done any good

sue

cussed this before and

should go into

it

is,

I, it's

an open wound and

or not, because

dr. J. {interrupting)

want

I

:

.

.

sue:

Int.:

Was

:

.

.

.

I

.

.

.

.

.

and your mother

take

much it

.

.

first,

is,

ah,

and, ah,

and it's

.

.

well not

as

I

to raise something else

ah, you've been in tears,

sue: I'm not

we have disdon't know if I

is,

.

obvious that you're both upset, although

dr. j.

with her or not.

one area, Mother, where you have, and that

that

I

mother): Well, you haven't as much. There, there

{tearfully, to is

I

.

.

as she

.

is,

that's

one thing.

both the mother and the daughter are weeping.

them at this point? Have you anything against letting people weep and show emotion? Dr. J.: No, but I usually will comment on it if nobody else does. The mother is crying all through this, but she doesn't say, "You upset there any particular reason for interrupting

me," or give any idea why, and nobody they're all affected

by

it.

else says anything,

and yet

The Int.:

who

of those

interesting that

It's

Eternal Triangle

you bring up the weeping not

are weeping, but in terms of the audience for

you wouldn't say

"Can we

to them,

get

it.

[

in I

199

terms gather

an understanding of why

you're weeping?" or something like that.

Dr.

ask that kind of question,

If I

J.:

I

Mr. S.): Yeah, doing to you? (Pause.)

dr. J.

him

don't really expect

(to

yes,

usually because I'm at a

somebody,

loss for anything better. If I say to

such and such?"

it's

and

to

"Why

are you doing

have any idea

at all.

wonder, you know, what's

I

this

sue: Hurt. (Sighs.)

mr.

(Pause.) Well,

s.:

to

sue:

(laughs),

over the years, um, ah, the

it

guess I've gotten kind of

I .

.

immune

.

(Laughing, inaudible words.)

MR.

s.

:

.

mr.

s.:

sue:

.

.

the tears are rather easy, in this family

.

.

can do

it

.

Hm.

dr. J.:

.

.

.

come by

to

.

.

.

(Laughs.)

mr.

sue MR.

I

s.

...

:

and, um, while

I

.

.

.

(Loud giggle.

:

s.:

.

.

.

I'm disturbed. (Breaks out in laughter.)

mrs.

s.:

sue:

(Laughs.)

mr.

(Laughs.)

You

too?

(Laughs. All three continue laughing.)

s.:

I

too.

Mmm.

dr. J.:

Your question must have hit the father hard, from the amount of time it took him to answer. He's starting to cry too, isn't he? Dr. J.: Yes. As he says, "I can do it too." It's funny, it's hard now to think of him as having wept. Int.: I suspect you touched it off by your inquiry. The father is Int.:

so accustomed to their being upset and to his being the one

them

it

Dr.

J.:

When one

Yes.

other would too, and

mr.

him back

s.

:

upsets

threw him when you made that switch.

that

bringing

who

Ah

it

.

in.

sue: I've seen

.

.

it

.

.

.

of the

women would

start to

weep, the

really left the father out in the cold.

I'm

TECHNIQUES OF FAMILY THERAPY MR.

(laughing)

s.

So

:

me

don't bother

become immune

I've practically

at all.

I, I

am

certainly

to tears, they

(sighs) sorry to see, ah,

Mrs. Starbuck hurt by, ah, things that Sue was saying sue: Oh,

mr.

s.

sue:

mean

don't

I

... and ah

:

.

.

.

.

.

.

.

.

.

.

not the point.

that's

.

.

to hurt her

[200

wonder that she was crying necessarily because she was hurt. Has that been established? mrs. s. Me, you mean? dr. j.: Yeah. I, this would be an easy assumption but I don't know

dr. J. (interrupting)

I

:

:

that

mrs.

s.

sue:

Is

it's

Was

so.

only reason?

A good deal of the time

:

has been.

it

now?

it

(overlapping)

dr. J.

this the

Well,

:

I

mean

right

now. Were you crying now

because you were hurt, do you think?

mrs.

I

s.:

know what you mean.

don't

(Pause.) Because

I

was (word

lost in crying)

dr. J.: Yeah, because you, I

you responded

think a rather touching closeness,

your daughter with

to, ah,

don't think

I

it

was

just a

hurt.

This

Int.:

is

one of those instances

which

in

it

would be very

easy just to go along with the premise they're establishing, which

Dr. that has

J.:

make you feel No,

I

do

been labeled

whatever you want to

it

wasn't so?

this often.

in a negative call this

This

It really gets their attention.

Dr.

J.

:

That's not surprising.

define

always

it

another way,

for

it

labeling

it

in a positive

way,

technique.

:

way

simply taking the motivation

is

way and

Int.

are doing in one

that

Did the mother do

the daughter hurt her mother and they're weeping.

something to

is

If

they have been defining what they

many, many

shocks them a

years,

little

and

if I

can suddenly

out of believing that they're

right.

Why do you pick "hurt" as the word you relabel?

Int.

:

Dr.

J.:

sents to

me

It

may have

to

do with the enigma

as well as to the other two. I

am

that the

mother pre-

saying, "Let's not be so

quick about applying the usual labels to Mother, she's a

little bit

more

enigmatic than that." Int.:

You made

daughter's aggressive

the

same kind of

manner

shift

as "touching."

when you

interpreted the

There you were saying

The Eternal Triangle

201

[

was not as threatening as she seemed, and here you're the mother is not as vulnerable as she seems.

that the daughter

saying that

Dr.

J.

Yes.

:

But why did you choose this method? You could conceivably have gone along with the mother by saying, "Well, about your being hurt, in what instances?" or "How did it happen?" or whatever. Int.:

Dr.

could have, except

I

J.:

Another

relabeling as the only hope.

ad absurdum, where

completely crushed by didn't say

it

the mother J.

is

possibility

would be the reductio

scientific fact that

anyone

her, talk about the

would have been say, "You know, I

else

so that she finally has to

it,

trying to shift the emphasis

from the idea that

a victim to a realization of closeness? I don't care

:

totally pointless. I see

that bad."

Are you

Int.:

Dr.

was

would be

would commiserate with

I

and the

cross she bears

it

A does X to get B

about closeness,

really. All I

am

saying

is

that

A-X, B-Y, then once the pattern has been established, A doesn't know whether it is A-X, B-Y, or whether it's really punctuated B-Y, A-X. Like the joke about the mouse in the experiment who says, "I get that guy to feed me every time I push the lever." I am only interested in breaking if

up do

the it is

way they tend to put

it

:

Dr.

J.:

You

establishes a pattern of

to label a particular pattern.

wise they'll never see

because

it,

will

A

are confounded.

it

out,

will

But

I

you

disturb

it first.

always say, "Well,

always say, "No,

upset the system by saying, "Well,

them

a nice

way

to

also trying to point out the system that's operating?

don't really point

A-X, B-Y," and B

Now

"good" framework, a warm, happy framework.

into a

Are you

Int.

do Y, and

to

think

it's

it's

I

Other-

think

it's

B-Y, A-X." You can C-Q," so that both of

think that you should stress positive moti-

I

vations where you can, because they are the most acceptable. If I say to you, "I think

don't think

I'll

understand,"

are too stupid to Int.:

being hurt.

you are not

You You

tell it

to

me

telling it's

me

the whole answer because you

a lot better than saying, "I think you

straight."

give the mother an alternative which

is

better than

are forcing her out of her position of being the martyr,

but in a face-saving way.

Dr.

J.:

Yes. Within the framework of saying,

you have been looking

at

the idea that Alaska

a terrible place because

is

it is

wrong." Supposing

"Maybe

I say,

it is

the

way

"You've got

always cold," and

TECHNIQUES OF FAMILY THERAPY

[202

Then if they say, "No, I a new way of looking at

so on, "but you've never tasted whale meat." haven't tasted whale meat," this reinforces everything, because

wrong on one

they are

if

they might also

detail,

have misjudged Alaska. This has repercussions on everyone else too. The daughter

Int.: is

going to be a

sure that she

little less

is

mother weeps, because you have questioned that

same thing when

on

of the weeping it

in this

way

Dr. the

the

women were

when

hurting the mother labeling.

You

the

did the

weeping, by talking about the impact

women had

the father. I'm sure the

never thought of

before.

Yes.

J.:

The sequence

way

of funny lines and the delighted

two women laugh together indicate that they must have been struck

by a new point of view. But

sue: Well,

mrs.

I

Oh

s.:

supported her and

mrs.

s.

I

I

:

I

think this

no, that doesn't upset me.

never understood sue: Yes,

that time I don't think I did

don't think

sue (overlapping)

:

it,

it's

Oh,

better than

you

You

something you've

see,

Dad and me.

think.

possible at your age to understand

eh,

now

my

what's

age?

dr. J.

more

insight than

.

.

I

.

lot

have a great

age.

But you haven't been married for a long time.

:

sue:

(Laughs.)

mrs.

s.

That's just a basic fact.

:

dr. J.

(overlapping)

MR.

(overlapping)

s.

my

most people

it

have an awful

I

of insight and I've been told by other people that deal

deliberately.

upsetting her.

the relationship between

is

understand

is

it

This, this

:

:

But

sue (overlapping) But than you think I do. :

dr. J.:

I

would buy

I

makes a

difficulty

never understand

I've seen, I've seen

that,

but

I

think you

.

.

.

.

.

.

you two more

still

objectively

have something to learn

here.

sue: Oh, sure.

Int. time,

you Dr.

:

Why

do you say

to Sue,

"You

haven't been married a long

still

have something to learn?"

J.:

Because the mother has said something that

true in the

way

it's

said as in

its

opposite.

"You

is

just as

don't understand about

your father and me," can mean, "You don't understand the love we have, but you also don't understand the hate

we

have."

And

I

think

The Eternal Triangle

was

this

203

Sue hadn't been married a long time, so she couldn't have

true.

quite an accurate picture. This Int.:

[

It's

way

a nice

is

quite pretentious of Sue.

to tell her to

keep out of

Your remark

it.

doesn't point to something she can interpret as a defect in herself,

it's

just her age.

Dr. like,

If

J.:

she stays in

"Oh, your father and

I'm trying to

tell

I

the mother

it,

able to say this kind of thing,

formation there." This

going to say something

got along beautifully until you

"Look, don't destroy

her,

is

this.

back and

sit

When

came

along."

your mother

because there

listen

is

in-

is

an accurate thing the mother says: "You

is

have never understood about your father and me." Sue thought they

were much closer than they were. Well, she did and she

much

she thought they were Int.:

closer.

would be possible

It

didn't. Overtly,

what you are doing as

to interpret

mother or helping the mother draw a generation

either supporting the line.

Dr.

I'm doing that too. But Sue can find out something

J.:

only stop and

she'll

your mother has

just said

for

it,

up

the mother, so I don't

and shake

reasons for doing

sue:

I

s.:

to look at

Sue

s. .

set of

I

I

to quiet

have for each other and

someone

graciously.

it's

only

.

.

.

think you two are the happiest married people

and

I

think

you have a

.

.

I

think

.

(low voice): Thank you. .

deep, deep and unusual love that not very

.

and

I, I

wouldn't ruin

hurt either of you and saying anything

I

sue: All

it

for the world and

don't

I

mean

I

many

people

wouldn't want to

to hurt either of

you by

say in here.

(starting to cry again)

s.

dr. j.:

ways

think you've always underestimated the, the feeling that

No. No.

find,

mrs.

do except

it.

I've ever seen

MR.

else to

everyone. But I would never have guessed your

fit

Daddy and :

my word

something important," without shutting

know what

There must be a

This one wouldn't

sue

look, take

my head.

Int.:

mrs.

"Now

say to her,

listen. I can't

if

:

We

don't take

it

that way, darling.

right.

But you

this is

see,

we're off on this hurt kick now, and

what, what was important.

I

I

don't think

think your mother was re-

sponding to you out of passion, not out

of, ah,

being hurt

.

.

.

TECHNIQUES OF FAMILY THERAPY mr.

Compassion?

(interrupting):

s.

dr. J.:

Hm?

mr.

Compassion?

s.:

dr. j.: Yeah, and because there

something touching about what

is

you've been through recently as only you, as you

wonder

well, but I

mrs.

s.:

[204

ah

if ,

.

.

know

only too

.

think you've put your finger right on a very important

I

thing, Dr. Jackson, because that

is

my

(wavering voice) exactly

feeling.

"Passion" was a peculiar word to choose, somehow.

Int.:

Dr.

J.:

It

was

"compassion," but Int.

moment.

entirely spur of the

I didn't think of

it,

I

might have said

the father did.

:

This wasn't an attempt to try to get several things into one

J.

:

word? Dr.

No, no. I'm sure

wasn't. I

it

the positive aspects and "compassion"

was

up

just trying to build

would have been much the

better word.

"Passion"

Int.:

is

interesting because

it's

not just positive.

some kind of intensity. probably what the father was

It

implies something more,

Dr.

This

J.:

trying to help

is

me by

correcting.

saying, "You're talking about the positive ele-

mean compassion." They had

ments, so you must

He was

plenty of passion

They fought each other, they hit each other. Int. Then you were coming too close to the truth. Dr. J.: Yes. The father's very helpful, as you notice,

together.

:

in several

places.

sue: Well, that dis-discipline issue

through

in a big

(starting to cry):

to learn to sleep,

mrs.

way

.

why (wavering

voice) I went

.

.

Mm-hm.

dr. J.:

sue

it

is

s.

:

had to learn it the hard way. when people around me were screaming .

.

.

and

I

.

I .

had .

We all do that, too.

sue (crying)

Not

:

this

way,

Mom,

not screaming like that. (Pause,

Sue sobbing.

mr. s. mrs. s.

Why were people screaming,

:

:

No,

I

means her hospital brush.

think she

dr. J. (simultaneously) tal hospital,

even in the dormitory?

:

She's talking about the experience of a

which can be

.

.

.

men-

The

MR. sue

Eternal Triangle

[

205

Oh.

s.:

sobbing)

(still

with everything locked, and no one trusting

.

.

.

:

you, and people really crazy around you, really bad cases, per-

manent mrs.

s.

cases.

That's a terrible experience for anybody to go through.

:

know, you've no idea (sobs), when the only thing that was wrong with me was emo-

sue (sobbing): tional

.

was

It

and

tion over that

.

.

.

me

to release a lot of

emo-

some emotion,

to release

ah,

and

that

you

never forget

this

.

.

.

starts crying,

.

.

You, you have some chance

dr. J.:

.

(Inaudible phrase) told

:

wagon then you

All of a sudden, you get on the band

:

Now I, I think, this is one of the

sue (interrupting)

I

just don't

your mother out. Your mother

bail

start.

you

.

.

(to Sue, loudly)

dr. J.

hell,

sue: No,

haven't

I

.

.

.

you have,

dr. J.: I think

don't have a lot

in

still

experience, but I think

when we

when

were,

with your problem

I

.

.

you should,

I think

I,

you about

it's

don't

I

this, you'll

mean

important for you to realize that just

was talking

to

your mother, you stepped in

.

sue: All right.

... and

dr. J.:

this

is,

this

may

we're talking about, ah, that

be part of the eternal triangle that

it's

got three sides and

.

.

how is it part of that? dr. J.: each person in his own way keeps boosting it sue: How is part of, how is this part of that? You mean sue (overlapping) .

.

when dr. J.

I

think

moment

at that

understood your mother a

I

is

when you

started

horrors of the mental hospital.

but

mrs. Int.

s.:

:

.

.

along. I interfere

.

.

Well,

:

Well,

:

.

.

.

on

I

little

better

the, the business

and

just

about the

agree with you with them

.

We all do.

Your

voice

(Laughs.)

is

very sharp

when you

interrupt Sue. I get the

impression that you've got your finger on something, that you've pinned

down some Dr.

invisible adversary.

J.:

I

think that's true.

that I've experienced in

Int.

:

many

What gave you

geration in Sue's voice?

I

consider this a typical rescue, one

other sessions.

the clue to this?

Was

it

the hysterical exag-

TECHNIQUES OF FAMILY THERAPY Dr.

J.

Yes. I'm not saying that she didn't have a tough time in

:

the hospital, although

think she

was not

it

quite a state hospital she

trying to use tonality to involve you.

is

:

daughter interrupts in

mother

J.

this

way, you are also isolating a

That's right.

:

lets it

happen.

don't say

I

If I

was

The way

"You have no idea," it doesn't ring quite right. Int. By pointing out that whenever the mother Dr.

[206

but

I

she says,

starts crying, the

rule.

but the implication

it,

in,

is

that the

rescue you, you are letting yourself be res-

cued.

This brings up an interesting comparison with individual

Int.:

therapy. In individual therapy, you

would naturally focus on the one

person. In family therapy, you would have to take into account the effect

you

of whatever

said

ual therapy, your

on the

first

thought might be

by directing a remark to one. Dr. J. Even in family therapy

I

:

than one person at a time.

with

me

don't say this to the two of

I

some

how

to reach the other people

don't think you can focus on

the

You

more

two of you deserve each other."

them

together;

it is

particularly horrendous accusation that

the other.

individ-

have a stock phrase which usually gets a

I

couple laughing: "It seems to

But

you had never done any

others. If

might say jointly to a couple

who

said in connection

one has made about are trying to destroy

each other in some symmetrical way, "You're really ruining each other,"

and

it

may be

a correct thing to say, but

it

does very

little

good

because the wife will reply, "No, he's ruining me," and the husband will say "No, she's ruining me." Int.: Well, a therapist might say to a husband

being particularly

difficult,

"Your wife

a very difficult

is

way of saying to him, "I understand having with this woman," but it's also for her. sist." It's

Dr.

a

J.:

Yes. She

is

overhearing

when

woman

is

dr. J.

:

But

I

you can

collectively.

I, I

think also that we've got to understand that there are

an interplay of forces here, that sue:

to re-

what brings a

different element into family therapy, rather than the idea that

aim your remarks

is

you are

the trouble

think this

I

it.

the wife

don't see

how

.

.

.

the forces work, here.

dr. J.: That's right, and see shifts like this,

I

it,

you were doing, but

I

don't see too clearly either, except it

alerts



think

me

to them. I can't tell

(Sue interrupts.)

when

I

you what

The

What do you mean when you

Int.:

this, it alerts

J.

a certain

was

"When

[

207

see shifts like

I

me to the forces that are at work"?

was working on the mother and she was responding with amount of feeling, and at this point Sue cut in. Now there was

Dr.

no need

say,

Eternal Triangle

:

I

to protect the mother,

why

in charge, so

Int.

Dr.

It

:

J.

Int.:

nobody was being unpleasant

to her, I

did Sue cut in?

was something unexpected.

mean a shift in that sense, yes. Which alerts you to the fact that I

:

there

is

something mean-

ingful here.

Dr.

Right.

J.:

Int.:

Do

you look to these moments

to tell

you what's

really

going on in the family?

Dr.

J.:

Very much

so.

At

this point in the interview I

thinking about the family "rules," but

I

wasn't

think that in general I do watch

for clues to family homeostasis. I don't

pay so much attention to the

content as to the kind of a shift that doesn't seem to

During one of

fit.

our structured interviews, the parents were discussing a proverb, and

was very

the father

polite to the

minute the boy came

in,

mother while they were alone, but the

the father took over and said,

that rolling stones don't gather

no moss

—now you

"Now

this says

understand what

moss is?" He just sounded different. You got the feeling that there was some kind of shift in him, he became all at once so positive and pedantic. That alerts me, not knowing what the motivation is. Int.:

Dr.

You J.:

wait for the inconsistencies, and that gives you a clue?

Right.

Much more

than the content, or

slips

of the

tongue. Int.: shifts are

Dr.

And you

are sharing with the family the idea that these

important and that you don't J.:

I

show

operation, but this

that I

still

know what

do know what

it is

this

one was about?

by calling

doesn't label the content of

it,

its

it

a rescue

specific

mean-

ing in this context. Int.:

Some

family in this way.

therapists wouldn't feel they should share with the

You

are telling

them what your operational methods

what you are looking for. Dr. J. I'm not doing it deliberately at this moment, but I do try to do it when I think of it. I try to make each member of the family a are,

:

monitor of the other's behavior, in terms of

shifts,

so that later

on the

TECHNIQUES OF FAMILY THERAPY father can say to the mother, talking with Sue

Int.

Dr.

and

Are you

:

J.

all

"Why do you jump on

of a sudden

trying to give

.

.

[208

me, you were

just

."

them an example of how

to

do

this?

I'm trying to act as a model, yes.

:

them under-

Int.: There's a fine distinction between "helping

stand the shift" and giving them a model of

how

to handle each other

tactically.

Dr. kind of

In this case, I'm both telling them

J.:

how

to recognize this

and being the model for the way to intervene when

shift

it

happens. sue: Well, maybe

No,

dr. J.:

I

don't think

how become some

just attracting attention to myself.

it's

it's

that simple.

Ah,

I

think you have some-

a spokesman for the family, and

it's

a very burden-

role to be in.

that

For someone who was assuming, ten or fifteen minutes ago, these parents had no awareness of any connection between them

and

their child's problems, or at least

Int.

is

:

going pretty

Dr.

J.:

no

willingness to concede

it,

this

far, isn't it?

Not

if

you think of what the parents have been able to do.

They have been able to come forward, and now the problem is to get Sue out of the way so that she doesn't become an obstacle. The mother is

weeping, the father

before

I

is

in tears, there is

something happening, where

wasn't sure what they would accept.

Int.

:

But you are going so

lems for which Sue with that

this

is

far as to say that the family has prob-

the spokesman.

Do

you

feel safe

enough to deal

soon?

must have been impressed by the mother's tears, the father's tears, the extent of the movement. Compare this with initial interviews in which the two parents sit solidly united on

Dr.

J.:

All

I

can say

is

that I

one side of the room and the patient

sits

isolated

on the

interview you get a feeling of divisiveness, implications

other. In this

on the mother's

part of other problems, and so forth.

you one thing I understand right now, not exactly a spokesman but I'm bearing most of the burden of my own emotional independence, and I'm not getting much help from my mother, and I'm sorry, I mean there are a lot of factors that are

sue: Well,

I

can

tell

The

Eternal Triangle

[

innocent and not exactly realized but (sighs) are a result of

makes,

It

makes

it

it

me

necessary for

Mm-hm. sue My own emotional independence

to

do most of

209

this.

it.

dr. J.: :

(overlapping)

dr. J.

Well,

:

something too, so that

know ... in that

sue: Oh, dr. J.

sue

:

I

.

mother):

(to

I

a

mrs.

s.

your mother

true,

is

it's still

.

.

losing

is

.

.

.

sense

a family problem.

it's

can, I can appreciate I

confused about

little bit

this

think

I

much, but

position very

if

necessary at this point.

is

am

and sympathize with your

—me, and sometimes

who me

is.

I

get (crying)

(Pause.)

Darling, that's part of growing up.

:

you please let me? (Sobs.) MRS. s. (simultaneously, crying) I want you to sue (crying) Oh, you say that but you don't feel it. I've said this to you before. mrs. s. (overlapping, crying) If you could see inside me, you'd sue (crying)

No,

:

it,

will

:

.

.

.

:

:

know how

I feel.

sue: I'm not the only one who's said

—you

don't think I'd

I

this,

Mother,

cook that up on

my

why do you

own, do you?

think

(Sighs.

Pause.)

mr.

I

s.:

We sent

.

.

.

me

.

.

.

sue: Let

mr.

know what more we can do

don't

.

.

you away to school

school

.

.

s.:

.

to let

you grow up, Sue.

at the early age of, first year of high

.

sue: Well. (Sighs.)

We

you out of staying away for the last two years, that's true, and brought you back home . sue (low voice) I didn't want to mr. s.: because you, ah, were getting very rough, tough, tomboyish, and you were going into a third and fourth year of high where in a marooned state like that existed in Arizona, you had no companions older than yourself

mr.

s.:

talked

.

:

.

.

.

.

.

.

.

sue: All

mr.

.

right.

...

Skip the reasons,

we

.

.

I realize that.

you back home. I'm saying the one time we imposed upon you we brought you back home for two years. s.

Int.

:

:

I

so

did bring

noticed that while you were listening to the tape, you were

shaking your head.

Dr.

J.:

I

was

thinking,

"How

can the father have said this?"

TECHNIQUES OF FAMILY THERAPY

[210

What he is talking about is a breakdown Sue had when she was fourteen. The way he puts it is almost unbelievable. He says that this was part of their helping her to grow up, when it was really a horrible breakdown.

Why do you keep silent during this interchange?

Int.

:

Dr.

J.:

had no idea about

I

all this,

you

know any-

see. I didn't

thing about the family history.

You

Int.:

don't usually inquire into the family history to ac-

quaint yourself with these past events?

Dr.

Not

J.:

debate. I feel

do better

I

a feel of the situation

ask about Int.

them

to

onto

know the family background and get know that she has done this, I am apt to sorts of things.

all

In the beginning you say to these people that one reason for

:

What

mind.

is

me

strikes

that certain past issues are very

how few

is

take the present conflict, even

sumptions and work with

Dr.

would

work with. then make your as-

past issues you

run on,

how much my knowing

no objection

contribute. I have

I

much

that.

I'm not sure

J.:

let it

used dynamically, right at that moment. people

a matter of

is

don't

if I

first. If I

off

think taking a history

I

meet together with you

in Sue's

You

and get

it

no.

initially,

much

supervise, not so

every single thing

to taking a history I

recommend

it

if it

can be

some

to

to collect facts but because

it is

of the

a

way

of getting into another area where things are not so disturbing.

sue: Well,

I

.

.

.

dr. j. (interrupting loudly)

sue:

mr.

.

s.

.

:

.

.

understand

this

we

sent

.

.

then

.

Now here we have

:

.

.

.

.

.

you away again

.

.

.

sue: Oh! dr. J. (overlapping)

sue:

I didn't

dr. J.

We

:

Here we have the two

:

say this

.

.

sides of the family.

.

have the tears on the one side and on the other side we've

got the president of [father's company] talking.

mr.

s.:

Um-hm.

dr. J. : This

sue: This

is

is

the

I

Mr.

know

sheet

.

.

.

a businesslike attitude toward something you don't be

businesslike

dr. J. (to

way you would read a balance

.

S.):

.

.

.

.

.

and you know

that you're affected

it

doesn't fool me, because

by both of the

tears

and that

I,

this

The

resorting to the balance-sheet approach and adding

"This

ing,

what happened," ah

is

.

[211

Eternal Triangle

and subtract-

.

.

You don't do that with life.

sue:

...

dr. J.:

where

something that must leave you disturbed some-

is

is,

inside,

just doesn't,

it

you don't even sound very convinc-

and yet you're an extremely successful person, so the business side of you must be convincing, but this side of you isn't, and I ing,

think this

is

something we want to try to get back to and that

what, what, what do you do for crying, you

know?

mean

there

few minutes you've been

To

Int.:

is

gather you

from what was a kind of tragedy here and in the last

cry too some but (female sighs in background) said, but, ah, I

I

I,

is

sort of staying out of

,

it.

the mother you've said, "You're not as hurt as you

think."

Now you say to the father,

Do you

often do this

when people

"You're more upset than you show." act as

though they weren't worried or

upset?

Dr. is

J.

Yes.

:

the message. I

let

tell

partly punishing

them

for saying that

them, "If you think that you can just

make

other people Int.:

It's

fools of themselves,

But he hasn't been

it's

sitting there.

no message

sit

there and

not going to work."

He

through the ex-

sat

change between the mother and daughter, but then he stepped about the daughter in high school.

this story

Dr.

J.

But that

:

in the emotion.

being out of

is still

I'm saying to him, Int.

"You

Your manner

:

it.

He

refused to take any part

Here were the two women, pleading with each other

and hating each other and so on, and facts.

in with

is

he's sitting over there reciting

are not going to escape."

extremely provocative.

Was

this tactical,

or

were you really annoyed?

Dr.

J.

:

pushed into

I it

do use

this

because

tone tactically but in this case

was so repelled by

I

his going

I

was probably

on about schools

was happening. You're giving him the "You're denying your

in the face of all that

Int.

:

Dr.

J.

true feelings"

line. :

But

he gets the message, "Look, you're going to be

I think

involved with us whether you like into

it."

For example,

quiet lately." Instead

Aunt Mary!" Then

I I

she'll

it

or not, so you might as well get

somebody, "You've been very "Boy, we sure are getting volumes from

rarely say to

say,

look puzzled because she hasn't said anything,

TECHNIQUES OF FAMILY THERAPY and

I

hope she

gets the idea that not being involved

is

[212

an involvement

and it's going to be labeled as such. Int.:

somewhat

It's

wrong, but in

facetious to say that the customer

this interview the

daughter acts aggressive, and you indi-

cate that she ought to go in the other direction; the

and you indicate that she ought to go acts businesslike,

always

is

mother

gets upset,

in the other direction; the father

and you indicate that he ought to go

in the other

direction.

Dr.

do

ordinarily

body

is

I really

J.:

think that's the whole story, because what they

like the

is

"Anniversary Waltz."

I

would

say, yes, every-

wrong, not because they are wrong in the ordinary sense, but

home and

because they are doing what they are doing at

worked. The thing

hasn't

it

them that they are wrong for the right reason. Then they are American and God-fearing and all, but they are is

to convince

just misguided.

Int.

You

:

use a humiliating tone in talking to the father, but

humiliating in a very special way. You're criticizing

what

is

in his best interest.

because you're on his

Dr.

you

If

J.:

He

him

it's

for not doing

can't say, "You're humiliating

me,"

side.

somebody

tell

that he can

do better than he

is

doing because you really think he can, rather than simply to cut him

down, you may be humiliating him

one sense, but you are also

in

ele-

vating him. Int.: tic

suspect that right there you have the essence of therapeu-

I

technique; this mixture of forcing people to behave differently but

phrasing

such a way that they can't

in

it

resist

it

because you are on

their side.

dr. J.

Mr.

(to

S.)

:

I

you do

don't think

really stay out of

it.

What

happens? sue:

Is it fair to?

dr. J.

:

ah

a question of being

It isn't .

.

sue: Well,

fair. I

don't think he can. I think,

.

if

he

don't think

is

it's

managing succex-, successfully right.

to stay out of

it,

I

feels

it

(Laughs.

dr. J.: Well, I don't think (laughing) he does stay out of

it,

he

somewhere. mrs.

s.:

'Course he feels

sue: Well,

I

(Pause.)

appreciate

it,

he

that.

feels I

it

deeply.

didn't

think he was

a vegetable.

The

was a compliment. sue (laughing) Oh, it was. I know you

[213

Eternal Triangle

dr. J. : That

:

mrs.

s.

:

All right now, this

sue:

.

.

.

MR. mrs.

This

s.:

.

.

.

.

.

Dad.

feel things pretty deeply,

(low voice)

s.

is

.

Thank you.

:

something right here. That was a compliment,

is

know, but the delivery of the compliment was a

little

I

rude and

sassy.

dr. J. : She smiled

mrs.

s.

Int.

:

Dr.

J.

when she

I didn't see

:

Why

it,

the smile but

very warmly.

heard the tone.

I

did you say, "That was a compliment"?

Because

:

said

I

assumed that

as

soon as the mother

ing things, particularly in this sentimental

has them so far away from what

is

"He

feels

it

deeply" way, she

happening that somebody has to

point out the relevance of other things as they occur. I is

starts label-

am

sure that she

a focal point at that moment, and that a siren could go off next door

and they wouldn't notice. Int.:

Dr.

Were you I think I

J.:

was showing the

could hear his daughter, particularly in the

way

she was.

explain her

I

was

comment

comment?

also trying to soften the daughter's

father that I wasn't sure that he

insulting him, I suppose,

to you."

On the

with his wife acting

this context,

other hand

by saying, "I have to I

was

saying, "It's

my

business to interpret you to each other." Int.:

You seem

to have been a

clairvoyant there.

little

The

mother comes in and begins to attack the daughter for what sounds on the surface like a rather sweet remark.

Dr.

J.

I

:

don't think

it

was clairvoyance,

I

think the mother prob-

ably was competing with me. Instead of saying, "Oh, I didn't realize

it

was a compliment," she immediately takes the opposite point of view:

"You

know my

don't

daughter better than

derstandable. However, this If I can, I'd rather

of

what was

say,

"What

ously

it

don't

want

ask another

just said, to

it

I

think

of the family about the

intra-family.

The

a facetious remark."

it

to

Then

I

is

un-

trouble

is

meaning that

if

I

have to top her by saying, "I

way at all." I don't like to get into that position. You ask somebody to come forward and then chop him off. I

that

know what the answer is, but I think it's member of the family to interpret what went on. don't

Which

exchange raises a technical problem.

member

keep

do."

did you think of that?" the mother can say, "Well, obvi-

was

didn't hear

little

I

usually best to ask a

TECHNIQUES OF FAMILY THERAPY Int.

You're saying that what you say

:

on whether you

them up to attack what you Dr. J.: I think as long as the

way

to

do

being s.

sue:

.

.

says.

Here

said, if they so wished.

therapist

is

feeling

up

to

it,

that's the

.

.

try to be adult, I get squished, just like that. I'm

I

.

(overlapping) .

member

it.

sue: Every time

mrs.

very different depending

follows or precedes what the family

it

set

better

is

[214

Sue, I'm speaking

:

.

.

.

sassy or I'm being impudent!

Int.: All through this interview, the daughter complains that she's being treated like a child.

Dr.

J.

Yes, but she introduces that note as

:

does, by going back

many

years:

By demanding

Int.:

"Now

much

you're telling

that she be treated as

an

as her

mother

me what

to do."

adult, she ensures

that she will be treated as a child.

Dr.

Yes.

J.:

And what

she

reinterprets her remarks, decides

they can only really

more powerful and it

from

mean

that

if

is

objecting to here

what

that the

they're supposed to

mother

mean. But

the daughter sees the mother as being

and so on than

brighter

is

her, because I think that she

herself. I don't

put up with

and her mother are nearly peers.

The mother and daughter are both playing some kind of powerlessness game. The daughter says, "You treat me like a child," Int.:

meanwhile acting

and the mother answers by weeping and

like one,

being hurt.

Dr. daughter

an odd interweaving of

It's

J.:

immature and irresponsible

is

time she says, "Look

how you

The mother says the and hysterical. At the same levels.

hurt me," as

if

the daughter should be

able to contain any kind of behavior the mother doesn't approve of. Int.:

"You

give

sounds

And the daughter is always complaining to the mother, me no help in becoming emotionally independent," which

like a contradiction,

describe the

mrs.

way

is

probably the only accurate way to

the mother deals with her.

No,

s.:

but

this is



Sue, I'm speaking to Dr. Jackson and trying to

explain that that would have been

me

.

.

.

sue: Your reaction

.

.

.

my

reaction to

it.

Now

let

[215

The Eternal Triangle mrs.

s.:

.

finish

.

.

.

.

.

(simultaneously): Yeah,

dr. J.

mrs.

s.:

sue:

Go on.

mrs.

s.:

sue:

Goon.

mrs.

s.

me

Let

.

.

:

.

.

.

.

because I'm trying hard to help get

finish, Sue,

to the root of this

.

and perhaps I'm supercritical of

sue:

Mm-hm.

mrs.

s.:

.

.

.

fact that I

.

look

let,

.

.

my

only

.

.

but

I

think there should be an effort

.

know

I

The mother

would

criticize

off her

own dislike

I

mean,

.

I

is

not

don't like to see Sue put-

where people could unjustly

criticize her.

remark not as something she

translates Sue's

of what Sue does onto these "others." is

a very

common

not confined to sick families. "I

when I'm speaking I'm a and

know

parental technique;

reality to this,

Int.:

Did you see

certainly

you do,

representative of other people you're going

which makes it

it's

the real world better than

same way." There's

they'll feel exactly the

amount of little

.

to correct

but as something that would offend others. She pushes

This

J.:

to run into

.

made

the mistaken impression

the,

mistaken impression.

ting herself in a position

so

don't question the

I

it.

am

... because

s.:

Dr.

.

Mm-hm.

dr. j.:

Int.:

.

.

.

what can be causing the mistaken impression mrs.

.

it

a certain

very hard to deal with.

as something this particular

mother did a

more than other people? Dr.

Yes. She set herself up as someone with very proper

J.:

standards and saw the daughter and father both as people with im-

proper standards, thereby forcing them into a coalition which she then

was repelled by. Even though the father was successful and so on, she saw him as boyish and rude and thoughtless, too much influenced by

work and his office. But there's something else here that I think is perhaps more important. Notice how quickly, when the mother said, "I

his

may be wrong, I'm only trying," the daughter forgave her. instantaneous way these two could get together as soon as

I

was proffered

in therapy.

is

a sign that something could be done with

it

think the

a coalition

A good prognostic sign. Int.

:

Dr.

J.:

I

never would have seen It

that.

happened so quickly. The daughter's tone

softens, as

if

TECHNIQUES OF FAMILY THERAPY know, Mother,

to say, "I

I

know."

It

a kind of plus the

How do you mean, plus?

Int.

:

Dr.

J.:

Their

ability to influence

you may be able

together. If they

extend

this is

if

work with.

therapist has to

that

shows that they can respond,

To me,

only on an instant-to-instant basis.

[216

to help

can do

it

at

each other momentarily means

them to stay on longer time segments all, you might be able to help them to

You

so they can get along for a whole luncheon together.

it

wouldn't hope for a whole week, but sue:

I realize that,

Mom,

more kind

deal

man-,

my

lems

.

.

mean

be

to people

who

demanded

s.

:

.

.

dr. J.

I

en-

are in trouble and have prob-

.

.

.

.

.

This, this

:

a great

because you

this,

No, you don't sue: and I had to learn to be kind, in everything otherwise it would have repercussions. mrs.

lot,

speech and manner, since

tered [hospital], necess-, necessity just don't

hours.

but you, I've also learned to be a

my

in

—two

is a,

a (sighs) family to

work with

I

said

all right,

and ah

did,

.

.

.

(Sue laughs.)

Dr.

Sue

J.:

is

ward where she was

psychiatric

who have just been

in hospitals

A beautiful

J.:

my

"I learned sent

first

had on the closed

hospitalized.

mean

She's saying, "Mother, you shouldn't be

Int.:

Dr.

referring to the experience she

manners

to people

and have trouble."

means that, and it also means, home. After your treatment of me

statement. It

after I left

me to a nut house."

Why did you come in then with such

Int.

:

Dr.

J.:

It's

hard to

a personal reaction?

recall the visual cues. I suspect I've gotten

three messages that conflict within the last minute: the looking, the

swers her.

way

And

the mother's talking, and the

just as I

way

way

the father's

the daughter an-

thought the mother and daughter were begin-

ning to get together, the daughter says, "I learned to behave away from

home,

some kind. be a way of putting some distance between

in a nut house." It's exasperation of

Int.

:

It

seems to

the

family and their problems.

Dr.

J.

:

Well,

it

makes them

all

equal. "I'm equally disgusted with

the lot of you." Int.: Yes, but

some

therapists

would never come out with a

[217

The Eternal Triangle statement that showed them watching their using this as a technique.

It's

own

techniques, let alone

though you were asking the family to

as

go around behind the one-way screen and watch you work with them.

them back

certainly calls

engaged

fighting they're

Dr.

what

they're there for, rather than this in-

in.

probably true that whenever people in a family get

It's

J.:

to

It

into an unpleasant situation with each other, they tend to think very individualistically.

but he

is

on your

this difficult,"

J.

not helping me,

"You're

affair.

one-down position.

Yes. Part of the treatment of this family involved

:

all

presenting yourself as slightly confused, you also put

yourself in the

Dr.

is

side." If the therapist says, for example,

he relabels the situation as a family

By

Int.:

"You're being mean to me, and he

my

try-

more and more to participate, which he began to do with varying success. I think it was helpful to take the one-down with him, so that he didn't feel that I was doing something he couldn't do for his own family. I was caught up in this on several occasions when I became a little too active, I felt, and usurped his role. Int. As mediator between the two women? Dr. J.: Yes. And you might say, why not get the mother to be more active? I agree with Milton Erickson's statement that you use whatever the patient brings you. The girl and the mother got along much less well than the girl and the father, so he was in a better posi-

ing to get the father

:

tion to act as the stabilizer.

dr. J.

(to

Sue)

:

We

were

feeling because I don't

everything

we

sue:

buy

about what your dad might be

this, ah, (to

Mr.

this

see,

you know, we did

S.)

you weren't feeling minute. (To Sue) And now we're off on your

could for you, in quotes, as

something right manners, you

just talking

um

.

.

if

.

Mm-hm.

dr. j.:

.

.

.

you, you were the one

who

started

again by saying

it

what you did to your dad. Your mother helped you by pointing it out, and then you help her by arguing with her over this relatively minor issue compared to the severity of the other troubles. sue (overlapping)

Well,

:

I

know we had

while but, ah, got interrupted dr. J.

(overlapping)

sue: Uh-huh,

I see.

:

.

.

But Dad's been

(Pause.)

a major issue there for a

.

left

out again

.

.

.

see?

TECHNIQUES OF FAMILY THERAPY When you do

Int.:

a

review like that, do you assume that

little

bringing to their attention what's been happening will help

change

them

to

it?

Dr. denly

[218

I

J.

No,

:

I don't. It's

way

a

of justifying your remarks. If sud-

say to you, "You're behaving miserably," this has no effect

except to

irritate

you, unless

much

don't think they get

you

Int.: Again,

can say, "because of the following."

I

insight out of

it,

get the emphasis

I

no.

on the family system. You're

pointing out a redundancy, a pattern.

Dr.

But more to imply that

J.:

something they can't

s.

That

:

exactly what

is

have some authority and can see

than to

see, rather

That would be too much to hope

mr.

I

make them

see things

my

way.

for.

referred to a

I

while ago

little

when

I said

two of them get recriminating back and forth and they carry

the

on

and

until finally I step in

or

.

.

say, will

you please shut up or stop

it

.

sue: Yeah.

mr.

...

s.:

sue: Well

mr.

.

...

s.:

annoyed

don't bicker so much, and, ah .

.



try to

that

sue: Yeah, and

sue

.

mr.

.

.

blow up

.

.

.

that's

what

I

was

just s-s-saying

.

.

.

.

you usually do

it

rather explosively

.

.

.

Yes.

s.:

sue:

I

well, I don't try to separate 'em, I get, I get so

Uh-huh.

s.: :

.

Mm-hm.

dr. J.:

mr.

.

.

.

.

and then

it

upsets us

all

the more, then boy, we've really

got a situation on our hands.

Dr.

J.:

The important

when he comes

thing here

in explosively,

he does break them up. Even

poorly done or unpleasantly done, Int.:

You made

that they missed the fact that

is

it

if

it's

breaks them up.

the point just

now

that

the family by getting the father to mediate

you were trying

more

effectively

to help

between the

mother and the daughter. Dr.

J.:

sometimes

Now,

Yes.

at one,

He

used to blow up

sometimes

to the extent that he

at the

makes a

at

them, and shout

at

them,

and sometimes

at

both.

other,

fool of himself, he doesn't

sound

[219

The Eternal Triangle like a leader. Also,

if

he makes them both very uncomfortable,

it

only

reinforces the conviction of each that the other one got her into trouble

with

Dad

again.

mr.

s.:

much on

s.

um,

I,

guess

I

the outside.

if I

get,

I

suffer I suffer inside, I don't

stomach

up

tied

in

show

a knot and

.

.

.

Mm-hm.

dr. J.:

mr.

perpetuates their dyadic quarrel this way.

(Pause.)

it

I

He

(sighs)

up, ah

my

I grit

:

— (Sue

and clench

teeth

my

fists

and

finally

blow

interrupts.)

That was quite a long pause, before the father came

Int.:

Were you looking

in.

him expectantly, waiting for him to continue? Dr. J.: I would suppose so, because he is responsive to the idea of intervening. He does enter in when he explains why he feels the way he does, and I'm encouraging him to go on. at

sue:

I

wish you could

mr.

s.:

What's that?

I

wish you could

sue:

mr.

Well, over

s.:

let it out.

let it out. It'd

many

be so

much

years of discipline

better for you.

guess you kind of

I

.

.

.

sue: Yeah, but you can overdiscipline yourself.

mr.

Well,

s.:

my dr. J.

.

.

maybe

I

have,

don't know.

I

I

try

to conceal

all

.

make

(interrupting): Let's not

that, that

people can do differently easily, you

own

experience they can't, so

let it

out,"

sue (laughing)

the mistake, Sue, of thinking

and another thing :

it's

know from your

one thing to say,

to be able to

do

"I wish you'd

it.

Yeah.

dr. J.: Yeah.

Dr.

J.:

One

Sue brings her

thing

is fairly

illness in, I

been a patient and

I

consistent in this interview; every time

won't tolerate

know; the

it.

psychiatrists

She's really saying, "I've

have told

She seemed to have decided that she would be both she and

I

knew what mental

illness

was.

my I

me

to let

it

out."

co-therapist because

didn't altogether care

for this. I'm always uneasy in early interviews with psychotics because

they try to put the focus on their illness and things can very quickly get

out of hand. Int.:

Are you

also

responding to a feeling that a daughter

TECHNIQUES OF FAMILY THERAPY shouldn't have this

does? girl

Were you

amount of freedom

to

comment on what her

trying to separate the generations

[220 father

by implying that the

shouldn't be supervising the parents?

Dr.

J.

:

That wasn't

my

reaction here.

I

think one generation can

comment on another and the line of separation can still remain if the comment is put in the context of the speaker's generation. Like: "It's all very well for you young fellows to say you want to make a million dollars; I can sympathize with your wish, though I know it's not easy to do." I would only jump on such a remark if I thought it was intended to stir

up

and deliberate provocation are two things

trouble. Illness

not tolerate. Here

it

was the

illness. I

was

don't think Sue

I will

trying to be

provoking.

You

Int.:

be

can't

fend

Sue and defend the father by saying, "People

off

an excusing kind of

different." It's

when you

thing, as

said,

"People do the best they can."

Dr.

J.

:

Yes, but

goes both ways.

it

daughter: "As you learned from your Int.:

It's

pline.

J.

My

it

equally to the

own experience."

his

own

self-discipline that

makes him blow

they're saying, I'm not even hearing

remark says that whatever they're doing,

to do. I'm putting

mrs.

it's

Whatever

:

can apply

such a complicated statement in the context of the fa-

ther's saying that

Dr.

I

them on an equal

Dad and know that s.:

.

.

I

are

it's

it

up.

as disci-

what they have

level.

two completely,

totally different people,

you

.

sue: Sure.

mrs.

s.

:

In, in

every way, but we've

ally happily, in

sue:

I

Dr.

J.

managed

to live together unusu-

your own words.

know.

:

The mother was

in

a peculiar bind

at this time.

She hated

her husband, intensively and actively; he did a lot of things that humiliated her, including bringing

women he was

going around with into the

house. Yet she was maintaining the fiction that they had a happy marriage.

She would naturally resent her daughter for claiming to be more

of an expert

many

on her husband than

years longer.

On

the other hand,

on him, she would have refute this

she, the mother, if

who had known him

she was really to be an expert

to admit the truth about him,

good relationship she claimed they had.

which would

The

may

Int.: This

way you

taken any

be

why

she uses the

like.

The

surface idea here

but the implication

fine,

is

that

because they don't get along.

Eternal Triangle

word "unusual." is

It

221

[

can be

that the marriage

is

unusual that they could stay together

it's

You

wouldn't raise any question about

the "unusual" happiness of the marriage?

Dr.

them

J.

No, especially not

:

in the first interview.

I'm trying to get

keep coming, so I'm in no position to indicate that they're

to

going to be under scrutiny.

mrs.

s.

sue

Well,

:

mrs.

s.

(starting to cry)

:

How do you suppose it happened?

you were in love. That's not enough

:

sue (overlapping):

.

.

.

took a give and take process,

It

working out ups and downs, a

lot

took a

it

of discussion, and

I

lot

of

think

you've even seen argument.

mr. s. That's normal. mrs. s.: That's right. :

know

sue:

I

mrs.

s.:

a lot

more about marriage than you

But you know what

I

think has

learning to accept each other as

sue: Well, sure, you'd have got to the altar.

Dr.

J.

To me

:

this is

Sue

Int.:

it

me

credit for.

possible for us? Is

(voice wavering) are.

otherwise you never would have even

(Long pause.)

this is so terribly pathological that I feel I've got to

do something and yet what to do. But

to,

we

made

give

the mother to shut up.

I can't tell

a bad point,

I

can

says, "I think you've

feel

I

don't

know

it.

even seen argument."

Had

the

parents had arguments in front of the daughter, or was she just guessing?

Dr.

J.

I

:

think they had arguments fairly often, but

knew with

the daughter

mother gave

me

the daughter

was

certainty

how bad

I

don't think

the situation was.

The

a letter which she had written the father but never sent, six

months old

at the time. It

was

really a fascinating

document and foreshadowed a lot of things which came to pass. They had only been married a little over a year, and the mother was already

know if she could go on in the relationship, that much involved with the daughter, was ignoring her

saying that she didn't the father

was too

and so on. Yet the father involved in his

first

at that time

had given evidence of being

extra-marital activity. So even then, at the age of six

TECHNIQUES OF FAMILY THERAPY months, the daughter got the blame.

mother made during a

the

I

was cued

later interview

into this

when

[222

by a statement

she said to Sue, "For

the past twenty years you've interfered between your father and me."

The

was nineteen! It's nearly twenty years later, and nothing has changed. The baby is now a college woman, and the same girl at

thing

is

that time

going on.

Did you appreciate the switch the daughter made? The

Int.:

"What has made our marriage possible is learning to accept each other as we are," and the daughter says, "Well, you'd have to, otherwise you'd never have even got to the altar." Then there's a big mother

says,

silence.

Dr. Int.

Dr.

J.

She refutes everything she's been saying.

:

J.

and then

From altar to altercation!

:

Yes, there's a

:

retracts

it.

Daddy and you can't Int.: I take feel

it

little bit

"What

To me

it

is

you're saying, Mother,

is

obvious



that

stand each other."

would make you

that this sort of "togetherness"

you had to come in. Dr. J.: It would make

on.

of sanity in that she goes overboard

me

very uncomfortable to see this going

highly pathogenic.

I

think

the therapist's duty to

it's

catch some of these things, so that the participants can learn to recognize the general configuration of this kind of brainwashing.

Why do you call it brainwashing?

Int.

:

Dr.

J.:

Well, that's just a

way

of putting

mother's brainwashing the daughter, but oversimplifying

had said

it.

his clothes on. it,

you'll

The mother I'll

is

saying,

it

It

it.

sounds as

if

the

takes two to tango, so that's

"Okay, you said the Emperor

go along with you, but

if

you now deny that you

open up a schism between your father and

me

that

you

can drive a truck through." So the daughter quickly says, "I don't want to

do

Yes, of course you're in love!" But she has to pretend she's

that.

crazy in order to accept

mrs.

mr.

s.:

We got there awfully fast.

(laughing):

s.

this.

I

don't think

(Laughs.)

we analyzed

it

very thoroughly at

that time.

mrs.

mr. mrs.

s.:

(laughing)

s. s. it

(Laughs.)

:

:

Oh,

I

did quite a bit

.

.

Oh, you were a cold-blooded man,

(laughs) now.

.

at least as I look

back on

The Eternal Triangle MR.

(overlapping)

s.

though

MR.

s.

.

.

(overlapping)

Hm. Remember, we

:

So

:

take that back,

I'll

had thought about

mind

um

.

had,

I didn't, it

had,

I

think

Int.

is

had al-



maybe,

all right,

thought about

it

than you do. all right,

longer but (sighs) I

spelled out in

it

my own

expected and didn't expect

I

and,

.

why

off

the issue

which

(sighs),

I

you're squirming, Dr. Jackson (laughing). This, this

not really the issue.

What was

:

we

start earlier

long enough to get

much what

pretty

.

I

sue (interrupting): Anyway, we're

is

I

.

(overlapping)

s.

was older than you were and

I

223

more time thinking about marriage than you had,

spent

mrs.

Well,

:

[

this

squirming Sue refers to?

was doing that I was not aware of. I imagine I was figuring out what to do about this critical exchange between Sue and her mother, and feeling impatient because I hadn't done anything about it yet. Dr.

J.

Int.:

I

:

think Sue's remark probably referred to something I

Sue diverts everyone from the issue that caused

by saying, "We're

off the issue."

You had

why Mother and

gotten to

Father got married, and whether they even thought about

But the daughter says Dr.

that's

it

at the time.

not the issue.

Well, the father said something classic, not in this inter-

J.:

view, but shortly after.

were

this flurry

in love, so

He wanted to

indicate

how much

his wife

and he

he said that they got on a cross-country train together

and by the time they got

off,

they were engaged.

a rather licentious statement; she didn't like

it

The mother found at

all.

this

But they were

engaged and got married rather quickly, despite some family questions. Int.

:

When

the mother says,

"You were

cold-blooded," does she

mean "You maneuvered me into this?" Dr. J.: The implication is that he pushed her other implication better to have

Int.:

it

is

the rather obvious one, that she

that he

into

it,

yes.

was pregnant.

pushed her than that they had

The It's

to get married.

The daughter would be even more a cause

of resentment

if

she had been what forced them into marriage.

Dr.

J.:

That's right.

One more question about comment that freely about you?

Int.:

often

Dr.

J.:

No. but

I

this

remark of

Sue's.

Do

patients

had a rapport with Sue from the minute we met.

TECHNIQUES OF FAMILY THERAPY I

know

don't

remark

entirely

what

it

was based on. But

I did

[224

not find her

surprising.

No, I was squirming because which is the most useful aspect sue: Well

dr. j. :

I, I

.

.

.

dr. J. :

sue

.

.

about dr. J.

of this to break into and, ah

.

useful as far as

me

to

my health

.

.

is

.

concerned

now

is

the issue

my independence.

Ah, but

:

.

.

The most

:

.

don't, ah, I'm trying to think

that, that will take

the groundwork.

is

some

getting together, so that that

Ah, I'm trying

to deal with your

more than

er's

statement, ah, I suppose

see,

Mrs. Starbuck, from what you've

any.

said,

Um, you

moth-

see,

you

you've put Sue in a

rather impossible position, because she will have to assume that

she either

is

an illegitimate child (Sue laughs) or adopted

that mental illness

which there

Dr.

J.

Int.:

is

is

no good

completely a matter of biochemistry, for scientific evidence.

That's a rather brave thing to say,

:

It's

you attack you

parents. You're saying to them, "If

come from your

you take these

—and come up with them— and use them

ideas of heredity which generally

ity

isn't it?

especially brave in view of the fact that

terview as the parents

or, ah,

attack later in this in-

treat

against the

Sue as though she couldn't

marriage, you're acting as though there were no hered-

involved."

Dr. treating

J.

Yes.

:

Sue as

It's

a tricky use of heredity.

It's

saying, "You're not

she were really your daughter," which

if

pangenetic concept. Actually, I'm on safe ground, because that they will think I'm talking about the

are good.

sue:

What

I don't

sue:

.

mrs.

s.

think

Ahh

dr. j.: .

.

bad about her

is

I

.

.

is

the

it's

mental

it's

emotional.

illness

ways she

way .

.

she

is

is

is

I

like

more of a can assume

them, which

not like them.

.

.

think

(overlapping)

:

I

don't understand

what

that

means, Dr.

Jackson.

you say that, that you and your husband have gotten along, you know, so well, and how have we managed to do this, ah, then obviously this means that she is the moldy fig, she is the troublemaker, the, the, you know, I, I mean (Mrs. S. overlapping,

dr. j.: Well,

if

The Eternal Triangle inaudible phrase)

it

cuts her out

you mean

don't think

:

That's pretty direct.

Dr.

J.

:

I didn't

was

think

it

know

quite

how

blame on the mother.

partly desperation.

Sue to come in and say, "Yes, Int.

:

You

Dr.

J.

:

am

I

don't consider

No. She does

does routinely

it

it's

that I

by,

and

invites

it

a poor orphan."

productive to support her like that?

this all the time. I don't think

anything she

"You What I

very useful. She can always be dramatic about

is

should have done

is

is

to say to the mother,

standard with her.

"You know,

I

think you and

common."

in

You mean,

Int.:

Time was going

Very adroit, because

don't appreciate me," and I assume this

Sue have a lot

way

to break into this. I'm almost focusing the

don't think

I

in a

225

to.

Int.

I

from the family

[

instead of putting

it

in a negative

way, "You

people are cutting Sue out," you should have said, "You, Sue, and you,

Mother, have a deep harmony."

Dr. way.

I

As

J.:

a matter of fact, they do; they just don't see

but as you'll see,

thought then that the

was

his parents

family, that

is,

to

himself.

from the old days.

It

J.:

We

way

show how

was

the parents are cutting

him out

of the

know why you

this helpful.

might be helpful

if

the patient

is

taking everything on

had to do a structured interview recently with a boy who

had been labeled a mental or, "I

defective.

The boy would

should go out and get a job."

the parents were cutting

him

out.

When

He would

limited tactic because is

being

you

left

can't

say,

"I'm

just a

never realize

how

they could actually be con-

fronted with this in not too maladroit a way,

the patient

It

to treat the schizophrenic in the presence of

to be supportive. I'm interested to

wouldn't consider

Dr.

didn't work.

it

That's such a different orientation

Int.:

at least

that

did try later to get the mother to agree that her daughter looked

like her,

dope,"

it

it

go any place with

was

useful.

But

it's

Also, showing

it.

a

how

out doesn't exactly bolster his self-esteem. But

he learns to recognize what's going on.

mrs.

s.

(to Dr. J.)

must learn

:

No,

to accept

sue: Well, you don't!

my

object

was

to point out that,

each other as we are

.

.

.

um, we

TECHNIQUES OF FAMILY THERAPY MRS. sue:

s.:

.

.

.

You

(To Sue) Dad and

and that Dad

don't!

You

[226

/ do.

two, yeah, where do / stand in this?

I

don't get

accepted for a person, for an individual, for an adult. I'm a child,

and I'm very painfully reminded of

every time you get a chance

it

The minute I say something like this (interrupting): What I was going to suggest is every time.

to,

dr. J.

this

is

my

we could

little

.

.

that, this,

hypothesis, I don't have good evidence for

from experience and from what think

.

it,

um,

ah, except

you've already said, um,

at least entertain the hypothesis that

I

one reason

you and your husband have accepted each other so well

is

partly

because you could see in Sue that part which you were not accepting in the other person but were completely unconscious of,

sue: Oh, boy! dr. J.: This goes as far back as the Bible,

business of

when Jews

sue (overlapping)

mr.

.

.

s.

think I

.

.

.

and

.

I've just sort of gotten

them from them

both.

You're saying that Sue represents the unconscious side of

Why do you bring in the unconscious here?

Dr. imate

me

Could you repeat that again? (Laughing.)

:

Int.:

them.

don't eat pig.

Mm-hm.

dr. j.: :

this

In other words, the things that they can't accept

each other are in

in

sue

:

you know, when you,

J.

way it

I

think using the unconscious as a ploy

is

a perfectly legit-

to get people to consider a different point of view. I don't

accomplishes anything to say,

On

know."

things a

:

"You may

would use

the other hand, I

it

not agree with

me

but

to get people to look at

new way.

A

That's interesting.

Int.:

lot of therapists

would avoid making

such a theoretical statement about what they think the trouble really

knowing the other people if

aren't seeing

you were explaining the case Dr.

way

J.

:

No,

of viewing

them

to

be

Int.:

more

less

all

it

that

way

at

all. It's

is,

almost as

to a colleague.

I'm doing

is

trying to give the parents a different

what they're doing to

their daughter,

one that

will

cause

judgmental.

What

is

surprising

is

a "behavior" therapy than

that in general your therapy seems

an "insight" therapy. Yet you seem to

be giving them insight here.

Dr.

J.:

I

think

it's

behavior therapy.

When you

use the insight

ploy in this way, you're not really referring to some kind of unconscious that they don't

know about and you

do; you're using

it

to stop

The

them and have

say. "Listen to

—pay

"You

me, because

Then

attention."

if

You

see

[

have knowledge that you don't

it's

unconscious,

how can you know?" them

as a tactical thing, rather than as "helping

it

227

they say, "You're wrong," you can say,

can't prove I'm wrong. If

Int.:

I

Eternal Triangle

understand."

Dr.

J.:

Yes. *

Because an outsider might think you were trying to give

Int.:

these people insight.

Dr.

J.:

You can

tell

the quality of the insight

when

the father

"Would you repeat that?"

says,

Int.

:

Naturally, they're not thinking that they're

making the

child

a scapegoat, and that's what you're implying.

Dr.

J.

:

No, I'm saying that they're doing

it

unconsciously.

don't have to say they're guilty, they can just say,

"We

They

didn't realize

it."

There's a fine distinction here between a tactical maneuver

Int.:

and an

insight

into this,

maneuver.

If

you were going to

would you go about

it

differently?

try to give

them

Suppose you thought

insight it

was

very important for the parents to discover that they're doing this?

them to treat the daughter the way they are already treating her, and let them discover how they're treating her. In other words, try to produce a "runaway" in the system. That would produce more "insight" than just telling them what I think they're doing. I would say, "The thing to do is be very firm with Sue, and the two of you must stand together and treat her like the child she is." Prescribing the symptom is more likely to produce insight than telling people how the mind works. Dr.

J.:

Int.:

I

would

tell

Would you

use this tactic with a chronic schizophrenic's

family in which the parents are saying, "We're very happy," and seem totally

unaware

that their child's

problems have anything to do with

them? Dr.

J.:

About a week

ago,

I

supposed to be mentally defective,

saw a family with a boy who was and of course wasn't. I urged the

mother to keep the father from being so benevolent to the son, because he was ruining his own life. As soon as I touched on this, the differences between the parents started to come out. If I had tried to give

them is

insight into

what they were doing, they would have

said,

"Oh,

Bill

so helpless, so sick, we've got to help him," or "Dr. So-and-so says

we should do such-and-such."

TECHNIQUES OF FAMILY THERAPY At the end of this interchange, you brought the Was that for some particular reason? Dr. J.: I knew the mother came from a very religious was saying to her, "Don't start arguing with the Bible." Int.:

You

Int.:

have quite a

bit of

[228

Bible

in.

family. I

ammunition, with both psychiatry

and the Bible thrown in.

Dr.

Well,

J.:

keep a

I

mind, from a variety of sources.

have brought mr.

dr. J.

I

:

mrs.

s.

sue:

I

may

:

think

I don't, I

not

.

I

dr. j.:

I

follow you.

it's

true.

may

not be too clear but

maybe one

of the

first

I'll

Sue does that are

mr.

you .

dr. j.:

difficult

(to parents)

What I'm trying to say is, we could again examine as a

is

that

some of

the things that

and cause trouble are exactly the things

do not complain about

in each other,

you

.

.

Um-hm. ... but

s.:

(Laughs.)

try.

things

hypothesis, and look for data for,

two

might

(Laughs.)

it.

ah, that

that

I

my

.

.

(overlapping): I'm sure

got

were an Oriental family,

If this

in

something from Zen or Taoism.

in

(cont.)

S.

and examples

lot of little cliches

they have been put into her, where they are then

dealt with.

Int.

The way you

:

of the

for,"

first

things

seems to

J.

Oh,

:

well,

set this

up

as a scien-

everybody believes in science. I'm saying, "This

not just personal opinion,

it's

something we're going to work on."

Int.: There's a funny quality here of "Let's

what

terrible things you're doing."

Dr. few

we could examine

enterprise.

Dr. is

"One

and look for data

as a hypothesis, tific

say,

J.:

I think I say

ideas, but I

it

Do you

you and

I

examine

often say this sort of thing?

very often: "I don't really know;

I

have a

need your help." Anybody who says he won't help

is

pretty bad.

mrs.

s.:

That's exactly right.

I

can give you

.

.

.

sue: Boy!

mrs.

s.

Dr.

J.:

:

.

.

See

.

specific instances of

how

it.

quickly the mother agrees with

something to people's attention by saying: "You

may

me?

If

you

call

not have been

The

aware of

but

it,

the idea that gives

this

[

229

could have been going on," they tend to seize on

was unconscious. The

it

Eternal Triangle

which they

avidity with

you an indication of how "unconscious" they

seize

really are.

it

These

parents were at each other's throats, they just hadn't publicly admitted it.

sue:

mean things Thank you! (to Mrs. S.)

It's

dr. J.

so true. I

.

.

.

:

sue:

.

mrs.

s.:

.

.

you don't (laughs) like. have recognized that and I've even talked about

things that

Well,

I

it

(inaudible phrase)

sue (overlapping)

Well, the things you don't like in each other are

:

way

here in me, and I'm sorry, that's just the

mrs.

s.

:

nobody minds the way you

Darling,

sue (overlapping) dr. J.

Well,

:

(interrupting)

:

all

right

.

.

am.

are.

.

up again! Your be helpful again and you start off on

Here you go lousing

mother says something to one of your speeches.

I

things

sue: O.K.

Dr.

J.:

You

see,

I'm trying to get

the mother says she's gotten

daughter says,

"It's all

my

it,

though

my I

point across to the parents;

don't believe she has, and the

fault," to take the focus completely off

what

I'm trying to do.

One might assume that this has touched some family chord daughter wouldn't come in so quickly. Again, you seem to feel

Int.

or the

:

pretty free to quiet

Dr.

J.:

I

Sue down.

wonder why

I feel

more

free with her than with the

parents.

Int.:

I

don't think you'd say, "Here you go lousing things

again," to the mother.

Dr.

J.:

It's

You make it sound very

mainly that

I

up

affectionate.

have a way, not entirely intentional, of

establishing a signal system with the identified patient, of indicating:

"You're crazy, but you and

me greater leeway. Int.: You seem

I

know

that's

not

all

to be suggesting you're

of you."

And

it

gives

more comfortable with

the schizophrenic.

Dr.

J.:

I

can do

this

with a married couple, with whoever

identified patient, in the sense that they've

is

the

agreed that he drinks, or she

TECHNIQUES OF FAMILY THERAPY steals.

You

can say to somebody, "You

[230

and have

really are a mess,"

sound hopeful. Here the mother hasn't admitted to anything, so

it

if I

criticize her, it's all negative.

When you

Int.:

say to Sue, "Here you go lousing things up

you introduce the assumption that she can you mean by "hopeful"? again,"

Dr.

J.

stop. Is that

Yes.

:

Int.

:

Perhaps you're not so sure the mother could stop.

Dr.

J.

:

If the

mother said something was wrong with

way

could give her credit for being wrong in a

daughter," or

my

"It's all

my

fault that

could say, "I'm sure you're not wrong It's

:

all

daughter

meant she could do is this

my

way," then

I

the time."

an interesting point, that with someone who's taking the

blame you've got something to work with. feel parental

that

her, then I

mother were saying, "I haven't been doing well with

better. If the

Int.

what

toward the

girl.

Some

I

wonder

also that

if it's

therapists feel parental

whole group, and they

treat the parents like children, as

matured enough to be

adults.

But you

if

you

toward the

they haven't

treat the parents like adults,

and

the girl like a child.

Dr.

J.

When the

:

child

is

there,

it's

easy to be against the parental

coalition. If only the parents are there, then there isn't

You

a coalition.

can make one by treating both as younger and pitting them against you. In some marital situations, the couple achieves

its

strongest rapport in

being against you. Int.:

Do you

Dr.

:

J.

use this consciously as a tool to get them together?

Yes. But

it's

not as hard to do with a symmetrical couple

with people like this

who have

a third person to focus on.

Even

as

it is

if

they were to get together, they would only get together over that

person. Int.: If the parents sense that you're aligned with the child, does this

make a problem for you Dr.

J.

:

Sometimes.

in handling

I try to

caught. I saw a very beautiful

keep

girl

them?

it

even, but every so often I get

a few

months ago who got married

and then had a psychotic breakdown. She was supposed to be crazy, unable to get a job, and so on.

We

established a rapport very quickly,

and then

in.

The mother

"What

I invited

the mother

we going

started saying to

me,

do about her?" and "She shouldn't see her exhusband," and "She doesn't know what she's doing." The girl and I are

to

The

Eternal Triangle

231

[

were talking past the mother to establish certain rules which sounded very sensible, such as what she'd do with her attorney, where she'd look

and so on. After the

for work,

session, the

mother went back to the

them to me and said that I must have seen the ex-husband before they came in and made an agreement of some sort with his family. I thought I was being nice to the mother, but I was obviously mistaken. The patient left a good deal taller, and the mother resented it. So I do get caught. But to get back to Sue, did you hear her say "O.K."? It was a perfectly straightforward, evenly modu-

psychiatrist

who had

referred

"O.K."

lated

Int.: Nothing crazy "about treating her as though she

it.

think that's also because you're

I

You

were sane.

react to her as a

young

girl

who's intruding or interrupting her mother. There's no quality of handling

somebody who is disturbed. Dr. J.: No. And her tone implies,

something Int. have. But

else," I

:

it's

if

is

let's

go on to

a good sign. She could have gotten angry.

you had been the

least bit patronizing, she

would

a sane "O.K."

:

Can you

Yes I can, a very Good.

s.:

dr. J.:

Int.

think

(to Mrs. S.)

dr. J.

mrs.

which

"I get the point,

think of an example?

specific one.

Here, when the mother does agree with you, even though

:

it's

doubtful whether she really does, you're so nice about asking her for an

example.

Dr.

Is this to test J.

This

:

is

her out, or

is it

to

go along with her?

to say, "We're in as

you as we are of examples from the

much need

of examples from

patient. It's again a

way

of equal-

izing them.

mrs.

My

s.:

he

is

husband

irritant to

me

married, and

first

now, and

late

chronically,

and

I

congratulated him today,

chronically late, unaware of the passage of time, which

an extreme

were

is

I

because

I

was a prompt person when we

adjusted along the line to him. I'm a

he's a lot better

was

about getting to places

earlier.

little

But

Sue had the same lack of sense of time, completely (Sue talking in background) and I was determined that she was going to learn (laughing) dr. J.:

I

hope

—I'm being honest about

so.

this

.

.

.

TECHNIQUES OF FAMILY THERAPY Dr.

J.

Here I'm struck by the cleverness of the

:

"I'm being honest."

says,

on you by That's

am

saying, "I

why

as

It's

I

if

The mother

tactic.

excused myself for putting the finger

being honest, for which

who

don't go along with the people

I

[232

I

deserve praise."

believe in thinking

disorders.

Int.: It could be argued that thinking-disorder tactics are ex-

tremely

This

skillful.

is

a beautiful one.

after agreeing so nicely

gives

it

about their doing these things unconsciously,

a twist that gets her out from under. She says, "I was aware of

my husband's is

noticed that the mother,

I also

and

influence,

I

fought

it." It's

the father's influence that

unconscious.

Dr.

J.:

You're

me

She puts

right.

in

my

place by saying she

wasn't unconscious. But at the price of admitting to some marital conflict.

One

thing about saying that something

is

unconscious

is

that they

The only way they can refute you is to say, "No, it was conscious," which puts them on the way to admitting what they are

can't refute you.

doing.

sue:

I

mrs.

s.

have learned, a

mr.

s.:

mrs.

was determined that she was going to learn she wouldn't impose on other people by forgetting time.

{overlapping)

so that

s.

:

lot.

I

:

So she wouldn't belike her father. (Laughing.) No, that isn't what I mean, because, so that she

dr. J.

(overlapping)

mr.

(overlapping, laughing)

s.

dr. J.

All right

:

:

.

.

.

.

.

.

That's a fact.

(overlapping, laughing): That sounded like

what you meant.

That's fair enough.

sue (overlapping) Int.

:

Dr.

J.

mother

:

Yeah,

I

think you've done a fairly good job.

Why did you come in then? :

Everybody's taking his hair down. Father says

says, "I didn't

mean

it."

They're having a

ness. I'm always willing to underline this

think these

Int.

:

moments It's

are

a mixed

all

culpa;

of together-

possibly can, because

I

too infrequent.

moment

of togetherness. Father has just inter-

preted Mother correctly by saying, late like

if I

moment

mea

"You mean you

don't want her to be

me."

Dr.

J.:

Yes, but that's an admission. Mother says, "Let's

honest," and everybody

is

all

be

being honest. Father said that about his late-

ness right after his wife said, "I'm able to be honest."

The

He

Int.:

forced her to take

it

Eternal Triangle

[

233

back. She then slid into a bit of

dishonesty by saying, "That isn't what I said."

Dr.

moldy

But

J.:

She

fig.

is

isn't

taking her usual role as the

being honest enough to say, "I think you've done a

good job." Everybody's mrs.

And Sue

girlishly.

just

—but

charming

oh, for so short a time!

You, you bucked for a while but you finally saw the reasons why it was necessary to be on time, because it often imposes on other people, it imposes on (to Sue)

s.

.

.

dr. J.

think you've been wonderful about

I

:

thesis,

.

Ah, but you said something else that supports I'm happy to say, you said she bucked for a while. In

(interrupting)

my

it.

:

you think of a child as being pretty malleable, ah, why wouldn't she have learned to be right on time from the beginning? So other words,

if

.

mrs.

I

s.:

been

.

.

don't think of a child as being malleable. Sue has never

in

her whole

life,

from the time she was born.

dr. J.: Oh.

Dr.

J.:

This

is

my

fault. I set this

up. I got a

with the mother and said, "Aha! You've proved

weak

tactic

all; it

was

pushed her into

You pushed

:

competitive

point," but

it

was a

because then she could say, "That doesn't prove anything at

inherited." I

Int.

my

little

this position.

her to contradict herself. She's been saying

it's

the father's influence, not heredity.

Dr.

J.

Yes, but

:

I

could have handled that better by not meeting

the mother head-on.

Int.

When you

:

said,

Sue wouldn't have resisted

"You proved my

you mean that unless there were some conflict between the thesis," did

parents?

Dr. mr.

J.

I'm saying that she's getting reinforced by the father, yes.

:

Malleable? (Sue laughs.) Is that what you said? Never been

s.:

malleable?

sue:

Um-hm.

mrs.

s.

:

There's never been one, this

one thing which

I

is

my

trouble, there's never

been

considered as normal teaching or training on

the part of a mother, and a mother's responsibility to her children,

which hasn't been a struggle with Sue. sue: Ohh, I don't think that's a fair comment. unfair and

it

blames

me

for something

.

.

.

I

think that's highly

TECHNIQUES OF FAMILY THERAPY But

dr. J.:

sue:

.

.

dr. J.

mrs.

mal"

is

Now wait a minute

:

(overlapping)

what she

is

.

.

.

Darling, no.

:

The mother goes

:

Dr.

.

.

that isn't totally true.

.

s.

Int.

.

pretty far there. "Sue has never been nor-

saying.

kind of talk: "She's been that

It's irrefutable, this

J.:

[234

way

ever since she was born."

Int.

Yet

:

When you

minutes ago she was agreeing completely with you.

five

think she must have heard

it

come from you," I way she brought Sue

not inborn, they

said, "Sue's troubles are

as a criticism of the

up, not as a reference to the father's reinforcing the daughter.

Dr.

J.

That's the trouble with her technique. She cuts

:

me

off,

as

I'm sure she does other people, and ends up in a worse position than she would

she could wait a moment.

if

may be

Int.: That ics.

They come

in too

dr. j. (to Sue)

sue: Well,

have

.

little

s.:

their

into.

Ah, how can

be

it

fair

or unfair?

haven't bucked her on everything. I couldn't possibly .



(overlapping):

dr. J.

MRS.

.

I

:

of schizophren-

soon every time, then they struggle to get

what they got

feet out of

main weakness of mothers

the

well,

It isn't

baby? Your mother

is

who

talking about

when you were a

you,

is

back to the

crib.

(Overlapping, inaudible phrase.)

know, but I couldn't possibly have re-rebelled on everything or I'd be faster in a mental hospital than I was.

sue: Well,

I

(overlapping)

dr. J.

So don't buy the statement.

:

sue: (Sighs.) dr. j.: Don't

sue

buy

it!

(starting to cry)

dr. j. (overlapping) this. It isn't

sue: dr.

Hm. j. ...

mr. mrs.

:

s.

:

s.

I don't,

:

I'm not buying

Your mother's

:

it.

expressing her feelings about

a fair or unfair statement because

it's

.

.

.

simply a reflection of what she's feeling.

That's her training,

(overlapping)

:

and you can (Mrs. S. and Sue

all right,

Well,

I

.

.

.

talk at once,

words

unclear) completely frustrated because simple, basic things,

how hard I tried, I could never seem mean, how you hold your fork at the table matter

.

no

to get the results. I .

.

The Eternal Triangle

Um-hm.

dr. J.:

mrs.

s.:

by

.

.

table manners, just habits that are instilled in children

.

their mothers, that

You come

Int.:

235

[

must

be.

in so persistently there, as

if

you

feel it's

very

necessary.

Dr.

I

J.:

would have

to see a

movie of

it

suspect from the tone of the voices that this vulnerabilities. ing, "I

know,

To me,

this is high-class

darling, I'm only telling

to

know, but

I

would

one of the recurrent

is

The mother sayyour own good," and

brainwashing.

you

this for

Sue saying, "You're being unfair," meanwhile

starting to

showing some moisture in the eyes and so on.

I

go downhill,

consider this whole

argument of the mother's, about Sue never being malleable, as pretty psychotogenic, a devastating thing to say. I'm almost pleading with the girl,

"Don't buy this!" Int.

You seem

:

to have a strong aversion to

washing. Is that partly

why you

what you

call brain-

turned on the parents before and said,

"The problem isn't Sue, it's what's going on between the two of you"? Dr. J.: If the brainwashing bothered me, it was more from the standpoint of Sue's being so confused that she would accept her parents' distorted

went into

it

view of things.

more

I

wasn't really blaming them.

I

think I

as a reaction to her prostituting herself in order to

be

So I think it would be more a question of attacking the John Rosen says. You're not fighting the patient, you're

their daughter.

psychosis, as

fighting that crazy aspect of her. In the

same way, you're not

fighting

the parents, you're fighting their contribution to her craziness. Int.:

You

take the daughter's side very feelingly here and

pletely dismiss the mother. It does

sound as

the mother

if

com-

had provoked

you.

Dr.

Only because her tactics are so good. She has to deny what she's doing by saying, "I'm putting the finger on you, Sue, but only for your own good, and I wouldn't do it unless I were a mother. It's

J.:

a mother's duty to suffer." She's gotten

all

it

in there. I

am

pro-

voked, not by the mother's chicanery, but by the very mechanics of

what she

did. I don't think there's the least bit of motivation there,

almost instinctual for her to do that.

animal experiences when hunting, or does

it

it

It's

gets a scent.

just react?

as

if

Does

it's

you were asking what an it

know

it's

a coyote out

TECHNIQUES OF FAMILY THERAPY Int.

You seem

:

to be saying that

you

can't

[236

blame someone who

any more than you can blame a hunting dog who chews up

acts like this

the neighbor's rabbit.

It's

a curious reason for not blaming someone.

In other words, you're provoked by the psychosis again.

Dr.

J.:

Int.

:

not the

Yes.

In dealing with

way

Dr.

buy

mother couldn't help her behavior. treat it's:

If I

You

to the mother, "This

say to the daughter,

is

"You

this."

must admit I'm a

I

J.:

you don't say

your daughter."

to handle

don't have to

this,

it."

proud of

little

this.

"Your

I said,

That makes the mother equally irresponsible in

way to This way

turned to the mother and said, "That's not the

makes her saner than the daughter. "Your mother couldn't help what she said, so don't take your daughter,"

it

it

person-

ally."

You're bypassing the issue of blame again.

Int.

:

Dr.

J.:

Yes.

If the

daughter hears herself being treated

by the mother, unless she "can't help

Int.:

it,"

It

she's going to

must have an

her on this directly but

what she

tell

it

way

because she

blame

her.

effect

on the mother when you don't

call

the person she's talking to not to accept

says. It cuts her out.

Dr. can't

mother does

realizes that the

this

J.:

Yes. She doesn't like that. But

do much about

Whereas

it.

"I'm as good a mother as anyone Int.

:

To it,

attacked her directly, she'd say,

"You

how

don't have to

It

buy

it" is also

they talk in that room. If she doesn't

up a new no matter what anybody says,

she doesn't have to argue about

precedent in the family.

content-less, so she

else."

say to the daughter,

asking for a major change in

have to buy

if I

it's

implies that

the others don't necessarily have to take

it

it,

which

sets

as the ultimate truth; they

don't even have to react.

Dr.

J.:

If

you

remarks a therapist makes,

classify the kinds of

one category would refer to what the rules of communication.

What

and the other would

refer to

you're talking about would

fall into

is

said

the second category.

The phrasing you use here through this family interview, you come Int.:

playing terms. ings,

When

you cut them

falls

into that category. All

in with bargaining or

people start getting caught up in their

off,

using some phrase

like,

"Don't buy

game-

own

feel-

it," "It's

a

The

Eternal Triangle

237

[

you don't have to fall into," "You won't win this argument." When you do this, you bring in the idea that feelings are tactics, that they take trap

place within an interactional framework.

Dr.

:

Yes, but you have to remember that feelings are also pre-

tactical. It's

not easy to remind yourself that your response, however

J.

emotional and purely nontactical, will be seen as tactics because that's

we

the kind of environment

You've got to help people to

live in.

inter-

own reactions.

pret their

Int.

But using

:

tactical phrasings yourself is a little different

from

directly interpreting reactions as tactics.

Dr. pret

J.

Well, I don't see

:

somebody

dying of cancer,"

don't let

and

in

him and

his depression

a tactical situation once he's said

me

think this

is

news for you, I'm

says, "I've got

upset you," you think,

what the psychotic

"Now

up

is

about not wanting to exit.

Then

if

no use saying

having

"Oh,

man

to the

against.

Because of

mean

and you'd

that at all,"

you've got enough time

some of

leg." I

his training,

he

on a group. But

with cancer or whatever, "Your misery

was dying and here you'd made him if

my

is

kinds of effects on other people," because then he'd say,

all

I didn't

"Well,

he adds, "Oh,

he's really pulling

doesn't recognize the effect of that kind of a statement it's

on what

doesn't matter that he's simply reporting

it

his internist has told it's

out directly and inter-

a group, or even in a dyadic situation,

else's feelings in

somebody comes

as tactics. If

pire;

how you can come

left,

feel

doubly bad because he

feel terrible. If

you could

perhaps you could help Christ do

work," that would be a way to get

his unfinished

say,

it

into an

interactional framework. dr. j. (to Mrs. S.)

ing from,

mrs. dr.

s.:

J.

:

But where was

:

the,

where was the other

side

com-

you see?

Um-hm. I mean kids

are

little.

If

they don't do what you say, do what

you tell 'em to, you can beat 'em, or you can scare 'em to death, or you can brainwash 'em, you can whisper to 'em while they're asleep,

mrs.

ah

.

.

(laughing)

s.

.

:

Well,

I

never heard that one,

I

should have heard

that one!

sue:

Dr.

works!

It

J.

:

You

notice here that I

went

just a little bit too far. I

one, two, three phrases, and then a fourth, which

used

was one too many.

TECHNIQUES OF FAMILY THERAPY She picked ately

up and said, "I should have heard that one." Just as an would like to sit down with a family like this and deliber-

it

experiment,

I

behave

way

in a

beforehand that

to get myself annihilated. I think I could predict

used certain too

if I

explicit, or

too extravagant, or

whatever, expressions, the mother would invariably cut

have to know when to stop. third, fourth,

dr. J.

mrs.

:

s.:

dr. J.:

mrs.

What, where was the other

side

The other side of The negative side. If

.

.

.

Yeah.

:

first,

second,

subject.

coming from?

.

.

she

.

.

of Sue?

.

.

me down. You

could hear this coming:

I

and then she wipes me out by changing the

s.:

dr. J.

[238

she was

If

for example, until she finally got over

late,

had to be some reason why she was

that there

do what you

said right

late,

why

from the beginning. This

is

it,

she didn't (inaudible

phrase).

MRS.

(overlapping)

s.

time thing

Well,

:

I believe, I

believe firmly, as far as this

concerned, that some people are just born without an

is

acute sense of time, and others are born with a better sense of time. (Sue laughs.)

MR.

s.

You

:

sue: No,

mrs.

s.:

it's

think that's an inherited characteristic?

something adopted.

I'm not

at all sure

it

you look, if you look you can find plenty of

isn't inherited. If

back through the families on both

sides,

evidence. (Laughs.)

Dr.

J.:

As an

aside, the letter I told

seven or eight o'clock in the evening, for dinner. This

was

now, twenty years don't It's

show up

marvelous

early in the marriage.

later.

And

for dinner;

how

What

is

She

tell

me

this genetic idea will spare

curious

shown up

about time:

"You

you're not coming."

her twenty years of

She doesn't even have to think about

is

things that she claims were

at

talks about sense of time

in that letter she talked

the examples the father set for the :

the father had not

you don't even

suffering as she looks back.

Int.

when

you about was written

all

little girl.

the

way

born into

the mother blames the child for her. If she

was born

that way,

how can she deserve to be blamed? Dr.

J.:

Well, the mother's tone

a kind of forgiving

way

too.

But the

is

complaining, yet she speaks in

fact that she's forgiving

them

all

The Eternal Triangle

the

more

the fact that they're terrible.

reifies

It's

239

[

a tough one to deal

with.

dr. J.: But that's

no

is

— (Mrs.

scientific

S. laughing.)

You know, there, there

evidence to date for any particular personality

being inherited,

let

(Inaudible phrase) must be adopted.

mrs.

s.

sue

Um-hm.

:

dr. J.

then a form of imitation?

Is it

Well, at least until there's evidence to the contrary,

:

would have to assume that this is a good daughter want to imitate her father? mrs.

s.

:

trait

alone something as specific as time.

sue:

:

actually

bet.

And why

I

think

we

wouldn't a

Well, I think she would.

sue: Pretty thin thing to go by. (Laughs.)

Are you assuming a metaphorical conversation here about

Int.:

mental

illness

Dr. I got

J.

back

and inheritance? Yes, sure. But

:

to the father.

do a

genetic doesn't

"Why

participant.

I

We

bit of

got off onto genes, but just saying

good.

You make

:

I shifted

when not

it's

to the father, a true live

wouldn't the daughter want to take after her father?"

That was a pretty good move, Int.

did do something rather good there,

it

I

think.

sound so acceptable for a daughter to imitate

her father.

Dr.

J.

:

Yes. Judging from what

says something the family. right out

bad

It's

is

:

blame her own

she

side of

Listening to that conversation about which side of the fam-

came from, I took it more thing we did. It was in the genes." J.:

In

my

as: "It

that's stupid.

Your

was independent

experience, with these families,

about the two sides of the family comes up,

lot

when

she can reproach her husband without coming

the trait

Dr.

of the mother,

and doing it. I'm countering that.

Int. ily

know

inherited she's not going to

way

a

I

side

is

it's

of any-

when something

usually the other side

stupid because your people

moved around a

or had a bad time during the depression. Int.:

When

you're speaking to the mother, you don't say,

"Do

you suppose Sue imitated her father?" and wait for the mother to say, "Yes," and then say, "Why shouldn't she imitate her father?" You're a step ahead. You're slipping in a premise that's accepted before

it's

TECHNIQUES OF FAMILY THERAPY really agreed to.

The mother

why

along, saying, "Yes,

when

replies as

Dr.

You're

J.:

ened and needs that she

but

right,

this particular

kind of power, she

her husband.

is

The reason

my own

game.

for If I

it is

theories

this family.

and goes back to blaming

that she cannot keep

from trying to

can say something she has to agree with

if

going to be co-therapist, she will suddenly find herself taking a

position she hadn't

Int.

meant

to take.

There seems to be a process of therapy of constantly using

:

what people have this

order to show

will, in

happened over and over again with

Here the mother denies her genetic at

making use of the which the mother is threat-

also a matter of

it's

as competent as the therapist, almost invariably not refuse

is

certain kinds of bait. It

she

all

shouldn't a daughter imitate her father?"

natural coalition formations. In families in

me

had been assumed

never even been discussed.

it's

top

this

if

[240

do

to

in relation to you.

It's

very evident in the

way

woman goes with you. mrs.

s.

think

I

:

did with mine.

I

to do, but I think

case

think

I

it

I

same

situation existed in

And

that's

why

think

it's

a perfectly normal thing

can be exaggerated too.

was, and

it

I

And

our particular

in

was not only Sue, I think the reverse with her next younger brother. think

there are

it

two other members of the family.

{Pause.)

sue:

I don't get that.

dr. J.

sue:

That's

:

I

why

two other members of the family?

there are

don't understand that.

you and just Pete, and Daddy and me, and you'd been Daddy's girl from the word go sue {overlapping) And Pete was yours. mrs. s.: very openly about it, and Pete came along and was an

mrs.

s.:

Because when there was

just

.

.

.

:

.

.

.

easy-going, peaceful, humorous, relaxed

little

guy,

who

relaxed

me, when you two have always been so high-tension that you exhaust me, to

tell

had the opposite stayed that

down

effect.

the other,

remember,

Bill,

that's to

of this."

And

way we were

the middle with

me on and

you the

which

when

I

it

good many

was only too obvious

going to have a family

Daddy and you on one

is

times, that

and Pete if

split right

side

not a healthy situation in

we

just

smack

and Pete and

my

book.

You

said to you, "There's only one thing to

do

one more child quickly, and get us out your grandmother was horrified when Laura was

have

And

a,

truth, a

at least

The Eternal Triangle coming, and doubly horrified when

have another one as

And

fast as I can."

although there was another

I said,

[

241

"Yes, and I'm going to

(Laughing, everybody laughs.)

girl

and another boy

didn't hap-

it

pen that way. dr. J.:

Um-hm.

mrs.

(Sue talking simultaneously, words unclear)

s.

and

I

fought for years to

that I could

him.

make him

nearly killed

It

to cry) but I won't

Int.

That's the

:

The

ing a child.

first

.

.

.

that way,

could lean so easily on Pete

into just a leaning post, but I won't

me

do

try, I

:

it

to have

him gone four years too

do

now it

to

(starting

to him. (Pause.)

time I've ever heard that motivation for hav-

coalitions are so tight that

you need another child

to

break them up.

Dr.

J.

:

I

don't

know what you can do

with that speech, she said

so much. She lashed out at her husband, her husband's family, her

daughter,

all

under the guise of explaining why she had to have another

child.

Int.

Dr.

:

J.

Int.:

Do you think this was calculated? :

I

don't know. But something set her

It's

possible that this speech

of turning point.

an indication of some kind

Looking back over the interview, the daughter seems

to have fallen into line with after

is

off.

you very quickly, and the father did

you called him on not showing

haven't been able to involve to blame, but not her.

is

his feelings.

too,

The only one you

the mother. Daughter and husband are

So you say

"You may have unSue." The mother won't

to the parents,

some of your problems into agree with you, because that would be an admission of guilt, but she can't deny your statement because the behavior was "unconscious." Her tactics are to agree at first and then slide into a different position. So she says, "You're right, my husband's problems are in Sue, and I have tried to get them out of her." The husband says, "So she wouldn't be like me," and you agree. To avoid exposing the rift between them and to refute you, she starts to suggest an alternative, that Sue was impossible from the beginning. You push her on it a little and she makes the remark about the baby who was born resisting her.

consciously put

She's is

the

been blaming Sue throughout, by weeping and being hurt, but first

time she's blamed her openly.

When you

this

then turn to the

daughter and say, "Don't buy your mother's statement," you cut her

TECHNIQUES OF FAMILY THERAPY out without directly attacking her. Her reaction side

and be

So

co-therapist.

to

is

ily.

Would you J.

agree that something like that think that's right, yes.

I

:

do over and over, but dr. J.

your

is

the hardest to pin

scene could be significant in establishing you with the fam-

this

Dr.

to

seems that you have now succeeded in

it

reaching or touching each person. Since the mother

down,

come over

[242

that

I lost

:

mr. and mrs.



to

first

you have to

interview.

have him gone four years?

(simultaneously)

s.

operating here?

the kind of thing

It's

especially in the

is

:

He was away

at school for four

years.

dr. J.: Oh, I'm sorry!

mr.

s.

We, ah

:

dr. J.:

mr.

.

.

.

get you.

I

s.:

.

.

much

.

around home, but

mr.

s.

.

.

.

:

sue:

.

.

.

.

.

.

.

.

.

.

.

which he liked

.

do

to

.

.

.

(Overlapping, inaudible phrase.) (overlapping)

DR. J.

MR.

and

I see.

:

s.

his independence,

up, and tear

it

he liked

MR.

him

:

s.:

dr. j.

him

in order to give

rather have

him away from the apron strings, we (overlapping) And not let myself lean on him deliberately encouraged him to go away to school, which

build

MRS.

much

Mrs. Starbuck'd

rather,

He's in prep school in

s.:

dr. J.

mr.

[city].

Um-hm.

:

s.

He's in prep school?

:

He's coming

:

home

this

June and, ah,

I think,

going to [univer-

sity].

Um-hm.

dr. j.

:

sue:

Now I really admire you for

mrs.

s.

(overlapping)

it.

Which has been

:

his

been any pressure from either of us on

Um,

own

that.

um, coaxing, but nothing, no sue: Well, anyway I, I think it's a fine thing. mr.

s.:

dr. j.

mrs.

sue

s.:

:

mrs.

s.

well,

insistence.

Who is Sue supposed to look like?

(to

mrs.

sue

:

decision, there hasn't

:

I

think she's a cross.

mother)

:

tell

always have. (Laughs.)

me

I

look like you.

Well, they say you look like Daddy, too.

More, more s.:

People

I

You

sue: Well,

like

analyze

my

you than more it

like,

than like Daddy.

yourself sometime.

high-school graduation pictures were

.

.

.

The

sue:

.

mr.

.

definitely

s.

is

a mix.

She's got

:

my

eyes and

wider face and, ah

MRS.

MR,

than her mother but she, ah, ah,

Um-hm.

dr. J.:

MR.

me more

think she favors

I

243

:

.

s.:

[

Mr. S.) What do you say? dead ringers for yours.

(to

dr. J.

Eternal Triangle

thin face, whereas her

mother has a

.

.

.

my

(Laughing, inaudible phrase.)

s.:

think her physical long muscles are a

I

s.:

little

more

closely re-

sembling mine.

mrs.

s.

disagree with you there.

I

:

sue: Uh-huh,

MR.

(overlapping)

s.

asked

mrs.

mr.

s.

s.

mrs.

mr.

:

:

s.

don't know,

To look at Laura, Much closer. Laura

:

.

never analyzed

I

it

distinctly,

you

.

.

.

I

:

is

physically Laura

you completely,

(simultaneously)

s.

Much

:

is, is

.

.

.

physically.

much closer.

closer,

Um-hm.

dr. J.:

MR.

(inaudible phrase)

I

This question was, which do

s.:

I

think she resembles the most?

(Sue talking in background.) dr. J. : Well, yeah,

and some families

parents on each side and the child will

than a Smith, but

MR. and mrs.

...

dr. J.:

mrs.

s.

mr.

Ah

.

(simultaneously)

s.

is it, is this

.

.

Well,

s.:

.

s.

Um-hm.

obvious in your families? In your relatives?

.

it's,

ah, very obvious in our other

or other three children, ah

mrs.

:

Uh-uh. No.

:

dr. J.:

.

you know, grandbe known more as a Jones

will have, ah,

Oh,

:

.

.

two children,

I think,

.

I don't.

mr. s.: that she f-, they favor one side or the other? (Pause.) mrs. s.: No. I think Laura, of the four of them, is the one you can pick out the most and say, she is so and so. mr. s. Starbuck, yes. .

.

.

:

mrs.

s.:

one

Laura I feel

sue: .Charles

Int.

:

Why

is,

yes, there isn't

any question

at

all.

But

she's the only

you can say that about.

is a, is

a true [mother's family name].

did you

make

Sue was supposed to look like?

that

remark about which of her parents

TECHNIQUES OF FAMILY THERAPY

[244

was my own personal opinion that Sue was very much like her mother and I felt that it was about time to get the two women together. They'd been talking about heredity, family, and so on, and I was trying to say to the mother, "Well, as an outsider, it Dr.

Because

J.:

me

appears to

that

it

Sue looks very much

had looked

beautiful." If she

her father,

like

because she's also

like you, I

never would have done

it.

The

was to bring about another little rift between the parents, because the mother then disagrees with the father. Int.:

effect

was surprised. I didn't think that anybody would think other than what I thought, which was that Sue looked like her mother. Dr.

And

J.

I

:

the mother

thing like me."

ness



Sue,

thought

The mother

Int.:

You do

I

tells

who

this

is

was

"You

very attractive,

don't look any-

heartless.

says she's a cross. Cross to bear,

if

anything.

ask whether father's pushing daughter to give mother the busi-

a subject you were on earlier.

Dr.

J.

When

:

I

introduced this other idea,

would agree with me. The assumption

that

is

I really

you look

if

body, then you've inherited some of their other genes. sarily follow,

Int.

but

it

It

like

some-

doesn't neces-

makes a good premise.

You're adopting

:

expected they

their genetic theories in order to

go along

with them again.

Dr.

J.

Yes.

:

I tried to

own game,

beat the mother at her

but she

stopped me. dr. J. (to Mrs. S.):

May

I see

your hand? (Mrs.

S. talking simul-

taneously, inaudible phrase.)

mrs.

s.

dr. J.

mrs.

MR.

(Laughs.)

s.:

From what?

:

s.

Uhh

:

mrs. dr. J.

mrs.

dr. J.:

mrs.

.

Treatment

:

for, ah, a malignant, ah,

ah

.

.

.

Bone?

:

s.

.

Treatment for what?

:

s.

.

X-ray. (Mr. and Mrs. S. laugh.)

s.:

dr. J.

an X-ray burn, Dr. Jackson.

Oh.

:

dr. j.

mrs.

It's

:

:

.

.

.

can't think of

it



yes,

when

I

was

five years old.

Mm.

s.:

As

a matter of fact,

I

saw

[radiologist] yesterday,

he had

The Eternal Triangle

some it

mr.

which he uses constantly (laughing) as demonstration.

s.

s.

mrs.

I'm lucky

:

have

I

Lucky you

:

s.

Ooooh.

:

still

it,

that hand.

have what's

left.

Yeah.

:

dr. J.: I'm, the reason I asked was

had any, ah mr.

s.

No,

dr. J.:

s.

ah, psychosomatic difficulties.

you know. have no

I

:

.

.

dr. J. (overlapping)

mr.

s.

.

.

.

and

vertebrae on

sue

s.

mrs.

s.

my

... from

:

Is arthritis

:

dr. J.

mrs.

.

.

.

is

aggravated by tensions.

.

.

.

s.

.

.

my

spine and five

damaged

.

It

:

.

spine

.

.

.

.

a

fall

and

—but

painful

but

developed about three

psychosomatic? .

.

.

can get tangled up in .

arthritis, ah,

fall.

Some forms

:

dr. j. :

if

you have an

when your muscles

it,

yes.

injury,

you can

certainly

make

it

more

tighten up.

Hm.

sue:

(toMr.S.)'. Are you in reasonably

dr. J.

MR.

physicians are

psychosomatic?

years after the

sue

.

severe arthritis.

skips')

have three disks in

I

... lower

:

Is it

:

.

Mm-hm.

:

mrs.

.

know who your

My spine, when I fell

:

s.:

dr. J.

.

(simultaneously): Neck.

s.

mrs.

.

there any headaches or

Whereabouts?

:

mrs.

.

Are

haven't had any

don't

I

:

I

:

Severe arthritis which, ah,

:

dr. J.

you

Hm?

dr. J.: s.

ah

I haven't,

Mrs. Starbuck (tape recording

s.:

mr.

either of

.

(simultaneously)

s.

mr.

if, if

.

.

ulcers or,

mr.

wondered

(Laughs.)

s.:

mrs.

ah,

No, no.

:

mrs.

.

I,

Hereditary defects?

:

dr. J.

245

and X-rays that he took of

beautiful, ah, color photographs

sue (laughing) mrs.

[

s.:

Very good

health. I

.

.

.

have no physical problems that

I

know

of.

sue: Well, I'm glad someone doesn't. (Laughs.)

mrs.

s.:

Well,

I

think we're an extremely healthy family. I think that

our, our overall record for

all six

of us for

all

the years

is

.

.

.

TECHNIQUES OF FAMILY THERAPY

[246

You make up for some of us. mrs. s. ... remarkably good. sue:

:

Mm. Well, ah Well, Mom, your health has

dr. j.

.

:

sue:

.

.

never been too sharp.

Honey, you have worried about sue: Well, you know why? mrs. s. much too much.

mrs.

s.

.'

:

sue

.

mrs.

s.

I

:

sue: No,

doubt

that.

Mom,

I

dr. j. (to Sue)

and sue:

You

:

.

.

think that

.

it's

.

always been thrown up to me.

.

win

aren't going to

agreement,

this particular

.

know.

I

dr. j.:

MR.

.

.

.

.

You know why? Because

:

it

:

.

.

we're running out of time and so

.

Why,

s.:

I

—may

want

Mrs. Starbuck did have

refer- (tape skips).

to,

ah

one thing that

just clarify this

I

I

TB

.

I

.

.

think she's

as a child

.

.

.

sue: Yeah.

mr.

... and we have

s.:

"Now

warned Sue,

constantly

don't run

yourself down."

when

sue: Yes, and

thrown up

to

me

I

wouldn't stay in bed

that

I

when

might get TB, and

it

I

was

sick

it

was

was the only means

of disciplining me.

mr.

s.

mrs.

I

:

have done

(simultaneously)

s.

s.

I

:

disciplined

haven't

.

.

.

.

Whenever I didn't behave and when I wouldn't be one way, you would throw my health up to me to

me

discipline

maybe s.

I

:

.

.

:

sue (overlapping)

mrs.

have done

You haven't. It's been mostly you, Daddy. don't even know this existed.

sue (to mother) mrs.

that, I

part of

:

and scare

me

into

it

by using

my

health.

And

this

is

my problem.

(overlapping)

:

never have heard

I

it.

I've never

heard that

before.

sue: Well, I've heard dr. j.

:

sue:

I

mr.

s.

dr. j.

mr.

:

it.

I

can give you a couple of

You won't win this argument. know I won't. But I'm just saying Well,

I

have said

it,

in that

I,

ah

.

it, .

specific instances.

so that they both

.

.

.

.

Yeah.

:

you caution your children, "For heaven's sake don't ruin your health." I mean it's one of the normal things sue: Yeah, but it was brought in when it didn't need to be a couple of s.

:

.

.

.

.

times.

mr.

s.

(sighs)

:

All right. All right.

.

.

The Eternal Triangle

247

Do you usually ask about psychosomatic difficulties?

Int.

:

Dr.

J.:

No,

think the mother must have winced or con-

I don't. I

way

ducted herself in some

had some kind of tension

neck problem she had. She

to reveal this

reaction.

do something to

twist her head,

Int.

[

She used to take hold of her neck,

indicate pain.

Did you know she had a medical

:

file

about four inches thick

at this time?

Dr.

J.

No,

:

I didn't. I

think

I

was

trying to switch the topic

and her neck movement and the scar on

that last area of disagreement,

her hand from the bone tumor must have given Int.

The mother

:

she says they're

Dr.

She was

J.:

And

matic?

a cue.

isn't.

bad knee cartiabout being healthy; she just had that thick

really very healthy except for a

lage. She's telling the truth file.

me

got herself into quite a corner there. Although

so healthy, she herself

all

from

the daughter correctly picks

it

up, saying, "Is

it

psychoso-

Is it? Is it?"

dr. J.: Ah,

I

wanted

weeks, ah, this

to,

ah, get onto the business of the next

ah, switching abruptly, but as I say,

is,

running out of time. Ah, as

I

understand

on a vacation, or a quick business Mrs.

MR.

s.

s.

Half and

s.

mrs.

mr.

s.

:

are going

something.

And you

will

be gone, roughly?

Nine days.

:

s.

all

half.

dr. J.: Half and half.

mr.

you, you

are

(Inaudible phrase.

:

:

trip or

it,

we

few

When

:

will

we

be home? Saturday?

A week

from Saturday?

Yes. Nine days.

Now,

dr. J. (to Sue): like

it

ah, in the interim, ah, will you, whether

you

or not particularly, but will you, ah, be willing to stay at

[hospital]? (Pause.)

sue

(sighs)

dr. J.:

:

No.

No? You

don't think you need

it?

sue: No. (Pause.) dr. j.: But where

would you have

sue: Well now,

have, this

I

I

is

in

mind

something

staying?

I

intended to bring up today.

have talked to a friend of mine, not Betsy Albright because

saw your

point,

I

I

talked to Debbie Carter this afternoon and her

family have sold their house. She was desperately looking for a

roommate

to share an apartment with,

she didn't ask me,

I

asked her, and

I

and

I'd love

think this

not as a geographical excuse, or escape, but

.

.

is .

it.

just

I

asked her,

what

I

need,

TECHNIQUES OF FAMILY THERAPY Where

dr. J. :

sue: I'd like

mrs.

s.

this?

is

it

to be in the area, somewhere.

You mean

:

she doesn't have an apartment yet?

And

sue: She doesn't, she wants someone to room with.

would be

[248

think

it

and I think it would be a good idea, considering the is now, not to escape, as I say, but to be independ-

fun,

situation as

I

it

ent. (Pause.)

mr.

s.

:

Have her parents approved of her renting an apartment?

sue: Well, she's done

mr.

s.

:

it

before

.

.

.

She has?

sue: She just ran out of a roommate because her roommate was getting married.

mr.

She's been living alone already or indepen-, independently?

s.:

sue (overlapping)

No, well they haven't moved out of her house

:

but they're going

mr.

(overlapping)

s.

yet,

to.

But

:

she's living in

an apartment, you say?

sue: She has, yes.

mrs.

s:

sue:

And

Yes,

right

I

know that. you've always told me, well,

I think, I'll

dr. J.

:

Well

sue:

.

.

get a job. If .

.

Daddy can,

dr. J.: I think

he

feels like

.

.

.

it is

fine. If not, I'll get it

on

my own.

obvious, Sue, from this conversation today, that

there are currents, ah, here that are pretty strong, and that

have sue:

I

.

you

unfortunate tendency to try and buck them, ah, to

the, the

your own

it all

.

he can help me,

.

if

could support

if I

.

.

don't see that.

dr. j.: Well, ah,

think you're

.

sue (overlapping) dr. J.:

.

.

.

think you, I can appreciate the spot you're in but

I,

.

:

.

It's

the worst spot (inaudible phrase)

trying to use a bulldozer instead of

getting, ah, cutting

sue (overlapping)

:

I

a,

.

a scalpel, ah, in

through some of these, ah, currents.

Well, yeah, the things, the spot I'm in

the ties that bind and

.

.

is,

these are

.

dr. j.: That's right.

sue:

.

.

.

they're binding a

little

too tight now, and this

is

my trouble.

what is wrong with me. dr. J. (overlapping) But I wonder if you won't really put us, ah, and this will include you, ah, on the spot if you insist on doing someThis

is

the whole thing. This

is

:

thing in the next nine or ten days.

sue:

Why? How could I do

that?

The

we haven't really gotten, about how they feel about your

dr. J.: Because folks

problem that you have had sue:

I

dr. J.

:

upset

this

Eternal Triangle

249

any feeling from your

ah,

independence, ah,

.

[

this,

the

.

.

know how they feel. .

.

.

and, yeah

sue (overlapping)

and

here,

I

.

.

Well, this upset

know how

is

the result of this situation right

Mom feels, she doesn't like

you have another forty or

dr. j.: But since

wonder

ah, I

:

.

if

you

can't

make

fifty

it.

or sixty years to

the sacrifice of postponing this for

the next couple of weeks, or nine days, or whatever

working

.

.

.

.

it

is,

and

.

.

sue (overlapping) dr. J. :

live,

:

Well, I know, but

on your problems

think these

.

.

.

.

.

.

I

sue: Yeah. dr. j.

:

.

sue:

I

know,

.

.

because

until

we can go

don't think Debbie

.

.

.

.

I'm not saying, get

I don't,

I

into this at a

.

apartment right away,

this

.

Good.

dr. j.

:

sue:

...

is

ready to and I'm not

But I'm

either.

just saying this is

what's going to hap-, what I'd like to have happen. dr. j.: Well, that's fair enough. easier if they

knew

But

I

think your folks would rest

the general course of things for

you while they

were gone. (To Mrs. S.) Wouldn't you? Int.

Dr. father

is,

:

What are you

J.:

after here?

Well, the parents are going on a vacation, at least the

because

it's

partly business. I don't

family therapy by having Sue get into

want them

some kind

to get out of

of scrape while they're

gone. If she had another psychotic blowup, they might withdraw from therapy, put her back in a hospital, I

and turn her into a chronic

patient.

hadn't anticipated Sue's reaction. I thought she was relatively happy

at this hospital.

Int.

:

So when you started

the fact that she'd be

Dr.

J.:

this discussion

you were

just clarifying

on the ward while they were on vacation.

Yes. Then the three of us would get together

got back. Actually, Sue

is

very reasonable about

this;

when they

she backs right

down. Int. :

You keep

hitting

one point, which

is

getting her to

go back

to the hospital. I gather that you're trying to arrange a protective situation for her

and a peaceful one

for

them while

they're away.

TECHNIQUES OF FAMILY THERAPY Dr.

J.

I felt that if

:

she could

make

it,

she would have

[250

made some

headway by the time they got back. If they had to come back on an emergency basis, she'd end up in an insane asylum. mrs.

s.

Oh,

:

yes, I couldn't go.

understand

sue: Well, well,

I

dr. J. (to Sue)

And

:

that.

don't think

I

you can

afford for your

mother not

to go.

sue: She has to go, she needs the vacation.

mrs.

mr.

(Overlapping, inaudible phrase) couldn't.

s.:

Whether you need it or not, you wouldn't leave. mrs. s. No, I certainly couldn't. sue: Well mr. s. (to Mrs. S.): You certainly need it, you've been through an awful siege here for the last, ah, two months. s.

:

:

.

.

sue:

I

mrs.

s.:

think

.

my fault,

it's

No, Sue,

I'm sorry.

a lot of

it

is

something which

to explain to

I tried

you before, is my problem which I must live with, and nobody can take it away sue: I know, I know. mrs. s. and you mustn't try to because it's mine .

.

.

:

.

.

.

.

.

.

sue: I'm not.

mrs.

s.:

that

you can say that, though. There is now a hope be able to work this thing out mechanically and I will

But you are

we

will

if

be out from under a great deal of the pain (starting to cry), which is

wonderful, and

to be an

I

am

immediate

and you mustn't take

Int.

Dr.

:

J.

What problem :

thing, it

and

it's

something

I

it

going

isn't

have to

live

with

on yourself.

are they talking about?

Mother's burden.

Int.

:

You mean the

Dr.

J.

:

in her

quite encouraged at that, but

daughter?

Yes, but she also has the neck problem. There's the pain

neck and the pain in her neck

sitting

beside her. Father's saying

what with one pain and another, Mother needs the vacation. He's pressing Sue to behave herself so that her mother can get away, and the mother is saying, "I couldn't go if I didn't know where Sue was." Int.: Not all parents would take a vacation when their child was

that

on a psychotic ward. Dr.

J.:

Well,

if

they had nothing to do with her breakdown,

why

The Eternal Triangle

it

trip,

would have to deny

that she

with Sue's

251

would put too much burden on the therapy if or if the mother stayed home. It would mean

shouldn't they go? I felt

they cancelled the

[

the

all

more

had anything

that she

to

do

illness.

Why

Int.:

would you assume

that she'd have to

deny

it all

the

more? Dr. think

if

Because

J.:

it

would be making her that important

to Sue. I

she becomes that important, she becomes that guilty too, or

that responsible. It can never

Int.

You mean

:

the

be a positive

thing.

more she extends

herself to

Sue in

this crisis,

more she's conceding blame for Sue's being in the crisis, and the more she will not want to concede it? Dr. J.: Yes. The more vital I am to you, the more responsible I am for what happened to you, and the more there is to deny. I think if the mother had stayed home, we would have heard her emphasize what kind of care Sue was getting, what kind of medication she was on; she would have taken charge in a nonpersonal way. What she did do was to leave an aunt in charge, and it worked out very well. Sue got along with the aunt; she came home from the ward on a couple of occasions and the

spent the night with her.

sue:

I

Mom,

won't,

but listen (wavering voice),

this isn't surgery, is

it?

mrs.

new kind of surgery, and you that way? Dad and I are very

s.:

Yes,

why

act

sue: Well,

mrs.

s.

.

:

mrs.

s.

I

:

doesn't

.

.

well,

why,

.

encouraged.

.

:

don't

sue (crying)

.



mustn't

.

... it upsets me Mom, it naturally does.

sue (crying) time,

a

.

it .

it's

:

go

to see

you go

in all the time, I haven't

.

.

in the hospital all the

.

Well, you've been in plenty, you've been in and out, a

lot.

mrs.

s.:

sue:

I

mrs.

s.

Int.

:

But

isn't

know, but :

that it

my problem?

affects

It affects all

me, of course.

of you.

I

know

that.

Sue doesn't object to her mother taking a vacation, instead

she objects to her mother leaving her to go into the hospital. Perhaps it's

a

way she does

object to the vacation.

TECHNIQUES OF FAMILY THERAPY Dr.

J.:

Yes.

You

notice that the conversation

from the question of whether Sue

[252

quickly shifted

is

going back to the hospital to

is

whether Mother's going in or not. Sue says, "You're in the hospital the time."

Then

Then Sue

says,

all

the mother has to say, "No, I don't go in very often."

"Oh, yes you do."

It's

a reversal of roles,

it's

switch of generations. In a fraction of a second, the mother

At the same time, don't make it obvious." position.

she's denying

again this is

in Sue's

"Worry about me, only

it:

(Tape recording distorted here, words unclear.) dr. J.:

.

some

.

.

sort of steps,

because

I,

I'm not about

(tape

to, ah,

recording skips) sitting tight so that your folks can go off into the sunset together, and, ah, have the peace of

be looked sue: Well,

mind

in

knowing

you'll

after.

can come

if I

home

sometimes, perhaps even spend the

night there sometimes, and be with

my

brothers and sisters

.

.

.

They aren't going to be there. sue: Where are they going to be? mrs.

s.

mrs.

:

s.:

On

again, off again, well, Charles

thing and Laura

sue (overlapping) mrs.

s.

:

:

.

.

on a school camping

is

.

How long is that going to last?

(Inaudible phrase) and you

know you

don't want to be with

Aunt Louise, 'cause she's there. sue I don't mind her that much. :

MR.

s.

(Female sighs

:

And you

in

background.) But you

fight with her.

you didn't want her. sue: Well, I don't mind her that much. MR. s. We have to have Aunt Louise there to take care of the house while we're away, and take care of sue (overlapping) Well, fine, swell, then we'll go up to [lakeside resort] as a result of her accepting all our hospitality, huh? I'm mrs.

s.

:

said

:

.

.

.

:

buy that. Will you make this

willing to

dr. J.

:

sue (overlapping) a

lot,

and

:

Well, as long as

MRS.

now,

s.:

I

I

I

mean

I

think you

mean

I

don't have to

as frequent as

it is

.

.

.

don't have to stay there pretty,

can come home, maybe spend the day or so

I

and, and, so long as is

now?

sacrifice for

make

it

permanent

as

at

home

as, as it

now.

But (inaudible phrase).

dr. J.: Yeah,

volves

all

I

think that, that the idea of going home, you see, in-

kinds of imponderables.

Aunt Louise

is

like,

I

mean,

I

don't

know what

and how the two of you get along, and so on.

The

Y-you do have a sue: Well, could

Eternal Triangle

amount of freedom on the ward, and

fair

.

.

.

Why

have a car while, while you're gone? (Pause.)

I

253

[

not?

mrs.

Well, that's,

s.:

I tried

to explain to

you the other day,

you see, honey, the use of sue: Well, we do have two cars. practical thing too,

mrs.

s.

One's being turned

:

that's a

the car, the

.

.

.

in.

Do

you have to do it now? Because now that you're going, don't have any way to get out, and I'm going to need it. dr. J. We're talking about a matter of nine or ten days. sue: I know, but nine or ten days locked up in the hospital sue:

I

:

just

dr. j.

.

.

.

You're not locked up. You'll be, you've got

:

sue: I'm not locked up (simultaneously)

dr. J.

sue

.

:

but

.

.

.

.

I

:

I can't get

(sighs, laughs)

dr. J.

is

.

.

.

hope you're

.

.

.

very far on foot.

You

:

.

can go into town to movies and, and so

on, and also, I think you're going to be pretty preoccupied with getting a couple of these things straightened out, these, these very

personal

.

.

.

sue (simultaneously): Well,

this is the

one that needs to be

ened out and these meetings are what's going to straighten

No,

dr. J.:

I

mean

things that, that

this is

.

dr. J.

:

.

you

sue:

I

don't

.

else,

mr.

s.

that

.

know

.

.

it.

some personal

.

.

also need to

if

do some thinking about.

Brown or anyone

you've talked to the, to Dr.

but there was one that was partly imagined.

Imaginative, did

:

thing, but there are

you mentioned

sue: Yeah, well

.

one

straight-

you say?

sue: Imagined. Things weren't quite as serious with that pervert as they, they

Dr.

J.:

were made out to

be.

Sue's talking about the delusion she

had

that she

was

raped.

And she now is

was imaginary? Dr. J. No, she says more accurately that it was partly imaginary. After all, there was a real incident with the servant. Int.

:

able to say that

it

:

Int.:

She

Dr.

:

trails

the

word "imagined"

off

and the father

fills

it

in.

to this,

J.

What's interesting

is

that the father responded right

away

and with good reason, because the delusion was a kind of sym-

TECHNIQUES OF FAMILY THERAPY bolic statement of

what was going on between them. She's very

I'm not sure but what she

whether I'm going to say

it

dr. j.: Yeah, but this

baiting

isn't

him a

little:

[254 clever.

"Do you know

or not?"

is, is

also

something to work on,

you got so upset? sue: Yeah, well, I know there are a

how come, you

see,

but

.

.

of personal

lot

problems,

.

know

you on the spot, but the mechanics of it is, are such that I think, ah, you would be doing yourself a favor to be the hero right now. You, you'll have your

dr. J.:

I

I,

that this

putting

is

innings.

sue: Oh, yeah, as long as

do

don't have to be there the whole time,

(Crying.) But you can understand

it.

how

I've seen

I'll

enough.

Yeah, yeah.

dr. J.:

mrs.

I

We all do.

s.:

dr. j.:

Except that

sue:

know, but

I

this is a

there's

very different ward.

still

the same, a lot of

them the same

basic

elements. (Pause.)

Yeah, and these are some people you can, you can also learn a

dr. j.:

great deal about

sue

Oh,

:

I

life

from.

know, you can learn a

learn a lot

more about life

.

lot, in

.

some, in some ways, you can

.

dr. J.: That's right.

sue:

.

dr. j.

:

.

from them.

.

This won't be wasted.

sue: No,

I

know

it

And

to get out too.

dr. J.

sue dr.

I

:

won't. But I'm just saying I'd like to get a chance I'd like a

... be on my own j.: Loud and clear!

.

.

for a

day or a

night.

(Laughs.)

you said to Sue, "Will you make this sacrifice?" "You would be doing yourself a favor to be the hero."

Just now,

Int.:

Here you

.

heard you.

:

sue:

chance to

say,

She's already the sacrificial victim, or scapegoat, but you're turning

and making it Dr.

J.

:

positive.

Making

setting experience

I'm trying to

it

sell

it

voluntary, yes. Also, she had a particularly up-

on the closed ward

her on the idea that

in the first hospital she stayed in. it

would be best for

all

concerned

The Eternal Triangle

if

she would stay where she was, which was an open ward.

that another break might put her in a closed one,

very bad reaction which would set her back a

Was

Int.

:

Dr.

J.:

it

deliberate

Yes. After

making a

on your part

I

was

[255 afraid

and she might have a

lot.

to refer to

it

as a sacrifice?

they are going off on a vacation, so she

all,

sacrifice. If

they were at home, whatever she did

would be negotiable from day

to day, but they're taking off for ten

really

is

days, so she's stuck. It

is

a

sacrifice.

on her repeated statement that she be independent. She's said before that she has been given her

Int.: You're also playing

wants to

"independence" by being sent away to a hospital, but you say to her, "This could be something for your real independence."

Dr.

J.:

I

know how much

don't

knew about

I

her background

then, but she did have a long record of acting the spoiled child, so that

there

and

was something for her

sticking to

it,

even

dr. J. (laughing)

you

if it

else's

advice

wasn't good advice.

Then can we arrange

:

someone

to gain in accepting

get back, because, ah,

to get together,

Sue keeps progressing the

if

when way that

ah,

she has been, then there will be this question of where should she

Home

go.

mr.

.

.

Yes.

s.:

dr. J.

.

...

:

or to elsewhere, and then

same problems terms,

it's

sue: Well

.

dr. J.:

.

mrs.

.

s.:

.

.

that

we were

it, it's

going to involve the very

talking about today in emotional

not just a practical matter, because, ah

.

.

.

.

there's

bound

to be feelings about

Yes, I'm sure there are.

I just

hope

it.

that

— (Sue

interrupts.)

on becoming patients in family therapy, as some people might; you're selling them on a return home to deal with a situation. From what you said before, I take it that you had the feeling that they wouldn't accept the idea of family therInt.

:

You're not trying to

Dr.

J.

:

sell

these parents

apy. I

did from the beginning, and

I

The mother was a very proud woman, very

think active

was not mistaken. socially, and it was

I

clear that she felt all of this as an affront. It wasn't until later,

when we

some months

got into the marital therapy, that she ever acted as

had something to be there

for.

if

she

TECHNIQUES OF FAMILY THERAPY Did you

Int.:

putting the emphasis

Dr.

J.

I

:

feel that

on

had a

you could get them back more

[256

easily

by

practical matters?

feeling that we'd slide into family therapy without

announcing when one thing became another. Remember, when the

girl

was fourteen, she was expelled from a school in Arizona and had some psychiatric help at the time. She had already been labeled as a patient and the troublemaker in the family, so it didn't surprise me that the parents took that attitude. Int.: This goes back to the very beginning of the session

when

you turned "problems" into "decisions." Here again you imply that

who

they are people

are facing difficult decisions, not people with prob-

lems.

Dr.

J.

Yes, the situation

:

made; anybody can accept Int.

Dr.

is

complicated and decisions have to be

that without admitting he's neurotic.

Particularly nervous people.

:

J.

Well,

:

than they were.

I felt

that the parents

were going to be more

think that they turned out to be less

I

they were against each other and neither one would

draw. But it

to

we had

a problem finding a time

difficult

because

difficult

let

the other with-

when everybody could make

an interview. sue: Well, emotional independence

is

important to

me

and

I

think

it's

a very real issue.

mrs.

s.:

nobody

Darling,

independence than

I

important.

is

world knows more that emotional

in the

And you

don't

know

any more

this

do.

sue (overlapping)

:

I

know. But

it's

a very real issue, and

it's

one that

had to do most of, mostly on my own, right now. mrs. s. Everyone has to do it himself. sue (overlapping): Yes, but you have made it a little hard. There you go with that bulldozer again. Mm! dr. J. (interrupting) sue: I don't (sighs, inaudible phrase) now. dr. J.: You just plowed right into this, you know, as if you could beat I've :

:

your mother down after twenty years sue:

I

dr. J.:

sue:

I

don't .

.

want

to beat her

.

.

.

down.

of fighting with her.

.

don't

want

to beat her

kind of person she

is

down. I'm

just saying that 'cause of the

I'm doing most of

it.

I

mean

don't

her down. dr. J.

:

But

that's

something to

feel

proud about,

it's,

ah

.

.

.

to

plow

The Eternal Triangle sue: Yeah, well,

who

to

I

it's

not making

any

it

easier,

you straightened out

as to

who you

you handle the

Int.: All through this,

as

directly.

The girl knows, just from my expression and "You can do better than your mother." In that

using her rivalry with her mother.

yourself

It

sounds as

girl

The

Int.:

felt

must

somewhat a

feel

almost a reductio ad absurdum to carry

I

it.

helpless victim with the

mother, but the image you use in connection with her

is

she was a better

more moral, more mature, more whatever. So

spoiling for a fight over girl

if

There was an element here of Sue's being "not

to."

girl,

was

sense, I'm

"You can handle her

good as" the mother. The mother obviously

person than the

tone, that

I'm picking on her,

if

but I'm not. I'm saying,

right,

it

you want

if

think the

are.

J.:

you don't hear

as

in relation to her

girl

mother without ever commenting to the mother I'm saying,

me

just confusing

it's

257

am.

dr. J.: We'll get

Dr.

[

it

that far,

is

a bulldozer.

when

all

It's

she's doing

making a noisy protest and not winning. (to Mrs. S.)

dr. J.

about

mrs.

s.

:

.

.

I lost

started to say about the practical issues, that there .

.

.

sue

(crying)

I

know you

:

mrs.

s.:

I've

I

:

would

(Long pause, unclear what's happening.)

sue: Told you she didn't like s.

make

to

kind of did too.

I

be emotional, ah

mrs.

you were going

the point that

(Pause.)

.

I'm afraid

You

dr. J.:

But

:

it.

want you to do

it,

Sue, I

.

.

.

do.

wanted you

the right way.

I

want

to for a long time, but I

want

it

to be

done so that

to be

it

done

going to be a good

it's

thing for you.

sue

Right. Well,

:

mrs.

s.

I

know

(overlapping)

what's good for me.

I

:

know

think sometimes you don't

all

the

things that are good.

sue

Well, yeah, but I'm

:

mr.

s.

:

You've not quite

sue:

It's all right.

mrs.

s.

mr.

I've

(overlapping)

me and

know me

live

with myself

to

:

.

.

.

.

.

.

.

.

.

.

.

go on your own as though you

.

.

some ways.

.

(Inaudible phrase) a long time

And, and, you're setting out were sue: Out? I'm not saying I'm doing s.

pretty well, in

lived twenty years yet

had to :

I

.

TECHNIQUES OF FAMILY THERAPY MR.

[258

... a thoroughly adult, of-age person. I didn't object to living at home until I was twenty-four, and I am sure I was dictated to and dominated and many things that I didn't like, but, ah, I felt my place was to be at home until I was out earning my own living

s.:

and, ah, fully of age.

sue: Necessarily

want mr.

I'll

be around.

couldn't help but being around, I

one reason

to be around, that's

(overlapping)

s.

I

I

want

Honey, your room

:

to be

nobody

We

dr. J.:

are already getting into the issue that I

(overlapping)

s.

come and go

as

you

stops you.

wouldn't get into (laughs) because

mrs.

.

.

in the far part of the

is

house, you have a private entrance, you can please,

.

:

I,

I

.

.

I

don't think

think

we

it is

a

was hoping we

little

.

.

.

are ready to get into that

one.

Now,

dr. j.:

mrs.

s.

Int.:

J.

want to

.

Let's just get through the next nine days.

:

Why

which you now

Dr.

I

:

up

did you open

a discussion of emotional problems

try to shut off?

What

I

was trying

come out with anything

else she

to

do before was to get the mother to

had

to say about the

problem of Sue.

I

was trying to see if she had anything else that she would bring up after they left and spoil the thing. I must have said "emotional" to jog her memory, so that she wasn't looking for emotional problems.

would get out whatever she had talking about

Int.

:

J.

The

girl

Int.:

in mind.

And

I

of course

says something interesting. She says,

She even

:

suspect

now

they're

dependence and independence again.

to be independent doesn't

Dr.

I

It's

when

mean

says, "I

that

I

"My

wanting

want to leave you."

have 10 be with you."

she went

away

that she

had a breakdown, both

times, so that's really quite a realistic statement.

Dr.

J.:

It also

poses the question whether she really can leave.

They don't know whether

she's staying out of love or out of weakness.

want to make one, one comment, though, about this. Ah, you know, the way the two of you treat Sue, you would think that she was a lot older and a lot tougher than she really is. You know, she, she raises her voice, you weep, you take this, ah, "Well, now, you got to understand," sort of approach, and here's a kid who, who has just gotten off the, ah, mental hospital ward,

dr. J.: Yeah.

I

The

all

Eternal Triangle

me

shook up, confused and, ah (to Sue) you called

show

find out the results of a physical examination, to there,

you know,

things,

ah

.

.

you

that

still

[

259

today to that, that

are feeling quite anxious about

.

sue: I'm not so confused, though, I'm getting squared away, I'm confused in some things dr. J.:

No, no, no, what

this, in

You

S.) her,

mrs.

way

a

tell

her she's a

dr. J.: Well, she

sue (simultaneously) :

but the

way

the

two of you

was a great big tough

that she

her she's a

tell

Well, you treat

:

many ways you

dr. J.: Well, in

this,

is

treat

—something.

little girl.

is.

sue (simultaneously)

dr. j.

little girl,

don't

I

:

trying to say to your parents

very peculiar situation. (To Mr. and Mrs.

this is a

(overlapping)

s.

am

I

you would think

.

.

.

:

me

like one.

are.

Well, you treat

me

like one.

That's understandable.

sue (simultaneously): Well, all right, I expect in many ways but they treat me more like a child than I am. dr. J. But they also treat you more grown up.

I

am,

:

sue: There's another inconsistency, that they treat me, and this con-

me and

fuses

DR. J.: Well,

I

it

me

messes

think this

up. (Starting to cry.)

worth thinking about. (To. Mr. and Mrs.

is

you the way she does makes

S.) The, the fact that she can hurt

her seem a

lot

more tough than she

is.

She

just isn't that sure

of

herself.

Int.

Dr.

:

Do you have any comments on that?

J.:

Yes.

independence.

Is

The

issue,

you

apparently dependence and

see, is

Sue ready to pull away,

is

she ready to go out, and so

on. She's pushing independence, though she disqualifies herself too. the

way

she puts

it

sounds as

blamed. I'm trying to turn if

it

she says untoward things,

if

and it's

she's being unloving

"Look,

say,

she's just

But

and so she

gets

a

and

partly because of her age

little girl,

and naivete."

I'm trying to reestablish the generations: "You're up there and she's

down

here,

and what's

distributing the blame. patient,

this bickering

about?" Also,

if

you

notice, I'm

Sue has agreed to accept the blame and be the

and I'm trying to spread

it

a

little,

so

we end up

it

I

say

was able to handle this, by coming over to my side and saying,

to the parents, "You're not perfect either." Sue

though she almost spoiled

even. So

"There's another inconsistency."

TECHNIQUES OF FAMILY THERAPY Int.:

What's curious

is

go with that bulldozer," as

[260

that you've just said to Sue, "There

you

you yourself were reacting to her the way

if

the parents do.

Dr.

J.

Yes.

:

me

"She gets

said,

were

If I

really distributing the blame, I

way

that

we

too," so that

would have

had

really

it

spread

around. Int.:

You mean you

might ordinarily have included yourself in

the picture?

Dr. do, to

This

J.:

make

is

pretty early, but I think

it's

a reasonable thing to

the parents feel that their reactions are not so unusual, that

anybody could have them.

you are attempting a completion of some sort with this interpretation. When you talk about the daughter hurting the parents, this refers back to several places in the interview when you questioned whether the mother was really hurt or the daughter so harmInt.:

ful. Is this

It

sounds as

an attempt

if

at

some kind

of overall unity?

Are you

tying

up with what went before? Dr. J. I'm not sure that I did it deliberately here. I'm not very good at what one would do in writing a speech, putting in a beginning, a middle, and an end.

things

:

Int.:

This interpretation

triangle" the interview

really a statement

is

began with.

Do you

about the "eternal

often summarize in this

way, so that people have something to take home with them?

Dr.

J.:

I

do

speech, as

give a

little

learn;

maybe by

Int.:

try to give I

some kind

did here, or

the next time

we can give

call

:

In a later session,

critical of the father

would be good tient

thought to

we

all

have a

I'll

lot to

this or that."

an "intervention." Can you think of an ex-

ample of an intervention you gave J.

say, "I think

The End.

Sometimes you end an interview by giving out a piece of

homework which you Dr.

I'll

of punctuation:

this family?

I tried to get the

and to get him to accept

training for him.

He saw

it

mother

to

be actively

on the grounds

that

it

himself as being terribly pa-

with her, but although she was always nagging at him, she didn't

see herself as being critical. that in the next

My

suggestion did seem to have the effect

few weeks they had some open quarrels, more

forward quarrels, which upset her more than pressure off Sue a

Int. critical?

:

How

it

did him. But

it

straight-

took the

little.

did you phrase

it

to the mother, to get her to be

more

The Eternal Triangle

Dr.

knew how

think she

I said that I didn't

J.:

to argue,

[

261

and

I

thought she needed practice in arguing. She nagged, she whined, she

moaned, but she never came interview,

it

right out

and said anything. In another

turned out that the husband gave his secretary the family

books to keep. The wife was very upset about

it,

because

it

made her

you take over the books." She

feel left out, so I said, "All right,

want to do

this

she preferred to be hurt about

it,

didn't

but in the end she

agreed to take them over.

Why did you ask her to do that?

Int.

:

Dr.

J.

I

:

good reason

think she had

hand, she didn't

know how

to feel left out.

to get herself in, so all she did

the sidelines and complain. It

was

way

a

And

I'm, one reason

why

pendence, emotional independence. islands,

we

need

all

pendent

mrs.

s.

:

But

thing.

[sic]

on than

now

dr. j.: Well,

mrs.

mr.

heart.

a fine

S.

.

.

are,

it's

going to be

laughs) because you're both very dynamic. that yet.

But can we

.

Gladly.

s.:

Absolutely.

dr. J.

(simultaneously): Fine.

MR.

(overlapping)

tions

dr. j.

I

(simultaneously): Oh, yes.

s.:

s.

we're not

mean it with all my what we think would be

and

We, we haven't established then when you get back?

Any time

s.

mrs.

family,

let's see.

get together :

my

But the kind of people you

:

kind of hard (Mrs.

s.

know

the inde-

We weren't finding any objections.

sue (overlapping)

mr.

If I were, I

is

that I'd rather be emotionally inde-

good, that's exactly

that's

it.

dependence emotionally on somebody,

de-,

but there's someone else

was stand on

because another thing

is

the other

of taking a small thing that

could be handled practically and focusing on sue:

On

:

I'd like to solve this out. I

have been very helpful and

(interrupting)

:

Well,

I

.

.

think these conversa-

.

think you'll find them a

little

upsetting

you know, ah, underestimate this. I'm not asking you here without realizing what I'm asking of you. Because it isn't easy. But on the other hand, ah, you've got somefor a while,

and

I

don't, ah,

thing worth saving over there. (Pause.)

Int.:

Why

wouldn't you go along with that remark of the fa-

ther's?

Dr.

J.

:

Because

I

don't want to enter into any obvious coalitions.

TECHNIQUES OF FAMILY THERAPY The

was making

father

a bid to get together with me, but here's the

mother and the patient being have the picture," it's

going to be

you

just

Dr.

makes us

can say, "You don't quite

left out. If I

equal, because

all

none of us knows what

like.

What's interesting

Int.: ple;

it

you do make

that

is

coalitions with peo-

them make coalitions with you. That's right. Although I can't avoid it with

won't

J.:

[262

let

way

a schizophrenic. I've never found a

to get

mother of

the

around giving the im-

pression that she's helping me.

mr.

We

s.:

certainly do.

Anything and everything that would give her

just the perfect life, that

wouldn't (inaudible words)

.

.

.

sue (overlapping) Nothing's perfect, Daddy. mr. s. as good as we can give her. :

.

:

.

.

dr. J. (to Mrs. S.)

Um,

I'll

call

week, but

I'm expecting you to get something out of

:

you then and,

I'll

call

ah,

you when

back then, and see

if

we

.

be gone,

get back.

I

.

I'll

.

(

too.

Easter and next

also,

You

it

should be just about

Unclear exchange between Dr.

J.

and Mrs. S. mr. s.: The first part of the second week would be better. I'll be in [city] the last part, the eleventh, eleventh of May, ah, around the seventh

sixth,

(overlapping)

dr. J.

mr.

.

s.:

.

.

:

Well,

get back

I

on the eleventh, unfortunately.

Oh.

dr. j.: I leave on the fourth and get back on the eleventh. Ah,

long are you

mrs.

s.

s.

:

.

.

(overlapping, to

eleventh,

mr.

.

No,

Mr.

you say? You

I'll

S.):

on the are you?

to [city]

gone long,

be gone that weekend.

(Unclear remark to Mrs.

mr.

That means

:

Are you going

aren't going to be

dr. J.: s.

how

I'll

be gone

S.,

till

who

laughs.)

Friday night.

I'll

Oh,

that's all right.

be back in

just

two

days.

dr. J.: Nice meeting you. See

mrs.

you

in a

few weeks then.

Goodbye. (Family leaves.) MR. s. (coming back in): Can you and I have a little, ah, discussion or instruction? Should I have some instruction on these conferences? I came in here totally blind and unprepared for what we were going to do and why, and I s.:

.

dr. J.

MR.

:

s.:

.

.

That's right. .

.

didn't

.

deliberately stayed quiet as

know what tack vou wanted

much

to follow.

as possible because I

The

Eternal Triangle

263

[

dr. J.: These are not, ah, these are deliberately arranged to have

everybody present, and

on

ing this

think that, that although you are do-

I

I,

now, maybe you

faith

was

why. That

will see

this

not,

is

you and your wife and say, "Treat Sue so and so," you know, and take this attitude, I would do it, but I think it is just a waste of time. I think it is only by our

that

thought

if I

how

understanding three of

MR. mr.

s.

.

mr.

.

s.

.

.

:

and

I

mean

the

.

that

.

we can

get

anywhere with

this, really.

me to speak up and

.

.

.

.

.

my

and spout out whatever comes to

mind, and

.

.

.

.

you maneuver the thing

.

or stand by and

.

I'm asked a question?

let

until

.

.

.

No.

dr. j.:

mr.

get along,

Yeah.

dr. j.: s.

you

wish you would.

I

s.:

mr.

the three of

But do, do you want

:

dr. j.:

.

.

useful to see

Um.

s.:

dr. J.:

you

it

.

:

dr. j.:

I

.

wish you would say anything, including objecting to what

I

say.

mr.

Well,

s.:

I

deliberately stayed as

much

.

.

.

dr. j.: Yeah.

mr.

s.:

.

.

.

out of

it

as

much

as possible today because

I,

I

thought

was your operation and you were maneuvering it the way you wanted to. dr. j.: No, I hope in the future you will say anything. I mean that. mr. s.: All right. that

it

dr. j.:

Good. Oh,

mr.

Thank you.

s.:

ing a

J.:

little

around

bound

to feel

pleased,

:

the

What's too bad here

I

one-down

is

that the father

was obviously

feel-

for a while.

should think that

if

:

Yes,

it's

him up and sent him out too with him which would be noticeable

you

coalition

when he got downstairs and joined J.

out.

one-down position. I don't know how you could get because he was such an important executive that he'd be

you would have a

Dr.

way

in the

that,

Int.

is

Right. (Tape recording ends.)

dr. j.:

Dr.

here, this

built

his wife

and daughter.

something they would pick up immediately. That

he was cheered up. Tnt.

minutes.

:

But

I

gather that you didn't

mind seeing him alone

for a

few

TECHNIQUES OF FAMILY THERAPY Dr.

J.:

No.

he repeated

If

somehow

indicating

that

this

maneuver,

this is

it

would block

was not acceptable. But

it

reason for affronting him now, because he didn't Int.: I take

I

not the

[264

I

by

don't see any

know any

way you would

it

better.

prefer to end an

interview.

Dr. I

J.

No.

:

had asked him

This

I if

might have prevented the father's coming back in

he had anything more to

may have been

indicate in various

partly

ways

why he came

say, as I did the mother.

back. People often call up or

that the interview wasn't finished, that

person ended up and the other ended down.

up before we

If I can, I

close.

making people

on your

moldy

J.

equal, putting

It's

:

them on the same

particularly important to

last statement, this either

do

on

plane.

this at the end. If

we end

puts you in charge or makes you the

why I want to be the one who terminates. One general comment before we end. You talk about your

That's

fig.

Int.

one

even everybody

Int.: All through this conversation, you've put an emphasis

Dr.

if

:

therapy in a strategic way, with the emphasis on manipulation. Yet with

you lean over backward not to appear manipulative. You seem to like to show the family when you are baffled or perplexed, or if you have a private opinion or a personal reaction, you often share it with them. I should think that this would tend to make you seem less manipulative and to invite trust. Dr. J. The only objection I have to the idea of being less manipthis family,

:

ulative

is

that I don't

trying to act as

ple

if I

know what you

could do to achieve that. I'm not

weren't influencing people, because influencing peo-

what I'm there for.

is

Int.

would

:

say,

Just the same, I think that you,

"You

got

me on

more than most

therapists,

"You confuse me." You someone who is in a situation rather

the spot there," or

take a straightforward position of

who is managing a situation. Dr. J. You notice that this tends to come up when / am saying, "I am confused." If they say, "You are confused," then I will rephrase it in some way, unless there's something I can make out of the state-

than of someone :

ment. Int.

Dr.

:

You prefer

J.:

to determine

who

has the right to say what.

Yes. I'm fairly autocratic, but in such a

easily object to it

way

that they can't

4]

The Growing Edge An

interview with Carl A. Whitaker,

What

Int.:

M.D.

contact did you have with the Fairchilds before this

interview?

Dr. W.

I

:

had seen them once previously.

Then this interview isn't the first one? Dr. W. No, but it was a continuation of the

Int.

:

:

that I

was

still

first

one

in the sense

working out the terms of therapy with the family. This

a preliminary stage that

I

is

don't even think of as therapy yet.

Did you see the whole family at that time? Dr. W.: Just the mother and father and seventeen-year-old son. A psychiatrist in south Georgia wanted me to see them because the boy was threatening to beat up the old man. He'd already hit him a couple Int.

of times,

:

had gotten around the community. The parents were especially since the father is a respected professional man,

and

very upset,

it

a lawyer. So they went to get the boy psychiatric help. But they didn't realize,

when

they were referred to me, that

it

would mean treatment as

a family. Int.

:

How did you handle that?

When they first came in, the son said he was there beMother and Dad needed help. The parents said they were there

Dr. W.: cause

because the son needed help.

I

agreed with both sides and said that

wouldn't see any of them unless they were that

if

all

three present. I told

we had another meeting and anybody was

missing,

I

them there

wouldn't be any meeting but that I'd charge them anyway. Carl A. Whitaker, M.D., is Professor of Psychiatry at the University of Wisconsin, Madison, Wisconsin. He has published a number of articles, is the author with Thomas Malone of The Roots of Psychotherapy (1953) and editor of Psychotherapy of Chronic Schizophrenia (1958).

TECHNIQUES OF FAMILY THERAPY Int.

standard procedure for you?

Is this

:

Dr. W.

Yes. Therapy has to begin with a

:

before they telephone, there's

But ordinarily

noticed.

no problem,

the fight can go almost un-

:

the context of therapy.

:

Int.

they capitulate

fight. If

there's a structural fight.

What do you mean by that? Dr. W. A fight over who controls Int.

[266

How can they capitulate before they telephone?

:

It

depends on whether the referring doctor has made

them understand

that they'll be seen as a family. If they haven't ac-

Dr. W.: cepted I

have to make

this, I

want

it

it

clear that I won't see

them any other way.

be understood that I'm in charge of what happens when

to

they get here.

The only

thing they're in charge of

is

whether they come

or not. Int.: testing

take

I

ground for

therapy.

that

it

you use "coming

this issue of control

more

in as a family"

as a

than as a stand you take about

not that you believe in seeing only families.

It's

Dr. W.: You're

right. I don't see

sometimes be about some other

issue.

The

only families.

fight will

But with these people

it

was

about coming in as a family. Int.

:

How did you deal with them?

Dr. W. son

said,

Well,

when

I

said I

wanted to see them

"I'm not coming back. I'm going to

Father said, to supply

:

"How?" Son

said,

"By

you with money?" Son

going to give you

money

to

"You

New

nodding agreement, "There you go,

together, the

New York

tomorrow."

plane." Father said, "Who's going

said,

go to

all

are." Father said, "I'm not

Mother always refusing me things!" It was York." Son

said, with

a ludicrous scene; here was this boy with his dark glasses and his dan-

manner and his green cravat, Father who looked foggy and not with it at all, and Mother who was fluttering about like an old hen. The son was being so utterly disdainful of these people. Well, the meeting broke up without any decision having been reached and we made no dyish

further appointment. to

anybody

together.

But I'm always available

after the first interview

So three days

later,

Father gave

me

a

call.

we

work The boy had blown

I've seen, unless I've already decided that

can't

up again, everything was a mess, it was worse than ever. I said, "Do you want me to save a time for you?" He said, "What are we going to do?"

I said,

bother

me

"You're living with him, I'm not living with him, don't

with

it."

"Well, you're a psychiatrist." I said,

"I'll

be glad to

The Growing Edge

see

you

three of

all

if

you want to come

won't come in." "Then what did you advice."

"Look,

I said,

troubles enough living said,

"Why

I

don't

my

own."

He

me

call

know

He

in."

said, "Well, the

life, I

said, "Well, I can't control

He

don't you call the police?"

Can't you suggest anything else?" So

boy

want some

for?" "I just

anything about your

267

[

have

him."

I

said, "I can't call the police.

"Well,

I said,

you.

I'll tell

I'll

be

glad to see you and your wife and your son and your four other kids

He

too."

mess?"

"You mean expose

said,

I said,

those

"Look, they've been

living in

A

an appointment for the whole family.

from Mother. "Did you suggest to those four

he said you did." "I

she approved of

it

I said,

She

said, "I think

children in."

or not,

I

said

I

Daddy had made. She surprise, they

man of his Int.

status

said she'd talk

"No,

I

to give

is

won't

come in,

Dr. W.: That's Int.

:

Int.

:

I

:

want

all

don't care

If they're

to cancel the appointment

over with him and hung up.

them one

if

chance that they

they

come

To

quite a thing for a

and then

set of terms, is

twice as bad.

may not come

in?

in or not.

coming,

I certainly

may

do want them

not be enough.

to care. I

If it isn't, I'll

rest.

You certainly put roadblocks in the way of this man. Dr. W.: That's right. He can come in on his hands and knees.

Int.

:

see this as the administrative battle I have to win.

example.

A

boy showed up

after he'd

typical, schizy sort of boy. It

and an identical twin brother

know

if

I'll

been

in

I'll

give

I

you another

therapy for four years, a

turned out that he had a father, a mother,

who was

the success of the family, bellig-

and probably part of the pathology. I said, "I see you without your twin." He didn't think that

erently counter-schiz,

don't

if

to care, though.

the affect they have, and that

have to supply the

just criminal,

right.

You want them

Dr. W.:

he wasn't

the seven have to.

Isn't that taking a

Dr. W.

if

willing to see the three of

they turn those down, you give them another set which If the three

didn't." "Well,

would be

showed up in the clinic, which was and wife and kids to do.

What you do

:

it

got a call

later, I

wasn't interested in whether

would only be

I

it

them plus the four kids and did she want me

my

hour

half

just suggested that as a substitute

willing to call the police." little

So we made

for years."

it

husband that we should bring

chldren into your office?"

little

to bring those

my

children to this horrible

little

TECHNIQUES OF FAMILY THERAPY would be

possible.

me

So then he asked, "Will you see

[268

twice a week?

My father will pay for it." I said, "I don't even know if I'm going to see you at all yet." We ended without deciding anything. But he came back we had

again and

attitude, so I said later, the

time, I

my

me.

therapist in with

father can't

pay for two

said he didn't like

finally

He

he

did.

my

A short time

said,

"Why do you need somebody

me." The next time he came in

went on.

I

I

want him

said, "I don't

psychiatrists." I said, "This

two meetings a week, only we have them

as

I

He

mother called and made another appointment for him. This

same

fight

this.

he was free to leave, and

had another

here too,

a continuation of

at the

you scare

in again

and the

wouldn't agree to give the other doctor up, unless

could do without him, and

I

wouldn't agree to cut

my

the

same hour." He

else?" I said, "Because

had the other doctor

is

in

fee.

He

I felt

asked

if

some other way, so I said he could go back to his first therapist, who was in another city. He said, "I can't do that, I'd have to change colleges." So then I said, "By the way, if you decide to go on with me, and you talk to your father about it, I want you to make it clear to him that I wouldn't have another interview with you without your brother and your father and mother. Because it looks to me as if they're in here whether we want them or not. And I'm not going to have them in as ghosts." Int.: I take it that until you win this round, you don't feel it's

there wasn't

really therapy.

Dr. W.

:

It

may have

a therapeutic

being therapeutic. I'm trying to get the

Otherwise there's no sense Int.:

It's

but I'm not playing at

field sterile

so that I can work.

starting.

a double framework.

but you don't want to control their life is his

effect,

You want

lives.

As you

to control the therapy said to this father, his

own business.

Dr. W.: Sure.

me

It's

up

to

him

to control his child.

But what he

"The people who do the controlling for the people who can't control are the police. Not psychiatrists. But if you want to come in, I'll try to help you figure out how to control him yourself." Int. If he accepts coming into therapy under the conditions you present, he has to get his son in. But if he gets his son in, that means he can control his son. So if you win this particular administrative battle, you have already produced a change. It's already therapy. wants

is

for

:

to control his child.

So

I say,

The Growing Edge

Dr. W.

:

soon as that happens. But

It is as

chiefly I

want

[

it

269

very

when he comes in here I'm in charge. I'm not going to be with him the way he is with his son. Int.: You give him a model for being an appropriate authority. Dr. W.: That's right. If he won't accept this, I say, "Then don't bother me," which is another kind of model. He can behave the same way with me that his son is behaving with him, only I don't have to be straight that

hurt by

it.

Does

Int.:

sometimes happen that when you say, "Don't

it

bother me," they take you up on

it?

Dr. W.: Sure they do, and

this

may have been what happened came back. come in, I get the

with this family. After the second interview, they never

When you demand

Int.:

that

all

the children

idea that you're redefining the son as one of several children.

Dr. W.:

I

don't think I did

it

consciously for that reason, but

was very much aware that the son and the mother were the parents this family and the father was the child. Int.

:

Do you

I

in

think the mother understood what you were talking

about when you said that bringing in the children was a substitute for calling the police?

Dr. W.: Good Lord, that was so clear compared to the usual confusion this family was Int.:

in.

What do you

come back a second

think decided them to

time?

Dr. W.:

I

suspect they pushed each other

pressing for the

boy

ents to get help.

But

to get help, I

had

my

in.

The

parents were

and the boy was pressing for the par-

boy a second time with the kind of power he doubts. I wasn't at

all

sure that the

was going to let me come in saw operating when I took charge of the threesoihe. Because he suspected that I was going to break up his entente with Mother. At the same time, he wanted to get free, to get out of that crazy house. So that

may have helped. Int. You said :

way

a

to avoid siding with

Dr. W.: of abstraction.

first

interview you agreed with the boy

were sick and with the parents that the boy was

that his parents this

that in the

I

think

it

The son

dealing with the son.

I

anybody?

has to do with is

sick. Is

my moving up

to another level

dealing with the parents and the parents are

deal with the threesome, with the bigger unit, as

TECHNIQUES OF FAMILY THERAPY though

I

weren't concerned with

they use to

one

make war

with.

When was

off against the other. I

components. This

its

is

and play

and they would try to use me get drawn in on this level. They

trouble,

But I refuse to have a common enemy, rather than a person they can use

becomes a

the unit that

there's trouble, they split

against each other too.

It

[270

to side with.

between them and me, rather than between them-

battle

selves.

Int.

Dr.W.: Int.

a

It's

:

way you get them

together.

That's right.

Who was present at this second interview?

:

Dr. W.: There were the two parents, who were Eric, the seventeen-year-old boy; Kathryn,

who was

in their forties;

ten; Eliza, eight;

Dirk, six; and Margaret, four.

Do you remember the seating arrangements? Dr. W. I was sitting at my desk and the mother was on one end semicircle facing me which went: Margaret, next to her, then

Int.

:

:

of a

Eliza, then Dirk, then Eric,

who

sat

near the door, then Kathryn, then

Father. Eric and the mother were sitting across from each other; they

had a corresponding Int.:

radius.

Had you

previously explained to the family about the tape

recording?

Dr. W.

No,

:

decide about these matters as

I

anesthetic. It's not a social issue. to

know about

there's

this interview. Just five

had been talking with me, and

But

to a medical student

I said,

I

would the kind of

one other thing you ought

minutes before they came

who had

a fellowship to work

"Look, why don't you come in to

and run the tape recorder?" So he

just sat

in, I

this interview

over in the corner with the

earphones.

Did you need him to run the tape recorder, or do you just to have someone else in the room? Dr. W. This illustrates an important aspect of the way I work. I Int.

like

:

:

didn't

need him to run the tape recorder. But introducing a stranger into

the interview set the whole

presence of an outsider

framework up

made

it

the whole world.

having an audience brings out the

someone

else there.

But mainly

differently.

ham

this is

a

in

me.

way

I

For one

It's

I feel I

thing, the

also possible that

work

better with

add an extra quantum, a

random element, which can give the whole process a twist. Whatever comes of it will be unforeseen and unexpected. This is what I look for

The Growing Edge

in

my

therapy

all

what a colleague of mine growing edge."

come

in,

I

I

push

call "the

you plan a

which something you didn't plan for can take place.

Dr. W.

would have

Yes. But

:

guy to come Int.:

When

John Warkentin, used to

in Georgia,

In other words, by asking this boy to

situation in

271

the time. Events that occur out of nowhere, which

haven't pre-planned, which I've never had happen before.

Int.:

[

have the feeling that

I

if I

had arranged for

weeks beforehand, and told the family about

in

it,

this

that

killed the possibility. It's

a mixture of planning and not planning. Like the Zen

"You can't do it by trying, but you've got to try." Dr. W. That's right. I'm very deliberate in the beginning

saying,

:

apy, but

my

hope

my

place which go past Int.

that

is

up

set things

right, these events will

reached, the

book

have to get

I

writes

Initial interview

take

"point."

Which make you know when your "point"

:

Dr. W.: Yes.

dr.

if I

of ther-

it

This

itself.

started,

is

is

there.

but after that point

what I'm always aiming

is

for.

with the Fairchild family

w. {referring

to

a "butch" haircut on Father)

You

:

got the kind

of brush I've been trying to find.

mr. fairchild: {Inaudible phrase.) eric {apparently referring to his

tie)

:

I

love pink.

It

does something

for me.

dr. w.:

It

does something for you?

gives

It

you a

sort of feminine

tone? eric: Right. I've got

it.

you may need more than a feminine tone. But at least we got here. I thought last time maybe we weren't ever going to

dr. w.: Well,

get together again.

mrs.

f.

:

Well,

I

guess fate

eric {overlapping)

mrs.

f.

{laughing)

:

:

.

.

.

I'm not sure. .

.

.

plays a role.

eric: This will be the last time though. dr.

w.

:

Again?

eric: Again. Definitely this time though.

why did you come make much sense, to, ah

dr. w.: Well, why,

doesn't

.

.

if this is .

the last time? That

TECHNIQUES OF FAMILY THERAPY eric: Well,

you

see

I really

much

don't have

[272

choice. I really {inau-

dible phrase) .

you don't have much open, maybe we can get together

dr. w.: Well, (Eric continuing, inaudible)

why

if

you leave it once a week for the next two years. choice,

Int.

turn to the son. Is

Dr. W.

you come

notice

I

:

it

don't

in talking to the father but immediately

usual for you to go right to the patient?

Yes. With a psychotic like this boy,

:

I try

to get immedi-

The reason the psychotic is talking crazy is because he's trying to find someone who will listen past the level of social games. So I don't postpone my participation till some other time. For instance, in ately involved.

one

interview with a family with a schizophrenic

first

girl, I

the girl after I'd been talking fairly emptily with the parents

"What said,

are

you here for?" She

"How long

We

years."

said,

"Contact

is

have your parents been cold?"

went on talking schizophrenese

turned to

and asked,

very good for colds." I

And

like this

she said, "Twenty

without any hesita-

tion.

Int.

boy

is

It's

:

Why does he say,

about.

Dr. W.

not quite clear what

:

I

think

I

this

exchange between you and the

"I love pink"?

was looking

at his tie. It

ing scarves in an extremely loud color. This

was

was one

of these flow-

his facade, his

way

of

saying he didn't belong in this picture, like his statement that he was

going to

New York. I move in here because I think the whole process

therapy

is

and to

breaking the mask. Otherwise

me

that's useless.

it

of

becomes supportive therapy,

Supportive therapy merely means that you're

going to postpone the administrative fight indefinitely. Int.: isn't

So you join issue with him

away. His feminine tone

right

going to be enough to get him out of there.

Dr. W.

:

Yes. That's

having come. This presence Int.

is :

is

why

I

follow

up with

the

remark about

to all of them, but I'm also telling the

a contradiction of his pretense of being out of

You're approving of

criticizing the

way

his goals at the

he's trying to reach them.

boy

he

Dr. W.

is :

embarked on an

same time

part of a big plan.

I

that you're

The statement "You may it

also im-

some moment. know he's up to something. We're

enterprise of

Yes. I'm saying that

that his

it.

need more than a feminine tone" sounds rather ironic but plies that

their

The Growing Edge

Int.

:

He

reacts to that

by saying, "This

will

be

273

[

definitely the last

time."

And

Dr. W.:

I

doesn't want to come, Int.: that

is

leave

it

He

suggest again that this

a contradiction.

Now

answers, "I was forced to come."

maybe we can

much

get together once a

body with a choice could leave it open. Dr. W.: I'm again answering the

why

week it

says he was forced to come. I pick

since he's admitted he has a choice, then

come? Second, since he doesn't have a make it for him?

He

has admitted

think part of

its

effectiveness

you swing along with me?" Dr. W.: Sure. Since decide to be Int.

:

is

it

to.

why

also

doesn't he choose to

why

doesn't he let

him

catches

he's such a willing victim,

me

either way. I

"Why

your tone, which implies

in

He

sides of the coin. First,

choice,

a double-level response,

two

open. Only some-

contradiction.

up the two

don't you

for the next

he has a choice about coming when he says he's not going

It's

he

your answer to

choice,

years." If he doesn't have a choice, he can't leave

Int.:

If

why is he here?

very strange: "If you don't have open,

is

why

don't

doesn't he

my victim?

What do you make

of that statement of the mother's, "Fate

plays a role"?

Dr. W.

:

Well, this

what

is

I

mean by

the battle. She's saying the

same thing as the son, that it isn't their choice if they're there. I'm telling them that as long as we avoid the decision that we're all going to be responsibly in

this, there's

no sense having these meetings. I'm pressing

for a settlement.

Int.:

It

seems absolutely crucial to you right

cede that they're going to keep on coming.

If

now

they don't

that they con-

do

that,

nothing

happens.

Dr. W.:

It's

not them,

want to commit myself They're saying,

"I'll

if

it's

myself I'm concerned about.

the therapy

sleep with

is

not going to

you tonight but

I

come

I

don't

to anything.

won't marry you." I'm

not interested in that. These torn-away fragments of patients hurt me.

For example, there was exciting gal

who had

this

woman

I

was recently working

with, a very

more and a sudden they whisked her away to an

a brain injury and couldn't talk.

more involved with her and all of institution. That hurt me for a long

I

got

time. I'm trying to avoid that.

TECHNIQUES OF FAMILY THERAPY Int.:

them.

a curious emphasis on what happens to you, not to

It's

You

say you want them to commit themselves not because

be bad for them

if

therapy, but because

Dr. W. Int.

to you, I should think,

It's

a self-protective device.

you

if

me

in the

would react

patients

make

to

a commit-

the right to raise hell with

commitment

their

way

on being able

insist

Sure. This gives

down on

will

be bad for you.

will

it

would make a difference

ment to them. Dr. W.:

it

they don't, or lessen what they could get out of

That's right.

:

It

:

they back

[274

to

me. Because

it's

them

if

a bilateral

commitment. {Inaudible phrase) but

eric:

cannot stand

just

won't be here. I'm definitely going.

I

ence. Absolutely. I'm living as

don't know.

I

dr.

w. {overlapping) black glasses.

now.

out,

.

.

if,

ah,

I

this business, exist-

was a hermit or something,

.

Well, you're hiding in that cave behind those

:

can't even see the cave you're in.

1

{Laughs.) No,

eric:

dr.

don't care

I

any more. Not

this existence

I

I

I just sit

w. {overlapping)

:

wear them

the time, though.

all

I, I

rarely

go

around the house {inaudible phrase).

The windows of your

soul are covered over,

huh? eric: Pardon? dr.

w.

The windows of your

:

You might

eric:

soul are covered over?



say that. I'd just rather not go

look any more,

move

don't

I

—nothing bothers me now,

in the right circles

that's

why

my

life.

And

that's the

always have been, and out, as

Int.

:

right circles

I

way

I

any more,

I'm leaving.

calm and peaceful point of view toward him, ing

don't care

I

am when

it's

I

can't

how I

don't

have a

completely ruin-

I'm at home. Always,

always will be. That's

I

why

I

I've got to get

soon as possible.

What does

the

boy mean when he

says, "I don't

move

in the

any more"?

Dr. W.

:

I

assume he means he's trying to get out of the homosex-

ual circles he's been

in.

The

right circles for

him would

still

be the high-

school squares. He's apologizing for the affectation. Int.

:

When

this existence, is

he alluding to

that he's nothing, that

he rarely goes

he says he can't stand

his fights with his father?

Dr. W.

:

Yes. He's telling

me

The Growing Edge out, that he has

no

life

him past Int.

mechanism

that level, as a

human

You're thinking of

:

Dr. W.:

assume the

I

275

of his own. He's presenting himself at the level

of being a patient, or a to

[

that the family uses.

So I'm talking

being with a soul.

this as

a scapegoat situation.

identified patient

the Christ, that he's

is

agreed to sacrifice himself, to be a nobody. I'm saying that he doesn't

have to be. Int.

You

:

speak about the cave he's use

symbolic

start talking in a poetic, in,

and the windows of

Dr. W.

:

I

use

many

happen

my

not deliberate. I'm convinced that

my

Do you

often

different kinds of language, the Bible, jokes,

vulgarity, free associations, fantasies that

by

his soul.

kind of language in therapy?

this

ally

way here when you

unconscious.

as

It's

though

to

therapy

is

were on a bank

I

past. It's usu-

flit

mostly operated

fishing,

not really

trying to catch anything, but every once in a while something gets

hooked on

my line

and

haul

I

it

up. This

of what's happening in the therapy,

is

what

what we're up

I

look to for evidence

to.

What are you up to here? Dr. W. Well, in the beginning, with that business about the feminine tone, we were talking about the front the son puts on. Now he's Int.

:

:

drifting

toward agreeing with

me

that we're here for something signifi-

behind the

cant. He's starting to talk about what's

use a subjective, introspective language.

He

go out," he

go on with

calls

himself a hermit.

So

talk about the cave he's in, the cave

move on

to the

windows of the

even further and get a step ahead.

He

starts to

doesn't just say, "I never this

language and

behind the dark glasses, then

I

assume we're moving further and

soul. I

further into psychotic-type material.

I

front.

When

If

a patient does

this, I'll

he doesn't go with me,

I'll

go

back

off.

Int.

:

And you want to go in the

Dr. W.: Yes. As

Another way special

I'll

often

I

said before, I

do

way

it's

want to

get behind the facade.

up words that seem to have Many times you get a word that stands out

this is to

meanings for people.

because of the

direction of this material?

said.

I'll

pick

even stop and go to the dictionary.

I

have three of them right here. Int.:

You mean you

look up the meanings and the derivations

and discuss them with people?

Dr. W.: Yes.

I feel

that I'm sharing part of

my

ignorance with

TECHNIQUES OF FAMILY THERAPY them.

I

know what

don't

they don't either. So

I

meaning which they

[276

word really means for them, and often up in a slang dictionary and often it has a

the

look

it

know about

didn't

but which

in exactly with

fits

what they are talking about. Int.

most

as

To

:

if

get back to your symbolic remarks here, they sound al-

they were in quotes.

unconscious

You

operating, but here

is

it

say that in these instances your

seems to be a very controlled un-

conscious.

Dr. W.

It's

:

true that I'm less apt to be personal in the beginning.

almost straight

It's

tactics,

we

haven't got any real intimacy yet. I

hadn't thought about this before, but I'm always anxious and a irritated

ever get

new patient. I remember saying to my secretary, "If you me two new patients in the same day, so help me I'll shoot

with a

you." Because I

I

have to reset

my

sights

from the personal involvement

have with the patients I'm currently seeing to

on

little

all

of a sudden putting

the act of being a psychiatrist.

Int.

:

Do you

see "acting like a psychiatrist" as a

way

of getting

into therapy?

Dr. W.: Yes.

I

can give you a good example of

this process. I

saw a nurse who had just left a young doctor she'd been married to. She was three-quarters drunk when she came in and was debating psychotherapy versus suicide versus going to Europe and living with some

man who wanted

her to join him.

you when you're

still

trying to

decide what you want to do

appointment,

know what

call

me."

A

she wanted to do.

I

"I'm not interested in seeing

make up your mind. Why

first

week

I said,

and then

later she

if

you want

to

was back, but she

don't you

make an still

didn't

got increasingly aggravated. I said at the

end of the interview, "Look, we haven't got anywhere today, you

just

come back." I said, "Okay, but it doesn't look as if we're up to anything." She came back and we still didn't make any headway, so she said, "Shall I make an-

wasted twenty-five dollars." She

said, "I'd like to

other appointment?" I said, "Well,

it

looks as though we're locked,

whether we

it,

and

like

it

or not.

I

don't like

I still

don't

know what

it is

much either of us can do about it now." Int.: That's an odd way of winning this administrative fight you've been talking about. First you make it more and more difficult for

you want, but there

people to

and

tell

come

isn't

into therapy with you.

Then

all

them they haven't any choice about

happened."

of a sudden you reverse it

because

"it's

already

The Growing Edge

Dr. W.

:

[

277

Well, I think of myself as having to be captured by the

countertransference,

you want

if

to use that term. Until that time, I

We've been considering therapy,

don't think of us as being in therapy.

when we move into a process that carries its own direction and is self-moving. Now, the girl I'm talking about was a messy person to get mixed up with, the kind that goes out into the community and gets herself pregnant and then comes

testing each other out, but there

comes

and debates whether she should get an abortion or

in

want to take her on,

really didn't

knew

at the

where

I'd

this point

same time

that there

knew

I

she'd be too painful.

would be a

point,

if

not. I

But

I

she kept pushing,

be captured.

Int.:

So part of

is

it

that they have to keep pushing. Is there

anything else a patient could do to capture you?

Dr. W.: Another part of

it is

enough, they're apt to get me. But I

it

just time. If they stay with

let it get

Int.:

ties

it

on or

turned on.

The

"it" being?

Dr. W.:

My

Where

I see

them.

long

has to be in the therapeutic setting.

can associate with colleagues, or residents, and never turn

never

it

perception of myself in them, or

more and more

my

attachment to

of myself in the other person. This

me. Int.

:

You see

it

as

an experience for

yourself.

Dr. W.: Yes. Because I'm trying to expand myself. That's what I'm here for. I'm looking for an experience that will excite me and open

me and

me to grow. I went down to a seminar in group psychotherapy in New Orleans two or three years ago and somebody asked, "What is your purpose in doing therapy?" And I said, "Well, I want to cause

some more

They spent the next two or three days trying to figure that out. Why was I doing therapy for my own sake, not for the sake of my patients? I think that's just a little more honest way to express the facts. Int.: At any rate, if you get that experience, you know it's experience

of myself."

therapy.

Dr. W. Int.:

:

That's right. If I'm tied,

It's

possible that

get tied together,

it's

no

I

know they're tied

when you and

accident.

It's

a patient "just happen" to

a natural outcome of the idea that

they've got to provide something for you, not vice versa. to the

girl,

"You

can't

come

too.

into therapy with

me."

You

You

don't say

suggest that

she won't commit herself, she's not worth bothering with. But

if

if

she

TECHNIQUES OF FAMILY THERAPY does commit herself, she's worth your while. resist that. It's

A

[278

people couldn't

lot of

a negative come-on.

Dr. W.: I'm not started this strategy

at all averse to thinking of

way back, when

I

it

in this way. I

got sick and tired of simply as-

suming that people were going to go on with psychotherapy. Every time

anybody

said anything negative about the process, I

ously and carry stay," I'd say,

to

it

its

"Why

would take

logical extreme. If they said, "I

don't

may

you give the whole thing up?

If

seri-

it

not want to

you want to

come back, you can. I won't disappear. But maybe I'm not the person you want to work with, or maybe it's not therapy you want." And I never got anywhere. Int.:

I

didn't get a single person to stop.

a technique that could have

It's

disadvantages.

its

Do

you

ever find yourself getting stuck with someone by telling them to go

away when you really do want them to go away? Dr. W.: It does happen. I had a horrible battle with a girl recently who showed up in the waiting room and just felt she needed some therapy. I was very busy and I thought the situation wasn't that critical, so I told her to go see someone else. But I found that I was discouraging her from coming to see

with her.

me

as

if I

were already involved

take her on, but that sort of thing can be extremely

I didn't

disconcerting.

Would you

Int.:

him

ever deal with a patient by trying to persuade

directly that therapy

Dr. W. terested,

:

who

Oh

yes, I

would be a good thing

would do

mechanical, adequate

to as a problem. said

to

He was one

lives,

is

in

really in-

had one therapy and had

of these people

I

who

lead

but there was nothing he could point

So we discussed what he could get out of therapy.

I

him, "I think that essentially you're living a good, well-

compensated, well-operating therapy.

anybody who

that with

man, whose wife had been

urged him to come and see me. tight,

him?

and honestly, "I want to grow."

says, seriously

patient, a very decent

for

life.

But

should think that you would

I

if I

were you,

come

out of

I'd

it

want

you have a

lot of fun,

like play quality rather

go into

with a kind of

throated living process which you really don't have now. of things,

to

You do

full-

a lot

but they seem to have a kind of child-

than the profound satisfactions which

I

think

are possible for you or for anybody else."

Int.

:

In other words, you don't see therapy as merely a matter of

helping people

who have broken down and have

You do what one

could

call

to be put together.

"expansion therapy" too.

The Growing Edge

Dr. W.

I see all

:

[

279

therapy as expansion therapy, as leading funda-

mentally toward growth.

The

patient

up

is

same thing I'm up

to the

to.

Maybe

dr. w.:

way

the best

to get out

eric: Actually, I think this thing (inaudible words)

—improved The

Int.:

you and

for

you

to help

I

home. (Pause.)

restructure the

be

is

—because of the behavior

patterns

don't think that can be done. Possibly

I

slightly,

but

don't think

I

it

whether he's going to come in or not.

He

says

can

can be done, actually.

you and the boy

basic issue between

it

still

seems to be

pointless, because

it's

nothing can be done about the family.

Dr. W. sible to

to

:

Well, he's backing off slightly.

improve

change

it

a

little.

In a tiny

way

He

says

it

he's accepting

might be pos-

my

orientation

things.

What do you think enabled him to make that shift? Dr. W. I would guess it was the fact that I was taking him seriously. I showed this in my warm feelings and my response to him. This Int.

:

:

is

the ultimate patient. His attitude

home and

toward going tation, this

curing

is:

"All

my

my mama." To some

efforts are directed

degree this

is

affec-

being the diagnostician, the superior authority, but to some

degree he's right. He's up to the ultimate therapeutic challenge, and tell

him I'm going Int.:

was

nicer,

him with it. By changing the home. The implication

I

to help

is

that

if

the

home

he didn't have to mediate between his parents, he could

if

leave.

Dr. W.: Yes, he can't leave dedicating himself to

be his assistant in Int.:

making

until his parents get together.

his parents happier.

So I'm

telling

He's

him

I'll

this.

part of family theory that children can only leave a

It's

happy home. Dr. W.:

for having given

Int.:

The only way you can pay your parents back you your life is to make sure they're happy parents.

It's true.

You

give such an appearance of siding with this boy.

You

could have said "we," meaning the whole group, "are going to restructure the

home." Instead you

say,

"You and

I." I take

it

you don't object

to siding with the patient vis-a-vis the parents.

Dr. W.

:

This

with individuals

all

may

be

my training in

the time. I start out

individual therapy, but I side

by

relating

first

to one, then to

TECHNIQUES OF FAMILY THERAPY move on to qualities. Then

Then

another.

interlocking

[280

the twosomes in terms of their reciprocal,

I

I

move from

these dyads to the whole.

Simultaneously, of course, I insist on keeping the whole always in view. But, as

I see

one to the Int.

the

it,

way

I establish

the whole

is

by

this

movement from

other.

You do

:

boy, you say,

"I'll

this here, too.

Within the context of siding with the

help you restructure the home." This makes

ter of the entire unit.

You

a mat-

it

between

step to a higher level than the battle

the individual parties.

Dr. W.

:

and out of so

One aspect of family work is that you have to move in many combinations. You have to better the relationship

between the father and mother, which child.

You have

threesome: "Look, of a sudden

Int.

Mommy

you sneak

relationship to these sets

Dr. W.:

his

to identify the operation of the

in between."

How

act.

would you describe your

and subsets?

I don't really

third side of the triangle

from

and Daddy are trying to get together and

a kind of balancing

It's

:

the essence of freeing the

to relate to the child in his effort to separate

At the same time you have

parents.

all

I feel is

know.

which

I

would guess

that I

become

the parents, the child, and me.

is

the

Maybe

I'm the mediator in the angle between the generations. Int.

That's a nice

:

way

to put

it.

At any

rate,

it

seems here that

you're not really siding with anybody. dr.

w.

:

Well,

I

guess that's what

if

about

there really

eric: Well, personally, dr.

w.

:

I like

like to decide this

morning.

the three of you don't have any hope of doing anything

Because it,

we would

I

is

no point

in

our being here.

don't care.

the fact that

all

three of

you are desperate about

it.

I

had

a telephone call from Dad, which obviously expressed his despera-

and what was going on. And a telephone call from Mother, and she was obviously expressing her desperation. And now you express yours and I like that.

tion about the family

eric:

Do you?

dr. w.:

I

think a family that has that

more chance

to

do something about

Dr. W.: Here, you

see,

much

What

I

concern, has so

much

it.

I'm ignoring the son's statement that he

doesn't care and jumping back to where he hopeless.



was doing was

sticking

was saying the family

them with the

is

identification

The Growing Edge

between the three of them. This phase when I'm

saw

still

is

my

one of

[

gambits in the

281

initial

being the psychiatrist. For instance, in one family

several years ago, the schizophrenic daughter said she

her mother on her shoulders.

And

I

was carrying

not more than three minutes

later,

Mother came along and used the same kind of phrase in regard to the daughter. My co-therapist asked them how in the world two people could be on each other's shoulders. Or Mother will say, "I feel sucked dry,"

and daughter

will say, "I can't get out

from under."

two don't see how much you've been helping each

other.

I'll

"You

say,

Mother,

And

if

you

daugh-

didn't

have your daughter around, you'd be dripping milk.

ter, if

your mother weren't here to feed you, you'd be starving." This

the kind of overlapping I try to bring out, this togetherness which their individual points of

Int.

When

:

view they can't

is

from

see.

the son says "I don't care,"

what was your reaction

to that?

Dr. W.:

I just don't believe

such a statement. There

thing as ultimate biological hopelessness. This of the biological model, the one

believe

it is

When you

own

its

see people under it,

I

see as the value

get out of medical school. I don't is

growth, within the limits of the nutrition and the

from the outside, and

push through

what

no such

want himself dead. The organism

possible for a person to

headed toward possibilities

you

is

is

it

what looks

you get an almost

will

push for

that,

regardless.

like utterly impossible pressure

religious feeling about this fantastic

operating power toward growth, toward extension, toward oneness.

This

is

brush

the

model

I

operate from.

When

I

hear talk like

this boy's talk, I

aside.

it

Int. perate as

With this remarkable statement that a family that is as desthis one shows great hope. You manage to define desperation :

as a positive thing.

Dr. W.:

I

think

it is.

You've got a wound and

and festering within. The scab comes at least

you can get

Int.: that

You're

at

it

and

off

start to treat

and

it

it's

scabbed over

looks terrible. But

now

it.

telling this family that

makes them such a hopeful prospect

it's

exactly their desperation

for therapy.

From

their point

of view, this doesn't exactly follow.

Dr. W. It does for me. Anxiety is the motor that makes therapy move. I frequently say, "You're not desperate enough. You're not dis:

turbed enough to really have a go at this thing."

TECHNIQUES OF FAMILY THERAPY Int.

"You have all three of you don't see how anybody could

You're really cheering them on.

:

managed

[282

and

to be desperate

/ like that." I

handle that statement.

Dr. W.

:

It

sounds perfectly reasonable to me. Desperation

who

proof that you've got someone

is

up

really

to something



is

the

like cra-

ziness.

Int.

The worse they

:

Dr. W.

:

are, the better off they are.

Absolutely. This

a gimmick, I honestly believe

isn't

a schizophrenic youngster comes in here and thing his mother and father did to him,

them

credit.

I

like

me what

If

a horrible

"Look, you've got to give

say,

They made you crazy and you

You're not out there dead case."

I

tells

it.

get something out of

most of these characters carrying a

life.

brief-

from insane. The insane are what Christ

differentiate crazy

called the "whited sepulchers."

The ones who go

to jobs every

morning

in gray flannel suits.

A

Int.:

seem

to get

people

lot of

more of an appreciation

ation of ordinary

Dr. W.: craziness. I've

It's true.

had

They may never is

why

Fm

those

who

of craziness

I also

that's the

less of

an appreci-

get

some

overt

and shades and shadows, but never the of these people have available to them.

around to using

it,

but they've got

it

right there. I

the psychiatrist frequently gets into craziness with his it

in himself.

who have been

You

can divide people into two

crazy and are trying to get over

haven't been crazy and are trying to get there.

a crazy person, "You're stuck with two but

and

who have had an

envious of people

my moments

mind. He's hoping to find groups: those

intensively with schizophrenics

life.

full-blown creativity that

think this

who work

want you to

lives. I

And

I'll

it,

and

say to

want you to stay crazy,

out there with those insane people, because

live

world you have to

live in

and you can get something out of

that too."

Int.:

people with

Do you

prefer to

less interesting

Dr. W.:

I

work with schizophrenics

problems?

don't necessarily prefer schizophrenics, but I like

cases to be as bad as possible. That's partly

An

old psychiatrist I

knew

took up couples therapy

When

I

is

in

why

I

my

took up family work.

Georgia once told me, "The reason you

because you got bored with individuals."

take on a family with a schizophrenic and an arthritic and an

ulcer, I've really got

more

rather than

vivid.

something to work with.

It's

more

of a challenge,

[283

The Growing Edge Int.

And,

:

you said

as

Dr. W.: That's Well,

Int.:

now,

it

shows more hope.

right.

redefining things as positive

if

framework, being positive

Dr. W.

just

to begin with,

is

therapeutic, your

is

really helpful.

At the level you're talking about, the level is helpful, and it makes good sense. But at another level, ration of faith in the human order.

of strategy,

:

eric: Well,

I really

don't care whether

we get

it's

my

it

decla-

along or not.

dr. w.: Well, I'm not talking about getting along. I'm talking about getting less desperate, or getting

more out of

life. I

assume

you'll

be leaving the family, one of these days. eric dr.

Do you

:

.

.

.

w. (overlapping)

I

:

would

like to see



you

growing up, you can't stay in the family

Oh,

eric:

am

yes. Well, I

well, of course, you're

all

your

life.

leaving, as soon as I graduate

from high

school.

The son again

Int.:

or not.

possible that

It's

concern has a to

much

says he doesn't care whether they get along

when you

better chance to

mean, "has a better chance

Dr. W. to help

of that

:

You may be

make them happier was

He

how to get thought

I

So

I

You're saying that the problem

is

approach you usually take when the patient

is

Dr. W.: Yes. help him to do

I'll

along together."

meant

that I

was going

say clearly that I'm not

New York

be leaving :

apy that binds

is

to get

them sepa-

concerned. Is this the

a child

makes

this

age?

after

tomorrow.

a reality level about his leaving and he picks

Dr. W.

how

it.

He's been saying he's going to

it

You

you say

that.

then put

it

up on the same

level

on

and

after I finish high school."

He's really been saying, "I don't want any part of a ther-

me

nering me, to see

and Father

it

say right out that he's going to be leaving and

Int.: That's a remarkable switch he

straight that

he takes

making them happier. boy

says, "I'll

it,"

with each other and a natural consequence

rated from each other, at least as far as the

I'll

much

family that has so

do something about

to learn

right.

"A

that he wasn't going to get out.

interested in

Int.:

say,

what will

further to these people." if that's

want

what I'm going

Now

he's testing

to do.

So

I

put

me, corit

him Mother

do is reconstruct the family so that be together where they belong and he won't be I

to

to

in the

TECHNIQUES OF FAMILY THERAPY bed between them. So that he can think that's Int.

why he makes

go

really

[284

and never come back.

off

that switch.

There's a kind of meta-conversation going on here with the

:

parents. You're putting in the premise that therapy

boy out of the home, which

getting the

are thinking

it's

going to do at

is

is

going to involve

probably not what the parents

all.

Dr. W.: Sure. They're the biggest problem. They need him

home.

If they're

going to

have been for them.

somebody Int.

each other. So the message

may

frequently talk to one person through

Family therapists often seem to talk repercussively.

:

B

or

Dr. W.

:

A to say something to in order to get a message

No, because

framework when :

Do you

C?

what comes along. Int.

I

killing

else.

consciously choose out across to

at

around hating each other, he's going to

sit

have to stay to keep them from really

I

Why

I

I

was

said

my framework

is

one of reacting

trying to look at

what

it

directly to

from a more

strategic

I did.

wouldn't you say right out to the parents, "You've got

to let your son go"?

Dr. W.: Because

I

assume that

at

any particular point the dy-

namics are so thoroughly fed back and forth that there's no one person

who is it

up

doing anything to the other.

that he'll

Int.: exclusively

It's

a joint arrangement. So I just set

be leaving.

What

stands out here

on the

patient. I realize that

is

that you've been focusing almost

you want

to get immediately to

the psychotic, and that in any case what you say to

But a

parents.

lot of therapists

wouldn't do

reinforcing the family's conviction that

it's

him

also for the

is

this at first, for fear of

who

the patient

is

the

problem.

Dr. W.

:

I've already dealt with the

problem of who

is

the patient

by agreeing that each of them is. But my basic assumption is that whatever I do with any one of them includes the whole family. If one of them wants to involve me, I'm involved. If the boy in the

first

interview

wants to talk with just

sit,

that's all right

Int. it's

me

:

Many

for the

whole of every interview while the parents

with me.

family therapists would say that

isn't

family therapy,

treatment of the individual in the presence of his family.

really talk with just

one member for the whole interview?

Would you

The Growing Edge

Dr. W. if

was

Sure, so long as I felt involved. If I

:

285

[

getting bored, or

he was tricking me, or seemed unreal or unrelated, then

I

might ob-

ject.

Int.

behavior

Another therapist might

:

is

say, "I'll stop

But you

interfering with the therapy."

him

if I

feel that his

him

if I

me and

the

say, "I'll stop

get bored."

Dr. W.

don't look at the cause and effect between

I

:

assume that

family. I just

if it

feels right inside

me

it

must be

right with

the therapy. Int.:

seems to be so here. Within the

It

boy has come back from

interview, the

first

few minutes of

his far-out position

and

this

is

talk-

some of

these

ing sense. dr.

w. (overlapping)

I

:

would

like to see you, ah, get



you have about it, and about yourself, straightened out before you leave, but that's your business.

tensions

Int.: There's something I'd like to get at here. Throughout this

you have a particular way of using "it." For instance: "I'd like to see you get some of these tensions you have about it and about yourself straightened out." Are you being deliberately ambiguous, or are you putting a lot into this one word, or what? Dr. W.: I wouldn't know. But the association I just got to your interview

question was Groddeck's for Id called

of the

was Es. Freud translated it

the

Int.: lies

Book

seem

me," not

It.

said,

to use equally. "It" "this thing that I I

:

suspect

"this

it,

here," "leaving

The

original

term in German

Id and Groddeck refused

this

and

"We don't live life; It lives us."

that passive tense

It's

Dr. W. think of

He

it

It.

is

which therapists and disturbed fami-

always "this thing that just happens to

do to myself."

it's

a loaded

whole mess you're

word

of mine. "It" can mean, as

in," "the thing that

I

brought you

home," "the relationship between you and your

father,"

or even "the collective unconscious." Int.:

By

not naming

it,

you avoid being

specific

about anything

that could be queried at that point.

Dr. W.: That may be why thing

is

very clear to me.

straightened out deliberately,

is

is

I

use

it,

I

don't know. But this next

say to the boy that getting his tensions

What I'm saying, and I do boy can leave home without solving

his business.

that the

I

this

his

very

prob-

TECHNIQUES OF FAMILY THERAPY lems, that he has a perfect right to do

this, just

[286

as he has a perfect right

would rather he solved them before he leaves, because that would mean he was leaving to go to something, rather than running away from something. to kill himself.

it's

I

You're recommending what he ought to do, but

Int.: that

But

his business

whether he does

it

telling

him

or not.

Dr. W.: Yes. At that point I'm accepting him as an independently activated person

who came

because he was forced

to.

He

today because he wanted to come, not

can go to

go and comes back for therapy,

I

New York

consider this to

too, but

mean

if

that

he doesn't

he chooses

to be here.

Int.

It's

:

part of the process of defining the contract.

Dr. W.: Yes.

I

do

this

very carefully and in great

detail.

again what we've been talking about; I'm protecting myself.

want to all

the

out on a long journey unless we've got enough

set

way

Int.

is

I

don't

money

to get

through, or at least a good part of the way.

This

:

in therapy

it

for himself.

right.

To go back

Int.:

that he has to choose

initial capital is

Dr. W.: That's lem

This

to the business of "life lives us," the big prob-

seems to be not to

let

the patient deal with therapy in the

same passive manner as he deals with the rest of the world. So you offer him two alternatives which amount to the same thing. Whether he accepts or refuses the terms of your contract,

Dr. W.

:

Yes.

I

you define

this as his choice.

don't accept the passive tense.

eric (overlapping)

:

But

I

have no tensions to worry about,

at least

with some people. dr.

w.

:

I'm sure.

When I get away, I obviously don't think of them. They don't bother me at all. That's why I have to leave. Because when I am home I just can't do anything. My father won't give me a penny. They

eric:

MRS.

f.

don't faze

if

at all.

Why

do you send birthday presents to the chilyou don't worry about them? Why do you remember

(overlapping)

dren then

me

:

their birthdays then?

eric:

mrs.

Why shouldn't I? F.:

Well, okay, you say you forget about us, you

remember them

(inaudible words).

eric (overlapping)

husband

.

.

.

:

Well,

I

might not give a

damn about you

or your

The Growing Edge Mrs.

Oh

p.:

eric:

.

.

but the children, you know, they

.

They may be following mrs.

(overlapping)

f.

you've

ing, that

eric (overlapping) plan to

I

MRS.

.

After

we

.

.

to live.

.

little feel-

.

have a

I

your husband's footsteps

in

life



faith

little

in the children, yes. (Pause.)

.

.

.

:

.

have a

still

Well, at least that shows you have a

:

(overlapping)

f.

287

.

.

.

[

:

we

Well,

don't expect

you

to be

on our

level.

much older than you are, of course. We wouldn't, get, um, we don't live in your generation, we wouldn't

we're

all,

couldn't

expect you, of course you would be, you're in their generation

eric

I

:

mrs.

.

.

wish

.

.

...

f.:

ing,

.

is

.

the understanding. But

it

shows you have a

you remember them.

eric: Well of course

I

have

feeling, I'm definitely not a cold person.

I'm very warmhearted. I'm passionate by nature. But

cannot get along with you and your husband, and able to.

never

mrs.

little feel-



their



just

never will be

can get along with you to a degree, but never him

I

he's not

Now

f.:

I

it's

on

my level and

listen, girls

at

all.

He's an antisocial.

their fathers get along

and boys and

mothers get along.

eric: Yes.

mrs.

f.

You've read

:

Of course

eric:

I

all this

have, and

.

I

have,

we

not to the, the degree

.

.

I

have expressed

this before,

Not

don't get along.

but

to that degree.

There's a bit of friction, yes, but not absolute anarchy.

mrs.

Well, that's a pretty big question,

F.:

isn't it?

eric: I'm not lying. (Long pause.)

(Dr. W. turns and starts speaking to the youngest child.)

Int.:

That's a beautiful statement: "I have no tensions to worry

about, at least with

Dr. W.

:

problems. This

why

I

If is

some people."

It

covers

all

the possibilities.

he can only get away from home, he won't have any typical. It's like the

can't get along with

my

woman who

husband,

I get

says, "I don't

know

along fine with everybody

else."

Int.

:

And Mother comes

presents then to the children, that's

in

if

and

says,

"Why do you

send birthday

you don't worry about them?"

I

think

an extraordinarily insidious move.

Dr. W.: She takes

his

remark and expands

it

to imply that he's

TECHNIQUES OF FAMILY THERAPY

[288

"The poor little children who are starving to death because they don't get enough affection from you." It's standard

turning on the children.

with the mother-father game. Int.

You see the

:

My

Dr. W.: Sure. phrenic

who had

girl

father in there too?

prototype for this sort of thing

dream

a

in

which she was in a

is

the schizo-

state hospital hall

and her mother had her up against the wall and had both hands around

The girl looked down at the other end of the hall where her father was rocking in his chair, paying no attention to anything. Then she saw Father nod his head and knew that this was it. Mother was just the executive secretary. her throat. She was going to

Int.

has

:

kill her.

Except for a few mutterings,

boy

time the mother

How would you describe what she is doing?

come in.

Dr. W.: There are several things the

this is the first

she's doing.

to herself as "father" to the children. It

One

is

was very

to reattach clear in the

was a piece of cardboard and the son was the gigolo and the mother was just sexy for the son. They were sitting directly across from each other. And she's saying, "Don't leave me, think interview that the father

of our poor children." Int.:

the

It's

feeling, you're

way some wives

will say,

kind to the children."

Dr. W.: Yes. The quality of her voice

You can

almost feel her stroking with

not a cold person," he's making cept that

really isn't sexual,

it

making him

"You must have some

it

it.

is

completely seductive.

And when

the

boy

says,

"I'm

a straight-out sexual question. Ex-

because with her seductiveness she's

into a baby.

Or into her husband and her baby at the same time. Dr. W. Yes. She puts him into her generation while telling him Int.

:

:

that after

all

Int.:

he

isn't in

her generation.

The boy then answers her by

can't stand,

it's

his father,

and instead of replying that

boys and their fathers to have some their

saying that

difficulty,

it's

not her he

it's

normal for

she says that boys and

mothers get along. So that you have to step-think to keep up with

her.

Dr. W.

:

Well, the

and-so. Inference:

boy

is

saying that his father

Goad me once more and

I'll

is

an

antisocial so-

clobber him. She says,

"Let's not, we're in public. Let's just talk about the combinations that

work

well, the

Int.:

dyads that are nice."

The boy answers

the other implication that

it's

normal for

The Growing Edge

them

way

to be the

He

they are.

"A

says,

bit of friction is

289

[

normal but

not absolute anarchy." He's quick, but you'd have to be to keep your feet in that. This

he

woman

is

so

fast,

on so many

levels, that

I'm surprised

isn't crazy.

Dr. W.

If

:

he

isn't, it

may be because

the mother has allowed

to direct his anger at her against the father.

And

him

also to transmit her

anger at the father against the father.

You mean

Int.:

if

he wasn't able to beat up

his father, he'd

be

crazy?

Dr. W.

It's

:

Do

Int.:

possible.

you

up your

that beating

feel

father

is

a healthier

thing than being crazy?

Dr. W.:

more

It's

interpersonal, at least. Being crazy

for masturbation, for a hermit

healthy in that

it's

At

more open

Any

life.

settling

is

interpersonal living

more

is

change over the course of time.

to

you turn to the youngest child. Just before you make this shift, the mother has been doing a number of things to the boy. She's been taking cracks at him while seeming to compliment him, and she has redefined him in two or three different ways. Now Int.:

when she does somebody else.

this point,

you don't intervene. You wait and then turn to

this,

Is it typical for

you not

to

break up an exchange

like

that?

Dr. W\: Yes.

I

would assume

locking system, one that

I

that this

wouldn't open at

delicate. This homeostatic, stabilizing force

and which also brought them test

may

whether I'm going to destroy

a-tete. I I

in,

a self-contained,

this stage

So it till

because

it's

self-

too

which binds them together,

well be put

it.

wouldn't be apt to challenge

is

I let

on the

table here to

them have

their tete-

we're further along. Just as

wouldn't challenge Mother's craziness for a long time. Int.

:

You mean mothers in general

Dr. W.: Mothers resistance.

And, as

I

in general.

often say,

I

I

or this mother?

think of that as the piece de

don't like to start the operation

till

I'm

sure of the anesthetic.

What do you mean by the anesthetic? Dr. W. The anesthetic is our relationship. I'm Int.

:

:

cutting

anybody up

until we're

not going to start

very secure in that.

Int.: That's very different from the idea of the therapeutic rela-

warm human encounter. Dr. W.: To me therapy is like

tionship as a

a surgical operation.

I

know

TECHNIQUES OF FAMILY THERAPY be pain. The relationship

there's going to ble.

And

is

[290

what makes the pain beara-

I'm very careful not to go any faster than

I

think they can

tolerate.

Int.

:

Are

Dr. W.

there cases where

Oh,

:

yes. I've

think the difference

you

you can move

feel

had one-interview treatment many

away?

times. I

whether they accept the structure, whether they

is

take their part of the responsibility for what feel free to accept

in right

my

is

happening, so that

I

can

part without having to take theirs too. Several

man showed up suddenly in the outer office and said he had to see me immediately. I asked him to come in and he sat down directly opposite me so that we were face to face. He said, "I'm a homosexual. Can you do me any good?" I said, "It depends on whether I'm a better partner than any partner you've had before." He said, "I don't understand." So we talked on, clarifying this, and all the time he

years ago, a

was swinging

his leg

want

to kick

me, kick me." So wham, he

back.

Then we both blushed. I said, "Man, wasn't "You mean you enjoyed it?" I said, "I think

said,

He

said, "Well,

up and

I'll

back and

forth. After a while I said,

be damned,

that's all I

What did you make of that? Dr. W. Well, he was carrying the

and asking

me

But

Perhaps he took

it

that everyone

that fun?" it

And

he

was wonderful."

know," and he got

responsibility for

what he was

to

I

haven't the vaguest idea what really happened.

mean

that

it

was a homosexual

was

all right

some

in

to

be a homosexual, or

sense, so he didn't

have to

don't know.

Int.:

You

Dr. W. like that

to

kicked him

a direct professional question. I was offering what was

available in me.

I

wanted

I

you

:

:

worry.

and wham,

if

never saw him again.

left. I

Int.

did,

"Look,

:

took his leaving so decisively as something positive?

No,

it

was

his not

coming back.

happen. There was another

I've

man who came

had several things in

and

said,

"I'm a

good husband, a successful businessman, a good father, my life is going beautifully, but I'm not enjoying it. What's wrong?" And I said, "I don't know, but what about the guy who trained all those people you're talking about?"

He

said,

"You know,

he turned and walked out.

I

never thought about that," and

never saw him again either.

he must have gotten something out of

what

I

was doing, or why

this

I

or he would have

assume that

come back,

do more, or whatever. But to get back to this first point, I think that the question of why you can move in at some points and not at others has to do with whether the to find out

I

I didn't

The Growing Edge

[

291

patient accepts his separateness within the togetherness of the therapy

process.

Int.

one reason you don't go

gather, then, that

I

:

the entente between the mother and the son

The

cepted this structure of yours.

Dr. W.

having a kitchen

fight,

or a

that they haven't ac-

contract isn't settled yet.

That's absolutely right.

:

is

and break up

in

bedroom

The

two of them are

fact that the

fight, is

something

I

have any right yet to do anything about, or even to look

own private

at. It's their

world.

You

Int.:

don't feel I

you waiting to Dr. W.

wait quite a while before you turn to the child.

see

would assume that

don't know. I

I

:

go on?

they're going to

if

get involved with those

two and

Are

I

had decided not to

that I'm accepting the father's

nobody-

ishness.

Are you accepting it or pointing it out? Dr. W. It may be the same thing, but it's a direct denial of him. Int. So you let them finish and then turn to the youngest child. Why did you choose her? Int.

:

:

:

Dr. W.: As

I

remember, she was looking

at

me, so

I

started to

speak to her.

Aside from the fact that she was looking

Int.: that

someone

else to get involved?

Some

right.

therapists will instruct people to talk to each other

while they're in the room.

Dr. W. that

I feel

never did

I

:

that

I it

take

when they do

this is

you never do anything like that. can remember. I guess the reason

it

that I

rangement. With couples, one

I'll tell

usually being the patient and one

the

way

You're

now

And

couple of amateurs and you've failed.

maybe we can go on from Int.:

is

and go the

first

period of

you've gotten to an impasse, you're locked, just

a therapist and his patient often get.

just a

flip

them, "This worked out fine during the

your marriage, but

is

they have a bilateral role-playing ar-

being the therapist and every once in a while they'll other way.

also

to

Dr. W.: That's Int.:

it

work involved with people? So if the mother and son you out, or if it's not anything you care to join, you'll turn

you prefer

are shutting to

at you, is

If

I'm taking over.

you face

this fact,

there."

Here, instead of stopping the mother and son, you turn to

the child. This

Dr. W.

:

is

a message, too, to ignore them like that.

I'm certainly pushing the family out in front as though to

TECHNIQUES OF FAMILY THERAPY my

turn

back on the twosome. The inference

anything very straight from them, so

be honest, the

one. But what I'm really trying to show, I think,

littlest

Are you

:

that I wasn't getting

go to the one who's most apt to

I'll

what we're up

that I'm interested in everybody's idea of

Int.

is

[292

some

trying to get

clues

is

to.

from the child as

to what's

going on?

Dr. W.

:

No, I'm not so much interested

The little

the contact.

Int.

:

Some

And I love talking to kids.

child values me.

therapists will

do

in the information as in

this to

make

it

very clear that they

see the problem as a family problem, since they're bringing even the

youngest child

Dr. W.

:

in.

That's part of

it.

I'll

often

"Now

make

me

this

kind of switch with

wrong with your wife?" in cases when she's supposed to be the patient. Then instead of asking the wife to tell me what she thinks is wrong with her, I'll say, "Okay, what's wrong with your husband? He's just finished raking you over the coals, now it's your turn." Then I may never get back to the question of what's wrong with the patient. I'll say, "Why don't the two of you tell me what's wrong with the third patient, the marriage?" Int.: Instead of turning to the youngest child, would you some-

couples.

I'll

ask the husband,

times turn to the father and bring

him

tell

in? If

what's

a silent father like this

it's

one?

Dr. W.:

I

don't know. I think here I

was

just

going along with

the father's passivity, but I usually try to get the father to have his

say before too long.

think of the father as being at a distance.

I

mother and the child are biologically an outsider. Therefore,

if

unified, but he's

he has anything to

say,

it's

The

a social accident, usually apt to be

hidden as soon as the people close to the problem, like the mother and patient, start defining what's going on. It's that

ence;

you usually

ber there, because

start if

in a staff confer-

memhis own

with the youngest or most inexperienced

you wait

until he's listened to all the others,

ideas will

become influenced or

ther

or to the youngest child,

first,

way

inhibited.

who

is

So

I will

often go to the fa-

the other person

who

is

dis-

tant.

Would you go

first if it

was a family

somebody besides a child was the problem? Dr. W. If it was a case where it was the sick, and she was living in the home, I might go

father's sister

Int.

:

:

move from

the outside

in.

to the father

in

which

who was

to the mother. I try to

The Growing Edge

Int.

You

:

[

293

might have started here with one of the other younger

children.

Dr. W.

five or six get

prefer the youngest one I can get hold of. Children past

I

:

very self-conscious, and in this kind of setting

that I wouldn't get

any contact with the oldest

afraid of exposing herself.

Int. after that

But the

little

Too

assume shy, too

ones are more available.

Perhaps you're also turning to

:

girl at all.

I

one for some

this little

relief

mother-son scene.

Dr. W.: Sure. I'm each other. With the

tired of these dreadful characters neutralizing

little

can forget about them and have a

kids, I

ball.

dr. w.

What do you think about the family? know? Or are you just holding out and won't

(to Margaret, age four)

(Pause.) tell

You

don't

Whose

us?

side

:

you on? Dad's or Mother's or your

are

brother's?

Margaret

Mommy's

:

on your mother's side. (To Dirk, age six) How about you? Whose side are you on? (Pause.) That's a heck of a ques-

dr. w.: You're

tion, isn't it?

Truly an unfair question. (To Eliza, age eight)

You

got a side? eliza: Yes. dr.

w.

Oh, good, what side are you on?

:

eliza:

My brother's and my mother's and my dad's. Oh-ho, you one-upped

dr. w.:

me

all right.

mother's and your dad's. Well,

age ten)

How

about you?

You

I

Your

brother's

and your

think that's nice. (To Kathryn,

got a side?

Would you be on my

side?

kathryn:

Mm-mm.

You

dr. w.:

wouldn't be on

my

side?

Oh

dear.

Whose

side are

you

on?

kathryn:

Int.:

My dad's and my, my brother's side.

When you

assume you're

ask one kid after another whose side he's on,

starting with the youngest

Dr. W.: Yes.

I start at

the bottom and

said, there's greater spontaneity in the first

and then the

move

and going up the

rest of the children

work

younger ones.

I

scale.

up, because, as I I

take the

little girl

can smile and be with her and then

with me.

Int.

:

You get

a response from each of the children, but you don't

TECHNIQUES OF FAMILY THERAPY stop and deal with that response.

You go on

[294

to the next. Is that deliber-

ate?

Dr. W.: Yes. I'm

just getting

them

related to me. Bringing

them

out of their isolation, making them feel that they belong here, that I

need them. Int.:

Why do

you do

by asking them whose side they are

this

on?

Dr. W.: like this one.

always assume there are sides, especially in a family

I

The

whole chaotic

this

struggle thing.

between Father and Mother

And

Brother

is

drawn

in

is

the basis of

by them on one side

or the other. Int.

But you say there are three

:

Mommy's side and Brother's side. Dr. W. Yes. Brother has a :

sides.

There's Daddy's side and

side because he's fighting to get free

from being used by the two of them. The mother and son combination exists to save the It's

a

way Int.

mother from being honestly involved with the

father.

of avoiding the real battle. :

You

not only define these three sides, you assume that each

person must be on one of them.

Dr. W.: Sure.

I

don't think that anybody can be

on more than

one.

Int.

:

The

little girl

says she's

on Mommy's

side.

Then you go

to

the younger boy, but

you don't get any answer from him. Dr. W.: No, and I didn't want to press him. His shyness and

made me back away. Int. The next oldest girl doesn't take a side either. Dr. W. Yes, she fixes me. Here I'm trying to expose her and she answers in a beautiful way to solve the whole problem. She's on every-

withholding :

:

body's side. But I

want any

felt

that this

was

just a social

gimmick. She didn't

trouble.

Int.:

When you move on

to the oldest girl,

you take a

different

You say, "Would you be on my side?" Dr. W. I was being directly seductive. The mother and son had a combine, maybe we could have a combine. Int. You didn't get one. Her "Mm-mm" is pretty noncommittal. Dr. W. I didn't get it overt. I might have gotten it.

tack.

:

:

:

Int.

:

you wanted

Were you being to

Dr. W.:

seductive because you

felt like it

or because

balance the mother and son? I

think I had detected something in the oldest

girl that

The Growing Edge

me

gave

295

[

the idea that I could get her out of this peculiar repetitious

And that

business they were

all

ship with her that

was more adult than the toy kind of relationship

was having with the

involved

in.

I

others.

The conversation about

Int.:

could establish a relation-

I

comes

sides

Mother

directly after

has been trying to stress the harmoniousness of the family. You're contradicting her

by assuming that

just a question of

whose

Oh

Dr. W.:

fighting

is

going on in the family and

it's

side they take.

I'm agreeing with the son that she's misrepre-

yes.

senting things.

Int.

But

:

ing friends with the

right. I

would want her

time. I

their best interests.

mak-

the surface, you're just

children.

little

Dr. W.: That's

some

On

in a very indirect way.

wouldn't tackle the mother directly for

do

to understand that whatever I do, I

That I'm not

in

just humiliating her or attacking her or

proving her wrong.

A

would say they won't tackle someone directly because they don't want to get into a power struggle, or that therapy wouldn't get anywhere if they did. You put it more in terms of Int.:

lot of therapists

the value of the personal relationship.

Dr. W.

I

:

think

lative. I

don't ordinarily think of therapy as something manipu-

more

trying to help."

in terms of, "They're

Now

this doesn't

purely technical level.

I

mean

up

to something

that I don't ever

and I'm

work on

a

do, in the beginning of therapy especially. I

do therapy of a less disturbed person on a fairly straight, technical level. But when I'm working with people who are very upset, the quality of the relationship becomes crucial. I had one think

it's

possible to

patient

who had

had

do with a family of

to

a fantasy that he'd been working on for

fifteen years. It

them

thirteen adopted children, each of

about nine or ten when he adopted them. The patient was a kind of older brother to these imaginary children and kept

When

plined and out of trouble with the law. fantasy to me,

I said,

"How

maybe even

again and

get

it

about

my

them properly

he started to describe the

taping that?

transcribed."

disci-

We

did,

We

can

and

I

listen to

it

almost lost a

patient.

Int.:

Why was that?

Dr. W.: Because

I

wasn't taping

but for an ulterior motive on research.

He

my

part.

I

it

him

for purposes related to

was only

interested in

sensed that and became genuinely cynical about

it

for

me

my

as a

TECHNIQUES OF FAMILY THERAPY person. Therapy started to

we

the reason

you when cause

I felt

dirty of

it

I said to

our verve with each other

lost

taped

I

go wrong, so

I

hope we get past

include the taping in the original contract, but

want

thing that I suddenly

was doing

I

my

if

it

different

it's

be-

was

residents. It

Of course

it."

guess

I

that I double-crossed

is

might be worth using in teaching

me and

him, "Look,

should have told you that

this. I

[296

if

I

a patient has some-

to tape, that's using him.

You're talking here about "manipulating" someone in the

Int.:

sense of exploiting him, doing something that

How

your own.

different is this

sake but for

isn't for his

from using therapy with patients to

expand yourself or increase your own growth? Dr. W. self,

:

There's a real difference. If

both the patient and

to either of us.

anything,

Int.

Making

I get

I

do therapy

something out of

it

or

expand my-

doesn't

happen

the tape for the residents didn't give the patient

it

was using him.

:

There seem to be two extreme positions therapists can take

with regard to manipulation. There are the therapists erately to manipulate a person so that

Then

it

to

there are the therapists

patient at

all

who

he

will

who

set

out delib-

change his way of

life.

claim they aren't manipulating the

or even trying to influence him.

You seem

to take a middle

course.

Dr. W.

:

I'd rather

put

it

that I'm

on both

sides. It's

can't change people without manipulating them, but

you

aren't going to

who

be of any use to them

if

you

obvious you

on the other hand

set yourself

up

as a

them what to do. I'm not trying to control people, I'm trying to help them to inherit themselves, or help them emerge, or however you want to put it. Int.: The problem is how to be manipulative and how not to be person

only

tells

same time. Dr. W.: It's a hard thing to get around. When people come to me, that automatically makes me a significant person. The only way I

at the

can counter that significant

hope

is

to

make

person to them,

that will give

I

it

clear that I'm not interested in being a

want

to

be a

them the courage

to

significant

become

person to myself.

significant to

I

them-

selves too.

dr. w.:

Your

dad's and your brother's. Well, we've got almost

variations, haven't

we?

I

didn't

even know

Dad and

all

the

Brother had a

The Growing Edge

common

Mommy, huh?

against

Mrs.

Dad and

there's

Brother

(Pause.)

She's a girl (laughs,

f.:

You mean

(Pause.)

side.

297

[

and Dr. W. laughs), favors the boys, and

the boy favors the mother. (Laughing.) dr.

w.

mrs.

Well, I don't

:

This

f.:

mal

.

.

common side."

not favor, but (laughing)

is it,

you

This

there are not only

is

and

the

it's

just the nor-

probably a

(Mrs. F. laughs.)

I

even

assume

that in

is

any mixed group

the females. I discovered this in group work,

all

after the third or fourth session

all

guess

the combinations of male and female but there are

all

the males against

where

I

know Dad and Brother had a completely new idea in this family.

say, "I didn't

Dr. W.: One of the things

all

.

.

Now

:

.

A regular family structure.

dr. w.:

Int.

.

know

women on

you

men on one

find all the

side

the other. I'm just acknowledging that this

is

another one of the dynamics that are operating. Int.

It's

:

not exactly just one of the dynamics in this family.

loaded combination that has to be kept out of includes the idea that the

schizophrenic, against

are against

somebody suggested

if

Mommy,

notice that

men

you'd expect

Mommy

It

:

may be

that I

in like

Brother were a shot, and

was responding somewhere inside

Mother's previous statement that

may have been

I

also

In a family with a

Dad and

come

to

it

a

I

Mommy does here.

Dr. W. mother.

Mommy.

that

because

sight,

It's

girls like

me

to

the father and boys like the

setting out to sink the first gaff in her

by

pointing out that the boys like the men. Int.

You

:

aren't just saying that

together with another

man

whom to who's

whom.

against

boys

against Mother.

Dr. W.: Well, she puts

it

right

back

men

like

You

but that they get

shift

again.

from who

The boy

likes

likes the

mother. Int.

:

Then you both laugh.

Dr. W.: Yes.

It's

That's a strange laugh of hers.

a psychotic laugh. But

this is the

laugh that

covers the hostility. She and I are clear that we're after each other, but

we're

still

Int.

have a

doing :

it

with the greatest delicacy and social comfort.

She doesn't reply to your suggestion that Dad and Brother

side,

she replies to your previous statement that the

girl is

on

TECHNIQUES OF FAMILY THERAPY Dad and

[298

Brother's side. You're offering her two propositions and she

chooses to go after the

Dr. W.

This

:

first.

a technical maneuver that I use

is

many

drop in a statement while we're talking about something can't really challenge

Int.

it

You say X,

:

Dr. W.

that they can't get at

I'll

and they

else,

because we're on the other subject.

Y, and Z, and

And

That's right.

:

times.

Y gets in there some way.

command them to talk about Z so really insist. And so Y sits and they

I'll

Y unless they

away from it. Int. When you put in "The men are against Mommy" within the framework of whose side the girl is on, the mother can't suddenly come out and say, "What do you mean, against Mommy?" without making

can't get

:

an issue of it.

Dr. W.: That's Int.

:

But she

right.

still

answers that point, when she says the boy nat-

urally favors the mother. It

sounds

like a

Dr. W.

non

that they are

Int.

sequitur, but in that context

really favor

not.

mean, damn females.

It's just

girls.

Mother; the only reason they don't

that they're against their

:

it's

Mommy?

Yes, she's countering me. She's also going after the

:

Everybody would

wrong sex

So how can he be with Dad against

an accident of

is

only because they're of the

It's

good old mother. birth.

She doesn't have to appear to

be attacking anyone.

Dr. W.: That's going to

fight

Int.

:

but

it

You

Dr. W.

:

I

right.

And

"Well,

I say,

I

don't know." I'm not

don't quite agree.

drop in that "I don't know" in such an offhand way.

This

is

a standard procedure of mine.

I call it

You seed an idea and drift away and leave it. Dr. W. The most frequent pattern I use is never to Int.

:

:

thing I've said. If I'm talking with the parents and that's

"seeding."

I

repeat some-

say something

loaded for the mother and she says, "I didn't hear you,"

"Well,

Dad heard me and

I'm not going to

tell

you because

it's

I say,

put in

now, but you don't have to worry, everything that goes into the computer stays there." says,

Two

"Would you say

exactly what

that again?"

and

I

say something to him and he

I say,

"You

happened a minute ago. I'm not going

either." I never

Int.:

minutes later

come back

Is this partly

see,

Mother,

to repeat

it

this is

for

him

to those things.

because you

point across, a kind of subliminal flash?

feel it's

a stronger

way

to get a

The Growing Edge

Dr. W.

me

to say

No,

:

it's

more

the other

way round. They're

again so that they can cut

it

it off.

affect is gone. It's like a wife asking for the

me?" Then she

love

When

I

say

second time,

299

[

trying to get it

my

again,

"Do you

really

and

detects the coldness in her husband's voice

because the

says, "I don't believe it." This fixes him,

first

time he meant

it. 4

The next

Int.:

saying that

you

her, but

you say

is

regular family structure."

your tone

Dr. W.:

very curious. Mother

is

again

normal for children to favor the opposite parent, and

it's

"A

say,

thing

very

is

You

flat,

You seem

be agreeing with

to

almost ironic.

could say that I'm agreeing with her, except that

when she says that her family is normal, she means the opposite. She means that it's an unfortunate trick of fate that she has all these females to contend with. I'm breaking up her suggestion that this is an unusual family.

That's pretty subtle. I wouldn't have gotten that meaning

Int.:

from her remark. Dr. W. ily is

we It's

I

:

introduce the idea that anything that happens in a fam-

normal whenever

I

think they're trying to say,

meaning that other people

are,"

in the family

"Look how

ought to be

strange

different.

how

a standard response of mine to any ploy that has to do with

abnormal the family Int.

What

:

is.

gets complicated here

mother's real meaning, which

And you do level

way

the opposite of her stated meaning.

by agreeing with her

ironically. It's a curious

w.

I'm just hanging her on her

:

(to Dirk)

That's

:

just like that,

mr.

f.

dr.

w.

mr.

that you're getting at the

(to

No,

:

f.

Dirk) it's

:

some red

own remark.

shirt.

and I'm very fond of

You know,

I've got

a red

it.

got a stripe. :

He's got one, he's got one like this

home

Int. :

came back to pick him Your tone changes when you turn from

It gets

warmer.

fore. I couldn't get to

:

too. I

one myself (inaudible phrase). (Pause.)

Dr. W.: I'm talking here to Dirk, the boy who bypassed

Dr. W.

shirt

Don't be so modest.

(overlapping)

like that

boy.

double-

of dealing with two incompatible positions.

Dr. W. dr.

it

is

is

him, so

I said this

I

about the

shirt

me

be-

up. the mother to the

with a lot of feeling, because I

TECHNIQUES OF FAMILY THERAPY have a red

shirt

and which

I like

Int.

:

my

which

made

fourth daughter

for

me

[300

Christmas

last

very much.

What do you think brought the father in just then?

Dr. W.:

I

would imagine he was about to

nobody left for him. Int. Did you isolate him on purpose? Dr. W.: Maybe. I may have been angry

feel isolated. There's

:

so aloof from

different,

Int.

:

You

common and

at

him

for being so in-

it all.

pick out something that you and the young boy have in

he comes right

He seems

want to share

in this shirt

was because we were talking

specifically

in.

to

affair.

Dr. W.: Perhaps

it

about things, instead of these loaded problems about the family. Int.:

Also, he

may have been

reasonably sure by

now

that

you

could handle the mother without disaster.

Dr. W.

:

It

could be.

what are we going to do? I think of us as kind of being here this morning to see if we can make up our minds whether psychotherapy is worth getting into, and whether the three of you can make up your minds to, ah, spend that much time, and effort, and money, trying to work at it (pause) and I guess I need to get

dr. w.: Well,

fairly clear

where

I

stand with

rough outline of how don't think of

of

it

it

I feel

and then

it,

about

this

I

you the rough,

kind of work,

I

mean

I

as being anything particularly exceptional, I think

as being the kind of thing that's

would, as

tell

said last time, be willing to

worth time and

work with

effort. I

the three of you.

would not be willing to work with any part of the three of you, either one or two, or any combination, because I think this would

I

be denying the situation as the kiddies

in, I

it

seems clear

think they belong

in every time, but I think they

them, that the family time.

I

think they

is

in, I

it

exists.

I'm glad to have

don't think they have to be

have to know, and I'm glad to

upset,

and they've known

know probably

as

one of the three of you do, because their understanding to be very

much about

I trust

it

tell

for a long

the upset as any

children's intuition

and

deep in these very early years.

don't think they need to be in every time, but

I'll

I

be glad to have

any of them who want to come, or any of them you want to bring, or

all

of them,

time they

if

you

come they

feel

you'd like to bring them.

contribute,

they get something from

it.

and

They

I

I

think each

think each time they

get something

from

it

come

because

The Growing Edge

[

301

they have a sense of their family trying to do something about

And

itself.

them from being panicked,

think this keeps

I

ah, in

by themselves, or being panicked, ah, at what they overhear, or what they think they overhear, or what they're their

bed

afraid

at night

going on, and, ah,

is

think the real facts are never as

I

dangerous or as frightening as the fantasies and dreams that dren can have about

mommy Int.

and

long speech about therapy.

wrapped

thing,

Dr. W.:

it

I

It's

almost as

if

shirt,

you launch

into a

you had completed some-

up.

think of this as a point where I've

the entire family, kind of shaking hands

back to

involves their

it

their daddy.

Right after the exchange about the

:

when

particularly

this,

chil-

talk about

what we are here

for.

all

round.

made

Now

Are we ready

contact with

we're moving

to structure this

thing?

You

Int.:

you don't

get

it

with that at the beginning of the interview, and

start

you go

resolved, so

into a diversion.

Now you

get

back

to the issue again.

Dr. W.: I'm not sure this

I'd call

it

a diversion.

What

I

did during

time was to set up the issue differently. Int.: That's true.

made

You've brought

in everyone in the family

and

war on and everybody's taking sides. It would be very hard for them to say, "Why should we come in as a family?" because you've redefined the problem as one in which they all it

clear that there's a

have a share.

Dr. W.: Exactly. Int. of them.

:

notice that

I

The

you go back

other children are

to saying you'll just see the three

welcome but they don't have

to come.

Why is that? Dr. W.

:

Before,

wouldn't come

in,

when

I said,

seven are to bring the three Int.

:

You mean

I

wanted to see the three of them and they

"Okay, then bring the seven

in."

But the

in.

that they'll be glad to get

had the ordeal of seven? Dr. W.: That's right. Because when

back to three now that

they've

turns out that five of

view

it's

even worse, because

which makes her.

them are on

three,

it's

my

I get

side.

the seven of

From

them

in, it

the mother's point of

clear that the females are against her,

and she knows the father automatically

is

against

TECHNIQUES OF FAMILY THERAPY And

Int.:

Dr. W.: So we've got nobody on her side. Int.

may be

Dr. W.:

If

them together by

don't think of

really got

Mother

She's

the

first

they won't

time they've only had each other in years.

come

together on purpose, I have to get

default.

be worth their while. Why, then, do you say that you

meant

I

that the family

is

nothing exceptional.

I

said

whole speech.

And

meaning the kind of problem we'd be working on. Int.

there are

that "it" again. It runs through this

It's

:

some other puzzling

things.

know about

children have to

On

things are worse than they are.

For instance, you say that the

the upset, so they won't imagine that the other hand, because they're chil-

dren and have a deep intuition, they've known about

Dr. W.

:

This

know would

that to

"upsetting"

Then

I

them by

it

for a long time.

again talking to the parents through the children.

is

The parents have maintained and

we?

isolated, haven't

as anything exceptional?

it

Dr. W.:

little

Dirk.

In this speech, you seem to be trying to persuade the family

:

that therapy will

"it,"

gotten

This operation of yours with the children has isolated both

:

parents. This

Int.

Daddy and

you've lined up big brother with

Daddy and little

together with

[302

upset them. So

letting

know

the fiction that the children don't

them

in

on the

I

take the responsibility for

fact that the family

is

upset.

laugh at the parents for making believe that the children don't

know by saying that Int.:

of course they've always

You seem

to

known.

be talking here about a kind of double-level

knowing.

Dr. W.

:

Yes.

At

the

same time

that I'm talking about

what they

openly know, I'm also talking about the Biblical, the carnal "know." This

is

they've

my

a real part of

known about

know about the Int.:

conviction. These kids have

Mommy

known about

and Daddy for a long time. They also

family upset, even though they pretend not

You

don't say

it

speech that the family upset

sex,

openly, but there is

the

same kind

is

of

to.

a suggestion in

open

secret as

this

what

goes on in the parents' bedroom.

Dr. W.: Yes.

I

what these people are

The

violence

the other

is

use the framework of sex to talk about really afraid of is that they're killing

it,

each other.

usually thought of as a disguise for sex, but I suspect

way round.

but

it's

The Growing Edge

[

303

What stands out is that you speak to the parents as if both you and they know what this family upset consists of, but you never make it explicit what that is. Do you mean the boy's violence at home? Dr. W.: No, his symptom doesn't concern me at all. Anyway, I Int.

assume

:

no

that's

secret. I felt that

know was

children to

what the parents

want the

didn't

the level of the affect of their disturbance, not

anyone's misbehavior as such.

By

Int.:

family upset, then, you

mean

the struggle between the

parents.

Dr. W.: The struggle between the

Because

three, really.

a

it's

three-person upset. If Father and Mother were willing to accept their

own

war, they wouldn't need the boy to conduct

David

fighting Goliath for

question whether the parents are taking

concession on their part so far that there is

fighting

I

assume that on some

what I'm talking about and telling

Int.

ing to get at

know is.

is

upset, but there's

a war,

let

a

no

alone that the boy

is

level they

do

know

perfectly well

too. This is also part of

them. telling

them anything. What I'm

really try-

the ambiguity of this speech. You're letting the parents

you know what's going on without ever saying what

that

still

that way. There's been

it

that the children

Without clearly

:

is

for them.

it

Dr. W.:

what I'm

for them. This

Mother.

We've got what you mean by the

Int.:

it

that "it"

You're speaking as ambiguously as these people themselves could

ever do.

Dr. W.: You're exactly

way they

The only way

do.

involved with them. the

way

And

when you

say that I'm talking the

treat very disturbed people is to get

way

I

can do that

is

to get involved

So I double-bind the patient and he mother and son do. I really believe that the

the mother got involved.

only person

who

gets to

be a psychotherapist for schizophrenics, or

for their families, since that's possibly the

one who

is

same

thing,

is

Therapists

who work

with families of schizophrenics often

to talk like the people in those families. It's not unusual.

hard to get

at is the difference

between what the therapist

way and what the family is doing. Dr. W. I've wondered about that myself. An

he talks

some-

schizophrenogenic.

Int.:

seem

can

the only

double-binds me, just like

maybe

I

right

is

What's

doing when

this

:

ex-patient of

mine

TECHNIQUES OF FAMILY THERAPY who was things to

group in Georgia once said to me,

in treatment with our

"Every one of you was

me

that she did.

break out of

with

this

my

just like

But

my

I

[304

mother.

You

were doing the same

found the difference.

mother, she would twist

it.

When Push

I tried to it

tighter.

When I tried to break out of it with you, you loved it." It occurred to me later that part of it is that the patient is not my child and therefore I don't have to keep him.

my last

Now there's

always the question of whether,

if

him go. I suspect I'm like a mother I once had in a mothers' group. She had ten children and one of the other mothers said to her, "Why did you have so many?" and she said, "That's the only way I can keep from spoiling the youngest."

he were

patient, I'd ever let

dr. w. (cont.)

:

I

as catch can. I think if

need to decide further,

would not be willing to go on catch we go on we need to decide, and we don't

would (pause), it

today, but

I

we need

to decide before

whether you're willing to undertake

project, all three of you.

Ah,

I

would not

like

we go much

this as a it,

unless

long-range all

three of

you made your own individual decision about this. I would accept it and assume it to be my responsibility as a physician to work with it, if just Mother and Daddy made the decision and insisted (to parents) that your son come along. I would much rather he came because he wanted something out of it for himself, (to son) but I would accept their decision, ah, if they, ah, decide that's the

way Dr. W.

:

it

has to be.

When

I say,

"You

don't need to decide today," I'm try-

them from making a pseudo-decision. This is a standard administrative demand of mine. "Go home and sleep on it, and if tomorrow morning you still want to come, call me and we'll make an appointment. Or call me six weeks or ten years from now. I don't care when you decide, but when you do, I want to be able to count on

ing to keep

you." Int.:

Is

it

enough of a commitment

statement that they agree to

Dr. W.

:

It is if I feel they're

we

are jointly

they

make a

plain, direct

come in?

state of the relationship that tells

standing that

if

up

being genuine. But essentially

me.

It

it's

the

has to be based on an under-

to something long-range. That's

when

I

think the formal process of psychotherapy begins. Int.

:

In trying for a commitment, you have a

way

of going

up

to

The Growing Edge these people and backing

come

sure them to

Dr. W. approach.

I

:

in,

off,

going up and backing

"You

then you say,

off.

First

[

305

you pres-

don't have to decide today."

think there's always this alternation of withdrawal and

It's like

And

a courtship dance.

the question

is

not,

"Do you

me?" but "Are you going to marry me?" I'll back up to see whether they'll come toward me, then I'll come forward because I'm

love

interested.

Int.:

Otherwise

You'd have it

I

Int.:

you

all

you

really

come

I'd say

:

it

was

move forward

make

in order to

whether they

to see

and then

so that they can

come

forward.

wouldn't really be their decision.

Dr. W. back up

move back

to

to

it

a reciprocal decision. I

will take their share of the responsibility tell

them

that I'm willing to take mine.

In this next exchange, you say, "I would not like

it

unless

you made your own individual decision about this." Do think it's possible for them to make individual decisions to

three of

in together?

Dr. W.

They make them

:

even though they don't admit

covertly,

They may go home and sit for six months and then somebody will say, "Oh, this mess, maybe we ought to go back and see Whitaker." Somebody else will say, "All right, if you want to," and the other one

it.

go along

will say, "I'll

Int.

:

if

the two of you are going."

What's "individual" in

the father doesn't

make an

really say this

is

father decides

I

assume that

stant confusion about boundaries. I

of a very psychotic

The

next

peculiar.

Suppose

come in and the son to come in. You can't

the father's individual decision.

Dr. W.: Well,

a car.

becomes very

individual decision to

him and the

hauls off and hits

this

in all these families there's a con-

remember one time when the

boy brought up the

week

I said,

"How

fact that they

about

it,

father

were going to buy

Dad, did you buy your new

And he said, "No, we haven't made up my mind yet." Int.: You start mixing the pronouns yourself in this

car?"

speech. "I

Mother and Daddy made the decision and insisted that your son come along. I would much rather he came because he wanted something out of it for himself, but I would accept would work with

it if

just

their decision if they decide that's the

Dr. W.

:

You have to remember

at the other. It wouldn't

Int.:

way

It's just

that

has to be."

that I'm looking

be so confusing

you go

it

if

first

you had been

at one, then

sitting there.

into such a fast alternation. In talking

TECHNIQUES OF FAMILY THERAPY

[306

about B's decision you address yourself to A, and in talking about A's decision you address yourself to B,

almost as

forth. It's

scribed,

which

it

back and

you were countering this tendency you've dewhenever these people are faced with a commit-

if

that

is

and you keep rocking

ment, they slide in and out of each other.

Dr. W.

It

:

The

Int.:

could be.

other strange thing

you want individual bring the son

Dr. W. ence in the matter

decisions,

that just after you've said that

is

you say

that

it's all

right

if

the parents

in.

don't care

I

:

office

brings

who

take each one's pres-

in. I'll

the overt decision. I didn't say

be equally acceptable to

You

who

next time as evidence of his choosing to be there, no

who makes

Int.:

certainly a strange speech.

It's

here, but

it

would

me if the son brought the parents in.

again set

choice, or whether

it

it

somebody

up so else

that whether

it's

does the choosing,

an independent each one's

it's still

choice.

Dr. W. in.

Yes.

:

The only

thing

All three have to be there. This

You

Int.:

wouldn't accept

I

is

what

I

first

I

:

Some

therapists will

but then drop him and concentrate on the

parents' relationship. Since he's only the surface

Dr. W.

any two came

keep pushing.

wouldn't see the parents alone?

bring the child in at

is if

wouldn't do

it

symptom.

with this couple. They'd say,

each other. There's nothing wrong with

us. It's just that

younger

love

boy."

Are there situations in which you would do this? Dr. W.: For me it depends on how old the child Int.

"We

:

child,

from four up to perhaps nine,

offer this alternative.

Or

if

the child

I

is.

With a

might be tempted to

had already made a move

to break

away from home. I once saw a couple with a schizophrenic daughter of seventeen, she was out on a pass from the hospital. After the first interview, she ran away. She was found and brought back to the hospital, but the parents came to the next interview alone and I said to them, "By running away, your daughter has said she doesn't want to be part of the family. I take that seriously, I take it as a fait accompli. I'll work with you as a couple but I won't work with you and your daughter." And this is what we did. Int. What was different about that case? This boy wants to run :

away, he

just hasn't

Dr. W.

:

done

it.

That's the difference.

I feel

he can be helped to do

it

a

The Growing Edge

why

better way. That's

leave

is

dr.

just

The way

has to be the three.

it

[

307

he's trying to

going to get him tied tighter into the family.

w. (cont.): The other thing say

that

is

ah, as

I

do not

feel that I

sometimes say to

I

that I think

am

important for

is

competent to do

a,

whatever

to

this alone. I,

be glad to take out an

patients, I'd

appendix with a good operating-room nurse, but touch a gall bladder or

me

I

wouldn't even

hysterectomy, without a

else,

good surgeon right there beside me or on the other side of the table, and I feel the same way with this kind of thing. I do not think

So

if

it's

we

by myself, ah,

possible,

I

don't think I'm strong enough.

decide to go on, either today or sometime in the very near

would want a second psychiatrist in with me, at each interview, ah, as I want to be strong enough, or want your therapist, the two of us, to be strong enough so that you can depend upon us, and I don't think I can do that alone. I might make it, but I don't want to take any chances, I'd rather play it safe.

future, I

(Pause.)

Int.

:

If

you don't mind,

moment and go all, how did you

I'd like to stop here for a

into your reasons for having a co-therapist. First of

doing this?

start

Dr. W.: In 1945, when John Warkentin and gether in

Oak

Ridge, one of us would

come out

were working

I

of an interview

all

to-

ex-

what a wonderful experience this had been. But the other wouldn't be interested. So one day one of us said, "Look,

cited

why

and try to

we

tell

the other

we can both talk about the same interview." After we tried it, we saw so many advantages in it that we never gave it up. This was even truer after we started seeing chronic don't

see patients together and then

schizophrenics, couples and finally families. Int.:

Why was that?

Dr. W. one

:

I

doubt that

therapist. I don't think

power necessary

to get in

it's

possible to handle any family with just

one therapist alone possesses the amount of

and change the family and

without getting stuck in the people salad. Even

when

get I

back out again,

think

it

might be

possible, I'm usually not willing to take the chance. I'd rather get a

good double team and be Int.:

The

other

gather, not a social

sure.

member

of that

team

is

another therapist,

worker or a student or something like that

I

TECHNIQUES OF FAMILY THERAPY Dr. W. the

team

Yes. Another professional therapist. Although

:

woman

are treating an older

and

identifies it

my

being the therapist. For instance,

itself as

calls

I

[308 think of

and

resident

I

with a menopausal depression. She mis-

him "Whitaker,"

as though she were trying to

make

most of what's been going on

clear that we're a team, even though

has been with me. Int.

You

:

still

Int. is

That's right.

:

When you

:

it

as

team therapy even though the other

ther-

an equal part?

apist doesn't take

Dr. W.

see

Even

if

he

is

relatively inactive.

talk of wanting extra

power

to handle a family,

you don't want to be too outnumbered? Dr. W.: No, I think of it as adding power to myself. The other

part of

that

it

me

person gives

I'm not isolated, that I'm not

security, a feeling that

going to be ham-strung by

my

attachment to one or

my

antagonism to

another. I'm able to keep clear of entanglements.

Int.

The presence

:

of the other person gives

you a platform

you want another

side the family structure. It's not that

out-

therapist for

the different skills he might bring, but because he becomes part of your

own

apparatus in dealing with the family.

Dr. W.

In

:

effect, yes.

Although

his skills

and knowledge are very

important. If in the middle of the operation I'm suddenly not quite clear whether this

you think?" But

is

the bile duct or the aorta,

this is a

I'll

say, "Bill,

what do

secondary gain. I've learned that you can go

on holding a family together and staying with it without changing it. I'm not willing to do that any more. I want to get in with enough power so that I'm going to be able to get out.

I

don't want to stay the rest of

my life with my finger stuck in the dike. Is the

Int.:

team always two people or do you sometimes work

with more?

Dr. W.

:

We tried all sorts of combinations,

but two was the basic

concept.

We'd

tient for

one interview, the other for the next, and then we'd meet

gether.

Or one would

would take the

We

occasionally split

other,

it

up; one therapist would see the pa-

take one spouse,

if it

to-

was a couple, and the other

and the next time we'd have a four-way meeting.

worked best if we alternated the individual patients rather than if each therapist saw the same patient. But we'd make sure that there were always four people there in spirit. The structure was always found

there.

it

The Growing Edge

Do

Int.:

you find that having two

therapists

[

309

makes therapy

shorter?

Dr. W.: There's

less

chance of

being interminable or never

its

getting off the ground, but I can't prove

therapist

is

more adequate. In a

where

serious situation like this one,

mother are grossly disturbed,

the father and

shorter. It's just that the

it's

I

would never go on with-

out a second therapist. Int.

:

You felt that the father and mother were that upset?

Dr. W.: taken a look

I think that

at

them and decided

What I had how crazy the

insane sense. too:

this,

out in

left field

:

Are

Dr. W.

:

no

already been told about the family confirmed situation

was

if it's

in the

how

reality controls at

there families

Yes,

were both crazy in the direct

that they

the father was, and

wild, chaotic, with

Int.

anybody with any experience would have

community, how

utterly

home

disorganized the

was,

all.

you would see by yourself?

a concerned family, with everybody interested

in doing something about the problem.

Int.:

Do

you usually bring

in

when

another therapist

you're

working with individuals?

Dr. W.

there

I

is

Always, with a VIP, or a millionaire, or a reputable psy-

or a patient

chiatrist,

whom

:

who

think of as good ones.

And

I'll

FBI picked

it

this

with families in which

Int.

:

had

tried to hire

it

it's

mostly that the twosome

The twosome becomes

who has to figure Int.

:

is

to kill his wife

and

violence?

Well, that's helpful, but again

both the person

I left

a responsibility problem, that you don't want to

be the only one on the spot in case there :

saw before

were sent to me.

Is part of

Dr. W.

someone

I

up. Since they said they were ready to try to go on

living together, they

think

do

a strong possibility of violence. In one family

the South, the husband the

has had two or three previous therapists

who

is

it's

not the main reason.

greater than the

the administrator.

has fun with the

When

little girl

sum

I'm alone,

and the

of I

its

I

parts.

have to be

reality

person

out what we're going to do.

It gives

you the freedom

to

be personal, to do what you

feel

like.

Dr. W.

:

Yes.

I

can take the next hour and

just play with the little

four-year-old.

This might be a tremendously powerful experience.

Mother might

see the fun she could have by being loving with her

TECHNIQUES OF FAMILY THERAPY daughter. This Int.

So

:

my

one of

is

[310

standard moves in therapy with the family.

been talking about the advantage for yourself

far we've

Does

of having another therapist in.

free the other therapist too?

it

Dr. W.: Yes. Because one can be the administrator while the

Or one

other plays.

of us can

Who

stays with the other one.

move

on one person while the other does which can change from moment to in

moment. Int.

take

I

:

it

you tend

that

keep in balance with each other.

to

one of you stops playing and becomes the administrator, the other fill

you just

the place

Dr. W. Int.

Yes.

:

You

:

view that one

If

will

left.

It's

usually complementary.

don't pre-set things, such as deciding before an inter-

will

be the supportive one and the other

will

be the

reality

one?

Dr. W.

No,

:

it

happens dynamically. Let

of this freedom I'm talking about. I

started telling us that

because he didn't think finally I said, "It

it

sounds to

It

as

if

how

I feel

his real life situation all

around

and

this,

you're talking about your being a

homosexual, and you don't have to explain to you

you an example

in

He hedged

pertinent.

me

give

on a case with a very the last interviews, and he

was asked

was one of he didn't want to talk about

homosexual.

schizy, overt

me

tell

me

about

about homosexuality.

I

but I'd like to

it,

often have a feeling of

envy toward somebody who has been overtly homosexual because that's a life

experience I've never had.

the feeling that you're

When you

somehow denying

talk about this, I

the fact that you've always

had a sense of lovingness with men that I'm not sure

I'll

ever have,

having missed that experience." This startled him and he became tered.

During the next interview, which was the

about

how much my

had been

statement had meant to him.

his therapist I

either because

last one,

Now

I

it

flus-

he talked

think that

probably would not have been free to say

he might take

have

if I

this,

out to the community or because

it

might precipitate both of us into some kind of panicky feeling about each other. With the other therapist there,

I didn't

have to worry about

this.

Int.:

The

fact that you're

you're like two parents.

Do you

peutic family for the patient?

the other

more

Dr. W.

:

two

therapists suggests the idea that

think of yourselves as creating a thera-

Does one become more

the mother

and

the father?

No,

I

think of us as both the parents.

We take both parts

The Growing Edge interchangeably, like hermaphrodites. It to represent the older generation

Or,

I'm alone,

if

I'll

and

is

like

a family in that

[311

we tend

our

treat the patient like

child.

think of myself as a kind of prime parent, not

sexually identifying.

Whether you take

Int.:

you're

a pair.

still

If,

as

is

the parts of

mother and father or

not,

often noticed, the schizophrenic patient

adept at splitting the parental pair,

I

is

should think that he would also try

to split the therapist pair.

He

Dr. W.:

remember one instance can make love

to

and

does,

why

I

what we deal with

which Malone said to a

in

Whitaker but he and

years and years and years.

and

this is

We

I

all

patient,

the time. I

"Look, you

have been sleeping together for

had a particularly good night

last night,

don't think you have the slightest chance of getting anywhere, but

don't you go ahead and try?"

crazy, symbolic language, but

We

would handle

we wouldn't evade

it,

it

in this kind of

we'd meet

it

di-

rectly.

Int.

You assume

:

that

it's

therapeutic

if

they attempt to

split

you

and don't succeed. Dr. W.: there's

I

think of that as crucial. If they split the therapists,

no way around

You

Int.:

it.

You're up the creek with a hole in the canoe.

could see that having two therapists there would

most invariably tempt the patient

to try to split you.

al-

Did anyone ever

succeed in doing that?

Dr. W.: There was one schizophrenic patient who blasted War-

me

At first, therapy went so well that we started to take turns with him. Then things became so difficult between us that we decided to drop the case. But I think that's why most therapists will kentin and

apart.

take on one schizophrenic and then never take on another. Because the

him into his masculine and feminine parts and he's not sure he can get them back together again. Int.: I should think that working in a team would be useful because it would allow you to handle this splitting in an easier way. With two bodies, it becomes a more obvious operation. Dr. W. I think so. It also allows us to demonstrate what a confident, direct relationship can be like. Co-therapy with us was a recurrent

patient will split

:

process of arguing, even fighting. I'd say to the patient, "Look, that s.o.b. is

Daddy

twenty minutes late today; you just

get this straightened out."

interview.

We would both be mad.

And

we'd

sit

there while

fight

Mother and

throughout the whole

TECHNIQUES OF FAMILY THERAPY Int.:

How mad?

Dr. W. Int.

:

[312

Really mad.

:

You mean you would

only enact a scene to show the patient

how to get angry if you really were angry? Dr. W. This would not be an enacted scene! :

you would

Int.: In other words,

the patient

:

Well,

may have been

it

could be that he was part of

late

because the

the patient and this time he

without him. But :

to get angry while

we would have it

it.

The

other thera-

time he thought I was stealing

last

was going

twenty minutes so that he could be

Int.

happen

was around.

Dr. W. pist

just

keep

to

mad

at

me

me

alone in there for

for having an interview

out right in front of the patient.

This becomes another example of

how you

refuse to let the

patient split you.

Dr. W. to

show

:

That's right.

the patient

how

The

great advantage of

to be challenged

it is

that you're able

and how to handle

this ver-

bally.

Int.:

We've talked about the advantages of co-therapy; what

about the demerits?

like

Dr. W.: Over a long period, you may find yourselves locked in a husband and wife, so that the two of you can't talk openly. You

them somehow and so you get into a pattern of stalemating and stultifying each other. For example, what began to happen with Malone and myself was that he was so

up tensions and you have

build

to adapt to

incisive in his interpretations that I I

agreed with him or not.

move

would tend not

Or he would know

to interfere, whether

would be tempted to so he would sit back and let me

in fairly early in the relationship,

that I

go ahead. Int.

:

You

could also see

this as

a division of functions along the

what each of you could do best. Dr. W.: Yes, but at times this tended to keep the other on the

lines of

outside.

Int.: You've said that

you want

to

work out a

contract with a

family in which you're in charge of the situation and can

make

it

go

where you want it to go. I should think that when somebody else, a peer, is in there, you would also have to work out a reasonably clear arrangement with him. Dr. W.: Yes. In the beginning Since I've

come to Wisconsin,

I've

it

may sometimes be

difficult.

been working in collaboration with

six

The Growing Edge or seven psychiatrists, seeing couples, and at

about

know what was

didn't

this. I

first I felt

a

[313

little skittish

going to happen. But so far

worked out very nicely, no problem. Int. Do you think this is partly because you come :

it's

in as the au-

thority in this situation?

Dr. W.: I'm not sure. I'm certainly still wearing some kind of halo that has to do with being from far* away, or perhaps it's because I'm the only one in town who does anything except individual therapy. But when you were working with experience, did you ever find you had trouble? Int.:

Dr. W.: Occasionally, as

in the case I

therapists of equivalent

mentioned of the patient

who broke up Warkentin and me. We finally had staff, and they recommended we drop the case.

to take

it

to the whole

You had a super-authority to go to. Dr. W.: Yes. But we very seldom had to use it. Int. You say that you feel it frees you to have another therapist with you. Many people might find it restricting to have that to deal Int.

:

:

in

with as well as the family.

Dr. W. here

I

:

I

think that's because they've never done

it.

After I came

suggested to two of the residents that they see a patient together.

They had one interview and they bent my ear for two solid hours telling me what a wonderful experience this was. One of them said, "I had more ideas in that hour than I had in a whole year of seeing patients alone. It was all of a sudden as if I was free." We used to define the requirements in terms of whether to the other person. If

we could be

either therapist or patient

you have enough respect

for him,

you can do

it

Int. : In your talk to this family, therapist,

you put

alone. This sets

when you say

it

when you say you want another

in terms of not being strong

up a peculiar

situation.

enough to handle them

You're stepping one down

that you're not strong enough. This

makes

it

impossible

them to hang you on omnipotence, because you're conceding your weakness to begin with. At the same time, this is going to make them want to build you up. With two people there, it's going to cost them

for

twice as much, and to try to

I

make you

should think that their natural reaction would be stronger, so that

you can do without the other

person.

Dr. W. apist.

:

People often ask

But once

me

I've decided to

if

we

couldn't drop the second ther-

have him

in,

the therapist has been

TECHNIQUES OF FAMILY THERAPY And no

structured as a twosome.

wouldn't

enough

we could go back to

feel that

Once you

Int.:

matter

how

[314

well things progress, I

one.

with a team, you've got to be not strong

start

right through to the end.

Dr. W.: Yes. The only way we would modify

down on

the frequency of the

visits.

Or

it

would be to cut

making sure

to alternate,

that

two therapists are always there in spirit. When we get going, it becomes a question not of strength but of who is the therapist. It's not me, or him, it's us, and if you change that, it's like starting with a new the

therapist.

The twosome becomes a new person. Dr. W. Yes. And a proof of this is that when I'm Int.

:

:

in co-therapy, I

can go to a cocktail party and meet the couple and be

perfectly comfortable,

uneasiness that

seeing a couple

and so can the other

usually present

is

when an

therapist.

There

isn't

the

individual therapist meets

the patient socially.

wonder what the difference is between the relationship of the co-therapists in the room and the relationship when they get outInt.:

side.

You

I

say that you'll sometimes insult each other or

outside having coffee,

would you be so

likely to take the

fight. If

you're

same tone with

each other?

Dr. W.: No. Outside just

it's

a relationship between professionals or

an ordinary friendship. Inside Int.:

The

it's

psychodrama,

courtesy rules are different in the

you

if

will.

room than they

are

we

call

outside.

Dr. W.: The courtesy each other names. office

than

fragment ference.

is

am

I

I

can

tell

outside.

is

what takes place

you one

My

thing; I'm a lot

thought about

it is

a pie section that goes deeper in but

When

outside. Inside

a patient attacks me, he

more mature

in the

that the professional

isn't

the whole circum-

may go way

in,

but he doesn't

attack the rest of me, just that particular area.

Int.

:

You

can't take

he's attacking the

new

it

personally, because he isn't attacking you,

therapist you've created.

That may be part of the

freedom you describe.

Dr. W. dr.

w. a,

:

That may very well be the way

it

works.

would think of a minimum of once a week as being a usable kind of relationship. I would feel it necessary to charge (cont.)

:

I

[315

The Growing Edge

you a

twenty-five-dollar fee for each of the therapists for the regu-

lar process interviews as

we went

along,

which

will

amount

to a

couple hundred dollars a month. (Pause.)

MRS.

f.

What do you

:

think,

mr. f. Well, I don't know. mrs. f. Ah, I think it's just

John?

:

:

violence out of our family,

we

certainly,

it's

get upset, but

all

we must

that, ah,

worse and worse and we

getting I

get this, ah, element of

mean

it

gets to a point

where

beam and, when you have so many

you're breaking things and, ah, completely going off

which

ah,

rather a contagious thing

is

people in the same family,

something

after a while. It's

Int.: Is this the

first

it

just goes

that's got to

on and everybody does

it

be defeated.

time you've brought up the subject of the

fee?

Dr. W. Int.:

think?"

think so, yes.

I

:

The mother

As usual,

"What do you

turns to the father and asks,

he's almost inaudible.

Dr. W.: He

really

is.

Two

hundred dollars a month and he's

speechless.

Int.:

The mother's next speech

implies that there's a

little

more

violence in the family than has been revealed. She seems to be saying that other people are being hit besides the father. after

a while.

Dr. W.

It's

I

:

"Everybody does

it

contagious."

thought she meant that she might catch

it.

"I might go

mad." Int.

:

When

there's a mysterious statement like that,

try to get at the facts

Dr. W.

behind

do you ever

it?

remember one poor man who spent an hour telling me about himself, and he finally said, "You don't seem to be listening." I said, "Well, I'm not interested in facts." I thought he was almost going to fall out of his chair. It never occurred to him that there was anything in Int.

Dr.

:

No.

life

I

besides the facts.

Do you feel the same way about taking a history? W.: When I was first practicing and teaching, I used :

exhaustive histories, but I've stopped doing that now. for myself during the

Int.:

You

first

interview, but that's about

I

to take

take a few notes

all.

don't feel you need information about what led

the boy's hitting his father?

up

to

TECHNIQUES OF FAMILY THERAPY Dr. W.

No,

:

I

don't want that part of their

two couples: one whose daughter

I've got

whose daughter absent child

me

away

thrust at

is

"Look, I'm not

me, leave

is

at college.

me

And

And

316

they can have

life,

in a sanatorium

it.

and one

with both of these couples, the

with a horrible drive and insistence.

interested, I don't care

alone."

is

[

what happens to

I say,

her, quit telling

they say, "Well, what are you interested in?

you about me?" "I'm not interested in the facts about you either." "Well, what are you interested in?" "I'm interested in you." Int.: What do you mean by "you" as opposed to what they mean? Dr. W.: I'm interested in the person. They say, "Well, that's what I am, my children, my husband, my home, my past." That doesn't Shall I

make

tell

sense to me.

Int.

How do you define this person you're interested in?

:

Dr. W.

The person who

:

is

sitting

here with me.

me from feeling lonely during that hour. Int.: You block off everything that isn't

The person who

keeps

their action in

connec-

tion with you.

Dr. W.: Sure. listen to

it.

"If you're not interested in

Don't bother

me

me,

I

don't want to

with what happened to you last night or

yesterday."

There's something strange here. This discussion with you

Int.:

about

this

can have haven't

family

And

it."

come

going to have a past, because, as you say, "they

isn't it's

not going to have a future, because so far they

back. That doesn't seem to matter to you either. For you,

therapy seems to be a matter of the instant moment, as

when you kick

a

guy and he kicks you back.

Dr. W.

:

That's right. I believe the transference

is

in the here

and

now. eric: Well, I'm definitely leaving. However, I'd be willing to to

come

back

to the sessions. I'm getting out of here, I can't stand these

people, and I'm not going to be near them. But

DR.

fly

I

certainly

would

want to come back and straighten out their problem. I say problem because I think it's more theirs than mine, I think. w. Certainly they were here first.

their

:

eric: I have been caught

born, and

I

was only two

was, ah, points.

up in it, it certainly wasn't my fault I was became a part of this triangle which once

The Growing Edge w.

dr.

Mm-hm,

:

I sure

the question that said

would

I

I

agree with that.

think the other question, and

I

addressed myself to a few minutes ago

from each of you,

like a separate decision

the process of your being caught

[317

up

is

when

I

that in

in the family structure that

up in, it has done things to you which I think you can gain from by really getting yourself out, rather than physically

you're caught

walking out.

I

think physically walking out does not get rid of

your parents. This

is,

ah, a sort of a scientific fact that we, ah, are

stuck with. That they will always be your parents, and that you will

always be like Daddy, and like Mother, inside of yourself, and

that

one of the big things

you

to get free inside of yourself, to be a separate person in a, ah, guilty,

less

I

think of this working toward

{Pause.) And, ah,

I

think this would be advantageous to you.

Dr. W.: Just now we had the mother agreeing to come least

Int. this to

come :

in too.

He's willing to

fly

That's a concession. But he

or at

point out to

I

because they were born Int.

:

him

that

New York.

back from

makes

help his parents, because the problem

Dr. W.:

if

is

it

clear that he'll only

"more

the problem

is

"more

Dr. W.: Yes. As he points." to

a nice

It's

walk

Int.:

way

theirs"

first.

a phrasing that takes the blame away.

It's

do

theirs."

The boy can

cept being part of the problem too, because he was born into

him

in,

conceding that something has to be done. So the boy says he's

willing to

it's

helping

reaction against them.

ah,

ah, less defensive, less,

is

says, "into a triangle that

to put

it.

As

if

ac-

it.

once had only two

the "set" were already there for

into.

In your next speech,

when you say

to the

boy

that he's

caught up in the family structure, you again use a phrasing that blames

nobody.

You

parents," and

could have said, "caught up in the struggle between your it

would have put them on the

spot.

Do

you deliberately

choose a neutral phrasing?

Dr. W.

:

It's

not deliberate. Here

it

may have been because

I

tend

to think of the family as a set of vectors, rather than people.

Int. that

:

This subject keeps coming up, but

it's

you describe something you do as an action

rare in talking to

you

that has a purpose in

somebody else. You prefer to describe it as an expression of some way. Now it could be that both ways of describing the

relation to

you

in

thing are equally valid.

You

wouldn't express yourself differently, and

TECHNIQUES OF FAMILY THERAPY yet

it

can be seen manipulatively, too, because

someone to do something. Dr. W. This is a strange swer

and

business,

:

I

appropriate to get

it's

don't

"family structure" as an attempt to manipulate. But

use the term so that the family can't wriggle out of

know how

my

have any problem with your seeing

that. I don't

to an-

use of the term

you mean that

if

my

problem by saying I'm attacking them as people,

[318

I

definition of the

wouldn't seem

this

accurate to me.

There's always a question of deliberateness versus calculat-

Int.:

edness.

You

take a master tennis player. His opponent

is

on one

side of

him

the court, so he puts the ball into the opposite corner. If you ask

why, he he's

may

way my arm swung."

well say, "That's just the

programmed

to do.

But

if

you

try to describe

what

what

It's

he's doing,

you

are likely to say that he put the ball there so that his opponent couldn't

reach

it.

Dr. W.: look at

it

is

I

tist

who

for.

tries to,

Now this may

and possibly a

In the

category,

first

and maybe does,

be valuable,

be can do. The person

who

it

ethical scruples

about

beyond

level I

this

which

don't

I

would put the immature hypno-

get rid of a hysterical paralyzed arm.

may be

dangerous, and

it

may be

the best

manipulates on a purely strategic level

be just a technically good therapist.

any

I

that there are three levels of operation in therapy: the

tactical, the strategic,

have a name

way

wouldn't argue with what you're saying. The

it.

The

I

do

and

that myself

which

third level,

is

I

may

don't have

what

I

think

we're struggling with, gets to an area where you can't be deliberate any

more.

I'll

give

you an example.

I

had been seeing

this older

woman

with

a post-menopausal depression; she had already been to another therapist at

when she came

about

this point

to

me.

I

saw her about

fifteen or

twenty times, and

began to act meaner and meaner with

strategic, or partly strategic,

and she began

her. This

to get angry with

was

me, but

come out with it. One day she came in wearing red shoes, and I commented on how pretty they were. The next week she came in wearing black shoes. The next time she came in, she was wearing hospishe wouldn't

tal slippers,

those canvas scuffs. She seemed about to express her hatred

of me, and was talking about going back to her previous therapist. I

found myself concentrating on her

slippers

and

forward, seized her foot, and began to draw

went through three or four pens before

I

all

my

of a

sudden

initials

I

leaned

on her shoe.

found one that would do

I it.

[319

The Growing Edge

She

tried to pull her foot

my

but she apparently saw

meanness

ing, derisive

in

away before

moment

me

meaning it had

got angry,

I

had been showing her before, because she gave

I

it

was very important

or to the other therapist. This

for both of us.

and

finished,

anger as something different from the taunt-

and was with me. She realized

she belonged to

was

I

But

I

didn't plan

it,

and

to

me

was a very

significant

know what

don't

I still

whether

in the therapy.

Suppose you were an outsider trying to make sense out of

Int.:

people

this for other

stand the process of therapy.

what you were doing Dr. W.

in terms that

don't

I

:

beyond the dance.

know how you work or to underCan you conceive of any way to present

who wanted

It's

to

were not

strategic?

know how you would

describe

To me,

it.

this is

not interpersonal. All of a sudden I'm not inter-

woman, I'm not interested in myself, I'm interested in the shoe. This is a creative moment. I had no sense of its being a creative moment when it was taking place, but fifteen minutes later it suddenly ested in the

me

occurred to

put her

that I hadn't completed the action

and

went back and

I

on the other shoe. So that there was a His and Hers, That second gesture may have been strategic.

like

initials

the towels.

Int.

You're saying that the

:

first

action

is

something that can't be

duplicated.

Dr. W.: That's

"You know,

ing the residents,

The

something that

right. It's

satisfaction I get out of

done

I've never

it

isn't just

just occurs. I this

before in

keep

my

tell-

life."

based on the relationship,

it's

comes from the breakthrough of a new set of thought connections. For many years I used to struggle with never saying the same thing the same way. If I can't think of anything different to

the satisfaction that

say, better not to say anything. I

but as

initial structuring,

less

something occurs to Int.

You

how

It's

:

could say

he's doing

pleasure.

it

it's

on.

But

if it

pretty I

to describe

like a child building

up a

pile of blocks.

and sometimes

it's

the parents are there while he does in relation to his parents

may be

related to the reactions people

I'll

Not

in this

what you do that becomes the problem.

:

therapy.

that.

don't ordinarily say anything un-

Dr. W.

It

much go by

me that has some pertinence.

to impress his parents,

would describe This

we go

still

Sometimes

just for his it,

an observer

no matter what the

can be very hard for an outsider to

have to

tell

my

own

intent.

the difference.

going to sleep in

go to sleep for a short while and have a dream and then

TECHNIQUES OF FAMILY THERAPY wake up and

the patient about

tell

fantasy, or a pseudo-hypnotic experience, or

I'm never aware of being sleepy, the

many

out of the dream. But

Int.

:

Do

thing I'm aware of

first

you ever drop

it's

just

this is

an ordinary dream. And

patients will say to

sleeping, you're just closing your eyes,

know whether

I don't

it.

[320

coming

is

me, "You're not

really

a fake."

off to sleep like this in

an ordinary

situ-

ation?

Dr. W.

No,

:

of a movie camera.

when

other period

only happens in therapy. I've even done

it

been going on for

It's

would get

I

fifteen years.

in front

it

There was an-

into fights with patients. This wouldn't

would be a bilaterally activated process. I'd get madder and madder and the patient would get madder and madder, and we'd end up in a wrestling match. be deliberate,

Int.:

it

the sleeping bilaterally activated too? If you're in a

Is

somebody must be putting you in a trance. Dr. W. I never thought of it that way. I suppose you're right. Int. Would you say the same of these spontaneous moments

trance,

:

:

of

yours?

Dr. W. it's

Oh yes.

:

I'm sure they arise in response to the situation as

developing. Int.: In one sense, then, they don't "just occur."

make them happen, but something

don't

You

in the relationship

yourself

makes them

happen.

Dr. W.: That's

true. Just before

one of these moments,

I'll

be

aware of a quality of resonance, a physiological resonance, between the other person and me.

Even though I'm almost unaware

the particular action

going on.

Int.

:

To

get

is

of

him while

back to the question of how to describe what you're

same time there's the these moments that make ther-

doing, you're being spontaneous here, but at the

underlying suggestion that

apy go

well. It's like

it's

exactly

Zen; the best way to

live is to

be spontaneous but

same time you have to plan. Dr. W. Let's put it this way. I'm not spontaneous

at the

:

ning, I'm aiming toward the point of being spontaneous.

reached that point, you don't have to do any more, like pole vaulting, rest. I'll

give

when

it

in the begin-

When

you've

just happens. It's

you're finally over the bar and gravity does the

you one other example of

had had three or four previous

this. I

was seeing a man who

therapists, a weird, schizoid

man who

The Growing Edge

came

in with a fabulous double-binding

[321

arrangement of impotence and

same game back to him, so that I was one step ahead of him all the time. This was all deliberate and he didn't know what to do about it. But one day I was playing a tape recording of bird calls to one of the residents and the patient walked in and it turned out that he was an expert ornithologist. omnipotence and

all sorts

of off-edge moves. I played the

We

had a tremendously exciting half hour, even though the next day we went back to the same game playing. Int.

:

Is

it

moments

like these that

you see as producing change

in

therapy?

Dr. W.:

moments

I

I don't

know. All

I

can say

is

can get into therapy the more useful

that the I

think

right that there's a basic contradiction there, because

"The only completely successful

of these

am. But you're it's

like saying,

strategy to use with another person

where neither of you

to get to the place

I

more

is

concerned with strategy

is

at

all."

dr.

w. (cont.)

:

I'll

agree with you that the problem did not originate

would even go so far as to say that it didn't originate with them either, that Dad is what he is because of his mother and father, and Mother is what she is because of her mother and father, and that what they could do about it they have done, for reasons which are not pertinent, but that whatever it is, you're stuck with what it has done to you, or what life has done to you, and the effort to get beyond that pain, to get bigger, to have, ah, more adequacy in constructing a life of your own that's worth something to you, I think is worth your spending time and effort and (laughing) Dad's money. But I'm prejudiced, it's my racket. It meant a lot to me, when I had my psychotherapy, and that's I guess the real, the only real evidence you have. with you.

I

Any comment on this? Dr. W. I guess it's just my preaching impulses coming out. Int.

:

:

Int.: It's

seems that you're again absolving everybody of blame.

It

not the boy's fault and

parents' fault.

And

it's

:

it's

not their

they have done what they could have done for rea-

sons which are not pertinent.

Dr. W.

not the parents' fault and

What do you mean by

That I'm not going

to

go into

all

that statement?

the reasons

why

they

do any better than they did. I'm making them responsible where they are and where do they go from here. couldn't

for

TECHNIQUES OF FAMILY THERAPY

322

[

The implication is that since they did what could be done then, they'll do whatever can be done now. By complimenting them on having done their best in the past, you catch them on current responsiInt.:

bility.

Dr. W.

Yes. This

:

They decided

decisions.

is strategic. I

in the past to

in the process of deciding

Int.

:

That

"it"

what

face

them with the

fact of their

do what they did and

they're

now

do next.

to

comes back

again. In talking to the

boy about

you say, "what it has done to you," and then has done to you." Now "it" could conceivably refer

his

disturbance,

shift to

"what

to

life

what

the parents have done.

Dr. W.: No,

I

think of

it

as their pathology

and

their parents'

pathology. Int.:



life in

But you don't get more

general. It sounds as though

Dr. W.:

I

don't think so.

this point, they're

It

You make

specific.

it

more

distant

you were being ambiguous again.

obviously

isn't just

the parents.

At

stuck with the effort the boy's making to get beyond

the pain, too.

Int.

:

This speech almost implies that they're stuck with having to

go into therapy.

Dr. W.

Well, this

:

one who, by attacking

is

the

way

his father,

I

read this boy's behavior. He's the

drove his parents to a psychiatrist.

frequently say to a teenager, or sometimes even to a younger child,

you think five

it's

possible that

you did

all this stuff

years just to get yourself in here?"

mother had been have

just stayed

all

dead

Or

I'll

"Do

for the past three, four,

say to a wife, "If your

that bad, you'd never have in

I'll

come

in here, you'd

your marriage. But your mother somehow gave

you something else. She kept goading you so that you wouldn't just fold up and be your husband's housekeeper. You ought to congratulate her for that, even though you can blame her for the rest." Int.: That's really turning blame into credit. Everybody is to be congratulated.

Dr. W.: Sure.

I

always pick up the deliberate aspect. "If you

hadn't been this disturbed, you might never have amounted to anything.

Now you're about to catch fire and do something." Int.: Do you usually try to sell people on psychotherapy

as di-

rectly as this?

Dr. W.

:

No,

it's

just that in this

second

effort to get the contract

The Growing Edge

settled,

I'm apt to push a

proved a second time that

Do you

Int.:

take

little

[

323

harder. Particularly since they have

this is necessary.

as a discouraging sign

it

when you

don't get

the contract settled quickly?

Dr. W.: Not

in

still

what

We're

Int.:

trying to

still

different

little

Dr. W.: That's why

know

them

referring

a bit complicated, because you're referring them to

It's

yourself. It's a

the referral

I call

work out an arrangement for psychotherapy. This can go on for a co\iple of years.

stage.

to

We're

necessarily.

from referring them to psychotherapy.

I tell

they might not trust

my

them I'm prejudiced. I'm saying

opinion, because this

the

is

way

that I I

earn

my living. mrs.

f.:

Well,

can show you

I

that's true in

my own

case. I'm sure

my life. It was only when I'd lost my, all my family and just had my mother, who's very old now and has had a stroke and, ah, she was always the, all my that I

was much too dependent

all



couldn't

move without

her, she

was

the, the great outstanding one,

mean I'm sure that I had to ask her to do every little thing all my life. And now I realize I'm a free person and now I realize that all I

was so dependent, terrifically dependent, and as you say even when I was, no matter how far away from her I was, you

these years

still

have

I

this feeling, unless

eric (overlapping)

Well,

:

I

you break

the

ties.

And

.

.

.

can see that with the children. Eliza and

Dirk are more attached to you than

Dad

or any,

Dad

or the rest

of the family. (Inaudible phrase.)

mrs. dr.

f.:

Well,

I

have to work on

w. (overlapping) because

I

:

This

that. (Pause.) I think

may

.

.

.

be worth saying something about,

think the two of you are saying something that

maybe

you haven't put together yet, and maybe I can help you put it together. What Mother is saying is that she knows she was sick, she feels she

is

better,

than she was, whatever.

And

I

think she's

acknowledging something that you (to Eric) have been saying, that in her sickness

we're up to to her

is

how

you

suffered.

to help

you with

motherhood of you. That

stuck with,

is

And

think the problem that

getting past

she, the

what she brought

mother that you are

woman you lived And she is saying to

not this person here, but the

fifteen years ago, or twelve years ago.

*That

I

woman was

with

you,

a very dependent, mother-dominated person,

and therefore she was inadequate as your mother."

And

I

think

TECHNIQUES OF FAMILY THERAPY on her

this takes a lot of guts it.

Many

Dr. W.

response to

Do

Int.:

mothers never admit

on

to congratulate her

it.

You'll notice that this speech of the mother's about her

:

own past is in

want

part, I

[324

my saying it's not pertinent.

you think she means

draws such a close

parallel

Dr. W.: She's

had therapy

she's

She

herself?

between herself and you.

saying, "I'm a case, just like

think she had ever had any therapy.

son from thinking about what

don't

I

think she was trying to keep her

I

had

I

you were." But

So she leads

just said.

off in an-

other direction. Int.

home

She's also going along with

:

it is

This

:

standard with this kind of mother.

is

by saying they're not doing

they're doing

is

You

upsidedown.

straight

no good

what

you break the

unless

ties."

answers, "I have to

work on

going to help them break the see,

that." ties.

the ties with me,"

she ends on an alternative:

see,

"It's

That's where the boy comes in

more attached

saying he can see that the children are

"You

define

:

:

which

To

it.

What do you mean? Dr. W. She says, or implies, "You must break Int.

that just leaving

You have to break the ties.

doesn't help.

Dr. W.

you by saying

She sounds as

But

it's

if

to her,

and she

she means she's

like the hypnotist saying,

I'm not going to hypnotize you, don't you, don't you, don't

you?" Int. life

:

without

The

tearful tone of her voice suggests,

my

mother, and

how

could

I

my

bear

"How life

can

I

bear

my

without you?"

"How could you bear your life without me? If I without my mother, you obviously can't get along with-

Dr. W.: Or: can't get along

out me. But you certainly should." Int.:

It's

interesting that she brought

up her mother.

It

seems

true of nearly every disturbed family that at least one of the mother's or father's parents

Dr. W.

:

is

I

involved.

keep a watch on

how many minutes

after the beginning

of an interview one of the adults says, "Mother."

Int.:

When

was to her, would mother in? Dr. W.: No.

the mother talks about this give

I

you the idea

don't ordinarily take

how that

on

important her mother

you ought to bring her

the extended family, un-

The Growing Edge

some

less there's

specific reason for

it.

was crazy too and had too

and her daughter to an interview. So

come in

with the

Int.

girl,

If the

:

and

I

I

and

girl

his wife

reality sense to get herself

little

got the brother and his wife to

kept them together in therapy.

mother's mother here were living in the house, would

:

tion of

When you

:

what

turn to the boy, you

mother

his

I

because

you bring her in? Dr. W. I probably would ask her to come in if it seemed that she was involved. That is, if they kept talking about her. Int.

325

There was one case in which

decided to bring in the brother of a psychotic the mother

[

make a

clear

pretty free transla-

She has said she was too dependent on

just said.

her mother, but she doesn't define herself as a patient or as someone

who used

to be sick,

Dr. W.:

by any means.

would say that anybody

I

is

who

sick

her age

at

still

thinks of her mother as "the great outstanding one."

But

Int.:

it's

an admission of

Dr. W.:

it

illness, either

I

well have said,

doubtful that her statement would be construed as

do

by her or by most people.

this sort of translating all the time. I

"Mother

could just as

you about her

craziness,"

and pushed

another free translation

when you

say, "She's

is telling

a lot further.

You make

Int.:

acknowledging something that you have been saying, that in her sickness you suffered." She isn't acknowledging this at

Dr. W.:

I

assumed that her statement about her

mother also referred to the boy's Int.

all.

ties

ties

to her

with her.

Well, you've got her admitting that she was sick, admitting

:

that in her sickness she drove her child crazy, admitting that she's

been

an inadequate mother, even though she's better now. Then you congratulate her

on having the guts to admit

mitted any of

it.

Dr. W.: never been

It really

sick, she's

all this,

when

leaves her stuck. If she says

showing that she hasn't any

I'm wrong, she's saying she

still is

as

bad

guts.

off as she

she hasn't ad-

now And

was

that she's if

she says

fifteen years

ago.

Int. ally that I

:

You do this so casuTo take what little they

Talk about a benevolent double-bind! gather

it's

somewhat routine

for you.

do concede and go with it like a rocket. Dr. W. I wasn't aware of doing that :

at

all.

TECHNIQUES OF FAMILY THERAPY Int.

It's

:

a complex speech. But there's another aspect to

say to the son that the mother he's stuck with It's

was

the mother he

Dr. W.

:

behavior years

dealt with

is

how

I

him

possible for

sick,

not because he's

it's

him now, but because dealing with him, based on the

dealing with

she's

ago.

him up

What maturing

is left.

is

think both are true. She

quality of her sickness, which set

sickness there

boy

later. If the

him fifteen years

Dr. W.: Actually,

it

not the problem.

is

the introject he's struggling with, yes.

It's

he's responding to his idea of

made

You

living with fifteen years ago.

responding to the way his mother

way she

it.

You're assuming that a person can have a trauma which

Int.: affects his

now

326

[

to

is

describing the

be super-sensitive to what

she has done since then has not

to get past the hypnotic spell she started in the

beginning. Like the neurotic sheep business. Experiment with them,

then put them back in the original fold, and the neurosis

one tenth of one percent of the

is all

gone, but

stimulus precipitates the whole

initial

thing again.

Int.

There's no evidence that the mother

:

is

any better

now

than

she was before, except for her statement. But she's saying that things are better, and that she's healthier, and that she's doing her best, and

you're accepting this positive statement of hers.

Dr. W. Int.

:

I'm catching her with

What I'm

:

it,

trying to get at

yes.

is

the difference between the

a concept can be used as part of therapy and the explain therapy. For a long time,

nation for the

Now

if

you

way

it

seemed

account for at

it

it.

If

you put aside the

The

offered

you a way

to

make

it

is

easier for her

in,

you

situation itself

introject as

as a tactic in therapy, this concept

can be used to

that the only possible expla-

look at the situation they're

don't need the introject explanation.

it

was the presence of

these people behave

start to

way

way

introjects.

feel that is

you

enough

to

an explanation and look

very useful.

The mother has

by saying that she used to be

now she's better. By saying to the boy that the mother he's living with now isn't the same one that set him up to be so badly off, you can provide a graceful exit for her. At the same time you're redefining sick but

his perception of her

Dr. W.: Yes.

by making her seem I

may be

stronger.

encouraging him not to be so concerned

now and he can go mine, now that I think

about the present situation because she's better

ahead and

fight her.

This

is

a standard tactic of

The Growing Edge about

say to a child, "Look,

I'll

it.

[

327

think your parents can stand a

I

more than you think they can. I'll help them if they get disturbed by what you're up to." Or for the same reason, I'll be mean to them myself. Here's a case in point. I was seeing a bitter, sanctimonious man together with his wife, and six or seven interviews along I climbed all over her, blasted her to bits. She was crying, and the husband said he had never before heard anybody say to her the same dreadful things he used to say to her. In a strange kind of way this made him more loving to her, even to the point of suggesting that they come at 12:00 so that they could have lunch together at 1:00. And great deal

armed warfare

they'd been living in a state of

was

in

one sense a pure

When

trick.

I

But

for fifteen years.

attacked the

woman,

I

did

it

this

with

a lot of lovingness for her and probably ended the interview with

arm around her shoulder Reading

Int.:

as she

out.

speech of yours to the mother, one would

this

think you were putting

went

my

on

it

But the tone of your voice

slightly.

quite

is

genuine.

Dr. W.

dr.

think this

Well, sure,

:

(overlapping, laughing)

f.

pose maybe

—you

had

I

but

dr.

f.

a good thing,

A group

:

mrs.

.

.

mrs. Int.

:

I

it's, it's

a lot of

.

.

.

They're more independent.

was

see that

I

course, ah,

my

I

sup-

problem. Eric was the

it

these varying



see one's here, one's there,

know.

First

it

was

just

one to one,

just

you and

.

fight to the finish

now.

you're in the big time.

The mother is laughing her

Dr. W.

think

Mm-hm. (Long pause.)

f.:

:

:

Now you're in,

:

more.

.

Yes (laughing),

f.:

w.

.

.

it

you've got a group therapy against you now.

a,

w. (overlapping) Eric

dr.

is

You've got

dr. w.:

Of

when you have

difficult

which

ah,

I just,

I,

fight

was a very bad thing to do, mothered him too much, but, ah, it's a little

only one for so long.

mrs.

quite tender in this, comfort-

is it.

w. (overlapping)

mrs.

was

Probably because the younger ones (laughing)

f.: I

that I

mother and the son.

ing both the

mrs.

me

occurs to

It

:

:

I

congratulations.

think she

strange laugh again.

may have been

a

little

embarrassed by

all

the

TECHNIQUES OF FAMILY THERAPY Int.: She sounds pleased, too. I'm sure she

you

to

tell

her what a bad mother she

about, "I used to be bad but

now

she's better but that she's great,

I'm better."

about

my

It's

Int.

compliment.

:

You

Dr. W.:

Now it

I

fight their

hard to

dren should get the

tell. It

If she's

credit.

then

her not only that

tell

that I used to be

bad myself.

she hasn't had any.

if

she mean, "The younger ones fight

That the younger mothers

Dr. W.:

You

which probably allows her to admit to

Psychotherapy has helped us both, even

What does

in expecting

so she goes into this business

is,

more than she otherwise would. Dr. W.: I set that up. I admitted Int.:

came

tell

meant

[328

it

more"?

mothers more than she did?

sounds to

me

as

she's being

if

modest

a better mother now, the younger chil-

Because they

her domination more.

fight

her that she has a group therapy against her.

that Eric

she has a whole group.

I

was her

sole therapist in those days.

think I'm supporting her implication that

was a good thing the other children came along

to stop her overmoth-

I

ering.

Int.:

She comes back with

"It's

a fight to the finish," and you

agree by saying, "You're in the big time."

curious that you define

It's

therapy as a fight not only to people you might be talking to about

therapy but to your patients as well.

what therapy with you

Dr. W.: That's

is

going to be

It's

a rather explicit statement of

like.

true. It's already

been a

fight.

I've

been lining

them up. Int. element.

When you say, "You're You frame up the whole :

you put

in the big time,"

in another

sordid battle she's in as something

heroic and grand.

Dr. W.

:

That's right. She's in Madison Square

Garden now with

the pros.

Int.: this,

You have

our group

:

I

may have

of emphasizing the positive

got this from Dr. Richard Felder,

fifteen years ago.

background was

in internal

He had no background

all

through

"against," it

it

it

was, he never saw

was always a

really rocked

me.

who

joined

in psychiatry, his

medicine and he had no training in defen-

dynamic thinking. So he saw everything as

any difference what

that,

way

but just offhand, just with the back of your hand.

Dr. W.

sive

a

positive

move

possible. It didn't

it

"for."

as

The

a defensive first

time

I

make move

ran into

The Growing Edge

Int.:

unsavory people stand

how you

of "If you figure

it

product of change.

w.

dr.

(to

me

help you under-

are exploiting your child," and assumes that once the this,

will help

it

them

to change.

That's the sorriest business

:

"Let

are, that takes the line of,

parents understand

Dr. W.

how

such a contrast to the type of therapy that shows

It's

329

[

ever heard

I

of, this

out, that will solve it." I believe that insight

business is

a by-

You have to go past it to see what it is.

Margaret)

Are you wishing for a

:

little sister

or a

little

brother?

mrs.

We've been wondering about

f.:

but

think we're going to have

I

Margaret: What's mrs.

f.

it

this,

we

haven't said anything

around December.

that? (Apparently pointing to mother's stomach.)

Hm?

:

Margaret: That? mrs. f.: You've been

telling

me

I

was

getting awfully fat, haven't you,

since the middle of the year? (Pause.)

dr.

w.

mrs.

was, ah

I didn't realize I

:

Well

f.:

.

.

.

.

.

(Laughs.)

.

dr. w.: Excuse me.

mrs. dr.

(Laughs.) That's

f.:

w.

mrs.

Precipitating a family secret here.

:

(Laughs.)

f.:

Anyway,

dr. w.:

would

I

even though they

mrs.

dr.

all right.

(laughing)

f.

:

like to

may

make

a guess that everybody knew,

not have said anything.

No, I'm sure they knew. Kathryn and Eliza have

had so many teachers drop out in the middle of the w. They know what happens then? :

mrs. dr.

(laughing)

f.

w.

mr.

f.

:

dr.

w.

:

mr.

Oh, they certainly do.

They have

and bees were

to the boys.

are

:

I

much more

.

to be rather unimportant to the boys. .

The

.

don't know. little

boy. (Alluding to himself.)

No?

know about that one (indicating Dirk) but this Gosh darn, when I had a little sister, it changed my whole

dr. w.:

just

babies too? (Pause.)

Those things seem

dr. w.: Gosh, not this f.:

that birds

Hm?

girls

f.

Did you know

:

Those things are unimportant

f.:

mrs.

:

(to the children)

like people?

MR.

year.

I

don't

one. life.

TECHNIQUES OF FAMILY THERAPY And

a

brother or a

mr.

little

little sister?

Dirk)

f. (to

(To Dirk) Would you rather have a

brother.

little

[330

Now

:

don't look at the other end of the room.

You

know. mrs.

f.

How about you, Eliza?

:

eliza: I'd like a brother.

You

dr. w.:

need a brother?

You

(To Dirk) You're

sure do.

You and

outnumbered, aren't you? (Mrs. F. laughs.) to get together,

maybe

the two of

you could

sort of

Eric ought

up

sort of equal

this

struggle.

mrs.

Well

F.:

.

.

Do you

dr. w.:

(Laughing.)

.

and Eric ever get together and

fight

Mommy?

dirk: No.

You

dr. w.:

tion.

don't?

Good

it

eric: That's a rather

—you know, he

mrs.

You

(laughing)

f.

:

:

F. laughs.)

You know,

men

I

Int.: there's

Mmm.

hope

not.

This

is

the

think you did

I

after

to, ah,

my

win.

father.

Well, ah, Dad's stronger, he's gonna link up three of

eric:

a natural combina-

did at that age too.

—maybe the

f.:

like

more

takes

with strong

mrs.

sounds

Because the two of you might have a chance

dr. w. (overlapping)

and

gracious,

it

you could

women.

against the

fairly

much

get together. (Mrs.

too, Eric.

(Long pause.)

the second time the mother-son thing has

been a silence and you've turned to a

child.

come up

Why

do you

again do this rather than bring in the father?

Dr. W.

:

was aware of

I

don't

know why

his suffering;

I didn't

bring the father

in.

I'm sure

he was obviously the most isolated one

I

in

the whole setting.

Int.

:

You

talking about the

Dr. W. cating with

He was

:

did get together with little

boy's

him

at

one point, when you were

shirt.

There may also have been points where

him nonverbally, which wouldn't show up

sitting close to

me

physically, so that he

and

I

I

was communi-

in the recording.

could have had a

kind of unspoken entente, a resonance.

When

on about her past and the difficulty she's had with the boy, many therapists would say to the father, "Weren't you around?" or something like that. Would you ordinarily have done this? That is, was it unusual for you to leave him out at this Int.:

the mother goes

point?

Dr. W.: I'm surprised

at

it,

so

I

think

it

was unusual.

I

may have

The Growing Edge

been waiting for him to sense that could

feel safe

enough

I

331

[

could handle Mother, so that he

Or

to get in verbally.

I

may have been

emphasiz-

ing the family imbalance by focusing on the mother and the children,

who were that he

the overt force in the family,

would react by

trying to get

and ignoring the

back

father, in

hopes

in.

and

Int.: This silence again follows a scene between the mother

son at the end of which the mother says that things are pretty good.

I

was wondering about the reasons for this. Were you again thinking that something had come to completion? Dr. W. I remember I did think that the first time. But ordinarily :

if

I'm

silent, it's

because

I

don't have anything

something to erupt in me, or to erupt

in

I

Int.

If

:

say,

I'll

just

completed.

You just sit and see what goes.

:

Dr. W. doing.

to say. I wait for

them. I'm not usually thinking

about what we're going to do next, or what we've Int.

want

they'll often

ask

me what

I'm

"I'm waiting for something to happen."

enough doesn't happen, something will.

If

:

I'm quiet long enough,

Dr.W.: That's right. Int.: What happens here is that you spring a pregnancy on the family. Did you already know the mother was going to have a baby? Dr. W. They hadn't told me, but it was noticeable. Int.: You get back to this point about the carnal "know." The children really know about the baby. Why do you then ask them if they know about the facts of life? :

Dr. W.: I'm again opening up a subject that's a secret in this family. I'm showing the parents that it's okay for them to talk with their children about sex, because they

Int.

notice the father

I

:

know about it anyway.

comes

in then,

something so unusual for least.

He

says

He's talking like Mother about what's normal.

It's

nor-

him, and contradicts you, or contradicts the mother, at the boys aren't interested in that sort of thing.

Dr. W.

mal

:

for boys not to

be interested in

and don't notice these he certainly Int. to

tell

:

him

is

So

I try to

give Dirk a

way

"Be

like

me

to admit that

interested.

You to

things."

sex. In other words,

still

don't get a confirmation from the boy. Father has

speak up.

Dr. W.: Yes. "Don't be

inhibited,

speak up." Which of course

inhibits him.

Int.:

Here

I

notice that

you bring the subject back to the ques-

TECHNIQUES OF FAMILY THERAPY Which sex

tion of sides.

baby

this

going to be

is

[332

obviously a loaded

is

subject in this family.

Dr. W.: Father has already made versus the

so I'm just going

girls,

certainly does

a matter of sides, the boys

on with

that. I

say the

little

boy

need a brother.

Not only

Int.:

it

that,

you ask why he and Eric don't get together

and fight Mommy. Dr. W.

:

This

realigning the family in a different way. Before, I

is

put Eric and his father against Mother,

now I'm

putting the two boys

together. I'm again changing the coalitions.

Int.

You're not only changing them, you're putting your weight

:

You

say that the two boys might have a chance to win,

behind

this one.

that

a natural combination.

it's

And everybody starts talking. That upsets them. You notice that Eric comes

Dr. W.: Yes.

and says of Dirk, "He takes more

after

my

father."

The

in

implication

is

that Eric goes with the mother.

When you

Int.:

say, "He's going to link

you mean that Dirk will want Dr. W.

:

I'm not sure.

My

to side with Dirk.

healthiest of the males.

family.

But

essentially

w.

(to Dirk)

dr.

dirk:

:

up with the

strong,"

do

to side with his strong father? I

could have meant the father would want

immediate association was that Dirk was the

He was

the only person with any strength in the

I'm trying to

set

up a male combination.

Mommy

Did you know

was gonna have a baby?

Mm-mm. You

dr. w.:

didn't? I think you're kidding

me. (To Eric) Didn't you

him Mother was going to have a baby? eric: No. (Pause.) dr. w. Did you figure out any names? mrs. f. That's something to work on, isn't it? Margaret: I already made up something. dr. w.: Oh, you already thought of some names? What names did tell

:

:

you think of? Margaret: Susie, Wendy, and, um, Jane. dr. w.: You sound very prejudiced. (Mrs. F. laughs.) What out to be a boy, will you name him "Jane"? Margaret: No, I'll name him Bill or Tom or, ah .

.

if it

turns

.

w. Bill or Tom, that sounds good. Margaret: or Joe or, um

dr.

:

.

dr. w.:

How

how

.

.

.

.

.

about Bradley? Or Carl, you can

about that? (Mrs. F. laughs.)

name him

after

me,

The Growing Edge

[333

Margaret: Nah. dr. w. You don't like that name, it's kind of a stiff name. Margaret: I could name him Eric, maybe. dr. w. Name him Eric? Margaret: Yeah. dr. w. You love Eric, I guess, huh? Margaret: Maybe Bill dr. w. (overlapping) You're buddies, aren't you? Margaret: maybe Dick, maybe, ah (inaudible phrase). dr. w.: Gosh, you're really a name catcher-upper. (To Kathryn) Did you have a name for the baby? Hm? What would you name the :

:

:

.

.

.

:

.

.

.

baby?

mrs.

Int.

Well, can

f.:

:

You

ask the older boy

Int.

I

:

(Pause.)

on

didn't let his brother in

another

How far along was the mother in her pregnancy?

:

Dr. W. Int.

why he

Hm?

way to get them together? suppose so. To make them men in a man's world.

this secret. Is this

Dr. W.

you think of a name, hm?

:

As

:

I

Did you

remember, find

it

it

must have been four or

five

months.

strange that she hadn't told the younger chil-

dren?

Dr. W. obvious that bring

it

up,

No. In many families nothing

:

it's

it

impossible to avoid.

can be passed

said about

is

Then when

it

until

do

the children finally

off as a fact of nature.

so

it's

Not "We're going

to

have a baby," but "There's a baby in the tummy." Int.

take

I

:

it

you're talking about disturbed families.

Dr. W.: Yes. You notice the schizophrenic quality of making something that just happened, rather than something they did. As

if

it

this

were an immaculate conception. Int.

:

Do

you have any

special reason for asking about

names

for

the baby?

was trying to unify the family. We've set up a whole series of subgroups and discussed splits, and now we arrive at a unified project. We did this before, if you recall, when we went from the discussion of sides to the question of coming Dr. W.: Looking back,

I

assume that

I

into therapy.

Int.: You're also taking this particular "it" and giving

You even

suggest to the

Dr. W. Int.:

:

I

You

little girl

that they

name

it

it

a name.

after you.

would guess that I'm being seductive again. could have said, "Would you

name him

after

Daddy?"

TECHNIQUES OF FAMILY THERAPY Dr. W.: That's

true.

[334

Dad

Apparently I'm determined to keep

in

the background. I'm not only refusing to talk to him, I'm not going to let

him in on what's going Int.

on.

There's a quality here of treating playfully what could turn

:

into a serious obligation. If the children really did decide to

baby

A

Yes.

:

might

feel they

the finish." I play with serious issues

go on to play about marriage and

all

the time. Later in this tape,

incest.

But the

fact that

has nothing to do with the seriousness of what we're up Int. cipitates

to

we

I'm playing

to.

This remark about naming the baby after you certainly pre-

:

you

into the middle of the family.

Dr. W.

This

:

is

consistently

the situation very quickly, any position valid

Int.

the

had to go through with it. good example of what Mother called "the fight

after you, the parents

Dr. W.

name

and usable and

my

way

pattern. I precipitate myself into

I can,

and then struggle to get the

significant.

You leap and then you look.

:

Dr. W.: Well, I'm sometimes very cautious, as in all the structuring I do. But in a relationship with children, or where I'm less concerned with the long-range objectives,

I

may plunge in.

Int.: Throughout this session, you structuring,

which

is

mainly directed

seem

to alternate between the

at the threesome,

and jumping in

with the kids.

Dr. W. to

me

:

I get

intimate with youngsters very quickly, and

that this has developed over the years. It

was

true

now, although

with a family,

I'll

I

don't see children alone any more.

seems

when

doing child-guidance work and work with delinquents, and truer

it

it's

When

I

I

was even

work

frequently do a lot through the children rather than

working directly with the parents. Int.: That's certainly true of this interview.

you're talking with the children, and even

Most

when you do

of the time

address the par-

usually as representatives of the family rather than as individ-

ents,

it's

uals.

You

hardly ever have a direct personal exchange with either of

them.

Dr. W.: That's because

I

don't get involved with people unless

they're willing to get involved.

on the subject of the children, could you explain in a little more detail how you handle them, what your policy is if they get too disruptive, and so forth? Int.: While we're

V

[335

The Growing Edge

Dr. W.:

you an example.

boys, and during the

little

money, so

the subject of

bucks.

five

give

I'll

gave him

Come on

two

a family with

interview one of the children got onto

first

"You want some money?

I said,

my

over here and turn over

my

paddles with

five

was seeing

I

give you

I'll

knee." So he did, and

hand, and he got back up and

"You want some more money?" He

said, "Sure," so I

I

I said,

gave him

more. In about three minutes he was sort of clowning around, so

five

I said,

"You want some more? How much do you want?" and he said, "Fortyfive," and we went on. I was whamming away, using both hands, and was standing there with

the father

his eyes

bugging out. Here was

this

was paddling the dickens out of him, just for fun. In the second interview the question of limitations came up. I started playing with the boy, and I didn't mind his hitting me and tearing the pipe out of my mouth and that sort of thing. Every time I'd light my lighter, he'd spit on it, until I had a handful of spit, and Mother was aggressive five-year-old

sitting

and

I

over there in her compulsive

as I usually do, that this

to stay out of

it.

Then

my

I said,

him operate Int.

:

and

I

began to

"That's

sounds as

if

having

it,

I

me

can

and she was

spit

But

it."

to

I let

as a body.

splitting yourself into

He

the personal and the professional.

told her,

The boy came over

desk, you can't play with

you were

had

but she couldn't stop her

set the limitations.

my

fits.

I'd set the rules,

complete freedom in regard to

in It

my office

just

So she couldn't stop

horror either.

desk and

was

way

two

aspects,

on your hand but not on

your desk.

Dr. W.

That's right.

:

"You

grown-up world, but you and

I

can't fool with

my

grown-up

self,

can be kids together."

What do you do when the playing gets too rough? Dr. W. I deflect it, so that I don't get harmed. This boy's

Int.

:

:

to hurt

me was

edge of

it

we

fantastic.

my

was on

toe

He

and jumped up and down on I

Int.

:

Then

You

I just

it.

So

suggested

I

loved scratching people, and he didn't

go for that but instead he started in return."

drive

turned a standing ashtray over so that the

scratch each other, because

you

my

biting. I said,

"Okay,

kept biting harder and harder

if I

till

can bite

he gave up.

handle these children by refusing their invitation to fight

back.

Dr. W.

:

I

have a book on Aikido, the Japanese

yourself without harming the other person.

ponent;

if

he

strikes at you, at the

end of

You

art of

defending

don't throw your op-

his strike

you back

off,

turn

TECHNIQUES OF FAMILY THERAPY then take his hand and give

slightly,

past you, using his

was

own

his

it's

You

energy.

a

little pull,

so that he goes on

movement which

just continue his

you and which ordinarily you would

directed at

harmed,

own

it

energy

harming him.

that's

[336

If he's

resist.

what

I think this is

I

do.

So much work with psychotics depends on

Int.:

deflecting

what

they try to do to you without harming them in return.

Dr. W.:

I

much

learned

of this technique working with small

children.

Int.

:

When you

game framework? Dr. W. No, :

set the limitations, is

it's

direct restraint.

tape recorder." If he keeps at

it, I'll

absolutely insignificant and forbid

shoe

off

but not

Int.

:

The more

insignificant

this alternation.

was expanding the

as,

it is,

I'll

And if

I

have

take something

"You can

the clearer

With

I'll

take

my

it is

left

that you're the

go back to playing again; there's

boy, for instance, in the

this

initial positive relationship,

second

in the

physically.

rules.

Dr. W.: Yes. But then

Then

look, Bill, not the

my right one."

one establishing the

ways

"Now

be absurd.

such

it,

usually in this benevolent

say,

move him

it, I'll

any feeling that he's going to push

I'll

it

I

went on to

set

up a

first

al-

interview I

the lovingness, the fun.

fairly hard-boiled limitation

pattern.

Int.

:

In that order.

Dr. W. Int.:

In the beginning, yes.

:

How

do you handle

it

if

the children start teasing each

other or create diversionary quarrels while you're trying to talk to the

parents?

Dr. W. I'll

get

:

If they're

them over

hair, while I

to

young,

me where

I

I

may handle

it

physically

can hold them on

my

by seduction.

lap or muss their

go on talking to Mother and Dad.

room? Arrange for them to get a glass of water to get them out of the way? Dr. W. No, I would never do that. It would give me the shivers. If they were older, I'd shut them up the way I do with adult patients when the two therapists are talking. "Mama and Papa are fighting now, Int.

:

Would you ask them

to leave the

:

just

keep quiet and Int.:

listen."

If things are getting

hot between the parents and the boy

The Growing Edge

would you make an

starts to act up,

that

337

[

interpretation such as, "I notice

when you two start to quarrel, your son does such and such"? Dr. W. No, I'm pretty sparse with that sort of thing. I guess :

because

don't believe in understanding.

I

In regard to the parents,

Int.:

I

take

to discipline their

Dr. W. all

is

you

that

don't require the parents

own children while they are there.

forbid them.

I

:

that your rule

it

You

take charge of the children in your office.

term

it's

the time. This

is

"This

I say,

make

again to

my

is

house," and

I

use this

clear that I'm in charge of the

it

process.

You

Int.:

use your policy with the children to set up limitations

for the parents.

Dr. W.: Well, they're pline their children

or challenge

they want

if

and they have some

guests, to.

But they mustn't push

where

pulling the cushion off this old sofa, say,

about, and

:

him

take

I

it

if

Int.:

you don't

nothing

I

care

I'll let

on family

step in

quarrels. If the

boy

you don't intervene.

Oh, no. That's

:

it's

they want.

that

tries to hit his father,

Dr. W.

the child starts

haven't yet established any relationship with him,

I

if

the parents stop

lect a

around

In what

:

Int.

me

my super-status.

way do they have some rights? Dr. W.: In the beginning, if they come in and Int.

right to disci-

their business.

How do you deal with

a horrified mother watching you col-

handful of spit?

Dr. W.: realize

what

I just

laugh at her. This

for her too. I

is

making the

she's depriving herself of. I'm

want her to

child respect

my

same time I'm giving him the exotic experience of enjoying the physical contact. The little boy I was telling you about took off my shoes, and I took off his shoes, and he got into mine. Then authority but at the

I

put his shoes into mine and the

them when

little

made

fellow

was time to go home. But intimacy, both for the mother and for the child. find

Int.:

On

it

having the children

them, but

insist that

if

the parents

want to bring

not essential that they be there?

it's

Dr. W.

this is really training in

general policy with you to

in, is it

say as you did here that they're welcome

believe he couldn't

:

Yes. Except

when

he be there because

the child

this

means

is

the

symptom, and then

I

that he's part of the parents.

TECHNIQUES OF FAMILY THERAPY It's

[338

a three-person bed rather than a two-person bed, so I have Int.

Do you worry

:

who may be

it in.

member or an absent sibling problem in a way you don't know

about an absent

contributing to the

about?

Dr. W.:

body

If things aren't

come

else

me

on a brother's being tion a child,

that therapy

there.

Or sometimes, him here

fashion, then I'd rather have

had

also the situation I

here,

who

(to

if

has some-

I didn't insist

the parents repeatedly

be here

men-

in spirit, ghost-

Bring him." There's

in person.

where the parents are opposed to bringing

Kathryn)

now, so

At

controls the therapy.

except defeat them or acknowledge

w.

because

failure

it

That automatically becomes a challenge, and we get in

the children in.

dr.

was a

say, "If this child is going to

I'll

a fight over

often push to have some-

I'll

In some long-term problems I've had,

in.

times occurred to

moving,

How

:

my impotence.

about

telling

can get to know them a

I

do nothing

that point I can

me

the

little bit.

little

What

kiddies' .

.

names

.

eliza: Jenny.

What? What's yours?

dr. w.:

mrs.

(laughing)

f.

:

You

thought of, she thought of the other name,

Jenny.

Huh?

dr. w.:

MRS.

(overlapping children's voices explaining that Jenny

F.

old kitty)

know who

you're calling, whether you're call-

ing the baby or the cat.

Our

their

We can't name the baby after the cat.

:

dr. w.: Only wanted to

eliza:

is

old,

our old

kitty's



named, ah

no, Muffy

.

.

.

(Over-

lapping voices.) dr. w.: Oh.

we used to have a another one and we still have it

eliza: Muffy, 'cause, um, so

we

got

Mm.

DR. w.:

(Mr. F. and others talking

garet) What's your

name? Hey,

in

cat but she ran away,

(inaudible phrase)

background.) (To Mar-

sweetie-pie, what's

Margaret: Margaret. mrs.

F.:

w.

(Inaudible phrase.)

It's

Margaret,

They call you Margie? MARGARET: No.

dr.

mrs. dr.

:

f.

w.

:

:

We call you Meggie?

Margaret: Mm-hm.

Meggie, don't we?

isn't it?

your name?

The Growing Edge mrs.

f.

eliza:

mrs.

And

:

I

[

339

this is Eliza.

guess so. (Inaudible phrase.)

f.:

eliza: Eliza.

w.

dr.

Do they call you Lizzie?

:

eliza: Yeah. (Laughter.) dr. w.: I think that's a nice name.

Do you

like it?

Or do you

like

You

can

"Eliza" better? eliza: Lizzie.

You

dr. w.: just

like Lizzie better, okay. We'll cross Eliza out.

use that

when you

write your name.

(To Dirk) What's your

name? dirk: Dirk. dr. w.: Dick? (Laughter.)

mr. dr.

With an

f.:

w.

Spell

:

it

"r."

for me, will you?

dirk: D-i-r-k. dr. w.: D-i-r-k. Oh, that's a nice name.

And

what's your name, big

guy?

kathryn: Kathryn. dr. w. What do they call you? kathryn: Kathy. dr. w. Kathy. Is it spelled "k" or "c"? mr. f.: No kathryn: No (spelling), K-a-t-h-y. :

:

.

mr.

f.

.

.

But Kathryn

:

is

the name.

w. K-a-t-h-r-y-n or kathryn: r-y-n.

dr.

dr.

:

w.

mrs.

Gee

:

f.:

whiz.

e-r-i-n-e?

How old are you, Meggie?

(Inaudible phrase.)

MARGARET*. Four.

Two? Four?

dr. w.:

mrs. dr.

f.

w.

:

:

Four.

Gee, you're

big.

How old are you, Lizzie?

eliza: Eight. dr.

w.

dirk:

:

Eight. Dirk,

Um

.

.

.

w. Six, hm? kathryn: Ten. dr.

:

(Doing

it

are you?

with fingers.)

My golly. And how old are you, Kathy?

(Long pause.) What do you think about Kathy?

dr. w.: Ten. fight,

how old

this

family

TECHNIQUES OF FAMILY THERAPY kathryn:

I don't

know.

Does it scare you? kathryn Mm-mm dr. w. You think it's just like families are, huh? kathryn: Yes. dr. w. I think you're right. How about you, Lizzie, do you dr.

w.

[340

:

:

:

:

ened

get fright-

family fights?

at the

eliza: No. dr. w.

You're not really afraid of what's going to happen? That's the

:

seem

nice thing about kiddies, they

to

know more about how

families get along than older people do.

Int.

What's

:

Dr. W. kitty's

The

:

about calling the baby after the cat?

this

little girl

may have

thought

I said,

"Tell

me

the

little

name.

Int.

But you were asking her

:

to tell

you the names of the other

children.

Dr. W.:

The

Did you have a reason

for putting this question to the oldest

one

little

and she

in

was asking this of the oldest girl. because I had turned away from her

I

wasn't asking her,

may have jumped

I

felt jealous.

Int.

:

girl?

Dr. W.: She was drawal, so

name the Int.

was bringing her

I

next to the father, sharing his with-

sitting

in

by asking her

to

be the mother and

children.

When you

:

go to each one and ask the name,

is

this to get to

know them? Dr. W.: To know them and to gether around me.

Then

I

line

them

up. I pull

them

all to-

apparently use this group-therapy structuring

to assault the threesome.

Int.

How do you do that?

:

Dr. W.

:

By

asking the oldest

girl

again to take charge and

what's going on with the family. She's the mother. First child

is

tell

me

always

the mother.

Int.

:

As

a law of life?

Dr. W.: Yes. She was there

had

to take over the

ally takes

baby while

first,

you know. She's the one who

Mommy got the dinner. And she gradu-

over the family while the parents struggle, and frequently

grows up to be a pseudo-mother, or what ant."

I call

a "psychiatric attend-

The Growing Edge Int. fights

What

:

up

are you

to

when you ask her

341

she's scared of the

if

"You think it's just like families are"? Dr. W.: This is really to the parents. The children and then

[

ask,

are frequently

not as scared as the parents think they are. Mother will

but

all

kill

the

be shaking for hours and

he'll

go on to some-

thing else. He's precipitated the fight, he's aware of

how

far

boy

and

in a battle

she'll

he can push

Mother, so he gets her involved and proves he's that powerful and that important to her. She's afraid she's going to

do

can't

it.

kill

him but he knows she

not in the interaction that the children are afraid,

It's

it's

in

the withdrawal.

Int.

You

:

offer the idea that this

is

how

just

f amilies are.

Do

you

really believe this?

Dr. W. with

life

:

is

the place where you're dealing

and death voltages.

Int.

But the kind of violence

:

going on in

all families.

Dr. W.:

may be

The family

Absolutely.

he loves her. But It

up

sons are beating It

may

their fathers.

oedipally.

Mommy as soon as the father

this is still

sounded in

isn't

not be expressed physically,

game framework, or

by reassuring

Int.:

all

think they are.

I

expressed in a

the father

Not

going on in this family

that's

it

The son may hit goes to work that

a pretty primitive battle.

this

exchange as

if

you might be reassuring

by telling her that her family isn't as far out as she thinks. Dr. W.: No, I'm saying this because the parents in their panic think that this is the end of the world. They are really playing a game that I deny them. It's like saying to a crazy patient, "So you're crazy. the

little girl

Well,

if

you want

to compete, I can

can." In the same

way I'm

"Every family has

its life

better at

telling this girl,

and death

Oedipus, or money, or

fight about,

do

it

any time than you

and through her the parents, and

quality,

I

don't care

a horror,

sister's

it's still

what you a normal

family fight." Int.:

It

sounds reassuring, but you're not contradicting the idea

that the fights are dangerous.

Dr. W.

:

Not

frightened too.

directly,

I'll

tions, so? It doesn't

but the inference

that

if

they were, I'd be

frequently say to patients, "So you

concern me.

Or: "If you were really suicidal,

You

is

I

I

somehow

wouldn't

don't feel upset about

sit

think you're suicidal, but I don't believe

had hallucinait."

here and be comfortable.

it."

Int.: There's a quality in this of undercutting their panic while

not undercutting the reality of the thing they're frightened

of.

TECHNIQUES OF FAMILY THERAPY Dr. W.: This

is

what

would think of

I

them that I know they can control the be overwhelmed by it.

And now you make

Int.:

naturally the

little girl isn't

more about how Dr. W.

coming to

was

all

as reassurance. I'm telling

situation, that they don't

a very curious speech.

I

:

me

You

have to say that

know

afraid of the fights because children

families get along.

Here you're talking about these

and suddenly they're a way the family

terrible fights

[342

don't find this strange.

I

gets along.

remember one of

one day in horror because

my

students

turned out that his patient

it

black and blue. Her husband had beaten her up over the week-

why

end, and he had asked, "Well,

"Oh,

I

came

in

don't

couldn't do that." So he said to me,

me

and he told the story to

you divorce him?" She

said,

"Come on in and help." So

again in front of her.

I said,

I

"How

long has he been beating you up?" She said, "Well, we've been married for twenty years." I said,

And To me,

"The

doctor's worried because

divorce."

she said, "But, Doctor, he's so nice to

week."

this is just

bear says

it

Int.:

another

way

of

making

love.

you don't get a

me during You know,

the the

with a slap.

What

strikes

me

that the

is

mother has previously said

something very similar to what you're saying. She has been suggesting that the family

normal, and difference

bad

it's

normal, that the

a happy, loving home.

really

The

:

fights

that they are

bad

of dissension they have

little bit

between her saying the family

Dr. W. aren't

is

difference

because fights

it's

is

that the

is

What do you

see as the

normal and your saying

mother means that these

normal for families to have them.

and that

it's

is

it?

fights I

say

normal for families to have them.

She's denying the fights so that she can continue to use the family as a

blood transfusion for

herself.

I'm saying, "Every child has to worry

about his mother being a bloodsucker, not just you." Int.:

It's

the difference between "normal" in the statistical sense

and "normal" to

justify the

way

things are.

But you come out

in the

same place as the mother, in a funny way, by adding another layer. The mother has said, "We don't fight, we're harmonious." You say, "You do fight, and this is what keeps you together." Dr. W.: I believe that there's a more profound and significant level below the level of the social and psychological battles. On this deeper level, the family is biologically unified and the loyalty and identification and need for each other are automatic. That's the level where they can be making love by beating each other up.

The Growing Edge

[

343

Margaret: (Inaudible phrase) and got some mice. dr. w.: You Ve got some mice? Margaret: Yeah.

we got some rats. Some rats. I wasn't

eliza: No, dr. w.:

about your

dr.

w.

was talking

(Everybody laughs.)

pets.

We have two rats, and

eliza:

talking about the family, I

.

.

.

Do they have names too?

:

eliza: Yes.

Margaret: One

Why

dr. w.:

a boy and one

is

didn't

mean they

can't

Margaret: Mmm. dr. w. That seems :

is

a

girl.

you bring them to the party? (Laughter.) You go with you on visits? unfair.

eliza: Eric was, Eric

You

didn't bring the cat either.

was gonna bring the

rats.

dr. w.:

Really?

mrs.

We thought the cat might (inaudible phrase). How about a dog, got a dog?

dr.

f.:

w.

:

No.

eliza: dr.

w.

Is that all

:

you have

is

just three pets?

Mm-hm.

eliza:

Margaret: (Inaudible phrase) we had a snapping eliza: Someone stole it. mrs.

f.:

turtle.

We put it out.

w. Someone what? Margaret: Took my snapping turtle. dr. w. Took your snapping turtle? Margaret: (Inaudible phrase.) dr. w. Oh, good gravy. Maybe he ran away.

dr.

:

:

:

mrs.

f.

:

I'm sure

He was

dr. w.:

it

did.

trying to find his

way

a secret the other day about turtle,

you know what they

to the lake.

turtles.

like

If

most of

You know

you ever all

I

heard

get another

to eat? I bet you'd

never guess. eliza:

What?

dr. w.: Bananas.

mrs.

F.:

(Inaudible phrase.)

w. (overlapping) They just love bananas. Isn't that strange? mrs. f.: The young ones like bananas, so, ah, I'm sure we have our

dr.

:

share of those.

Margaret: Monkeys eliza

:

eat bananas.

We used to have

.

.

.

TECHNIQUES OF FAMILY THERAPY do

dr. w. (overlapping): So

because

I

eat so

why

That's

I.

I

[344

look like a monkey,

many bananas.

Margaret: Monkeys eat bananas, and people eat bananas. dr. w. Do you think monkeys eat the peelings too? :

MARGARET ( Laughs. dr. w. Be kind of silly, wouldn't I

:

it?

They

don't really taste good.

Margaret: (Laughs.) mrs. f. No, they don't. Margaret: I guess they (inaudible phrase) elephants eat bananas. dr. w. Maybe they just throw them at the people who are watching them, huh? Margaret: (Laughs.) Yeah. You can eat them. You can eat the :

:

peelings.

mrs.

(Inaudible phrase) I don't know.

f.:

w. (overlapping) You do? You Margaret: (Laughs.)

dr.

dr.

:

w.

eliza:

you eat banana peelings. slipped on a banana peel and my neck felt so

People will say you're crazy

:

One time

I

banana peelings?

eat

if

swollen.

dr. w.:

It's

really a slippery business,

on a banana peel

Slipping

never

know what's

is

isn't

it?

(Margaret laughs.)

just like talking to

a psychiatrist, you

going to happen. (Mrs. F. laughs.)

Any comments on this? Dr. W. This is something I often Int.:

:

do.

I'll

talk with the children,

kind of free-associate with them, but use the double meanings to com-

municate with the adults.

For example? Dr. W.: Oh, that joke

Int.:

their

two

rats

and

I say,

I

made, when the

"I wasn't talking about the family, I

was

about your pets." I'm saying that Mother and Father are

on Eric by calling in a Int.: Throughout this

ratted

about

littlest girl tells

talking

rats,

they

psychiatrist. last section there

seems to be a continual

identification of pets with people.

Dr. W.:

I

assume that any conversation about pets can

easily

become a metaphoric conversation about human beings. Int.:

Do

you think the parents are understanding

it

metaphori-

cally?

Dr. W.: I'm sure they do in some way. You notice that the mother makes the identification herself, when she shifts from turtles

The Growing Edge

liking

bananas to children

young ones," so

"children," she says "the

She doesn't even

liking bananas.

that

[

345

them

call

you would almost think

she was talking about animal young. Int.:

The

difference

when you

that

is

you name what you are doing by making Dr. W.: Yes. The mother does can't

from

slip

rats to people,

a joke.

it

without any facetiousness, you

it

be sure which category she's talking about. That's a real quality of

craziness there.

Int.

:

notice that the conversation gradually leads to the subject

I

of craziness. First

you bring up because

you

start talking in a joking, nonsensical

craziness. I

would have suspected that you were doing

a crazy family, to show that you don't mind

it's

Int.

:

would

call

a crazy family.

it

I

:

think of his behavior as crazy in the accepted sense of

the term. I didn't here, but

and

girl

I said to her,

business of you being crazy.

and

let's

you and me get

said, "Well, I don't

I

"Look, I'm

You

craziness

just not

can turn

it

off

straight what's going

know

and move on to

was seeing a family with a schizogoing to tolerate

and keep

gradually gets at her craziness and then

at

it

this

turned

off,

on with the family." She

anything about them." So

Mother, when were you crazy? Let's get

it's,

up

often bring

I'll

the mother's and father's craziness.

phrenic

people are

mean that the boy isn't an identified psychotic.

I

Dr. W.

I

if

this

been defined that way.

crazy, but this family hasn't

Dr. W.:

way, then

I said,

"That's

fair.

your craziness." So Mother

we work on Dad, and each

time

"How's your homework going, have you found out any more about

your craziness?" Int.

:

When you

think of

it,

by changing the meaning of the word

"crazy," you're altering the relationships between a She's

number

no longer crazy while they're well. Dr. W. Well, it takes three or four weeks for them :

my use

fortable with it

to cover anything

Int.

you

:

of the

which

Dr. W. Int.:

is

Did you know

started talking about

it all

non-rational, reasonable,

that

you were leading up

bananas?

Was

this

to feel

the time.

com-

We use

and boring. to craziness

when

planned?

Heavens, no!

:

What you do

nana peels and Dr. W.

word and then we use

of people.

:

next

is

to

psychiatrists. They're I

make an

association between ba-

both slippery.

assume that they know I'm slippery and that one of the

TECHNIQUES OF FAMILY THERAPY ways

to

make

therapy less frightening

is

[346

to agree that psychiatrists are

weird people. Int.

you

say,

You're also setting up a precedent for your behavior.

:

"With a

psychiatrist,

you never know what's going

When

to happen,"

you're telling them that you're going to do the unexpected.

Dr. W. Int.

Would you

:

unpredictably, this

Dr. W.

No

:

want

the rules. I

way

That's the

:

I

prefer to work.

also accept the interpretation that

makes

it

if

you behave

harder for them to handle you?

question of that.

what

It's

down

to have the right to lay

was saying before about

I

the rules and the right to

change them too.

One

Int.:

of the

ways to look

working to define a situation

you can get

this

in

at this interview is that you're

which you have

maximum

freedom, and

freedom by saying, "There are no rules about me,

I

can

do anything I choose." "The rules in my house are my rules, and I'll make them any way I want to and I'll change them any time I want to, any way I want to, and that's the way it is." I met a family out in the hall last week and moved them into the playroom. I said, "I didn't tell you why I changed the hour this week and I didn't tell you why I brought you into this room, but now that you're here, I want you to know that there are several residents on the Dr. W.:

I

say this right out to

other side of the picture

can

listen."

Int.

:

They have

many

window and

this

patients.

microphone

is

so that they

is

the one right

the right then to walk out.

Do they know they have that right?

Dr. W.

If they're

:

angry about

it,

I tell

them. This

But to go back to this other point, being able to shift your ground whenever you want gives you an immense advantage. I do it informally, too. With the two little boys I was telling you about, the kids were trying to yank the pipe out of my mouth and they finally made it, working one from each side. Then I congratulated them on they have

left.

having made

had fought them. they challenge you, you

it

Int.: If

after I

shift

your rules to include the

challenge.

Dr. W.

:

I get

over them at the next

level.

Margaret: Cats eat bananas (long inaudible phrase) dr. w. Do you think your white rat would eat bananas? :

The Growing Edge

Margaret mrs.

Margaret

(Inaudible phrase.

:

He don't eat the

:

peelings though.

Who belongs to the rats,

:

eric: Yes, dr. w.:

eric:

347

(Inaudible phrase.)

F.:

dr. w.

[

are those yours, Eric?

sir.

Really? got them from a friend of mine

I

who works

in the endocrine

lab.

dr.

w.

Good

:

How long have you had them?

for you.

eric: I just got

them

yesterday.

dr. w.: Oh.

eric dr.

I

:

always

.

.

.

w. (overlapping)

:

Going

to breed

them?

eric: Yes. dr.

w.

:

Good

for you.

eric: In order to get small ones. I wanted to see whether I could, ah, teach a cat to get along with rats. I think in

can get a cat to mother things dr. w.:

like

guinea pigs

.

.

some

cases

you

.

Mm-hm.

eric: This happens to be a male [talking about the rat] but

maybe

I

I

thought

could bring out the maternal instinct [talking about the

cat].

dr. w.: I think

it's

very possible.

It's

hard except

if

the animals are

tiny, I suspect.

eric: Yeah. She doesn't

seem

to like

them jumping

all

over her,

though. dr.

w.

:

Oh, you put them together already?

we put them together. Hm.

eric: Yes, dr. w.:

eric:

And

after a while,

it

took about a half hour, she started to get

rather nervous.

dr. w.: Well, there's



gosh, the

usually have to take cat,

eric:

it

slow.

first

acquaintanceship like that you

Did you put the

or put the cat in the cage with the rats?

No,

rats free with the

How did you do it?

was on the chair, and I put both the rats under They went climbing around, touched noses (inaudible

ah, the cat

the chair. phrase). dr.

w.

:

Good. Sounds wonderful.

Dr. W.: This whole conversation about the cat and the straight mother-son.

I

must have

intuited this before,

when

I

rats is

made

the

TECHNIQUES OF FAMILY THERAPY joke about the rats in the family. Here the boy's the

went into the breeding, because about an oedipal situation. I

Int. rats,

it

You're not listening to

:

you're listening to

it

as a

was very

this as

rat,

and

that's

we were

clear that

[348

why

talking

a conversation about cats and

metaphor about the family.

And I'm speaking to the boy in terms of his teaching Mother and Father how to breed. Dr. W.

:

Yes.

As any child should. Dr. W. Somebody has to. Then, you

Int.

:

:

to bring out the cat's maternal instinct, but

Mama's going Int.

that there are did, talk

he describes his

it isn't

working very

effort

well.

to get him.

She doesn't

:

see,

like the rats climbing all over her.

two ways you could handle

this.

One

is

to

I'm thinking

do what you

about the cat and the rats with the son while thinking in your

own mind

in terms of his situation at

home. The other

is

to share this

understanding of yours and point out to the boy that he's really talking

about himself and his mother.

Would you

ever do that instead of going

on with the metaphor? Dr. W.: times, shift

if

I

think I'd

I'm aware of the

more often go on with the metaphor. Somemetaphoric similarity and it's vivid to me, I'll

and make a facetious extension of

about the

rats.

But

I

wouldn't

make an

it,

as I did before with the joke

interpretation here unless I felt

the meaning

was pretty close to the surface with the boy, or unless I wanted to get through to Mama and Papa, who probably think of this conversation as a waste of time. To me metaphors are like dreams, and I

frequently think

it's

more valuable not

to interpret them. I'm inter-

ested in feeding the computer, not the cortex. Int.:

What do you mean when you

say that metaphors are like

dreams?

Dr. W.

:

I

think of dreams and metaphors and any other fantasy

material as an effort to communicate something secret.

The

patient

is

wrong with him, but he has to say it in a foreign language. I'm glad to try to help him figure out what it is he's trying to say, but I don't like to work on dreams too much. Many times it's a delicate dream, and if you work on it, you're apt to reduce it to a code and then you don't get any more dreams. Int. I should think that if you work on dreams with people, they would tend to dream more within your theory.

trying to talk about what's

:

The Growing Edge

Dr. W.: dream,

think so.

I

Anyway,

some crazy

when people

I believe that

349

tell

a

whole communication. They don't want to hear any

that's the

psychiatric nonsense about offer

[

it.

If I talk

about a dream,

association that pops into

Int.: That's

very

from

different

it's

usually to

my head. psychiatrists

who

interpret

dreams according to a fixed system. Dr. W.:

I

don't have one. But in working with groups I've no-

sometimes two-thirds of an interview

ticed that

will

be a

recital of

dreams. We'll go right round the room and then we'll drop the dreams

and

start talking

about other things.

They want

they want out of the dream. veiled fashion, so that

Int.

get the idea that this to

tell their

Dr. W.

in at another entrance.

I feel that to talk

:

Such a

sacrilegious.

the process of telling

too

much about

dream or a fantasy

a

sacrifice of inner life

me

the story of

was a public acknowledgment

see,

know

people don't

their satisfactions

Int.:

It's

all

is

children. In

was very

of the death of his secret world. it's

is

involved. I told

these people, he

until afterwards that

sad.

You

possible to increase

by giving the dream up.

as though

you were

pay your respects

patient could It's

what

secrets but in a

you about the patient who had the fantasy of the adopted It

is

You're very respectful of dreams.

:

somehow

comes

it

You

setting

to this

it

dream

up so

you and the

that

he's deciding to give up.

not really supporting the dream.

Dr. W.

know,

:

No,

it's

not. I

had a patient who once

said to

me, "You

been to four psychiatrists and the difference between you

I've

You must

and them

is

willing to

be intimate, but you must be willing to accept the person-to-

that they don't stay for breakfast."

person level afterwards. their dreams.

mrs.

What

you're trying to do

Dreams are not a substitute

for

is

not only be

get people out of

life.

wonder how long they're going to be friends, you know, whether it's gonna it's a basic, ah, you think something'U happen to the rat. (laughing)

F.

:

Sometimes you

just



dr. w.: Really?

mrs.

F.

dr. w.:

:

It's

a gentle cat, but I don't know.

Time

will tell, I suppose.

the cat gets hungry or not. it

a

little easier.

Maybe

Keep

it

has to do with whether

the cat well fed, that

may make

TECHNIQUES OF FAMILY THERAPY mrs.

We

f.:

have no problem, everyone feeds her, you know (laugh-

ing) she goes to one

dr.

w.

Smart

:

cat,

and then the

other, so this

Oh,

she's a very

The

first

one up

smart

in the

everybody gives her a

morning feeds

little

her,

food, so (Dr.

she's hungry.

and then successively

W. laughing) then she

no problem.

She gets well supplied, huh?

dr. w.:

She's smart. (Pause.)

F.:

The mother comes

Int.:

Everyone says

cat, yes.

also goes to the neighbors, so she has

mrs.

is it.

huh?

f.:

mrs.

[350

here so quickly.

in

That metaphor

touched her.

Dr. W.

You

Yes. She's worried about

:

hear that

"it's

a basic



how

long the rat will

"? That probably

was going

to

last, too.

be one of

those statements about what's normal. "It's a basic law of nature for cats to kill rats."

Int.

:

So you say

that perhaps that won't

happen

if

the cat

is

well

Are you speaking metaphorically again? Dr. W. I'm talking on a second level of perception to the mother and father. Father should keep Mother fed. In other words, "If you'd love Mother the way you're supposed to, you wouldn't have to worry

fed.

:

about the

little

Int.:

The

food.

The mother cat goes

Dr. W. there's

rat getting eaten up."

assures

around

to

you

that there's

everybody and they

Everybody but Daddy. But

:

all

no problem about feed her.

me

that

about the

cat.

she's anxious to tell

no problem.

Int.

:

The mother

is

supposedly taking

this literally

Do you think she has any idea that she's talking about herself? Dr. W. Int.

:

She's not aware of

:

And you

Dr. W.: Not

know

that I

it,

don't feel that

particularly.

was with her on

no. it

But

this.

would do her any good it

would do her a

That

it

to

lot of

know?

good

to

wasn't a private, psychotic-

type, isolate thing.

Int. are

:

If

she doesn't

know about

it,

and you're not

telling her,

you communicating the idea that you're in on it? Dr. W. When I say, "She's a smart cat," there's something :

tone of voice that

tells

how

in

my

her I'm seeing right through what she's talking

about. Int.:

It's

more a sharing than a

discovery.

It's

not the under-

[351

The Growing Edge standing that she's the cat that's going to help her,

it's

the knowledge

that she's sharing this with you.

Dr. W.: Or that covers

been discovered. Whether or not she

she's

someone was sharing

it.

keeping up, because

not any more a fantasy that she can enjoy

It's

not secret any more.

it's

within her that she can feed from.

the whole thing lost

normal the son sounds

Dr. W.: Yes.

was the same with the man with

purpose for him. Because

we go

Before

:

its

It

on,

impresses

it

I

his fantasy with

was

me how

compared the mother who is

in this part

It's

not a closed circuit

It's

Once he had shared

the imaginary adopted kids.

Int.

important than the fact that

in the conscious sense is less

it

dis-

in

on

me,

it.

straightforward and

to the mother. crazy.

Her laugh

identifies

that.

f.:

We

train

it,

MRS.

it

mr.

f.

have to get a dog too when we can, ah, everybody can it's

just that

was eight years :

old,

f.

f.:

.

.

:

a dog

Eric was small until

um

.

:

What

(inaudible phrase).

type?

eight years old.

.

(Inaudible phrase.)

Margaret: But our cat dr. w. (overlapping) Gosh, I should think you have a Margaret: We have a dr. w. houseful already. Margaret: We have a cat (inaudible phrase). .

.

.

:

.

.

:

MRS.

f.:

.

.

one more thing to

Oh, boy.

mr.

Dirk would

I

like a

I

.

think dogs are fun, but they're

train,

you know. (Laughs.)

dog (inaudible phrase)

.

would.

MARGARET: I Would. dr. w. What kind of a dog would you :

dirk:

.

.

(Inaudible phrase to child.)

dr. w.:

dirk:

.

.

certainly just

f.:

.

.

last night.

We have a cat

:

when

died of old age, but,

(overlapping, to Mr. F.)

Margaret mr.

it

was offered a dog

I

Margaret (overlapping) Mrs.

—we had

Umm

Margaret

.

.

like,

Dirk?

.

would like a Lassie dog. dirk: I would like a police dog. dr. w. A police dog, huh? I'll bet you would. MARGARET*. I would dr. w. (overlapping) They scare me, don't they scare you? :

I

:

.

.

:

.

TECHNIQUES OF FAMILY THERAPY

[352

eliza: I would like a poodle. dr. w.

Gosh, I'm always afraid they're going to turn into wolves.

:

Margaret (overlapping) dr.

w.

You'd

:

:

like a Lassie

eliza: I would like a

little

What would you

dr. w.:

I

would

like a Lassie dog.

dog?

don't

F.

dr. w.

blame you.

dog.

You know, a spitz, the little beagle, how about a beagle?

a spitz?

like,

white fuzzy ones? (Pause.)

mrs.

I

Or

a

Oh, they, they say they're good, very good, with children.

:

Yeah, beagles are

:

lots of fun,

and they're good, you can take

them hunting. (To Dirk) When are you gonna old do you have to be before you get a gun?

A hundred. w.: A hundred!

get a

gun?

How

dirk: dr.

long time to wait.

like a

mrs.

f.

Why

:

(Mrs. F. laughs.)

don't

you

dr. w. (overlapping)

dogs

—they When

when when

he's seven.

boy

is

get a ball

You know

a dog

is

and bat? dogs are funny.

one year

when

he's twenty-one.

Do

you know how do you know

old, he's as old as a little

So by the time he

boy

all

worn

out.

gets to be,

is

is

a

you

Like people, and he's

old, he's seventy years old.

old and very tired and

:

will get tired waiting that long.

When he's two years old, he's as old as a boy fourteen. When he's three years old, he's as old as

know, ten years

Int.

gracious, that sounds

get old seven times as fast as people do,

that?

he's

:

The dog

Good

About ready

to die.

Now we get onto dogs. What's going on here?

Dr. W.

In her psychotic quality, the mother

:

is

talking about the

dog, the boy, Eric. He's hard to train. Int.:

Are you

also talking about the

boy when you say that

you're afraid of police dogs because you think they'll turn into wolves?

Dr. W.: Well, bar of

justice.

At

the

he's the

one who brought the parents before the

same time

he's the acter-outer, the violent one.

He

could be dangerous. Int.:

As

a point of information, did someone

call

the police

about the disturbance in the family?

Dr. W.

:

No, there wasn't anything

like that.

Int.: What's this long speech of yours about the age of dogs as

compared to people? Dr. W. I'm again making the :

animals.

It

occurs to me, too, that

ten years old

is

the equivalent of a

the son as the father of his parents.

identification

when

man

I talk

between humans and

about the fact that a dog

seventy years old, this identifies

The Growing Edge Int.

The son is the

:

[

353

old man.

Dr. W.: Yes. Facing death.

My

other association

that I'm

is

talking about death in terms of the father. Father looks dead.

Int.: There's a quickening of the pace of the associations here,

and they don't follow

as logically as they did before. It sounds as

though you were building up to something.

Dr. W.: As

my

said before,

I

thenapy

often controlled by

is

my

unconscious. You're right that I'm building up to something. I'm sure I wasn't aware of

it

but

at the time,

we now move

whole question

into the

of incest and marriage. dr.

w.

dirk: dr.

(to Dirk)

don't know.

I

w.

How old are you gonna be before you die?

:

Haven't decided

:

Margaret: Probably dirk:

I'll

yet,

huh?

be about

.

.

.

(Inaudible phrase.)

Margaret: No, um, a million. dr. w.: A million, huh? (Whistles.) Boy, how many boyfriends can you have in a million years? eliza: dr.

w.

I

already have some.

You

:

already have some. You're starting on your

you keeping a

huh? Are

list,

of them in a special black book?

list

eliza: Yeah. dr.

w.

eliza:

mrs. dr.

That's the old

:

I

have Ricky, and, ah, the boy next door, and, ah Eliza

f.:

w.

spirit.

is

.

.

.

the family tomboy, she (laughing) does very well.

Aren't you gonna leave any for the other sisters?

:

eliza: No.

Gosh, you mean

dr. w.:

gonna have w.

go some place

else,

No

:

And

eliza:

him but

huh?

chance of getting them in your neighborhood. I

I

dr. w.: Well,

have,

think it's

um I

a

(inaudible phrase)

could marry

little

.

early yet.

.

I

eliza (overlapping)

w.

eliza: dr.

w.

.

:

.

I

hope

I

think that would be .

and Eric

.

.

don't think I could marry

think you have another year or that.

can marry, ah,

Dad

.

.

.

fine.

.

Do you think he'd be a good husband?

Yeah (inaudible phrase) w. The only trouble is with being

eliza: dr.

I

:

:

I

.

two before you need to worry about dr.

to get a boyfriend, she's

Mm-hm.

eliza: dr.

to

Kathy wants

if

.

:

a dad who's a lawyer like that,

TECHNIQUES OF FAMILY THERAPY husband because

he's, he's

hard to be

so much.

You know, he

background),

always

bothering

w.

talking in

(To Margonna marry

him.

about you marrying me? If Lizzie's

Daddy? Margaret: I'm gonna marry Dirk. (Mrs. dr.

always going away

he's

away (Margaret

gets called

are

clients

How

garet)

a

[354

F. laughs.)

You're going to marry Dirk?

:

Margaret: And Eric. dr. w. Well, that would be nice. eliza: And I'll marry Eric. dr. w. You're gonna marry Eric too? :

:

mrs. dr.

f.:

He's pretty (inaudible phrase)

w. (overlapping): Well,

that's

fine,

you know. You have

That's against the law,

have two husbands.

you'll

to divorce

one before

you can marry the next one. Margaret: I'm gonna marry Eric. eliza: Well,

have one husband, and

I'll

if I

don't like

it I'll

change to

the other one. dr. w.: That's a

good

Or maybe you could have one on Mon-

idea.

days and Tuesdays and another one on Wednesdays and Thursdays. Sort of change around.

Mm-hm. Then

eliza: dr.

w.

have to get married almost every single day.

Well, you could sort of get

:

marriage ah,

if,

I'd

How about that?

certificate or

Kathy

a,

you know, a

something. (Pause.)

sort of a revolving

What would you do

on having Daddy or Eric for her husband?

insisted

Then what would you do? eliza

I

:

would

call

the police.

dr. w.: Call the police, stakes right

off.

huh? (Laughs.)

w.

:

Yeah.

You're playing big

Why would you call the police?

eliza: Because I'm (inaudible phrase) dr.

Wow!

You think the

police

.

would back you up?

eliza: Yeah. dr. w.: Well, that's nice. call then,

Um,

eliza: dr.

w.

:

huh? What's

You know his

the right kind of policeman to

name?

Joe.

He's one of your boyfriends too?

eliza: Yeah. dr.

w.

eliza:

:

Well, that's a good

way

of doing

it.

(Long inaudible phrase.)

dr. w.: Well,

Kathy,

it

looks

like

you've

been

out-maneuvered.

(Laughs.) She's not only going to take both the

men

in the

The Growing Edge

[355

family, she's going to get the police to back her up. You'll have

go some place

to

eliza: No, dr.

w.

eliza

One

:

all

the people in the world.

after the other or all at

once?

All at once.

:

dr. w.

take

I'll

else.

All at once. Looks like quite a party.

:

Margaret:

Dad.

First I take Eric, then I take

You take Eric first, and then Dad, huh? Margaret: And then Dirk. dr. w. And then Dirk. dr. w.:

:

mrs.

(laughing)

f.

How

:

Poor Dirk. (Pause.)

would that be all right with you, Lizzie? Meggie takes Dirk? You want Dirk too?

dr. w.:

about

it,

If

eliza: Yeah. dr. w.:

The competition around here

mrs.

(laughing)

f.

w.

It's

getting pretty rough.

always been very rough. (Mr. F. inaudible

background.)

in

dr.

:

is

It

:

looks like the

men have

sort of got

Do

you think say about who they marry?

ing in background.) to

it

made. (Mrs. F. laugh-

they're going to have anything

What?

eliza:

Dad

marry you, or Dirk doesn't want to marry you, or Eric doesn't want to marry you? Then what are you gonna do?

dr. w.: Suppose

eliza:

I'll still

doesn't

want

to

marry them.

w. Marry them anyway, huh? Whether they like it or not. Margaret: (Inaudible phrase.) Then they wouldn't go with you.

dr.

:

(Laughs.)

They wouldn't go with me at all, hm? eliza: I would put 'em on my shoulders and carry them

dr.

w.

:

to the

wed-

ding. (Mrs. F. laughs.)

would be (inaudible phrase). Margaret: Dad'd kill you and then woof! dr. w. You'd have to get a big strong wedding gown so they wouldn't

dr. w.: Boy, that

:

tear

it.

eliza: If they teared

it,

I

dr. w.: Tear 'em apart,

would

hm?

kill

them.

Piece by piece. (Inaudible talking in

background. Long pause.)

Dr. W.: This

is still

a double conversation. I'm kidding around

with the children and at the same time raising issues for the parents.

TECHNIQUES OF FAMILY THERAPY Int.

[356

Do

:

versation to

you bring up the subject of boyfriends to lead the conthe family love match?

Dr. W.: I'm not being that started to talk about

it

deliberate. It's

more

likely that I

because the child was responding to

me

boy-

friend fashion.

Int.

a

moment

take

I

:

it

that

you prefer

to lose yourself in the interaction at

like this, so that this is all there

is,

there's

no other communi-

cation.

Dr. W.: Yes. said,

"Why

thing."

I

several occasions a patient has

come

in

and

you do the talking today? Last time you didn't say a But when I would play the tape of the other interview, it would don't

turn out that

what

On

said

I

was such a continuation of

had completely forgotten that of a perfect interview:

Int.

say that's

:

dawned on me that what they were up to that they

had talked half the time.

"He

So now Eliza

fine,

I

had

It finally

said anything. This

is

my

concept

didn't say a word."

tells

you she wants

except you wonder

if

he'll

to

make

marry Daddy and you

a good husband.

Dr. W.: Because he's always gone. He's been gone the whole interview, too. He's only said three words.

Int.:

You

wouldn't

Mother already has him? Dr. W. No, this is :

make a comment fantasy, this

is

to her about the fact that

play. It's a standard thing with

children: "I'm going to

marry

my

don't recognize that this

is like

playing with dolls, that

learning to fight with

mother.

its

daddy." But so often the parents

And

it

the kitten

it's

suddenly becomes a problem

when Papa gets an erection or when Mama gets a sexual makes her feel guilty. They put it on an adult level, when just playing. So I keep it on the level of play. And I show

feeling that

the child

is

the parents

how this can be done. Int.: father

is

object to

wise

I notice that

your objection to the

not on a reality basis of it

"You

little girl's

can't, he's

your father."

because he's away so much. The implication

would be fine. Dr. W. I've often said that the basic contribution

is

You

that other-

it

:

of

marrying her

my patients is my belief in incest. Int. When you talk about the :

difficulties of

I

make

marrying

to a lot

men who

away from home, I assume this is also to the mother. Dr. W.: Yes. There's no question that I'm alerting both Father and Mother to my perception of their struggle. are always

The Growing Edge

Int.:

Again you

ation by asking the

357

[

precipitate yourself into the middle of the situ-

littlest girl if she'll

marry you.

Dr. W.: This also validates the incestual process between father and daughter, mother and son. I'm saying,

marry me, I'm your symbolic father in

And

Int.:

you know,

to sex

you

it's

up.

it

as long as Father

strange of

it's

And

household.

Kathy and Mother and Eric

you

to

I'm an older-generation person and the

father.

this

"It's all right for

As long

as

it's

and

a game."

a good husband to Mother. But

is

to say,

also all right for Father

"You

shouldn't marry your father

man and not around much." You're a professional man and not around much too. Dr. W. I wouldn't have thought of that. But essentially I'm tak-

because he's a professional

:

ing the standard picture the patient has of the therapist as an ideal mate

and turning needs

is

it

by saying,

"Mama

really has a lousy

husband, what she

me."

Int. tive with

:

should think the father would begin to feel quite competi-

I

you

Dr. W.

after hearing that. I

:

do

this quite routinely. I

keep your cotton-picking hands Int.:

Do

you put yourself

move toward her? Dr. W. Yes. :

Int.

:

to get

It's

All through

this,

them

between them so that he

just

then

will

together.

you have a way

putting in obstacles. In this case your

Dr. W.

"You

I'm making love to your wife."

off,

in

say to the husband,

own

of resolving something by

person.

do make it personal. For instance, I'll say to Mother and Father, "Now, look, one of the problems we're going to have is that I'm going to steal your daughter and she'll never come back." I tell them that they'll worry and fret and

mourn but

:

I guess you're right. I certainly

that I think they've got

what

it

takes to stand

it.

Are you toying with the edge of a question about whether you really mean to take their daughter? Int.:

Dr. W.: Yes, the symbolic act

is

in their

minds

preparation for the real loss in

the future.

Int.

:

When you

whether you mean stir

it

flirt

with a wife so that the husband

or not,

is it this

isn't certain

uncertainty that you're trying to

up?

Dr. W.

:

I don't

know. By warning the husband beforehand,

I get

his tacit agreement. This brings us together, too, in the sense that

men who sleep with the same woman sleep with each

other.

two

TECHNIQUES OF FAMILY THERAPY

[358

Does a husband ever object to your flirting? Dr. W. No, but I use facetious language, so that he has no way Int.

:

:

of doing anything about

Anyway, he knows no

it.

If

he takes

psychiatrist

it

seriously, I say he's a square.

going to get himself into trouble

is

like that.

That may not be so

Int.:

that psychiatrists

do crazy

clear.

You've already told

this

family

things.

Dr. W.: Touche. Int.

Now when

:

you

"You have

said,

you

to divorce one before

can marry the next one," were you consciously thinking of that as a metaphoric statement about the mother and her husband and son?

Dr. W.: Perhaps not talking about incest

keep

at

and we were going

was aware

right at

it

and

I

that

we were

was going

to

Why would you want to keep at it?

:

Dr. W.: Because

them about

mind

way

this is a beautiful

their situation.

And

to

tell

them

that

to talk to the three of it's

fine with

me, that

I

their sleeping together.

Int.:

You

bring

could get them into

Dr. W. Eliza

I

it.

Int.

don't

But

at the time.

:

of the disadvantages of incest too. It

fights.

That's right. I talk about the rough competition and

had better Int.:

up some

get a big strong

how

wedding gown.

That's a strange sentence to end on, "Tear them apart,

What are you referring to by "them"? The wedding gowns for all the men she

piece by piece."

Dr. W. This

is

:

standard child therapy talk or schizophrenese.

plans to marry. I

use

it

all

the

time with families. Int.:

You've suggested that the

and violence. In

this last

exchange, you seem to be showing the family

how to play at violence as well Dr. W. They're aspects

as sex.

of the

:

dr.

w.

{after long pause)

why

incest process contains both sex

same game.

Good

:

gracious, we're overtime already.

you think about it, talk about it together. {Pause.) If you decide you want to do it, Eric, how about you giving me a ring? Since I've already had a call from both Mother and Dad. If you decide you want to do it, how about you calling me? If you can't get me here at the hospital, which is sometimes

Well,

kind of

don't

difficult, call

me

at

home

in the evening.

You

can speak

The Growing Edge

me

to

ing,

or the day

the children) Well, will

after.

tomorrow mornbe back then.

I'll

you come back and

you again. (To Eliza) Bye-bye. Goodbye,

f. (referring to

w.

dr.

Monday

well, I leave

see us?

Goodbye, Dr. Whitaker.

:

dr. w.: See

mrs.



be away

have you come back. Bye-bye.

I'd love to f.

I'll

be away until

I'll

Okay? (To mrs.

Except

there.

359

[

(to

Dirk)

Dirk)

think he wants to shake hands.

I

:

You want

:

Eric.

to shake

hands with me?

Good

for you.

Bye-bye. (Inaudible conversation under the noise of leaving. Tape recording ends.)

Why

do you say that the son should telephone you? because you've already had calls from Mother and Dad?

Int.: really

Dr. W.: I'm trying to give status.

more

Although

I'll

antagonistic or

all

three the

same

credit, the

Is

it

same

frequently take the one who's least interested or

more dubious and

give that person the responsi-

touch with me.

bility for getting in

Why is that?

Int.:

Dr. W.

To

:

Int.: This

him involved. also setting up another

get

is

obstacle; the one

who

least

wants to come has to make the appointment.

Dr. W.: Yes, and and

on

say,

I'll

"I'm very upset."

me

till

you

him

come, then

him

if

it.

wife will call

doesn't want to come."

get that straightened out. If

ready to come, then have him "I need

say, "Well, get

"My husband

in." She'll say,

don't call

I'll

A

up your husband and come

be very clear about

call

I'll

say, "Well,

your husband gets

me." "Well, he hates psychiatrists."

I'm going to work with you, and

if

he doesn't want to

don't want to see you. If he has any question to ask, have

I

call."

Int.: called

Would you

it

if

she straightened

it

out and then

you?

Dr. W. she'll

accept

:

Sure. She

go home and Int.:

You

they'll

knows

I

see the setup as jointly sponsored, so

make another

picked the most

plan.

difficult

family

member

to

make

the

appointment here, too.

Dr. W. Int.:

:

Yes, and he didn't

Did you

Dr. W.:

When

make it.

get any subsequent information I

on

this

family?

did a follow-up on the case, about a year later,

TECHNIQUES OF FAMILY THERAPY the disturbances in the

who was home that

home seemed

the father,

quite friendly

living at

past year

have quieted down.

and told

me

that the

I

spoke to

boy had been

and was now a freshman

in the local

There had been ups and downs, as before, but the boy was

university.

behaving more Int.

to

[360

like a natural teenager.

Before we end, there's one thing I'd like to bring up. There

:

seems to be a major theme throughout

You seem

and that

this interview,

is

a

how to play: with names, with words, with issues, with each other. You use your relationship with the children as a way of instructing the family in how

quality of playfulness.

to be teaching the family

to enjoy themselves.

Dr. W.: That's

right.

This

therapist. We'll say to the patient,

is

part of what I can do with a co-

"Don't bother us with your nonsense,

we're having fun." We'll talk about what interests us, not about the patient. If

me

something comes up that bores

in

an interview,

quently start reading a book, or put on some music, or

I'll

fre-

make a phone

call.

Int.

:

Is this to get

Dr. W. for

Well,

:

people to be more lively? say to a patient, "I've been involved with you

I'll

some time and you keep turning me down.

my

erection forever. If I lose

drag

me back

aware of

in,

that,

it's

because

can't turn myself

Int.:

and

I can't

maintain

interest in you, you're going to

my

have to

going to be harder every time. You'd better be

if

you

lose

me,

as

it's

bad

as

my

losing you. I

on on purpose."

Like so

much

in

your therapy,

there's another thing about this playing. It's

people are in absolute misery and paying

it

has to just happen. But

done

money

in a context in

to get out of

which it.

Yet

within that context, you play.

one of the things people can misunderstand. Sometimes someone will say to me, "You don't seem to be

Dr. W.: That's

true,

and

it's

"Were you kidding when you said that?" I tell them, "This is a life and death job. There's nothing I do here that's for fun. I'm dead serious from the time you get here to the time you leave." taking this seriously," or

5] Cleaning House An

Frank Pittman

interview with

III,

M.D.,

Kalman Flomenhaft, M.S.W., and Carol DeYoung, R.N.

Before

Int.:

we

start the

tape of the session with the family,

would you describe the project you're working on? Dr. P. The project was conceived by Dr. Donald Langsley and :

Dr. David Kaplan of the University of Colorado Medical Center in

Denver.

It is

the hospital

an experiment to

by using a

try to

keep people

in acute crisis out of

brief family therapy approach.

The

project

is

being supported by the National Institute of Mental Health and was started in July 1964. haft,

who

is

The therapy team

consists of myself,

a social worker, and Carol DeYoung,

public health nurse.

We

who

is

Kal Flomena psychiatric

plan to treat a group of 150 to 200 cases over

a five-year period and contrast them with another group hospitalized through the usual channels. This

we work

out our techniques.

four years.

The

last

year

first

We

we won't

year

is

will take

take any

more of a

pilot study, while

about one case a week for

more but

will continue fol-

This group is at the University of Colorado Medical Center, Denver, Colorado. Donald G. Langsley, M.D., is Director of the Family Treatment Unit and Associate Professor of Psychiatry, University of Colorado School of Medicine. David M. Kaplan, Ph.D., is Co-Director of the Family Treatment Unit and Associate Professor of Psychiatry, University of Colorado School of Medicine. Frank S. Pittman III, M.D., is the psychiatrist for the Family Treatment Unit and Assistant Professor of Psychiatry, University of Colorado School of Medicine. Kalman Flomenhaft, M.S.W., A.C.S.W., is a psychiatric social worker with the Family Treatment Unit. Carol DeYoung, R.N., M.S., is a psychiatric nurse with the Family Treatment Unit. The project is supported by NIMH Grant 1577. In this interview, the conversation with the therapists has been simplified by having most of the statements of the group presented by Dr. Pittman, even though Mr. Flomenhaft and Miss DeYoung participated regularly in the conversation, and Drs. Langsley and Kaplan took part from time to time.

#MH

TECHNIQUES OF FAMILY THERAPY low-up studies and evaluate our

results.

[362

We won't know who the control

families are until the patients are discharged, at

which point we

will

same follow-up procedures on them that we do on the families we are treating. Our hope is to show that a brief, family-oriented apstart the

proach

a suitable alternative for hospitalization. We're against un-

is

necessary hospitalization, and with alternatives such as think most hospitalizations are unnecessary. hospital or

how

matter

strong the indications for putting

process of removing someone from his pitalized mental patient

mous adverse

No

society. It implies that

someone

declaring

both regressive and stigmatizing.

is

on

effects

home and

he

is

is

it

isolates

him

as the

also the danger of hospital addiction.

when declare him

sick,

Often

:

Dr.

P.

:

Sure.

our patients go into

who

is

is

to

more

person with a

kick him out of the

even a matter of extruding a person,

isn't

it's

hav-

him while he's still involved at home. What makes our approach different is not whether the hospital or not, it's the different emphasis upon

responsible for solving the problem. We're declaring the family

responsible, instead of agreeing that society

we

it

responsibility to the state.

it

ing the state restrain

and

The family and

problem, the only thing to do

Int.

has enor-

his return

there's a

and give the

It

problem in the family

the patient can easily get the idea that

family,

him a hos-

dangerous or incompetent. Not only does

and consolidates the family's extrusion of him, making There

there, the

his relationship with himself, his family,

prevent his functioning, but

difficult.

we offer, we how good the

we make

hospitalize someone,

that the person

may

it

is

responsible.

Even when

clear that this will be temporary,

be back any minute, and that we'll be seeing the

family while he's there.

So you might use the hospital briefly.

Int.

:

Dr.

P.:

Yes, although we'd prefer not

hospitals for brief hospitalization.

one, but

it's

set

up

Ours

is

to. It's

hard to use most

a good hospital, a very good

for an average stay of twenty-five days

and the wheels

turn slowly by our standards. We're trying to get people back to work,

which

We

is

harder to do once they get integrated into the hospital program.

do sometimes

trollable

hospitalize a patient overnight,

and the family

is

exhausted.

the general hospital for this and there

if

he

is

really

uncon-

We can use the emergency room of is

no stigma and no question of the

person staying longer than overnight. The next morning, when the family is

rested

and the patient

better basis.

When

is

there's

calmed by drugs, we can proceed on a much

no home and no

effective family, or

when

[363

Cleaning House

who is appropriately leaving home, or even an adult who doesn't know whether to go home or not, we've boarded the patient at a guest home rather than the hospital. It seems we're dealing with an adolescent

more appropriate to figure out just what the patient does need and give him only that, rather than take everything he does have away and replace

it

with the entire hospital setting.

Int.

Dr.

How long do you usually treat a family?

:

From a week

P.:

sessions over a

to

We

two or three months.

two-week period, then maybe a few phone

ourselves to dealing with the immediate

that

crisis; after

average five

We limit

calls.

we

try to refer

people to appropriate community services, vocational rehabilitation agencies, visiting-nurse services,

we

and so

forth.

are immediately available to the family

if

But we make

it

clear that

they meet another

crisis.

What are your criteria for taking cases?

Int.

:

Dr.

P.:

We

take,

by a random

selection,

about one out of every

four cases that would ordinarily be admitted to the hospital as acute.

The admitting resident must decide that the patient needs admission. Most patients who are seen in the emergency room are handled without admission, so the patients that come to us are pretty sick. Also, the patient must live under the same roof as some other relative over the age of sixteen and must

must come Int.

Dr. we'll

live

within

fifty

miles of the hospital.

And

he

in voluntarily.

What if the police bring someone

:

P.

If there's

:

no judge

in?

that says he has to

go into the

hospital,

take him. We've had quite a few instances in which people

still

were refusing to be hospitalized and we stepped in before the family got the person legally committed and prevented try to

it.

Whenever

keep the matter of whether or not the patient

hospital

is

to

possible,

we

be put in the

from being discussed with the family beforehand, though we

can't always control this. In the family we're going to talk about, there

were several people who had already told the family that the patient had to go into the hospital. Int.

:

What follow-up procedures

Dr. P.

:

each year for Int. in the

:

plan to see each family routinely at six months, then

five years.

Are you going

to bring

them

in to the hospital, or see

them

home, or what?

Dr. P. will

We

are you using?

:

We are training social workers as independent raters who

go out and evaluate the cases

in the

home. They

will see

not only

TECHNIQUES OF FAMILY THERAPY our cases but the controls as well.

As

of now,

we

[364

are doing the evalu-

ations ourselves.

What sort of information are you after? Dr. P.: The same information we get during an initial interview: what everyone is doing, who is living at home, who is getting help and Int.

what

:

are there any problems or symptoms.

sort,

repeat

some

What

Int.:

Dr. goals.

tests

we

them in the beginning

give

also have people

of treatment.

standards are you using for the success of a case?

Very simple ones, because we're setting very simple feel we've done well if we just get a family back to the pre-

P.:

We

quo. So far we've hospitalized less than 5 percent acutely,

crisis status

but whether they've gotten through the hospital

We

would have

left,

we

don't

crisis

know

with fewer scars than the

yet.

We

can compare our group with the hospital group.

won't

We

know

until

we

are finding that

only another 10 percent or so of our cases go on to be hospitalized within the year, which

is

a

much lower

figure than the hospital group's

30 percent. So we must be teaching our families to use other solutions than the hospital to handle problems. to resolve their

own

We hope

will

be able

we hope they'll a family. In many cases,

future crises a bit better. If not,

seek help on an outpatient basis, preferably as

we do much more than

I don't think

our families

this,

the family we'll be talking about, in which

but there are some, such as

we do

set

something new in

motion, different ways of relating, different roles and rules for the family

that allow

rely

its

members

on long-term

referrals for

ever, our project focus is

when we do

to operate at their best possible level.

follow-ups

we ask about

school, whether the wife

the family has faced and

Dr.

:

is

functional things.

We ask whether

working, whether the children are in

We

also ask

what subsequent problems

how well it has handled them.

Are you using this

project for research, too?

Yes. Besides comparing the cases we've treated with

P.:

those treated by the usual hospital methods, we're trying to

new method a

work out a

of treatment. We're also hoping to learn something about

crises in the family.

how

How-

keeping up the house, whether anybody has

or in the hospital.

jail

Int.

is

characterological change.

on functioning and functional change and

whoever should be working been in

more

We

crisis is

We

plan to build up a body of observations about

handled within different types of family structure, what

part the extended family plays in a

crisis,

what part the patient

plays,

[365

Cleaning House

and so

We're also trying to learn something about hospitals, what

forth.

why

they do to people, and

When

We

have a psy-

Machotka, working with us now.

chologist, Dr. Pavel

Int.:

families send people there.

did the family we're going to talk about

come

in?

About two months after the project was started. It was our ninth family. Mrs. Willy was in her late fifties, but she looked much older. She was brought in by her twenty-four-year-old son, Paul, and Dr.

her older

P.:

sister,

Mrs. Clapp.

When

Int.:

the tape begins, you're alone with them.

Is

this

routine?

Dr.

P.:

No,

office at the time.

was the only one of the team in the Kal Flomenhaft and Carol De Young were at a meetit's

just that I

They showed up midway through the session, and I asked them to come in. Int. Do all three of you usually work together with a family? Dr. P. No, we work two together in loose rotation, with the third member behind the screen. Don Langsley and Dave Kaplan, the orig-

ing.

:

:

inators

and

directors of the project,

and Pavel Machotka, the project

amount of time behind the screen. We all six talk a great deal together about what we see and do, so the ideas and even the techniques we use have come from all of us.

psychologist, also spend a fair

Int.:

come

What

usually happens to a family between the time they

to the hospital

Dr.

P.:

They

and the time they are

emergency room, who

first

is

arrive at

your

office?

seen by the psychiatrist on duty in the

one of the

residents. If the psychiatrist de-

somebody who has to go in the hospital right now, and can't wait till tomorrow or next week, and if our number, about one out of four, is up, he calls us and we go upstairs to the emergency room and bring the family to our offices. Int. Is the family briefed on what they are to expect from you? Dr. P.: With this family, the resident did say something such as, by the usual standards

cides that

this is

:

"Mrs. Willy needs to go in the hospital, but Dr. Pittman and his group are going to try to keep her out."

from transmitting

But we

his opinion that this

them

is

try to prevent the resident

a case that ought to be admit-

makes it a lot harder for us to convince the family to take the patient home. Int. At any rate, this family knew it wasn't going to be a straightted acutely. If he

tells

:

into-the-hospital deal.

this,

it

TECHNIQUES OF FAMILY THERAPY Dr. P. with

Well, they

:

me first. Int.: Do you

knew

that they

[366

were going to have to discuss

it

generally get any information from the resident

about the family?

Dr.

P.

we

Usually

:

get a bit of verbal information

from the

resi-

dent in the process of taking the patient out of his hands, but nothing

We do get his write-up later, but that's usually family ourselves. We have the old chart, if there

written.

after

the

is

social worker's report, is

that this

is

she's seen the family.

somebody

When I walked

But

all

one, and the

we

usually

know

the resident feels should be in the hospital.

in to get this family, I didn't

who the identiAs we went down to my

even know

found out rather quickly.

fied patient was. I office,

if

we've seen

Mrs. Willy was shrieking about the floods in Holland, the dikes

breaking, and

mud all

over the

streets.

What information do you take from the family yourselves? Dr. P. Our secretary makes out a fact-sheet for base-line inforInt.

:

:

mation such as names, addresses, and so Int.

Is there a presenting

:

Dr. P.

No,

:

forth.

problem on that?

With the

just factual information.

to get a bit of firsthand information

was able

Willys, I

by standing behind the observation

screen and watching the family while the secretary had them

make

out

the forms.

Int.

:

Dr.

P.

see who's

Is that If

:

what you usually do?

we

can.

We

feel we're better

who and what's what

before

we go

than a history and diagnosis of the individual Int.

Dr.

What impression

:

P.:

The mother's

prepared

in.

That

if

we're able to

tells

us a lot more

who is the patient.

did you get of this family? sister,

Mrs. Clapp, was an overdressed,

woman who runs wedding dressed. He had a sarcastic

middle-aged, middle-class lady, the sort of rehearsals.

The son was

also quite well

smile on his face and seemed terribly bitter toward his mother.

mother was

sitting

her hair

wild, her clothes disheveled.

all

longed to them at

had brought Int.:

Dr. Miss

P.

The

between the two of them, wailing and carrying on,

all,

She didn't look as

and they looked on her

as

if

if

she be-

she were a thing they

to the hospital to get rid of.

Did you :

I

think

talk I

much

walked

with the family before the tape begins? in

and introduced myself, explained that

DeYoung and Mr. Flomenhaft were

at a meeting,

and

told

them

Cleaning House

how we

something about

way

give

but

it is,

I

don't think

:

Dr.

P.

We

:

were

still

behind the screen,

is

I tell

anybody was there that day.

Did you give the family any

Int.

367

operate by explaining to them about the one-

screen and the microphone. If anybody

them who

[

tests?

juggling tests around at this time

and

didn't

We've now started giving the tests after the first because we had a number of pretty disturbed people who

any to

interview,

this family.

weren't able to

out the forms right

fill

and we want

off,

it

as standard as

possible.

with Mrs. Willy, her son Paul, and her

Initial interview

paul: Well, myself, mother, and uncle in [nearby

mrs. w.: She

just

little sister

who

is

Mrs. Clapp

now

with an

state].

How long has

dr. p. :

my

sister,

she been in [nearby state]?

went yesterday.

paul: Just sent her

down there.

mrs. c: For school. mrs. w.

I

:

He

think they'll send her back.

couldn't get that transcript

of grades now.

He wanted

mrs. c:

to take her, for school.

better there than

.

.

mrs. w. (overlapping):

Thought maybe she'd be

.

He

couldn't get that,

you know, because

they, ah, well (inaudible phrase).

mrs.

c.

(overlapping)

W.

study (Mrs.

down girls

mrs. w.

:

:

This was so upsetting to her, and she couldn't

talking in background)

there with other

and I

it

would be

members of

and

it

the family.

was better They have

for her several

better for her.

don't think they're going to keep her.

dr. p. (overlapping, to Paul)

:

How

old are you?

paul: Twenty-three, twenty-four now.

mrs. c: Tomorrow. dr. p.: You'll be twenty-four tomorrow.

paul: Um-hm.

You live paul: Um-hm.

dr. p.

Int.

:

:

From

at

the

home?

way

asked some question about

Miss DeY.

:

the tape begins,

it

who made up the

You usually

ask,

"Who

is

sounds as though you had family.

in the

house?"

TECHNIQUES OF FAMILY THERAPY Dr.

P.:

read and

just

think

think I was under the influence of

I

"How do you

I asked,

some

define your family?

[368

had

article I

Who

do you

makes up the family?" Actually, we don't have any standard

first

question.

Int.

:

You go

started with the

Dr. P.

to the son right

Why

that?

is

You

might have

supposed patient.

The supposed

:

off.

to get information,

patient,

had been

about these people, but

when

the secretary

totally uncooperative. I

I felt I

had made

wanted to

efforts

find out

wasn't going to get anything out of her.

Anyway, we would tend not to start with the supposed patient, because this would point to her as being the trouble right away. If I had walked in, shoved Mrs. Clapp aside, and said, "111 take responsibility for this crazy woman here," that would have been disastrous. It would have given them exactly what they wanted, which was to get the old lady off their

hands for good. Int.

:

always interesting to see

It's

Granted that you wouldn't the

first

question of her

Dr.

P.:

start

who

first.

with the mother, you might have asked

sister.

might, but she seemed a

I

the therapist turns to

little

my

too eager to be

in-

had the feeling that there was something important going on between the son and the mother and that the sister was somewhat peripheral. Int. You head for the mystery right off. Dr. P.: I think we start with the things we don't understand. I didn't understand what was going on between this boy and his mother to make her act that way. And you see, the sister comes right in and

formant. Watching the family from behind the screen,

I

:

takes over. So I shift Int.

:

Dr.

P.

tary while I

Int.

:

Dr. P. Int.

:

You

back to the boy.

ask him

Oh,

:

it

yes.

how

that?

that information to the secre-

him when you already knew it.

He didn't know I knew it. You also knew that he was living :

Dr. P.

:

I

more ignorant

was wondering why, suppose

still

living with his mother. I

this

was a somewhat unusual family :

Did you already know

screen.

curious that you asked

erately putting yourself in a

Int.

is.

He'd already given

was behind the It's

old he

at

home. Were you

position?

at the age of twenty-four, I

delib-

wanted

to

make

he was

the point that

constellation.

You're not really getting information, you're giving

it.

[369

Cleaning House

Dr.

P.:

suppose

I

spokesman and was explaining everybody back

was

to the boy, I

letting

had

so. Also, the sister

up

By a grown man, why

as the

turning

else's feelings.

"Look, you're

saying,

set herself

are

you

your aunt speak for you?"

Int.

This also brings in the assumption that he

:

is

part of what's

happened.

Dr.

P.

:

Yes.

The

boy's air of superiority to his mother, the

way

he was baiting her as the secretary took the information, suggested that he didn't think he had any share in

happened to

mother and he was

his

was involved and that the family

me

wanted to

I

was

it.

This was something that had

suffering unfairly for

find out

how.

I

I felt

it.

he

wasn't buying the picture

presenting. Their behavior told

me

wanted

that they

do business with the sister, worry about the old lady, and ignore the son. What I did was to shut up the sister, ignore the old lady, and to

talk to the son.

Int.:

Whatever the family

indicates,

you go

in the other direc-

tion.

Dr. P.

:

Yes.

One

to dispel their set idea of

Int.:

You

On

:

occasion

family that this well.

"You're

You can I

what

first

is

we

things

try to

do with a family

directly.

Some

the

say that to a family and not have

way

I

it

mean much. telling the

see the problem, but they don't take

Focusing on the person

any involvement seems to

therapists

in treatment."

all

have made the mistake of walking in and is

me

is

going on.

might have done that more

will say to a family,

Dr. P.

of the

who seems

least willing to

a more fruitful

way

it

very

acknowledge

to shatter the picture

they present and get at the real one. Here, by bringing in the son, I'm questioning whether the

sister,

volvement, has any right to

it.

who

is all

too eager to display her in-

This also puts

me

in control rather than

the aunt.

of

Int.

:

Dr.

P.

Or than

the son,

who

is

defining the situation by staying out

it.

:

Or than

the mother,

Int.: You're also doing

who

what some

the label off the identified patient." the

six

is

claiming to be the problem. therapists

Can you

would

call

"taking

give another example of

way you might start a session? Dr. P.: One of the largest groups we've seen was a couple with children. We saw all eight of them together. I remember that we

TECHNIQUES OF FAMILY THERAPY started

by questioning the youngest child who could

or four. This was the clearest the problem was, they were

talk,

way we could demonstrate

all

part of

it.

We

the time,

all

girl

how

of three

that whatever

got the child to

concept of what was going wrong. She brought out a

how her parents were fighting

a

[370

tell

us her

lot of information,

her mother was going to

work and leaving her fourteen-year-old sister in charge, and how she didn't like this. The problems she brought up were no secret, but the parents had no idea of the extent to which even the youngest members of the family were affected by them.

dr. p. (to Paul)

:

Do you work?

paul: Yes. dr. p.:

What do you do?

paul: Ah, I'm dr. p.

:

just a

warehouse worker out

at [store].

Why do you say "just"?

What cued you to pick up that "just"? Dr. P.: This was a very pompous boy, and he Int.

:

me

apologize to

more expected him

for not being

about his problems.

I

and

his failures as well as hers,

failures

I

successful.

to put the

told

blame on

the need to

me his

something

mother for

wanted to draw him out about

was another way of

first. It

That

felt

getting

him involved

his

as a patient,

rather than merely as the son of a patient.

paul: Well,

it's,

ah, substandard as far as I'm concerned in that I've,

ah, I'm studying to be an engineer. Electrical engineer.

Are you paul: No.

dr. p. :

in school

now?

When were you last in school?

dr. p. :

paul: About a year ago. dr. p.

:

That's not too temporary then.

paul: No.

Do you plan to go back? w. He won't get to go back for

dr. p.:

mrs.

:

paul (overlapping) that's

mrs. w. mrs.

:

.

.

:

Well,

won't

be

going

He won't get to go :

He

at all.

needs another year,

What do you mean, he won't get to go mrs. w. He doesn't have the money to go.

dr. p.

:

:

back for a while,

.

(overlapping)

c.

I

(inaudible phrase)

if

at all?

he can

finish.

Cleaning House

[

371

(To Mrs. W.) Are you working? (Pause.)

dr. P.: Uh-huh.

MRS. w.: (Shakes head.)

Have you been?

dr. p.:

mrs. w.: No.

worked much

I've never

in

my

life,

that, that's

I'm not trained for anything, to be specifically

just can't,

Um-hm. mrs. w.: You have

.

.

it.

I

.

dr. p.:

to be trained for something. I tried to do, ah,

baby-sitting with [agency].

dr. p.: Yeah.

mrs. w.

They'd send me,

:

[street]

.

.

well, I'd

go twenty miles, clear out here by

.

Um-hm.

dr. p.:

mrs. w.

:

.

.

and make a dollar and

.

fifty cents.

For three hours.

How much were you making?

dr. p.:

mrs. w.: Fifty cents an hour. dr. p.: Fifty cents an hour?

mrs. w.: Yeah, and

You

fifty cents.

make Dr.

P.:

set three

can't

hours in the afternoon.

make

it

that way,

You

and then she came

know

yet

see,

can't

Mrs. Willy broke in with something quite ra-

to his defense

Her tone suggested

how much

ing on a level where Int.:

and

a living that way.

corner grimacing and making noises until

to school.

dollar

you know. You

She quit her crazy behavior. She had been

tional.

A

I

was

was

over in the

started attacking her son,

by saying he couldn't

that she

truth there

I

sitting

also

afford to go

blaming

back

herself. I didn't

to this, but at least she

was operat-

could deal with her.

When you

started focusing

on the boy's problems, she be-

came sensible. Dr. P.

:

If I'd started

by focusing on her problems, she probably

would have gone on being crazy. Int.

:

But when she becomes

sensible,

you

talk to her. Is this rou-

tine?

Dr. P.

:

Yes. The son and the

this

woman's

was

crazy. That's

craziness

why

I

by paying her

had obviously been rewarding

all sorts

refused to talk to her at

she said something uncrazy,

I

of attention first.

But the

when first

she

time

rewarded her.

The way you rewarded her must have been something of a You asked her if she were working. You must have known she

Int. shock.

sister

:

couldn't be working.

TECHNIQUES OF FAMILY THERAPY Dr. Int.

I did.

So again

:

Dr. P.

a question to get information.

this isn't

"We

a directive question. I'm telling her,

It's

:

we

to work;

we have

Yes,

P.:

[372

You may

expect you to function.

expect you

be crazy now, but

a right to expect certain things of you and so does your son."

You

Int.:

don't put

"Why

it,

an implication here that

that she can. There's

they were capable of working, they will

Dr.

We

P.:

you working?" you assume

aren't

you

if

treat people as

if

come up with that.

think intolerance of psychotic behavior

in itself

is

pretty anti-regressive medicine.

You go

Int.:

ing and then

if

she

so smoothly here,

is

You

P.:

asking the son

working. The implication

doing as well as he could.

Dr.

first

middle-aged, inexperienced

them

that neither of

nicely she responds.

is

That speech of hers

perfectly sensible, perfectly sane.

is

work-

is

cancels out the difference between them.

how

see

about the baby-sitting

It

is

he

if

woman would

It's

say about the

what any

difficulties of

getting a job.

Have

dr. p.:

things been pretty

mrs. w. (tearfully)

You

dr. p.:

bad

as far as

money

concerned?

is

Yes.

:

don't think they've been (inaudible phrase).

mrs. w.: They have.

He

can't

make

it.

He's got more

bills

than he

can meet. paul:

Now

frankly,

I

think, ah, we're probably getting

on

as well as

anyone we know. mrs. c: Average working family, you know.

mrs. w. dr. p.:

Int.:

Now, Paul, why don't you admit the truth? Your mother is pretty discouraged, isn't she? :

Do

you remember the

think they've been

Dr. P.

:

I

.

.

don't

."?

think I was trying to get at the facts about the financial

was the Mrs. Willy seemed

situation. This

first

with.

pretty upset about

out

"You

rest of that sentence,

clear-cut, specific

problem

money, and

how realistic she was being. Int.: You sound so sympathetic when you

I

could deal

I

wanted

ask her

if

to find

things have

been bad.

Dr. P. Int.

:

:

I

guess I'm always sympathetic to people

You might have chosen

not to

who

show sympathy.

are broke.

Cleaning House

[

373

was trying to encourage her. This was the first sensible behavior she had demonstrated since I saw her in the waiting room upstairs. I was probably sitting on the edge of my chair, saying, "Yes, yes," and begging her in every possible way to continue with this Dr. P.

think I

I

:

nice, sensible behavior.

The

Int.:

prognosis must have looked good

through as well as

Dr.

P.

Int.

I

:

why do you

that.

was very surprised and very pleased.

When

:

when she came

the others break in to say the finances are just fine,

ignore them? Did you think they might be

wrong and she

might be right?

Dr. there

I didn't

P.:

was no

know. There were plenty of reassurances that

real financial problem.

thing that this

woman was

But there must have been some-

perceiving. That's

"Your mother is pretty discouraged." some reality to what your mother says." Int.

new premise

in the

P.:

saying,

"There must be

I

it's

world to assume that when somebody

says something there must be

Dr.

was

some

reality to

the son,

I said to

sounds terribly reasonable to us now, but

It

:

I

why

a relatively

who

is

crazy

it.

don't think I've ever run into a delusion that

on some

level wasn't true.

Int.

Until ten years ago, most therapists would have interpreted

:

that statement about that.

with

You

ity

in terms of love or

don't say to Mrs. Willy, "Let's see

money Dr.

money

P.

really :

something symbolic

like

what your preoccupation

means."

We tend to accept the idea that there's

to psychotic productions.

To assume

that the

an underlying

symbolism

is

real-

what

is

important would be putting the cart before the horse. Int.:

It's

part of the crisis framework.

You

are out to change the

reality situation as rapidly as possible.

Dr.

P.

:

That's right. If

we were

taking this

woman on

as a long-

term individual psychotherapy case, or even as a long-term family case, we might spend a lot of time on the symbolism. But this is a crisis we're dealing with. Mrs. Willy

money and her a hurry

if

is

screaming that she doesn't have enough

family says she does. I've got to get the facts straight in

I'm going to convince the family that her security

threatened in some real

whole family

is

way and

involved.

that this

is

is

being

a real problem in which the

TECHNIQUES OF FAMILY THERAPY

You're not only getting the facts straight but also teaching

Int.:

what

the family

ters lays the

Dr.

[374

P.

groundwork

Your

about.

is

what comes

for

interest in practical

you want them

to be.

training people to be

You're trying to establish with

game this is. I'm telling these people that this is game and that we're interested in immediate results.

sort of a

reality-oriented

mrs. c: She's worried about money and

seem

mat-

later, inevitably.

With any therapy, you're constantly

:

the sort of patients

them what

procedure

this

bills

and she

a

just doesn't

have confidence that Paul can keep things up,

to (sighs)

some reason or another. mrs. w.: How can he keep things up on the little that he makes? See, he'd have no deductions. He gets about dr. p. (overlapping, to Paul) How much do you make? that's all, for

.

.

.

:

paul: $2.69 an hour. dr. p.

How many

$2.69 an hour.

:

paul: Well,

mer we

hours a week do you work?

about guaranteed forty, plus during the sum-

forty, just

get quite a bit of overtime.

dr. p.: That's pretty good.

paul: That's not bad.

mrs. w.

Well, he just can't

:

dr. p.: This, this

bound

is

make to

it,

though.

add up to well over a hundred dollars

a week.

a,

paul: Yeah,

grosses about a hundred, hundred a week.

it

dr. p.: Yeah.

mrs. w.: But you

(overlapping)

dr. p.

he has no deductions.

see,

Why not?

:

mrs. w.: Well, he has no children, mrs. c: Well, honey dr.

p.

mrs.

But you're

:

c.

.

and your

sister

paul (overlapping) .

self

c.

paul:

.

.

.



see, to

exemptions.

.

.

.

.

.

.

.

:

Yeah,

.

.

.

she's a deduction.

it.

.

.

not exactly,

mrs. w. (tearfully) to sign

you're the sole support of your mother

.

Just one .

if

.

.

and the two

:

Yeah,

:

then you, you have these, you have deductions for your-

.

.

paul: Well

mrs.

.

He's got you, he deducted you this year.

:

dr. p.:

has no, ah

.

.

(overlapping)

dr. p.

.

He

:

my sister has a government

.

She won't be getting that now,

.

.

I

won't be there

Cleaning House

The

dr. p.:

thing

is, if

she's not getting

.

.

mrs. w.

I

:

375

and

as a deduction.

.

won't be there to sign

...

dr. p.:

she's living there

you can take her

you're supporting her, then

Ah

and

it,

[

she's living

if

it.

somebody

elsewhere,

else

will

be sup-

porting her. (Pause.)

mrs. w.: Now, Paul, you know you're painting a picture different than dr. p.

Int. ation

Well

.

.

Here

I

gather you're both clarifying the reality of the situ-

:

:

(Mrs. C. laughs.)

it is.

.

and doing more. Dr. P.

think one

I

:

is

always doing "more."

What are you doing here? Dr. P.: The old lady had started going way Int.

:

up and once more focusing on

shutting her

been saying, he

is

his responsibility as

Dr.

P.:

Int.

:

is

baiting

him

before.

Now

you're supporting

him

in

head of the family.

That's true. But in the interest of supporting the mother.

:

By

pointing out to the son, in the mother's presence, that

making a reasonable Int.:

How

that he can't

Dr.

they've

How are you supporting her?

Dr. P. he

From what

in charge of the financial situation in the family.

You were

Int.:

the son.

out again, so I'm

does

make

living.

this

support her?

It

contradicts her statement

it.

may be

wrong word. I'm reassuring her, telling her that things aren't so bad. But I do this indirectly by talking to the son. To argue her down directly would be futile. As it turned out, my reassurance was pretty futile too, because it wasn't about the real P.:

"Support"

the

issues.

What were the real issues? Dr. P.: At this point I didn't know. Int.

:

We

found out in the next

was very concerned about being dependent on her son because she had no way of knowing that he was going to be able to support her. He never made her aware of the financial situation, and he interview. Mrs. Willy

wasn't giving her enough

on

herself. That's

some

why

money

to run the house or anything to spend

she kept bringing

bitterness at the fact that he

was

she wasn't getting anything in return.

up the deductions. She

felt

getting her as a deduction while

TECHNIQUES OF FAMILY THERAPY Int.: So in spite of the fact that the son

was doing

[376

well, they

really didn't live well.

Dr.

Exactly.

P.:

As

it

turned out, Mrs. Willy had been married

four times and none of her husbands had ever supported her properly.

After she got divorced the last time, she turned the house over to

had a great weakness for men, and she realized that if she kept the house, some other man would probably come along and take

Paul. She

her for a ride. But she got into the same situation with her son that she

had been

money

in with the husbands.

He had

to invest in the stock market,

he had or how well he was doing. just

used the money to reinvest.

himself,

and as

far as she

mortgaged the house, taken the

and wouldn't

He

tell

her what stocks

didn't share his profits with her,

He was

leading a very meager existence

knew, he was pouring house and

down

all

the

drain.

Did she know he was playing the stock market? Dr. P.: Oh, yes. But he kept telling her, "This is none of your business, everything is taken care of." He was in a difficult position himself. All the other relatives, including a stepson who was the rightful heir to the house, were terribly bitter that Paul had gotten it. This was one reason why he didn't want anyone to know he was making money Int.

:

on it.

Was he?

Int.:

Dr. P. five.

:

Sure. In that

What made Mrs.

kept quiet about his

mine her

one year, he had made a thousand

Willy's situation worse

profits,

faith in Paul's ability to support her, in the

:

Dr. P.

:

that Paul

hope that she

estate.

So when she goes on about being homeless,

literal reality as

she would have to perceive

it's

close to the

it.

Yes. Later in the interview she starts wailing that the dikes

are going to break in Holland, that there'll be they'll all

was not only

on

but that the other relatives tried to under-

would do something to redivide the Int.

dollars

run naked

in the streets.

mud

This was pretty

all

over,

and that

literal too. It

turned

out that one of the big issues between her and Paul was that the wash-

had broken down and neither of them would do anything to fix it. Each insisted it was the other's responsibility. So for many weeks Mrs. Willy was taking the clothes to have them washed by Gloria,

ing machine

her oldest daughter,

who

lived

down

the street. Gloria used entirely too

much bleach on the clothes and they came out ragged and full So when Mrs. Willy says, "We're going to run naked in the

of holes. streets,"

Cleaning House

that's exactly

377

And when she says, "The dikes are goand there'll be mud all over," this is her way of

what she means.

ing to break in Holland saying,

[

"The washing machine has broken down and

I can't get

any-

thing clean."

mrs. c: She's

been worked and worried about these

just

that's just the thing,

got to where she just couldn't cope with

it

the problem of financial things and in her

times worse than they are, see

mrs. w.

.

.

mind they

are three

.

That's just not true.

:

mrs. c:

.

.

.

and that thing

just feels like there's

mrs. w.: There

isn't.

is

the thing that's done

know

it,

it's

Right now, they're liable to shut our water

telephone

they'll shut the

for,

and they're

she

bill off

next

off

liable to shut,

month

.

mrs. c: Sweetheart, Paul's paid them every month, and he mrs. w.:

just,

never enough to go around.

because the water hasn't been paid I

and

bills

.

.

will.

He won't!

mrs. c: Paul always

will

keep paying them.

mrs. w.: His cars are shot and the rear end went out of

his, ah, car,

was parked and the windshield blew all to, you know, the heat got in there and just popped the whole back. So there he's got no car. the other day. Oh, ah, his car

(to Paul)

dr. p.

You

:

can drive

it?

mrs. w.: Huh? dr. p.

You can drive

:

mrs. w.

:

it,

can't

Oh, no, he can't

.

.

you? .

paul (overlapping) Yeah, we have transportation. mrs. w. He can't drive it paul: As far as that goes, if I need one, I can always buy another :

.

:

.

.

one. dr. p.

:

That's right.

mrs. w.: Now, Paul! dr. p.

:

How's your financial

position right

now?

we get along. You know. Now, that is not true!

paul: Well, mrs. w.:

paul: Small savings, ah, about twenty bucks a week builds up, so

mrs. w.: Paul paul:

.

.

.

.

.

A lot of people don't do that well.

Int.: There's such a sudden flowering of the old lady here.

conceivable that missed.

.

it's

because she

felt

It's

her point about the deductions was

TECHNIQUES OF FAMILY THERAPY Dr. P.

I

:

think she

may have

felt

[378

she wasn't getting across to me.

was trying to get at the facts and was being reasonably neutral about whose reality I was going to accept, especially since I didn't understand what was going on yet. I

Int.

:

Dr.

P.:

one single

Is there

We

you look for?

reality

people. We're looking for points of

Somewhere, among so that

if it's

all

all

own concept of reality on agreement among their concepts.

imposing our

try to avoid

the different perceptions,

is

enough information

out on the table, most of the family will arrive at a

consensus. Int.

:

why you let the

Is that

Dr. P.

:

She was coming

in

sister

take the floor here?

with her

reality,

and

I

thought

it

was

worthwhile. She obviously shared Mrs. Willy's fear that Paul would

abandon

her,

which would mean that she would have to take her

She wanted to make

in.

clear to us that Mrs. Willy ought to

it

away, so that she could go back Int. seriously

:

When

Mrs. Willy

and ask about

Dr. P.

:

be put

home in peace.

starts wailing

Was the

about the car, you take her

son driving her car?

No. Both cars were out of commission, and he was

was

ing a motorcycle. She

grease from

it.

sister

it

pretty upset, as

kept dripping

down onto

wild and hysterical here, but she

is

it

driv-

turned out, because the

the front porch. She sounds

really lodging a legitimate complaint

against the son.

Int.: That's

doesn't

tell

a pretty slippery statement the son

you whether the car

is

in

makes.

He

shape to drive, he just says, "I

have transportation."

Dr. ation.

P.

:

He's continuing his secretiveness about his financial

He's trying to send

money,

I

can buy a car

if I

me

situ-

the message, "Look, I've got plenty of

want, but

let's

not go into details."

Int.: There's a very striking thing here, and

it

happens many

Whenever Mrs. Gapp starts to talk about Mrs. Willy jumps in, as if on cue, and demon-

times during this interview.

her

sister's craziness,

strates

it.

Dr. P.

:

Isn't

it

beautiful? Every time the sister

We

opened her mouth,

had a patient who started acting crazy as soon as he got to the hospital. We asked him why he was behaving this way, and he answered, "Isn't that what I'm supposed to do here?" People act very much the way they're expected to, and in

it

seemed that Mrs. Willy got

crazier.

Cleaning House

wanted

this case the relatives

woman

this

to prove to us

how

379

[

crazy she

was, so we'd put her away. Int. saying,

When you

:

talk

about families,

"These people give each other

it's

almost as though you are

explicit instructions

on how

to

behave."

Dr. P.

expects them

way

that they

burden

that takes the

up

couldn't live

they don't

to. If

them

pressure on

a

think they do. I think people

I

:

role,

such as being a patient,

off the family for putting

to in the

is

with their idea that there

strength of the person

agreeing with the family

them

in the role they

place. Putting the person in the hospital

first

the family absolves itself of guilt for

pressure,

whatever role the family

that role, the family puts such great

some other

fill

declares to the world that he trists,

fill

fit

making him

sick.

is

This

incompetent by nature. Even psychiais

something wrong with the basic ego

who becomes psychotic under on this. But we feel that anyone,

pressure, are

given enough

capable of becoming psychotic.

is

Int.: This classification of people

saying that they

can tolerate

face essentially the

all

and some

it

can't.

by ego strength

same

situation

a

is

and

way

of

some the same

that

But obviously they don't face

situation.

Dr.

P.

dr. p.

They

:

certainly don't.

Ah, how does, how does

:

money

to be able to go

paul: Well, unless

I

.

.

don't think

.

.

mrs. w.

:

.

.

make

the necessary

back to school? I'll

be going back to school for a while,

.

something

.

look for you to

.

mrs. w.: Well paul:

it

else

happens, you know.

We're going to lose the home,

It's

quite distant.

there.

dr. p.: What's this something else that, ah, you're anticipating hap-

pening?

paul: Oh, I'm not anticipating, might inherit a million

I

mrs.

(laughing)

c.

They took

He

:

it's

possible, that ah,

dollars, or

doesn't have

something

much hopes

you know,

like this.

of going back.

program off the air. paul: Uh-huh. You know, my mother might become more, dependent and decide that she wants to work and stuff like dr. p.

mrs.

:

c.

dr. p.:

:

I

think

How

.

that

that

.

do you

ah, inthis.

.

feel

about the fact that she's not working?

TECHNIQUES OF FAMILY THERAPY mrs. w.

:

He knows I'll never work.

paul: She never has,

:

ah, probably quite an adjustment for her,

it's,

seemed to have had a

too, she always, she's

mrs. w.

[380

lot of difficulty.

work.

I just can't

Would you like for her to? mrs. w.: They won't even take my application when I go. Penny's: "You had any experience?" "No." Ward's: "You had any exdr. p.

:

perience?" "No."

Have you been to the State Employment Agency? See what they could work out for you? mrs. c: I don't think she could cope with a job at all because she's

dr. P.:

and too upset about

entirely too nervous and,

dr. p. (to Mrs. W.)

paul

:

Do you feel you're too

She, ah, she's been

:

to, ah,

all

these things.

nervous to work?

the local State Board and they always

give her housecleaning, or something.

mrs. w.:

A

cleaning job, twenty miles, and then

I

got to go

way

out

here and clean one day. dr. p.

How do you like it?

:

mrs. w.: Why,

mind

didn't

I

he's having to drive just threadbare,

get a sticker

on

my

the work, but, car,

and

it's

an old

it's

nothin'



thing, the tires are

brakes are gone, the windshield's cracked, I

it,

know, and

now,

just,

that's the truth.

You

it

won't

can't

deny

that.

Ah, I'm wondering whether mrs. w. (overlapping) They're trying

dr. p.

:

.

.

.

:

than

Dr.

P.:

it is, I'll tell

When

you the

mother away and

truth. (Pause.)

the son says he can't go back to school unless

"something else" happens, his

I

was wondering

When

he had

know

in

mind

putting

yet that he already

it.

he answers your question about what that "some-*

thing else" might be, he puts

it

as something that could never in the

world happen. In the next breath he equates out and working.

if

selling the house. I didn't

had the house and was making money on Int.:

to paint a picture brighter

"It's

this

with his mother going

inconceivable that she could work,"

is

what

he's

saying.

Dr.

P.

She eventually did go out and work.

:

Did you feel that helping her get a job would be the best way to get her on her feet? Dr. P. Yes. At the same time, the most effective way to say to the Int.:

:

[381

Cleaning House

family that Mrs. Willy tent

by talking

is

time I've done Int.

not necessarily lazy and crazy and incompe-

is

to her about

how

is

the second

this.

Is this typical of the

:

she can get a job. This

way you

operate, to give people

some

practical task?

Dr.

We

Yes.

P.:

try to get people to

work

whatever seems

at

appropriate to them. Int.

working

:

is

I

take

it

woman

that your assumption that this

capable of

is

based on a therapeutic ideology, not on the basis of what

she's delivered in the interview so far.

Dr. this

That's true, but you'll notice that every time

P.:

assumption, she immediately starts talking Int.:

It's

a

way

introduce

I

realistically.

of helping her to get to a better state of

compe-

tence, whether she gets a job or not.

Dr. P.

Yes.

:

don't think that her getting a job

I

is

as important as

whether she cleans her kitchen or not. Int.: You're really talking about functioning in general. that off

you believe that people who go

than people

Dr. P. it

was

some is

work and earn money

not

are better

who don't.

Mrs. Willy was complaining about not having money, so

:

logical to think

it

But you're

herself.

might help matters right.

better than not functioning,

you

to

It's

if

she were able to earn

We're taking the stand that functioning

and the family

more rewards if you don't. Int. So just as she is sensibly

is

taking the stand that

get

:

talking to

you about how

to get a

job, the family rushes in to say she's too sick.

Dr. whether battle,

cause

Don't forget that we're fighting a battle right

P.: this

and

woman

goes into the hospital or not.

at this point I didn't realize

I didn't

know

that the resident

how hard

It

now

as to

was an unstated

a battle

had already discussed

it

was, be-

hospitaliza-

tion with them.

Int.:

When you

think someone should get a job, do you actively

go out and find work for the person?

Dr. P.

:

No.

We make

telephone calls to vocational rehabilitation

services or send the person to the State all

Employment Agency, but

that's

we do right now. Int.:

Do you

have access

ganization of employers

who

in the

community

to jobs, or

are willing to cooperate?

some

or-

TECHNIQUES OF FAMILY THERAPY Dr. P.

No, we haven't investigated that

:

been

in

an institution

382

who

has

possibility.

would be a problem. and has no experience would

Int.: I should think

[

A woman

it

find

it

hard to get a

job.

Dr.

P.

but she got

buy some Int.

Dr.

:

She got one.

it

and was very proud of

It

woman, gave her some pin money to

was a part-time job it.

It

as a cleaning

things for herself. :

P.

How long after this interview did she get it? About two months

:

dr. P. (to Mrs. W.)

MRS. w.: Well,

wake up

I

How

:

guess

to the fact

dr. p. (overlapping) rible situation

.

A

:

.

long has

it's till

later.

it

looked

been happening

a year ago that

.

bad

this

to

you?

the time, but I didn't

all .

.

year ago you started realizing what a ter-

.

MRS. w. (overlapping)

:

I

woke

have been starved to death

up, I

now

woke up

if it

to the fact that I

hadn't been for Paul

.

would

.

.

mrs. c: But you've got Paul.

mrs. w.:

.

.

.

women my age on woman fifty years do

me

because the Welfare here told welfare,

now what

old can't get a job,

they do, I

don't

I

don't know.

know what

A

they

here.

You don't say to Mrs. Willy, "How bad?" but "How long has it looked bad?" Int.:

Dr. P.

they don't put

:

This was the

moment

at

which

I

long has

Now

at

it

as

been J

decided that Mrs. Willy's

perception of the family's financial situation was not totally

began looking

it

a symptom, whereas before

it

realistic. I

had been an open

was important to find out what had taken place to precipitate this symptom. Int.: Do you typically try to find the provoking situation for a symptom? Dr. P. Always, if it's a recent symptom that's causing the trouble. Sometimes the symptom isn't a new one, but something has happened to make the family less tolerant of an old symptom. That can be a more question.

I felt

it

:

difficult situation.

The family has been rewarding

a certain symptom, and

all

of a sudden

it's

the patient for having

because of the symptom that

he has to go. But Mrs. Willy did have a new symptom, which was her constant distress about

how badly

off they were.

Once we had

clarified

[383

Cleaning House

that,

our interest would be to see what change had taken place that had

made

it

necessary for her to act this way.

You

Int.:

whole

Int.

it

the

situation.

Dr. tion

symptom on

are placing responsibility for the

P. :

Well, she didn't develop

:

You

you belong

was thought

it

in a

say that so automatically. to.

that

something entirely

vacuum. shows what a new genera-

It

when people had a symptom something had gone wrong inside them. You assume different, that a symptom comes about as a way of For hundreds of

years,

handling a change.

Dr. of

P.:

Exactly.

some change

shift of roles.

We

believe that a

symptom develops

that produces a family crisis in

which there has to be a

could say that Mrs. Willy developed her symptom not

You

only because she had a childhood predisposition toward

down, but because something had happened Paul that made her begin to doubt his

Dr.

P.

How would

you describe

her

in her relationship with

terms of a

shift in roles?

Well, the event that led to the shift in this case

:

let

or desire to support her.

ability this in

which was

it

who had

reinforced by her experience with several husbands

Int.:

as a result

was the

mother's turning the house over to the son. This led each one to have

new

expectations in regard to the other.

The mother,

in return for the

house, expected the son to be the economically good husband she never had.

The son accepted

liability that

responsibility for the

mother as an unfortunate

went with the house, but one he was

willing to accept as

long as she kept house for him and didn't get in his way. relatives shared Paul's expectations of his mother.

realize

was

that in his attempt to play

down

The

What Paul

other didn't

his financial success so as

not to arouse jealousy, he also caused Mrs. Willy to believe that they

were about to be

destitute.

So she went back on her part of the bargain

as a

message to him that he wasn't keeping up

her.

The only

role she

saw

that

was

all

by supporting

would provide her with

for her to be crazy, totally helpless,

around and do

his part

security

and then everyone would gather

the things for her that needed to be done.

that they tried to put her into the hospital.

she was really against

it.

was

And

I

The

result

don't think

She had pretty well given up on the idea that

Paul was going to help her, and the hospital, which she had experienced

was a fairly nice place where meals and clothes were provided and you didn't have to run naked in the streets. What we tried to do,

before,

TECHNIQUES OF FAMILY THERAPY then,

was

to get Paul to

fill

We

certain aspects of the role Mrs. Willy

expecting him to

fill.

financial situation

and give her a few

He was that

it

willing to

him

tried to get

go along with

would cost him money

dollars a

week

up

worked

But

here, at this early date,

we

say,

this?" I

how Paul was

"What have you done

was

to

was the

herself.

pointed out

came

as

what he wanted. So

didn't

have the neces-

contributing to Mrs. Willy's

would have been inappropriate to turn suddenly on Paul

craziness. It

and

we

on

to have her in the hospital, which

got her, in turn, to live

sary facts to piece together

to spend

this, especially after

We

out.

on

to keep her posted

a surprise to him. it all

[384

your mother to make her act

to

just trying to pinpoint

it:

when

did

it start,

like

what led up to

it?

You

some people do, start by taking a family history and get the information that way? Dr. P. I am taking a family history. Int. I mean a more formal kind of history. Dr. P. Sometimes, if we're trying to get to the basic problem and Int.:

wouldn't, as

:

:

:

things are confused,

when

met,

we

will

they got married, and so on.

mit to any problems at rather

go back and

all,

we

Or

:

Well, then I see one thing

you

find a job. But, ah,

if

to

one by one, how they

we

can't get people to ad-

watch them

we can do

meanwhile,

today to get a job, maybe you'll

Ah, now, what did you come

out,

formal history, but then

will take a

becomes a framework within which

dr. p.

sift

I

right off,

mean,

if

it

interact.

which

is

to help

you're too nervous

feel like getting

one tomorrow.

to the hospital for today?

Again the same maneuver, treating Mrs. Willy as if she were perfectly capable of functioning, and expecting it of her. Int. When you say "we" will help you find a job, do you mean Dr.

P.

:

:

your

outfit?

Dr. for

them

P.:

I

meant us and the son and the

too. It involves

them

sister.

This statement

in our joint effort to help Mrs. Willy

is

go

to work.

Then comes this remarkable statement, addressed to a woman who has just been brought in raving, "If you are too nervous today to get a job, maybe you'll feel like getting one tomorrow." Dr. P. I was making it clear that we felt her disability was only Int.:

:

temporary.

[385

Cleaning House

Int.

using a framework in an interesting way. Here they are,

It's

:

putting her in a hospital, talk to her as

Dr.

she

if

came

and within

persistently

there looking for a job.

way

Well, that's the

P.:

framework you

that

she's acting

now. In these

five

min-

from a mental patient to a housewife looking for a

utes she has changed job.

Int.

Would you

:

say this to any patient, or have you had enough

indication that she can be rational?

Dr.

P.

we

think

I

:

say this to most patients. We've used this tech-

nique with even the most psychotic patients with good course,

works better with

it

and

hysterics,

this

results.

may be why

Of

Mrs. Willy

was more a hysterical quality to her than a psychotic quality. Her craziness was so much in response to what was going on, and so obviously under her control, that I had the feeling that she was a wild hysteric playing a role. responded to

Int.

so well. There

it

You

:

"Why

ask,

did you

come

to the hospital today?"

Was

that to Mrs. Willy?

Dr. P.

It

:

was

Int.: Is there

of them. I'm trying not to say "you all" since

Dr. P.

some reason why you wouldn't ask

If I'd

:

Mrs. Willy

asked

crazy,"

is

it

at first, I

would have been

"Because

told,

and we wouldn't get anywhere. Now, even

have agreed that she has a

I

that question

along in the interview?

until this far

that she

all

South, but I should have here.

I left the

though

to

slight

symptom,

it's

a

little

clearer

not as sick as they thought and that they are more involved

is

than they thought.

Would you use

Int.:

this question as

an opening with another

kind of family?

Dr. not clear

P.

With people who

:

who

the patient

is.

we might,

aren't this verbal,

In general

we

avoid

it,

or

because

when

it

it's

puts us

under the handicap of having the problem stated in a prejudiced form

from the beginning. Int.:

Dr.

had

for

P.

So when you ask :

No,

it's

to

it

make

this far along,

it's

clear that the reasons they thought they

coming here are not good reasons. She

psychosis they Int.

reframed

:

It

came to deposit. would be very hard

this situation this

not for information.

way.

for

them

is

not

to say she

now

is,

the bag of

after

you have

TECHNIQUES OF FAMILY THERAPY Dr. P. position.

That's right.

:

From

this

We

point on,

are putting

it is

them

in a

perfectly all right

through a whole lot of psychotic behavior, because her psychotic behavior

is

related to the

way

she

is

somewhat if

[386 difficult

Mrs. Willy goes

we have shown

that

treated.

Are you always able to get such a good first five minutes? Dr. P. It's what we work for. It creates a problem too. In one of the few cases that we hospitalized, the patient, who came in with his wife, was doing fine as long as we were in the room structuring him and Int.:

:

supporting him, the

way we were doing

with Mrs. Willy.

walked

out,

tried to

swing from the microphone in the

he started throwing ashtrays, took

As soon

as

off all his clothes,

ceiling.

we

and

His wife refused to

him home and in the hospital he displayed all the symptoms he'd ever had or ever seen. After all, the way to act in a place for crazy people is crazy. It's expected of you. The people in the hospital encourage this without realizing it. They focus on pathology and expect the patients to show it to them. And the patients do. Int.: Do you feel you lost ground with this man because you put him in the hospital? Dr. P. I think putting him in the hospital encouraged him to be crazy. On the other hand, he was so frightened of what he might do, on the basis of the perception of the people around him, that he was afraid to go home, and his wife was afraid to have him. The man had become take

:

when his

violent once

wife

left

him

briefly

he was in the hospital for three years after

twenty-two years before, and that. Since then,

he has never

Yet she is constantly expecting him to be, and has subtly reminded him every day for the past twenty years that he was in the hospital for three years because he was uncontrollable and she certainly

been

violent.

hopes he doesn't do that again today. This

latest crisis

occurred

when

mother was removed to a nursing home under circumstances which he couldn't prevent but felt very guilty about. The day his mother was

his

taken to the home, he was found wandering around the golf course

two o'clock in the morning, and

his wife

brought him to the hospital.

at I

think the whole thing would have cleared up very satisfactorily as soon as the

mother became

body around him kept

home if it hadn't been that every"Remember what happened twenty years

settled in the

saying,

ago, you might get violent again." Int.: This like to

look at

it

is

a

such a clear turning point in the interview that I'd little

more.

It's

possible to see therapy in terms of an

Cleaning House

[

387

encounter or conflict between the therapy group and the family group,

and hypothesize that out of

this struggle

Here, the relatives have come in with

dump

this

comes some kind of change. woman with an inclination to

her and the inclination of the therapy group

Now

not to have her

is

made and you have managed to reframe the situation. There's not nearly as much wrong as they thought, they are involved in it too, and it is probably temporary anyway. Then dumped.

comes

this

contact has been

"Why

hard for them to

group

is

on dumping

insist

that the conflict

her.

What

between you and the family

can't formulate their goals as neatly as

say

is,

"We want

to

keep

this

first

would give you enormous Dr. P.

does, but

It

:

just

woman from

assume you have some deeper aims

so evident.

is

way you

you can, because

produce a change without articulating

what

that

their goals are

But

is.

all

you

in mind, but phrasing

it

this

way

at

strength, I should think.

not just a surface action.

it's

We

can't try to

one member

if

weaving baskets and the others are home

in the hospital

is

do.

Most They

going into the hospital." I

even up responsibilities and work for better functioning of the family

it

unusual about your

is

therapists don't have a clear crusading purpose the

to

makes

did you bring her to the hospital?" which

have nothing to do with his problem. Keeping people out of

feeling they

the hospital

is

not just a display of virtuosity,

it's

basic to our whole

approach to treatment.

paul: Well, we didn't come here, ah, a psychiatrist over

on

[street]

.

.

directly,

we went

to Dr. Clark,

.

dr. p.: Yeah.

paul:

.

.

my

mother and

my

aunt and

I

for a

.

.

Um-hm.

dr. p.:

paul:

.

to

and then he suggested that she be admitted to a hospital

while,

for

and he talked

.

.

.

.

intensive treatment and, ah, he suggested probably that,

since he thought

become

it

would take quite some time for

better, that a state-supported hospital

my

would

mother

be, ah,

to

more

ideal.

dr. p.:

How

that

Mrs. c: dr. p.:

do you

we can do

feel

it

Do it what? How do you

about the fact that Dr. Gray and

otherwise, or

feel

that we'd like to give

would

like to give

it

ah, think

a try?

about Dr. Gray's feeling and it

I,

my

feeling

a try keeping her out of the hospital?

TECHNIQUES OF FAMILY THERAPY

[388

mrs. c: Keeping her out? dr. p.: Yes.

mrs.

c.

Well, that would be wonderful,

:

paul: Yeah,

if it's

possible.

ah (Mrs. W. talking

that's nice,

in

background), but

was under the impression Dr. Gray wanted to put her hospital]. That's, he mentioned that to us, didn't he? dr. p. Well, now, let's find out what you want to do. mrs. c. Well, we don't want

I

in [state

:

:

.

Do you want to put her in

(simultaneously):

dr. p.

.

.

[state hospital]?

mrs. c: No! Definitely!

paul (overlapping)

:

Well,

I

think the ideal thing would be

give her a few tranquilizers and let her stay at

would help her, but would change her mrs.

(overlapping)

c.

ah paul:

.

.

.

mrs. c:

Dr.

P.

Int.

:

I

thought she would probably need these,

.

attitude, or

.

.

that

.

.

anything like that.

shock treatments, but he says no.

Dr. Gray was the admitting psychiatrist.

And you were hopefully bringing him in on your side.

:

Dr. P.

:

I didn't

know

Who was Dr.

Int.:

Dr.

.

if

.

.

:

and,

ah,

don't, frankly, I don't think that tranquilizers

I

.

home

to,

P.:

The

that he

had given them a

different opinion.

Clark?

private psychiatrist

who

told

them

woman

that the

needed to be admitted. Int.

When

:

the son quotes the psychiatrist as saying that

it

some time for his mother to get better, is he implying that therapy would be too expensive because it would take too long? take

Dr. P.

:

would

private

He's implying that he doesn't expect her ever to get well

and that he wants her put away. As he so

delicately puts

it,

"a

state-

supported hospital would be more ideal." Int. hospital,

Then you make

:

and they go

Dr. P.

was up

:

I

the statement about keeping her out of the

into a flurry.

think that was the

first

indication they'd

had of what

Suddenly the battle was out in the open.

to.

Int.: That's a classic example of social hypocrisy, there.

aunt says,

"How

wonderful,"

the son says the ideal thing

when he has Dr.

I

P.:

when

would be

just said the ideal thing

He

says

it

she means, for his

"How

quite sarcastically.

dreadful," and

mother to stay

would be for her

He

to

The

at

home

be committed.

sounds very doubtful

Cleaning House

389

[

about the tranquilizers because she had been going to a day hospital for

most of

and getting various medications that didn't help very

that year

much. Of course, Int.

And

:

I didn't

know

they didn't

this at the time.

you. But

tell

even that ambivalent mixture of

you had

I

:

doubt

wonderful

would

it

by declaring your intention. too. A lot had happened in these

started right out

Dr. P.

"How

doubt that you'd have gotten

I

it

paul (overlapping):

I'd prefer to

trying to break in),

Clark

psychiatrist, Dr.

.

.

"

if

five minutes.

avoid the hospital, ah (Mrs. W.

possible, ah, apparently

it's



be, but



does

it

see, the

.

dr. p.: I'm a psychiatrist, too.

paul: Yeah, well

.

.

.

He

mrs. c: (Inaudible phrase.)

said definitely she

would have

to

come.

paul (simultaneously)

He

:

directed us here, so there seems to be a

conflict.

mrs. w. dr. p.:

Does that mean, ah No, there's no conflict of opinion, :

.

.

.

ah, at

all

about

We

this.

only take patients that everybody feels should be in the hospital.

Those are the only ones we bother mrs. c: Um-hm. dr. p.

Int.:

They

:

don't, they don't call us

to, that

we even

see.

about any others.

What do you mean when you

say to them, "Let's find out

what you want to do"? Dr. P. "Let's find out what neurotic reasons you had :

for wanting

to get rid of her." I realized that I couldn't bring the admitting psychiatrist

in

them

my

on

side, so I

was

shifting

my

technique.

into refuting the ugly idea that they

I

began to browbeat

wanted her

in a state institu-

tion.

Int. since

:

And you go on

you only take people

hospital. That's

to indicate that

whom

everybody

such a nice piece of

dr. p. (cont.)

:

Ah, our team

it

really isn't a conflict at all else feels should

be in the

logic.

consists of

me, a

social worker,

and a

nurse.

mrs. w. dr. p.

:

You mean

(overlapping)

that's all there is :

No,

here or in (inaudible words)

in this particular unit.

We

take as

patients as the, each of the other units of the hospital,

.

many

we keep

TECHNIQUES OF FAMILY THERAPY them out of the hospital

if this is

mrs. c: Well,

that's

(overlapping)

dr. p.

hospital.

We

do have beds

[390

to put people in the

necessary.

what Dr., :

name? some time we have not found

ah, what's his

Ah, for quite

it

necessary to put anybody in the hospital.

mrs.

c.

:

Well, that sounds wonderful.



And

dr. p.:

we've managed to get

well,

I'll tell

you

guarantee you any results, of course, but the

this,

that I don't

last patient

whom we

in,

talk,

talk with us at

saw last Wednesday, he came he was shaking all over, and couldn't

Thursday he was back

at

work

for the

first

we had

he was unable to

On

all.

time in two months.

mrs. c: Wonderful.

And on

dr. p.:

Saturday, he

left

fishing trip. He's doing fine

Int.

with his family to go on a weekend

now.

Do you usually explain your project to people?

:

Dr.

P.

:

Ordinarily

we

don't.

The

family

may be

ambivalent about

keeping someone at home, but they don't usually bring don't usually ask. the family over

We

don't like to get into an open

power

struggle with

it.

What happens when you do? Dr. P. If we win, as we did here, Int.

up and we

it

:

:

it's all

where we've gotten into a power struggle and serious difficulty.

We

right.

But

in the cases

had

didn't win, we've

have to present a tremendous aura of confidence

and strength to people.

If

we

we back on and we

lose the initial battle over the hospital,

are no longer the strong authority figures they can

fall

lose ground.

Have you worked out any

Int.:

sort of calculated technique for

preparing a family not to put the patient in the hospital?

Dr.

P.

:

We play it

express no doubt at

by

ear.

We've found

that the best course

to act absolutely sure of ourselves, but to

all,

pathize with the real difficulties of having the patient at home. the time the families

come

the expert recommends.

in desperate

And

is

to

sym-

Most of

and ready to accept whatever

often the family

is

delighted to take the

person home. But when there has already been experience of hospitalization, or

when

other authorities have told the family that hospitaliza-

necessary, as they did here,

tion

is

sive.

That's

why I went

Int.:

It's

we have

to

be particularly persua-

into such detail about the last patient

a nice positive emphasis. So

many forms

we

had.

of therapy

Cleaning House

start

391

[

by saying, "I had a patient who did well." Usually the framework

of the office and the waiting

was the

explicitness of

list

does

this.

your statement.

It

What was

impressive here

shows that you've worked

with hypnosis. With hypnosis you don't have to persuade the person that he

is

going to be hypnotized, but you have to persuade him that

it's

a good possibility.

Dr. P. therapy,

I've

:

we

have to

kind of

we have to back up our promises. We don't feel we can minutes, "You go home and everything will be better."

effect

around the family small one which

Int.

this

feel

say, after ten

We

done some work with hypnosis. But with

issues. It doesn't

some hope

inspire

for change,

have to be a big change;

it

can be a

we make look big.

It's like

:

some change, or

You need

any form of brief therapy.

show

to

evi-

dence of a change quickly.

Dr.

my

in

P.

It's

:

private practice,

wouldn't succeed

work too. When I do long-term therapy there's no need to effect immediate change. I

part of crisis

if I

tried. If

people aren't in a

crisis,

they are not

them how to run their lives. But these families do arrive in a state of crisis, and it's not only that you are expected to do something right away, you've got to do something right away or you'll miss your chance. going to listen to an expert

Int.

Timing seems always to be important

:

the therapist has

how

tell

all

the time in the world.

quickly you can

make a change but

It's

even when

in therapy,

not so

much

a matter of

of whether you can

make

it

at

the right time.

Dr.

P.

I

:

think you're right.

Int.: There's one other aspect of your

you a particular advantage.

It

comes out

in

work which should

give

"We

only

your phrasing:

take patients that everybody feels should be in the hospital. Those are the only ones trying to

do

we

in a special category, as though keeping the person out of

the hospital were

on

to say

bother to see." This immediately puts what you are

how

some kind

successful

of heroic achievement.

you

are, there's less

Then when you go

chance that

you, because you're being successful against odds. This it

could offer an

irresistible

they'll resist

way

of putting

appeal to some families to join you.

the things about the psychotic family

is

that, as villainous as

One

of

they are,

they are so protective. If they see you standing alone against the world, they'll join

you to protect you. Your procedure

is

unique enough to set

TECHNIQUES OF FAMILY THERAPY

[392

you against the majority of your profession. If you can get a family to join you in this crusade, they will have to improve because they are part of the crusade.

Dr. zeal.

At

We've thought a

P.:

we used

first

Int.:

healing

it

was transmitted

We've calmed down a

important a factor it It's

that

is

Dr. P.

I

:

bit

missionary

new

thing

we

mixed

to the families, with

now, and we've been wondering how

is.

One

not a minor aspect.

it

this question of

to get very enthusiastic about this

were trying to do, and results.

about

lot

works best when

thing that seems true of faith

there's opposition to the faith healer.

do think we tend to make people

feel that they are part

some magnitude which goes

of a scientific experiment of

against estab-

lished practice.

mrs. w.: What'd you do to him? dr. p. (laughing) the family to

now



:

We

found out what the

make him need

devil

was going wrong

in

one thing, right

to get sick. I can see

you were well have to worry about

ah, I think there's a general feeling that

taken care of some place where you didn't

if

anything, then the rest of your family could go about their business without having to worry about you.

mrs.

c.

But

:

dr. p. (overlapping)

mrs. c:

.

.

.

if

we

that

it isn't

:

up

don't want to have her locked

.

.

.

No. No.

there's

any way to

.

.

.

No, what I'm saying

dr. P. (simultaneously):

is,

what

.

.

.

mrs. c: ... to make her well so she could come back and be

home, mrs. w.

:

what we want.

that's

Did you hear about

dr. p. (interrupting,

family

is

mrs. w.:

to

.

.

.

Mrs. W.): What I'm saying

very worried about you

mrs. c: Well,

at

.

.

is

that your

.

yes.

Do you, you don't

dr. p. (overlapping)

:

.

.

.

(inaudible phrase).

and they would

like for

you

to be

some

place where you were well taken care of.

mrs. w.:

You

don't have those hot baths and things any more, here,

huh? paul: Well, ah . mrs. c. Well, we want what's the paul (overlapping) I know this .

.

:

:

mrs.

c.

:

...

best .

.

.

.

.

.

so she can get well and be at home.

[393

Cleaning House

You

Int.:

the family to that

say,

"We

found out what the devil was going wrong in

make him need

And you

a family problem.

it is

can't resist

it.

This

is

to get sick." This

phrase

it

is

your

first

in such a

statement

way

that they

probably a brand-new idea to them, but they can't

say, "There's nothing

wrong with our family," because you're

talking

about some other family.

Dr.

P.:

I didn't

want to

them on our approach. Also,

alienate them. I I

do go on to

was

trying to sell

still

their family in the next

statement.

Int.

:

one thing," family."

With such an appearance of logic. You say, "Now I can see as if you were about to finish, "one thing wrong with your

But you

don't. Instead,

you go into a long "ah" and

start talk-

how they want to see that Mrs. Willy is well taken care of. They could make the leap and say, "So that's what he thinks is wrong ing about

with us," but

Dr. P.

:

it's

I

framed so benevolently that they can't be

may have been

hesitating because I

sure.

wanted to point out

some obvious problem and couldn't think of one. Int.: What you do here seems to be a common technique in therapy. You manage to side with everybody and at the same time keep out of coalitions with individuals. Here you're rephrasing the family's desire to get rid of Mrs. Willy in the same benevolent terms they would use: "They want you to be where you'll be well taken care of." You could have sided with Mrs. Willy against them by saying, "What you really want to do is to get rid of Mrs. Willy," and they would have become antagonistic. Instead, you appear to go along with them in such a

way

that they have to refute you, but they can't take exception be-

cause you are on their

Dr. P.

:

side.

Yes. After that they couldn't pressure for hospitalization

without making

it

clear that

what they wanted was not

to

have to worry

about her any more. Int.:

And

makes

the aunt

that terrible slip: "It isn't that

want to have her locked up." Dr. P.: I was kind enough not effectively

dr. p.

to take her

up on

it.

we

don't

But that

put an end to the issue of hospitalization.

(overlapping)

:

mrs. w. (overlapping)

Well, the thing :

lock people up here?

Do

is this,

the thing

is,

we

.

.

.

they have cells and things where they

TECHNIQUES OF FAMILY THERAPY We can put you in the hospital

dr. p.:

mrs.

(overlapping)

c.

We

dr. p.:

.

[394

.

.

See, she has that fear.

:

can put you in the hospital

if

we have

to,

there are

no

hot baths, no locked doors.

mrs. w. (overlapping)

No, no

dr. p.:

Do they have

:

cells?

cells.

mrs. w.: Thanks.

No

dr. p.:

your

mrs. w. dr. p.:

own

gonna have

.

.

we'd

.

Ah, the thing

is

.

.

.

my own clothes.

to give

like

You wear

just like this.

is

clothes, everything's very nice.

I ain't

:

the rest of the hospital

cells,

a try of keeping her out of the

it

hospital.

mrs. w.:

What

dr. p.:

gonna have no clothes

I ain't

this

to wear.

going to involve

is

—of

course,

it's

going to be

cheaper, to keep her out of the hospital, our charges are

far, far

very, very small for our services, the reason being that, ah

mrs. w. (overlapping) dr. p.

.

:

.

we

.

The

dr. p.:

hospital

.

.

Do people have to pay it?

:

encourage people to stay out of the hospital.

try to

mrs. w.: Do, ah, the

.

relatives is

much

.

.

.

too crowded and

it

turns out people get

months and, ah (sighs), ah, it takes a month or so for people to get accustomed to the hospital enough so that they can start getting better. If you keep them out of the in the hospital, they stay for

can

hospital, they

mrs. c: Well, paul: Well, ah

it .

start getting better

immediately.

sounds wonderful. .

.

dr. p.: You're skeptical.

paul: Well, ah, as far as I'm concerned, ah,

Mother c.

paul:

probably worry, you know,

been kind of hard on

it's

mrs.

will

She gives

:

.

.

.

.

.

.

.

.

mrs. w.

that

the time, but lately,

around home

but she hasn't been able to do anything, ah

.

.

.

.

.

I

:

.

don't even cook or anything.

take care of the house, ah, the garden or anything like

and

this,

me

seems to

.

mrs. w. (overlapping)

paul:

me and everyone

all

it

.

.

.

(tearfully, overlapping):

He

hasn't

come home

.

.

.

paul (overlapping) it's gotten to be quite a burden mrs. w. ... he ain't even eating anything. paul: and I figure if you could get her adjusted to assuming some kind of responsibility, it would help a lot. mrs. w.: Do the relatives have to pay for them to be in here now:

.

.

.

.

.

.

:

.

.

.

adays?

How

are they going to pay

it

and make the expenses?

Cleaning House

what I'm saying, you're not going

dr. p.: Well, that's

395

[

to have to

go

to the hospital.

mrs.

c.

Wouldn't you

:

mrs. w. (overlapping)

pay for

afford to

dr. p.

enough.

it

You

whole

way?

These people

:

that are poor,

all

how can

they

their folks to be in here? to,

but you're not poor

have got plenty of money.

mrs. c: Her whole concern the

that

poor enough, you don't have

If you're

:

like

is

about money,

that, that

seems to be

thing.

mrs. w.: Paul

just can't

make

that's all,

it,

he

just don't

have the

money. mrs.

c.

:

He'll be sending

mrs. w.: Oh, my, mrs.

c.

:

Does

you home.

always (inaudible phrase).

it's

it?

mrs. w.: (Inaudible phrase.) mrs. c: No,

if

there's

any way to keep her out and get her

well,

we

want that (Mrs. W. overlapping, inaudible phrase) he mentioned [distant state hospital], but that

is

Mrs. Willy was apparently

Int.:

out, definitely.

just getting the point that she

wasn't going to be locked up.

Dr.

P.:

Well, she didn't

know

quite

what was happening. She

wanted to find out whether the hospital had changed since she had been there.

She was

Int.

:

Dr.

P.

:

same place some years before? Yes. That didn't come out till later in the interview, but in the

would be an important

fact for us to

the hospital before are

much

their

problems

are.

know. Families who haven't used

easier to deal with,

no matter how severe

In this case, they had experience with hospitals,

they expected hospitalization, and this was another reason

hard time

it

why

I

had a

them on our approach. Int.: Why did you mention how inexpensive the treatment was going to be? Do you often use this as a selling point? Dr. P.: No. Here I was very anxious to get them to cooperate with us, so I was being pretty direct and a little bit desperate. But most families do react pleasantly when they find out that it's so inexpensive. The most we charge is ten dollars a week. I think they are more willing selling

to use our services

Int.

:

I

if

they

know this.

have the impression that you caught yourself because you

found yourself painting too pretty a picture of the hospital.

TECHNIQUES OF FAMILY THERAPY Dr.

P.

It's

:

a fact that hospitals are too nice these days.

[396

It

makes

our job that much harder. dr. p. (overlapping)

mrs. w.

:

Well, I

first, first

step

.

.

.

.

.

.

Okay, the

:

dr. p.: First step, find out what's going on, because the problem that's

have

it

making her have

(inaudible phrase)

mrs. w. (overlapping)

we

can solve

to act like this, then she'll

.

I tell

:

if

you,

if

you'd go to our house and just

looked around, you'd know.

we come out tomorrow? mrs. w.: You going to come over to visit? dr. p. Would you rather that we come out tomorrow dr. p.

Okay,

:

shall

:

to look at

your

you came tomorrow morning. (To Paul.) What hours do you work? paul: Eh, tomorrow, from nine till, whenever we get off, usually house, or Friday?

think

I

it

might be best

ah,

if,

.

in

.

.

dr. p.: Okay.

paul: dr. p.

.

from 5:30

.

.

to 7:30.

Okay. Can you come

:

and be a

in at eight

tomorrow morning, then on Friday mrs. w. (interrupting): Oh, he can't do

.

dr. p.:

I

think

paul: Possibly

mrs. w.

:

it's

Well, her battery won't work.

:

your mother

I

:

have an older

for the

.

.

dr. P.:

Ah

mrs. w.

:

.

.

:

.

.

is, if

.

huh?

it,

what you mean? you're very interested in your mother

.

.

:

will ask

But he can't stop work

you

to

make

.

.

.

moment,

a few sacrifices for the

.

he's

all

ever done,

is

make

sacri-

.

.

.

He can't miss his work.

paul (overlapping) dr. p.

out that way.

in here? Is that

mrs. w. (overlapping): That's .

.

.

saying

mrs. w. (overlapping)

... we

.

:

:

.

lives

What do you mean, he's got You want me to start missing work over

:

getting well

who

at least. I think, I think

is,

paul (overlapping) mrs. c. You mean, bring her

What I'm

sister

think that you're as involved in this as

I think, I

mrs. w. (overlapping)

fices

that.

my sister could bring her in.

dr. p. (to Paul)

dr. p.:

.

quite necessary.

paul (simultaneously)

dr. p.:

.

work

late to

little bit

Well,

I

:

Oh,

I

can take

off the

whole day,

don't think that's necessary, but I think

you and your mother, and your

sister

.

.

.

it's

if

.

.

.

you can,

if

[397

Cleaning House

mrs. w. dr. p. :

mrs.

.

.

c.

can come in

.

Mm.

:

mrs. w. dr. p.

Why come in again?

:

.

.

you

if

dr. p.

.

:

.

paul: All dr. p.:

Int.

right,

I'll

.

.

.

in

.

.

.

She's a widow, she has to

:

bring your mother in

.

.

bring her

at,

ah

.

.

.

.

.

.

in.

Why, why in the morning? What's you gonna do then? Then on Friday, we'll go out to the home and try to arrange

mrs. w.

it

.

come

can't

mrs. w. (overlapping)

.

.

She can't do that

:

Well,

:

Well

morning

ah, eight o'clock in the

at,

:

at a

I

:

Dr. P.

time when, ah,

take

you always make a home

it

We

Yes.

:

feel that

than from several hours in the Int.:

You

(Mrs. C. interrupts.)

this, this

we can

get

visit.

more information

that

way

office.

included these

visits right

from the beginning of the

project?

Dr. P. ily

Yes. We're sold on the value of one, though not necessar-

:

more than

We

one.

use the

home

visit to get

a quick assessment of

why we

the situation, not usually as the setting of an interview. That's

go out right away, at the beginning. Also, the home

try to

When

with our notions of functioning.

up a

clean

where

it's

Int.

kitchen,

that

we're trying to get someone to

talk with authority.

We know

what's in

it,

messy, what has to be done. :

I

P.:

you're coming out

would put some pressure on them

Sometimes.

we wanted

was planned

know

should think the fact that people

to see their kitchen

Dr.

we can

visits tie in

We

to clean

day

up.

told Mrs. Willy during the next session

her to clean her kitchen, and our impending

for the

it

after,

had some

effect.

At

visit,

which

least Gloria,

her

daughter, was out there and they were making a stab at the mess.

Home

Int.:

is

admittedly a big feature of this interview.

did you find out about

Dr.

P.

:

It

been well kept

it?

was a very

attractive

until recently. This

The

duration of her dysfunction.

what people wasn't, not

the yard

tell us.

right

home, which looked as

was a

pretty

visit is also

if it

had

good indication of the

a check on the reality of

Mrs. Willy insisted the place was hopeless, but

by our standards.

It

was messy but not unbearably

was overgrown, but there was nothing

weeding wouldn't

What

set to rights.

about her clothes.

We

On

that a

little

the other hand, she

so,

it

and

mowing and

was

perfectly

saw every garment the woman owned and

TECHNIQUES OF FAMILY THERAPY they really were in shreds. She talked about starving, and there actually

Int.

was very

Why

:

little

[398

we found

that

food in the refrigerator or on the shelves.

did you choose that particular

moment

up

to bring

the

home visit? Dr. P. out,

bring

I didn't

:

we'd see

how

it

up, Mrs. Willy did. She said

hopeless things were. So

I said,

"Okay,

if

we came

we'll

be out

tomorrow." Int.:

how

It's

such a rapid sequence. Mrs. Willy

terrible things are at

up on

as

it

if it

were a

home,

if

starts off again

you could only

literal invitation to

come

see,

about

and you take her

out. It's such a

sudden

Then you cut off any argument by saying, "Would you rather we came out to your house tomorrow or Friday?" Then you shift again and say that it might be best if the family came in the next morning. You hadn't prepared them for this at all. Dr. P. That's right. I was working on them to come in. I remember one case where the man refused to come in, so we said, "Well, if you don't want to come in, shall we come out?" and he said, "Oh, no, don't come out." And we said, "All right, then you'll come in?" He said, "No, I won't come in," and we said, "Okay, take your choice, shall we come out to your house or do you want to come in?" And he shift, it

sobers her right up.

:

"Okay,

said,

Int.:

be

111

It's

the real issue

in."

the technique of giving people alternatives that assume

is settled. I

notice that

you don't bother

to deal with the

mother's objections but go on working out the matter of the next meeting with the son.

Dr.

main

P.:

If I'd

stopped to

listen to her, I

issue settled, the issue of

whether she was going into the hospital

The son was the one who would be the one I had to work on. or not.

Int.

Dr.

:

He's trying to hand the job to his

P.:

That's

why

mother." His response it?"

So

I

ask him

miss work,

it

if

in,

so he

was

sister.

say to him, "You're as involved as your

"Do you want me

to start missing

he's interested in getting his

means he

:

Dr.

P.:

I'm

get through in the

too.

bringing her

doesn't

mother

want his mother to

work over

well. If

he can't

get well.

You put a lot of pressure on him there.

Int.

Int.:

is,

I

wouldn't have gotten the

You

just trying to settle the routine business first

we

generally

session.

also get in the first direct statement that he's a patient

Cleaning House

Mrs. c: They want to

you tomorrow,

talk with

that

is

it,

[

399

yes, trying

to get her started.

mrs. w.: You come out there

know, the things are gone

you'll

(start-

ing to cry).

come

dr. p.: We'll

Ah

mrs. c: dr. p.:

mrs.

c.

.

.

.

Now this Now,

:

I

out.

.

.

.

could come in

mrs. w. (overlapping, weeping) to death

dr. p.

MRS.

:

C.

If

.

.

.

.

.

you could noon? dr. p.

:

I

.

.

to take off

You

:

off in

if

more work, and

I'd rather that

could

come

earlier in the

morning than

do you mean, Paul? Do you think the morning, and you go back in the after-

he came

paul: I'm sure they'd

...

.

.

Well, see,

dr. p.:

.

in the afternoon,

you

they'd let

.

off as little as possible.

(overlapping)

c.

nephew

.

would have

.

gonna starve

.

he has to take

mrs.

You'll see that, we're

:

wasn't quite so early, your

it

He

!

dr. p.:

.

wasn't quite so early.

if it

in at nine, at eight

.

.

.

me off

let

you'd be an hour late to work, which I'm sure you

see,

could arrange.

mrs. c: Yeah.

For something paul: Uh-huh.

dr. p.:

dr. p.

:

I'm sure

.

like this.

.

.

mrs. w. (overlapping, crying) there

.

Things didn't used to be

:

like

that

.

.

Where? mrs. c: Well, now, I mrs. w.: At home, they didn't used to, it's hard, you couldn't even believe it! I mean mrs. c: You know what's happening, she can't keep up the house.

dr. p.:

.

.

.

.

.

day and

.

.

He works

all

mrs. w. (overlapping) mrs.

c.

:

And

mrs. w.:

I've

then

.

.

:

.

.

It's terrible!

.

never seen anything like

it!

mrs. c: She can't get the dishes washed and she gets her clothes throwed around and that sort of a scramble of all these things in the

house messed up that

mrs. w. (overlapping)

and

.

.

.

:

.

.

.

Why don't you just come

out there tomorrow

TECHNIQUES OF FAMILY THERAPY mrs. c:

.

.

.

confusion of clothes and dishes

mrs. w.: Paul mrs.

c.

.

.

.

.

[400

.

.

That's right.

:

dr. p.: We're going to have to be seeing

you every day for the next

week or so. mrs. w. They

boy

:

me

just can't bring

in,

my

do

just can't

it,

he's got

to work, he'll lose his job.

dr. p.

mrs.

We,

:

we'll arrange

mrs. w.

Gloria, she don't have

:

dr. p.: I don't think I think

it's

it's

Dr. P.

talks

I

:

you

thought

in here

.

a matter, Mrs. Willy, of just you coming

starts to

.

in,

in.

go here. at

all.

She had

it.

might be a reaction to the cold way the

it

.

.

.

She hadn't been able to get our attention

:

to scream pretty loud to get

Int.

.

get

a matter of you and your son coming

Mrs. Willy really

:

it.

maybe Gloria can

(overlapping): Honey,

c.

Int.

we'll arrange

it,

about "getting her started."

It's

the

way you'd

sister

talk about getting a

patient started in the old days.

Dr. P.

That may be.

:

cue from Mrs. Willy Int.:

It's

you

If

if

it's

the sister

who

takes the

"She can't keep house, she can't cook."

this time:

almost as

notice,

And

they were trying to block you.

sister is still insisting that there's

Gloria could bring Mrs. Willy

when

only one patient,

You

in.

the

she says that

counter her pretty sharply on

that.

Dr.

P.:

sometimes think our most successful therapeutic ma-

I

neuver was getting Mrs. Clapp out of the way and back to her home. mrs.

c.

:

Well,

if

Paul can't get off every day

mrs. w. (overlapping) mrs.

c.

:

.

.

.

we

:



He

could put

it

well,

.

.

.

now listen

.

.

.

in reverse. If I could

come one day and

he the next, would that help you, Paul?

mrs. w.: Clear from

[sister' s

town]?

know how

Mrs. C.)

:

I

don't

mrs. w. (weeping)

:

I

know you

dr. p.

(to

city of

C.) Look,

how do you

mrs. w. (overlapping) .

.

this.

don't, there's nothing like

it

in the

Denver.

DR. p. (overlapping): This

dr. p. :

you're involved in

.

:

is .

.

what we want

to find out.

.

There's absolutely nothing like

what's your contacts with your sister?

it!

(To Mrs.

Cleaning House

mrs.

c.

She's

:

my sister.

know, but how often do you see her? mrs. w. Why, she's been coming up every little

dr. p.

I

:

bit.

:

mrs.

(simultaneously)

c.

two weeks, always

on Sundays, and

Monday dr. p.

Well, I've been coming up every, every

:

come

I

in

and see

her,

on Sundays,

few times that

there've been a

I've

come in come in on I'll

afternoon.

Yeah. Yeah.

:

And I come in and pick up the mrs. w. (overlapping) I don't know mrs.

401

[

c.

:

clothes

.

.

and straighten the house because

.

.

.

what's going to happen

:

mrs. c:

.

.

.

.

that's the thing that

upsets her. dr. p.

What do you

:

mrs. w. (screaming)

c.

a terrible situation that's ever been

It's

:

on?

See, she gets hysterical about

:

mrs. w.:

admit

It is, you'll

happened,

known

Denver.

in the city of

mrs.

think's going

when

it,

don't know,

just, I

it.

when you

you're,

it's

see,

it

it,

just,

just gotta, everything got out

of hand.

mrs. c: She

financial thing,

mrs. w.: mrs.

c.

and

that's

.

she couldn't cope with this

.

why Paul gave up

and stayed

college

.

felt like

now.

that

It ain't

...

:

where she

just got

.

his,

gave up his going back to

.

.

mrs. w.: (Inaudible phrase, weeping.) mrs. c: dr. p.

.

mrs. c: mrs.

.

and stayed

to, to get this job,

.

.

.

and

(overlapping)

c.

can't

Then,

:

seem

to realize that

mrs. w. (interrupting) c.

:

...

that he

mrs. w.: No, he mrs.

c.

.

.

.

Then

.

.

.

inconceivable!

It's just

:

to try to stay there.

seemed

it

mean, even though he meets

mrs.

see

Here's the Kleenex, Mrs. Willy.

:

mrs. w.

.

isn't.

(overlapping)

:

.

.

the

bills,

and

all that,

she just

.

Well, he can't meet 'em.

:

is

he

all

like that didn't help, see, I

taking care of these things

.

.

You're painting a picture that .

.

.

.

isn't true.

and she gets hysterical about these

things.

There for a few months now, she was, she would cook his meals, and she would keep things up pretty good, but she's just getting to the point,

about

more and more she

all this that,

just gets

so nervous and hysterical

up

late lots of times in the

that she just gets

morning, she never dresses

all

day long, she

just

walks around the

TECHNIQUES OF FAMILY THERAPY house and goes on and about these

and things that are

bills

mrs. w. (overlapping) believe

because

it,

know

I don't

mrs. c: Because she

Well,

:

.

.

the

it's

what,

all

[402

to herself all day,

piling

up

most

terrible,

in her

mind. I

just

can't

.

wash the dishes and she doesn't clean the house and she doesn't put the clothes away and she just throws things everywhere and then the house is terrible and then when I can go up and straighten things up, well, when I come back, it's in the same mess, see. mrs. w. (overlapping) She always does what she can. can't

:

dr. p.

Mrs. C.)

(to

:

What's your financial situation?

mrs. c: Well, I'm a widow and that

mrs. w.

it

and

people

who

my home

and

it.

what her contacts with Mrs. Willy

was the point

at

which you had decided that she

this.

had decided

I

sister

have a [business] in

meet.

bills

making

ask the

this

if

shouldn't be a part of P.:

make

She's just barely

:

sounds as

Dr.

I just

When you

Int.: are,

is it,

I

that the sister

was probably one of those

enter the picture after the crisis with the prime function of

continuing the

crisis

and encouraging the symptom. In almost every

somebody whose job it is to stand there and fan the flames. It is usually somebody who handles the crisis by taking sides in such a way as to make things worse, and then deciding that so-and-so has to go to the hospital. The uncle who came up and told the family that something had to be done about Mrs. family where

crisis

occurs, there seems to be

Willy played this role, and Mrs. Clapp did too. Int.:

Do

you often

find that there

is

some person who has

to be

taken out of the picture in order to get some progress?

Dr.

P.:

Yes. The

new

people,

family during healthy periods,

come

who had no

real function in the

in during the crisis

unwittingly by infantilizing or blaming the patient.

them out of the way

Nobody can

to get the patient

clean her kitchen

if

back

and continue

You

it

have to push

to reasonable functioning.

she has her sister standing there telling

her she ought to go to bed or to the hospital. Int.:

The

idea that there

is

somebody who

going and should be taken out of the family idea that there

is

is

keeping the mess

such a change from the

something wrong with the patient and that he should

be taken out of the family. Yet the formal process

someone

is

out. Here,

how

did you

know

is

that the sister

similar, in getting

had no

real previ-

Cleaning House

You had

ous function in the family?

very

little

403

[

information about her at

this point.

Dr.

P.:

knew

I

and that the

that she didn't live with Mrs. Willy

had been greater during the time of the illness. It was obvious from the sister's attitude that she felt it was her job to come down and

contact

help Paul put his mother away. Int.

That seems

:

to

be the

agreement between the two mother. The

two

women

There doesn't seem to be any

about

P.

Paul

failing his

is

even take a neutral stance such

don't think she

I

:

knows what she

one purpose, to put her crazy

You come

Int.: this

is.

sister

thinks. She's

"These

as,

and ask her what her

right out

P.

now

Well,

:

that I've got the contract to

established with the family, I'm going after

would

down

here

away.

Why didn't you deal with her by ignoring her,

Dr.

I

how

aren't getting along."

Dr. for

sister doesn't

alliance.

as

justification for

you did before?

come

into therapy

more information.

I

thought

narrowed things down to the nuclear

try the sister before I

pair.

Int.: You're looking forward to dealing with the mother and

son?

Dr.

P.

:

That was the

meaty

big,

issue.

Mrs. Clapp seemed more

like hors d'oeuvres.

She gets right back to how

Int.:

you decide Dr. Willy.

So

Int.:

turned her

You

is.

Why

did

I

off.

wouldn't consider

relative

No,

P.:

Int.:

sister

She was fanning the flame again and upsetting Mrs.

you can from a Dr.

her

to stop her at this point?

P.: I

terrible

I

if it isn't

it

useful to get all the information

being given in a productive way?

wouldn't.

notice

you switch

to the subject of her finances. Mrs.

Willy says later that the sister paid for a divorce. Did you think the

was worried that she might have to contribute to the therapy? Dr. P.: I wasn't thinking along those lines, I was just groping. Money seemed to be a topic that everyone enjoyed talking about. sister

Int.:

It

does seem the only topic that ever effectively competed

with Mrs. Willy. dr. p.

mrs.

(overlapping, to Mrs. c.

:

No, no.

I live

alone.

C):

Does anybody

live

with you?

TECHNIQUES OF FAMILY THERAPY mrs. w.: She's

just barely

.

.

[404

.

Do you have any children? mrs. c. Two grown daughters. dr. p. Two grown daughters who are married. dr. p.:

:

:

mrs. w.: She's

much

just barely

week,

and, I think she's going to lose

I don't.

mrs. w.: Well,

I do.

make my

I

any money,

bills, I

put

let's

it

make

everything meet, but I don't save

that way.

Who does?

dr. p.:

mrs.

come up so her home this

fact, she's, she's

this winter.

mrs. c: Well,

mrs. c:

me

to see

making, in

c.

No, nobody does.

:

mrs. w.

She paid for a divorce for

:

dr. p. (overlapping)

anybody mrs. c:

It

else I

seems

MRS. c:

:

know of .

.

as far as saving

.

is

.

.

up

tears these things

her hysterical, the

little girl

all

.

.

nice!

things around and then the dishes pile

cause she goes on

.

.

Her house

mean, she

I

and, and she

Things don't seem to be getting better for

:

like

mrs. w. (loudly)

me

just got to

day long

just

about

all

day long and throws

up and then that makes where she couldn't be-



that,

about these terrible

things that are going to happen.

dr. p.

Now, now

:

paul: Mara, the

the girl

— (To Paul) What's your

little sister,

we have

a

.

.

sister's

name?

.

mrs. c: Thirteen.

paul:

.

.

.

a married

mrs. w. (wailing) dr. p.:

:

sister.

She's gone,

I'll

never see her again!

Tamara?

paul: Mara. dr. p.:

Mara?

paul: Just Mara. dr. p.

(spelling): M-a-r-a?

paul: Right. dr. p.: That's a pretty name. I've never heard that before.

paul: Uh-huh.

mrs. c: Well, Mara got so she, she would rave like this all day long. mrs. w.: She would go to the neighbors all day long and stay .

mrs. c: She'd close the

.

.

blinds, she stays in there all alone, she won't

do anything, she won't, ah, have the going on all day long, all over the house

read, she won't

radio, just

that terrible

.

,



Cleaning House

MRS. w. (overlapping)

You'll think that they'll lock us both

:

the rest of your lives dr. p.:

Who?

mrs.

:

c.

dr. p.

:

This

little girl

if

you ever come out

405

[

up

for

there.

just couldn't stand that.

Who should we lock up?

mrs. c: So Mara would go over to the neighbor's and long with the

So now, Mara

dr. p.:

she just couldn't stay in the house with

little girl,

her. Well, then Paul is

day

stay, all

had that

to face

when he comes home.

staying with your brother.

mrs. w. (weeping): She's

just

down

know

there, but I

Arlene, she's

going to send her back on the bus naked.

mrs.

c.

No, dear, she won't.

:

mrs. w.: She

And

dr. p.:

Your

mrs. w. mrs.

:

c.

this

your brother, or your

sister that she's

with?

A brother.

mrs. c:

dr. p.

is

My brother.

mrs. w.: dr. p. :

will, too!

brother.

She

:

ain't

gonna put up with

Did, ah, your brother :

know

her.

she was coming?

They were here Sunday and took her.

mrs. w.: Took her.

And took her. Uh-huh. mrs. c: He talked with Agnes [Mrs.

dr. p.

:

dr. p.

:

How did they like the idea?

mrs. c: They talked, and he about three hours and he

mrs. w. (overlapping) mrs.

c.

W.'s name],

:

.

.

.

.

.

Mara is

:

.

.

.

and he was shocked to

mrs. w. (overlapping)

Well,

:

and talked with Agnes for

sat there

it

.

find her in this mental state

ain't

.

.

.

only that, he's just shocked!

(Sobs.)

mrs.

c.

:

He

Mara

says he'll take her back with

on her you know.

couldn't concentrate

couldn't cope with

it,

mrs. w. (loudly, tearfully)

:

Two

him and

studies or anything, she just

years ago that border, that flower

border was cleaned as clean as that table. it,

and

tu-,

and

iris

was

because

that'll help,

set in there,

on

that

You

couldn't believe

whole

side.

Now

it's

that high with weeds. (Weeping.)

dr. p.

:

Who, who

takes care of the, of the grounds?

mrs. w. (weeping)

mrs. c: Well, the

mow

it,

:

Nobody's taking care of sister

it,

it's just,

comes down and mows

and when Paul has time, they,

I

it,

mean

.

just

the girl .

.

.

.

.

would

TECHNIQUES OF FAMILY THERAPY MRS. w. (weeping, overlapping)

:

[406

I just can't believe

It's terrible,

it,

I'm just a mess!

W.)

(to Mrs.

dr. p.

mrs. w.

:

She

lives

Where does your

:

older daughter live? (Pause.)

out in [town].

Out in [town]? Does she live near you? mrs. c: Out in [suburb]. mrs. w. (tearfully): She's (inaudible words).

dr. p.

:

start

dr. p.

:

mrs. w. dr. p.

:

mrs. w. dr. p.

:

mrs. w.



the battery wouldn't go yesterday

Ah, :

.

Yeah, but her, the battery wouldn't go Well, he's, he's not with her right

I

.

.

.

does her husband do?

Where :

.

she's married?

What :

.

She's got her problem

now

.

.

.

he?

is

don't know.

Are they separated? mrs. w. Oh, he just takes out, he gets mad and goes off. dr. p.: How do you feel when your son-in-law leaves like this? mrs. w.: They're gonna starve to death, that's what's gonna happen

dr. p.

:

:

to them.

Int.: This scene tion

badly off she

is,

wild.

You've been trying

is

and she

is

be blocking them with a

carrying on in the background.

series of factual questions,

tionnaire, except that the questions are completely

you

to get the informa-

what happened to make Mrs. Willy get sick, give you the information they want, which is how

you want, which

and they're trying to

is

You seem

to

almost like a ques-

non

sequitur.

Were

really interested in the answers?

Dr.

and

I

P.

:

knew

tions. I

No.

I

was

getting tired of Mrs. Willy screaming in

that I could get her to quiet

down by

my eardrums a rest. But I "How do you feel when your

wanted to give

my

ear,

asking simple ques-

fouled up on the last

son-in-law leaves?" I when I asked, didn't know any better then, but I have since learned that asking people who aren't functioning how they feel usually leads nowhere. It only gets them to act crazier. If you ask about the facts, they are much more apt to be reasonable. We now instruct our secretary, when she takes infor-

one,

mation from the families, to ask the patient tions that are appropriate to

him and not

at least

one or two ques-

to accept the answers that

members give. I did go in one day and find her desperately "Where do you live?" to a man who was screaming and beating

other family asking, his

head against the wall, but

in general

it

works quite well.

Cleaning House

The tone

Int.

:

Dr.

P.:

of your voice that

I'm deliberately using

Int.

Dr.

She

:

this

is

hadn't heard

equality.

was

I

:

and

to talk very softly

tone with Mrs. Willy.

little girl's

really interested in

right

it

This

Int.:

are shouting and things

that in the midst of this dreadful morass,

you take time out to ask about the

I

here.

Yes.

P.:

P.

flat

407

down when you do that?

settles

Int.: What's amusing

Dr.

so calm and

when people good way to act is

We've learned

are getting out of hand, a quietly.

is

[

and

shifts

They have

it.

It

name.

was an odd name. But

wanted to be sure of

I

it.

you from the position of expert

to

tell

you the

also

to

one of more

suddenly a more social

spelling. It's

interchange.

Dr.

P.

I'm

:

fairly relaxed

with families.

have to get some enjoy-

I

ment. dr. p.

I've

:

never heard of anybody starving to death.

mrs. w. (loudly)

Well, you're gonna hear

:

this time,

it

it's

gonna be

in the papers!

dr. p.: Well, we've got a social worker, Mr. Flomenhaft,

who

I

think

can prevent that from happening.

mrs. w.

:

No, they

told

me

out there

.

.

.

dr. p.: But they can.

mrs. w.: dr. p.

.

.

they wouldn't help me.

.

(loudly)

mrs. w.:

:

When

Ah

.

are

you comin', are you

.

.

actually

mean

that you're

comin' out there? dr. p.

:

Yes, we're coming out.

mrs. w.:

When?

Coming out Friday morning. mrs. w.: What day is this?

dr. p.

:

dr. p.

:

mrs.

c.

dr. p.:

This :

is

.

.

.

Wednesday.

Wednesday, honey.

We can't come out,

mrs. w. (overlapping) dr. p.:

We can't

No,

there'll

:

ah,

Just

tomorrow.

one of you?

be three of

us.

A

nurse, a social worker,

and me.

In fact, you'll meet the nurse and the social worker in a few

minutes, they're at a meeting right now.

Int.:

This exchange about the starving

is

a curious one.

The

mother says they're going to starve to death, and instead of ignoring

TECHNIQUES OF FAMILY THERAPY been doing, you

her, as you've

saying, as

Dr.

she could understand

if

P.

literal truth

of what she's

how crazy she's being.

me in

flamboyant fashion or I won't understand you." I'm

her to stop acting crazy. In the next line you switch and accept the reality of her

Int.:

statement.

Dr. saying

her on the

think she can. I'm telling her, "Look, don't talk to

I

:

this exaggerated,

telling

call

[408

You

tell

her your social worker can keep her from starving.

There I'm

P.:

telling

her that

that she needs security,

is

I

know

that

what

she's really

and that we're there to provide secu-

rity.

Int.: But you don't put

guage to talk back to her.

it

plainly like that.

think

I

it's

You

own

use her

lan-

and the rapidness of the

that

succession that get her. She sobers right up and starts asking you about the visit you're going to make.

Dr.

P.

Int.

:

Yes.

:

How

we

are

going to go about giving her

this secu-

rity?

a sequence of two parts. The

It's

you present what you say

literally,

I'm not going to accept

agree that we're speaking metaphorically,

Dr. P. ing her a

You make

:

:

:

back

support you."

No,

it isn't.

suppose

I

I

am

and

I felt I

was

just ridicul-

agreeing with the family that

making

with her that she's not getting what she needs. this

If you'll

to earth.

the literal presentation of poverty she's

about

it.

not the same as saying, "Stop acting crazy."

It's

Dr. P.

I'll

sound very involved.

trying to bring her

little,

Int.

it

part says to her, "If

first

it

didn't

is

We

crazy, but agreeing

were communicating

have to do with food, or even money, but secu-

rity?

Int.

They

:

What you do

say, "I never

is

to follow with what the family never does.

heard of anyone starving to death," but they never

add, "If you start to starve,

I'll

take care of you." I think that's

why

you reach her. mrs. w. (loudly): Well,

111 tell you, I can't tell

you how

this

hap-

pened. dr. p.: Well,

find out

let's

MRS. w. (loudly)

:

what

sort of things you're worried about.

That home was nice

there, even, ah,

even them

two years ago, it, ah, you couldn't believe it, I had my clothes closet, up on the shelf I had all my hats and my pocketbooks, my clothes, then I had, ah, just some, ah, you know, old checks and things I had written down there.

Cleaning House

dr. p.

:

[

409

Mm-hm. Ah, what size house is it?

Mrs. w.: (Pause.) There's two bedrooms and a mrs. c: Three, you might say. They've

word)

.

.

.

made one

into a (inaudible

.

paul (overlapping) (Inaudible words.) mrs. w. (weeping): I say, I just, I just can't stand it. dr. p.: How old is, how old is your (laughter? Your mrs. w. She's about a year younger than he is. paul: No, the oldest daughter, Mother. mrs. c: She's older, honey, Gloria's older, Gloria's :

oldest daughter.

:

dr. p.

:

older.

How old is Gloria?

paul: Thirty-five.

mrs. w. (overlapping)

:

Oh,

that's right.

dr. p.: Thirty-five?

mrs. w.:

I

was

dr. p. (to Mrs.

thinkin' she

W.)

:

was

.

.

.

Now, how many

times have you been married?

(Long pause.) mrs.

c.

Well,

:

tell

him, honey.

mrs. w. (tearfully)

mrs.

c.

:

I

don't

want

to.

Well, he wants to know, this

:

dr. p.: I need to

know

this. I

all

mean,

I

helps.

know your

son's

name

is

dif-

from yours. mrs. w.: I was married to his father. (Pause.) We nearly starved to death when, when they was little. We lived 'way down there in the dust bowl down there in the drylands, you know, during those ferent

five years, in that

dr. p.:

awful dust

.

.

.

Where?

Down at [town in nearby state], dr. p.: Down at [town in nearby state]. mrs. w. You know, where that mrs. w.:

.

:

No, I'm from Georgia, I've mrs. w. Well, you don't know mrs. c. It's up near [town].

dr. p. :

.

:

.

.

.

just

been here a couple of months.

.

:

Int.:

Did you already know how many times Mrs. Willy had

been married?

Dr.

knew

was several times. I was starting to focus on her now, trying to make some sense out of her confused life. Int.: Did you suspect that this subject of marriage was so loaded? That was a long pause there, and the tone of her voice when she finally answers is very faint and solemn. Dr. P.: Four marriages and all that trouble, it would make me P.:

I

only

that

it

TECHNIQUES OF FAMILY THERAPY solemn

At

too.

least I

found out that

was one subject

this

[410

would

that

sober her up. Int.: I take

you don't mind

it

you

yourself. If they ask

Dr.

if

you're married, you'll

Yes. We'll sometimes

P.:

telling patients tell

something about

them you

about our

tell stories

own

are.

families

or problems we've had with our kids that are similar to theirs. In long-

term psychotherapy ilies

in a crisis, I think

it's

human

about me, to be more

There seems

Int.:

much about

don't reveal so

I

to

necessary to

myself.

let

them know a

hit

them

be a need to

the knowledge about yourself. Also,

Dr. into

P.

right

them.

I

I

if

to

more common

I

don't do, and that

think a professional attitude of mutual respect

Int.

You

:

for

fam-

is

to get

first

names

is

degrade

far better than

exist.

don't want to be too condescending with your patients,

same time you don't want

at the

yourself and

their children are present, tends to

a pseudo-friendliness that doesn't

and

it's

is

think that calling older patients by their

them and,

infantilizes

think

away and de-

respond when asked about themselves.

names.

first

I

Yes. But there's one thing

:

more

little

with them.

velop a quick relationship, and one technique you use

ily therapists to

But with fam-

to be too free

and easy, you want

keep a good balance.

Dr. P.

I'd say the relationship I try for

:

doctor-patient relationship. ship with

Int.

all :

the mystery about

That can

a pedestal, and dealing with a

Dr.

It's

P.:

it's

is

similar to the classical

not the usual psychotherapy relation-

it.

inf antilize the patient. It also puts the therapist

very hard to

sit

up

there, I should think,

if

on

you're

crisis.

In a

crisis,

I'm serving the family better

position of expert, the doctor they

mysterious father image. I'm too

come

much

to, rather

if

I'm in the

than some sort of

of the authority figure as

it is.

You don't have to add to your authority, the crisis does it for you. You have to keep them from adopting an attitude of helplessness with you. This gets back to the way you use "infantilize." You Int.

:

seem to see it as equivalent to "making a person act helpless." Dr. P.: Yes. When we say we don't want to infantilize somebody, we mean we don't want him to become too dependent on us as father or mother

figures.

Int.

:

Or power

figures.

So you present yourself as an expert, and

same time you

at the

them

treat

the time. Otherwise they won't

like equals,

work

Cleaning House

[411

and you play with

this all

hand

for you. They'll

the re-

all

sponsibility to you.

Dr.

P.:

It's

a delicate balance and one

we

don't always achieve.

A few times we've built up such an enormous transference reaction that it's

created problems.

Int.

"Transference"

:

is

another word that therapists don't always

What do you mean by it here? Usually I mean feelings that are

use the same way.

Dr.

P.:

from previous

ferred

Do

more of pa-

relationships, but here I'm thinking

an ideal parent upon

tients transferring their expectations of

Int.:

inappropriately trans-

you see a whole family

us.

as having transference in this

sense?

Dr.

Yes, but I'm thinking more of individuals in a family.

P.:

We've found that

member

there's a great danger in letting

establish too strong a relationship with

and I'm the doctor,

talk a lot,

others. I'm the

ways

us. Since I

me more

than to the

to

and family

to look at transference,

some problems about

raises

come

any one of

one who has to be most careful about it.

Int.: There are two

work

this tends to

any individual family

One way

it.

to see

it is

that the indi-

vidual has a set of expectations from the past which he carries into

therapy and pins on the therapist. Another therapist promises

more than he means

him dead same on the

tient takes

seriously

seem the

surface,

way

to or

can

and hangs him on

and

I

to see

is

it

deliver,

that the

and the pa-

The phenomena

it.

wondered whether you were think-

ing of transference in a family setting in terms of this second thing.

Dr. P. to in

many

straws,

and clutching

at

and we probably do hold out some straws camouflaged

as

ways. Families in

We

branches.

but

I'm sure we do promise a great deal more than we mean

:

we do

don't try to cut into their magical expectations too early,

try to clear

them away before we

got magical expectations the get

are desperate

crisis

first

day,

all

let

the family go. If they've

the better, because then

some hypnotic phenomena and a good placebo. But

attachment get too strong,

it

dr. p

:

Where

did

I

we

let

the

does create problems.

Mrs. w.: The dust storms are so bad believe this, but

if

we

got pictures

you come from,

.

.



that, that

.

originally?

I bet,

you won't

TECHNIQUES OF FAMILY THERAPY mrs. w.

And my

:

baby,

I couldn't

even see

it,

on

my lap,

[412

for the dust

storm.

Where did you come from originally? mrs. w. [Name of state.] dr. p. Where in [state]!

dr. p.

:

:

:

mrs. w.: Oh, around

[city].

How old were you when you came out here?

dr. p. :

mrs. w.: Eight. dr. p.

Eight?

:

mrs. w.

My dad was

:

real well

What

dr. p. :

mrs. w.

and

my mother

a good provider and

had

me

dressed

all.

did your father do? Farmer?

Truck, mostly.

:

dr. p.: Truck?

mrs. w.

:

Farm work and farm.

mrs. c: Farm. dr. p.

How many children were there?

:

mrs. w.

Her

(overlapping)

dr. p.

.

:

dr. P.: c.

.

.

:

.

You, your

Bob ... and your

mrs. w. mrs.

Three.

:

sister

.

.

.

.

.

brother

down

in, ah,

down

in [state].

Uh-huh.

:

And he's a, a success! dr. p. You the youngest, oldest? mrs. w. Uh-huh. And he's the youngest. mrs. w.

:

:

:

mrs.

c.

dr. p.

He's the youngest.

:

He's the youngest.

:

mrs. w. (loudly): Yes, dr. p. :

Which

mrs.

:

c.

my brother is a big success!

of you two

is

the older?

Hm?

Which of you is the older? mrs. c: Which? (Laughing.) Oh,

dr. p.

:

dr. p.

mrs. c: I'm older, I'm

mrs.

am.

Oh.

:

dr. p.

I

Uh-huh. You're

:

c.

five years older.

:

five years older?

Uh-huh.

mrs. w. (loudly) she does

:

it all

dr. p.: Well, now,

Now

she's got a nice

home and

it's

well kept

and

herself.

you have a nice home,

too, don't

you?

mrs. w.: Oh, no! dr. p.

:

Well, you said

it

used to be nice, so

it

must be a nice house.

[413

Cleaning House

mrs. w.:

mrs. c:

any more,

It ain't

messed up and throwed around (inaudible phrase).

It's just

MRS. w. (overlapping)

mrs.

c.

It's terrible!

:

the confusion that she can't keep these things up,

It isn't, it's

:

everything. I (starting to cry).

just

it's

see.

mrs. w. dr. p.

:

Well,

terrible, it's

it's

beyond

all

.

.

.

How long have things been so bad? I know you

:

been perfectly

way about

feeling this

how

a year, but

terrible for

say that they've

long have you been

everything, that everything

you're going to starve and

.

.

was

.

mrs. w.: Well, the borders was, ah, pretty clean, and the

back yard, we used to keep mrs.

(overlapping)

c.

:

ba-,

and the

mowed.

Honey, he wants

How

started worrying?

it

terrible,

know, how long since you

to

long since you

came

to

my

house and

stayed a while?

mrs. w. mrs.

c.

dr. p.

:

It's

:

gonna starve,

Paul's

been a year,

you

.

.

.

a year.

Paul will never starve.

:

mrs. w. (loudly) dr. p.

just

I tell

Look,

:

mrs. w.:

I'll

bet

I

:

Yes, he will!

feed you, before you starve.

you would! You want me

to

come over your house

for

supper? (Everybody laughs.) dr. p.

Tonight?

:

mrs. w.

:

Yeah.

dr. p.: Okay.

mrs. w.

:

But your wife wouldn't be expecting

dr. p.: That's okay. (Mrs.

MRS. w. (tearfully)

:

I

W.

us.

sobs.) I'm not going to let

you

don't believe that. I can't understand

starve. it,

it's

never happened in the city of Denver. Never. People have been

drownded, they've been burned up in airplanes, they've been

burned up

and

in houses,

:

on the

street

know what

they do,

why

they

naked.

.

.

.

:

p.

Int.

and what, when the hotels burn

Ah w. Do you understand that?

dr. p.

dr.

hotels,

their clothes burn, I don't

all

don't go out

mrs.

and

:

:

Yes,

I

understand.

When you

ask Mrs. Willy for supper, what are you trying to

do?

Dr. starving,

P.:

I said I'd

feed her before she starved. But she wasn't

and neither was Paul, and we both knew

it.

So

this

was a

TECHNIQUES OF FAMILY THERAPY reductio ad

absurdum

[414

that effectively stopped the talk about starving. I

was expressing as clearly as possible my faith would provide her with whatever she needed.

that Paul, with our help,

same thing you did before when you said the social worker would take care of her. Again it's in a sequence of two parts. First you say jokingly, "I'll feed you before you starve," meaning, "Don't be crazy." Then you come in without joking and say, "I'm not going to let you starve." Dr. P.: I'm bringing her back to the reality of, "No, of course Int.

the

It's

:

you're not coming over to care of you

all

house for dinner, but we're going to take

the same."

She

Int.:

my

you

tests

make

to

sure you

mean

and then

it,

starts

going on about the hotels burning down.

Dr. P.

I

:

think she was responding genuinely to me, even

using that same crazy language.

When

she's

if

she says, "It's never happened in

the city of Denver," she's really saying, "It's never happened that any-

one has promised

me

this." It's the

way someone

will

weep when

he's

offered a bit of consolation.

Int.: There's an impressive

moment

when she says, "Do you understand do." The whole tone of the exchange

at the

that?" and

end of that speech

you answer, "Yes,

I

suggests that you'd really gotten

together.

Dr.

P.:

I

we

think

communicating, that

I

had. She was agreeing with

was beginning

me

that

to get the message in

we were crazy

all this

talk.

Int.:

She's pretty straightforward.

Many

psychotics would say,

"There's some understanding in China," or something like that. After all

the confusion that went before,

come through Dr. P.

mrs. w.:

and dr. p.:

must have been a

relief for

her to

so well. It certainly

:

it

If all

you was

was. in a hotel

your clothes

.

.

and

all

the people out, hotel burned,

.

They wrap themselves up

in blankets. (Pause.)

mrs. w.: Well, where do they get any more clothes

if

they're

on a

trip?

dr. p.

:

Go down to the Salvation Army.

mrs. w.: Well, they wouldn't have enough for a whole so darn

much nowadays. Did you

ever go

down

—they charge

there?

Cleaning House

same sequence

Int.: Here's the

again.

[415

She asks what people do

they don't have any clothes, and you say, "They

wrap themselves up

if

in

blankets."

You

we were

Dr. P.

:

Int.

Then comes

:

This time

the second part, where you're not quite joking.

down

say that they can go

already presented your outfit as

Dr.

P.

You're

:

right. I

Her responses

Int.:

really joking.

Army. After a kind of Salvation Army.

to the Salvation

all,

you've

hadn't thought of that.

are mixed, too. She's pulling you

down a

kind of logical absurd path. She asks where do they get more clothes, but in such a sane way. Then she quibbles with you

humorously when she says the Salvation

Dr. P.

We

:

were

still

together. I

Army charges

legalistically

but

too much.

had cut through

this

crazy stuff

and we were talking through a joke.

dr.

(coughs)

p.

you.

How

Now,

me

some more about many times have you been married? And when was Mrs. Willy.

:

let

find out

the last time?

mrs. w.

:

Well,

I

married his father when

You stayed married to him for

dr. p. :

mrs. w. (low voice) dr. p.

:

Twenty

What happened?

:

mrs. w.: Yes, in

Is

I

was nineteen.

a long time?

years.

he living now?

[state].

dr. p.: Is he married again?

mrs. w. dr. p.

:

Yes, he married a

:

woman up there.

Did he leave you?

mrs. w.

:

Huh?

Did he leave you? mrs. w. Well, he was workin' up here at a Denver, ah, at this [hospital] as a janitor for a hundred a month, and there was five in the family, we couldn't live on that. dr. p.: Your son's making a hundred a week. And there are just two

dr. p.

:

:

of you.

mrs. w.

:

A

Then.

hundred a month we couldn't

on a hundred a month. dr. p. Okay. But you managed. mrs. w. No, we didn't manage. :

:

dr. p.

:

What happened?

mrs. w.: Well,

I

had

to

went

to

my folks

.

.

.

live,

we

couldn't live

TECHNIQUES OF FAMILY THERAPY You sound

Int.:

drawing out the

so sympathetic to Mrs. Willy,

hard

details of her

present to remind her that her son

life.

how she can complain when things were so much worse then. toms

was

For some reason

:

at that point. I think

reliving the

same

you're

back to the

shift

about being so badly

off

the need to get back to the

I felt

was beginning

it

when

making a hundred a week. You're

is

really asking her

Dr. P.

Then you

[416

to be clearer to

situation with Paul that she'd

been

me

now

symp-

that she

in with his

father.

Int.

But that's not what you say

:

Dr. P. tion of

I'm implying that

:

if

to her.

she's miserable

now,

it's

not a ques-

money.

Int.

:

She goes

right

back to the past again and again you under-

cut her complaints by saying,

Dr. P.

:

Int.:

You might

of getting

Dr.

That's a reassurance, too.

someone P.

also have

woman, when

along. This

"You managed." resisting her ability to pull

you

she does go sane, has a very skillful quality

to feel sorry for her.

You may be right.

:

been

It's

clear I liked her.

dr. p.: Here are Mr. Flomenhaft and Miss

them to come in. (Dr. P. goes MRS. w. (Inaudible phrase.)

De Young.

Let

me

ask

out.)

:

mrs.

c.

mrs. w. MRS.

Well, that's

:

It ain't fine.

:

(to Paul,

c.

fine.

low voice)

:

He's giving her the psychological treat-

ment right now. See what I mean? mrs. w. He'll give Paul one, if he comes out there mrs. c. No. mrs. w.: Now, how're you gonna get me up here tomorrow? mrs. c: This is the way they talk to them. You're gettin' as good a one right now as we had today. .

:

.

.

:

paul: (Inaudible phrase.) dr. P. (entering with nurse

DeYoung and Mr.

Miss miss oeY.

mrs. w.

Dr.

:

P.:

:

How

and

social worker)

:

Okay. Now,

Flomenhaft.

do you do.

Hello.

Paul and the

sister are getting together

here about what

treatment Mrs. Willy's going to have. With her overhearing course.

this is

it,

of

[417

Cleaning House

them when she says, "He'll give Paul one, if he comes out there." That's the first remark any of them have made pinning something on Paul. Now, when you bring your team in, is it usual for you to introduce them in the middle of an interview? Dr. P.: No. Ordinarily, two of us will take the family and we Int.

She gets back

:

at

member

won't call the third

ringing and

till

I

Miss DeY. P.

by the

feeling irritated

an interview.

fact that

so long to get there. There was another reason

Kal and Carol took

why

I

it

was kind of "Come

Int.

When

:

in

and see what

a family comes

in.

yet seen,

caught."

I

how do you

in,

wanted them

we had

This was the most interestingly psychotic family that

and

in this

You did look pretty distraught.

:

was

I

:

But

I

I'd ever gotten out of a family in the first part of

Dr.

the end.

was needing reinforcements. My ears were was floundering. This was about as little information as

was alone and

interview I

of the team in

decide which two will

take them?

As I think I said before, we more or less take turns, with the third member observing. If I'm behind the screen and something comes up about drugs, I'll come in and deal with it. Or if something Dr.

P.

:

comes up about Int.

put

this

social agencies

When the project was

:

him out. organized, why did you decide

and Kal first

is

there, we'll bring

to

kind of team together?

Dr. P.

It's

:

partly the crisis nature of the work.

moving

get things

quickly,

it's

working on the case. There are

we go from

more than one person so many immediate decisions: where do

here, when's the next appointment,

background

in public health,

have to

helpful to have

A team like this provides

contacted.

When you

Kal

is

which agency should be

a variety of expertise. Carol has a

a social worker, I'm a doctor.

We

each contribute specific areas of knowledge.

Mr.

F.

traditional to

Int.:

I

:

I

think another reason

why

a team was set

up

that

it's

would almost require

all

is

have a team in a hospital.

was thinking

these different

skills,

that your emphasis

because you go outside the

office into the lives of

these people in a very practical way.

Dr. P.

:

Yes. Kal and

I can't

go out to some woman's house and

spend a couple of hours cleaning up her kitchen. Her husband would

come home and shoot say

"Come

off it!"

we

can't do.

And

us. Also, Carol's motherliness

with a beatific smile on her face

the

way Kal can manipulate

and her

is

ability to

the sort of thing

social agencies

is

a joy to

TECHNIQUES OF FAMILY THERAPY behold. His function

is

[418

very important, because right from the begin-

ning of therapy, we're trying to get the family out of therapy. Anything

beyond the acute Int.

group

crisis,

we

try to

hand over

to other social agencies.

This seems to get to the heart of what your goals are.

:

only trying to deal with the immediate

is

Your

and restore the

crisis

family to previous functioning.

Dr. P.

Our goals

:

are very limited.

We

over. There's one exception to this, which

make a family House of Cards

don't try to

we

call the

type of family, in which there never was a real contract between the

members this type.

to begin with. Mrs. Willy

and her son are a good example of

Here we helped them write a contract

for the

time, so

first

they had something they didn't have before. But in the majority of

we just try to get the family back to its previous way of life, no matter how peculiar it might seem to us, and then leave them alone. cases,

We're pleased

if

our project.

that's outside of

successful case

who

they want long-term therapy for further change, but

sometimes say to people that our most

I

was a married couple, two paranoid schizophrenics,

lived peacefully supporting each other's delusions

country. Every time

some neighbor came and

built a

way

out in the

house too near

move further out. This couple had a child who was when we saw them. They had apparently survived this

them, they would five years old

experience but weren't letting the child go to school. Otherwise, they

were doing

fine, until

the wife's parents tried to get her to take charge of

more paranoid schizophrenic sister, who was just coming out of the hospital after ten years. Then the wife started having delusions that people were spying on her from airplanes and looking down the her even

chimney.

We

want the

responsibility of the sister,

encouraged the couple to

tell

and

symptom. Then we did something which

umph.

We

I

the parents that they didn't this relieved the

think was a therapeutic

convinced these people to send the

school three days a week. the church every Sunday,

We

also got the wife to

and

finally

immediate

little

girl

tri-

to nursery

go and play bingo

at

she was even able to go to the

grocery store by herself. But the funny incident that happened at the

end of treatment

—was a

—which took only

that they finally broke

home

visit. It

wife called nice people,

was

all

me up and

three visits over a two-week period

down and allowed Kal and Carol

very polite, except that after

it

was

to

make

over, the

"Your nurse and social worker are very but would you please tell them to stop circling our house in said,

[419

Cleaning House

and go home?

that helicopter

ceiling so they can't see

My

husband

me

tells

there

through even with radar, but

is

lead in the

wish you'd get

I

them away because they're upsetting me and I can't hang out my clothes." So I said I'd keep them away from her house and we never heard any more about it. I thought it was a good sign that instead of the

enemy

was now only

airplanes circling the house, there

with a friendly nurse and a social worker.

A

paranoid about us but not about anybody

else.

continue to be exposed to the outside world,

still

And if the little girl can she may survive. So we're

unusual to hear a therapist take

It's

they were

later,

one of our successes.

willing to count this as

Int.:

year

a helicopter

family therapists feel that

if

this position.

they haven't broadened

Some

for each indi-

life

vidual in the family, they've failed.

Dr.

The family

P.:

pattern here

before, but that wasn't the

problem was that

suit us

when we

was being threatened.

this pattern

try to

as

problem the family came to us

job was to remove that threat, not threaten trouble

now

almost as sick

is

it

We

it

for.

was The our

felt that

even further.

We

get into

change completely family patterns that wouldn't

but which other families manage to live with quite well.

Int.

Do

:

you

in helping a family

Dr. P.

We

:

feel that

your intervention has any long-range

cope better?

hope that the

be a turning point, and that

crisis will

with our help and the help of the other agencies will achieve

effect

a better level of functioning. But

if

we

refer

another

them

to,

they

crisis arises,

we

expect to see them again. Int.

:

Dr.

much

Do

P.:

:

find that this

they've had a

If

We can

easier.

Int.

you

The

criticism

that a family changes

and

gets out than

period. But in

if

it

us,

it's

with a couple of telephone

most often aimed

at brief

methods

is

with? usually calls.

that they

but these changes are superficial and don't

good evidence

pretty

crisis is easier to deal

good experience with

often handle

may produce changes Now, some

second

more

if

is

accumulating to support the idea

the therapist gets in

he keeps the family

most therapy of

last.

in

and makes a change

weekly treatment over a long

this sort the patient will

come

in for a

recharge after a certain period of time. There will be a recess and the patient will

come

this sort of thing

Dr.

P.:

in again because of

some new problem. Do you

find

happening?

We

do.

We

hope there won't be future

crises that the

TECHNIQUES OF FAMILY THERAPY

[420

we make it clear that we want to be called. What we don't like is when families come in for a touch of magic from us without having any acute problems. And we get concerned when there are severe or recurrent crises. We try to make a new

family can't handle, but

there are,

if

or better referral then.

You

Int.: start

don't

them again Dr. P.

on your own

for a few sessions

initiative

and then

let

ever bring people in and

them go?

No, though on occasion we have seen danger

:

signals in a

family during a follow-up interview, and would have liked to spend

some time doing preventive work. But selves to being

community

an acute service and leave

less pressing

we

limit our-

matters to the

We're finding that subsequent contact with us

agencies.

up a lot of old problems. We even avoid follow-up by the team cases where the family was overly dependent on us before. We work

may in

as things are now,

stir

we tend

so briefly that

Miss

dr. p.:

worker.

to

remind people of the

De Young

Now

is

this is

a nurse here and Mr. Flomenhaft's a social

Mrs. Willy, who, ah, has been

that she's convinced she's going to starve,

mrs. w. (overlapping) dr. p.

This

:

is

:

dr. p.:

And

Paul

too.

dr. p.

:

And this

working and making about a hundred

is .

is

.

dollars a

.

bringing

Mrs. Willy's

is

sister,

sixty, he's starving to death,

Mrs., ah

.

.

.

Clapp.

:

Clapp.

mrs. w.: Believe dr.

.

am.

home about ( Weeping.) Look how thin he is.

mrs. w.: No, he

c.

.

.

me

her son, Paul Gibson.

week and, ah

mrs.

ah

telling

I'm gonna starve to death, too.

mrs. w.

dr. p.:

I, I

:

not the resolution.

crisis,

it

home there. p. I know she :

mrs. w. but

does.

Well, you won't believe

:

it's

miss DeY.

or not, her home's nice in [town], she's got a nice

:

it

when you come out

to

my

house,

true.

Where do you

live?

mrs. w.: In [town].

Um-hm. p.: What I suggested was morrow at eight, ah, since

miss DeY.: dr.

mrs. w. (overlapping) out there Friday?

:

that, ah,

Paul bring his mother in to-

he's got to get

on

to work,

and

.

Couldn't you just skip that and just

.

.

come

Cleaning House

And

dr. p.:

mrs. w.

mrs.

:

No,

:

we

can't skip

421

it.

Well, he might get fired.

(simultaneously)

c.

dr. p.

then we'll be out there Friday. No,

[

day's work.

he's not going to get fired.

mrs. w.: Well, he

make

can't

One

:

just as well get fired

work

out there to

it

now

as

any time because he

the rest of the winter in that old

car of mine. dr. p.

Bet he can.

:

mrs. w.: Brakes are gone, the windshield's got a chip in get

it,

ah, sticker

on

it

.

.

he can't

it,

.

Now

you were telling me something a minute ago, Mrs. Willy, you were telling me how many times you were

dr. p. (overlapping)

married.

:

You were

married to Paul's father for twenty years, then,

he wasn't making enough money to support

went back

to

your parents and he went to

of you, so you

all

[state]

and

he's

married

again and you apparently married again to somebody. You've

been married three times?

mrs. w.:

And

then, ah, he died, ah, he died, ah,

[Name of hospital.] mrs. w. [Name of hospital], a heart, paul

at,

ah

.

.

.

:

:

Int.:

was

up here

Why

ah, heart attack.

did you start off by telling your team that Mrs. Willy

was going to starve? Dr. P. That was what Mrs. Willy had mostly been talking about. I was saying, "Here is Mrs. Willy and this is her delusion. And this is her son Paul and he assures me there's no reality to it." afraid she :

When you get to the Dr. P.: To them, partly. Int.:

marriages,

is

that to

them or

to her?

was trying to share with them the meager information that I had. But I mainly wanted to make it clear to Mrs. Willy that I knew that this business of her marriages was very significant to her and I wanted to get back to it. Int. (to Miss DeY.) You come in here too, to ask where Mrs. Willy fives. Was this merely to acknowledge her, or did you have a I

:

practical reason?

see

Miss DeY.: She had just been talking about our coming out her, so I was asking her address. It was practical. Int. (to Dr. P.): Is

it

usual for you to summarize your impres-

sion of the situation for the people

Dr.

P.

:

Yes,

if

we

to

who have just come in?

don't start together. Sometimes

one of us to summarize in the middle of an interview

it's

helpful for

just for

our

own

TECHNIQUES OF FAMILY THERAPY "I'm a

benefit.

I'll

Correct

me if you

Mr.

say,

F.

it

confused, but this

the

is

way

it

looks to me.

differently."

There was one funny time you did

:

rationale for

see

little

[422

what was going wrong

in the family,

this,

went

into a long

and the father blurted

out, "I disagree!"

Dr. P.

:

Do you

Int.:

team member Dr. P. don't mind,

Then

we'll

Well, I could be wrong, and

:

it

helps to get their reaction.

sometimes carry on a conversation with the other

in the presence of the family?

Sure. We'll go into long asides,

we want

to talk together about

go on for about

fifteen

first telling

some

them, "If you

points that puzzle us."

minutes to clarify issues for them, or

simply to demonstrate communication.

Or

we'll stop in the

middle of

an interview and keep the family waiting while we go out and compare notes.

Or sometimes one

give up," and

of us will say, "I'm not getting anywhere, I

hand the interview over

to the other

team member

till

he

gets revived.

Int.:

Do you

ever clown around in front of the family, to break

some other reason? Dr. P.: We don't clown, exactly, but we do tease people sometimes. One time Carol and I decided we would show the family what they sounded like, so we repeated a bit of dialogue they had just gone through. Another time, a woman was brought in to us supported by several people. She couldn't walk or talk; you had to lean your ear right between her teeth to get what she was saying. I was responding to her by talking very softly and gently to her and for some reason this annoyed Kal. Mr. F.: I didn't feel we could get anywhere as long as she was mood, or

the tension, or change the

for

controlling the situation with her

symptom, so

much

if I

louder than

I

usually do, as

she whispered something,

would speak up, what's

I

you're going to speak up, please quit telling Int.:

One

is

you

her

were hard of hearing. Every time

would shout, "I

that

I started talking to

can't hear you, I wish

say, you're saying

you

something about

that it?" Finally she yelled, "Will

you

me to speak up!"

interesting question is

who

a therapist tends to side

man, the woman, the child, the patient. A single therapist can easily become the victim of his own preferences, and it must be an advantage to be working with a team from this point of view.

with, the

Dr. P.

:

I

think that

my

greatest

weakness as a family therapist

is

Cleaning House

423

[

my

tendency to look upon the patient as invariably the victim. In even-

ing

up

on the

the responsibility, I weigh too heavily

spouse and

the patient

let

But with three of

off.

someone too hard, one of the others

why we

the balance. That's also

us,

will instinctively

relatives or the

I'm fingering

if

come

in to right

We

try to see the family as a system.

when we pick on an individual. Having more than one therapist in

get into trouble

Int.

you

:

You

flexibility.

can drop out of character, or

to yourselves, or take turns, or

Dr.

P.

dr. p.:

Is

mrs. w.

:

dr. p.

think

I

:

we

Little girl.

mrs. w.

.

.

mrs. w. dr. p.

:

the

with her uncle :

yesterday to go to [nearby

little girl left .

.

.

Yeah, but they

they ain't gonna keep

ain't,

they, they'll send her back.

.

dr. p.: This

And

And

with Mrs. Willy's and Mrs. Clapp's brother.

.

.

:

gives us.

.

.

.

.

it

Uh-huh.

mrs. w. (overlapping) dr. p.:

from the family

whatever you fancy.

appreciate the freedom

all

little girl.

state] to stay

her

shift

certainly gives

he [second husband] the father of your youngest daughter?

Your

:

room

the

the thirteen-year-old daughter, Mara.

is

then, after your second

husband

died,

(To Mrs. W.)

you married

again.

Yeah.

Uh-huh, and was that Mr. Willy?

:

mrs. w.

:

No

.

.

.

paul: No. Mr. Willy was the second. mrs. w. (overlapping) dr. p.

:

mrs. w. :

:

I

got

the third

.

.

.

.

.

my name back.

Yeah, and you, and your third husband, you were divorced

mrs. w. (overlapping) last

mrs. w.

:

I

.

.

married Mr. Larrabee, and then, that didn't

then did you marry again after that?

No.

So you've

:

:

.

very long.

And

dr. p.:

dr. p.

.

Uh-huh.

And then

dr. p.:

p.

Mr. Willy was, ah

Mr. Willy was the second.

:

mrs. w.

dr.

:

just

had three husbands?

mrs. c: Four. Four. (Pause.) Yeah.

dr. p.:

mrs. w. dr. p.

:

But things weren't

(interrupting)

last

:

like this then.

But when was the

husband, your fourth husband?

last,

when

did

you leave your

TECHNIQUES OF FAMILY THERAPY mrs. w.

November, wasn't

:

mrs. c: Well,

424

it?

about in August, honey, a year ago.

really, last year,

What happened there? Was this Mr. Larrabee? mrs. w. {tearfully) It's just un inbelievable. dr. p. What happened with Mr. Larrabee? paul: Well, she divorced him, ah, once, after how long dr. p.

f

:



:

:



with him the

mrs.

time? Several years,

first

No, she was married two paul: Yeah, two years. mrs. w.: No c.

:

.

mrs.

c.

you

live

I think.

years, altogether.

.

They were divorced twice

:

And

paul:

.

did

in one, in

know

then, ah, I don't

if

two

years.

he divorced her or she divorced

him.

mrs.

c.

He

:

divorced her the

first

time, she divorced

him

the last time.

paul {overlapping) But, ah, they went back together for a very short period of time and then mrs. c: Well, nine, ten days, they were just together for ten days. dr. p. {interrupting, to Mrs. W.) Well, you haven't really been with:

.

.

.

:

out a husband except just the

mrs. w.

Well,

:

I

last year, for

any length of time.

guess so.

on a woman who has been used to having a, a husband around, doing without one for a year. mrs. w. We're gonna, we're gonna be throwed out in the street. dr. p.: Oh, now, we're going, not going to let that happen. {Mrs. W.

dr. p.: Well, this must be very hard

:

trying to talk.)

now,

let's

I

told

you

to

come

to

my

house for dinner tonight,

not worry about that, but, ah, for the last year, you've

been without a husband, have you ever been without a husband for that long before?

mrs. c: {Pause.) No. mrs. w.: Well, now, mrs.

c.

remem-,

yes,

when

Jerry died,

I

was

.

.

.

Two years, honey.

:

mrs. w.

I

:

Longer than

that.

mrs. c: Yes, she was two, two years there before she remarried. dr. p.: How did you do during those two years? Did you find it hard?

Did you worry a lot? mrs. w. I always kept the bills up. dr. p. Uh-huh. Were you working then? mrs. w. No, I had, ah, some Social Security and mrs. c. Social Security and Veterans, so she didn't have to work then. dr. p. Uh-huh. mrs. c: She had approximately, what was it, three or four hundred :

:

:

:

:

.

.

.

Cleaning House

a

month coming

and dr. p.

where

and then she

seemed to

it

lost

it all

when

425

she got married,

go.

How long were you married to Mr. Larrabee?

:

mrs. w. dr. p.

that's

in,

[

Oh, about two years.

:

Now, now, what about

:

the third husband?

mrs. c: That was Ed. dr. p.

mrs.

That was who?

:

c.

Ed.

:

mrs. w. (tearfully)

mrs.

c.

mrs. w.

it.

tell

.

.

:

See

:

don't want to talk about

I

him about Ed, honey. Well, there's no use

mrs. c: Tell him, mrs. w.

:

:

.

.

.

.

.

.

he couldn't be, he couldn't under-, ah,

.

I could, I

could

you about Paul, but if you didn't see him, you wouldn't know one thing about him, would you? tell

dr. p. : That's right, that's

I just

to see him, too.

So what's the use of me trying to tell you? want to find out, you know, what happened, what

mrs. w. (overlapping) dr. p.: Well,

why we need

:

went wrong. Int.

:

I

gather that

all

through

this

long interrogation you're trying

what led up to the crisis. Dr. P.: Yes. I got one clue when Mrs. Willy spoke of her

to get at

life

she was confusing

him

with her son. Another clue was that she seemed to have to have a

man

with her

first

husband

in

such a way that

I felt

around, because she apparently couldn't tolerate being unmarried for

any length of time. Int.: clearly.

It's

certainly

a chaotic history. But she

She even corrects her

Dr.

P.:

As

sister

comes

in very

from time to time.

long as I'm focusing her on matters of fact, she does

pretty well.

mrs. c: Well,

seemed like from the time after she had had money coming in there for two years and then she married it

guy, this Ed, and for didn't

want

some reason or

other, he

swayed

this this

her, she

to get married, she even, she says she even, cried

going to the,

to, ah,

to get married because she felt like that

wasn't what she would do, should do, but after she had been

married just a few days

when

the

first

it

checks didn't

dawned on her, she had, especially come in, what she had done, and he

TECHNIQUES OF FAMILY THERAPY was very worthless, he

didn't work, he didn't

do anything, he was

supposed to be some kind of mechanic, and

it

seems as though

he actually married her for was because he thought she had

all

money coming

all this

in,

and

home

this

that he

would eventually

he was just a rounder.

get, he,

dr. p.

How long did this last?

:

mrs. c: Well mrs. w.

:

.

.

He was

.

a rounder.

mrs. c: Well, he was gone more times than he was

and

just in

then,

and

out,

weeks

at a time,

was no money coming

that there

so, the

and

and

in

in, that

out,

was

there.

when he saw

a different story

little,

just (inaudible phrase).

mrs. w.: Uh, ah, you know when they had those floods there land and, ah, washed away

and the ocean come

They were

dr. p.:

mrs. w. :

all

in

all

on them

.

the people's homes, .

in

Hol-

you know,

.

insured.

In Holland?

:

Now

.

.

.

mrs. w.: How'd the people build homes in the dr. p.:

He was

time went on for a year but actually they weren't

living together in that time, very

dr. p.

[426

They were

all

insured,

insured. (Pause.)

all

how your mother

appreciate

mud

puddles?

(To Paul)

Do you

has gone through an entire lifetime

of never having anybody that she could rely on to support her?

Do you see this pattern? paul: Ah,

mrs.

c.

paul:

:

I

don't understand your sentence.

Well

Do

I

.

.

.

appreciate the fact that

my

mother has never had

to

work

for a living?

No, do you appreciate the fact that she's never had anybody to support her, and she's never had the security of knowing that she had a man who was going to be bringing in a paycheck that was going to be adequate to meet the bills each week?

dr. p.:

Int.:

sponses.

"They're

all

You jump from

insured,"

I

was trying to Int.:

another of your crazy-talk re-

the husbands to the people in Holland, and

you go to as literal an extreme Dr. P.: She didn't want So

is

ridicule her a

as she does, except in the opposite way. to talk about the third husband. I did. little,

dismiss

all this

Again, you don't just ridicule her.

nonsense.

You

meaning by saying the people are insured. You're have more security than you think."

pick up her real telling her,

"You

Cleaning House

Dr. helpless,"

Well, underneath the

P.:

427

[

absurd talk she's saying, "I'm

and I'm saying, "No you're not."

Why

Int.:

did you turn to the son here? This

you've suggested that, whatever

is

the

is

first

time

wrong, he might be contributing to

it.

him know that in this discussion of the marriages we were really talking about him and not the husbands. He was another insurance policy. I was seeing this pattern of looking for security a little more clearly. Int.: When you see such a pattern, and you share what you see with the family, do you feel that this knowledge is going to help them Dr.

P.

was

I

:

finally letting

improve?

Dr.

was going that he

to

sharing this observation with the son

produce any magical changes, but

was included So

Int.:

some

I didn't feel that

P.:

it

in

I

wanted him to know

what Mrs. Willy was talking about.

really wasn't to give

him understanding, but

to shift

responsibility onto him.

Dr. into a

Yes. But without confronting him directly and getting

P.:

power

struggle. I

still

mother with

to provide his

of the problem,

and

I

didn't

know

in

what way Paul had

security, but I suspected that this

wanted to

alert

him

failed

was part

to the fact that I suspected

it.

So

Int.: as

if

often,

when you

get an interpretation like that,

you're providing understanding, and yet

You

functions too.

When you

could presumably not share

it

has so

this

it

looks

many

other

information at

all.

up

in

your mind and go on to the particular action prescription you think

is

begin to sense a pattern or a trend, you could store

going to help.

Dr. P.

:

it

Would you ever do that? I think storing it up would have been a mistake because

some point I would have had to burst forth with everything and take him by surprise. Then I would have a fight on my hands. at

Int.:

By

isolating the mother's experiences with

men

as a pattern,

you avoid blaming the son. It's not him, it's the whole pattern she has lived through, of which he is a part. Dr. P.: Yes. I'm not saying he's a bad son, I'm saying that his mother has a need which has arisen from certain experiences

and which now places a certain argue with me.

responsibility

on him. He

in the past

can't very well

TECHNIQUES OF FAMILY THERAPY What he does

Int.: that

my

to twist

is

and

it

say,

[428

"What you mean

mother has never had to go out and work for her

is

living in her

life."

Dr.

Which was a very good

P.:

technique.

And which

I

then

counter.

Int.

cause

But

it

It's

:

is

weak because

which is that

Dr.

she's crazy.

it

contradicts the position he's been

says she's lazy, there's just as

reality to his perception as there is to

his perception of reality wouldn't

tionship between

him and

his

In other words,

:

it

just lazy."

He can't have it both ways.

when he

Actually,

P.:

Int.

are defending her behavior be-

determined by her past. Then he says, "No, she's

is

his position

taking,

You

a tricky exchange.

mine. The only

work

difficulty is that

in establishing a future rela-

mother because isn't

much

it's

a blaming thing.

a question of what

is so, it's

a ques-

what can be engineered to go somewhere else. Dr. P.: That's right. A relationship depends on an immense

tion of

amount of cooperation; it can't be worked out through mutual blame. Int.: If you can get them jointly to blame the circumstances of her past, it would be better. Dr. P. Right. If they can scapegoat the past, or the "pattern," :

rather than

blame each

other, then they

can go on.

Int.: I suspect that's the reason for

all

the fascination with the

past in the development of psychiatry.

Dr.

Well, there has to be another step beyond blaming the

P.:

had one patient who had had several years of intensive psychotherapy and he said, "Isn't it a shame that I don't work and support past. I

my

family and that they are on the verge of starvation, but you see

had this

relationship with

Int.

mrs.

my father."

:

That's really using the language against you.

c.

:

paul: dr. p. :

Only

I

Jerry, Jerry did.

Ah Now this was her husband who ... .

.

.

The second husband. paul: The second one.

mrs.

c.

:

mrs. w.

:

That died

at the

[name of

hospital].

dr. p.: Yeah. Okay.

paul: Yeah,

I,

am

ah, I

security, she,

ah

.

.

.

sympathetic to her,

when

she doesn't have

Cleaning House

[

429

Thank God he died, he's out in his grave. Yeah. You haven't got much right now, either, do you?

mrs. w. (overlapping) dr. p.:

paul: Well,

I

:

don't know,

it's

.

.

.

dr. p.: Except yourself.

paul: I'm as secure

ah

as,

.

.

.

dr. p. : Okay.

paul:

.

.

I

.

want

to be.

mrs. w. (tearfully): You're most secure, more secure, insecure than you've ever been.

The day you was

on the doorstep and secure

mrs. w.

:

I

mrs. w.:

said, "There's the world, there," that's

how

care of himself pretty well, can't he?

No. think so. I don't.

The son

He knows

P.:

wanted

I

so I was giving

put up a front.

comes around to agreeing with you about Then you move rapidly to his own insecurity.

to support him.

He had

agreed with

my

point,

him a bonus.

You were

Int.:

better, he's just trying to

finally

his mother's insecurity.

Dr.

you out

No? Can't he?

dr. p.:

Int.:

if I'd just set

.

.

He can take

dr. p. :

paul:

.

born,

also shifting the

symptom

again.

"You

feel in-

secure too."

Dr.

was pointing out that it applied to both of them. His mother wasn't providing him with much security either. Int.: The son is courteously agreeing with you while somewhat P.:

I

reluctant to accept that.

Dr.

P.:

I still

wanted to avoid blaming him.

I

could have

said,

"You're a bad guy, you're not being good to your mother." But again it

wouldn't have led anywhere. Int.:

When

the mother

comes

in to agree with

you switch again and

say,

Well, I have to defend

him

son's insecurity,

"He can

you about her

take care of him-

self."

Dr.

P.:

in his independence

from

his mother.

Int.

:

It's

a complicated sequence.

dr. p. (to Paul) to

make

:

Look, what's happened here in the

last

few months

the situation get so bad about your mother's fear that

TECHNIQUES OF FAMILY THERAPY

[430

somebody's not going to be around to support her? Are you, are

you threatening to leave her? MRS. w. (overlapping) He may be called to the Army any day. paul: Well, ah mrs. w.: He's eligible, you see. While he was in school paul: I don't know, she seems to, ah, feel real upset any time :

.

.

.

.

on a date or anything like this. dr. p.: Oh, so you're afraid that he's going to

.

get married

.

I

go

and leave

you.

mrs. w.

:

Well, he could go to the

dr. p. (to Paul)

Army any time.

You thinking about getting married?

:

paul: No. mrs. w. paul:

:

It's

mrs. w. dr. p.

Well, he

:

drafted.

a possibility, but not right away.

I

don't think he will ever get married.

Well, do

:

may be

you want him

to?

paul: As far as being drafted, ah, when she was

changed

ah,

mrs. w.

:

Then,

paul: Well,

You

dr. p.:

my

Dr. at this

was

that year.

3-A.

same

get the

happen to go to Int.

rating to 3 -A, or something like that.

see, that

it's still

at [hospital], they,

rating.

(To Mrs. W.) Now, how did you

[hospital] last year?

Why did you ask the son if he was threatening to leave?

:

P.:

This was a straightforward question because

point that this was what he was planning to do. It

I

was sure

still

hadn't

been established that he had any real responsibility for his mother, so

was

you are preparing to leave her, this is having a great deal of effect on her and we'd better consider whether this is the wisest move for you to make right now." I

suggesting, "If

Int.

Dr.

:

P.

Did :

this turn

out to be true, that he was planning to leave?

Actually no.

You still get in the point that he has some responsibility for her. And you do this just after his mother has said, "No matter what circumstance I would put you in, you'd still be insecure." He Int.:

would have to react against that. Dr.

P.:

It

had already been

providing his mother with the security to give her.

Int.:

So I'm asking him, It's

was capable of the other men hadn't been able

established that he

"Why don't you take care of her?"

quite a pressure

on him

to take the position of the

Cleaning House

Then you

strong one.

Why

getting married.

get to the question of

431

[

whether he's thinking of

you pick up the mother's statement that

didn't

she doesn't think he ever will?

Dr.

was

Because she was denying

P.:

admit her fears about

willing to

something to come back

Miss DeY.:

to. I still felt

MRS. w.: Well,

me some

Paul had to pay

What

don't know,

I

medicine,

And,

didn't

my

do

me one

do

me

bit

of good.

out there.

were they?

Just shots, they didn't

:

.

.

a

bit

of good.

.



is

:

pay seventy-five

.

now

dollars to get the darn thing fixed,

just, just drips.

Look mrs. w. ... four new :

Then

his car

.

.

don't

.

tires for his

car

.

.

.



Mrs. Willy, what happened about your going to a

it

.

.

:

pital]?

ah,

anyway, then the washin' machine went out and he had

ah,

making

sister's,

Whenever you doctors think a shot in the of gonna help somebody that's upset, you're mistaken.

work, the water

dr. p.:

which

shots,

must have

MRS. w. (overlapping)

dr. p.

was

a (inaudible phrase).

just

mrs. w. (overlapping)

to

a possibility.

to [sister's town] and, ah,

fifty dollars

sort of shots

MRS. c: Nerves, paul:

was

at.

went up

I

doctor gave

:

noted that as

That's right.

P.:

dr. p.

didn't feel that she

also think that the previous hospitalization

I

something you wanted to get

Dr.

I

at that time. I

it

it

and

it,

good

How

living

did this

look, he's

—what happened about your going

come about

mrs. w.: Well, the doctor up

you went there? town] recommended

to [hos-

that

at [sister's

it.

You

know. dr. p.

:

How long were you there?

mrs. w.: Well,

November dr. p.:

paul

I,

he hauled

clear

me

out there every day last winter from

spring and

till

.

.

.

How long were you in the hospital?

She was an outpatient. mrs. w. (overlapping) Well, :

:

I

was

a,

ah, outpatient.

paul: We'd take her out there in the morning when they were there. mrs. w. (overlapping) They don't keep hardly anybody there any :

length of time, they kick

paul: Then

my

older sister

bring her home.

them out. would pick her up

in the afternoon

and

TECHNIQUES OF FAMILY THERAPY MR.

f.

Mrs.

Is that

:

c.

c.

and this

fall

But they

:

around a

goin'

.

It's

:

.

(overlapping)

c.

seem

really didn't

mrs. w. (overlapping) mrs.

spring.

Hm.

dr. p.:

mrs.

spring of this year?

Yes. Last

:

[432

to give her

any help.

just a treadmill,

it's

a mouse

just like

.

She went

:

in

on her own, and she was mrs. w. (overlapping) You would in

.

.

on her own,

see,

we

let

her go

.

:

just

go and then come home, and

go and come home, and go and come home, and mill up and

down the halls and miss DeY.: What section of the MRS. w. [Name of county.] miss DeY. [Name of county.] .

.

.

hospital, what,

ah (inaudible words).

:

:

Dr.

P.:

Here

I

was

getting at the facts about Mrs. Willy's pre-

vious hospitalization. This was the

Int. (to Miss

DeY.)

:

Why

first

time I'd heard about

it.

did you ask her what section of the

hospital she'd been in?

Miss DeY.: Because Int.

I take

:

it

I'd

been working

at that hospital last year.

she had been a day patient there.

Miss DeY. Yes. I thought I might know some of the people who had worked with her, in which case I could contact them to get some :

quick information about her instead of waiting for the written report.

One

we

of the things

try to

do

we

right off is to get all the information

can from a current or past agency that has worked with the patient or the family. to

For

know about

some medication has been helpful, we because Frank might want to prescribe it again.

instance,

it,

if

How

would you you take them?

dr. p.:

mrs. w.: Well,

I

feel if I

like

gave you some tranquilizers? Would

could take them but they wouldn't

make me go

to

sleep.

dr. p.

:

Well,

mrs. w.

:

maybe not, but would you

Oh,

take them?

yes.

Paul: Yeah, she'd take 'em home mrs. w. (overlapping)

:

you give them to her. Won't do any good. I haven't slept if

or two. dr. p. (to Paul)

mrs.

c.

:

Well,

:

it's

You sound kind of discouraged. been awfully hard on him.

for a year

Cleaning House

paul (overlapping): Well, you, you, if you will. dr. p.

have heard her carry on,

Yeah.

:

paul: This

starts

come home

I

ah,

[433

about five in the morning when I get up, and the

it's

same

thing, so, ah,

it

kinda gets on

when

my nerves.

He don't get any rest day or night. You need tranquilizers, too?

mrs. w. dr. p. :

:

paul: What? dr. p.

You need tranquilizers, too?

:

paul (laughing) Int.:

Why

I

:

probably could have some.

did you bring

up the question of medication

at this

point?

Dr. P. get

:

from her Int.

:

I

was wondering what

after she

sort of cooperation I

was going

to

had expressed doubts about previous medication.

Do you give medication of some kind routinely?

Dr. P.

:

We

give

some

three-fourths of our cases.

sort of medication to the patient in

Or maybe some

to the family

about

and none to

the patient.

Int.

Is this partly for psychological reasons, to

:

make them

feel

they are getting a proper doctoring?

Dr. P.

:

We've had

relatives call us

and

say,

"How

long are you

going to keep on with this talking before you get around to the treat-

ment?" So we do sometimes give drugs, simply to make the family

feel

But usually we give them because we

feel

that something's being done. that they are indicated. I I

do believe

that drugs work.

And

in this case

had been saying that shots weren't be sure that she would take tranquilizers. If

think they did help. Mrs. Willy

any good, so

I

wanted

to

she wouldn't take drugs, Int.:

Dr.

P.:

Dr.

:

knew we would be

in for trouble.

In what way? I felt that

home without some Int.

I

they would have a hard time handling her at

degree of sedation.

Hadn't they been putting up with her

P.:

Well, coming to the hospital

is

fairly well?

a sort of an end point.

The family comes in expecting to get immediate relief from the problem of having somebody crazy. If you don't take the patient off their hands, you've got to produce some kind of result within twenty-four hours. I felt that drugs would produce sufficient results in this woman, even if we didn't

do anything in psychotherapy

in that first hour.

TECHNIQUES OF FAMILY THERAPY Int.: So the medication

Dr.

P.

You do

slept for a year,

son,

as

much

for the family as

The mother

a curious thing here.

and instead of sympathizing with

"You sound kind of discouraged." Was Dr.

because

Oh,

P.:

we knew

I also

would be a hardship on him

it

for her.

says she hasn't

her,

you say

to the

this deliberate?

reward that comment of hers

yes. I wasn't going to

was a crazy comment.

it

it is

In a way, yes.

:

Int.:

is

[434

wanted

to

to

have her

show the son at

home

that

instead of

at the hospital.

Then you go on

Int.:

to ask

he needs tranquilizers too. Did

if

you genuinely feel he might? Dr.

Yes, but I'm also telling her, "You're not the only pa-

P.:

tient."

Do you

Int.:

way

family as a

Dr.

P.:

Int.

:

often prescribe medication to other

members

of the

of suggesting this?

Oh,

yes.

As an

indication that

we know

they're hurting

too.

What

you continually

is

unusual about

shift perspective

this part of the interview is the

way

from the mother to the son. She's

in-

secure, he's insecure; she's got problems, he's got problems.

I'm trying to focus on the relationship between them.

Dr. P.

:

Int.:

But not

you told them they were both

in a direct way. If

part of what's wrong, they could ignore you or disagree. But by playing first

you

one, then the other,

same time keep them even. Dr. P. You may be :

derpinning than anything

I

tease out their involvement,

right.

But

this is

more

and

at the

of an instinctive un-

do formally.

you what he needs dr. p. (to Paul) I can sympathize. (To Mrs. W.) What does he need? mrs. w.: Well, yeah, eh, did you ever have an operation? You never had an operation? dr. p.: Yeah, I've had an operation. mrs. w. They put you to sleep? mrs. w. (loudly):

I tell

.

.

.

:

:

dr. p. :

Um-hm.

mrs. w. dr. p.

:

:

Didn't

know

a thing?

Right.

you doctors could invent some kind of medicine, you know, give people a shot like that, put 'em to sleep, you just keep on sleepin', never wake up

mrs. w.: Well,

if

.

.

.

Cleaning House

Do you

dr. p.:

want

to

kill

dr. p.:

:

not very easy,

It's

mrs. w.: No,

it

dr. p.: That's right,

kind of

mrs. w.:

mrs. w.

:

Is

it

hurts.

make

yourself

sick.

patients out there at the hospital, they slashed their

saw

I

ways from It

yourself?

take a knife and stick your-

you'd end up doing would be

wrists with a razor blade, a

dr. p.:

You

hurts. Just a teeny bit, all

kill

is it?

(Laughing.)

it isn't.

self a little bit,

Int.:

435

yourself?

Be out of their troubles, then. dr. p.: Do you want to kill yourself? mrs. w.: I couldn't if I wanted to, now how would you mrs. w.

[

sure

It's

a long

killing yourself.

(Pause.)

is.

a long ways.

It's

it

teeny cut along there.

little

routine with you to handle talk about suicide in this

way? Dr.

P.:

We

about suicide very

talk

somebody says confront him with it

freely.

anything that sounds like a suicide threat, we'll

If

right off.

Do

Int.:

you think you got a true answer, when Mrs. Willy says

she doesn't want to

Dr. sounded

me

P.:

I

kill

think

I

herself?

got a true answer, yes. She

like suicidal thoughts, so I

the assurance that she didn't

asked her about them and she gave

want to commit

repugnant to her. She even implied that she would even think about

But you

Int.: hint at

P.:

best to bring

it,

may make him doubt

this

idea, not hers, that

at that.

up

it

this directly

if

there's

it

it

himself, doubt his control over

any

as

it.

But

openly, rationally and calmly, you re-

hope that he has control over

affirm his

able to

go

was

you convey to the patient that you are afraid of

by talking with him about to put

I let it

my

it

Yes. If you react to a suicide threat with alarm, or by

shying away from

and

it

So

was

it

suicide, that

all.

Dr.

it,

find

it.

was expressing what

it.

something he wants to do, not as

why we always try something he may not be

That's

resist.

Int.

Dr.

:

You P.:

Yes.

suicide because

you not want

pick up the control aspect.

We

say, "It does appear that

you want

to."

to so badly. Let's see

you might attempt

what we can do to make

TECHNIQUES OF FAMILY THERAPY Int.:

Have you had many problems with

[436

suicidal patients since

the project began?

Dr. P.

We

:

we have done been

had one

suicide that really threw us,

a lot of things differently. This

and since then

was a woman who had

nonfunctioning and getting tranquilizers from multiple

totally

sources. She'd been hospitalized for

most of the past eight years and

had never made any improvement. She came to us after she was discharged from her last hospital as untreatable. We took her off drugs and made the greatest little

effort

and her husband seemed

started to see them, the her.

We

she.

When

back of the neck with a later. It

Anyway,

us the family can't take

dependency,

Dr.

it,

like the drugs,

Do you ever

:

this,

and neither did

knife, severing the spinal cord.

what was on

this

P.:

his

mind, we could have

shook us up very badly and since

don't press people too hard. We're

Int.

we had

was apparently an accident; she hadn't scare him into staying. Hopefully, if the

told us beforehand

averted the tragedy.

we

after

husband suddenly decided that he was leaving

to kill herself, just to

husband had

more

alert to signs telling

and we're more careful to leave sources of temporarily intact.

use hospitalization for suicide prevention?

We're willing to hospitalize any suicidal case we can't

handle on an outpatient basis, though

Our experience isn't

Then, ten days

he told her, she beat herself up in his presence and stabbed

She died three days

wanted

satisfied.

had no inkling that he was thinking of

herself in the

then

we've ever made. She began to function a

this doesn't

happen very

often.

so far has borne out our conviction that hospitalization

always the way to prevent suicide. We've had two cases of people

who made serious suicide attempts, or threatened to. One was a young man who couldn't live with his mother and couldn't live without her. He had tried to get married several times, and each time the marriage broke up. He had also been in several hospitals, but he couldn't get away from

his

mother

that

way

cide attempts in front of her,

So he kept making bizarre suiwhich she both encouraged and coneither.

demned. The other case was a domineering little

When

husband and three husky sons.

woman who had

a

weak

her health failed and the

four males began to rebel against her, she used suicide attempts to try to control them.

unbending, so

Both patients stayed

we

treatment. But the fact,

hospitalized

them

woman made

suicidal

at

and both families were

another hospital for long-term

a suicide attempt in the hospital; in

she ran through several hospitals before she got electroshock

Cleaning House

treatment, which finally helped her.

man

another is

in the hospital;

now under maximum Int.:

amount

he

The man made a

[

437

suicide pact with

but not himself, and

killed the friend

security.

should think a major question for you would be the

I

of risk you're willing to take with this kind of project.

Dr.

We

P.:

even

like to take

risk

now, but we'd

We're working on a prognostic scale on which

less.

to score the families, to try to

make our

We're examining various

predictable.

much

don't feel we're taking too

more adding new ones as we

successes and failures

factors,

we can tell more quickly who is going to stay who is going to return to the status quo, and who

go, hoping

out of the

hospital,

is

be a suicide

All of this

risk.

fairly tentative

is still

going to

and needs much more

few factors that seem to hold up. Most

investigation, but there are a

of these factors are just clues to the family's willingness to be involved

and

symptom

to see the

dependent on

as a family problem, because our success

Whether someone goes

that.

into the hospital

how

depends on whether they've been there before and

is

or not

often. This

applies mostly to psychiatric hospitalization, but an excessive use of

general hospitals

an indication that there may be a pattern of the

is

family using the hospital as an escape from problems. We're also finding that

a good sign for a return to the status quo

it's

of the extended family

means

involved in the

some member

crisis.

Why is that?

Int.:

Dr.

is

if

Well,

P.:

that

is visiting,

collapses of

the family falls apart

pretty unstable. If

it's

that

if

is

its

it

weight,

it's

apart

its

when

The analogy

a different matter.

own

falls

on I

own, we

feel this

the mother-in-law

use

is

that

if

a house

probably weaker structurally than a

house that collapses under the weight of a

falling meteorite.

Int.: Like a mother-in-law.

Dr. predict

P.:

We

Exactly.

hope we

outcome but £ven

will eventually

be able not only to

to score the prediction.

If

we know

the

chances of success with a case are slim, we'll be more alerted to suicide.

But

it's still

too early to be sure about these factors.

mrs. c:

When

she was at

my

house she was so upset,

there had been this interval

when

this

been, ah, separated

time,

and she was

to

make ends

so

it

a

was

little

all

work

all this

see, this, ah,

fourth husband, after they'd

meet, see, and the son was in

at that

time trying

his, in his college,

her then, too, she'd babysit and did housework and in,

ah [hospital], but there was

just

not enough

TECHNIQUES OF FAMILY THERAPY money

make

to

the rounds, and

think she got frightened and

I

afraid that, that, ah, she just wasn't

mrs. w.: Well, mrs.

c.

So

:

knew

I

moment.

gonna make

couldn't.

to him,

anyhow, so she

mean and

a lot of things in that ten days, and

come back from

and get that

it.

I

was going

I

mrs.

And

:

Now

brought her to [Mrs.

I

me

up, because he didn't want to

husband would keep comin' out

this

and threaten her and

there

to kill her or lock her up.

bill.

(overlapping)

c.

and

kept her for two months.

mrs. w.: No, he wasn't gonna lock

pay the

tried to beat her

was on a trip, and when me that morning to come

went down and got her and

and

C.'s town]

I

the trip she called

her, that he

was

on the spur of the

did,

She went back to him and that lasted ten days,

(Sighs.)

because he was very rough and

I

it.

fourth husband had always been poundin' at her

this, this

come back

to

I

[438

and

all this

He was

that.

a very high-

tempered, wild sort of a fellow and, ah, our doctor had given her these treatments for these

mrs. w. (overlapping)

He gave

mrs. c: dr. p.

Said

:

.

.

had a demon and he could

I

her the injections

.

.

cast

it

out.

.

Sounds kind of crazy.

:

mrs. c:

.

.

.

just wild.

thing

is

(Sighs.)

don't

I

know what was

think the problem

apparently happening to

(overlapping)

c.

mean

for nerves. Well, he was, really, I

What do you

dr. p.:

mrs.

.

is

right

.

.

man was

the matter with him.

make your

Well, well, you see

:

the

now?

mean, some-

I

sister

.

.

.

.

make the two of you feel, and Dr. Clark feel, that, ah, she should come into the hospital today. mrs. c: Well, Dr. Clark told us that she should come right on in, we had no thought, I thought if we took her out there

dr. p.:

.

.

.

make you

feel,

.

(overlapping)

dr. p.

Yeah,

:

mrs. w. (overlapping)

:

I

well, what, what, what,

ah

.

.

.

.

.

'em they couldn't afford no, how could

told

they afford to pay Dr. Clark?

Okay. What made you decide to bring her to see Dr. Clark? mrs. c: Well, when my brother come up from [nearby state] and he

dr. p.:

came and saw her and

just, just

dr. p.: Well,

is

she was raving and carrying on there

like that,

simply wild

.

.

.

she any different from the

way

she's

been for the

last

year?

mrs.

c.

(overlapping)

:

He was shocked

her and he was shocked.

to see her.

But he hadn't seen

Cleaning House

DR. p. (overlapping) the

—has she been

c.

(overlapping)

mrs.

Well, do you feel that she

:

any

is

[439

different

from

getting gradually worse?

Yes,

:

through,

all

much

of August she was getting

all

through July and month

worse. 'Cause

I

could go up there

on Sundays and we'd take a ride and there would be times she would be real calm and we'd go on a picnic and, and everything was all right, only she'd keep going back to this starving and all that.

dr. p.

Mrs. W.)\

(to

I

home

daughter being at this

wonder

had anything

if it

do with your

to

during the day rather than in school.

Was

hard on you? (Pause.)

mrs. w. (tearfully):

me

It's killin'

to see her like she

how

child in the block, oh, I can't understand

is,

the worse

things got so out

of hand. dr. p.:

They have

gotten out of hand, haven't they? Things have really

gotten out of hand.

mrs. w. (overlapping)

when

was there he had a nice little flower box there in front of the porch on this side, and a nice one here, and it fell over and this one fell over, and the water frost got in 'em and, and they, ah, busted open, you know, from the drain. dr. p. Well, we'll come out Friday and see. mrs. c. (overlapping) It just seemed like that through, through July and August she began getting more worked up about these bills :

It

didn't seem,

Jerry

:

:

(inaudible phrase) insecure.

mrs. w. (overlapping, loudly)

:

your hands and you'll say

When you come well,

God,

I,

I

out there you'll wring couldn't solve

it,

not

God couldn't solve it. Int.:

I

take

you're again trying to get at the precipitating

it

factor for Mrs. Willy's at

home during Dr.

P.

:

the

symptom. Did you

summer could be

I didn't

know.

I

feel that the little girl's

being

it?

was groping. But the

fact that the family

got her out of the house to relieve the situation suggested that at this point that they perceived there

was a problem.

I

was

it

was

trying to

jog their minds back to that time. Int.: All through this part

brought them

answer after,

yet.

in,

and

it's

you keep asking the family what

apparent that you haven't got a satisfactory

Could you be more clear about what

sort of thing you're

not necessarily with this family, but in general?

TECHNIQUES OF FAMILY THERAPY Dr.

leading up to the

come

decision to

posed short

symptom makes such good

Until a

P.:

crisis,

to the hospital,

we

story,

recommendations

woman who

to

all fit

decide

how

to

sense that the events

and the symptoms, and the

crisis,

com-

together like a beautifully

what we feel we've got handle the case and what specific

continue looking. This

we can

to have before

and the

[440

is

make. The story we've developed here

that of a

is

who needs some man to take care of her financially. We've got a son who by his story is doing this, but by her story is not. We still don't know why she looks to this son for security or why he's living at home. And we don't know the part the sister

is

Int.

desperately needs security,

playing in

The

story

obvious that the family

It's

:

all this.

still

isn't

Mrs. Willy as a beautifully written short

why they're there, Dr. P.

:

Int.

Not

:

Dr.

make

P.:

I

has holes in

it.

thinking of the problem of

story.

When you

ask them

they say, "Because she's crazy."

don't expect

them

to share

my premises.

therapists share your premises either.

all

They're the logical outcome of the idea that symptoms

sense.

Int.: But not everybody operates on the assumption that

do

can't

you understand them. It hasn't been any connection between what's wrong and what

effective therapy until

established that there's

you do

you

to fix

it.

There are many methods that ignore causal factors

seem to work. Dr. P.: We feel more confident about moving in and starting to make recommendations if we can all arrive at some agreement about and

still

what the

situation

The way we work

is.

specific directives, so that

cal to do.

So we

problems

are, in

try to find out as quickly as possible

figuring out the short story.

And ending it

didn't

all

cases,

agree about what was going on.

say, "Everything'll

way

in

be

and support.

all right,

Did you

:

Dr.

P.:

trouble

differently.

It just didn't

get

The husband was out terribly nice

about

of

it.

work She'd

honey," and present herself as a tower ring right, but

which she was contributing to

Int.

we have had no

There was one case we had some question about and

and depressed and the wife was acting of love

what the family

order to decide what kind of action will be most

most of our

F.:

to give out, right away,

people have something objective and practi-

useful in solving them. In

Mr.

is

we

couldn't find any

his depression.

him over his symptom?

Yes, and he went back to work.

It

was a very successful

Cleaning House

Many

case, really.

quite understood

[

441

we never

important changes were set in motion. But

it.

Mr. F.: I often wonder if we don't make people feel better even though we may be completely wrong about what's happening. Dr. P.: Kal may be right. As long as we get a short story that satisfies us,

Int.:

want

to

perhaps

it

doesn't matter

Since therapy

the right one.

if it's

what you

often a matter of engineering

is

have happen, you can equally well say you write the story you

want people to read. Dr.

P.:

better about

build

That

may

what we're doing and where we're

up a meaningful all.

on with the

picture of what's going

I'm not succeeding

this interview, unfortunately,

of a picture at

we feel a lot going if we can first

well be. Just the same, I think

family. In

in building

up much

wasn't until the second interview that the facts

It

we began to see what the arrangement between Mrs. Willy and her son was and why it was breaking down. Int.: You may have had trouble getting the facts, but you've about the house came out and

managed

to get in quite a bit of therapy.

Dr.

P.:

Well,

we

are working rather acutely and

need to use therapeutically

at

we do

feel the

any given point in time whatever comes

up, rather than waiting and holding

hatching

it,

it,

nurturing

it.

So

if

we get some interpretation that seems appropriate, we go ahead and make it, even though we haven't gathered all the information. The fact that the interpretation may turn out to be inappropriate at a later date doesn't seem to matter. Mrs. Willy,

dr. p.:

talk for a

let's

minute about the financial

situation.

{To Paul) You're making over a hundred dollars a week. Mrs. w. {overlapping) Paul's puttin' up a big front, now. :

paul: Yeah, ah,

that's the gross.

income

tax, all this,

I

save twenty of

dr. p.

{overlapping)

mrs. w.: Tries to dr. p.:

.

:

.

all I

You

the time

it's

get

I

get done, ah, union dues,

about eighty and then, like .

.

I said,

.

save twenty of

it?

.

For what?

paul: Well,

just to

have

mrs. w.: They'll take dr. p.

so

it,

By

it.

{simultaneously)

paul: Oh,

I

don't

it.

know,

:

Okay. it's

How much

around four

.

.

mrs. w. {loudly): They'll come and take

do you have saved? .



I

owe Dr. Cooper

fifty

TECHNIQUES OF FAMILY THERAPY my

dollars for fixin'

dr.

.

talk-

gonna come

the collectors are

.

.

(overlapping, to Paul)

p.

and Paul

can't pay. (Dr. P.

I

And

inaudible exchange.)

ing,

in

teeth that

[442

Do

:

you have any particular outstand-

ing bills?

mrs. w.: 'Cause

I

pay that

just can't

fifty dollars.

mrs. c: Just the house. paul: Just the house payment,

that's

the only one, that's the only

regular big one. dr.

p.

So

:

money. mrs. w. (tearfully) dr. p.:

no reason for your mother

there's absolutely

paul (simultaneously) mrs. w. (loudly):

worry about

That's not true.

:

think that things are

I

to

.

Well,

:

.

.

I

wouldn't worry.

owe Dr. Cooper

I

miss DeY. (to Mrs. W.)

Now listen,

:

fifty dollars

you have

.

.

.

to listen.

Your son has told me what the financial situation is. He's got money in the bank, he's got enough money to pay the bills, and he's got money (simultaneously): Just a second, just a second.

dr. p.

coming

in.

This

is

much

about as

you could ever ask

as

You're in good financial shape. Your son

Now

for.

going to take care

is

you are saying, at all, that your son's not making enough money. I think what you're saying is that you're afraid your son's going to go off and of

all that.

then,

I

don't think this

is

the thing

leave you.

mrs. w.

:

Dr. Cooper

mrs. w.:

He won't.

He's gonna put

(overlapping)

mrs. w. (overlapping)

Your son can

:

.

.

take care of :

He

Int.:

I

P.

:

don't know,

I

that,

think

notice Carol

It

was

hands

.

it

.

.

in a col-

anyway. it

and

I feel

bad, I'd rather have

Cooper?

you've got to

it's

comes

about

fifty

this time.

listen, it's

Carol was

very important.

or sixty bucks.

in twice here to

quiet. Is that her usual function with a patient

Dr.

years.

.

Miss DeY.: Never mind I

in a collector's

it

it,

needs

:

:

more

After two years.

my tooth p. How much do you owe Dr.

paul

years.

not worry about that.

:

MRS. w. (overlapping) dr.

two

What's he going to do, well, put

:

lector's hands, let's

dr. p.

ah, he's waited

Mrs., Mrs. Willy, Dr. Cooper can wait two

dr. p.:

dr. p.

is,

keep Mrs. Willy

who is upset?

sitting right

next to Mrs. Willy,

hovering over her, trying to focus her attention, and being somewhat

I

Cleaning House

motherly. She was conveying to me,

on doing what you're

remember

I

443

take care of her and you go

"I'll

trying to do."

[

the relief I felt at

being able to turn the control of Mrs. Willy over to her.

Mr.

F.

Int.

:

Mr.

I

:

think Carol and

on

I sat

either side of Mrs. Willy.

Do you position yourselves strategically? F.

we

Quite often

:

try to get in

between the members of the

family, to separate them. If we're seeing a couple, that

have to look

each other.

at

Miss DeY. try to

We

:

communicate

as

(to Mrs.

dr. p.

like to sit so that

we go

we can

Okay. Look,

W.)-.

money, we're not worried about worry about about

is

that

come over

your son

mrs. w.: Well, he

may

is

(overlapping)

now

money and you

if

making you, if you

he's

think what you're worried

I

going to leave you.

be drafted.

I

:

talk about this, ah,

to the house, we'll feed you, don't

mrs. c: She worries about that a dr. p.

let's

this, I told

Ah, now then,

that.

We

a very small amount com-

it's

not the money, your son's got the

start to starve,

see each other too.

along, to keep in touch.

pared to what, what you've got. Look, it's

means they

lot.

you worry about his being drafted, he's in a category where he cannot be

don't think

he cannot be drafted,

drafted.

Why? He isn't in school. p.: He can't be drafted because he has to support you. So he cannot be drafted. He is not going to be drafted. Okay? Will you believe me? Now, then, how else could he leave you? He says

mrs. w. dr.

:

you're scared

when he

dates anybody, for fear that he's going

to get married

and go

and leave you.

mrs. w.

He

:

about dr.

p.

:

off

won't get married,

I

know

that. I ain't the least

worried

that.

This

is

the only thing

which makes

me

you

tell

think that this

us that you're not worried about, is

the one thing

you

are worried

about. (Laughing.)

mrs. w.

:

No,

if

a

were to marry him

girl

mrs. c: Knowing Paul, she

He never dated through



mrs. w.: He's not so

isn't

.

.

.

worried about that,

I

don't think.

high school and college.

that kid's smart, he, ah,

you

can't believe

it,

but he's smart, you know, you have to be smart to go four years to college.

dr. p.: Uh-huh. Okay.

TECHNIQUES OF FAMILY THERAPY mrs. w.

It's

:

hard to

Not only

dr. p.:

[444

believe.

he smart, but he's got a good job and he's making

is

good money. {To Paul) What do you think she's worried about? How do you think she paul {overlapping) I think just about everything. .

.

.

:

How

dr. p.:

do you think she thinks you're going

paul: Oh, I'm not, is

I, I

wouldn't want to analyze

to leave her? it

and say that that

her problem, because, ah, she's always {inaudible phrase), she's

been that way for a long time. {overlapping)

dr. P.

thing

that

is

.

.

:

I'm not saying

that's

the only problem, the

.

mrs. w. {overlapping): I'm not {inaudible phrase), clothes

paul:

gonna

last

me

the rest of

wouldn't want to say that

I

my life? my leaving

how

are these

was her big problem,

frankly.

mrs. w. mrs.

{simultaneously):

c.

mr.

Now the store's not gonna give me any.

:

I

don't think she's afraid of that.

What's that?

f.:

mrs. w.: The

store,

you any

give

you gonna walk up

to the store they ain't

clothes.

paul: She's always had the same basic attitude

mr.

Well,

f.:

paul:

.

.

Dr. P.

:

.

gonna

let's, let's listen

I'm trying to narrow

And

planation that's

left for

why Mrs.

life.

down here. I got the money thing draft. Then I go on to the one ex-

it

can't be the

it

.

to Paul.

for probably her whole

out of the way.

.

.

Willy

is

afraid that her son

is

going

to leave her.

Int.:

Did you

get any evidence that he really

was thinking about

getting married?

Dr. is

boy

And I think they were right. He was quite asexual. Was part of his motivation for staying in this situation

that

No. Everybody agrees that

going to do. Int.

it

this is the last thing this

P.:

:

saved him from the draft?

Dr.

P.

:

I

don't think so.

that in return for the house he

I

think he

made a

would give up

deal with his mother

all else

and so took vows

of poverty, chastity, and obedience.

Miss DeY.: I remember he wore a ring on his wedding When we mentioned it, he switched it to his right hand. Dr. P.

:

He was

finger.

a peculiar boy. I didn't feel I should pass judg-

Cleaning House

445

[

ment on his life, though he certainly got his kicks in a different way from the way I get mine. But he did have some feeling that this was not the culturally accepted role for him and that he was sacrificing himself to be his mother's keeper.

Sometimes you find that a wife or mother

Int.:

way

to pieces as a

of holding

somebody

like this will

As

else together.

go

she began to

pull herself together, did he begin to fall apart?

Dr.

would allow

who

had some concern about whether he did,

you allow them

rate,

Yes.

P.:

was

I

much

as

in the

And, of course, the major

threatening to leave her but that he

missed her allusion to

dr.

(to Paul)

p.

you

to convince

it.

that getting

dark as ever. Kal was the one

started to notice the hints Mrs. Willy

clothes.

and encouraged

the problem.

isn't

Dr.

We

didn't.

mother to get well. But he

his

At any

Int.:

married

No, he

P.:

:

issue

was dropping about the

was not

Paul was

that

was not supporting her properly.

here. I even missed Kal's effort to pick

it

What do you

I

up.

it

think would be the best thing for your

mother?

paul (laughing) Oh, I haven't any dr. p. What do you think? :

idea.

:

paul:

really don't.

I

mrs. c: Well,

I, I

couldn't

needed some kind

of,

dr. p. (overlapping)

:

3£Ct

mr.

f.:

.



*

.

had thought

that

it

I,

maybe I

was a nervous condition,

That would help temporarily, but

go right back to the same .

I, I

ah, of these shots, because

what she needed, maybe

that's

mrs. c:

you,

tell

I

she

thought see

.

.

.

think she'd

state.

a terrible nervous condition but,

now

I

don't know,



Now you don't know

mrs. c: Well,

I

mean

nitely didn't

need

thought that

it

.

.

.

the doctor out here in the hall said she defishots, so

was

I

have to go along with

that. I just

a terrible nervous cond-, condition, that

had

been brought up through the years of not always having security and, and she just sort of couldn't cope with

it

like the rest of us

can.

Int. (to Mr. F.)

you don't know"?

:

Who

were you talking

to

when you

said,

"Now

TECHNIQUES OF FAMILY THERAPY Mr. really

ing

The

F.:

think

sister. I

was

I

trying to say, "Since

[446

you don't

know, why don't you keep quiet?" That voice of hers was

affect-

me too. who

All the same, she's the only one

Int.:

giving

is

you any

facts.

Dr.

manage

Sure. We're trying to

P.:

her, but

we

don't want to

silence her completely. She's the only informant we've got.

woman, who

People

aren't so involved as the principals,

can see the

overall picture better, even though they sometimes drive

you out of

like this

And

your mind.

some more

cooperate with us and give us

at least she's starting to

real information, instead of cueing

Mrs. Willy

off

onto some

of her crazy talk.

C): Okay,

(interrupting Mrs.

dr. P.

how's she going to get

man

it?

okay, okay, she needs security,

She can't get

it

by marrying one more

after another.

mrs. c: No. No, no.

(To Mrs. W.) How are you going to get some What would give you security? What about a job?

dr. p.: She's tried that. security?

mrs. w.:

can't get a job. (Crying.) This

I

is all

the dress

I got!

mrs. c: Sweetheart! dr. p.

If

:

mrs. w. dr. p.

can't get

you could buy there, I have no car. job,

new

dresses.

He's got to go to work.

:

(overlapping)

c. .

.

think

I

:

Mr. Flomenhaft's got a

mrs. w.

Now, why do you say He can take you down

find

if

she

had some money coming

.

dr. p.:

dr. p.:

sorts of

all

Paul can take you.

:

in

I

:

mrs. w. mrs.

you got a

:

car,

he can take you.

foolish things like that?

and you could, once you your way, you can go on the bus. (Pause.) How would you

like to get

a job?

mrs. w. (overlapping) for a lady

to get a job

:

I tried that cleaning,

on one day and then she'd

and

I'd

go out and clean

say, well, I'd

work myself

nearly to death cleaning her house and then she'd want, ah,

on Friday, they all want, they think there's a lot of Fridays in a week, you know. dr. p.: Everybody wants a maid, wants somebody to do the cleaning on Fridays. mrs. w.: Yeah. (Pause.) mrs. c: It does seem to me like that she lost that security when she

somebody

to be there

Cleaning House

lost this

[

447

money. She had never worked before, she'd always

just

done housework.

And

Mrs. w. (overlapping)

was

that

Well,

:

I

thought that was

as I could write a check, that

mrs. c: That was

it,

more

a lot

mrs. c:

.

.

to

:

.

.

.

seemed

it

.

.

I

thought as long

.

.

.

.

to the fact that there

to be the beginning of

it,

she begin

money coming in and since done her own housework through

have

had never worked, only it,

woke up

but I

seemed

to see she hadn't, didn't

years,

security

it,

than that.

it

that, that

.

was

and then when she remarried

mrs. w. (overlapping)

was

it.

this

like then these

checks weren't coming in

.

she the .

.

Mm-hm.

dr. p.:

and now even though Paul

making the living, somehow or other she feels like that that's coming to Paul is not coming to her, and she worries because she doesn't want Paul to have to, it's, a lot of it's pride. She doesn't want Paul to have

mrs. c:

.

.

see,

.

and support

to take care of her

mrs. w. (overlapping) mrs. c:

I

mrs. w.: dr. p.:

know

that.

had

If I

her.

not pride.

It's

:

is

my

way, you know what'd happen?

What?

mrs. w.:

take a

It'd



well,

it

just couldn't

be done, that's

all.

What? What would you like to see happen? mrs. w.: You know when they built the May Company up

dr. p.:

how deep dr. p.:

there,

they dug?

How deep?

mrs. w.: Well, pretty deep, you know, was you here? dr. p.:

No,

wasn't here, I've been here two months.

I

like to see

mrs. w.: Just

happen? like

like that and,

dr. p.:

I

What would you

my

ah

don't think

mrs. c: That's

it.

.

whole house to sink down and be covered up .

(Starting to cry.)

.

you mean

When

she

that.

came

I

think you want to

my

some

security.

house she went to bed in

the daytime, to cover up. dr. P.

(overlapping):

fact that

Int.:

determined.

some of

Your I

And

I

think you're having to face

this security

has got to

tone changes here.

It

come from

up

to the

you.

sounds more forceful, more

get the feeling that you're shifting gears, changing over

from getting information to the stage where you decide what you're going to do.

TECHNIQUES OF FAMILY THERAPY Dr.

P.

we do tend

wasn't aware of this here, but

I

:

[448

to bear

down

toward the end of the interview. People are screaming, wanting some-

one

to

matter

go into the

how

small.

mrs. w.

MRS.

Alice

:

is

gonna

(simultaneously)

c.

Aw,

dr. p.:

mrs. w.

Yes, she

:

mrs. w.

(Inaudible phrase.)

:

cover up and

too.

is

—and maybe

I

seemed MR.

want

to

bed

in the

I gather, I just

git in

bed and cover up, because she say, "I just

want

walked

in here,

you know,

be able to continue to support you

mr.

know he won't

I

But

f.:

to hide

that, that

has happened lately that you feel that either Paul

mrs. w.:

daytime to

she'd go to bed just the minute she'd

and she'd

to hide,

to

from

see?

all,"

f.:

would go

See, she

:

swallowed her supper, and

it

home.

is.

(overlapping)

c.

this year.

she's not.

Yes, she

:

home,

lose her

she's not going to lose her

No,

dr. p.:

mrs.

and we've got to accomplish something, no

hospital,

.

.

.

.

.

is

something

not going to

.

.

.

.

MRS. w.: (Inaudible phrase.) dr. p.: You're saying

it

has to do with the draft, but

I

don't think this

because Paul's pretty secure as far as the draft

is it

is

concerned.

Have you thought

(Mrs. W. talking in background.) (To Paul)

about joining the Service?

paul: Oh,

sure.

mrs. w.: He'd college dr. p.

like to,

and

.

.

he wishes

now

he'd a joined

when he

got outa

.

(overlapping)

:

Have you thought about running out on

this

situation?

mrs. w.:

.

.

paul: No, not

You

dr. p.:

paul: Ah, well as

well as

paul:

1

don't think there

I

do and who could I

think you get

it

.

would handle

it

as

gratification out of handling

it

ao

anvone .

some

else that

.

wasn't existing, actually, but, ah

Okay. I

is

vou do.

I'd rather

dr. p.:

paul:

lately.

haven't?

Okay.

dr. p.:

get outa this mess.

.

wouldn't run out on

it.

.

.

.

Cleaning House

dr. p.

Okay.

:

I

mrs. w. (overlapping)

We

dr. p.:

way

want

to

or another,

just of all the

all

know

He's gonna be put out on

:

can't understand

I

people in the world,

paul (overlapping)

:

that.

make your mother more more secure.

mrs. w. (tearfully):

much

we

think that

449

[

why

one

self-supporting, in

does

you know,

just,

it's

it,

it.

it

happen

it's

me?

to

wouldn't mind her just being dependent as

I

as her constantly worrying

and talking about

the time.

it all

mrs. c: Just pacin' the ground, you know. Int.: You're finally confronting the son, asking

what he has done or such a

thinking of doing that has put his mother in

is

been

to

I've really

P.:

and

in bits

the sister

was

right out

state.

Dr. it's

him

pieces, because the

and the son

too,

is

been dealing with him for quite a while, but sort of deflects

con him into giving

which was that Int.

Dr.

P.

Int.

me some

Because he

:

At

:

it.

pretty distracted,

is

What

I

and

was trying to do

glimmer of what

I

suspected,

he was thinking of running out.

yes,

But you couldn't con

:

mother

least

it

out of him.

really wasn't thinking of running out.

you got the negative

side into the picture, to reassure

the mother. She's voicing doubts again.

Dr. his

own

P.:

She was feeling that he was doing too much, to stay with her.

life

able to keep

it

up.

And

sacrificing

She couldn't believe he was going to be

she probably

felt guilty too.

After

all,

she gave

Paul the house as a bribe to stay with her.

Was

Int.:

whether,

if

Dr.

there an element of testing in her craziness?

To

see

made it really impossible for him, he would still stay? The boy was clearly not going to put up with his mother

she

P.

:

being crazy. But he was quite happy to put up with her as long as she

cooked

meals and kept his house

his

straight.

having to go out and be a heterosexual, and better

husband to

the use of

Int.

his

mother than

his father,

it

This kept him from

enabled him to be a

and to gain power through

money. :

That's

why you

say he's getting some gratification out of the

situation.

Dr.

P.:

I

think the whole problem was that they hadn't worked

out a contract and her efforts to convey to return for the house

had failed.

him what she expected

in

TECHNIQUES OF FAMILY THERAPY All through this interview, but here particularly,

Int.:

way

you have a

members about Mrs. Willy

of talking to the other family

[450

as though

she weren't there.

Dr.

P.:

It's

way

hysterical

1

usually to let her

know

that

when she

don't approve of her. All the same,

talks in this

would always be

1

careful not to give the family the impression that by ignoring her

agreeing with them that she

but that

after

is

it

the patient.

is

I

do here

has been established that she

is

some

to

I

am

extent,

not as crazy as they

Once we have reached

commitment about the proper way of approaching this, I can go ahead and admit that she's acting crazy and deal with the other family members think and that they are part of

about the

reality of

too.

about the technique of dealing

in general

with one person by speaking to someone

where you aim

Dr.

P.

I

:

one

think

else. It's like

playing billiards,

ball in order to hit another.

we do

that

the time.

all

People can't very well counter you when you address them

Int.: that way.

for

a

her craziness.

I'm thinking more

Int.:

it

one of the merits of family therapy.

It's

—and

paul: There's no

she, she should

be able to function

as,

as a

housekeeper, or something, around the house, there.

mrs. c:

hard on Paul.

It is

When

morning dishes

a mess, the

mrs. w. (loudly):

He

still

he comes

there

.

.

home

to everything in

.

don't eat, that boy don't eat,

you know what

he eats?

What?

dr. p.:

mrs. w. (wailing): Maybe a few, couple a eggs lunch, he

in the

morning, no

comes home and he don't have any supper.

He can afford it, if he wants to. w.: And workin' in that [store] warehouse. c. (overlapping) He comes home for supper,

dr. p.:

mrs.

mrs.

:

she won't have

mrs. w.

mr. mrs.

He's

:

ready, see.

you,

(overlapping)

c.

skin and bones.

just, he's just

What do

f.:

it

but she can't,

why :

don't

She

you

.

just can't

.

.

seem

to get in there

and do

that.

mr.

... why

f.:

mrs. c:

mr.

f.:

dr. p.

Now

you cook him the meal? she did that all until the last two months, she did don't

What stopped (to Mrs.

W.):

that.

that?

Why

can't

you cook him a meal? Like you think

Cleaning House

he ought to eat? (Pause.)

I

[

43 J

think you ought to start cooking every

meal.

mrs. w. (overlapping)

mr.

f.

dr. p.: Well

miss De y.

Int.

.

.

Int.

is

what you've decided you're

all

How did you signal for this? And

a

woman

should cook. Every-

that.

You came up with this spontaneously?

:

Dr.

that's all.

.

She wasn't cooking.

P.:

body knows

and

you go out and cook him up a meal?

clear that the cooking

going to zero in on.

Dr.

don't

alive,

And start kicking.

:

It's

:

why

Well,

:

I'm

:

P.:

wasn't quite as simple as that. But everybody was

It

agreeing that one of the big problems was that she wasn't cooking

We

Paul's supper.

knew now

wasn't going to leave,

and

that Paul wasn't going to leave,

how were

they going to

work

if

he

things out while

he was there?

When

Int.:

keeper, that cues

Dr. P. me,

I

:

the son says she isn't functioning as a good house-

you

Yes. Paul was saying, "If only she would keep house for

could put up with everything else."

supper that night,

We

off?

were

start everything

end of the

all

know

:

Yes.

when Kal suggested

thought

was

cook.

It's

Dr.

:

a

all

in too,

had nothing

cook the meal,

and Carol followed

way you go about

getting this

I

us.

woman

to

a triple assault.

:

That's right.

You

into cooking, but

Dr.

the

that Paul

that Mrs. Willy should

good idea and jumped

It's interesting,

P.:

Int.

you're looking for that lever before the

The two women were saying

to eat, so

Int.

change that would

session.

P.

it

little

moving.

And you

Int.:

she would only cook his

a lever for the next day's interview.

looking for that lever. That

still

Dr.

we would have

If

P.:

don't see

it

as a

problem of how

to

manage

this

woman

how to pressure her into it.

There are two ways of going about

it.

One

is

to cut off

would prevent her from cooking. We'll say, "What keeps you from cooking?" and she'll say, "The pans are dirty,"

side issues that

is it

that

and well

say, "We'll

come out and help you wash

the pans."

Or

we'll

TECHNIQUES OF FAMILY THERAPY use a direct frontal assault, as

we

Though

did here.

it's

[452

com-

usually a

bination of the two.

But you would never, for example, get together with her

Int.:

by sympathizing with her about how bad a cook she was? Dr. P.: Never. We just tell people straight out what they have to do. The other way might work in a week, but we have to have results by the next day. We borrow a page from military psychiatry: "If you're tired and can't work, we'll give you a hot meal and a good and expect you to go

night's sleep

work tomorrow." This

to

basic,

is

the expectation of function.

Mr.

F.

She could spend ten years on the couch, finding out why

:

she couldn't cook. Int.: Another device into somebody's house

Dr.

Yes.

P.:

Willy while she Int.

A

you

use, as I understand

and put the few days

it,

is

to

go

right

mop in her hand. Carol was standing over Mrs.

later,

mopped her kitchen floor.

How far do you go in coercing people? P.: Pretty far sometimes. We had a school

:

Dr.

fourteen-year-old

who

girl

refused to go to school. Carol went out,

tried to get her dressed, struggled with her,

forcements. So Kal and

I

phobia case, a

and

dumped

joined her,

finally called for rein-

the girl in the car

and

sent her off to school.

Miss DeY.

After that, the family was able to take over and get

:

her to school themselves. Int.: I should think that part of your success

yourselves a

Dr.

little bit

Oh,

P.:

do whatever we "Okay, out of

I will

that

you make

disagreeable.

yes.

We've had people

them alone and stop picking

just leave

is

said.

my

sink

if

us and say that

:

One

us to say,

you'll just get this visiting nurse

of the functions of working this

the family together against the

team

way would be

Mr. F. Well, when someone comes for help, the whole means "There's something wrong with me." So we try to

want to Int.

say, "Let's agree that I don't :

people too

go halfway.

relation-

get

them

need you."

There's another factor in this direct assault, that far, they'll

to pull

that steps in.

:

to

we'd

my house."

Int.

ship

if

at all these fine points, they'd

woman who phoned

There was one

go back to

call

if

you push

Cleaning House

Dr.

That's possible.

P.:

Int.: There's something else about

When you

453

[

it

too. It's not really so direct.

you suggested that Mrs. Willy might go to work and everybody said, "How can she, she's crazy!" All this time you've been working to make her seem less crazy and to implicate started this interview,

the son, and you never push her to take responsibility without pushing

him

Once you got him to acknowledge that he wasn't going to then you could move in and say, "All right, Mrs. Willy, you

first.

leave her,

cook."

Dr.

P.:

It's

the process of negotiating a contract.

on only one person and

into trouble every time we've focused

make him change his way son to make a move too. "Since Paul

tried to

of operating without getting the other per-

We

have to be able to say to Mrs. Willy,

home and have

willing to stay

is

We've gotten

the burden of you,

why

don't you cook

him a meal?" When you say this, you're

Int.:

also telling the rest of the family

that they can act differently with her.

Dr. P.

:

Yes.

We

are relieving

them of the burden of making con-

cessions to her craziness.

Int.:

putting the environment to work. You're the experts,

It's

and when you refuse to make concessions to her, it invites them to follow suit. But from then on, it isn't so much that she's going to cook because you say

Dr.

P.:

so,

but because they say

gestions crisis.

When

There's another aspect.

they are in a state of

crisis,

and

it's

had two cases of

girls

these families

make come in when

a lot easier to

and have them followed than

We

so.

if

they

who were

come

in,

direct sug-

there

is

no

arrested for shoplifting. In

and we cleared

up by working with it on that basis. But in the other case, the girl was supporting her family by shoplifting because she didn't want her husband to go to work, she liked him at home with her. She had been picked up for this, and the judge let her off because she said, "I've got this one case, the shoplifting was part of a

fear that I'm going to kill

my

child."

crisis,

it

So he sent her down to the hos-

and she was sent on to us. When we investigated, we found everything peaceful at home, no crisis, no believability to the announcement about killing her child, nothing. What we did was to discount the

pital,

symptom and

tell

her husband to go to work, which, with sufficient

prodding from the authorities, he did.

We

treated

it

not as a

crisis in

TECHNIQUES OF FAMILY THERAPY be

their relationship but as a matter to

settled

[454

between them and

their

parole officers.

Int. ful

when

You seem

:

to

be suggesting that

there's a crisis. I

would question

direct pressure

is

only use-

A kind of mystique

that.

has

developed that a psychiatric patient should never be told what to do, but there's tremendous advantage in doing just that, not only in

crisis

situations but in chronic situations too.

Dr.

We've found

P.:

it

works

in

our situation. After

all,

we

did

get Mrs. Willy to cook.

That night?

Int.:

Dr.

P.

Int.

Willy to at

No, but the next one.

:

This interview travels from the point where you invite Mrs.

:

come

where you

to supper to the point

tell

her to cook supper

home. Dr.

We

P.:

feel that talking

about cooking

is

way

a better

of

dealing with someone's helplessness than talking to her about her helplessness.

That seems

Int.:

to

sum up your

approach.

But

the kitchen-sink school of psychiatry.

it's

One

could

call

you

not quite a real kitchen

sink.

Dr. P.

We

:

do tend

to use things like the kitchen sink as symbols

of functioning, but I wouldn't like our

method

to

be characterized that

way. mrs. c: We've house up, mills

it

around

phrase)

seemed all

two of you

in the

:

meal and keep the her so, she just

house and everything gets (inaudible

You know,

:

Well,

dr. p.: She's not helpless at

Int.:

his

like this thing just worries

that she's helpless,

(laughing)

c.

day

have

.

(overlapping)

dr. p.

mrs.

tried to talk to her to

maybe

she has just about convinced the

and

she's not.

you're right, there,

I

think

it's

.

.

.

all.

What's your evidence for saying that Mrs. Willy

is

not

helpless?

Dr. P.

:

Anybody who can keep

turmoil for that amount of time Int.: others.

But you don't

You

tell

is

this

many people

in that degree of

not helpless.

direct this speech to her.

You

talk to the

them, "She's convinced the two of you that she's help-

Cleaning House

way he

again that method of accusing somebody in a

less." It's

[

455

can't

counter because you're not talking to him.

Dr.

that she has convinced them, the implication

that she

is

You

Dr. P.

is

an

effect

This

:

is

to admit that they're being conned.

placing responsibility

on

her, too, for

making them

way.

Int.

Dr.

And on them for buying it. You

:

a very complicated

It's

That's what I want

:

mrs. c:

I,

I've got

comment when you

stop to think

she couldn't convince anybody.

If she's helpless,

Dr. P.

distribute the responsibility.

That's right.

P.:

Int.: it.

that this

say

put them in a bind. Either they stop letting her get

away with it or they have

about

is

I

trying to produce, that she has effectively produced.

Int.:

feel this

When

I'm not accusing her, I'm appreciating her.

P.:

a

silly

them

to see.

feeling that if she

had a pay check coming

week and she could see that pay check and it's made out in her name, that that would satisfy her (inaudible words). mrs. w. (overlapping) If I had a billion dollars in greenbacks in every

:

my

(inaudible phrase)

me one

wouldn't help

whole clothes

bit. It

closet,

or a house

might help you, but

it

full, it

wouldn't help

me. dr. p.

Why wouldn't it help you?

:

mrs. w. dr. p.:

Might not help you, either. Why wouldn't it help you?

mrs. w. dr. p.:

:

:

It

Because

it

just

wouldn't help.

wouldn't be enough?

mrs. w.: Well,

it

just ain't what's

needed. (Laughs.)

dr. p.: What's needed? I think what you're telling

man.

A

man you

A

can rely on.

man

me

is

you need

a

who's going to take care

of you.

mrs. w.: No, they're

around

like a

just like

—jack

in the box.

The whole group seems

Int.

:

Dr.

P.:

I

think

we

all

a stick to me, they're just walkin'

(Everybody laughs.)

to breaking

up over

this.

appreciated her sense of humor. For her

to put over a point as indirectly as that

and have everybody get

it

was

pretty effective.

Int.:

You must have welcomed

she wasn't really so crazy.

this

as another indication that

TECHNIQUES OF FAMILY THERAPY Dr.

P.: Yes. It

showed

had a

that she

lot of control

[456

over what

she said and did. Int.

Why

:

You

did you turn here and go in the other direction?

stop telling Mrs. Willy what you think she needs and ask her instead

what she'd

Dr.

like.

I'm

P.:

expects of her, so

I'm trying to find

bargaining for them. Paul has told

still

now I'm

he

what she expects of him. out what aspect of a man she wants him to provide, trying to find out

since as far as I could see she didn't need tells

me what

one for money. Well, she

me what aspect of a man she doesn't need. MRS. c: {Laughing, inaudible words.)

What?

dr. p.:

mrs.

dr. p. {to Mrs. W.) c.

last

two were such {laughing) mistakes.

think she'd want another.

I don't

mrs.

The

{laughing):

c.

You've had bad luck with them,

:

She did take care of the money and

:

the

all

I

know.

bills all

the time

Jerry was in the hospital sick with this heart trouble and, and she

she

felt authority,

these

bills,

felt like

even though these

that she has to, to lean

Int.:

The

money and pay checks were coming in, and now

she could handle the

it

seems to have

.

.

.

has swung around here. She's swung from her

sister

astonishment that her

on Paul,

sister isn't

going into the hospital to an apprecia-

how well she has handled a very hard life. Dr. P.: Yes. When she came in, she was on

tion of

she's

on her

she's

had a

wrong,

it

sister's side.

lot of trouble

must be

in the

She's saying,

and

she's

way Paul

"My

sister hasn't

coped with is

If

it.

Of

all

isn't

is

repeatedly

is

family member, the one least involved in the family, in the best position to change.

And

change in everybody

why we

else.

This

is

the

is

going

first

ad-

the person

that the extended is

the one

who, by changing, can focus so

is

so crazy.

the people in the interview, the sister

who has changed her attitude the most. Dr. P.: One thing we've noticed

Now

done so badly;

something

treating her." This

mission we've had from anybody that Mrs. Willy Int.:

Paul's side.

much on

who

is

effect a

the extended

family.

Int.

:

Do you try

in with the patient?

to see everyone or only those persons

who come

Cleaning House

Dr.

P.

Everyone that we can get hold

:

of,

[

457

everyone that we feel

plays any kind of part in the family.

mrs. w.: See,

had a

I

litde girl that

had

cirrhosis of the liver. Died,

eleven years old.

MR.

When was that?

f.:

mrs. w.

mrs.

c.

dr. p.

Oh, here a few years ago.

:

:

Four, four years.

Was this

:

between Gloria and Paul?

No, just four years ago. paul: She was the youngest. mrs.

c.

:

mrs. c: She died after Jerry. She died died

.

.

.

paul: She

.

.

mrs. c:

.

right,

a year after Jerry

.

husband died and he paul (overlapping) She was the youngest child by the mrs. c. that was a terrible shock to her. .

one year

.

after her

:

:

.

And

paul:

.

first

husband.

.

.

The youngest

dr. p.:

.

.

child

by the

first

husband.

she was the second from the bottom, as far as age goes.

mrs. w.: Anyway, she died.

was at the hospital most of the time with her for four years, off and on. (Long pause.) dr. p. (to Mrs. W.)\ What do you enjoy? What do you like to do? I know you like to have your house looking good, but what else do you like to do?

Why

Int.:

I

does Mrs. Willy suddenly come in with that story

about the child?

Dr. about in

P.:

how

I

think she was reacting to what her sister

well she

had done. She wanted to display another instance

which she had struggled with a Int.:

Dr.

was pleased feelings

I

don't think I

was very sympathetic

to her,

though

I

gather you're not interested in helping her explore her

I

Dr.

P.:

Int.

:

No.

Is that

Dr. P.

:

I

who died.

didn't

why you

want to get into a long

grief reaction.

cut her off?

She cut herself

end of that story and where :

time and done well.

to see her functioning so well.

about the child

Int.

difficult

She's talking with a lot of real, not crazy, feeling. P.:

Int.:

was saying

I

off.

came

There was quite a pause between the in.

All through the interview you've been asking about the bad

TECHNIQUES OF FAMILY THERAPY happened

things that have

you

to her, but here

[458

"What do you

ask,

enjoy?"

Dr.

This

P.:

a technique I use quite often

is

when someone

is

depressed.

Then you

Int.:

from "What do you enjoy?" to suggesting

shift

You

that she enjoys housework.

go from what she

what she

likes to

When it doesn't follow logically.

likes to do.

Dr. P.

We know

your house clean.

way

another

It is just

:

"We

of saying,

expect you to have

you're going to be functioning from this

point on." Int.:

hypnotic technique again.

It's

work;

she's going to

it's

just a question of

mrs. w. (overlapping) pies,

mrs.

c.

mrs. w.

.

.

.

cream

.

...

pies,

.

.

it

for granted that

when she has

lovely

.

No, I'm not either. you know, with frosting on them

:

mrs. c:

.

she,

:

She loves flowers

:

.

take

what kind of work.

When

mrs. c: She's a wonderful cook. salads and things like that

You

I .

used to

make

chocolate

.

.

and

.

.

.

she had beautiful roses in the back, she was proud of

them.

mrs. w.: mrs.

c.

I did,

Now

:

oh,

my gosh!

the roses are

all

up

in

weeds and that bothers

her.

mrs. w. (wailing): Weeds, weeds, weeds, weeds! Hundreds of growin' up, dr. p.

it's

gonna, the neighbors are going to

.

.

trees

.

Why don't you go and mow them?

:

mrs. w.:

I can't, they're, they're,

dr. p. (to Paul)

:

What

beyond, beyond, ah, control.

are your plans this weekend?

paul: Pardon?

What

dr. p.:

mrs. w.: paul:

are your plans this

weekend?

He works.

work.

I

He has no weekends. paul: Except for Monday and Wednesday. dr. p.: You work every day except Monday and Wednesday. Okay.

mrs.

c.

:

What paul: Oh,

are your plans I

don't

dr. p.: Okay.

know.

Why

and clean the

Monday?

you and your mother thing up? don't

mrs. w.: Beyond control.

get out in the yard

Cleaning House

Aw,

dr. p.:

don't believe

I

control, we'll pass

mrs. w.

Oh,

:

know

I

We'll see

it.

judgment on

it

and say

just the

it is. It's

on Friday.

it

it's

gonna be up

to

(overlapping, to Paul)

dr. p.

.

.

beyond

weeds, they're growin' up, the it's

gonna be that

tall,

.

Would you

:

it's

so.

edges are growin', and by next summer,

and then

If

459

[

like a chocolate pie?

paul: Not especially.

What would you like your mother to cook? dr. p.: What would you like for your mother to cook for you? paul (laughing) Oh, I don't know, whatever we have, chicken mrs. w. (overlapping) He'd like to have a good meal once more mr.

f.

:

.

:

:

.

.

in

his life.

mr.

f.

What's a good meal?

:

miss DeY,

:

He wants

chicken.

dr. p. (simultaneously): Look,

what I'm saying

is

this

—chicken, he

wants chicken.

mrs. c:

If

up

it's

to Paul,

it's

baked duck. (Laughing.)

He

used to

bring the baked duck home. (Laughs.)

Int. I

take

When you

:

this is

it

Dr. sister

P.:

was the one who had handled the and by putting Paul in charge we were making a

that Mrs. Willy

change from the way things had been. But try to point out

members can do osition,

"Okay,

even if

for

if

you go

around with

mother to clean up the yard,

Yes. Something they can do together this time. The

then,

till

his

again finding something specific they can do.

was saying

yard up

and

direct Paul

some

to

think in every interview

we

relatively small, practical thing the other family

to help. just

it's

I

As

I said before, it's

got to be a mutual prop-

a face-saving device.

I'll

say to a husband,

work and bring home a pay check and

women and

quit drinking, your wife will

quit running

cook lamb chops

you once a week." Int.

:

Dr.

P.:

sibility

It's this

bargaining again.

That's right. Since

the yard was,

we

said,

we weren't clear about whose respon"You do it together." Otherwise we

might have handed the task to Paul alone. Int.:

How

successful were

you

in getting

them

to clean

up the

house and yard?

Dr.

P.:

The day

after the

Gloria, the oldest daughter,

second interview,

we went

out,

and

had done some work about the house and

TECHNIQUES OF FAMILY THERAPY was out mowing the lawn.

We

told her to leave

it till

[460

Paul came home.

He got the yard done by the following Monday.

Why was Gloria there mowing the lawn?

Int.

:

Dr.

P.:

for our

visit.

She was invited All the same,

to.

Mrs. Willy wanted things to look nice

when we

around wringing her hands and saying that simplified her task.

We

focused

first

was walking hopeless. So we

got there Mrs. Willy

was

it

all

on the kitchen

floor,

then on

this,

then on that, until she finally got the place cleaned up. Int.

:

You went step by step with the housecleaning?

Miss DeY. she'd

No, we'd

:

know what

to do.

she had done what till

she did

floor,

it.

It

just say generally,

"Clean the kitchen," and

We'd check with her each day

we expected her

to do, or

sure

all

mop

the kitchen

the rest.

And you kept on pressuring Paul to do his share?

Int.

:

Dr.

P.:

Yes.

To weed

the yard, get the washing machine fixed,

get his motorcycle off the porch.

came quite sophisticated and with some of them. Int.:

make

go out and stand there

took us several days to get her to

but as soon as she did that, she got through

to

How

With other

subtle.

families, later on,

We'd go through

do you decide on what

we

be-

entire schedules

practical tasks to give your

families?

Dr.

P.:

It

depends on the kind of things they say they haven't

been doing. With one woman,

and moving it

to the laundry

it

was picking up a

pile of dirty laundry

room.

What do you do when you have somebody whose can't be pinned down to a matter of mopping the kitchen floor? Int.:

Dr. P.

:

We don't usually deal with kitchen floors with nonpsychotic

women. When people lives,

are able to handle the daily aspects of their

there isn't the problem of getting

to deal

more

trouble

in abstract ideas.

But we

them still

to function,

feel that if

and we tend

we can

take the

some practical gesture, we're ahead of the game. One case we had was a nurse who was married to a very hard-driving, successful man and had managed to keep up with him. He would call her on the phone and say, "I've got a live one here, come on down and we'll have martinis for lunch." And she'd come down and join him in this salesman-like world and it was abstract and reduce

it

to something concrete, to

became physically ill and had four operaThen she began demanding that he stay home witr

a great relationship, until she tions in a year.

Cleaning House

her and give her a

and he'd

little

if

you want to be with me, you've got

me." Finally she called him and

join

I'm going to

psychiatrist,

kill

about

it

said, "If

And

myself."

now, I'm closing a big deal,

right

up with you,"

support. She'd say, "I can't keep

say, "I don't care,

[461

I

you don't

he

won't be

me

to a

"Look, I'm busy

said,

home

get

to

tonight, we'll talk

We

tomorrow." So she made the suicide attempt.

saw these

two people together and we were dealing with abstractions the whole

The only

time.

One

practical suggestions that

made was

suggestion the husband

which she had done before.

And

were made came from them.

that she take a job in his office,

she did, and they've

made

a pretty

good adjustment. But I don't think we assigned any other tasks. Miss DeY.: We suggested that they go out and have sex undei

was because they

the trees. This

marriage when they

go

felt

most

told us that the times during their

and happy was when they would

free

summer cabin, and when they felt like it, they would woods and "have sex under the trees." So we took their

off to their

run

off to the

happy reminiscence and based a

practical suggestion

on

it,

to try

and

bring out the strengths in the marriage.

Dr.

We

P.:

don't like to impose a task

come up with one one, as

it

was

Mr. F. come from

themselves. If the situation

we can is

get people to

a relatively healthy

here, they usually do. I

:

if

think

it

also

makes a

difference that

a lower-income population.

It's

most of our patients

easier to reach a task-

oriented outlook with people in that group. Int.: That isn't always true.

more

The more educated people

often this sort of approach works, because

can't handle

you by

it.

it's

People come in expecting a

are, the

so simple.

They

lot of psychiatric

them to perform some ordinary task. Dr. P. We've had a few people come in and say, "What kind of therapy is this? I thought you were supposed to lie down on the couch

gobbledygook, and you

tell

:

and is

talk."

They

are quite surprised.

But

I

agree with Kal, this approach

often resented by upper-middle-class families.

Int.

Your kind

:

of therapy also has the advantage of not threaten-

ing to expose people. You're not going to drag

all

the skeletons out of

people's closets.

Dr.

P.:

That's true.

have been careful about

secrets,

for

up more trouble than we could deal with in a few We're trying to separate secrets that are known, or should

fear that we'd dig interviews.

We

TECHNIQUES OF FAMILY THERAPY from those that should be kept

be, but are being denied, feel

we

move

can't

frozen relationships so long as there

secret.

ial

looked

it

There

at.

is

We

something

is

we

embarrassing which everyone knows about but can't face, so get

[462

try to

also the kind of secretiveness that looks triv-

but which actually amounts to a block in communication, such as

On

Paul's hiding his financial setup.

the other hand,

we

don't see

advantage in having everybody shout out the details of past

Miss DeY.

what impresses us most

I think that

:

is

much

affairs.

amount of

the

confrontation families are able to take. They're not as fragile as you'd think.

what I'm trying to say

dr. p.: Look,

a helpless child

like

is

this

—anybody who Now

going to act like one.

is

is

treated

somewhere

along the line your mother has started telling everybody she's a helpless child

and she

anything, and

all

do anything, she

can't

the world's going to

fall in

As

own

you've begun to believe

it.

far as her

can't take care of

on top of health

is

her,

and

concerned.

paul (overlapping) Oh, no, I, I usually get up. I say, "Would you mind fixin' my breakfast?" And lately she hasn't been fixin' my breakfast. But when she did fix my breakfast couple eggs, no salt, no pepper, burnt Mrs. c: That's just in the last :



.

.

.

.

paul:

.

dr. p.

.

.

so I'd rather

dr. p.

(to

c.

:

Mrs. W.)

She

just

.

:

Can you

.

.

silly

mrs. c: See, she does

them burn up.

it's

I

around the

on the

fix his

eggs? (Pause.)

start these things,

just forgets

Again you make the point that

:

As

I

if

is

fix his eggs.

but she walks away and

lets

about them.

if

Mrs. Willy

helpless,

is

she were helpless.

said before,

patient. This

you can

we put

also the

the responsibility

most

effective

way

on the people

to put pressure

patient.

Int.:

By

this point in the interview, the

not treating Mrs. Willy as

about

breakfast.

question, of course

mean, she

because they treat her as

Dr. P.

my own

Um-hm.

dr. p.: Well, that's a

Int.:

.

That's just been in the last couple of months.

:

mrs. c: Yeah. mrs.

fix

.

how

if

son and the

she were helpless.

well she cooks, and the son

is

The

sister are

sister is talking

complaining about

how

his

Cleaning House

breakfast

being fixed, not that his mother

is

is

crazy. This

is

[

463

a major

shift.

Dr. P.

We've gotten down to the

:

real issues.

why you

Int.: Like burning the eggs. I'm wondering

wouldn't

bring up the idea that she might be burning the eggs because she was

Why you wouldn't go into the feelings behind

angry at Paul.

Dr.

Because, whether she

P.:

is

angry or not,

you

feel,

feelings

you

still

something

don't care

her aware that this

make

her stop burning the breakfast. Making

something she can choose not to do, and making

is

the person she's cooking the breakfast for aware of this too, to

how

have to clean the kitchen." Exploring Mrs. Willy's

not going to

is

this is

"We

she has control over. Carol once said to a patient,

it.

is

going

make her stop it.

You

Int.: tell

wouldn't

some

feel, as

her that burning the breakfast

she'll feel

is

a

therapists might, that

way

of being

mean

if

you

to him,

so guilty that she'll stop?

Dr.

P.:

We'd have

think that would be a

I

to get her agreement

on

little

complicated and abstract.

and work through

that motivation

the whole thing. Int.:

notice that

I

you

felt

you'd

made a mistake

here,

where

you corrected yourself about fixing the eggs. Dr. P.: I did make a mistake. We're not asking her opinion about whether she can

fix his eggs.

You would have

Int.:

We're assuming she can.

preferred a phrasing of "Will you fix his

eggs?"

Dr. I

Yes. But by making a mistake and covering

P.:

made

think I

the point

more

effectively than

if

it

I'd said

that way, it

right to

begin with. miss dcy.

mrs. w.

:

:

Well, Well,

tomorrow morning before you come I

don't see

dr. p.: Look, let Paul

how

in

.

.

.

Paul can miss work.

worry about

that,

he can miss work tomorrow

morning.

mrs. w.

Can't, can you, Paul?

:

dr. p. : Sure he can.

paul:

I'll

mrs. w. paul:

:

just call

'em up,

they'll

probably give

Well, what are they gonna do for a

me

the whole day

off.

man?

(Inaudible phrase.)

dr. p.: Let

them worry about

that, you're

worried about everybody

TECHNIQUES OF FAMILY THERAPY

[464

problems, even people in Holland, and that's a long

else's

way

away.

mrs.

c.

Well, that's where her mother was born.

:

dr. P.: Yeah, but she's not there now, so

Holland, or

not worry about his problems.

let's

MRS. w. (overlapping)

on the dr. p.

mrs. w.

till

she had a beautiful

little

the street.

home.

And

she kept

up

real

she was aged seventy-six years old.

paul: She can

.

.

.

(simultaneously): That

c.

mrs. w.

a problem.

is

No, she has three babies and she dr. p.: She can bring them, too. mrs. w.: She's got to get some of them in school and dr. p. She can bring the three babies, we'd like to see :

.

.

.

:

mrs.

it

Look, can your daughter come in tomorrow, too?

:

mrs.

died before she was thro wed

street.

And

:

nice dr. p.

Thank God she

:

Now, nobody's been throwed on

:

not worry about

let's, let's

(low voice)

c.

paul: Would you miss DeY.

:

I

don't think she'd

like to

come

.

.

.

.

.

her, too.

.

have her come?

Yes.

:

dr. p.: Yes.

mrs. w.

:

I

don't think she can come.

paul (overlapping) Well, we can request it. mrs. c: You're going to find part of the trouble terical, nervous woman. mrs. w. Well, why wouldn't she be? :

there, a very hys-

:

mrs.

when, when she has her problems and brings them home to her, and she carries on and goes on about her c.

She upsets

:

her,

family and her problems with this terrible, hysterical (sighs) tone of voice and then she's

all

(overlapping, to Paul)

dr. p.

the world's going to

paul: No, ah, mrs. w.

:

come

:

upset for days and days about Is

she just like your mother, thinking

to an

end the next minute?

she's pretty optimistic, but she just

She's

more

it.

.

.

.

optimistic than she's got a right to be.

paul (overlapping): She's, she's kind of, ah, ah, I don't know, you know, she talks in either a loud voice or screams or mrs. c: Nervous. paul: Very nervous. mr. f. Does she make you nervous? mrs. c: Yes. dr. p. You know, it's a wonder you've stayed as long as you have. .

:

:

.

.

Cleaning House

MRS. c:

And

she goes on then for days about their problems,

they are, the daughter brings these problems

home

Int.:

It's

.

.

how

and she

to her

them but she does paul: I know, she's not like Mother at all, she, ah, seems control when it comes to talking like this, you know. shouldn't mention

465

[

.

amazing to hear the son now defining

who has some control over herself. Dr. P.: I think he may be reacting to the new mother that has come out during the interview.

his

to lack

any

mother as a

person

Was

Int.:

evaluation of his

Paul right in saying that Gloria was

less controlled

than his mother?

was continually reinforcing her mother's belief that the dikes were going to break in on her. Mrs. Willy would say, "Maybe if I could get things cleaned up, the house would look a little better," and Gloria would say, "No, it won't." And she'd say, "Paul is going to starve," and Gloria would say, "He probably will." By constantly undercutting him, she was expressing her anger at her mother Dr.

P.

:

Well, she

for turning the house over to Paul.

Did you work with

Int.

:

Dr.

P.:

We

tried to get

this

daughter?

her to

come

in,

we Wayne, who

but she wouldn't. So

concentrated on extruding her. There was another boy,

was Mr. Larrabee's son by a previous marriage. He was the and he had been heard to say that he was so

heir to the house

Paul that he was going to

We

kill

him.

He was

rightful

mad

at

a very psychopathic boy.

never saw him, but the opinion of everybody in the family seemed

to support this.

There was some

realistic

basis for Mrs.

Wayne would make some effort to hurt We never saw the uncle who came and took the

Willy to

believe that

or incapacitate

Paul.

little girl

away,

but his primary concern was that she shouldn't be around because

Paul wasn't strong enough to handle the situation. All these relatives

were trying in one way or another to undermine Mrs. Willy's Paul's ability to support her,

and they were

house as

station.

get

them

if it

all

Int.:

were a railway

One

all

coming

of our

first

in

belief in

and out of the

maneuvers was to

out of the picture as soon as possible.

How

did you do that with Gloria? She lived just

down

the

street.

Dr. P.

:

We

got them to

fix

the washing machine, so that Gloria

TECHNIQUES OF FAMILY THERAPY have to do Mrs. Willy's laundry.

didn't

was making

that her dismal outlook

that

it

would be

better

home

to her shop,

later.

So we reduced Int.

Mr.

:

little girl

this chaotic

same

didn't return

sent Mrs. till

Clapp back

a couple of months

house of cards down to the duo, which

How did things turn out? Very

F.:

met Mrs. Willy

well. I

may

in the supermarket the other

you wouldn't know she was

attractive

She has a part-time job and

lady.

gone back to school but job and

We

mother and

quite successfully.

day and she was so pleasant and the

pointed out to Gloria

things worse for her

she'd stay away.

if

and the

we then worked with

And we

[466

thinking about

is

What was

take that instead.

Volkswagen, which Mrs. Willy over the state in

just loved,

is

it.

doing nicely. Paul hasn't

He's been offered a better

nice

was

that Paul

bought a

and they've been traveling

all

since.

it

you give some information quick before she gets away?

dr. p.: Okay. Well, look, ah, can secretary real

to our

mrs. c: Yeah. dr. p.:

And,

take

.

I will

give

you some medicine

for

you

to

.

Do you know

mrs. w.: Miss DeY.

.

and

ah, yeah,

where to come

at,

ah, Friday

morning?

We'll find out tomorrow.

:

and you and your son and hopefully, come in at eight o'clock in the morning and

dr. p.: We'll find out tomorrow,

your daughter,

will

see us.

mrs. w.: Now, what

would you Miss DeY.

:

.

.

if

don't

make

it,

what

if

he can't get

off,

.

He'll get off,

dr. p.: He'll get

we

off,

and

make it. make it. If there's any

you'll

you'll

difficulty

about

anything, call us on extension 506.

paul: All dr. p.:

right.

399—

Miss DeY.: 1211. dr. p.:

1211. (To Mrs. W.)

Now,

room.) paul.:

399—

Miss DeY.

:

1211. Extension 506.

paul: That's Dr. who? Miss DeY.: Dr. Frank Pittman.

paul: Pittman.

we'll give

you some

pills.

(Leaves

Cleaning House

My name

Miss DeY.:

paul: Oh,

all right.

miss DeY.

Ah, and

:

paul: All

there's

if

be

right, we'll

467

Miss DeYoung. (Spelling) D-E-Y-O-U-N-G,

is

Y-O-U-N-G. And

capital

[

he's

any

Mr. Flomenhaft.

difficulty, this

evening or

.

.

.

Ah, where do you want us to come?

in.

miss DeY.: Right here.

paul: The same, ah miss DeY.

Yeah.

:

.

.

.

Voices fading away, tape recording ends.)

(

When you

Int. (to Miss DeY.):

begin that

"Tomorrow morn-

come in," what were you planning to tell them? Miss DeY. I was going to say to Mrs. Willy, "Tomorrow mornbefore you come in, fix Paul's breakfast."

ing before you

:

ing,

Int.

Dr.

And this got lost in the shuffle?

:

P.:

I

my

guess

impatience to end the interview was pretty

evident in that I was cutting Carol

shouldn't have, because Carol

off. I

was pursuing something very important, which was that Mrs. Willy should

Int.

cook a meal.

You would

:

to settle the issue

ideally

aim

to settle at least

one issue that

first

interview?

Dr.

was

Yes.

and

settled,

would

it

I

think

Dr. P.

:

Int.

:

Did you take

Dr.

P.:

agreement on

We

specific

took

the case again, I

that.

the breakfast the next day? it.

this as discouraging?

as a

it

little bit

discouraging and were a great

about what she was to do the day

and cook Paul's breakfast

we

course, one important issue that

was the matter of the

knew

we were doing

Yes, and she hadn't cooked

to clean the kitchen floor

Of

that the matter of the cooking

assumed

Did you check about

:

more

I

certainly wasn't. If

try to get a clear-cut

Int.

deal

P.:

pills.

after,

too.

did settle in the

Before they

left,

I

made

which was

And first

she did.

interview

sure Mrs. Willy

she had to take them.

Int.:

Dr.

And did she?

P.:

Yes. That was the

first

We

also got her to admit that she

feel

we have

to obtain

thing

we checked on

night's sleep.

We

improvement during the

first

had had a good

some evidence

of

the next day.

twenty-four hours. ,

What would you have done if she hadn't taken the pills?

Int.

:

Dr.

P.:

We

would have asked for a very clear-cut understanding

TECHNIQUES OF FAMILY THERAPY about

why

[468

member

she hadn't, particularly whether some other

of the

family had been standing in her way. Int.: Is

it

also that

you want evidence

that they have followed

through on a directive of yours?

Dr.

Oh,

P.:

the interview

yes.

was the

But since the only thing we

we had

pills,

on in she had

really insisted

to establish not only that

taken them but that she had allowed herself to feel better. Int.

she

is

:

You put in the assumption that if she feels better it's because

willing to feel better, not because she has taken the

Dr.

P.:

We made

That's right.

it

clear that

pills.

it's still

something she

controls.

Int.

:

I'm beginning at

and

to this interview,

this point to notice

I'd like to

know

if

a fairly clear structure

this is the

sequence you

comes the confrontation when your group wants out and the family wants to put her in, and you pull

generally follow. First to

keep the patient

makes it very difficult for them to press for hospitalization. Then you get them committed to coming into therapy as a family. Then you start exploring the issues that are involved. Finally you move that switch that

in to

make specific recommendations. Dr.

we

thing

P.:

think you're right. In

I

try to

do

is

all

our

initial interviews,

to dispel the family's idea of

the idea that "So-and-so

is

crazy and has to

the rest of us are not involved but

we

the

first

what the problem

come

to the hospital

suffer a lot as a result of it."

is,

and

And

minutes are the most important part of the interview. Then

this first five

we go on and convince the family of the value of our approach in such a way that they are prevented from doing anything else. Then we get information. And in the last part of the interview, we make it clear what we expect of everybody for the next twenty-four hours. We don't deliberately divide the interviews that way, but this

roughly follow. Of course in this interview as

Int.:

I

rationale for

Dr. P. as

we

see

Or

We

much

didn't get as

information

we generally do. it

moving

you usually provide the family with a into the last stage than

Yes. We're usually

you did

much more

little

more

here.

explicit

about the picture

You

couldn't be explicit here, because

you

didn't under-

it.

Dr. it.

varies.

a pattern they

it.

Int.:

stand

:

take

it

is

P.:

That doesn't mean we couldn't

at least tell

tell

them we understand

them what we do understand. I'm surprised

at

how

Cleaning House

we were. The next of the way we saw the thing. inexplicit

Int.:

we gave them a

day,

469

very clear outline

you want, do you

you're not getting the information

If

[

sometimes take a break and then meet again?

Dr. say,

:

If

we

good moment to

don't have a

"Look, we don't understand

about

and

it

in half

was

this yet,

and

we'll get together

picture looks to us so far

getting late

and

was going on a little

I

was

we do

and

it,

We

we

this,

also thought

P.:

it

specific directives

Yes.

We

hadn't

that

when Paul

and

filled all

told

Dr.

P.:

comes up during the

Yes.

We

tell

you he wasn't

move

to the stage

the holes in the picture but

we

right direction.

name and number

Before ending, you give them a

in case anything

But here

start to close.

were pretty clear and we were moving in the Int.:

it.

we understood what

going to leave, this gave you sufficient assurance to

Dr.

usually explain

we did.

Int.: In any case, I take

where you give

we may

meet back

we'll

and ask them to work on

tired.

better than

If

start closing,

so you get together and talk

talk about

an hour and compare notes."

how the it

P.

to call

night. Is this routine?

the family that

we

are available any time

they need us. We're offering an alternative to hospitalization, and the idea

is

that since the hospital

is

available to a patient twenty-four hours

a day, we should be available too.

How long did you see this family?

Int.

:

Dr.

P.:

They came

in eight times over a six-week period.

At

the

end of that time they were doing so well that we didn't refer them. Instead,

we asked them

Int.

Is

:

Dr.

P.:

during the

it

to call us

if

they needed us.

usual for you to see people this long?

This was longer than usual.

first

We

saw them

intensively

week, and after that mostly when Paul was

off

work,

Mondays and Wednesdays. Miss DeY. I made home visits on two Saturdays. Int. How do you decide when to terminate? Dr. P.: I usually say that it's when they no longer present the symptoms that brought them to the emergency room. But we take care :

:

to spell this out to people

from the beginning, so that they won't expect

a long-term arrangement. Int.:

You make

it

clear that you're a limited service

they have to start pulling their

Dr. P.

:

Yes.

and that

own weight.

We make a referral if treatment seems to be dragging

TECHNIQUES OF FAMILY THERAPY on too

We

long.

gencies and that

we

we're referring them Int.

Do you

:

them

explain to will

that we'll

cooperate in any

be available

still

way we can with

[470

in

emer-

the source

to.

have any problem in educating

the approach you use, so that they won't

work

you out of some different treatment ideology? Dr. P.: Our experience with the people

We see them

they are very receptive to us.

referral agencies in

at cross

purposes with

in these agencies

is

that

as vital to the success of our

work and extend ourselves to them, and they are very cooperative as a result. They may see what we do as a different kind of therapy than what they're used that

it is

to,

but

I

think that the fact that

and even simple, makes

practical

it

not mysterious,

it's

very appealing to them.

Also, part of our hope in educating these agencies

to

is

make com-

munity resources more available to people who are in trouble, so that they won't automatically think the hospital

is

the only answer.

Part of your fight against hospital addiction

Int.:

is

to train the

social agencies that could take the hospital's place.

Dr.

P.:

who work

That's right. For the most part, people

outpatients are not accustomed to handling psychotics, or see them,

it's

generally in a hospital setting.

As

a result,

if

if

with

they do

a patient acts

crazy or threatens suicide, they get frightened and call the hospital. Very often a person gets sent to the hospital because of that kind of anxiety,

not because this Int.:

You

is

what ought to be done.

feel that

some

of the difficulty lies in the

community

services that feed the hospital.

Dr.

P.:

Yes.

And

no advantage

the hospital can't survive without patients, so

them in keeping people out. well-functioning emergency service. The admitting there's

to

beginning to sort out some of the people tion

and

who

to provide short-term treatment for

alternative.

We now

have a

psychiatrists

are

don't need hospitaliza-

some

individuals as an

As

a result, we're getting tougher cases now, which delights

At

least you're

us.

Int.:

having some impact on the hospital com-

munity.

Dr. P.

A little. But what we

do goes against established practice and is far from being accepted. One difficulty we face comes from certain aspects of psychiatric theory. I teach residents and medical students that a doctor is very limited in what he can do. Most of what he :

Cleaning House

can

effectively

accomplish

aspects of reality, then

let

is

remove

to

the body's

stresses

own

[471

and manipulate certain

innate defenses take care of

the healing process. This applies to surgery, to psychiatry, to anything in medicine. It's certainly possible to try to reinforce the body's ability

to handle stress, but this

is

difficult

and not often

effective. Psychiatry,

under the influence of psychoanalysis, has gotten into the habit of thinking that this

is

the only thing of value. I'm not questioning the

theory, but I feel that

we need

niques which concentrate not so ing the situations they are

in,

to develop new,

more

practical tech-

much on changing people as on changso that they have room to grow and

develop on their own. Int.

and a

:

You seem

to have

changed the situation here. In

half, the relationships that

realigned.

The mother and son

came

are

now

in the

P.:

You're

right. It's

then on was only reinforcing

door have been

hour

totally

acting as equals in a friendly

become a sympathetic bystander. possible that everything we did from

bargaining situation, and the sister has

Dr.

this

this basic

change.

Bibliography

This selection of articles and books on marriage and family therapy emphasizes therapy more than diagnosis or research.

Ackerman, N. W.: "A Dynamic Frame for the Clinical Approach to Family Conflict," in Ackerman, N. W., Beatman, F. L., and Sherman, S. N., eds.: Exploring the Base for Family Therapy. New York: Family Service Association of America, 1961.

Ackerman, N. W.: "Emergence of Family Psychotherapy on the Present Scene," in Stein, M. I., ed.: Contemporary Psychotherapies. Glencoe, 111.: Free Press, 1961.

Ackerman, N. W.: "Family-focused Therapy of Schizophrenia," in Scher, S. C, and Davis, H. R., eds.: The Out-Patient Treatment of Schizophrenia. New York: Grune & Stratton, 1960. Ackerman, N. W.: "Family Psychotherapy and Psychoanalysis: Implications of Difference." Family Process, 1 (1962), 30-43. Ackerman, N. W.: The Psychodynamics of Family Life. New York: Basic Books, 1958.

Ackerman, N. W.: "Toward an Integrative Therapy of the Family." American Journal of Psychiatry, 114 (1958), 727-733. Ackerman, N. W.: Treating the Troubled Family. New York: Basic Books, 1966. Ackerman, N. W., and Behrens, M. L.: "The Family Group and Family Therapy: The Practical Application of Family Diagnosis," in Masserman, J. H., and Moreno, J. L., eds.: Progress in Psychotherapy, Vol. 3. New York: Grune

&

Stratton, 1959.

Alexander, I. E.: "Family Therapy." Marriage and Family Living, 25 (1963), 146-154. Appel, E., Goodwin, H. M., Wood, H. P., and Askren, E. L.: "Training in Psychotherapy; the Use of Marriage Counseling in a University Teaching Clinic." American Journal of Psychiatry, 117 ( 1 96 1 ) 709-7 11. Arlen, M. S.: "Conjoint Therapy and the Corrective Emotional Experience." Family Process, 5 (1966), 91-104. Arnold, A.: "The Implications of Two-Person and Three-Person Relationships for Family Psychotherapy." Journal of Health and Human Behavior, 3 (1962), 94-97. Bannister, K., and Pincus, L.: Shared Phantasy in Marital Problems: Therapy in a Four-Person Relationship. London: Tavistock Institute of Human Rela,

tions, 1965.

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474

"Family Therapy in an Army Mental Hygiene Clinic." Social Casework, 44 (1963), 452-457. Basamania, B. W.: "The Emotional Life of the Family: Inferences for Social Casework." American Journal of Orthopsychiatry, 31 (1961), 74-86. Beatman, F.: "The Training and Preparation of Workers for Family-Group Treatment." Social Casework, 45 (1964), 202-208. Becker, J.: "Good Premorbid Schizophrenic Wives and Their Husbands." Fam-

Bardill, D.:

Process, 2 (1963), 34-51. Beecher, W., and Beecher, M.: "Re-Structuring Mistaken Family Relationships." Journal of Individual Psychology, 13 (1957), 176-181. Bell, J. E.: "Contrasting Approaches in Marital Counseling." Family Process, 6 (1967), 16-26. ily

Bell,

E.:

J.

"The Family Group Therapist:

An

Agent of Change." International

Journal of Group Psychotherapy, 14 (1964), 72-83. Family Group Therapy. Public Health Monograph No. 64, U. S. Department of Health, Education, and Welfare, 1961. Bell, J. E.: "Recent Advances in Family Group Therapy." Journal of Child Psychology and Psychiatry, 3 (1962), 1-15. Bell, J. E.: "A Theoretical Position for Family Group Therapy." Family Process, 2 (1963), 1-14. Belmont, L. P., and Jasnow, A.: "The Utilization of Co-therapists and of Group Therapy Techniques in a Family Oriented Approach to a Disturbed Child." International Journal of Group Psychotherapy, 11 (1961), 319Bell, J. E.:

328. Blinder, M. G.,

Colman, A. D., Curry, A. E., and Kessler, D. R.: "MCFT: Simultaneous Treatment of Several Families." American Journal of Psychotherapy, 19 (1965), 559-569. Boszormenyi-Nagy, I., and Framo, J. L., eds.: Intensive Family Therapy: Theoretical and Practical Aspects. New York: Harper and Row, 1965. Boszormenyi-Nagy, I.: "Intensive Family Therapy as Process," in BoszormenyiNagy, I., and Framo, J. L., eds.: Intensive Family Therapy: Theoretical and Practical Aspects. New York: Harper and Row, 1965. Boverman, M., and Adams, J. R.: "Collaboration of Psychiatrist and Clergyman: Case Report." Family Process, 3 (1964), 251-272. Bowen, M.: "Family Psychotherapy." American Journal of Orthopsychiatry, 31 (1961), 40-60. Bowen, M.: "Family Psychotherapy with Schizophrenia in the Hospital and in

A

I., and Framo, J. L., eds.: IntenFamily Therapy. New York: Harper and Row, 1965. Bowen, M.: "The Use of Family Theory in Clinical Practice." Comprehensive

Private practice," in Boszormenyi-Nagy,

sive

Psychiatry, 1 (1967), 345-374.

W.

M., and Hayden, M.: "The Intrateam Reactions: Their Relation to American Journal of Orthopsychiatry, 27 (1957), 349-355. Brody, S.: "Simultaneous Psychotherapy of Married Couples," in Masserman, J. H., ed.: Current Psychiatric Therapies, 1 (1961), 139-144. Carek, D. J., and Watson, A. S.: "Treatment of a Family Involved in Fratricide." Archives of General Psychiatry, 11 (1964), 533-543. Carroll, E. J.: "Family Therapy Some Observations and Comparisons." Family Process, 3 (1964), 178-185. Carroll, E. J.: "Treatment of the Family as a Unit." Pennsylvania Medical Journal, 63 (1960), 56-62. Carroll, E. J., Cambor, C. G., Leopold, J. V., Miller, M. D., and Reis, W. J.: "Psychotherapy of Marital Couples." Family Process, 2 (1963), 25-33. Charny, I. W.: "Integrated Individual and Family Therapy." Family Process, 5 (1967), 179-198.

Brodey,

the Conflicts of the Family in Treatment."



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Framo,

"Rationale and Techniques of Intensive Family Therapy," in Boszormenyi-Nagy, I., and Framo, J. L., eds.: Intensive Family Therapy. New York: Harper and Row, 1965. Framo, J. L.: "The Theory of the Technique of Family Treatment of Schizophrenia." Family Process, 1 (1962), 119-131. Freeman, V. J.: "Differentiation of 'Unity' Family Therapy Approaches Prominent in the United States." International Journal of Social Psychiatry, Special Edition 2 (1964), 35-46. Freeman, V. S., Klein, A. F., Riehman, L. M., Lukoff, I. F., and Heiseg, V. E.: "Family Group Counseling as Differentiated from Other Family Therapies." International Journal of Group Psychotherapy, 13 (1963), 167-175. Friedman, A. S.: "Family Therapy as Conducted in the Home." Family Process, 1 (1962), 132-140. Friedman, A. S.: "The Incomplete Family in Family Therapy." Family Process, 2 (1963), 288-301. Friedman, A. S., Boszormenyi-Nagy, I., Jungreis, J. E., Lincoln, G., Mitchell, H. E., Sonne, J. C, Speck, R. V., and Spivack, G.: Psychotherapy for the Whole Family. New York: Spring Publishers, 1965. Friedman, A. S.: "The 'Well' Sibling in the 'Sick' Family: A Contradiction." International Journal of Social Psychiatry, Special Edition 2 (1964), 47-53. Fry, W. F.: "The Marital Context of an Anxiety Syndrome." Family Process, 1 (1962), 245-252. Gehrke, S., and Kirschenbaum, M.: "Survival Patterns in Family Conjoint Therapy." Family Process, 6 (1967), 67-80. Gehrke, S., and Moxom, J.: "Diagnostic Classifications and Treatment Techniques in Marriage Counseling." Family Process, 1 (1962), 253-264. J.

L.:

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and Gerber, N. M.: "Joint Interviewing: Treatment Technique with Marital Partners." Social Casework, 41 (1960), 76-83. Glower, C. G., and Brody, L.: "Conjoint Family Therapy in Outpatient Practice.* American Journal of Psychotherapy, 18 (1964), 670-677. Gomberg, M. R. "Family Oriented Treatment of Marital Problems." Social Casework, 37 (1956), 3-10. Goolishian, H. A.: "A Brief Psychotherapy Program for Disturbed Adolescents." American Journal of Orthopsychiatry, 32 (1962), 142-148. Goolishian, H. A., McDanald, E. G., MacGregor, R., Ritchie, A. M., Serrano, A. C, and Schuster, F. P.: Multiple Impact Therapy with Families. New York: McGraw-Hill, 1961. Gralnick, A.: "Conjoint Family Therapy: Its Role in Rehabilitation of the Inpatient and Family." Journal of Nervous and Mental Diseases, 136 (1963), 500-506. Gralnick, A.: "The Family in Psychotherapy," in Masserman, J. H., ed.: Science and Psychoanalysis, Vol. 2: Individual and Family Dynamics. New York: Grune & Stratton, 1959. Gralnick, A.: "Family Psychotherapy: General and Specific Considerations." American Journal of Orthopsychiatry, 32 (1962), 515-526. Green, R.: "Collaborative and Conjoint Therapy Combined." Family Process, 3 (1964), 80-98. Greenberg, I. M., Glick, I. D., Match, S., and Riback, S. S.: "Family Therapy: Indications and Rationale." Archives of General Psychiatry, 10 (1964), 7-25. Grosser, G. S., and Paul, N. L.: "Ethical Issues in Family Group Therapy." American Journal of Orthopsychiatry , 34 (1964), 875-884. Guerney, B., and Guerney, L. F.: "Choices in Initiating Family Therapy." Psychotherapy, 1 (1964), 119-123. Gullerud, E. N., and Harlan, V. L.: "Four-Way Joint Interviewing in Marital Counseling." Social Casework, 43 (1962), 532-537. Haley, J.: "Marriage Therapy." Archives of General Psychiatry, 8 (1963), 213— 234. Haley, J.: Strategies of Psychotherapy New York: Grune & Stratton, 1963. Haley, J.: "Whither Family Therapy." Family Process, 1 (1962), 69-100. Hallowitz, D., and Cutter, A. V.: "The Family Unit Approach in Therapy: Uses, Process and Dynamics." Casework Papers. New York: Family Service Association of America, 1961. Hallowitz, D.: "Family Unit Treatment of Character-Disordered Youngsters." Social Work Practice. New York: Columbia University Press, 1963. Hallowitz, D., Clement, R. G., and Cutter, A. V.: "The Treatment Process with Both Parents Together." American Journal of Orthopsychiatry, 27 (1957), 587-601. Handlon, J. H., and Parloff, M. B.: "The Treatment of Patient and Family as a Group: Is It Group Psychotherapy?" International Journal of Group Psychotherapy, 12 (1962), 132-141. Harms, E.: "A Socio-Genetic Concept of Family Therapy," Acta PsychotheraGeist,

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207. Lindberg, D. R., and Wosmek, A. W.: 'The Use of Family Sessions in Foster Home Care." Social Casework, 44 (1963), 137-141. MacGregor, R.: "Multiple Impact Psychotherapy with Families." Family Process, 1 (1962), 15-29. Machotka, P., Pittman, F. S., and Flomenhaft, K.: "Incest as a Family Affair." Family Process, 6 (1967), 98-116. Markowitz, I.: "Family Therapy in a Child Guidance Clinic." Psychiatric Quarterly, 40 (1966), 308-319. Martin, F., and Knight, J.: "Joint Interviews as Part of Intake Procedure in a Child Psychiatric Clinic." Journal of Child Psychology and Psychiatry, 3 (1962), 17-26. Messer, A.: "Family Treatment of a School Phobic Child." Archives of General Psychiatry, 11 (1964), 548-555.

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278-286. Minuchin, S.: "Family Structure, Family Language, and the Puzzled Therapist." American Journal of Orthopsychiatry, 34 (1964), 347-348. Minuchin, S., Auerswald, E., King, C, and Rabinowitz, C: "The Study and Treatment of Families that Produce Multiple Acting-Out Boys." American Journal of Orthopsychiatry, 34 (1964), 125-134. Mitchell, C: "A Casework Approach to Disturbed Families," in Ackerman, N. W., Beatman, F. L., and Sherman, S. N., eds.: Exploring the Base for Family Therapy. New York: Family Service Association of America, 1961. Mitchell, C:

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Research Reports, 20 (1966), 188-195. Rabiner, E. L., Molinski, H., and Gralnick, A.: "Conjoint Family Therapy in the Inpatient Setting." American Journal of Psychotherapy, 16 (1962), 618-631. Ravich, R. A.: "Short-Term Intensive Treatment of Marital Discord." Voices, 2 (1966), 42-48. Reding, G. R., and Ennis, B.: "Treatment of the Couple by a Couple." British Journal of Medical Psychology, 37 (1964), 325-330. Reidy, J. J.: "An Approach to Family-Centered Treatment in a State Institution." American Journal of Orthopsychiatry, 32 (1962), 133-141. Ritchie, A.: "Multiple Impact Therapy, an Experiment." Social Work, 5 (1960), 16-21. Rubinstein, D.: "Family Therapy," in Masserman, J. H., ed.: Progress in Neurology and Psychiatry, Vol. 18. New York: Grune & Stratton, 1963. Safer, D. J.: "Family Therapy for Children with Behavior Disorders." Family Process, 5 (1967), 243-255. Sager, C. J.: "The Development of Marriage Therapy: An Historical Review." American Journal of Orthopsychiatry, 36 (1966), 458-468.

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480

Family Treatment of Schizophrenia," in Boszormenyi-Nagy, I., and Framo, J. L., eds.: Intensive Family Therapy. New York: Harper and

Row, 1965. Wyatt, G. L., and Herzan, H. M.: "Therapy with Stuttering Children and Their Mothers." American Journal of Orthopsychiatry, 32 (1962), 645-659. Wynne, L. C: "Some Indications and Contraindications for Exploratory Family Therapy," in Boszormenyi-Nagy, I., and Framo, J. L., eds.: Intensive Family Therapy. New York: Harper and Row, 1965. Wynne, L. C: "The Study of Intrafamilial Alignments and Splits in Exploratory Family Therapy," in Ackerman, N. W., Beatman, F. L., and Sherman, S. N., eds.: Exploring the Base for Family Therapy. New York: Family Service Association of America, 1961. Zierer, E., Sternberg, D., Finn, R., and Farmer, M.: "Family Creative Analysis: Its Role in Treatment." Bulletin of Art Therapy, 5 (1966), 87-104. Zuk, G. H.: "The Go-Between Process in Family Therapy." Family Process, 5 (1967), 162-178. Zuk, G. H.: "Preliminary Study of the Go-Between Process in Family Therapy," in Proceedings, 73rd Annual Convention of the American Psychological Association, Chicago, 1965. Zuk, G. H., and Boszormenyi-Nagy, I.: Family Therapy and Disturbed Families. Palo Alto: Science and Behavior Books, 1966. Zuk, G. H., and Rubinstein, D.: "A Review of Concepts in the Study and Treatment of Families of Schizophrenics," in Boszormenyi-Nagy, I., and Framo, J. L., eds.: Intensive Family Therapy. New York: Harper and

Row, 1965.

PSYCHIATRY/PSYCHOLOGY

Techniques FamilyTnerapy JAY HALEY* LYNN

HOFFMAN

"The authors masterfully examine the complete transcription of

interviews by different therapists, interspersing the recorded

initial

material with a discussion

between the authors and

analyzing techniques.

all

In

.

.

.

For

interested

in

therapists,

family therapy."

— Pastoral Care

the belief that family therapy can best be described by examining

what family well-known ily

five

engaged five intensive conversations about initial fam-

therapists are actually doing, the authors therapists in

interviews each had conducted.

The

five

long chapters of

this

book

are the distilled record of these

interwoven with the verbatim transcripts of the actual therapy sessions. Thus the reader not only watches the therapists at work, but is party to their later reflections on the course of conversations,

the interview, the reasons for their strategies, and the unfolding of the encounter between therapist and family, with ties

uncertain-

all its

and improvisations.

Under

skillful

Charles

R.

questioning by the authors, the five therapists

Fulweiler, Virginia Satir,

Don

D. Jackson, Carl A. VVhit-



team in Denver bring us close to an understanding of what happens when therapists and family meet

aker,

and

a brief-therapy

to explore the possibility of change.

JAY HALEY is Director of Family Research at the Philadelphia Child Guidance Clinic and was formerly Director of the Family Research Project at the Mental Research Unit at Palo Alto, California. He was editor of the journal Family Process and is the author of Strate/* gies of Psychotherapy.

LYNN HOFFMAN Clinic

is

on the

and has contributed

staff

of

t

to Family

ISB-N-Q-MbS-QSSie-?

Cover design by Madlyn W. Dickens

2 675

95

*9.

09/09/86 TECHNIQUES OF FAMIL ^ A m
Techniques of family therapy - Haley, Jay, 1925-

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