Family Healing: Strategies for Hope and Understanding

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THE FREE PRESS

1230 Avenue of the Americas

New York, NY 10020

www.SimonandSchuster.com

Copyright © 1993 by Salvador Minuchin and Michael P. Nichols

All rights reserved, including the right of reproduction in whole or in part in any form.

First Free Press Edition 1998

Published by arrangement with The Free Press, a division of Simon & Schuster, Inc.

THE FREE PRESS and colophon are registered trademarks of Simon & Schuster Inc.

Manufactured in the United States of America

5 7 9 10 8 6 4

Library of Congress Cataloging-in-Publication Data is available.

ISBN-10:   0-684-85573-9

ISBN-13: 978-0-684-85573-8

eISBN: 978-1-439-10789-8

Contents

Preface

I. THE MAKING OF A FAMILY THERAPIST

1. Family Roots

2. From Individual to Family Therapist: A Journey of Transformation

3. Families and Family Therapy

4. The Formation of a Couple

II. COUPLES

5. The Wife Beater

6. The Unspoken Contract

III. PARENTS AND CHILDREN

7. A Crutch to Move Away

8. Parents as Prisoners or Jailers?

9. A Father’s Rage

IV. REMARRIAGE

10. The Second Time Around

11. The Stepdaughter’s Habit

V. AGING

12. The Hypochondriac and His Understanding Wife

13. Death and the Gorilla Mask

Epilogue: The Silent Song

Preface

After thirty years as a family therapist, I proclaimed myself an elder. After all, I was there when family therapy began. I was one of the ones who helped it grow, and I have seen it move, for better or worse, from being a radical new departure, a novel way of looking at people and helping them, to its present secure position within the mental health establishment.

In the best tradition of storytelling, the elder, seated on a low bench, regales his audience with the exciting adventures of his youth. So I wrote four autobiographical chapters. But when I began to look at cases that could represent a universe of families and describe the way I work, I felt overwhelmed by proximity. I realized that one of the barriers to an honest account of therapy would be the tendency to read my own theories into my client families, recreating them in my own image. The collaboration with Mike Nichols began at this point. Together we reviewed dozens of cases to select ones that would illustrate various stages of family development and the issues that crop up to bedevil all families. Although we included some exceptional and unusual families, most of the stories in this book are about ordinary human beings learning life’s painful lessons. Mike took on the thankless task of transcribing the tapes of the sessions and brought fresh eyes to encounters that had become so much part of me that I was in danger of imposing my bias on what actually happened. As you will see, I have tried to help the reader understand some of the critical issues that families wrestle with and some of what was going on in my own mind as I tried to help them solve the problems that brought them to therapy.

After Mike sent me the transcripts, I went over them to reduce them to manageable size and to add my thoughts about the meaning of the therapeutic encounter. We met on numerous weekends, going over the material together, pruning the superfluous content, and rechecking the tapes to ensure complete accuracy. It was a rich and satisfying collaboration.

Because I wanted to let the family members tell their own stories, we limited our selection to cases for which I had tapes. For that reason we could not include some long-term treatment cases. We also excluded the whole body of my work with poor and welfare families. I felt that the characteristics of this work would require a description of institutions and larger systems than could be encompassed in the format of this book. Naturally we changed the names and identifying characteristics of the families, but otherwise the stories you read are told exactly the way they happened.

I want to thank my wife, Pat, who has been an integral part of my life for more than forty years and now shares more than half of my memories. She read and reacted to the stories, but her participation in the autobiographical chapters was even more essential: She brought flavor and accuracy to my description of the events we lived together. I thank her for the past and for the present.

As with all my previous books, I want to thank Fran Hitchcock, who has become indispensable in my writing. She is my grammarian, editor, sounding board, critic, and friend. Mike and I would also like to thank Joyce Seltzer of The Free Press for expert guidance and encouragement.

PART ONE

THE MAKING OF A FAMILY THERAPIST

1

Family Roots

FEBRUARY, 1992

I am in a state psychiatric hospital to do a consultation with Tony, age ten, and his family. Before I see the family, the staff tells me about Tony. I listen attentively. When he was eight his mother took him to a prestigious university hospital, where he remained for ten months. His diagnosis was attention deficit disorder, a variation on the previous label, minimal brain dysfunction, that replaced his first diagnosis, hyperactivity—all of them meaning pretty much that the child has poor impulse control and a short attention span. In the university psychiatric ward, doctors tried to find the appropriate dose of medication that would make him fit to return home. After trying a variety of doses and medications, they decided to refer him to a state psychiatric hospital. Tony has been here for a year, so he has spent 20 percent of his short life in psychiatric wards.

At the state hospital Tony has individual, group, recreational, and sundry other therapies. He attends a highly structured school and lives in a cottage with other children in a token-economy milieu, meaning that they earn stars for good behavior that can be exchanged for special treats later on. Focusing not on Tony but on his neurological system, the psychiatrist rattles off a long series of pharmacological trials. He says that at the university hospital, Tony was given Ritalin and Mellaril, with the focus on aggression and the attention problems, while here the issues of separation anxiety are the focus of the medication efforts. To that effect, he says, Tony was tried on and then off Clonidine, showing clear differences on and off medication. Toward the end of December he was begun on copharmacy of Lithium with the antidepressant: We are a long way, I would say, from expecting self-control in a home situation that can still destabilize, which destabilizes Tony when it does.

The precision with which the ten people talking with me cover up the narrowness of their point of view impresses me. When I ask about Tony’s future, the answer is a vague hope that he will spend less than another year in the hospital, and then something like a lifetime in what the psychiatrist calls parallel institutions. I assume that these are day hospitals or less restrictive settings. And Tony is only ten years old!

I talk to Tony. I expected a monster. Instead I find a boy who is impulsive but alert, making contact with me without difficulty. I wonder if anybody connects the experts’ statements to life, or even to cost. Tony’s hospitalization costs the state more than one hundred thousand dollars a year. For two years this child has been separated from real life and institutionalized in a hothouse where his pathology has been observed while it expanded in the absence of significant, age-appropriate activities. The staff is wedded to an ideology that says Tony lives only inside himself: not even that—inside his nervous system. Couldn’t we do better?

Later I meet with Tony and his mother. I ask her why Tony is here. I can’t control him, she explains.

"Well, then, why aren’t you here?"

Tony and Mother laugh. Though it is a strange question, I don’t think it’s funny. Mother looks at me, puzzled. Tony will remain here as long as you and he don’t fit, I say.

That’s a very different way of looking at things, Mother replies, and she is right. My view of Tony is that he exists not only inside himself but also in the interaction between him and his family.

During the session Tony throws a tantrum. I point out that he is not acting his age and ask his mother to help him be ten. She sets limits; he calms down; and I congratulate them both for their competence. Later I talk to the staff again. I am indignant because this child, who faces life imprisonment, could be living at home, treated in an outpatient facility. His family would need support and help in managing him, but outpatient treatment would be more efficient, less painful, and less costly.

Tony’s life and future are organized by a very narrow view of people. This book is about a new way of looking. It is partly about me, partly about my theories and therapy, and always about the dynamics of families. It is a book of stories, because therapists are always storytellers. We are like anthropologists, exploring other people’s lives. And like anthropologists, we are inevitably guided by our own experiences in describing others. The observer, however impartial, necessarily selects what seems important, shaping what is observed in ways that make sense.

I want to begin with my own family story. You need to know who I am, since I am the observer of the family dramas that follow. If I describe who I am, the family I grew up with, my family today, and how the world has changed during my lifetime, I will be telling you something about the transformations within all families, about the ways in which we all resemble each other.

Later I will be telling stories about families who have come to see me in therapy. I am concerned that these stories—with their family stresses, their difficulties, and their deviances—may titillate. But these people should not be seen as psychiatric specimens. They are people, like us.

First my family will appear very similar to yours. Then it will become clear how little it differs from the families described in this book. Professionals tend to draw the line that separates therapist and client with heavy strokes. We center on difficulties and problems, but that is a highly artificial distinction.

Let me take you to my hometown, the setting of my early life. It was a shtetl, a small, tightly interwoven Jewish enclave, turning inward for protection and continuity within a majority society that was very different. My village was in rural Argentina, but it was nonetheless a shtetl.

Main Street Number 11 was one of seven streets in San Salvador, a small town in the province of Entre Ríos, Argentina. The 11 reflected the optimism of our town planners, who had hoped for a brighter future.

Our home—three large bedrooms, two dining rooms (one for guests), a newly installed bath, an outhouse, a detached kitchen, a maid’s room, and a chicken coop—was connected to my father’s company store: Everything for the farmer, from tractors to espadrilles. The store had a large zinc-lined warehouse in which grain was stored until it was sold to Bunge y Born or Dreyfuss—large corporations that sold Argentinean grain throughout the world.

Four thousand people, one-fourth of them Jewish, lived within six blocks. I knew everybody in those six blocks, and they knew me. We were an important family in town. The neighbor to the left was my cousin Paulina, La Gorda (the Fat One). Between her house and the corner was my Uncle Elias’s pharmacy. My father worked there as a bottle washer when he was eleven years old. To the right were my Aunt Ester and Uncle Isaac, with their hardware store. My father’s parents, Jose and Jaiatable, lived next to them; by then they were supported by their children. Across the street was my Uncle Bernardo, my mother’s brother, who was married to my Aunt Jailie, my father’s sister, and their seven children. They owned a clothing store. My Uncle Isaac’s mother and his older brother also lived in the same block. While we didn’t live in an actual compound, membership in this extended family was in the air we breathed.

Let me open one of the doors in Main Street Number 11 and tell you its story. It is a hardware store. He is thin, she tends to fat; he is neat, she is flabby and unkempt. They yell at each other, but it is her voice that carries. Everybody in town knows she shacks up with the salesmen who come from out of town. I wonder what the attraction is, but I never wonder whether the rumor is true.

Another door: The pharmacist is an older, unmarried man. He lets his hair grow long like a Romantic poet, though his speech is as abrupt as the language of medical prescriptions. He carries on a love affair with the beautiful, married schoolteacher, who is some ten years his senior. Theirs became a Greek drama—by Sophocles or Aristophanes, depending on your perspective—when, fifteen years later, the pharmacist, still thin, married the schoolteacher’s beautiful daughter, twenty years his junior. Whom would she select to avenge her father? It was only a matter of time.

Another door: Maria, the wife of Perez. She underwent a false pregnancy. We all waited for months while she grew bigger and bigger, waiting for the child who never came.

There were many stories. One man killed himself. One family had a retarded child, who was always hidden inside to conceal the family shame. Everybody knew these stories. But for us children, it was the sexual stories that were heard and amplified, and they have remained most vividly in my memory.

When in memory I enter the barbershop, the two butchers, the bakery, the movie, the pharmacies, and the grocery, I realize that all the stores are Jewish. Other than the two banks, I have no images of non-Jewish businesses. Perhaps only Tenerani, the publisher of the weekly newspaper. I had a big fight with his younger son. We fought until we could end with honor—when blood gushed from somebody’s nose. I suppose whose was important then; it’s not now.

I lived, my family lived, in a Russian shtetl transported, modified, and improved by the Argentine culture. We Jews stuck together, shopping in each other’s stores. We coexisted in this checkered Argentinean town, but each community was self-sufficient. We even had our own drunkards. Goodson, who was Jewish, would shove his pushcart full of fish through the town once a week. He got drunk on grappa and insulted his customers, canceling sales by blustering: If you want a fish, wet your ass. We children thought this was screamingly funny. Spindola, the gentile drunkard, was a housepainter. When he got drunk on cheap wine he would yell at the top of his lungs: I am Salvador Spindola! It was a challenge to the world, with a cadence resembling that of dogs barking at the moon, when he lay on the sidewalk with his finger lifted to the skies.

I grew up Jewish in a town in which graffiti read: Be patriotic; kill a Jew. But I got drunk on the Argentinean music, learned the local ghost stories, fought if another child stepped on a line I drew in the earth or if somebody wet my ear, just like other rural Argentinean children. In issues of defiance we had no alternatives. I fought and was beaten with honor by children older and stronger than me. I grew up Argentinean, but without knowing it. My sense of pride and honor, the need to keep my good name even if it meant challenging windmills, had little to do with Russian Jewry—it was authentically Hispanic. Part of a despised minority, I learned to despise my Jewishness, to try to pass, and to hate myself for it. I grew up divided, internalizing the prejudices of the Argentinean majority and fighting the unfairness of prejudices both inside and outside myself.

Who was I at three? At five? At eight? I have snatches of memories, disconnected phrases that I thread into a plot I make continuous. The demands of storytelling always construct a childhood that wasn’t. But, for want of any other perspective …

I am the oldest of three. My sister, Sara Dina, whom everyone called Chola, is two years younger than I; and my brother, Rogelio, known as Kelo or Kelito, is eight years younger. My aunt Ester, father’s younger sister, had children the same age. They lived in the next house. We climbed the fence instead of walking the twenty yards to the front door. My father was important. He worked hard and was successful. My mother elaborately created space for him: Be quiet, Father is sleeping … Father is eating … Father is working … Father is tired…. Mother was the overseer who made my father’s life an organized and predictable little world.

My father was a loving parent; he cuddled and kissed us a lot. But he was also involved in the store, always trying to solve important issues in a large enterprise that bought grain from the farmers and sold them plows, tractors, and clothing and often advanced credit until the next harvest. He had a reputation for being just. Employees and clients alike knew they could rely on Mauricio. Business agreements were sealed with a handshake. They were written in a ledger for accuracy’s sake, but the real contract was in the handshake. I was in awe of my father. I wanted to be just like him—fair, honest, and just.

Mother worked too. We had a full-time maid who cooked, a woman who came twice or three times a week to do the laundry, and a hired girl who helped with the children, among other things. They all helped in the house, but Mother was always dusting, cleaning, knitting, mending, and organizing what had to be done. She was always protecting something: father, the dining room, the furniture, the children. Someone had to stand against illness, dirt, and disorder.

This view of my father as loving, fair, and often distant, and my mother as protecting, controlling, and always involved with us, was constructed, reinforced, and confirmed in millions of transactions throughout my childhood and adolescence. Of course there were also many other exchanges that might have challenged this view. But families are conservative organisms. They develop certain pathways that at first are only preferred. Over time they become comfortable, until finally they become so familiar that variations will make family members uncomfortable. In time pathways become ruts, which can be very difficult to get out of.

Discipline was strictly enforced in our house. Father was the disciplinarian. Mother might get angry if I broke a rule. She might spank me, twist my ear, or slap me. But I was never afraid of her. With her I could get angry back, run away, argue, or repeat my offense just to spite her. Father was something else. When he got upset an involuntary tic on his left cheek would begin to flash a warning. But his spankings were methodical, reasoned, and rather calm. I knew he would spank me if I did something wrong, particularly if I lied. He would simply beckon to me, and I never disobeyed his command. He would explain exactly why I was to be punished, take off his belt, tell me to lie across his knees, and whip me. If I thought he was in the wrong I absolutely would not cry, in spite of the pain. I would move away from him, tight-lipped, in silent protest. I was a stubborn child, and clearly my father was a stubborn man—though I couldn’t see that then. Once, in third grade, when I was nine, I brought home poor grades. I had had a nine in history; this time I got a seven. Afraid of what Father would say, I wrote over the seven to make it a nine. My forgery was crude, and Father immediately asked if I had done it. I said no. Father said yes, I said no. The next act in the drama was all too predictable. After every whack he asked if I had done it. No. Another whack—No. Another whack—No. Father was afraid he was hurting me; he begged to me to say yes. No.

Mother tried to intervene. Say you did it, she implored.

No.

Mauricio, please, you are hurting him! By now my Aunt Ester, my mother, and my seven-year-old sister were all pleading with Father, and he was pleading with me. I didn’t give in. By then I couldn’t; I was too busy not giving in, defending myself against parental authority. By now both my father and I were trapped. His duty as a father demanded that he punish my wrongdoing. For me it had become a question of pride; I would not submit.

Sixty years later I have only to close my eyes to see this scene. I can hear my mother crying, pleading. I don’t remember the pain, but I can still feel a nine-year-old’s rebellion and challenge.

In today’s world that whipping would have constituted child abuse. The belt left me black and blue. But I never experienced my father as abusive, and neither did anyone else. His whipping was just. He was doing what he knew was right, and everybody else knew it too.

To me, well into adulthood, my father was always larger than life. But in that place and time, a father’s authority was simply one of the givens.

One of my earliest memories is of being on his shoulder, watching a parade of Jewish flags. I was three, and it was the fifth anniversary of the Balfour Declaration, establishing a homeland for Jews in Palestine.

I was five when he bought me my first horse. We kept the pony, Petiso (Shorty), on the farm, but if Chas the farmhand let him loose, he would come to the house to find me. With Petiso I joined the Argentinean rural culture. Like the other children I was almost a centaur, and I joined them in many escapades and on Sunday outings.

I liked to go with my father when he supervised the warehousing of grain at the railroad station. He discussed business with me and asked my opinions as if they really interested him. He was sometimes asked to arbitrate conflicts among other Jews, who were reluctant to bring their problems to the gentiles’ justice, and I was proud of him. I was proud of his negotiating with the president of the bank—to me the most powerful non-Jewish authority after Mr. Lopez, the chief of police. I still see all these memories from the height of about three feet, looking up.

My parents ruled different worlds. My father went to the store in the morning. My mother organized the house. We children walked to school and returned at noon. Lunch was a family event. It was the main meal and the family council. Father sat at the head of the table, Mother to his side. It was time together. We talked, discussed school, or listened to my parents talk about adult issues.

Then in 1930, when I was nine, the Great Depression took away my father’s power. Suddenly we were very poor. There were no more maids, no more store; food was scarce. My mother prepared polenta and told us to eat it with bread. Now the memory of my father attains mythic stature. With a friend, one of my uncle’s brothers, he became a gaucho, driving horses from Entre Ríos to Corrientes, hundreds of miles away. There, with a loan from one of my uncles, they bought cows to be herded home and sold in the province. For a year in fact and fantasy I saw him sleeping under the open skies, his saddle for a pillow, fishing in small rivers, herding cows in a never-ending scene in which my father, Tom Mix, and Gene Autry alternated in the saddle.

Meanwhile I was becoming an adult. I helped my mother sell potatoes and kosher salami. Every morning we cleaned and burnished the potatoes. I suppose it was to prevent spoilage, but I also knew that my mother’s aesthetics simply prevented her from selling dirty potatoes. Today I wonder how it was that my father became a hero to me but my mother did not become Mother Courage in my eyes. Only after many years did I recognize her strength.

As we grew older, things changed. When my uncle Pablo came to town from Concordia, a nearby city, he would sit at the head of the table. He was the principal partner of the company, and my father’s superior. When he came, we all felt the change. I could not understand my father’s subservience to him or why my father insisted that he also act the head of the household, and I disliked Uncle Pablo intensely. My mother resented his autocratic ways, too, and this became one of our secret coalitions.

After my grandmother died my grandfather came to dinner every Friday, the beginning of the Sabbath, and he sat at the head of the table. My mother lit the candles, blessing the Sabbath. My grandfather’s absolute authority was never, ever questioned. He looked patriarchal, with his large frame, his white beard, and his skullcap. He used a cane that—since he walked straight and firmly—was mostly an aesthetic artifact. He died at eighty-six with a full set of teeth.

One Sabbath, on a hot summer evening, my mother served him a glass of tepid beer. Grandfather stood and spat the beer at my mother, the table, the world. I remember it as a gesture of regal indignation: "You don’t do that to me!" My mother froze; my father’s tic pounded; time stood still. But did Grandfather leave the house? Did my mother apologize, wipe the table, and bring another beer? The images have vanished. I only know that it would have been impossible in our family for my father to challenge his father, even in defense of his wife.

I remember my parents as a very close couple. When they had conflicts my mother would withdraw, unhappy and silent, nursing her grudge. My explosive father would apologize, persevere, expressing affection until my mother gave in. I remember listening at night as they read each other romantic novels, like José Mármol’s Amalia. Then I would hear muffled giggles that I refrained from interpreting. Their strength as a couple lay in their need for each other and their clarity about their own turfs. Embedded in a huge extended family within a rigidly hierarchical society, they supported each other by carrying out roles and functions that were clearly defined. They were comfortable in traditional roles, with my father the vital breadwinner—demanding the respect of wife and children—and my mother the vital caretaker. I think Mother saw her tasks in life as first to support him and then to protect her children, and I don’t think she ever questioned these priorities. She saw herself as dependent on my father, and to her that was as it should be.

A helpful person, committed to doing things for others, often sacrificing herself for others, dependent on their dependency, my mother was frequently sad. But it would never have occurred to any of us that her sadness had anything to do with her family life. The death of her nephew Abraham, who was a noncommissioned officer in the Argentine army (unheard of for a Jew), kept her crying for more than a year. We simply ascribed this to a naturally sensitive nature. Today I can see my mother as the youngest daughter of a very close family, very beautiful, very close to her mother, very protected by her six siblings. When she married my father she moved to a town more than a hundred miles away—a four-day journey on horseback. She was very nearly absorbed by my father’s family, in which she held a position subservient to my father’s blood relatives. But at the time, all of us, including my mother, would have felt very uncomfortable with the idea that a proper wife might not find complete happiness in wife- and motherhood. To us, my mother was simply sensitive.

The harmony of my parents’ marriage was based on their neatly fitting complementarity. Each developed an expertise that supported the other. Both served the needs of