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Friday, 02 January 2009 10:39

It's More Complicated Than That

Written by  Annika Land
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It's More Complicated Than That

Don't Smooth Out Life's Wrinkles Says Salvador Minuchin

by Richard Simon

IT'S BEEN ALMOST 20 YEARS SINCE I FIRST SAW SALVADOR MINUCHIN in action. Back then, I was a young Ph.D., just a few months into my first clinical job. In graduate school I had of course read Minuchin's books Families of the Slums and Families and Family Therapy, which were, as far as I was concerned, practically sacred texts, but I had never actually seen him do therapy in person. The family field was at the peak of its messianic, we-shall-change-the-world phase and Minuchin, in his staunch opposition to psychiatric orthodoxy, was both its leading visionary and presiding clinical wizard, part Moses, part Merlin with a little dash of Rush Limbaugh thrown in on the side.

So my trip to the Philadelphia Child Guidance Clinic for an introductory workshop Minuchin was giving on structural family therapy was more than a quest for a few C.E.Us. It was a pilgrimage to the place that Minuchin had turned into the Mecca of family therapy itself, an initiation into the mysteries of how to put the airy abstractions of systems theory to work transforming lives. Standing in front of the audience of 200 therapists, Minuchin, a compact, dapper man with a Latin accent as thick as his black mustache, exuded an air of brusque command at odds with the traditionally pacifist culture of psychotherapy. Heaven protect anyone who stumbled through a lame question or tried to say a kind word about psychoanalysis. He seemed to me the most confident person I had ever met, as if he had been to the mountaintop, seen the Truth and discovered he was It. Of course, he was exactly the kind of hero I was looking for. And when he began to explain a clinical strategy by quoting from a 16th-century book called The Way of the Samurai, any last reservations I may have had completely disappeared.

The centerpiece of the workshop was a live family therapy session broadcast to the audience via closed circuit TV Once the interview started, Minuchin's intimidating aura dissolved and he became a kind of therapeutic sleuth patient, respectful, infinitely curious, frequently playful, surprisingly gentle, but, above all, utterly focused on figuring out the puzzle of what was maintaining the problem the family was trying to resolve. Sometimes Minuchin leaned back in his chair and took long drags on his cigarette as he questioned the family a poor, black, single mother and her three young children about their presenting problem, the 8-year-old boy's disobedience and school difficulties. Hyperalert to the family's every gesture, every pause, every shift of mood, he seemed to drink in information through all his pores as he pursued his inquiry.

Toward the end of the session, Minuchin asked the defiant 8-year-old to stand up, explaining, "I am still trying to figure out what makes you so powerful." The boy smiled slyly as he rose to his feet, clearly delighted to take part in whatever game this curious man was devising. After speaking with the boy for a while and complimenting him on how strong and healthy he looked, Minuchin asked the mother to stand up. As she did, towering over her small child, Minuchin asked, "Where has he got the idea that he is so powerful? He is a healthy boy, but look, he is just a little kid who somehow has convinced you that he is much older than he really is." It was, I learned later, one of Minuchin's favorite gambits, but as I watched it unfold, I was stunned by both the power and the sweetness of the moment. Both mother and son were smiling, basking in the attention they were receiving, coming more fully to life as if renewed by the prospect of order being restored in the family. And later, as the mother, with Minuchin's gentle, persistent coaching, was finally able to lay down some simple rules in the session with a newfound authority in her voice, there was no doubt that she and her family had recorded a small victory in that room.

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