Remembering Salvador Minuchin

To be a young, intellectually curious therapist in the 1970s was to fall under the spell of the field’s new breed of systems practitioners, who were redefining what psychotherapy was all about, and who believed in zeroing in on the dance among family members as both a prime mover of dysfunction and a powerful agent of change. Rather than focusing on the lonely psyche, à la the psychoanalysts, these clinicians saw the relational system as central.

And no one embodied what it meant to be a systems practitioner with more skill, creativity, and chutzpah than psychiatrist Salvador Minuchin. Watching him in action was to see old psychoanalytic commandments being smashed to smithereens, one by one—the dusty ethos of passive taciturnity, infinite discretion, and unassailable privacy being swept away like so much old debris. He trampled underfoot the standard assumption that nobody can change anybody else—that psychological change must come from within. Before awed spectators, he poked, prodded, and jollied client families into changing right then and there.

Another standard assumption he rode roughshod over was the idea that people’s feelings have to change before their behavior can change. Minuchin not only seemed to make people change, he did it regardless of what they were feeling, or whether they even knew what they were feeling. He acted on the premise that if you change the way people relate to each other, their feelings will change as well.

The premise that relationships change people—so commonplace now, so novel then—opened the door to an astonishing new view of personality itself, which had always been assumed to be innate to a person, something solid and static, as if made of stone. But Minuchin could examine a family in a way that showed how malleable human personality was—that it shifts according to context. Minuchin not only created a body of clinical theory and practice, but also, through the sheer blockbuster force of his own personality, defined a style of working that seemed to offer a muscular, therapeutic counterpart to liberation theology.

From its earliest days, through the four decades of its existence, the Networker has maintained its fascination with Minuchin’s clinical genius and the hurricane strength of his personality. Every few years, we checked in with him to see how his clinical thinking was evolving and how he was meeting the challenges of whatever stages of life he happened to be experiencing. Sadly, this past October, not long after his 96th birthday, he faced the ultimate challenge as he passed away, just a few months after receiving our first-ever Lifetime Achievement Award.

Beginning with an interview published in the Networker in 1979 and culminating in 2017, when he wrote a piece on the elemental principles of structural family therapy at the age of 95, Minuchin continued to articulate his particular vision of both clinical change and social justice. Throughout, he’s been an essential presence in our magazine, as both a regular contributor and a role model embodying the highest standards of the profession. What follows are excerpts from Networker pieces that are either about or by Minuchin—writing that we think captures both his originality of thought and his commanding personality.

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November/December 1996

It’s More Complicated Than That

Don’t Smooth Out Life’s Wrinkles, Says Salvador Minuchin

It’s been almost 20 years since I first saw Salvador Minuchin in action. Back then, I was a young PhD, 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’d 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 its leading visionary and presiding clinical wizard, part Moses, part Merlin, with a little dash of a standup comic’s audacious willingness to challenge his audience.

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 CE credits. 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’d ever met, as if he’d 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 eight-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 eight-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’s so powerful? He’s a healthy boy, but look, he’s just a little kid who somehow has convinced you that he’s 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.

I’m equally sure that over the next weeks and months, the therapists in that audience went on to direct hundreds of children and their parents through a similar routine, the image of Minuchin’s mastery still alive in their memories. The fact is that once you saw Salvador Minuchin at work, a little part of him lived on indelibly inside you. Through family therapy’s formative years, he became the standard against which therapists measured their best work, and when they failed miserably with a family, they asked themselves what Minuchin might have done.

PSYCHOTHERAPY NETWORKER: Janet Malcolm once wrote in The New Yorker, “Watching a Minuchin session, or a tape of it, is like being at a tightly constructed, well-directed, magnificently acted play.” You seemed to relish dealing with explosive situations in therapy. What do you like about dealing with those situations?

MINUCHIN: I think what drew me to family therapy was the excitement. Every family represented an exciting puzzle. When I worked with delinquents and their families at the Wiltwyck School back in the ’60s, the particular challenge was to help them find concrete ways to calibrate relationships. We were concerned with helping disorganized families to give more order to their relationships. So we’d interrupt a fight in the family to say, “When your mother talks, you cannot talk. Okay, now you can answer.” The emphasis was on guidance. At that time, Virginia Satir had developed a very popular therapy that emphasized nurturance and the midwifing of feeling. But we felt that in the families we saw, people already knew how to nurture. The problem was that the parents were ineffective in taking control of their kids. What they didn’t have was the constancy that allowed them to give the children a sense of self-efficacy.

PN: A lot of your reputation as a master therapist has to do with your getting seemingly resistant families to do what you asked them to do. How did you manage to accomplish that?

MINUCHIN: When I wrote Families of the Slums, I was full of political passion in defense of the underdog. I had an enormous amount of zeal, and people responded to that. All of us back then were tremendously hopeful about teaching poor people to become competent in this social laboratory that was the family. We relied on techniques of moving in and out of the conflict, of being both an observer and a participant in the session. So we’d say, “Mom, talk with Jimmy and find a way to make sure he really listens.” The goal was to get the parents to exert competence in an area in which they could succeed. The more competent people felt, the more they’d listen. Our naivete at that time was that we couldn’t yet look beyond the boundaries of the family and recognize the impact of the larger culture. That came later.

PN: When I think of the teaching tapes you made at the Philadelphia Child Guidance Clinic, what stands out for me is the art of the small victory in going through some hellish struggle to get somebody in a family to do something they’ve never done before. Of all the cases that you treated, is there one that stands out for you?

MINUCHIN: There’s a famous tape of an anorexic girl eating a hot dog. That was a family situation that was horrendous. Carol was so underweight that she was in danger. So I said to the parents, “Unless she eats, she will die. You’re the parents. Don’t let her die. Do something.” So I tried to help the family discover a new pattern of interaction by creating a crisis in which the parents had to do something that was novel for them. Now these parents were faced with an impossible situation. The mother starts by saying, “Carol, I want you to eat,” but soon she and the father are beginning to fight, so I say, “Look what’s happening now. Carol is still not eating.” And the parents now attack the girl, “You will eat!” And food is no longer the issue, and questions of power, autonomy, and control become the central issue in this transaction. At that point, it’s possible to enter by supporting the girl’s autonomy not around eating, but around what her parents are doing.

PN: But how did you get out of being stuck in the power struggle?

MINUCHIN: A therapist must walk both sides of the street. At the same time you’re getting the parents to take control, you also talk about the girl’s autonomy. You explain that good parenting isn’t just control: it’s also about giving space. And while you encourage the girl’s autonomy, you talk to her about the parents’ need to be respected. Bringing the conflict into the therapy room is just the first step in challenging the old pattern and moving parents outside of the world of the girl.

Maybe I’m thinking of this particular family because Carol just called me a few months ago to tell me that her father, whom I hadn’t seen in 25 years, was dying and wanted to speak with me one last time. After all these years, he still felt connected to me and what had happened in therapy. Somehow talking with me at the end of his life was his way of closing a circle. I’m frequently surprised how long the memory of a therapist can last in the life of a family.

PN: Since the last interview we had 12 years ago, what have you discovered about being a good therapist?

MINUCHIN: At age 75, the certainty that I had when I was younger has disappeared. I no longer believe that I own the truth, and I’ve become more accepting of other points of view. I know myself better and realize that when something new happens in the field, my first response is to oppose it and only later do I begin to incorporate it. My first response to the feminist group was to respond negatively to what I saw as its stridency, especially since I was the target of much of its criticism of the field. But the feminists made me realize that I had put women in certain narrow categories and that my labels for women had gender biases: for me, for example, a mother’s concern could too easily be dismissed as “overprotectiveness.” I focused on men providing guidance and women nurturance, and my work emphasized the importance of guidance and took nurturance for granted. I don’t think I do that anymore.

I’m more aware of the messages of the labels, and I pay attention to what I privilege. But I still work systematically, seeing how couples trigger each other in their interactions. I still look at the way in which the current transactions in a family support conflict. I’m always saying to people, in one way or another, “There are more possibilities in you than you think. Let’s find a way to help you become less narrow.” But the ways that I say that today are less dramatic than they used to be. I ask more questions and give fewer prescriptions. As you get older, all certainties become question marks.

— Rich Simon

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January/February 2O17

Systems Therapy

The Art of Creating Uncertainty

All therapists need a range of tools to master their craft, but tools are just that—a means to accomplish an objective. When the carpenter begins with a piece of wood, he has an end goal in mind: to change that wood into something else. The saw, chisel, hammer, and nail are a means of transforming what the carpenter first sees into what he wants it to become. The effective family therapist also uses tools as means to an end, not as ends in themselves. The craft of family therapy lies in how these tools are used to produce a difference in the family—a useful change. An enactment on its own doesn’t move the family, but a therapist who understands that the enactment is a way to view the family’s interaction can shift the process. So the most important tool is the therapist’s use of self in guiding the process of change—and understanding how to use that tool is the biggest obstacle for beginning therapists. Ultimately, learning how to use the silent dialogue with the homunculus on one’s shoulder is central to mastering the craft of family therapy.

Besides my understanding of the craft of therapy, the related ideas of belonging and having multiple selves became more and more important in my work over the years. The systems that you belong to—that give you a sense of who you are and make you feel accepted—are the entryway to the experience of multiple identities. I see this now so clearly, both in my work and in my own life. I grew up in a Jewish family in a small town in Argentina that was a kind of shtetl where, up until the age of 12, I didn’t know anybody who wasn’t Jewish. Then at 18, I went to medical school, and my world grew larger. At 20, I was put in jail for three months with a group of other students for protesting against Perón, and my concept of myself changed again: I became an Argentinian Jew who was committed to social justice. From then on, I was a revolutionary and a fighter for social justice, and it seemed natural that I should join the Israeli army, in which I served as a doctor during the War for Independence. Later, when I emigrated to the United States and was on the staff at the Wiltwyck School, I was a cultural outsider and found myself identifying with the poor black people around me as I learned to speak English. And as I came to feel that I belonged with the staff and children and families at Wiltwyck, I felt I expanded even more.

My idea that we’re all multiple selves led me to develop a therapy of challenge, rather than one of being gentle with people. My goal as a therapist wasn’t to be cautious and empathic, but to be an intervenor who creates uncertainty in clients about who they were and are and what they’re capable of becoming. I wasn’t interested in their “true self”: I wanted them to experience a series of selves and the expansion of possibility that can grow from that experience. Above all, I wanted them to recognize that there were more ways of being than what their life experience so far, whatever it was, had made them aware of. What I did in therapy was say to people, “You know, belonging may give you a sense of security, protection, harmony, but it also limits you and creates an invisible pattern of relationship that fools you into believing it’s the only way of being.”

So when I look back on my life, I see a sheltered Jewish child, a rebellious young adult, a revolutionary, a soldier, a stammering, helpless immigrant, and many, many, other things. At 95, I think of myself as having journeyed through life as many different people, and I think of a line from Antonio Machado, one of my favorite Spanish poets: “The road is not the road; you make the road by walking.” I hope in my own walking I’ve cleared away some debris for those who will follow.

— Salvador Minuchin