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Still Crazy After All These Years? - Page 2

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A rich vein of therapeutic folklore celebrating Whitaker’s zaniness and unflappability grew out of what he said and did, giving young therapists plenty of chance to ponder lessons not included in their grad school training. One story involved an irate, paranoid patient who once told Whitaker, “I’m going to get you and you’ll never know when it’s coming. One day, you may be standing at the urinal and a steel club will hit your head. What do you say to that?” To which Whitaker replied, without missing a beat, “Thanks for helping me. Up until now, all I had to worry about at the urinal was getting my shoe wet, but you’ve given me something else to think about.”

He cared not a fig about science or data, and would have been incredulous at today’s demands for therapists to meet empirical-validity standards. “I’m deliberately not interested in scientific rigor. . . . I would rather suffer for taking what I have and going full tilt with it than to be cautious and not get anywhere.” He certainly did not believe that he had any kind of world-changing destiny, as did some of the field’s crusaders—he just professed to do therapy because he couldn’t do anything else. For aspiring free spirits, he was the go-to role model of the day.

Perhaps nobody I interviewed had a greater sense of diva-like certitude or put on a more exhilarating show than Mara Selvini Palazzoli, leader of the Milan Team, a group of therapists whose work offered the purest expression of heady systems principles like “second order change” and “recursive loops.” Entering the family therapy field in the ’70s, her interventions offered deeply troubled families complex, double-level paradoxes warning them against the dangers of change. But then in the ’80s, she and her group switched and began issuing a series of “invariant prescriptions” or fixed directives. The most famous of these advised the parents to disappear from home for as short a time as three hours and as long as three months—without warning or explanation to their children. Since the families for whom this intervention was intended usually included a teenager diagnosed as “schizophrenic” (she tossed the word around with carefree abandon) or anorectic, the order threw families into an uproar. This was, of course, just the point—intended to break apart seriously dysfunctional coalitions between children and parents. Of course, it’s a form of intervention hard to even contemplate using in today’s far more litigious therapy world, but many were awestruck by the daring and intricacy of her procedures.

Listening to Palazzoli talk about her work was less like hearing someone describe the travails of a weekly caseload than like listening to an artist’s reflections on the evolution of her oeuvre. When asked whether it bothered her that she hadn’t stayed faithful to the model that had made her famous and had taken up with an even flashier one, she said grandly, “I am not interested in what I said 10 years ago. But this is typical for me because I have the tendency to despise everything I have already done and to be interested only in what I will do in the future.”

For many people, Virginia Satir was family therapy, the very embodiment of the optimistic, can-do spirit that launched the movement. The foremost woman among the field’s founding fathers, she seemed to tap effortlessly into people’s hidden emotion and turn the too-often stilted, diffuse rituals of therapy into exhilarating celebrations of people’s ability to transform their lives. You didn’t go just to listen to Virginia Satir present a workshop or interview a family. Even as you sat hidden in the anonymity of a large audience, she had a way of slipping past your guard and getting to you. Whether she was making you squirm by having you stare deeply into the eyes of the complete strangers sitting around you or just going on in that friendly, enormously reassuring voice about the untapped potential in every person, she refused to let you remain at arm’s length.

While others, like Haley and Palazzoli, approached the therapist’s task strategically and at a cerebral remove, Satir’s power was far more elemental, communicating an immediate sense of nurture that many found irresistible. In an early Networker interview she said, “When people come to see me, I don’t ask them if they want to change. I just assume they do. I don’t tell them what’s wrong with them or what they ought to do. I just offer my hand, literally and metaphorically. If I can convey to the person that I am trustworthy, then we can move and go to the scary places.”

No leader in the field seemed to communicate more of a sense of social mission than Salvador Minuchin, who also was recognized as family therapy’s most imitated maestro. In his work with poor families at the Wiltwyck School for Boys and later at the Philadelphia Child Guidance Clinic, he seemed to feel that his mandate went beyond therapeutic innovation to broader social change. Here’s how I described my first glimpse of him in a workshop I attended as a young therapist right out of grad school: “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 persona I had ever met, as if he had been to the mountaintop, seen the Truth and discovered he was It.”

In his clinical demonstrations, another persona emerged as well—a playful, charming, sleuth; a laid-back Inspector Poirot, taking in, as if by osmosis, every tiny clue that might help explain a family’s problems. More than any of his peers, with the possible exception of Satir, he transformed therapy into a kind of performance art. In a New Yorker profile, Janet Malcolm once described him this way: “Life is supposed to be disorderly, boring, fragmented, repetitive, in need of drastic editing. Watching a Minuchin session, or a tape of it, is like being at a tightly constructed, well-directed, magnificently acted play.”

For example, in one classic demonstration, he was working with a poor, black, single mother who couldn’t control her defiant 8-year-old son. After spending some time with the two, Minuchin asked the boy to stand up, saying, “I am still trying to figure out what makes you so powerful.” The boy stands up, grinning, and after complimenting him on how strong and healthy he looks, Minuchin asks the mother to stand up, too. As she towers over her small child, Minuchin asks, “Where did he get 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 alive as if renewed by the prospect of order being restored in the family.

Later, under Minuchin’s gentle coaching, the mother finally was able to lay down some simple rules with some newfound authority in her voice. There was no doubt that she and her family had recorded a small victory in that room that day. 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. Through family therapy’s formative years, he became the standard against which therapists measured their best work, and when they failed miserably or were confused about how to handle a case, they asked themselves what Minuchin might have done in the same situation.

Therapy’s Golden Age

While the early 1980s were a heady period for the entire field of psychotherapy, it was an even more exciting period for family therapy. Training institutes, clinical centers, and conferences popped up like daisies in early summer, while printing presses cranked out books and periodicals on systems theory and techniques with smoking speed. There was a sense that family therapy was part of an irresistible movement that would one day cure schizophrenia, defeat the slums, and resolve long-term depression and alcoholism in a few sessions! At times, it seemed as if psychotherapists had replaced the clergy as the wise, benevolent counselors of the era.

In short, the ’80s were a great time to begin publishing a therapy magazine chronicling the creative ferment and the cavalcade of clinical innovations. But as the decade progressed, it became more and more apparent that the journey to a therapy utopia wasn’t going to be such a smooth ride, nor without internal debate. Having originated in systems theory and a recognition of the broader society’s role in shaping human experience, the field kept exploring new perspectives that revealed the blind spots and limitations of its leaders. Among the field’s first and most influential critics were the Woman’s Project in Family Therapy, a group of outspoken feminists, who, by the later ’70s, had already begun to bring to the fore themes of female disempowerment that had been ignored by the profession’s largely male founders. As Networker Senior Editor Mary Sykes Wylie once wrote, the members of the Women’s Project were the first to articulate the cognitive dissonance many women in the field were experiencing, “a sense that family therapy techniques often resembled confidence tricks: within a framework of neutrality and equal respect for all, mothers were being had.” As Olga Silverstein, one of four Women’s Project’s members (the others being Betty Carter, Peggy Papp, and Marianne Walters), put it in a Networker interview, the family was “constituted so as to protect the patriarchal structure of society and the one-down position of women. The conventional family puts the male figure in the leadership role. The woman’s job is to serve. The better she serves, the better she is. If she doesn’t serve, it throws everything out of kilter.”

According to the feminists, the family therapy field itself had reconstituted a kind of professional patriarchy, with most of the power and authority in the field being held by men. Why did family therapy theory assume that the male and female roles in the family could be viewed in a social and political vacuum, without regard to the larger context that determined them? How was it that family therapy, which claimed to be so evenhanded, so often blamed the woman for whatever happened to the kids? Why did family therapists so often put pressure on the women in families to make the changes?

The feminist critique was just the first of a decade-long series of reexaminations of therapeutic practices and orthodoxies that the Networker published regularly through the ’80s, echoing changes in the broader culture. In magazine after magazine, we focused on topics and social issues not previously considered in the consulting room—race, domestic violence, social class, ethnicity—tackling subjects that most clinicians hadn’t thought relevant to their work. But in the increasingly psychologically attuned, tell-it-all ’80s, in which seeking therapy had become a kind of de rigueur new rite of passage, all sorts of once-taboo subjects were being addressed for the first time.

The lid to the Pandora’s Box of family secrets was literally exploding open, not just in therapy rooms, but in the recovery movement and self-help groups around the country. It was a Vesuvian eruption of revelations, touching on just about everything by everybody—alcoholism, drug addiction, infidelity, eating disorders, sex abuse, and incest. These formerly undiscussed subjects became a mainstay of People magazine and daytime TV. Phil Donahue, Oprah, and Sally Jesse Raphael shared the wealth with tens of millions of viewers. Psychotherapy had become a window on changes reverberating through society, and the Networker was in the thick of it.

If there was one secret revelation that overshadowed the others in the sense of shock and horror it evoked, it was surely the recognition of the widespread incidence of incest. Beginning in the late 1970s, the feminist movement made it possible for hundreds of thousands of women to share their long-hidden stories of childhood sexual abuse—and be believed. Soon thousands of women and men were telling the world about the traumatic sexual abuse perpetrated by their parents or other relatives. Commercial publishers quickly realized the potential marketing bonanza of this hot potato and books proliferated, filling whole sections of bookstores. It was both shocking and titillating to discover just how routine sexual abuse really was in even the “nicest,” most respectable families. A former Miss America revealed publicly that her father had sexually abused her for 13 years. The term “recovered memory” entered the popular lexicon, as did the name of a once-rare diagnosis, Multiple Personality Disorder, the presumed sufferers of which began to fill entire wards of psychiatric hospitals. The abuse chronicles reached a kind of dark apotheosis with the bizarre, widely broadcast tales not just of incest, but of satanic cults whose members used children in ritual acts of rape, torture, and murder.

With relatively little up-to-date research and almost no clinical tradition to rely on, therapists seeing these difficult cases were often flying by the seat of their pants. Many were essentially gob-smacked by the outpourings from their clients of terrible memories, images, and sensations of past abuse. The “excesses” of some therapists, as well as the sensationalized prosecutions and trials of parents accused of having years earlier abused their now-adult children, or taken part in grotesque satanic sex and death rituals, grabbed the headlines and the public’s attention, while steady, patient, careful work by mainstream therapists went unnoticed and unremarked. In March 1992, a group of parents protesting their own innocence of child-abuse charges formed a support and advocacy organization, the False Memory Syndrome Foundation. The foundation energetically targeted a large, amorphous “sex abuse industry,” including radical feminists, for fomenting general hysteria. More specifically, its members vented their fury at unethical, badly trained, credulous and/or manipulative therapists who used dodgy clinical techniques to elicit or pressure false disclosures of incest from essentially brainwashed clients. At the same time, psychotherapists who treated adult survivors found themselves defending their clinical integrity from what they often regarded as, at best, the reactive denial of accused parents, or at worst, a cynical, orchestrated attempt to once again suppress the truth about widespread child abuse.

In 1995’s “Caught in the Cross Fire,” Networker Features Editor Katy Butler captured the disorientation many clinicians were experiencing at “a time when old models can no longer explain new data and are being abandoned. And it had all the messiness that such shifts often entail. Some therapists believed every memory of satanic ritual abuse as gospel, passed around their own invented statistics, misused hypnosis, overdiagnosed, and drew heavily on self-help literature, autobiography, and pop psychology, borrowing checklists, insights, and simplistic dogmas from the addiction-recovery movement. If the influence of past abuse had gone unrecognized by the old paradigm, those involved in the new paradigm would focus on it to the exclusion of the present. . . . If earlier therapists had tacitly colluded with abusing fathers and mothers, they would now champion the daughters and sons. These were the excesses.”

But the critique of psychotherapy went beyond the repressed memory controversy and led Networker authors to focus not only on the field’s promise and potential for improving clients’ lives, but also on the harm that psychotherapy can do. Critics began to claim that the banalities of psychobabble and the “abuse excuse” were undermining individual responsibility. Psychotherapy, it was claimed, was creating a whiney culture of victimhood, which, instead of helping people acknowledge the past and then move on, was keeping them stuck in the victim role. Increasingly, as the decade progressed, those criticisms came not from outside the field, but from within it as well.

Commentators began discussing an imbalance afflicting the field that led many therapists to focus almost exclusively on their patients’ suffering, rather than their strengths and resilience—often encouraging the endless reliving of old trauma and reinforcing the survivors’ sense that they were deeply, perhaps irretrievably, wounded. As Laura Davis, coauthor of The Courage to Heal, the bible of the recovery movement, wrote in the Networker, “Eventually identifying only as a survivor is like wearing a sweater that is too small, and you need to take off, to stand up and say, ‘I am responsible for my own life, for what I do and what I am.’” Psychotherapist Dusty Miller, a survivor of child abuse herself, wrote, “The ripples that flow outward from every traumatic event don’t have to sink us, or assign us a single identity. ‘Victim,’ I want to tell them, describes a specific moment in time, not a permanent self-definition. This is a comforting aspect of the impermanence that transforms every emotional state.”

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