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The Therapist’s Most Important Tool - Page 2

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Caught up in the overall drama, it’s easy to forget that Minuchin, like most of the great family therapists, is a master in the use of self. It’s his very consciousness of himself, his persona, and how to inject that self into the family’s force field—now coming closer, now distancing himself, now becoming the earnest questioner, now delivering an inspirational pep talk, now shaking a mother gently by the shoulders—that’s so stunning. Always, he’s consciously using himself as what he has called “the central tool,” more important than any particular technique or body of techniques, toward certain ends. In a way, this tool of self, the core of family therapy as Minuchin sees it, was an invention born of necessity, emerging when he and his colleagues were starting from scratch, when, he once said, “we didn’t know anything [and] invented everything.”

But if the family therapy pioneers relied by default less on what they did and more on who they were—if the self came first and the technique followed—the situation is almost entirely reversed today. Currently, the typical young therapist has probably spent much of his or her training in an academic setting being “bombarded,” as Minuchin writes in his new book—excerpted on the following page—by a “multitude of different theories.” Peruse the course list of any graduate-level, university-based clinical psychology program and you’ll find a staggering array of topics and approaches: many different brands of psychodynamic and cognitive behavioral therapies, as well as different takes on trauma, eating disorders, depression, adolescent, families, and couples, not to mention clinical hybrids involving any of the above mixed with somatic, attachment, neurobiological, mindfulness, and schema-based methods. Family therapy itself is a perfect welter of theories, methods, techniques, and orientations. Students today are buried under an avalanche of textbooks and subject to a cacophony of different lectures. They learn all about theory and technique. They’re taught to become highly proficient technicians, experts in the deployment of many methodologies. But where and when do they learn who they are and how to deploy their own selves in therapy?

Mostly, they don’t. While not exactly like the old rebellion against the taciturn, disappeared persona of the analytic therapist, Minuchin’s new crusade resembles it in its intrepid focus on the indispensable role of the therapist’s own personality in therapy. Mainstream therapists 50 years ago purposely held themselves back because that’s what they were supposed to do. Today’s young therapists, in contrast, seem unable to express themselves fully in sessions because they don’t know how and are scared to try. It doesn’t seem to occur to them, or their teachers, to even look at their own inevitable, if unconscious, participation in the family system. In fact, it seems they haven’t even considered opening the door to their full inner resources to see all the rich and varied garments the self can wear. In the end, Minuchin suggests, therapists are too worried about offending, afraid that if they’re anything but nice, empathic listeners, they’ll drive clients away.

For young therapists, weighted down with multiple tools, methods, approaches, theories, and techniques, what’s missing, in Minuchin’s view, is exactly this capacity for shape-shifting—being able to call on many instruments in the rich, multitoned orchestra of the self. Following is an excerpt from Minuchin’s new book, The Craft of Family Therapy, about bringing the too-often buried self of the therapist back into the center of the therapeutic enterprise.


From The Craft of Family Therapy: Challenging Certainties

by Salvador Minuchin

When a family comes into your office, what do you do? What’s the correct way to start the session? Do you ask about the problem? Do you offer your services as a healer? Do you smile and ask about the trip to the office? Are you silent until one family member begins to talk? Yes, yes, and yes. Therapy is an encounter between strangers preparing themselves for a significant journey together. Therefore, the early joining in the process will be idiosyncratic, depending on the particular family and the particular therapist. It’s a journey that starts in uncertainty.

Most new therapists tend to fall back on theory as a way to reduce their anxiety so they can function. But how do you choose a theory that’ll enable you to be effective? These young therapists look at therapy as a course of action in which the therapist observes a family and implements techniques to help them with their problems. They don’t understand the complexity of the process. The craft of therapy includes not only an understanding of the characteristics of the family and a grasp of techniques that can facilitate change, but an awareness of how they, the therapists, are functioning within the therapeutic system.

There are many ways of learning how to become a family therapist, and these methods have changed over the last 50 years or so. When family therapy first began, in 1957, there were no family therapy theories. There were no introductory textbooks on different family therapy approaches. The field was not yet established, and the ideas and understandings of how families functioned and what to do with them were hidden within the families that were being seen. Practitioners learned by viewing and doing. The originators of the field—people like Nathan Ackerman, Murray Bowen, Jay Haley, Don Jackson, Virginia Satir, Carl Whitaker, Lyman Wynne, and others—developed their understanding through meeting with families and then evaluating what happened in the session.

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  • Comment Link Wednesday, 16 October 2013 10:06 posted by Marilyn

    This is the kind of "therapist" I'm talking about! This man is exactly the type of counselor/therapist society needs to kick people into gear and into reality. No more sitting back, scratching notes and scratching your head while your client speaks and cries, wondering what the hell your writing and why aren't you paying attention. This is what people want and need, a REAL person to talk to and to get feedback from. Why don't the "professionals" get that? Take off your suits & ties and get out from behind that pretty desk, put on your regular clothes and sit on the floor or a chair with your client and just BE REAL!