Dancing with the Family: A Symbolic-Experiential Approach

A Symbolic Experiential Approach

Carl A. Whitaker, William M. Bumberry

• Publisher: Routledge
• Year: 2004
• Print ISBN: 9780876304969
• eBook ISBN: 9781135470838
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Dancing with the Family presents something of a clinical importance, not to offer an all-encompassing theory of the family therapy. This book emphasize on a dual focus. You will be asked to remain cognizant of the centrality of the person of the therapist, as well as of the evolving process of the therapy.

1
Beginning with the Family: Joining, Reframing and Expanding the Symptom

As we settled in for the initial session, there was a sense of tension in the air. John and Marie selected the couch to my right, nervously fidgeting as three of their five adult children found places on the remaining couch. Their two missing offspring would join us for the final day of this three-day experience.

This was obviously a farm family, perhaps similar to the one I grew up in. Dad was decked out in brand new bib overalls, while Mom was neatly but casually attired. Their three daughters, Vanessa aged 30, Doris 27 and Marla 18, were more fashionable and less rural in appearance. As we spent a few minutes engaged in small talk, Vanessa emerged as the family spokesperson.

We briefly reviewed how they had decided to come for these sessions and covered the logistics for our three-day experience. Vanessa had instigated the idea of meeting. She was in the process of studying to become a therapist. Though geographically distant from the rest of the family, she felt tied up by the family struggles and wanted relief. She was also concerned about her 28-year-old sister, Gail. Gail had been hospitalized due to emotional stresses. She had recently entered a halfway house program and was being maintained on medications.

Interestingly, Gail’s therapist felt that their current treatment regime was quite successful and opposed her participation in the family sessions, fearing it would jeopardize her progress. Despite the risks, Gail decided to attend the final day, apparently with the blessing of her therapist.

Twenty-three-year-old Mike, the only male among the siblings, was also delayed in arriving. He had work conflicts and was to bring Gail to the sessions. They all lived out of town and had lengthy drives.

Beginning

The opening moments of the initial session are often pivotal. The anxiety level far exceeds mere social discomfort. An intense, covert, bilateral sizing-up process instinctively begins. While we frequently mask the undercurrent tensions, they do exist. Questions such as, “What are you really like?” “What are you going to do to me?” and “How far will we be able to go together?” flood into our collective unconscious.

This is a time for establishing some personal connection, not for remaining “professional” and aloof. One of the initial tasks is to let them know something of how I operate and what I expect from them. I need to establish the parameters of my involvement with them and to clarify my conditions for the relationship.

As I take a position, an interactive process is triggered. My action begets their reaction. As they react, I respond to them and an interactive set is under way. Hopefully this dialectic will eventually lead to a higher order synthesis.

Another component in understanding how this works is to consider the very real difference between assertion and aggression. In taking a clear “I” position, I’m not really out to bully them but rather ready to share with them some of my convictions. They, of course, remain free to respond in any fashion they desire. They may balk, rebel, capitulate, or act completely aloof and uninterested. In any event, the process is under way. Rather than the first hour revolving around the revealing pornography of a sterile “assessment interview,” we are learning to dance.

In the brief opening segment that follows, notice the political positioning that sets the structure for what is to follow. My intent is to share with them my belief that their willingness to expose their pain is essential to growth in therapy. Additionally, they need to accept the fact that they remain responsible for their own living. Attempting to relinquish control or responsibility to me will do nothing to enhance their living.

Carl: How did you decide to
come? What would you like to
get out of it? How can I help?
Let me tell you how I deal. I’d
like to hear about you to get a
sense of the pain you are going
through. So I can feel my way
into the family. But I need to be
clear with you, that I’m sort of a
coach on this baseball team,
I’m not playing on it. You have to
make the final decisions about what
you do with your living.
(pause)
I should warn you that I get mean.

Being straight with the family about my conditions for working with them is crucial. I want them to understand that while I am willing to work with them, I’m not interested in becoming a real family member.
My responsibility includes being as personally responsive as I can to their pain but does not rest on accepting any responsibility for their real living.

My addendum about being mean is to free them from the cure fantasy they arrived with. I try to contaminate this idea. Merely attending will

do them no good. There is hard work ahead. I can’t do it for them, or spare them from the struggle.

Dad: We’re used to that on the farm.
Carl: You’re used to that on the
farm? I was born and brought up on
a dairy farm. I should have brought
my cow! I did a workshop and
someone gave me a little toy cow
with udders, in case I was feeling
lonely and wanted to cuddle up to a
cow again.

Dad’s reaction to my offer triggered a joining reply on my part. I wanted to let the family know that I too was a farmer. That I might be able to feel for them. That I might be able to relate to them in a personal way regarding their struggles. This type of joining can be particularly powerful because it’s for real. It comes from a common life experience. This is far more personal than the standard professional offer of, “I’d like to help you.”

At this point in the interview, Mom seems nervous. She may be concerned that Dad and I will have too much in common. Her automatic reaction is to lodge a slightly disguised complaint against him. If she can discredit him in some way, it may reduce the odds of my being seduced by him. While her concern may have some merit, I was not ready to be drawn into a crossfire at such an early phase.

Mom: He just had to wear his overalls! I said, “Do you think it’s OK to wear them to this sort of meeting?”

He had them for six months and wouldn’t try them on. Wouldn’t even try them on! I was supposed to shorten them. Well, finally I measured them against his old ones and sewed them up last night.

Carl: I’ve often had the feeling that one of the things I carry over from my childhood is when something would break down, the tractor, the mowing machine or whatever….

Mom: Yes.

Carl: …and my dad would come up to the house to get the keys to the car. My mother would say, “Are you going to town? Don’t you think you ought to change into a pair of trousers?” and he’d say, “I don’t see what’s wrong with overalls!” That’s about as hot a fight as my parents ever had, as far as I know about.

Mom: Really?

Carl: I have the feeling I’m

still carrying it. That I can buy a suit and
have it looking like overalls in about three
days.
(laughter)
So I’m still fighting with my mother about
wearing good clothes.

This was an instinctive reaction to Mom’s effort to seduce me into siding with her against Dad. She wanted me to agree with her that Dad is irresponsible.
Though she was talking about overalls, the real implication was clear. This was a way of defining herself as not being responsible for any of their struggles.

We have now completed one cycle of a process that will repetitively occur throughout the course of therapy. In these first few moments I have moved to join with them, as well as to individuate from them. This freedom to move in and move out is a basic task of the therapy, and of all living. We seek simultaneously deeper levels of belonging and individuating.

When we talk about life, we’re really talking about relationships. We don’t exist in isolation. Emotional living is always “other” involved.

Ques: OK Carl, I’ve got some questions about this segment right off the bat. What were you trying to accomplish with this kind of opening? Especially warning them about your being mean? Is it that you don’t care about them or what?

Ans: Of course I don’t care about them! I just met them! I hope to come to care about them, because it would be lonesome to sit there and just talk to strangers. But I want them to be clear that I’m not artificially playing host. I’m like any surgeon. I’m interested in getting the pathology resolved, not in preventing the flow of blood. They need to know that it’s painful, so they’re prepared. Just like a dentist would tell you, “You know this is going to hurt” before he puts the needle in your tooth. I call this the Battle for Initiative really. It’s making them maintain the initiative in their own life. It’s making sure that the anxiety they came with stays there. That they don’t go anxiety-free and collapse and expect me to handle their world.
Ques: But they’re coming to you for some help with their anxiety. That’s why they’re there! You’re saying you’re not going to do that?

Ans: That’s right! I do not want to relieve their anxiety. I want their anxiety to be the power that makes things move. Then I want to combine with it to make their anxiety more productive.
Ques: Near the end of that segment, you started talking about cows and the farm and that you were from the farm. What was all that about?

Ans: That’s a way of what Minuchin calls joining. If you can make common cause….

I think the transference, … Freud made a serious mistake, … I shouldn’t tell him, … by assuming the patient’s transference is what makes the therapy work. I don’t think that’s true. I think it’s the mother’s breastfeeding that makes the child love the mother, not the child’s loving the mother that makes the mother have a flow of milk.

I think the therapist needs to internalize the patient’s pain so that he identifies with him. So that he gets an empathetic response in himself. Then he has to be very careful that he’s not sucked into taking over.

Searching for Father

Early in the initial session I typically engage the family in a history-taking process. This is not just a history that surrounds the presenting problem. Q...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Preface
• 1 Beginning with the Family: Joining, Reframing and Expanding the Symptom
• 2 Person of the Therapist: Personal Integrity and Professional Role Structure
• 3 Process of Family Therapy: Political/Administrative Aspects and Stages of Therapy
• 4 Symbolic-Experiential Family Therapy
• 5 Getting Personal: Challenging Rigidities and Creating Pathways
• 6 The Universal Dilemma: Hopeless Men and Hopeful Women
• 7 The Secret to Unhappiness: Getting What You Want
• 8 Caring Revisited
• 9 The Healthy Family and Normal Pathology
• 10 Which Direction Is Growth? Three-Year Follow-up
• References