Mastering Family TherapyJourneys of Growth and Transformation

Second Edition

Salvador Minuchin

Wai-Yung LeeGeorge M. Simon

John Wiley & Sons, Inc.

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Mastering Family Therapy

Other Books by Salvador Minuchin

Families and Family Therapy

Family Healing: Tales of Hope and Renewal from Family Therapy(with Michael P. Nichols)

Family Kaleidoscope: Images of Violence and Healing

Family Therapy Techniques(with H. Charles Fishman)

Institutionalizing Madness(with Joel Elizur)

Psychosomatic Families: Anorexia Nervosa in Context(with Bernice L. Rosman and Lester Baker)

Families of the Slums(with Braulio Montalvo, Bernard G. Guerney, Bernice L. Rosman,and Florence Schumer)

Working with Families of the Poor(with Patricia Minuchin and Jorge Colapinto)

Assessing Families and Couples: From Symptom to System(with Michael P. Nichols and Wai-Yung Lee)

Mastering Family TherapyJourneys of Growth and Transformation

Second Edition

Salvador Minuchin

Wai-Yung LeeGeorge M. Simon

John Wiley & Sons, Inc.

This book is printed on acid-free paper.

Copyright 1996, 2006 by John Wiley & Sons, Inc. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.Published simultaneously in Canada.

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To Andy Schauer (19461994), a friend who was openand lovable, lived his life without grudges, and

left us long before his time.

vii

Foreword

This book is a bottomless bag of tools. Part I is a pathbreaking contri-bution, in which Salvador Minuchin offers his unique perspective onthe major ideas of the fields luminaries, selecting some of the most ex-citing conceptual and clinical tools for helping troubled families.

In Part II, we hear the individual voices of eight therapist-supervisees as they struggle to transform themselves and the fami-lies in their care, under their supervisors masterful guidance. Wewatch them improve the complexity and accuracy of their interven-tions, and we observe them learning to abandon unworkable goals.We see how they use Minuchins catalyzing reactions, and we sharetheir pain and joy as they sharpen their skills and enhance theirstyles.

The manner in which each therapists story is told, as well asMinuchins ongoing comments on their work, make reading this bookbecome, in effect, like sitting in on a master class. We follow both theteachers and students perspectives and see how they intersect andhow those perspectives affect the therapy. This work is especially im-pressive in light of the examples presented: a formidable gallery of Di-agnostic and Statistical Manual casualties of high difficulty levels.

For the beginner searching for new approaches to problems that atfirst appear to be inside the individual only, Mastering Family Therapy isa remarkably rich resource. For the experienced therapist seeking tocultivate fresh ways of unbalancing pathologic systems, to amplify di-vergences, and to challenge the usual, the harvest has never been soabundant. This book is particularly valuable in stimulating the super-visors imagination. All of us who have found ourselves in conflictwith a supervisees chosen direction will learn from the ingeniousways Minuchin finds to resolve clashes and promote growth. He showshow a supervisor can thrive on the differences between himself andthe supervisees, and the supervisee and the family he or she workswith, turning those differences into productive conflict, unexpectedproblem solving, and healing. He teaches how to make efficient use ofthe supervisors most fundamental instrument: the ability to join thesupervisee in a tough and honest dialogue in which both search avidlyfor ways of anticipating and creating scenarios.

These ideas do not fit in a field inclined to sacrifice the use of theevocative and probing conversation in the planning and carrying out of

viii FOREWORD

therapeutic interventions. These ideas do not accommodate the quickand automated protocol as a principal means of training. They do be-long, however, in any professional setting that employs a family-basedtherapy, delivered by providers who value the relevance and usefulnessof interventions above all. These clinicians will heartily embrace thebooks main point: discovering feasible goals and improvising a flexi-ble trajectory for therapy by gaining a systemic understanding of fam-ilies. Minuchins guidance in achieving such an undertaking cultivatesand releases the therapists protean imaginationthe endless capacityto shape new options. He teaches how to assume different forms de-pending on what the case requires.

In the future, when the field of family therapy is examined and thetools in its workshop are inventoried, Mastering Family Therapy will becounted as more than the work of a brilliant craftsman from whoseforge came an extraordinary collection of tools that go on shaping thestructure of family therapy. It will be remembered as the source bookon inspiring therapists to fire their own imaginations and forge theirown tools to better serve the families they work with.

BRAULIO MONTALVO

xv

Contents

FOREWORD viiBraulio Montalvo

PREFACE ixSalvador Minuchin

ACKNOWLEDGMENTS xiii

PART I FAMILIES AND FAMILY THERAPY

1 Family Therapy: A Theoretical Dichotomy 3

2Family Particulars: All Families Are Different 17

3 Family Universals: All Families Are Alike 33

4Family Therapies: Clinical Practiceand Supervision 41

5 Contemporary Trends: Whatever Happenedto Family Therapy? 61

6 The Therapeutic Encounter 75

PART II STORIES OF SUPERVISION

7 Supervision of the Therapeutic Encounter 99

8The Feminist and the Hierarchical Teacher 107Margaret Ann Meskill

9One Head, Many Hats 123Hannah Levin

10The Poet and the Drummer 137Adam Price

11The Oedipal Son Revisited 159Gil Tunnell

12Into the Crucible 177Israela Meyerstein

13Men and Dependency: The Treatment of a Same-Sex Couple 195David E. Greenan

14The Shit-Painter 215Wai-Yung Lee

15Filling the Empty Vessel: Andy Schauers Story 243Wai-Yung Lee

EPILOGUE 261Salvador Minuchin

REFERENCES 267

INDEX 271

xvi CONTENTS

xiii

Acknowledgments

To begin with, we owe a deep debt of gratitude to the therapists whosechapters constitute Part II of this book. Were it not for their courageouswillingness to expose their clinical work to mass perusal, this bookwould have become a dry, academic affair, with lessened utility forthose who are involved in the flesh-and-blood work of doing and su-pervising family therapy.

We would like to acknowledge the contributions of Richard Holm,our fellow faculty member at the Minuchin Center for the Family.Richard is present everywhere in this book, albeit invisibly. His contri-butions ranged from the sublime to the meticulousfrom helping uscrystallize some of the theoretical ideas to working with the analysis ofvideotapes.

Authors can count themselves blessed if they find an editor who canunderstand their material and make it better. In writing this book, wewere fortunate; we had four such editors. Frances Hitchcock worked thebasic transformations when the material first emerged from our wordprocessors. Nina Gunzenhauser alerted us to the flaws in the manu-script when we believed it was already flawless. Jo Ann Miller, the exec-utive editor at John Wiley while the first edition was being written,brought an understanding of the field and an ability to integrate thework of many writers into a coherent volume. And Patricia Rossi, oureditor at Wiley for this second edition, managed to infect us with her en-thusiasm for a project of revision and rewriting that we would neverhave undertaken on our own.

Our profound thanks also to Lori Mitchell, Jenny Hill, and GailElia. They labored tirelessly and with tactful patience to type the nu-merous revisions through which the manuscript passed.

Finally, we would like to thank our spouses: Patricia Minuchin,Gail Elia, and Ching Chi Kwan. They accompanied us through thisbook, and they represent the best of complementarity in work andmarriage.

ix

Preface

Once upon a time, a wise old rabbi listened fondly as his two brighteststudents engaged in a polemical discussion. The first presented his argu-ment with passionate conviction. The rabbi smiled approval. That iscorrect.

The other student argued the opposite, cogently and clearly. Therabbi smiled again. That is correct.

Dumbfounded, the students protested. Rabbi, we cant both beright!

That is correct, said the wise old man.

Like the wise old rabbi, the authors are of two minds concerning themaking of a family therapist. Meyer Maskin, a brilliant and caustictraining analyst at the William Alanson White Institute, used to tellhis supervisees how once, when he wanted to build a summer house,he asked an architect to show him the plans of homes he had previ-ously designed. Then he went to see how they looked when they werefinished. Here Maskin would pause for dramatic effect. Shouldnt wetake an equally rigorous approach when we are searching for an ana-lyst? In other words, before we start the arduous psychological trek to-gether, shouldnt we look at how a potential analyst has constructedher life? How well does she understand herself? What kind of spouseis she? Even more important, how well did she parent her children?

An equally critical observer of clinicians, the family therapist JayHaley, would disagree with this point of view. Haley says that heknows many good people and excellent parents who are mediocre ormiserable therapists; he also knows good family therapists who havemade a mess of their personal lives. Neither life skills nor self-knowledge via psychoanalysis or psychotherapy improves the capacityof therapists to become better clinicians. Clinical skill, he would ob-serve, requires specific training in the art of therapy: how to plan, howto give directions, how to rearrange hierarchies. It can be achieved, hewould say, only via supervision of therapy itself. For Haley, to knowhow good a family therapist is, one would need to interview her previ-ous patients. Even a therapists written work, he would say, tells usonly about her writing skills, not about her therapeutic skills.

So here we find ourselves in a quandary because, as in the rabbisstory, the two sides absolutely disagree, and we agree with both of them. In previous writings, I (SM) have indicated how I respond tothe specific needs of patients by using different facets of myself. My