The Therapist's Most Important Tool

CLINICAL GUIDE The Therapist’s Most Important Tool: Salvador Minuchin on What Today’s Training Approaches are Missing psychotherapynetworker.org The Therapist’s Most Important Tool: Salvador Minuchin on What Today’s Training Approaches are Missing BY MARY SYKES WYLIE sychotherapy trainees today are buried beneath textbooks on was considered a key player in the sometimes rowdy theory, bombarded by lectures on current research, and taught to be goings on in session. Who the therapist was and how she Pexperts in a variety of therapeutic methods. But where and when showed herself in therapy, the way she’d related to her own do they learn who they are and how to use their own selves in therapy? family of origin, her personality, and, most of all, her use of At 92 years old, Salvador Minuchin, the world’s most her specific, personal self in therapy was vital to the success famous living family therapy pioneer and probably the of the whole therapeutic transaction. most imitated clinical practitioner ever, is still too young for After being trained as a psychiatrist, Minuchin went on the retirement. Now, nearly 50 years after helping foment a usual pilgrimage to New York City—Psychoanalysis Central revolution in psychotherapy and becoming himself an icon in those days—to learn the tricks of the analytic trade. But and an institution, the old lion is back in the arena, and with psychoanalysis wasn’t a good fit for a gregarious, assertive, the publication of his latest book, The Craft of Family Therapy, curious, extroverted Argentine Jew, who simply wasn’t cut he’s once again challenging the therapeutic status quo. out for the muted, self-suppressing work of listening silently During the mid-1950s, when Minuchin first began his psy- to people verbally meander through their lives and psyches. chiatric career, almost all therapists followed the psychoana- Bored and dissatisfied, he leapt at an opportunity to work as lytic rule book. The goal was to bring to light the individual a psychiatrist at a residential institution for inner-city delin- intrapsychic conflicts from which the patient’s life problems quents, a school called Wyltwyck. were thought to originate. Because truly meaningful change The experience changed his life. The tough, ghetto-raised was thought to emerge only from within the patient’s mind— black kids at Wyltwyck were no more cut out for psychoanaly- carefully cultivated and encouraged, but never imposed sis than Minuchin was, though for different reasons. They from without—the therapist wasn’t supposed to get in the were nothing like the quiet, cooperative, verbally skilled, way. Well-trained clinicians were expected to embody a kind and introspective middle-class patients most analysts saw. of divinely empty blank screen, maintaining a posture of And analytic therapy was useless for them: after months of reticence and neutrality, so as not to interfere with the in-patient treatment, they’d fall back into trouble soon after workings of the holy transference: the patient’s subcon- returning home. As much from desperation as anything else, sciously generated projections onto the therapist of emo- Minuchin and his colleagues decided they might as well take tionally important figures from his or her deep past. How, it a look at how these kids acted with their families. After read- was argued, could the patient see and relate to the therapist ing an article or two from other far-flung embryonic family as his mean father, her overprotective mother, his seductive systems theorists, they punched a hole in the wall, installed a older sister—thus revealing the source and lineaments of his one-way mirror, and started watching families in vivo. psychic distress—if the therapist kept butting in with ques- It was a revelation. They saw immediately that focusing on tions, remarks, opinions, observations, encouragements, or, the “individual motivation” and “intrapsychic processes” of God forbid, emanations of his or her own personality? any one family member was beside the point: all the action, Minuchin and the other family therapy pioneers didn’t all the life, all the juicy emotional “processes” happened merely inject a bit of fresh air into this hothouse: they blew between people. The way family members behaved, the the roof right off, taking all the furniture and psychoanalytic feelings they expressed—the yelling, the crying, the stomp- tomes along with it. Not only was the focus of their new ing around, the fist-shaking, the interrupting—didn’t seem therapy different, but so was their view of the therapist. No to emerge de novo from deep within any one psyche, but in longer the self-contained cipher, sitting mostly silent and obvious response to the behaviors and expressed feelings of sometimes invisible behind the patient’s head, this new kind the others. Back and forth and up and down the personal of therapist—dazzlingly exemplified by Minuchin himself— interactions went, in complex, intermingling feedback loops. was brash, interventionist, bossy, and frequently in clients’ Early on, these innovators instructed people to talk to faces. In fact, the therapist’s personality—the “self of the each other, rather than to the therapist, and these “conversa- therapist,” as it eventually came to be called— tions”—staged and kept more or less orderly by the therapist The Therapist’s Most Important Tool: Page 2 of 5 Salvador Minuchin on What Today’s Training Approaches are Misisng For more free reports, visit http://www.psychotherapynetworker.org/free-reports © PSYCHOTHERAPY NETWORKER referee—became the basis of “enactments,” which revealed welter of theories, methods, techniques, and orientations. the family’s entrenched emotional patterns better than any Students today are buried under an avalanche of textbooks spelunking into the deep psychic caves of the individual and subject to a cacophony of different lectures. They learn participants. Through all of this, the therapist was an active all about theory and technique. They’re taught to become participant. “The idea was to help the dancers dance, and the highly proficient technicians, experts in the deployment of therapist would be the one leading the do-si-do,” Minuchin many methodologies. But where and when do they learn who recalled later. they are and how to deploy their own selves in therapy? To this day, Minuchin’s style, caught in classic Mostly, they don’t. While not exactly like the old videos as entertaining as they are instructive, represents rebellion against the taciturn, disappeared persona of the the embodiment of the antianalyst: energetic, active, analytic therapist, Minuchin’s new crusade resembles it in its expressive, now here, now there, now everywhere at once, and intrepid focus on the indispensable role of the therapist’s own anything but retiring—except when retiring, or strategically personality in therapy. Mainstream therapists 50 years ago “stepping back,” becomes itself an active intervention. purposely held themselves back because that’s what they were Minuchin himself is often mesmerizing: he mocks, reassures, supposed to do. Today’s young therapists, in contrast, seem flatters, cajoles, charms, needles, encourages, congratulates, unable to express themselves fully in sessions because they and confronts the families he sees. Sometimes, when the don’t know how and are scared to try. It doesn’t seem to occur family seems terminally stuck in its own roundabout, he to them, or their teachers, to even look at their own inevitable, looks bored, as if he is mentally checking his watch. At other if unconscious, participation in the family system. In fact, it times, he makes jokes, interrupts, orders people around, seems they haven’t even considered opening the door to their touches them, gives them short lectures—all in an Argentine full inner resources to see all the rich and varied garments the accent that probably thousands of Minuchin wannabes have self can wear. In the end, Minuchin suggests, therapists are unconsciously mimicked. These performances (Minuchin has too worried about offending, afraid that if they’re anything been compared often to a stage director or impresario) are indeed but nice, empathic listeners, they’ll drive clients away. entertaining, funny, serious, and often moving. For young therapists, weighted down with multiple tools, Caught up in the overall drama, it’s easy to forget that methods, approaches, theories, and techniques, what’s Minuchin, like most of the great family therapists, is a missing, in Minuchin’s view, is exactly this capacity for master in the use of self. It’s his very consciousness of shape-shifting—being able to call on many instruments in the himself, his persona, and how to inject that self into the rich, multitoned orchestra of the self. Following is an excerpt family’s force field—now coming closer, now distancing him- from Minuchin’s new book, The Craft of Family Therapy, about self, now becoming the earnest questioner, now delivering bringing the too-often buried self of the therapist back into an inspirational pep talk, now shaking a mother gently by the center of the therapeutic enterprise. the shoulders—that’s so stunning. Always, he’s consciously using himself as what he has called “the central tool,” more From The Craft of Family Therapy: important than any particular technique or body of Challenging Certainties techniques, toward certain ends. In a way, this tool of self, the by Salvador Minuchin core of family therapy as Minuchin sees it, was an invention When a family comes into your office, what do you do? born of necessity, emerging when he and his colleagues were What’s the correct way to start the session? Do you ask about starting from scratch, when, he once said, “we didn’t know the problem? Do you offer your services as a healer? Do you anything [and] invented everything.” smile and ask about the trip to the office? Are you silent until But if the family therapy pioneers relied by default less one family member begins to talk? Yes, yes, and yes.

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