Downloaded by [New York University] at 12:57 13 August 2016 The Presence of the Absent Where live our most cherished (or painful) memories? Where are lodged those whom we loved (or dreaded) after they have departed? They inhabit, at least for a while, in a gray zone located between our self and our world, sometimes as internal reminiscences sometimes as strikingly vivid images detected and inter- acted by individuals and occasionally by whole collectives, as tenuous or as solid presences. This book familiarizes us with six examples of individuals and families in therapy who live and interact with the presence of their absent, pivotal people in their lives who either died or disappeared, but are still there. It familiarizes us with their plight in a tender, compassionate style, describing in detail interviews and therapeutic transformations and, in several cases, follow-ups as well as echoes of those processes. It teaches us to respect those presences as well as how to help families and individuals treasure them, and in many cases to let them go. Written in a vivid, intense language, The Presence of the Absent offers a marvelous insight into these processes that may prove transformative for the therapist (both family and individually oriented), as well as enlightening to the general public. Carlos E. Sluzki, MD is Professor Emeritus of Global and Community Health and of Conflict Analysis and Resolution at George Mason University, and Professor (Clinical) of Psychiatry and Behavioral Sciences at George Washington Downloaded by [New York University] at 12:57 13 August 2016 University School of Medicine. He is an internationally renowned psychiatrist and family therapist who trained in both Argentina and the United States. This page intentionally left blank Downloaded by [New York University] at 12:57 13 August 2016 The Presence of the Absent Therapy with Families and their Ghosts Carlos E. Sluzki Downloaded by [New York University] at 12:57 13 August 2016 First published 2016 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2016 Carlos E. Sluzki The right of Carlos E. Sluzki to be identified as the author of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Sluzki, Carlos E., author. The presence of the absent : therapy with families and their ghosts / Carlos E. Sluzki. p. ; cm. Includes bibliographical references and index. I. Title. [DNLM: 1. Family Therapy—methods. 2. Attitude to Death. 3. Culturally Competent Care. 4. Family Relations. 5. Hallucinations. 6. Professional-Patient Relations. WM 430.5.F2] RC488.5 616.89′156—dc23 2014049492 ISBN: 978-1-138-84779-8 (hbk) Downloaded by [New York University] at 12:57 13 August 2016 ISBN: 978-1-138-84778-1 (pbk) ISBN: 978-1-315-72650-2 (ebk) Typeset in Berkeley by Swales & Willis Ltd, Exeter, Devon, UK Contents About the Author vi Acknowledgments viii Foreword, by Salvador Minuchin x 1 Ethereal Presences 1 2 Forbidden Words, Forbidden Thoughts: Semantic and Somatic Effects of Political Repression in a Family with a Hole in its Center 10 3 Rekindling the Experience of Freedom: Ghosts of a Dictatorship and Reverberations in a Liberating Process 34 4 House Taken Over: Culture, Migration and Developmental Cycle in a Moroccan Family Overtaken by Ghosts 45 5 The Ancient Cult of Madame: When Therapists Trade Curiosity for Certainty 68 6 The Naming: The Awakening of Two Ghost Children 80 7 Saudades at the Edge of the Self and the Merits of Downloaded by [New York University] at 12:57 13 August 2016 “Portable Families” 89 8 Wrap Up 100 References 105 Index 110 About the Author Carlos E. Sluzki, MD, was born and raised in Buenos Aires, Argentina, where he graduated from medical school and was trained in psychiatry and in psychoanalysis. In turn, he was trained in family therapy at the Mental Research Institute (MRI), Palo Alto, California, during the early days of that discipline. In 1972 Dr. Sluzki migrated to the United States with a prestigious John S. Guggenheim Foundation Fellowship. Since then his career has included being Director of Training and later Director of the above-mentioned MRI (1976–1983) as well as Professor of Psychiatry at the University of California San Francisco (1975–1983), at the University of Massachusetts Medical School (1983–1993), and at the University of California Los Angeles (1993–2003). Dr. Sluzki resides currently in Washington, DC, where he is Clinical Professor of Psychiatry at George Washington University School of Medicine and Professor Emeritus of Global and Community Health and of Conflict Analysis and Resolution at George Mason University. Dr. Sluzki has been Editor-in-Chief of the journals Acta Psiquiatrica y Psicologica de America Latina, Family Process, and the American Journal of Orthopsychiatry, and Vice-President of the American Family Therapy Association. He is a twice awardee of the American Family Therapy Academy, a Distinguished Life Fellow of the American Psychiatric Association and of the American College of Psychiatrists, and a honorary member of multiple professional organizations in Downloaded by [New York University] at 12:57 13 August 2016 the United States, Latin America, Asia, and Europe. He has published extensively—including more than 200 articles in professional journals, book chapters and books, including The Double Bind: Foundation of the Communicational Approach to the Family (with Donald Ransom) and his recent The Social Network, Frontier of the Systemic Practice. Dr. Sluzki has also been actively involved in human rights and the plight of refugees/IDPs, has been About the Author vii consultant to the World Health Organization and to the Office of the Prosecutor of the International Criminal Court, has received multiple awards and delivered countless keynote and panel presentations and conducted workshops worldwide, with special emphasis on family therapy, social networks, violence and victimization, refugees and human rights (www.sluzki.com). Downloaded by [New York University] at 12:57 13 August 2016 Acknowledgments Chapters 3, 4, 5, and 7 evolved from articles previously published in professional journals, listed below. I acknowledge with appreciation those journals for their authorization to utilize that material as a base for the corresponding chapters. Sluzki, C.E. (1990). “Disappeared: Semantic and somatic effects of political repression in a family seeking therapy.” Family Process, 29(2): 131–143. Sluzki, C.E. (1997). “Rekindling the experience of freedom: From the personal to the collective . and back.” Human Systems, 8(3–4): 225–238. Sluzki, C.E. (2004). “A house taken over by ghosts: Culture, migration and developmental cycle in a Moroccan family invaded by hallucinations.” Families, Systems and Health, 22(3): 321–337. Sluzki, C.E. (2008). “The ancient cult of madame: When therapists trade curiosity for certainty.” Journal of Family Therapy (UK), 30: 119–130. Sluzki C.E. (2008). “Saudades at the edge of the self and the merits of por- table families” Transcultural Psychiatry, 45: 379–390. I also wish to express my gratitude to these and many other families, couples, and individuals whom I accompanied, and who accompanied me, in the course of my professional practice. They incorporated me temporarily as a meaningful Downloaded by [New York University] at 12:57 13 August 2016 member of their social network, and allowed me to dive into their stories— stories that ended up inhabiting a space that included me—while opening up to my contributions, sometimes incorporating them into their worldview and sometimes wisely questioning my premises. In doing so they taught me many things about life, suffering, rebuilding, hope and joy, about my fallibility while occasionally validating my capacity to help them to introduce changes in their Acknowledgments ix lives. This recursive process of learning and helping to learn, of changing and helping to change, has been and is for me an ever-present source of nourishment. Likewise, my heartfelt appreciation to mentors, colleagues, and friends who have oriented, expanded and enriched both my personal and my profes- sional life and contributed to its evolution at different moments of my journey. Looking backwards, a few shine with special light: Mauricio Goldenberg, Eliseo Veron, Paul Watzlawick, Virginia Satir, Don D. Jackson, Janet Helmick Beavin, Heinz von Foerster, Gianfranco Cecchin, Elida Romano, Julio Aranovich, and Donald A. Bloch. To them, and to many other colleagues and friends with whom I shared and share community, my love and my debt. I wish also to express my deep appreciation for colleagues and friends who at different moments provided me with constructive suggestions in the process of writing this book. Special thanks are due to my beloved wife and personal and intellectual companion, Sara Cobb, PhD, for her solid stimulation and warm sup- port and for the many ideas conveyed in many conversations and in her admirable book Speaking of Violence (Cobb, 2013); to my admired senior colleague, creative pioneer and generous friend Salvador Minuchin for his kind prologue and for so much more; to my friend Saul Malozowski, MD for his detailed review and feedback of this book while in progress; and, of course, to the late Gabriel Garcia Marquez, Nobel Prize of Literature, who brought forth magic realism and validat- ing that dimension through the esthetic door, thus bringing it out of the closet of our private if not secret world into the light of our explicit daily experiences.