Adolescents bring their own brand of headaches to their families. Using a personal arithmetic, they know they’re two or three years older than their parents think they are, and they demand a relaxation of the rules before they know what to do with the autonomy they insist on. The parents are caught. They’ve “been there,” but that was a different time. They’d like to share their wisdom to protect their adolescent from the uncertainties of life, but find themselves with a child they don’t recognize. Since they’re uncertain about how to protect their child, they increase control, while the adolescent, certain that this is unfair, tests the rules. A therapist who enters this minefield needs to empathize with both camps, working both sides of the street, like any competent professional, in the search for better pathways.
As if coping with the demands of adolescence weren’t enough, doing so in a blended family adds a whole new set of challenges. Blended families have to go through the same process of accommodation and boundary-making as any families, but with one big difference: in first-time families, parents have time to forge a bond before they have to deal with children, but blended families don’t have that luxury.
The Boyds are a threesome: Mary, Richard, and Whitney, who is 15 years old. Whitney is Mary’s child from her first marriage, which ended in divorce when her daughter was an infant. Mary married Richard one year later, and now they’ve come to therapy because Whitney can’t be trusted. She lies compulsively, and most of the time, she’s caught in the lie.
When they enter the room and settle down, Mary takes the lead, telling me that her daughter “has lied to us as long as I can remember.” This is clearly impossible, but it isn’t the logic of the statement that’s the problem, but the intensity of the assertion: “as long as I can remember.” The family’s interaction has been restricted by a story that started at the beginning of time
Opening Up the Presenting Complaint
Richard then takes up the story: “We don’t know why. We thought we could fix it ourselves, but it’s gotten worse.”
“We’ve tried everything,” adds Mary.
Most families define their problems like this—in a way that invites the therapist to join them in the trap of their fixed perspective. Asking for more details at this point may reinforce the family’s certainty that Whitney is the patient and her lying is the problem. If I join with the parents, I may lose Whitney, and I certainly can’t join with their narrow definition of their daughter and themselves. I need to introduce uncertainty, curiosity, and hope into the family dynamic. And I must also make contact with Whitney.
I ask the parents’ permission to talk with her for a while, and I start by saying that I’m curious about her life. We talk about her school, her friends, her interests. She tells me that she keeps a diary, that she likes poetry, and that she writes poems but doesn’t show them to anybody. I ask her if she knows what a metaphor is. We agree that a metaphor can bring something to attention by calling it by a different name. I say that, in effect, a metaphor is a poetic lie.
I’m pleased with this image. It transforms a symptom into a skill, and I’m pretty sure it appeals to Whitney, who’s bright, engages with me easily, and, like any young person, would like me to understand that she’s more than just a liar. I know that the parents probably feel I’ve been seduced by Whitney, however, and have fallen for her lying.
I ask, “Can you talk with Whitney? I’m a stranger, and you’ve come to see me about something that’s very significant for your family. Maybe you can talk together, and that’ll help me to know how you deal with each other.”
Richard says, “I can’t explain it. That’s why we came here.”
“In the beginning, she’d just lie to us,” says Mary. “Now she’s getting into trouble with other people. She never tells us the whole story. She’s getting out of hand.”
They’re continuing to focus on Whitney, directing their remarks to me. Family members rarely accept the invitation to talk with each other at the beginning of a session, because they’ve come to tell me their story, and they want me to listen and respond.
I turn to Whitney and say, “Can you help me to understand what your parents are saying?”
“Well, I’ll do something, and they ask me if I did it, and I deny it,” she says.
“Can you give me an example?”
Her father chimes in: “A week ago, she was grounded because of her poor grades and wasn’t allowed to use the phone. But I know for a fact she did use the phone.”
“How did you know?” I query. “How did you become a detective? By the way, who is a better detective, you or Mary?”
ighlighting Problem Interactions
Mary responds to my question about which parent is a better detective with more evidence of Whitney’s mysterious illness of lying. “We’re more on top of things now. We pay more attention. Her choice of friends isn’t always good, and we’re more careful about who she’s with. The other day she said she went to visit a friend, but I found her in the mall with a boy.”
“Are you afraid she’ll get involved in a sexual relationship?” I ask.
“I really don’t know. Whatever she does becomes a secret.”
“I’m concerned about you,” I say. “Trying to follow an adolescent child can become a full-time occupation. Are you both equally worried? Or is one of you more worried than the other?”
“She gets caught up in it more,” admits Richard.
“It depends on the situation,” says his wife.
I’ve been trying to separate the story from the storyteller. The parents appear united in their view of Whitney’s behavior, but that’s rarely the case. Now the father’s comment suggests that he’s ready to depart from the appearance of a united front.
“Why do you think that happens?” I ask. “What does Mary want from Whitney?”
“She wants her to be truthful. They used to be very close,” he replies.
When family members say “very close” they usually mean harmonious, but to a therapist the terminology suggests enmeshment: a closeness that can be hard to sustain when children become adolescents and want to become their own people.
“So lying can be a defense,” I say to Mary. “At this point, you and your daughter are hooked together. She’s pulling at you so you’ll watch her continuously. How will you free yourself from her?”
“If I could trust her to do the thing she says she’ll do,” she says.
I say to Richard: “Your wife tries to relax her surveillance of Whitney, but then Whitney does something that says ‘Look at me!’ and Mary is hooked again. They’re both caught. Whitney needs Mary to look at her, and Mary is hooked into observing and responding to Whitney. It’s a circle. Can you help them? Can you free these two people from this vicious circle?”
“I can see where Mary may overreact,” he says. “Until a few months ago, when we tried to set up punishments, Mary would holler and yell, but an hour later, they’d be going to the mall together. Mary would feel guilty and give in.
“What did you do then? What did you say to Mary?”
“That I didn’t think it was right,” Richard responds. “They’re close, and then sometimes they’re not. I’d say, ‘Let her alone. Let her think about it.’
“And were you successful?” I ask.
“No.”
The less involved parent is often a critic, but often not a forceful one. Being forceful means getting involved. A therapist who chooses to push for more commitment at this juncture would be doing so without yet understanding why Richard was reluctant to get more involved. I decided to explore this question later.
Instead, I say to Whitney: “I don’t understand your mother. Why is she watching you so much?”
“She doesn’t trust me,” Whitney answers
“And you make sure she doesn’t trust you,” I say. “What are you doing that makes her watch you so closely? How can you help her to release her hold on you?”
I’m asking Whitney, who came as a symptom-bearer, to become a helper.
“It’s not as if I insist on her keeping a watch on me,” she says. “I don’t understand why she gets upset about small things.”
“Something is wrong when they hold you prisoner and you hold them prisoner,” I say. “Something strange has happened in a family where the jailors are prisoners, and the prisoners are jailers.”
I frequently use this metaphor with families trapped in power struggles. It highlights their helplessness to escape a box of their own making. It conveys the message, “There are no villains, only victims.”
I ask the couple, “Do you have spaces that are your own?”
“Not as much as I’d like,” says Mary.
“Who interferes?”
“Sometimes it’s Whitney’s behavior,” says Richard.
“Richard, almost any adolescent who’s under observation may become a liar,” I say.
Whitney then says to her mother: “You’ve always been like this—thinking that I’ll mess up. It’s not a new thing.”
“I’d like to let you go and be a normal teenager,” replies Mary. “How many times have we let you try? Remember the weekend Richard and I went on a mini-vacation? Not one day passed before we received a call from Sally.”
The discussion heats up. I sit back and let it go on for a few minutes. Mary and Whitney are tense and angry. Their voices rise in attack and defense.
“Is that how conversations go on between you?” I ask. You become caricatures of yourselves—fisherman and fish.
Prisoners and jailer, fishermen and fish: I use these images to describe complementarity in families that are overinvolved. They’re powerful precisely because they’re familiar, not pathological.
Mary says: “I’m trying to help you understand this. When Whitney was an infant, she needed constant attention. She was 11 months old when I divorced, and she was a year and a half when Richard and I became a couple.”
“I think you need to help them,” I say to Richard. “Mary spends more time worrying about Whitney than enjoying you. Talk to her about how she can be freer to become your wife.”
Again, I’m suggesting a conversation that doesn’t include me. By now, however, it seems more natural, and Mary and Richard turn to each other to talk.
“If only I could trust her!” Mary says to Richard.
“There are times that I agree with you,” he responds. “I don’t trust her either. We need to establish better limits and rules, without getting caught up in the arguments.”
“I think Mary has become a detective, and I’m worried about her,” I say to Richard. “She might be trying to do the impossible. She’s overstressed, and she may break.”
“I can see that your life is consumed, and so is mine,” Richard tells his wife. “We’re always worried about Whitney’s behavior. There’s no fun for us anymore.”
We’re now changing the family’s understanding of how they function, and challenging their certainty about the nature and location of the problem. Whitney is a liar, but that isn’t a full or fair description of who she is; nor does she create the problem alone. Mary contributes, and so does Richard, whose role of critic on the sidelines is part of the picture.
“Where did you learn to be such a worrier?” I ask Mary. “Why do you think that a catastrophe is waiting just around the corner? You seem to be bringing a world from your past into predictions for Whitney’s future. I’d like to explore with you where you learned to be like that. Could you have lunch and then return for another meeting?”
Mary is hesitant. She probably feels that I’ve colluded with Whitney and am blaming her for the family’s difficulties. It’s Richard who proves persuasive. He’s gentle and protective in the way he talks with her, suggesting that it might really be useful, and she finally agrees to come back after lunch.
Second Session
When the family returns, I tell Whitney that I want to talk with her parents alone, and she can join us later. Mary, Richard, and I settle down to talk. They look expectant and tense, unsure of where we’re going.
I imagine you were somewhat confused about what I was trying to do,” I say. “Did you talk about the session during lunch?”
“You were approaching our problems from a different angle than we expected,” Richard confesses. “I know this is a short period of time to explain our situation at home, and maybe we were focusing a lot on the last couple of months, when we were really upset and trying to enforce rules. Before that, Whitney had more freedom.”
“It was interesting,” adds Mary. “You were seeing things I never saw before.”
Mary’s comment is a surprise, and it’s encouraging.
“I’d like to tell you a bit about my ideas about families,” I say. “I see people as interconnected. If a child is having problems, I look at the parents and at the ways that family members connect. Of course it’s true that Whitney lies. The question becomes why. I was impressed, Mary, by your pessimism, and your fear of catastrophe. Some people see life through rose-colored glasses, but you . . . .”
“I only see things getting worse,” she finishes my thought.
“Yes. I’d like to spend some time exploring with you who you were before you met each other,” I say.
“My parents divorced when I was 5,” says Mary, speaking without emotion. “I left home when I was 18, on a Christmas Eve. There was a snowstorm. I was supposed to be in by 10 o’clock, but I didn’t get home until midnight, and so my mother threw me out.”
“She threw you out? In a snowstorm—at midnight?”
“She’d recently married, and she didn’t want kids around,” Mary recounts matter-of- factly. “My mother has a lot of good qualities, but she wasn’t a good mother. I wasn’t sure what to do. I’d lost my girlfriend the previous August—she committed suicide—so I called her mother, and we’ve been a family ever since. I never really understood my own mother. I think she was depressed most of the time. She could be cruel. . . . It’s hard to talk about. Sometimes it’s like water flowing, and you’d like to dam it, but you can’t. My younger brother is schizophrenic. He stayed at home while my other brother and sister went to foster homes.”
I was struck by Mary’s composure as she told this heartbreaking story. Was it the effort to keep her feelings buried that prevented her from connecting her fear of the future with the cruel uncertainties of her past
“How did you learn to trust people?” I ask
“It’s always been an issue. It takes a long time, and if the trust is broken it’s hard to repair. For years, I didn’t talk with my mother, but I talk with her now.”
“How predictable is Richard?” I ask.
“It took me a long time to open up to him. I kept to myself a lot, for years.
“You were married before. How was that experience?”
“I didn’t know my first husband very long. We married and moved to Montana, away from my family. I got pregnant, and then I discovered he was addicted to drugs and alcohol.”
“How were you saved from that situation?”
“I tried to stay with him. He went through rehab after rehab, and finally there was an incident that ended everything. It was a Sunday afternoon, and I didn’t know he was doing drugs that day. He was driving and passed a red light, and we had an accident. I was trapped in the car for a long time. I nearly lost Whitney. My husband left the scene, and I never saw him again. Later he was arrested for armed robbery. Whitney was released from the hospital before me, and my mother took her home. I picked her up at my mother’s house when I got out of the hospital and took her back to Montana. That’s where I met Richard.”
The flat way Mary tells her story may signal a low threshold for stress, and may indicate the need for supportive understanding before she can hear a challenge.
“So you enter into the scene,” I say to Richard. “What happens?”
“I was attracted to her and Whitney. It was an instant family. I’m an only son. My parents divorced and both remarried. I lived with my mother, her husband, and my youngest stepbrother.”
“And how did you learn to be nurturing?”
“I don’t know. I tried to protect my brother from my stepfather. He was crazy. He had mood swings, and he’d threaten to kill me. Sometimes he’d be fine. Other times, he’d sit and stare at the wall. When I was 17, I left home.”
“I’m thinking about what you both bring from the past, and how that affects Whitney. How old were you, Richard, when you met Mary?” I ask
“Twenty-three.”
“You were a young kid marrying Mary and Whitney. How did you deal with both of them?”
“One day at a time. I just stuck it out.”
“How did you gain her trust?”
He hesitates and then says, “Once we broke up. She wanted to return to the life she had before.”
“I decided it was time to get out of the marriage and go on,” his wife says. “We didn’t talk, and I thought maybe it was too much for him—Whitney and me dropping on him all at once. We returned to the town where my family was living, but then we decided to make one last try. There was a lot of tension. I kept a lot to myself.”
“How did you solve it? How did you become a couple?”
“I made an effort, read some books,” Richard says.
“When did Whitney become your daughter?”
“I always felt her as my daughter,” he responds. “We were very attached. I knew that if we split I didn’t have legal binding with Whitney.”
“Whitney was a difficult child,” her mother adds. “If she didn’t get her way she’d cry and cry, to the point of throwing up. Growing up, she thought that was the way to get things.”
“She was very close to you. Are you afraid she’ll become a drug addict like her father?” I ask.
“She lies like he did.”
“You’re wrong,” I say. “She lies like an adolescent.”
Mary’s description of Whitney’s behavior carries her traumatic experience with her first husband, and is an imposition of Mary’s past onto her daughter’s present.
“Sometimes when I look into her eyes, I think she doesn’t feel anything,” Mary says.
“What do you think about what Mary said—that she looks into Whitney’s eyes and sees the eyes of Whitney’s father, whom she hasn’t seen for 13 years?” I ask Richard. “Mary’s fear and mistrust come from her past, but that fear makes her see things that don’t exist. I think she needs help, and that you can help her.”
Mary says, “Sometimes I feel like I’m doing it all alone.”
“Richard is a gentle man, and I think you need his gentleness, but you push him back and he restrains himself. Then you feel alone. How do you ask him to enter?”
“Usually I’m pretty stressed, but I just don’t ask. I’ve thought about that before.
“How will you change him so he becomes available?” I query.
“He has to want to be in.”
This has been a marathon session, touching on deep and difficult material. They trust me now, and I feel bonded to them. I want to be helpful. We all know that this is the end of the encounter, and we’re searching for pathways to a positive change.
“I want to be in,” Richard says to his wife. “I guess I don’t react fast enough for you.”
“Do you think she’s so competent she doesn’t need help?” I ask him. Then I say to Mary, “You hold your cards close to your body. How can you become a team?”
“I guess if I don’t try so hard, and if I ask him for help.”
“Will he be there, or will he run away?”
“I’ll be there,” Richard says assuredly. “If I was going to run away, I’d have done it a long time ago.”
I say to Richard, “Sometimes Mary finds her connection to Whitney easier than her connection with you, but I think one thing has to do with the other. Whitney fills a void. To help Mary detach from Whitney without feeling alone, you’ll need to bring her closer to you.”
The session is coming to a close. Both Mary and Richard can now see how important it is for them to move toward each other, and what each of them has to do to close the distance between them. Before saying goodbye, I feel that it’s important to invite Whitney back in so her parents can let her know what they’re thinking.
Exploring Alternative Ways of Relating
I say to them, “I’d like you to explain to Whitney that her lying is part of an old story about how you’re connected with each other. I’d like her to be free of the prediction that she’ll be a delinquent. Can you do that without giving her the feeling that she doesn’t need to be responsible?
Richard goes over to Whitney and hugs her.
Mary says, “I want to be able to trust you, and I’m going to work at that. I’m going to stop worrying and concentrate on everyday stuff, and I really will try to have more faith.”
Although Richard and Mary aren’t clear what exactly the changes they need to make are, the problem they’re talking about is no longer just Whitney’s lying. It now has something to do with relationships: the relationship of the couple with each other, and the relationship of the parents and Whitney as a family.
As in most cases when a child carries the problem, the goal of therapy focused on transferring the ownership of the symptom from the intrapsychic machinery of the child to the interpersonal drama of parents and child affecting each other. Whitney’s lying was a response to her parents’ overprotectiveness. Another focus of therapy was on bringing to the awareness of the mother how a traumatic past was distorting her relationship with her daughter.
Case Commentary
By Carlos Sluzki
The goal of the case under discussion, it appears, is not only to destabilize the family’s “official story,” but also to question some of the readers’ assumptions or practices, so as to make everyone more receptive to “the better pathway” to which Salvador Minuchin and his coauthors adhere. Reading the material from this viewpoint enriches the already rich understanding of the dynamics of the case that Minuchin demonstrates.
For instance, after joining with the reader, the authors subtly begin the process of destabilization in the second sentence of the first paragraph. It isn’t that adolescents “assume” that they’re older than their parents think they are—they “know” it. Unlike my own usage of this term, all this is written without the use of quotation marks, that grammatical wink that establishes the “as if” nature of the statement. Several other ironic comments in that paragraph further challenge the reader’s assumptions: Is Minuchin empathic with the parents dealing with a battling adolescent? With the adolescent battling rigid parents? With both? And how? Will he search for encompassing frames or negotiate whatever they bring?
Paragraphs two and three, by contrast, are an oasis of empathy and clarity: the discussion of the tasks couples face in a blended family is filled with wisdom, constituting a pivotal conceptual frame for what follows.
In his opening moves with the family, Minuchin—repeating what he did with the reader—legitimizes all participants through friendly dialogues with them, so as to make them part of the therapeutic process and assure that they’ll tolerate occasional challenges and temporary disqualifications.
He then attempts a complex move: while assuming a one-down position (“I’m a stranger”), he asks them to “talk together” (so he can observe them), something that’s difficult in the early stages of a session, especially when it hasn’t happened spontaneously. Not surprisingly, his request isn’t followed.
Other destabilization moves include some interesting circular questions of difference (“Who is a better detective?” “Who is more worried?”) Later he proposes a systemic description of the symptom in context (the daughter lies in order to keep the mother tied). But as this design initially doesn’t include the husband, he’s later brought in to the systemic description as one of the “prisoners.” Now the whole family is part of the pattern, even though the husband/stepfather is defined as an excluded member (“Mary spends more time worrying about Whitney than enjoying you), which leads to the husband’s first solid complaint (“There’s no fun for us anymore.”)
At that moment, Minuchin goes to the rescue of the wife in what looks like a fishing expedition (“I’d like to explore where you learned to be like that”) that soon leads, however, into mother’s dramatic story of her extremely chaotic, deprived childhood and traumatic first marriage. Minuchin highlights her strengths (“How did you learn to trust people?”) and supports her struggles, while challenging her (“You’re wrong. She lies like an adolescent”) and indirectly provoking her (intimating to Richard that she feels she needs to do it alone).
The new family story elicited throughout the session, Richard’s increased centrality, and Mary’s pivotal role and commitment to open up all contain promises of positive changes to come, while leaving us hungry for a follow-up.
We have here all the elements of an illuminating consultation: a clear contract, a strong engagement, the elicitation of the family story while unbalancing it, the proposal of a viable alternative interpretation of events, and the anchoring of these new views through optimistic appraisals and closing rituals. And the reader, well, the reader also becomes illuminated. The master has done it again.
***
Case excerpted from Assessing Families and Couples by Salvador Minuchin, Michael P. Nichols, and Wai-Yung Lee. Copyright © 2007 Pearson Education, Inc. Used by permission. All rights reserved.
Carlos Sluzki, M.D., is a professor in the College of Health and Human Services and in the Institute of Conflict Analysis and Resolution at George Mason University and clinical professor of psychiatry at the medical school of George Washington University.