By Ema Genijovich
Getting to know Salvador Minuchin, architect of the Structural Family Therapy model, opened up my mind and transformed my understanding of what we as therapists can aspire to in our work on human relationships. In the early 1980s, Salvador came to Mexico City, where I had been living for a number of years, to give a lecture. I was one of a handful of family therapists who came together to work with him over a period of a few days.
I was greatly struck by the social commitment evident in his work with low-income, marginalized, and immigrant families, and his work with families with children. He engaged with people in a very direct way, from a position of proximity. His curiosity, enjoyment, and enthusiasm when exploring different ideas were both palpable and contagious, and he was extraordinarily generous in sharing his knowledge and insights.
I was so inspired by the experience that I resolved there and then that if I ever had the opportunity to go to the US, I would find a way to study with him. As fate would have it, in March 1984 I relocated to New York, and, the very next day, I gave Salvador a call.
By happy coincidence, my move to New York came about just as he had decided to set up an experimental training group for aspiring supervisors. Securing a place in this group was no easy matter. Because I had only just arrived in the city and had no work lined up, Salvador told me during my initial interview that, first of all, I would have to find work with a therapeutic institution so I would have cases to supervise. My disappointment was acute, but then I recalled the times that Salvador had refused to accept the definition of the problem presented to him by the family at the center of a case. If he was told by one member of the family that he or she was the problem, he would reply, “Don’t be so sure! Who told you that?” A short while later, my heart still set on landing a place in his new group, I picked up the phone. When Salvador answered, following his example I asked, “So who told you I can’t be a part of that group? Don’t you believe it—I’ll get myself a job.” He laughed, and then he gave me the details of the director of a clinic who was to take part in the group. He told me that if I could get the clinic to take me on, he would accept me. He would later call me back, anxious to find out if I had managed it, and ultimately that was how I ended up joining the group to train as a supervisor. The experience also taught me first hand that when Sal got involved in something, he gave it his full commitment. I also realized that he was someone who would confront and challenge people, and who, in turn, was open to being challenged by others.
Salvador was a pioneer of the Family Therapy model that revolutionized the field of psychotherapy. A child psychiatrist born in Argentina, his work with families in the United States began with young offenders at the Wiltwyck School for Boys in New York State, where he and his colleagues were called upon to develop new ways of working with low-income families with multiple different problems.
Subsequently, from the mid-1960s to the late 1970s, he served as director of Philadelphia’s Child Guidance Clinic. He later moved to New York, where in 1981 he founded a new center for family therapy: the Family Studies Institute, now the Minuchin Center for the Family, NY.
At the end of my two years of training in the supervisor group, Sal invited me to work with him at the Family Studies Institute. Once a week, we would get together with Sal, his wife Pat (a psychologist specializing in child development), and other members of the staff to discuss the projects we were working on in various organizations. At this time, Sal was on a mission to reshape every possible body that came into contact with families in the context of mental health or support services in New York. We worked with the foster care system, with various hospital-based services, with women’s shelters, with programs for the homeless or for pregnant teenagers… The basic goal was always the same: to change agencies’ own attitudes to help them see the families they were working with as resources, as healers, and not just as problems to be solved. As Sal would say, “Families create problems, but they can also heal.” For me, being able to take part in these collaborative projects and discussions was an experience like no other. It was an inspiration to see how committed Sal was to this community-based and social work. Commitment was a common theme in everything Sal took on: the agencies he wanted to transform, the people he trained, and the families he helped.
In his work with families, one of the forms that this commitment took was the way he engaged and connected with each and every family member. I was always amazed to see him sprawled out on the floor in the middle of a session, playing with the children and enjoying himself immensely. He helped me to cultivate that side of myself, and to bring more of myself to my work with children in a family context. Sometimes, a short time spent playing on the floor would demonstrate that, for example, a child diagnosed as hyperactive or uncontrollable was perfectly capable of connecting with others in a normal way for his or her age. Although at times he could be firm, he tended to adopt a playful attitude with children, using linguistic and spatial metaphors to communicate with them and their families at the same time. One of his favorite tactics was to ask everyone to stand still so he could get an idea of their respective heights, which gave him a visual image and an instinctive impression of what was going on in the family. He would then put the question to the parents, “How is it that this child, who only comes up to your waists, has so much power in this family?” He always put the child’s issues into the context of the family as a whole; his approach was always relational.
In all of his work with families and couples, Salvador consistently emphasized the idea of complementarity and the way we co-construct one another through our relationships. He would say that the truth could be gleaned from small maneuvers, from the micro-movements through which patterns are formed. If we are not aware of these micro-movements, they will come to control us. For example, if Sal asked a little girl if she had any friends, and she glanced at her mother, he would make a note of this and might then ask, “How is it that your mom knows more about your friends than you do?” In other words, he would begin his exploration based on what he observed about the relationship, and how each individual set limits for the other.
Sal always said that the only instrument for change was the therapist, which is why, in his training, he would place great emphasis on the therapist as an individual, and his or her relationship with the family. He didn’t teach us techniques; he taught us a way of being and engaging in the session. He taught us how to connect. His objective was to help us expand our repertoire as therapists, and the resources available to us. He talked to us about books, films, theater, and poetry. He told us that the more complex we were as individuals, the greater the resources we would have to draw upon in our work. Sal was an intensely curious person, highly knowledgeable and possessed of a prodigious memory. As a therapist, he was extremely active, involved, and unafraid to take risks. If, for instance, there was some breakthrough in a session that he wanted to highlight, he would get up and congratulate the relevant family member with a handshake, to emphasize that he or she had achieved something that had seemed impossible up until that moment (perhaps the daughter had finally sat down, or the wife had engaged in conversation for more than two minutes straight). Sal always brought his full self to his work, risking the uncertainty of how people might react to a non-neutral therapist.
When working on the position of the therapist, sometimes Sal would notice that a trainee was keeping him or herself at a marked distance from the family, and would ask that therapist to sit by his side during the supervision, progressively bringing his or her chair closer and closer to his own, so as to experience what proximity felt like. He would explain that the training experience had to mirror the reality of working with a family in a therapeutic context. By shifting the position of a chair, Sal helped the therapist become aware of his or her own limitations, gradually breaking down barriers to growth. On another occasion, he felt that a therapist he was supervising seemed a little disconnected and was not taking a very active role in the session, and so he asked her to come to the front and sit next to him. Before she could sit down, he placed a bunch of keys on the chair, telling her that she needed more schpilkes (a Yiddish word meaning something like “pins and needles” or “the fidgets”, and which he knew she would understand). It was entirely typical of him to use metaphor, humor, and the element of surprise to impress upon the therapist in an experiential way that she couldn’t stay all comfortable and relaxed in her seat during the session.
I always describe Salvador as a “benign provocateur”. He created disruption so that new alternatives could come to light. His ideas and interventions were unfailingly consistent, and with his great generosity of spirit, he was happy to share his knowledge with others. He was a man who lived his beliefs; with Sal, everything was experiential. The therapeutic relationship was always a highly-charged dance; he imbued every session with intensity and drama. The only certain thing about Sal was the uncertainty that surrounded him. His work and his ideas offer us a blend of complexity and simplicity, provocation and support, determination and openness, curiosity and humor. He was true to his convictions until his last breath, never bending to therapeutic fashion. Although, as therapeutic textbooks rose to prominence, Sal did try to break down his way of thinking and working on simple steps and actions, he remained firmly resistant to the idea of a fixed structure of “recipes”, seeing this approach as an impediment to the organic, human-focused co-construction of the therapeutic experience unique to each individual family.
I had the good fortune to be able to learn from and with Sal, both as a professional and as a human being, for more than thirty years. I regard it as a great privilege to have been so close to him, even though he was constantly confounding and surprising me, and I never knew just what he would say next. I’m going to miss him.
Photo credit: The Minuchin Center for the Family/The Minuchin Center for the Family
Ema Genijovich is a licensed psychologist and international consultant and trainer in systems and family therapy. She is a renowned lecturer, supervisor and visiting faculty at many institutions within the US and internationally. She travels, presenting her work, all over Latin America, North America, Europe and Asia. Ema has been a long time collaborator of Dr. Salvador Minuchin, with whom she worked for over 25 years. She is a founding member of The Minuchin Center in New York and was its Director of Training for many years.