Measuring Relationships

Marriage and family therapists are frequently asked the question whether or not a relationship is a healthy one.  Our clients want our opinion on whether their partner is good for them, whether they are soul-mates, and whether we can predict a long, healthy relationship.  Obviously, therapists are not in the position to make such statements.  Also, therapists are not immune to wondering if their own partner is good for them.    How can we determine whether a current relationship is healthy?  There is a viable way to assess a relationship to determine whether it is in fact healthy.  

What seems insignificant in this problem is the concept of love.  There are many people in life that one can love.  Loving others is very easy to do.  However, loving someone else seems almost inconsequential when it comes to whether the relationship is healthy.  We fall in love for numerous reasons that have nothing to do with compatibility.  People fall in love because of chemistry, because they are opposites of who we are, or even because they resemble a parent.  Probably everyone has had the experience of loving someone who was unquestionably bad for them.  

Usually when you ask how come someone is with their partner,  most will answer because they love them.  In substance abuse treatment, when counselors ask partners how come they are together, clients are first cautioned that they are not allowed to refer to love when answering the question.  This often results in partners having difficulty answering the question.  It is easy to say that you are with someone because you love them, but if you were to lay that aside, would you be able to give coherent reasons for being with your partner?  

When I was a young man, my insecurity had a huge effect on my relationships.  I was always afraid that my girlfriends would meet someone ‘better’ than I was.  I was afraid they would meet someone who was better looking, more athletic, richer, cooler, smarter or drove a better car.  The result was that I would hold on to these relationships with a death grip, to keep from losing them.  As you can imagine, no matter how much a girl likes you, if you hold on that tight, they will eventually run away, usually kicking and screaming.  

Then, when I became engaged to my wife, I remember Carl Whitaker telling me, “you shouldn’t get married, unless you can handle being all alone.”  He knew that marriages fail if you hold on to your partner too tight.  This gave me a clue as to how to recognize a healthy versus an unhealthy relationship.

In a healthy relationship, your world grows.  You are involved with your family and friends.  You are involved in activities you enjoy, sometimes with your partner, sometimes alone.    When you are in an unhealthy relationship, your world gets smaller.  Your partner discourages you from seeing your family.  They don’t like your friends.  They complain when you stay at work late.  They may check your cell phone to see who you are calling.  They may monitor your Facebook or Twitter accounts.  They are constantly giving you feedback that you need to spend your time with them exclusively.  

The next time someone questions whether their current relationship is a positive one for them, ask them if their world is growing or getting smaller.  They will know right away whether they are in a healthy relationship or not.  

Reading List

I would like to recommend a terrific reading List. My great friend and colleague, Ginger Blume has created a wonderful reading list, which she has attached to her website. I would strongly recommend it to anyone looking for further information on mental health issues. I also strongly recommend Dr. Blume and her associates as excellent therapists. Her website is:
www.drgingerblume.com

2nd Entry, We Never Cry: The conspiracy of avoidance

I believe there are aspects of grieving that need to be emphasized, but have been overlooked in the literature. Having become very familiar with the books on grieving, I am now well versed in how the individual grieves. I believe in Elizabeth Kubler-Ross' work on the stages of grief, and the process the individual goes through. But the first thing that happens when someone dies is that the family joins together. We don't grieve individually, but most of us grieve within the family. This is very important because pain is contagious. When one person in the family is hurting, it effects all the other family members. Therefore, if Mommy cries at the dinner table every night, Daddy might stop coming home. This aspect of grief has been ignored.
If I had a dime for every person that told me they had to be strong for their family, to ease the pain of the family, I would be rich. People avoid feeling the pain, crying, breaking down, so that other family members don't feel the pain, cry and break down. Most families grieve through a conspiracy of avoidance. Years later the family ends up in my office because no one has been allowed to grieve and now they are doing crazy things to avoid the pain. It is then my job, to remove those obstacles and allow the pain to vent. This is what happens in the therapists office.

We never cry in my Family: First Entry

Years ago I realized that if I live long enough, I would eventually have to lose everyone I love. It's a very disturbing thought. Having experienced many losses in my life, you would think one would become used to it. But that's not the way it works.
Yesterday was the anniversary of my mother's death. It's been 34 years since I lost her. Having mourned her extensively, her death has lost its sting. I'm convinced that what happens is that if you allow yourself to feel the pain over and over, while the wound remains forever, it losses its ability to control you.
For years after her death, the loss dominated my decision making. I tried to avoid the pain. I learned every trick in the book, to not feel the hurt. But in the long run, they didn't work. I did feel the pain, deeply and repeatedly. I believe this saved my life. If I had succeeded in avoiding the pain, it would have consumed me. It would have continued to dominate my decision making.
I can remember a few months after she died thinking, "family is good. I really appreciate having had a family. I will have to have another family someday." It was over 10 years later that I began having a family. Yesterday, I spent the day surrounded by my new family. There were the usual fights and skermishes. But it was indeed a blessing. My new family is much more connected and loving then the family I grew up with.
The key for me is that by learning to let go of people I have lost, I learn to let in new ones. My heart has continued to grow over these decades and my life is much richer having learned to mourn and then let more people get close to me. This is a great blessing in my life.
I intend to continue trying to write about my loss and how I survived. I trust this will be useful.

Marriage & Family Therapists and Self Esteem

MFT Self Esteem

Marriage and Family Therapists often struggle with self-esteem. Most of us who have been in this field for some time have spent part of their career fighting for equal rights among the mental health disciplines. Again this year, our peers have had to battle in the Connecticut legislature not to lose the rights we have previously gained. I appreciate and commend our colleagues who continue to fight these battles.
The reality is that marriage and family therapists are incredibly well trained. We spend longer in internships and are more effective as therapists than other mental health practitioners. We have a longer academic life before we enter the job market. Even more important, because of our systemic approach, we understand our clients, their families and our institutions better than our peers from other disciplines. Yet, we still see employers hiring clinicians from other disciplines because they do not know what we are capable of offering. Frequently I find that my students wonder if they made a mistake by going into family therapy instead of counseling or social work. Sometimes it seems that they believe they are second class citizens when compared to other disciplines.
One of the ways I believe we can overcome this attitude with the next generation of family therapists is in their training. I believe we need to instill in our students a confidence and belief in themselves that we have earned as a field. I have begun sharing a thought about this with my students.
The other morning I was waiting to be interviewed for a radio show and I was scared. I had no idea what I would be asked, whether I would have answers that were reasonably intelligent, or whether I would make a fool of myself. While I was sitting with my friend at breakfast, he was surprised that I was afraid. He finally reminded me that no one knew my topic better than I did. The moment he said it, he took me back to a time before my orals for my Doctorate. My advisor, recognizing my fear at the time, had made a similar suggestion. No one knows your topic better than you do.
Now when my students have to present in an interdisciplinary treatment team meeting, or approach the psychiatrist about a client issue, or even ask for supervision from me about the family they are seeing, I remind them that no one knows the family better than they do. In the treatment team, they can offer a unique systemic perspective on the client and their treatment needs. Indeed, they are in the best place to offer a recommendation as to whether the client will be safe living at home.
I believe we need to keep reminding our students of the many advantages of family therapy. Family therapy is an incredible intervention that can have huge repercussions for generations. Psychotherapy has had over a hundred years of evolution. In the process of evolution, family therapy has proven to be the most effective and powerful tool. Perhaps by instilling this into our students, we will be reminded of how we ended up becoming family therapists.

Minuchin's Structural Family Therapy

Minuchin’s Structural Family Therapy
Sliver Article


It may sound superfluous to say that I learned my most important lesson about Structural Family Therapy from Salvatore Minuchin, but it’s true. When I was first introduced to family therapy in the ’70’s, Families and Family Therapy was my first textbook. Minuchin’s book was my primer for entering the field. I devoured that book.
Throughout my career, I have had a hobby of having authors inscribe the books they write. Attending a Minuchin workshop gave me the opportunity to have him inscribe my copy of Families and Family Therapy. When he was finally alone, I approached him and he was pleased to honor my request to write in my book.
As he was signing his name, I started talking about how meaningful the book had been to me when I started doing family therapy. As he finished inscribing, my last comment was that Families and Family Therapy had been my bible entering the field. He closed the book, handed it back to me, smiled and said, “I hope it isn’t any more.”
I walked away somewhat stunned. Minuchin had ditzed his own book. At first I wasn’t sure what to do with his comment. On reflection, I realized what he was saying. Structural Family Therapy, as put forth in Families and Family Therapy was written as an introductory text book. It describes a simple model of understanding the family and techniques to intervene. A family therapist should develop beyond techniques. A family therapist needs to integrate all the techniques. At some point a therapist stops using techniques and is able to be with the clients.
So if you, like me, started your career with the building blocks of structural family therapy and it was your basic outline for doing therapy, I hope it isn’t any more.

My book interview on the Faith Middleton show (CPBN)

In February of 2009, I was interviewed by Faith Middleton, a WNPR radio show host of the two-time Peabody Award-winning Faith Middleton Show who has been widely recognized for fostering insightful, thought-provoking conversation, about my book Bedlam.

Listen to the interview