at the morgue, and added, in comfort, that she may be reassured, he was barely scratched. My colleague went on to say that he saw no need to tell her the truth about what a 75 mph head-on crash would do to her husband’s body. Perhaps now, two years later, as she was fully recovering from the trauma and again thinking of taking her place in society, she might be ready for the full truth — which she is probably beginning to admit to herself anyway. And my colleague turned to me and said, “What possible need could there have been to be open with her before this?”
My answer to him was, “You wasted two years of that woman’s life.”
About a year after this paper was delivered I was able to apply ideas originally conceived in its preparation to a situation I was quite familiar with in my own family. My mother had always told me that I was born with a spasmodic muscle in my stomach. Since I knew that my grandfather had been dying of leukemia during that period I imagined my symptom had something to do with my mother’s upsetness over his condition. Though I always wondered why she had been so upset — everyone does die, after all. The impression I had always gotten was that my condition lasted for about the first year of my life. Then one day she happened to mention that it lasted for eight months. That was exactly the period of time my grandfather lived after my birth. In other words, my stomach got better right after be died! And then it hit me. They had never told him he was dying. That’s why my mother was so upset during the terminal stage. I immediately called and asked her if my grandfather knew he was dying. “Of course not,” she replied. “Throughout the whole two years he had it?” I pressed. “Naturally,” she responded. “He was such a gentle man, we never could have done a thing like that.”
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1. Though it should also be stated that the opposite phenomenon, someone who is incapable of keeping a secret, also stabilizes pathological processes.
2. Three years later, after the order brother had remarried and moved out of town, the parents, having retired and wanting to moved to Florida, came back to work on the irresponsibility of the younger son.
3. Actually, my experience has been that the person to whom the secret is revealed is more likely to be critical of the therapist than the family member whose confidence has been “betrayed.” But then killing the messenger who brings bad news is an old tradition. In all events, such anger suggests that the secret-keeper in the family, far from always being the “manipulator,” may often be doing it for the one who doesn’t want to know!
Three
HOW TO SUCCEED IN THERAPY WITHOUT REALLY TRYING
My approach as a therapist has been shaped at least as much by what I’ve observed outside the domain of therapy as by anything I’ve seen in my consultation room. I’ve spent much of my life trying to promote change in one way or another. I started out as a garden-variety Reform rabbi who was dismissed by my congregation after five years for conduct unbecoming a suburban clergyman, i.e., considering education more important than the building fund, and social action more significant than being social. I lasted two and a half years as a community relations specialist for the White House in the early 1960s, trying to help urban communities develop their own plans for integrated housing. I left when I realized that I was harboring ideas that were heretical for a civil servant, like the notion that getting things done now was more important than waiting till after the election, even if that meant upsetting the political applecart.
Preparing this essay has forced me to examine closely just how I approach my clinical work after nearly twenty years of being a family therapist. I anticipate that some may regard what I am about to say as indicating a deep pessimism regarding human nature, perhaps even an uncaring attitude towards my clients, but the fact is that I am as excited by doing therapy today as I was when I conducted my first session. I have had no struggles whatsoever with “burnout,” that seemingly ubiquitous scourge of modern-day professionals. And while I never take my clients’ anxiety home with me, I seem to have a clearer sense of personal fulfillment than I perceive in many of my colleagues who are far more “involved” with their clients — and far more caught up in perseverative attempts to bring about change.
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First published in Networker (May–June 1987): 27ff.
When I finally decided to become a therapist, my view about the conditions that promote change had already begun to develop. What struck me then and what has continued to impress me is how difficult it is to will fundamental changes in any social system, even when it is the best meaning, best educated, wisest members of the human species who are doing the willing. It has seemed to me that most efforts to bring about change anywhere wind up failing. Actually, the most profound changes I have witnessed are those that no one seems to have intended or predicted.
If one remains a clergyman in the same community for almost fifty years, as I have, one gets to watch an entire generation go by. Children whose bar mitzvahs I officiated at when I first came to Washington today have kids graduating college. I’ve not only done weddings (and funerals) for children whose parents I married; I’ve also done the second-time weddings of the divorced parents of those kids. I’ve seen many families change without going into therapy and many families fail to change despite decades, and I mean decades, of seeking help.
While being in therapy undoubtedly helped many families in my congregation through difficult periods in their lives, it would be hard for me to say that many of them changed in any fundamental way. Few seemed able to become more flexible in handling distance and closeness in their relationships or in becoming less anxious in the face of crisis or developing less victim-like attitudes towards life’s setbacks. Similarly, as I look back at how kids have turned out over the years, there was no way I could have predicted their life course based on their early functioning and certainly not on the basis of how their parents raised them. Many of the most outstanding teenagers I knew have wound up deeply troubled, while many of the most troubled and troublesome have really taken off. I have never found any clear correlation between what society says makes good parents and how kids eventually turn out.
The evolution of the larger institutional systems I’ve observed over the past thirty years — whether religious, educational, medical, or governmental — has followed a similarly enigmatic course. In fact, I cannot think of any institution that I am familiar with that is functioning any more effectively today than when I first encountered it, despite changes in its leadership, policy, the economy, or progressive advances in the racial and gender mix of its employees. My guess is that the success rate among business consultants trying to change these large systems is no greater than that of family therapists trying to change families.
It seems to me that whether one is viewing the macrocosm (society) or the microcosm (the family), most of the changes that take place in social systems involve minor alterations rather than fundamental transformations. Further, few important changes follow from a deliberate act of will. I believe my survival as a therapist — by which I mean the fact that I am just as fascinated by the process of therapy today as when I conducted my first session — has to do with how I came to grips with the capacity of social systems of all sizes to absorb those who try to change them.
The Other Side
There is, of course, another side to the portrait I am painting of a world in which fundamental change is so unusual. During the past thirty years, we have all lived through a time of profound changes. Here are three brief vignettes of striking changes — one social, one political, and one from our own field —
