Facebook Like


Friday, September 07, 2007

Mr. Satuday Night

I want to teach you a simple family therapy technique. It is the whole of family therapy, really. Not that you can't learn from it if you're not a therapy doc. Maybe you can.

Deep breath.

We use big words like process, meta-message, homeostasis, triangulation, and the like. But the most complicated lessons are more intelligible without all that jargon. Process is one of them.

Do you remember the movie, Mr. Saturday Night?

I haven't seen it in years and can't remember the entire plot. I keep meaning to take it out and watch it again. But I usually remember the key messages in films, the ones that family therapists take out and mull over to eventually tell over when the time is right.

It's about a comedian, Buddy Young, Jr. (Billy Crystal) and his brother Stan (David Payner). Buddy has all the ego; he's a performer and he's brilliant, but he emotionally and verbally abuses Stan, his accountant for many years. We watch them age, Stan more gracefully than Buddy.

One of the things Buddy does well, for all his faults, is teach Stan process. After he tells a joke, or better yet, enacts the joke, performs a sight gag, Buddy says to his brother, See what I did there?

That's process. What he does, is process, not usually what he says. If you can see what Buddy does to make his audience laugh, you get process. It's much more than telling a joke. Families do this, too. Everyone in a family behaves in ways that make everyone else respond. Except usually, if they're in family therapy, they're not getting laughs.

Forget Mr. Saturday Night for now. Let's use a typical family therapy example that a student presented to me in supervision. He tells it over like this.
It was great. We were sitting in your office and Don (15) completely ignored his mother's request to stop playing with his cell phone. But he put the phone away when his father asked him to. So I asked the father, "Why do you think Don listens to you and not to her?"

"Because she never makes him do anything," Dad replied.
My student was very proud of his question and how the father got involved, how dad thought about it and proffered the interpretation about the content. But it's times like these that I press an imaginary buzzer and say bzzzzzzzzzz to indicate wrong and I say as much. Wrong.
"What's wrong?" asks the student.

Give me your best shot.

"I thought that went well, actually. We were making the point that mom has to get tougher to get respect."

And who made the point?

"Well, Dad did."

So this is a chidish, him beating on her in front of the children? (a chidish is Hebrish, a combination of Yiddish and Hebrew, meaning something new).

"I suppose not."

Well, we really showed her.

"I guess it didn't accomplish anything."
It didn't accomplish anything because the student got sucked right into the family system, played into their family hand, joined the family discussion about "safe" content. The problem isn't really about the kid listening to one parent over the other. That's "safe" content that allows Mom and Dad to disagree, probably to avoid intimacy, which as we've already established, scares almost everybody.

Most functional couples will disagree about parenting but they find ways to do it together without egregiously annoying one another. They talk about differences and find resolutions without putting one another down, especially in public.

This couple had a fight in my office so that someone, theoretically the therapist, would stop them from fighting destructively. What my student witnessed was a family enactment of their biggest problem.

After they hurt one another, couples will retreat to their own respective little corners and won't come out for awhile. Kids are very uncomfortable with this. They want their parents out of the ring altogether. They want their parents to be happy. So a kid will lure his parents to my door by becoming the "identified patient." You have to misbehave to do that.

Kids are very smart, so they do that.

I told my student that one of the things he might consider doing with families is commenting on process. You try to make the family aware of what they're doing. You ask, DID YOU SEE WHAT HE (anyone in the family who does just about anything) JUST DID THERE?

Or

(to the group) DID YOU SEE WHAT JUST HAPPENED HERE?

Someone might say, Well, so and so insulted so and so. Or So and so isn't listening.

Then you can say, Why don't you guys talk about that.

Even if they look clueless and say nothing and act as if they didn't see anything, you don't interpret for them. You don't fall into that same old trap of being the smart, wise old doc with all the answers. You say, Why don't you (anyone) talk to him (anyone else) about either (anything) or (anything else).

You get 'em talking. If they hurt one another you stop them. Wait, I'll cry. You can't do that here. Now talk about . . .And do it nicely.

And as soon as it makes sense, you dismiss the young sacrifice, ask it to wait in your waiting room while you talk awhile to its parents, keeping in mind that the goal is for them to talk to each other, to love each other and express that. Take that risk.

Leave your office happy.

Junior is superfluous, really. Once you have the 'rents alone you can cut right to TherapyDoc's favorite list of questions (Q) and directives (D) that a therapist could care less about but which are far more interesting any day of the week than talking about how to punish Junior.
(Q) So how did you two meet?

(D) Talk to each other about how it feels to be in this predicament at this stage of your relationship

(D) Talk to each other about what you could have, should have done differently over the years. . .


If you feel resistance you can start a little more softly with,

(Q) What was he like as a baby?

(D) Tell her (him) when you first noticed that Junior stopped looking you in the eye?

(D) Tell her (him) how it was for you when Junior left for nursery school.

(Q) Did you two argue when he was a baby?

Then crescendo with a vengeance to

(Q) Did you two argue when you were engaged?

(Q!) Why do you think that was?

(D) Tell him (her) how you felt about (
pick content)

(Q) Did you think it wouldn't last, this marriage of yours? DO you think it will last?

(Q) What's it need, really, your marriage?
And that's just the short list. Your objective is to track back to better times. Everyone likes you when you get them to talk about happy times. And the goal, of course, is that they like you so there's a chance of trusting you and coming back to see you so you can help them get out of their corners, get out of the ring, and into the sack.

And you definitely want to do some individual work with ALL of them. Early as possible. Especially with Junior. It hasn't been easy being Junior.

But the family will do best if you teach process. Without process they'll never stop playing Who's the Better Parent? Or Who's the Worst Kid?

And they'll NEVER get under the covers together that way.

Interpreting, chatting with the patients, holding court, this is what therapists who haven't been trained in family therapy do when they think they're doing family therapy. These are psychodynamic, individual therapy techniques. And they're great for individual work.

But you have the family in your office. MAKE 'EM TALK TO EACH OTHER.

This way they don't have to depend upon a professional for the rest of their lives. It's not about learning one lesson. Face it, nobody remembers anything for more than a week. (See The Five Minute University on U-Tube.)

Okay. Back to Mr. Saturday Night. If you haven't seen the video and plan to see it, don't read any farther.

At the end of the movie Buddy, always the star, is seeing pretty hard times and Stan, always in the proverbial shadow, is retired but happy. The men are old, well into their 80's and they're reminiscing.

Stan says something to the effect that he wasted years of his life working with Buddy. Buddy defends himself. I didn't take your life, Stan. I gave you one.

Then Stan tells over the line I've repeated a thousand times in therapy, and now you probably will, too, at least once, to someone.
Yeah, but you could'a been nicer.
I just love that line.

Did you see what I just did there?

Copyright 2007, therapydoc

10 comments:

doctor a said...

Well done, Therapy Doc, well done. Right to the heart of what family therapy is all about and no jargon! Thanks for a great post.

Anonymous said...

I'm in couples therapy. Have been off and on for over 10 years (more on than off) and I couldn't agree more. The only way forward is to break the pattern that you are stuck in. You can only do that by breaking down the stage and not just re-enacting the scenes.

I'm going to think about that when I go to our next session.

AuthorMomWith Dogs said...

I do so enjoy how you illustrate -- share process -- through your story-telling. Your student is very lucky to have you!

Familydoc said...

I found myself learning quite a bit from this post. It's important information for any non-mental-health professionals who finds themselves having to do a little family therapy from time to time.

Tiffanie said...

I enjoyed the video so much. Thanks for sharing!

Joan said...

Really enjoyed the post. Have a teenage grandson who was in therapy some time ago. Your example was right on! Made me (a non-pro) see the problem in a whole new light. Thanks!

MT said...

Buddy's "You see what I did there?" didacticism is corrupt, I feel sure. Always the thing he wants his conversational partner to see is how he pulled the rug out from under him or her (actually, I'd be surprised if there's an actual "her" instance in the film). Meanwhile, always there's a thing Buddy wants the other not to see, which is Buddy's hatefulness and the fact the other has been assaulted and victimized. "You see what I did?" is a cover in other words, which allows Buddy to plausibly deny to himself, at least, that he's being hateful and aggressive. In their romantic meeting in which Buddy opens up to the woman who becomes his wife, Buddy analogizes what he feels on stage to being in control in a boxing match. Buddy's "You see what I did?" exploits the notorious ambiguity (c.f. Hamlet) between sparring or a mock duel and real intentions to hurt and humiliate. It's the kind of control Laertes acquires by poisoning his rapier--cowardly, unfair and oblivious to the rights and welfare of others (Buddy's brother calls him a terrorist). I think it goes with feeling under threat, outmatched and alone, and I think the people who Buddy "pulls in" get this. It's part of what makes him a tragic figure, even while being an SOB.

therapydoc said...

Great stuff, MT. Process is by its very nature veiled. Like being raised in a culture, privy to a secret language.

April_optimist said...

So true and so thought provoking...

Adam said...

Nice blog. Please come and visit my blog about Quit Cigarette Smoking :
http://quit-cigarettesmoking.blogspot.com/