The Circle Game

“Ambivalence:” What It Is and How It Affects Your Family

2009-06-16T16:37:00.008+03:00

This article appears in the current edition of Connections Magazine (Israel).

For those seeking therapeutic intervention for a continuing crisis chances are that relief will come not soon enough and that is too bad. Every family I have seen and every therapist I know would prefer that comfort arrive sooner than it does. The delay may result from missing information, diminished abilities (client’s or therapist’s), or a family member’s non-compliance. Sometimes there is no viable way out. Other times more subtle reasons inhibit progress. One such factor – ambivalence – refers to having mixed feelings towards a particular circumstance. Ironically, the hurtful interactions that plague a family may also have consequences that are somewhat practical. And useful cycles are less likely to go away.

In some way we are all ambivalent. We may be comforted by food but want to lose weight, content with employment but want more money, comfortable with solitude but want more interaction. A neighborhood may want more commerce but less traffic. A society may want more cars but less pollution. A country may want both peace and more land. Our likes and dislikes, needs and desires, are not organized neatly in boxes on a shelf. More likely, they lay piled in a heap on the ground.

It is tempting to believe that presenting problems are entirely dysfunctional but that is hardly the case. While negative feelings are what bring you to therapy there are often positive results of your interactions that help to maintain them. Patterns that are wholly destructive would have no reason to endure. While no one is in favor of quarrelling spouses or delinquent children, such behaviors may be strangely advantageous. So long as those benefits remain unidentified, attempts to curb a behavior may be in vain, due to your unwitting wish for their continuation.

By the time you turn for help the negative symptoms of your behavior will have become intolerable. Therapy is often the last resort on a list of attempts to secure relief. Considering the extent of your anguish it is understandable to want an end to the pain. At the same time, the very patterns responsible for your distress may also provide a valuable function. While the gloomy results may be more obvious, the functional elements of your behaviors are what help to uphold them. To successfully alter your patterns of conduct it may be necessary to identify your mysterious motives. You may want the pain to stop but need the behavior to continue.

The first sign that you may have mixed feelings toward your predicament is difficulty in making and keeping appointments. It is not uncommon for a family to schedule appointments at the peak of distress only to cancel them when the distress temporarily subsides. Other families, instead of canceling, are habitually late for appointments or hesitant to disclose key information about their plight. Such behavior delays the progress of therapy and ensures that the elaborate pattern of family interactions persists. The first step toward ending a wearisome cycle is to understand your hesitation to confront it.

For parents of delinquent children the reluctance to meet head-on the challenge of change is complex. Parents who have exhausted every other resource may be overwhelmed by the prospect of another disappointment. Parents struggling to raise other, more obedient children may feel like investing their limited energies elsewhere. When a child is defiant and aggressive parents may fear the consequence of affronting him or her. When a child is somewhat functional parents may not want to disrupt their family’s tenuous balance.

There are also times when parents have personal interest in delaying progress. Having a child in crisis serves to distract some couples from addressing their troublesome marriage. Some couples unite only in the process of parenting and relish that bond too much to give it up. Some mothers and fathers require the stimulation provided by conflict with their children. Some parents shoulder private burdens that are more painful to confront than the tribulations of child rearing. Some parents struggle vicariously along with their children.

In addition to parental ambivalence, a disturbing household cycle can be maintained by a symptomatic child’s mixed feelings. Children may both suffer and benefit from the effect of engaging in disruptive behavior. Some children profit from attracting their parent’s attention, arousing their concern, or discovering the extent of their affection. One child may have an interest in prompting an alliance between otherwise distant spouses. Another child may sacrifice himself or herself by drawing interest away from a mistreated parent or sibling.

The existence of surreptitious impulses is neither shocking nor dreadful. Family dynamics are necessarily intricate and tend to have more than one cause and effect. Negative interactions are commonly sustained by positive consequences and it is not unreasonable to harbor mixed feelings about them. Your failure to move forward may be more a result of ambivalence than a genuine lack of ability. Your wishes can be compelling. Instead of replacing them, sorting through your various needs can lead you toward meeting them in healthier ways.

Stop Calling Me Names

2009-04-24T17:48:00.003+03:00

This article appears in the current edition of The Jewish Observer magazine.

In the summer of 1998, Jewish Action published an article, which began, “The problem of at-risk and rebellious orthodox youth is finally receiving deserved attention.” In 1999, The Jewish Observer devoted its November issue to the matter of “Children on the fringe and beyond.” The introductory essay stressed how rarely entire issues are dedicated to one subject and made clear that the current phenomenon “can no longer be ignored.” On those pages rabbis, teachers and psychologists openly described what many suspected – that children were turning to drug abuse and promiscuity and shunning religion in intolerable numbers.

Since then, society has become mindful of such young people. The term “at risk” commonly refers to youth who experience a cluster of difficulties in meeting with the expectations of home, school and community. These individuals present both observable and non-observable symptoms. At once parts of the system and apart from it, these personalities comprise a listless strain of youth. More indifferent than aggressive, more apathetic than mean, the children we call “at risk” are frightened, vulnerable and hurting.

The motto “kids at risk” was employed with good intent. As a result of that invention opportunities became available to those previously deprived and a quantity of youth were reformed. Flexibility was introduced to rigid systems and society appeared more accommodating. Alternative curriculums were created to substitute conventional ones, mentor programs were designed to succeed where classrooms failed and psychologists were sought for counsel. Some rehabilitated youth have become counselors who champion the cause of those disillusioned. While the categorization brought dread it also begat hope.

The problems, however, have not vanished. In 2005, Yeshiva University’s S. Daniel Abraham Israel Program held a seminar on identifying mental health issues in young adults. According to a press release, “further sessions throughout the year will focus on topics including drugs, alcohol, smoking, eating disorders, death and divorce in families, and coping with problems arising from Internet pornography, gambling, and male/female relationships.” In 2006, The Jewish Observer published “Kids at risk revisited.” In that special double issue, an article headed “Why are there still children at risk?” affirmed, “The problems confronting us have not gone away – if anything they are increasing.”

Disappointingly, while suggesting the phrase “kids at risk” is overused, this magazine offered no substitute means of assessing the phenomenon. Two simple syllables cannot ever describe the variety of youth so labeled. Moreover, by concentrating on one family member, all others are overlooked. No article focused on the family unit as a possible source of intercession. No author addressed the family system. Each “kid at risk” is part of a threatened system whose collective suffering is too often ignored.

The limitations of popular conceptions of youth are becoming evident. Branding all nonconformists “at risk” may be convenient but it is also risky. Some individuals are from broken homes while others are learning disabled. Some children ride a wave of peer pressure and media influence that is fleeting and non-toxic. Some children are too hastily marked and go all-out to live up to their labels.

In place of labeling, the turn to family therapy can avoid ostracizing individual family members. Family therapists emphasize the effect of relationships on psychological health and seek solutions in the family system. Through such a process, families can learn to identify their own resources and activate their own potentials for healing.

What Is Family Therapy?

Unlike traditional psychology, family therapy regards the entire household as one emotional unit. Instead of past conflicts, this approach considers the ongoing impact of relationships; each family member plays a role in the developing symptoms of others. In place of tending to individuals, family therapy maintains that any change in the emotional functioning of one member can benefit the entire family system. Consequently, treatment need not be directed at the symptomatic person.

The starting point of family therapy is that when one member of a family improves his or her emotional functioning, the whole family will improve in response to that person’s ability to change. Where the symptomatic person refuses therapy, family members can still receive assistance and positively influence the distressed individual. This approach does more than discover each member’s part. Family therapy makes room for each member’s pain.

Family therapy sees symptoms as adaptive behavior. Rather than assuming it unreasonable, a symptom is imagined as an adjustment to a current social situation. It follows that therapy should focus on altering the social situation if a symptom is to recede. Family therapy addresses the context of symptom development in an effort to facilitate lasting change. Sometimes a straightforward adjustment is enough to make a difference.

Ari, a fifteen-year-old boy living with his parents and four sisters was referred for therapy when he became anxious about attending school and aggressive towards his mother when she insisted. At the same time, Ari had begun to hang out with a “bad crowd” and to grow his hair long.

During the initial session, mom's energy kept the mood fairly light while dad seemed to have attended reluctantly. Eventually, it emerged that Ari’s father was often away from home and that the burden of child-rearing rested mostly on his mother. Himself an only child, Ari’s father felt threatened by the intensity of his son’s emotions. Ari’s mother compensated for her husband’s limitation by becoming overly involved. Ari, in turn, yearned for his father’s attention and resented the lack of male companionship. Ari was able to reveal his desire only after his father’s apprehension was uncovered. Ari’s symptoms diminished as his father became more involved in his life.

Families often have a repetitive account of their condition that identifies one member as the patient. Such stories are seldom helpful. The pressure of being a lone offender is awful. By retelling the tale to include parents and siblings, family therapists can help to inspire more useful ways of thinking. Family therapy does not necessarily mean sessions with the entire family present. Instead, the therapy is based on thinking that considers family members. By assuming all members are strained and addressing their specific concerns, each member is valued. Blame is not the goal. The aim is to excite change by introducing a creative perspective.

It is not uncommon for parents to identify a child as the patient when seeking help. Burdened by the “at risk” label, such youth are often unwilling to accept that diagnosis and stifled by its weight, with recurring family styles commonly maintaining the status quo. In family therapy, parents can receive support and learn to cope in more productive ways. When joining their child in therapy, parents can discover their dynamic roles and begin to foster more nurturing relationships.

Shira, a nineteen-year-old with a history of addictions, entered therapy after her arrest for possession of marijuana. The oldest of nine siblings, Shira began to rebel at around age fourteen. Fearful that her rebellion would be contagious in the family and embarrassed by her “unusual” appearance, Shira’s parents sent her to an “out-of-town” high school from which she was promptly expelled. Shira has been in more than six schools since age fourteen and has been in and out of trouble, in her words, “for as long as I can remember.”

In family sessions, there was much exploration of Shira's social relationships and potential reasons for her challenges. From collaboration with Shira’s parents, it became possible to tell a new clinical story about their difficulties: over time Shira had begun to feel that she was not important to her mother who had eight “regular” children; the father partly sensed this, but had not wanted to acknowledge it openly since that might de-stabilize the relationship between him and his wife. These unexpressed fears of the father meant that, despite feeling close to his daughter, he had to maintain a distance from her to preserve his marital relationship.

Through communication and acceptance of conflict, family members developed a better understanding of themselves in relationship to each other. As the complexities of their relationships were identified, parents and child learned to articulate their individual needs and to take steps toward fulfilling them.

Regrettably, the Orthodox community has not appreciated the optimistic message of family therapy. Common attempts at treating kids have focused on observable symptoms and on modes of therapy that address individuals. When families are involved, members are fearful of being blamed for symptom development and neglect to examine the compassionate message of the method. This is unfortunate because family therapy is interested in solutions. The same home that rears weakness breeds strength and family therapy aims to find it.

What Schools Can and Cannot Offer

Instead of therapy parents often seek aid in the school system. Society’s concern is reflected in new pedagogical methods and interventions often occur in educational forums. While some programs are indeed special, they cannot replace therapy when it is needed. Fresh teaching styles have been successful at reaching some, but other youth do not respond to such involvement. My experience in both arenas suggests the inescapable influence of family dynamics and the limitations of interventions that do not involve family members.

The familiar trend is for “at risk” youth to spend time in Israel programs designed for social and religious rehabilitation. Such courses are academic in spirit but are combined with various modes of informal counseling. Some teachers function in dual roles: one aimed at the relevancy of Torah, the other at the required maturity to embrace its ideals.

Time abroad has its benefits. Students often use their time away from home as a forum for self-discovery. Geographic isolation from parents enables some youth to make strides in their emotional individuation. Capable educators can inspire noteworthy change by facilitating introspection. At the same time, the distance of schools from the social structures in which symptoms develop may impede their effectiveness. Without exposure to their wider lives educators have only partial access to students’ commanding family dynamics. Some students bear emotional burdens from domestic styles and expectations. Some students are defied by dramatic household concerns and others by modest but potent ones.

A psychologically informed curriculum is progressive and creditable. It may also not be enough. Treating students as individuals, cheering their doubts, and hearing their misgivings, can sometimes nurse distressed youth toward health. Some students shed their “at risk” label in Israel and return home refreshed. For others, rebellion is more social than religious and more determined by domestic forces. Among those who need more than edification and encouragement, the sensitive ear of a non-judgmental, non-intrusive and non-threatening teacher falls short of their essential needs.

Moshe, a seventeen-year-old dropout with a history of behavior problems, was sent to Israel as “a last resort.” The youngest of five children, three of Moshe’s older siblings were married and a fourth was recently divorced. Moshe described himself as an “underachiever” who will never be “good enough” for his family.

In yeshiva, Moshe bonded with a teacher and gradually increased his functioning. While making significant academic progress throughout the year, Moshe’s two trips home were marked by high anxiety and diminished functioning. After one such trip, Moshe began sporadic drinking binges.

During a second year in Israel, Moshe continued to progress scholastically but appeared socially and emotionally detached. He continued to drink and confided that his father “is probably an alcoholic.” After two years, Moshe was undecided about his future plans and insisted that his drinking was not a problem.

How Families Can Help

In today’s climate, the line between teachers and counselors is at best vague and often nonexistent. Various institutions provide students with teacher-counselors who function in expanded roles. Much is expected of teachers and the lessons of psychology can enhance their effectiveness. By respecting students and being curious about their needs, teachers can foster relationships that go a long way to ward off danger. But teachers are not superheroes. The success of all educators – especially those who engage challenging youth – is limited. Some youth may be better served in the context of family therapy.

While current trends of delinquency may be no more significant than ever, the mood seems desperate. Educators are constantly sought for relief as parents bemoan their misfortune. This cycle is lamentable and is often counterproductive. It may be that youth are being viewed out of context and are bypassing nearby resources. Perhaps parents and siblings can provide more lasting support than teachers. Perhaps the theme can change from “we are a normal family with a symptomatic child” to “you are a family that got stuck in your progress and must adjust to the development of your adolescent children.”

Family therapists insist that symptoms are developed and maintained in the social context of families. Accordingly, those contexts also contain antidotes for the anguish symptoms arouse. Adjusting family interactions can help to alleviate that pain. Family crises affect all family members and each deserves to be part of the solution.

Since Freud, the individual became of primary concern while the system that shaped him was left unexplored. This is a shame. All individuals exist in contexts that continuously affect them. Every person has a family and every family has patterns of interaction in which members influence each other. According to the family therapist Salvador Minuchin, “Life consists of growing, mixing, cooperating, sharing and competing with others. Surely most of us have had our most significant experiences within some form of the social unit we call a family.” Families are powerful units that can be persuasive, supportive and loving.

It is time to discard the label. Kids who exhibit uncommon behaviors do not belong to a group of similarly classified children. Each child has a particular surname and they who share it are liable for each other. The causes for and effects of disillusion are seldom anguished individuals. Calling kids names will not make their troubles go away. As youth are sliding to peril and beyond, families are suffering too. It is time to share the burden. Risk is not limited to kids.

Psychotherapy: Bad Movie or Good Book?

2009-04-24T12:38:00.005+03:00

This article appeared in Connections Magazine (Israel) 2009.

Therapy is a lot like a movie. Like the kind of movie you intermittently wish you had never started. The kind of movie that is difficult to follow and as exciting as watching paint dry. Like that movie (which can be a comedy, tragedy, or both) you endure therapy for its mysterious yet anti-climactic conclusions. You do not pursue therapy because you want to but because you have no better choice.

Between the monotony and unease therapy can still provide dramatic insight. Under precise conditions a simple question may elicit profound awareness. Sometimes, a sensitive therapist can ease or even solve a long lasting predicament. More often however, the value of therapy exists in the tedious telling of your story and your tiresome commitment to that process. The solutions to your troubles may be as complex and subtle as the details that led to them in the first place. And not terribly exciting.

At the same time, therapy is not meant to bore. Far different than a forum for advice, therapy contains elements of intrigue that can be delicately powerful. While your actual story may lack bells or whistles, the act of telling it often proves remarkable. From the initial phone call to the awkward first eye contact and beyond, a therapeutic relationship involves client and therapist in a process that stirs up deep-seated themes. What you think about seeking help and how you go about obtaining it become clues to the mystery of your predicament.

Each consultation is bursting with paradox. When initiating therapy you are typically expressing hope. You want something to change and change is the essence of therapy. Within such optimism however, there is a gnawing fear of change that tends to inhibit progress. An ongoing crisis can be both unpleasant and improbably cozy. You may be comfortable with what is familiar and dreadful of what is unknown.

The irony of both seeking and resisting change is the foundation upon which other incongruities lie. For some, sincere disclosure is tempered with make-believe confessions. For others, straightforwardness is avoided by rambling monologues. It is not uncommon for a client to offer nothing but silence, awaiting a therapist’s direction, while secretly yearning to be more assertive. Loads of couples enter therapy wanting only their spouse to change but hardly willing to admit it. Each therapeutic relationship has its own quirks of fate that develop from session to session.

In addition to its peculiar process, there is sometimes ambiguity regarding how successful therapy is measured. When your marriage is on the brink, your child is out of school, or there is a concern of mental illness, accomplishment may be plainly determined. A renewed matrimonial or scholastic commitment or a proper psychiatric diagnosis can be discernible. But when the presenting problem is “distress,” “discontent,” or “discomfort,” how do you know when you are better?

With a graceless procedure and hazy purpose, psychotherapy may sound less than enticing. Because of its uncertainty many people do without such treatment. Like others, however, you may choose therapy as a means toward self-awareness that can enrich your life and help you toward more fulfillments. For those who choose psychotherapy, the oddity of its method sometimes proves its greatest allure.

Unlike other social situations, including those portrayed in movies, psychotherapy provides its characters with the opportunity to reveal their motivations. As your therapist, I will address your thoughts as much as, if not more than, your behaviors. I will know more than my eyes observe because I can – and will – inquire about your experience. The exploration of what is generally unspoken imparts a profundity more akin to the pages of a novel than to the Silver Screen.

You may not know it when you call but your input is as important to the process of therapy as mine. My questions may guide you and my ideas may at times seem prudent, but it is your answers and understanding that are the principle substance of our dialogue. When understood, your anxiety, ambivalence, and audacity can generate ample momentum for change.

For some, the chance to be unconditionally listened to is appealing enough to balance the strangeness of consultation; the prospect of change sufficient to offset the indignities of self-revelation. But such pros and cons are not mutually exclusive. Not only are conflicting feelings likely, those very doubts can provide a means toward understanding your essential struggles.

When helpful, psychotherapy is a precious experience. Unlike a movie that you wish would already end, therapy may be like a compelling story. Like a narrative to be savored. Like a book you cannot put down.

The Real World: Alternative Reality in the Therapy Room

2009-04-24T12:34:00.004+03:00

This article appeared in Connections Magazine (Israel) 2009.

In the real world we would not be having this conversation.

We would not be on these padded chairs, under these fluorescent lights, sharing these awkward glances.
You would not have shyly dialed my number nor would I have gallantly answered your call.
You would not have schlepped to this colorless office nor would I be waiting here patiently for you.
I would not be crossing and uncrossing my legs nor would you be finding interest in the floral pattern of Kleenex.
You would not be wondering what to say, when to say it or how it will sound to me.
And you would not be paying for the experience.

In the real world you have somehow managed until now.
You have had your share of successes and moments of satisfaction.
You have skills, abilities, and unique qualifications.
Your life experience is rich and you have learned much along the way.
You are needy but far from desperate.
You know less than I do about some things but more than I do about yourself.

In the real world I am a professional therapist.
I have read texts books, attended lectures, and completed exams.
I have helped others like you and have grown from those encounters.
My head is full of theories, explanations, and diagnoses.
I can conceptualize your predicament and promote a plan for your improvement.
I am qualified, certified, and experienced.

In the real world we each have no problem talking.
Our conversations with others are fluid and uninhibited.
We are clear, if not articulate; insightful, if not astute.
We each have those who rely on us for support and those upon whom we depend.
Our lives include a series of ups and downs, good times, and not so good times.

In the real world you are surrounded by family and friends but are often lonesome.
You are more or less functional but feel somewhat inadequate.
Your colleagues and neighbors are well-meaning and you have countless sympathetic, yet shallow, encounters.
Some of your relationships are fulfilling, others trying, and others, downright thankless.
You have more questions about yourself than answers.
Sometimes the real world is good to you, but not always.

In the real world I have goals yet accomplished.
I am at times proud and at times self-effacing.
I have family, colleagues, neighbors, and friends who cannot answer all of my questions.
Some of my habits are wholesome and others disconcerting.
I too experience frustration and have turned to others for help.
Sometimes the real world is good to me, but not always.

In the real world we would not be sitting here together.
You would not be taking the time to unburden yourself.
You would not be struggling for words nor anxiously awaiting my advice.
You would not be questioning my loyalty nor would I be calculating your commitment.
We would not be stepping on each other’s toes.

In the real world you disguise yourself well.
You are well known but hardly understood.
You have tried numerous interventions but are not yet self-sufficient.
You are more helpful to others than to yourself.
You are terribly aware of your limitations and less convinced of your strengths.
You are tired, forlorn, and cold.

In the real world I cannot help everyone.
I make sincere efforts, but trying is sometimes not enough.
I too have limitations.
My patience is not unwavering and I sometimes rush to conclusions.
I have made my share of mistakes and have my share of regrets.
I wonder about tomorrow.

In the real world we would not be confronting your ambivalence.
We would not be stumbling through a jarring dialogue on a path toward your awareness.
We would not be finding words for your sadness and distrust.
You would not be avoiding ugliness nor would I be encouraging you not to.
We would not be addressing your hesitation and shame.

In the real world we would not be on these chairs or under these lights.

In the real world we would not be having this conversation.

The Derech: One Family’s Anxious Adventure

2009-04-24T12:27:00.004+03:00

This article appeared in Connections Magazine (Israel) 2009.

The mini-van was tightly packed. Provisions were strapped to the roof, maps secured in the glove compartment, and edibles snuggly entrenched in bulging coolers. The check-list was yanked from the refrigerator door where it had been earnestly revised throughout the winter. Peanut butter, jelly, and suntan lotion were appropriately smeared. It was to be the trip of a lifetime.

During their youth, both Father and Mother had been on similar excursions with their respective families. Each family had forged its own path toward the mountain peak and neither could appreciate the specialness of the other’s trail. While the mountain was unchanged, Father and Mother were unsure they could retrace their parent’s steps and uncertain that they wanted to. Instead, both agreed to initiate a new route, based on their shared experience and knowhow.

The compromise was not easily arrived at. Father was initially adamant that his family’s approach was more scenic. Mother insisted that her family’s way was the most secure. Back and forth they bickered. Maps were pored over, the virtues of well-being versus loveliness feverishly debated. Over time, Father grew cynical of a reckless aesthetic pursuit while Mother began to question her family’s fanatical avoidance of danger. The course they agreed upon was striking and solid – one that afforded a moderate combination of safety and splendor.

On the surface, Father and Mother were excited about the new pathway. Each was keen for the fresh perspective and proud of their combined creativity. Still, there was great anxiety beneath their optimism. Neither was entirely confident about their concessions. Father pondered negotiated vistas as Mother fretted about protection. While the agreed upon passage appeared to offer the best of both preferences, it was untried and unfamiliar. Father and Mother were thrilled but had a hard time containing their worry.

The children could feel their parent’s apprehension. Father and Mother wanted to believe that the children experienced only excitement but they knew better than that. Indeed, when the children clamored to help select a passageway, both Father and Mother turned them away. When the children referred to their friend’s mountain adventures, Father and Mother abruptly ended the dialogue. “We know which path is best,” they shakily insisted. And so it was.

With Father at the wheel, the mini-van rolled toward the mountain. Despite underlying tensions the family made valiant attempts to enjoy the ride. The trip was not unpleasant. Snacks were munched, beverages slurped, and music drenched the air. The mood was modestly boisterous. With the children smiling and eager, Father and Mother exchanged satisfied glances. Their efforts were not in vain.

Nonetheless, when passing other vehicles, the family members wondered pensively about their itineraries. While no one voiced a concern, parents and children both could not smother their musings. Father imagined the eminence of other roads, Mother visualized a dreaded catastrophe, and the children dreamed of having more fun. The family was tentatively, but not uncomfortably, together.

The mountain loomed majestic, more awesome than either Father or Mother recalled. In their enthusiasm everyone scrambled fruitlessly for the trailhead. The map was unfolded, muttered at, then summarily shoved into Father’s pack. Father insisted on marching rightward, Mother on trekking leftward, the children impatiently scampered to and fro. The family was not off to a good start.

The path was eventually located and the family began to climb. Frustration turned to marvel. Spectacular views abounded and Father was pleased. The ground was firm underfoot and Mother was glad. The children scuttled playfully and were grateful for their parents’ commitment. So delighted were Father and Mother with their innovative direction that neither grieved for their childhood routes. The sun shined overhead and everyone was content.

While each member proceeded at a particular pace the family stayed primarily in sync. Father led, children followed, and Mother guarded the rear. Sometimes, a child would dart ahead or to either side of the trail but the familiar pattern would ultimately restore itself. Along the way, Father tended toward exploration and Mother toward precaution but each was deferential to the other.

As the sun burned higher and their enthusiasm waned, Father and Mother became decreasingly tolerant. At some point, one of the children noticed fruit in the high branches of a distant tree and hurried toward them. Father shouted encouragingly but Mother shrieked with dread. Then, halfway toward the summit, one of the children saw a stream slightly off the path and darted toward its inviting waters. For some reason, now Father was concerned while Mother encouraged the needed refreshment. The contentment had disappeared.

From then on, the children’s curiosity became increasingly harder to manage. As the children moved farther away from the designated path, Father and Mother became more alert to their fundamental concerns. Perhaps it was the heat or maybe the altitude, but one thing is certain: the children were each creating their own derech and neither Father nor Mother could stop them. Each juvenile exploit elicited objection from a parent, which in turn prompted further unexpected behavior. Pretty soon the family was trudging lonely paths. Panic was setting in.

Here the storyline ends. The family is still on the mountain moving upward. Perhaps the heat or altitude, or maybe a precipitous cliff, will inspire them to seek each other. Perhaps they will cry out for help. Perhaps, as they move closer to the summit, each member will be moved to see the beauty of other trails. Perhaps as they reach the crest, Father and Mother will join hands with children and complete their journeys together.

Perhaps.

Talk Therapy: It’s Not What You May Think

2009-04-24T12:22:00.002+03:00

This article appeared in Connections Magazine (Israel) 2009.

Throughout my career I have heard numerous versions of the same misconceptions. “Only crazy people see therapists.” “There is nothing a stranger can tell us that will work.” “If I go to a therapist I am admitting that I am weak.” “Why should I go for therapy? I am not the one with a problem.” As a family therapist, I am dismayed each time I hear any of the above misunderstandings. I do not think of my clients as “crazy” nor do I see my role as “telling people what to do.” I view my function as offering support more than as solving problems. As for clients being weak, I regard my clients as some of the strongest people that I know. It is unfortunate that families who may benefit from therapy do not seek help because they are misinformed about the therapeutic process.

To be sure, some therapists do specialize in treating mentally deficient individuals, some therapists may at times be compelled to give advice, some problems need solving, and some clients are indeed frail. There are various reasons for seeking treatment and there are numerous styles of therapy. Psychiatrists can prescribe medication for individuals diagnosed with psychological disorders. Educational psychologists can assess learning disabilities. Behaviorists can treat precise maladaptive behaviors and are fairly directive. Other therapists focus less on diagnosis and more on personal growth. Many therapists, rather than "telling people what to do," try to assist people in getting to better understand themselves so that they are more equipped to make healthy decisions.

Therapy has evolved since Freud. The original “talking cure” was a means of accessing a person’s unconscious by engaging in a process of free association. In traditional psychotherapy, patients lie on a couch and speak whatever comes to mind with minimal interruption from the therapist. Today, many therapists adopt more collaborative approaches that are not focused on the unconscious. Therapy offices are generally arranged with chairs facing one another. Therapists tend to ask questions, listen to answers, and work proactively to understand what is being communicated. Those who seek therapy are often referred to as “clients” as opposed to “patients,” and “improvement” has replaced “cure” as a goal of successful therapy.

In addition to uncertainty about what therapy is, there is often confusion about who should be in treatment. When a child is troubled, the natural parental impulse is to seek help for the child in distress. Parents are often sensitive to their children’s needs and can help their sons or daughters by seeking professional interventions. Psychologists, social workers, counselors and mentors can all offer support for suffering youth and may be able to help them toward more productive behavior. This approach is sensible and often, sufficient. There are, however, circumstances in which a family may benefit from another approach.

Family therapists view the family as a comprehensive emotional unit instead of regarding individuals as independent entities. In this view, each family member plays a role in the overall functioning of the family. Accordingly, when one member of a family improves his or her emotional functioning, the whole family will improve in response to that person’s ability to change. One benefit of a family therapy approach is that treatment need not be directed at a specific individual. When the symptomatic person refuses treatment the system can still benefit in dramatic ways. Another benefit is how it considers the pain of mothers, fathers, and siblings. Family therapists do not blame parents for their children’s troubles. Family therapists offer support to hurting family members and believe that such assistance can benefit the family system.

To seek help for emotional distress requires a particular courage. The therapeutic process is time-consuming, mind-consuming, and at times, unpleasant. While the specific circumstances are countless, in a sense, there is but one motivation to seek professional help. If you are distressed, therapy can at times diminish the pain. When you’ve tried every way you know how and can no longer do it alone, a competent therapist can help you discover new possibilities. But therapy is not foolproof and success is not guaranteed. Therapy is an unhurried process that depends on your commitment, creativity, and daring. There are those who find therapy helpful and for them, it is worth the effort.

It’s Not Magic: How Therapy Can Help Parents Help Their Families

2009-04-24T12:02:00.002+03:00

This article appeared in Connections Magazine (Israel) 2009.

Circles have no beginning. Unlike line segments, circular shapes do not originate at a particular point nor does any one of their coordinates precede another. Family dynamics exhibit similar properties. In families, each behavior and sentiment is both the cause and effect of other actions and feelings. Over the course of infinite family interactions patterns emerge that reveal no indication of their origin. When a family seeks treatment, their patterns of interaction are often so intricate that a true starting point cannot be determined.

One effect of their circular nature is that unhealthy interactions can be modified by any of the people involved in that relationship. Families do not have to wait for a troubled individual to change before beginning to experience relief. When a family therapist suggests that parents be involved in treatment there is no implication of blame. Rather, family therapists believe that relationships can be a source of comfort, support, and motivation. Therapy that allows parents to better understand themselves can enable them to adjust the ways they interact with each other and with their children. Ideally, parents can then use their understanding to inspire change in the family system.

Child rearing tends to generate challenges. While some trials are fleeting and serve to promote togetherness, others become isolating ordeals that stubbornly endure. When a challenge turns into a crisis, family relationships are unavoidably affected. While the difficulty may begin outside of the home, it is often possible to find solutions within the family system. How families deal with crisis often influences how long the crisis persists. The goal of therapy is not to find the cause of trouble but to identify possible solutions.

The experience of having a child in crisis often creates substantial pressure on parents. Frustration, resentment, anger, fear, and inadequacy are some emotions expressed by parents of distressed youth. The intensity of such feelings is often enough to magnify existing family conflict and to trigger marital discord. Such tensions inevitably aggravate the principal crisis and contribute to an unrewarding cycle of interaction. Children know how to push their parent’s buttons and will continue to do so as long as they are able. Therapy can be a step toward knowing how to react to children more effectively.

One reason why families in crisis tend to stay in crisis is that the continuing tumult weakens parents when their strength is needed most. In the best of times, children rely on their parents for stability, security, and support. When the family system is strained, children need their parents even more. Parents who are divided in their parenting method or who are independently insecure are more likely to react impulsively and inappropriately to their children’s needs. While it may be appropriate for parents to feel anxious –or even overwhelmed – about their children’s trouble, it is important that they act deliberately, sensibly, and constructively.

No one begins therapy because they want life to remain the same. Every client wants change. When a child engages in physically, spiritually or socially hazardous activities, parents understandably define “change” as the ending of those behaviors. Sometimes, as a result of parents becoming more self-aware, they are able to encourage their children toward more suitable and productive lifestyles. Alternatively, parents may learn to adjust their expectations and to define “change” differently. When a child adheres to harmful behaviors or when parents discover that their child’s conduct is not exceptionally tragic, parents may be moved to accept the prevailing value of their child’s relationship in spite of reasonable disappointment.

It is a conceptual leap to correlate adolescent disobedience with family relationships. Some parents prefer to fault the community or the personality of the defiant child. While at times truthful, such thinking often renders parents feeling helpless. Instead of looking elsewhere, therapy can help parents to find solutions in their own home. While family relationships may not be the cause of misconduct, they often serve to maintain it. Therapy can help parents discover their role in such interactions and empower them to find creative resolutions.

Therapy does not assure change. The process of therapy is complex, with “success” being constantly redefined. For parents who are tired of feeling powerless, therapy may help expose strengths within their existing relationships. While the results may not be precisely what they imagine, therapy can lead to improved family relationships and a refreshing sense of hope.