In Solidarity With The “Nasty Women” of the World

img_1650AB: I’m in Los Angeles this weekend, and decided to make myself a T-Shirt  to express my solidarity with all the “nasty women” in the world. For those of you who may be unaware of the origin of this phrase, check out Donald Trump’s latest self-revealing remark from the last debate:

Unconscious Family Patterns: A Woman Learns To Be Sick

DK:  I have  a long interest in patterns of illness in families. Much of my clinical work is involved in working with families referred by a physician where a member has an ambiguous chronic illness. An ambiguous illness is one where there are symptoms and disability but there is no definitive physical or laboratory evidence of disorder. Early in my life in Psychiatry I discovered that including the whole family is extremely helpful in illnesses of this sort. The situations that lead to and perpetuate illness are complex. I have learned there are no templates that lead to understanding or to healing, rather therapy requires attention, caring, tolerance for ambiguity, which in my case turned into a thirst for ambiguity. In the case that follows it seems that part of being a woman includes “not feeling well”.

The  Case: The Swensons were referred by their family doctor. The main concern revolved around the oldest daughter,  17 year old Kim.  She had had surgical repair of her scoliosis 16 months prior to the first interview.  Eleven  unknownmonths after surgery the ‘halo’ appliance was removed and she started getting used to life unencumbered. But within two weeks she was diagnosed with infectious mononucleosis and was ill for eight weeks. While the serum findings faded out, suggesting recovery, her energy did not return. She had been an active athlete and a good student prior to the surgery. She was having a hard time finding her way back into the world and into her body. She was an apprehensive version of her pre-surgical self.  Her difficulty returning to school, and life, prompted the family to call me.

Mother, Norma, and Father, Fred, were in their late 40’s and there were two more daughters, ages 14 and 11. They were what we think of as a conventionally normal family. There were no out of the ordinary stresses. Fred was the most emotionally dynamic parent, a lively, nice man who was considering a career change, looking for a better job. Norma was a bit more subdued, but involved with and thoughtful about her kids.

I saw them weekly, they talked about Kim’s experience of surgery and how she thought about her return to school. They talked about life events, how they were attempting to encourage Kim, how Kim responded. Sometimes, even when helpful, family therapy is not exciting. At the third interview they described a weekend family adventure, a trip to Fred’s sister’s lake cabin. Norma stayed home at the last minute because she was not feeling well. She didn’t say what the problem was. I hadn’t heard about a health problem and thought maybe menstrual cramps, or perhaps she had some unease with his family. There were no details. She “just didn’t feel well”.

unknown-2Father and daughters had a wonderful time. Kim went for a swim and even did some diving the first time in over 18 months. Then the mother Norma didn’t come to the fifth interview because she wasn’t “feeling well”. I tried to better understand what her illness might be. “She’s just kind of under the weather some times,” said Father. As we went along I heard that Norma’s mother had health problems. Norma was troubled by her own mother’s health problems which had disrupted many family events. This had gone on all of her life. She had never been in good health. Like Norma she missed some family events because of her poor health. But also like Norma, there was no diagnosis. She was treated with a variety of medications. But I could get no clues as to what her illness was. Norma was surprised when I suggested she was following in her mother’s pattern.

Kim was getting better, feeling more confident. She and Dad and her 14-year-old sister shot some baskets the day before the interview. That was a giant step forward.

Short digression: I have lived and practiced in several different cities. I was working with the Swensons while in practice with the Family Therapy Institute in St. Paul, Minnesota where I had grown up. At the end of the 10th session as the family was leaving, Mrs. Swenson surprised me with a question. “Is Betty Keith your mother?”

“Yes, do you know her?”

She nodded, smiling warmly. “You used to be our baby sitter.”

images-6I was amazed and puzzled. She told me a bit about her family and where they lived. I remembered babysitting in her house when I was 12 and 13. They lived in one of the larger new homes 2 blocks from our decidedly middle class neighborhood. Her mother was a trim, attractive, blonde. Her mother and father appeared energetic and appealing. The point is that Norma’s mother did not seem to be a woman who was given to poor health. So the characterization of her in the present was surprising.

I had developed the idea that Kim was caught in a family pattern where part of being a woman meant having an illness. Could it be that part of the problem was her identification with her mother and grandmother? I know it sounds a bit far-fetched, but this is how I think. I take the uncertain symbolic strata of the family into consideration. Identification is part of loving, especially part of the child’s attachment to a parent. Children in families are inevitably affected by the emotional atmosphere of their family.

My impression here is that Kim’s slow recovery was complicated by something to do with how to be a woman in this family. She went through a major surgical procedure, which probably disrupted her relationship to her body. It was as though being a woman meant having an ill-defined ‘health problem’ without diagnosis, it meant “not feeling well” when uncertain.

images-3This unconscious mindset caused me to think the women in this family had an uncertain or ambiguous relationship to their bodies. Pediatrician/psychoanalyst  Donald Winnicott suggested  it is not a given that the soul shall reside in the body. The implication is that experience can disrupt the relationship between body and soul. Therapeutic experience can restore it. Kim recovered from what was troubling and she returned to school. Anxiety in the family went down and they soon ended their therapy work with me.

I was concerned they were leaving too soon. I proposed we have a few more sessions to include Norma’s mother, but they didn’t think it possible for the grandmother to come to my office. To be honest I don’t know what I did except to attend to them, to parent them which involved caring, empathy and attention. I wish I knew what happened next, but I don’t. I don’t know if the therapy had any effect on Norma.



This Woman’s Perspective: What “Trump-ism” Has Awakened In Me

AB: When I sat down to write this post today, I intended to write about the more “clinical” matter of anxiety. But, somehow, I kept thinking about this past week of revelations regarding Donald Trump’s objectifying and sexual bullying of women. And I noticed that this political drama playing out on the U.S. stage has re-awakened something in me regarding what we used to call “sexual politics.”

My fellow blogger David Keith and I write quite a bit about the male-female dance as it appears in our office setting. Although I do occasionally see a bully-man who appears intent on denying the “personhood” of his female parter, this is rather rare in my office practice. (An example of such is a case is the post from 4/24/16 “Teaching A Hopeless Husband to Dance“). Most of these men would not submit to the therapy process, for obvious reasons.

images-1The public conversation these past weeks about sexual bullying of women has had an unexpected effect on me. It feels personal. I find myself reacting to  casual comments  in conversations in new ways. For example, when I recently called my accountant, whom I’ve known for 25 years, to ask him a tax question and he left me a voicemail saying,  “You don’t need to do anything, just stay beautiful”,  I heard that with new ears. I know surely  the comment wasn’t in any way threatening and was harmlessly intended. And when I recently visited an acupuncturist, who, in his limited English, commented on my “beautiful body”, I knew he was speaking from a health perspective. There was nothing scary about how he said it.  But I inwardly paused.  My sensitivities are heightened.

Lately I’m remembering the many years of feeling exposed walking down the street in New York City. While, as a middle-aged woman, I still occasionally hear a “Hi, lovely” from a guy, these days  it’s more amusing than threatening. But there were years where I would cross the street rather than have to walk in front of a line of construction workers and feel undressed by their eyes.

One of the worst incidents of sexual violence occurred for me when I was a graduate student; as I began to descend the subway stairs, on the way to my psychotherapy appointment,  a man approached me and sexually groped me and pushed me down the stairs. I arrived at my therapist’s office shaky and tearful. And, I remember that  my therapist  didn’t really “get” the traumatic nature of what I’d just experienced. Strange as this seems now, he implied that I had exposed myself to this violence  by being in the “wrong neighborhood.”

unknownI also vividly recall the time that I lost my way in New York City and found myself in a rather sketchy part of town.  New York in the 80’s could be a bit treacherous, reeling with the rampant crack epidemic.  I remember my relief when I saw a policeman on the corner and approached him for directions. Instead, he began “flirting” with me, leaving me feel even more stranded and unsafe.

I mention these stories because most women have experienced these types of humiliations and violations. And these experiences are relatively trivial compared to what some women have gone through. I have quite a number of friends who’ve been raped. I  believe  this feeling of vulnerability becomes a part  a woman’s consciousness. Now seems like a good time to broaden this discussion.  I guess we can thank–if that’s the right word–Donald Trump for that.

I also recognize, despite the awful echo-chamber of right-wing media, that most men are not like this. I happen to be pre-disposed to liking men. I had a warm and loving father, and two older brothers who were, in different ways, my heroes. I have a son who is an amazing young man, and is, at almost twenty-nine years old, one of my best friends. And I have a husband who is as much of a feminist as I am, and who is truly an equal partner.

images-3I was lucky enough to have a strong and capable mother who never appeared to me like a victim. I know I’m very fortunate in this way. And I’m comfortable with healthy aggression, having grown up in a football-playing family. I love all things sports-related, and believe that the rough and tumble of competition can be helpful in building character strength.

But what we’re hearing from Trump and his ilk has disturbed me to the core. It’s awakened, almost in flashback-like fashion, the many subtle and not-so-subtle diminutions and violations  I’ve experienced as a woman. Maybe I thought I was over it, or that as a culture we’d gotten past a lot of this posture of male domination, sexual and otherwise.

The ugliness of Trump’s rhetoric and behavior has unexpectedly awakened in me a feeling of solidarity with other women, and with men who abhor this type of “man” as much as we do. I guess that’s why I felt moved to share my own experiences. This is an opportunity for all women–and like-minded men–to talk about this deep, pervasive and often subtle power dynamic in the relationship between the sexes. It’s a chance to expose, and then hopefully cleanse, the wound carried, often invisibly, by so many women around the world.

We need to shed light in order to overcome this darkness.



“Toxic Masculinity”

AB: In this Op-Ed from The New York Times, writer Jared Sexton beautifully captures what he calls the “toxic masculinity” of Donald Trump. Sexton, who became familiar with this version of “masculinity” in his childhood, writes movingly about the self-protective function of this kind of bravado. He captures the emotional fragility underneath the posturing, while noting the dangers–to self and others–of maintaining this posture into adulthood.

In Praise of Self-Pity

AB: I love this little post from Alain de Botton’s The School of Life. He talks about the importance of honoring the Baby in all of us. From a personal perspective, my best coach on this matter is my husband, who’s pretty good at letting himself whine when he’s got an emotional boo-boo. I’m slowly getting better at it.

A Surprise Twist For A Couple: A Jazz Therapy Consultation

AB: (This is a continuation for my post from 10/2) 

Of all my Jazz Therapy cases,  several stand out. Sometimes the response was unexpected, and dramatic. This is such story:

Case: I had been seeing a couple, Steven, and his parter Charles, for about  a month. Steven originally approached me for therapy for his “depression”. He felt, as he called it, “alienated”; his work as a literary agent felt “lackluster”, and he was not his usual social, self-described “extroverted” self. It soon became clear that Steven felt unhappy in his partnership with his boyfriend of three years, Charles. He said he felt “disconnected” and unappreciated by Charles. He felt that Charles “didn’t know how to be in a relationship” and had withdrawn.  Of course, I suggested he come for the next session with Charles.

The Couple: The Charles that I saw in my office was very different than the “Charles” described by Steven. I had the impression that Charles was inept when it came to relationship, and clueless about intimacy. Nothing could be further from the truth.

This couple, both men in their early forties,  quickly revealed the nature of their relationship and its imbalances. Steven was clearly the “expert” of the couple: He had lived with a boyfriend before and felt he knew how it was done. And even though Steven described himself as depressed, Charles, in fact, DID seem unknowndepressed. Although highly accomplished in his field as an urban planner, with Steven he looked and acted tentative, worried, and appeared to adopt Steven’s view that he was clumsy in a relationship. In fact, Charles revealed himself as a highly intuitive, sensitive and thoughtful partner. But Steven failed to recognize this, apparently believing that his special relationship expertise was what the couple  needed.

As you would expect, the first couple of sessions I worked to subtly identify these patterns, hoping to create a shift. I decided to call on the expertise of my jazz musician consultants. We scheduled a “Jazz Therapy Consultation” for the following week.

The Jazz Therapy Consultation: My musician co-therapists for this session were two talented and accomplished instrumentalists, Peter  on tenor saxophone and Diego, multi-percussionist. Both men, friends of mine,  were in high demand as jazz musicians. This was the first Therapy Consultation for both of them.

The session began, with Peter and Diego watching on the other side of the one-way mirror. The couple showed their stuff: Steven, with his patronizing, superior attitude toward his partner, and Charles, needlessly trying to please his boyfriend and failing. After about twenty minutes of the session,  I invited the musicians in to “comment”:

images-7The music was dramatic, free, and powerful. Peter  and Diego  played for about five minutes, with Peter’s saxophone as a rather plaintive voice, and Diego almost shouting with his drums. Their music revealed a painful disconnection, which, for me, exposed the undercurrents of the couple.

After the musicians left, it was time for the couple–and me–to respond to this musical commentary. What happened then was stunning.

Steven adopted the same attitude toward these brilliant musician that he used with his boyfriend. He acted unimpressed: He felt he could have played just as well (he was a REALLY amateur musician), and basically, responded as if he had heard nothing new. He conveyed that these musicians didn’t have much show him, and if fact, if given a chance, he could show THEM a thing or two.

That was the first and only time anyone had (non) responded to a jazz consultation that way.

images-6Charles seemed upset by Steven’s reaction. From my therapy perch, it almost seemed like he was seeing Steven for the first time. Charles looked directly at Steven and asked Steven why he sounded “so arrogant”? I had never seen Charles confront Steven in this way. I was pleased; I thought this was health breaking through.   True to form, Charles, deep waters that he was, talked about how he resonated with the music, how he found it “disturbing”, especially in terms of what it might say about his relationship. Steven listened to Charles, but dug in: He repeated that he “could have played as well”, and didn’t really find the music enlightening in any way.

For the remainder  of the therapy session, I tried to use their responses to the music  to create a new dynamic for this couple. I highlighted the (human) artistry of Charles, and to let Steven’s smallness speak for itself. It’s not that I disliked Steven, by the way. I felt rather sorry for him; though a highly intelligent guy, Steven  seemed to be quite blind to his own limitations, and resisted learning about himself.

The session ended. The couple left and I returned to the other side of the mirror to de-brief with my musical consultants. I always enjoy hearing what the musicians were thinking, and what they experienced from the session that shaped their playing.

As it turned out, they both found this couple troubling.  While saxophonist Peter seemed sympathetic to both men, he said he felt worried that Charles was always “overshadowed” by Steven. He thought Charles should learn how to images-1fight back. Diego, on the other hand, felt little sympathy for Steven. He sounded annoyed at Steven’s arrogance. In fact, he said he found himself directing some of his percussive energy TOWARD Steven. (He mimed an aggressive drumming motion).  Diego said he wanted to “put this guys in his place”. He laughed when he said this, but I thought he may be (unconsciously) wanting to show Charles how to fight.

I expected to see the couple the following week. A few days before our scheduled visit, I got a call from Steven. He said they wouldn’t be coming in. Charles had decided to leave the relationship.  He had plans to move out the following week. I was shocked. Steven didn’t sound too upset about it, though. He said he thought it was, perhaps, “long overdue”. He thanked me for my help.

I decided to call Charles to check in. We spoke briefly on the phone. Charles said the Jazz Therapy session opened his eyes. He said he was deeply “embarrassed” by Steven’s arrogance.  He  said it changed how he felt about him: He said, “I realized I didn’t really like him very much.”

I felt bad, and a bit guilty. I always do when a couple breaks up. I always feel a little bit of “If only I could have…would have…). In this case, however,  I didn’t really have those feelings that I “missed” something; it’s just that it’s my tendency to vote in favor of the couple.

In retrospect, I think health broke through, and the couple didn’t survive. Their relationship was based on a flawed, static agreement, and  good therapy will challenge those patterns. In this case,  a couple of amazing  musicians became a catalyst for that change. Like good jazz, the results can be both  unpredictable and, hopefully,  life-affirming.




When Jazz Musicians Become Co-Therapists

AB: Among the strangest–and most enjoyable– things I’ve done in my career is to create what I called “The Jazz Consultation”.  I first got the idea of inviting  jazz musicians to comment on family therapy sessions when, as a budding jazz pianist/vocalist,  I attended legendary pianist Barry Harry’s Jazz Cultural Theatre workshops. At these sessions, I worked on developing my skills as a singer.   But I also learned a lot about rhythm, self-expression and–dare I say–life.

unknownThese Jazz Cultural Theatre  workshops were often on my mind when I attended professional family therapy conferences. A conference presenter would show a tape of a family session and wondered to myself, “What would Barry Harris say about the interactions of this family?” I began to put these crazy internal ruminations into practice when I created the first “Jazz Consultation” in 2000. I continued to work with jazz musicians as my co-therapists until a few years ago.

I guess the obvious question is, Why?  What does jazz music have to do with families?

My history with jazz, as a listener and performer, has taught me a lot.  I think that a good jazz ensemble shows us what a healthy family looks like. Many of the ingredients that make a jazz group “swing” make the family “swing” as well. Here what it looks like from the perspective of a jazz player:

  1. The foundation is solid. The group knows what’s it’s playing and they agree, more of less, on the chord changes. The broad outlines of the map are set, but no one knows yet how they’ll get there.
  2. Each band member openly enjoys the other. When my bandmate sounds good, it makes me sound good. His/her success doesn’t detract from mine: au contraire. And I’m rooting for him/her to sound good.
  3. Each member of the band has the freedom to play what he/she wants; in my band there are no limits on self-expression, but the band sounds better when the broad “culture” of the tune is respected.
  4. Healthy competition makes the band sound good: In a swinging band, members don’t coddle each other, but rather challenge each other, respectully, to be the best he/she can be. We enjoy setting the bar high, but “failure” doesn’t matter.  As Miles Davis said, “There are no wrong notes.”

images-3A swinging jazz band makes room for maximum individuality, while respecting the mutual respect/cohesion of the whole. The connection and mutual enjoyment of the band members are critical; it’s this  connection that contributes to freedom, rather than inhibition. And a good night on the bandstand inevitably comes with ups and downs: The band survives them; we forgive ourselves and each other, growing closer through the adversity. We’re all in this thing together!

When I began the “Jazz Consultation” I didn’t know how it would go, or what would come of it. By the third consultation I developed a format that seemed to work:

Briefly, the structure of the consultation went like this: I invited a couple of top-of-the line jazz musicians to observe one of my couple or family sessions, using a one-way mirror. Mid-way through the session I would invite the musicians to come in the the therapy room and comment, musically, on the interaction of the couple or family. The musicians had been watching the session on the other side of the mirror: I instructed them not to decide what to play beforehand, but to play whatever they felt, based on their experience of watching the couple/family. Of course, the couple/family gave their consent to such a consultation, so I didn’t worry about anyone having a heart attack when a jazz musician walked in and started playing music in the middle of their session.

The process of selecting musical consultants was relatively easy. I worked in New York City, and have many friends in the jazz community;  great musicians are plentiful. But I did select some criteria: First, he musicians had to be, or have been, in a committed relationship. (This eliminated about a quarter of the jazz community!) I wanted the musicians to know the agonies that come with a real relationship, so they would be able to empathize with my clients.

images-7Second, the musicians had to be willing to play “free”, meaning without a script. This, as you would expect, should be easy for most jazz players, whose art form is based on improvisation. Mostly, when I described the jazz consultation to prospective musicians, they readily agreed, though they acknowledged they’d “never heard of anything” like this. I had only one guy, a well-known trombonist, turn me down: He said “I don’t do that”. (I’m not even sure if he knew what “that” was.) Also, in case you’re wondering: I paid the musicians well for their time. These talented, hard-working folks get exploited enough; I didn’t want to contribute the that trend.

I continued these jazz consultations for about fifteen years, employing my musician consultants with all kinds of couples and families. Each one of these family therapy “jam sessions” offered a glimpse into the inner workings of the family that may not have been possible otherwise. And each couple/family responded differently to these consultations. Sometimes the initial feedback from session was intense, at other times neutral.

But at times something totally unexpected happened. On a couple of occasions, the reaction to the jazz consultation unbalanced the couple/family in unpredictable ways.

I will tell the story of a just such a couple in my next post….



“Self-Questioning”: An Important Ingredient In Family Health

DK: Here are some final reflections on my recent posts regarding the Martin family. (See posts from 9/23 and 9/25).

In this series of postings I have described and illustrated a rather subtle, yet insidious family pattern characterized by  invisible (unconscious) demands for false togetherness, the demand that all family members pretend to think the same. This enforced “togetherness”  has a formidable, unyielding tone, suggesting it is not to be questioned. The family in my illustration, the Martins, was stabilized by the fact that John is a problem, perpetually breaking rules. His behavior was viewed as defiant by the parents, when in my view it seemed fairly innocent; what kids do when they are growing and trying to figure out how to be a person.  Enforced group-think inhibits growth.

Mother is a woman who knows how to “act” as though composed, calm. After being married to an assaultive madman, she married a tacit, reasonable images-7Corrections Officer or prison guard. I did not sense he was abusive to her, but he was silent and distant, qualities which constitute a type of emotional regulation to a woman with her history, whose self is likely to stay hidden around any man. Naturally, the new husband does not like her to be upset, and together they imposed prison-like rules on John. Probably not physically threatening—but domineering—questioning not allowed. Spontaneity not allowed.

As I said, my interview pattern destabilizes fixed, dogmatic ideas. The destabilization is subtle; parallel,  not directly confronting. Talking with me ever-so slightly destabilized the foundations of pseudo-togetherness  on which a family’s narrative is based—it is inevitable. I had no investment in defining John as a problem. This enforced unity arising out of the couple’s living patterns stabilized the world for this tightly choreographed odd couple.  This kind of rigidly organized “togetherness” neutralizes the impact of chaos, crisis and uncertainty that characterizes modern living.

It is of interest that in the post-interview hallway monologue she did not say a word about John, except for the short sentence I quoted. She talked only about his father, the destructive crazyman who was her ex-husband. This  systematic unity is based in a narrative that serves to keep anxiety/craziness/ confusion/ambiguity at bay; and in this case to stabilize the marriage. In retrospect the family interview had virtually no momentum, no spontaneity.

unknown-2Of course I seem to have developed my own alternative systematic characterization. I am characterizing a unified view, but I like to think my characterization is more dynamic, “collideroscopic”, if you can stand a pun. Thus it is a destabilizing characterization, it has ambiguous words in it. Puns and irony are made of playful ambiguous words. My view is open-ended. Instead of reducing anxiety my pattern of questioning increases anxiety in the interest of creating the possibility for change. I was disappointed they did not return. I have the feeling the step-father called it off. He was the family’s thought monitor.


I am promoting an elusive idea. It is an idea that challenges common assumptions. It demonstrates how a family can be dependent on a growing child’s symptoms to stay together. It creates a unity which does not nurture, it restricts. The parents can be united by John’s misbehavior whatever it is. Mother is anxious and fearful of raising a copy of her ex-husband. Her current husband’s harshness is covert. It is likely he manages her with withdrawal, with silence. She is phobic, terrified of a man’s anger whatever form it takes, whether overt or covert.

They came seeking help. I give the man credit for coming to my office, 50 miles from their home. In order to get help in my framework, the people who become patients have to learn to question themselves. Becoming a patient means learning to use a relationship in order to question oneself. I think Mrs. Martin was in a state of perpetual self-questioning, always on the edge of chaos. Mr. Martin’s mindset made self-questioning unnecessary, irrelevant.

unknown-2I’m reminded of some dynamics which we find in our current political scene.   There are strong conservative populist movements afoot in the political dynamics of the U.S. and Western Europe. Here in the U.S. the spokesman for one kind of  populist movement, a presidential candidate, is a role model for deflecting responsibility and avoiding serious self-questioning.

I am writing about something I consider elusive, I hope I have brought sufficient clarity to the topic. I think of this blog as a forum;  a place to meet and share ideas. I invite your comments, your questions, your critique.

Beneath the Surface Of the Family with “Enforced Unity”

DK:  (This is a continuation of the session with the Martin Family:  See the post from 9/23, “Disrupting A Unified Family Story”)

The Martins  scheduled a second session. Then the family left my office. I made a short phone call then headed for the hall. Mother was waiting for me just outside my door, her husband and the kids had gone to get the car. Her body was tense and she started into an urgent description of John’s father. There was a startling contrast between her manner in the office and this frenzied woman in the doorway. My memory affected by her intense emotion somewhat distorts the situation. Her face was close to mine, her hair now slightly undone, her eyes larger, mouth distorted by emotion, she spoke rapidly in an intense hushed undertone.

She had not wanted to say much in front of the children, and expanded on details of what sounded like five years of horror for her. He had beaten her. He images-3was involved in a trucking accident that killed a friend. She was certain he had murdered the man and made it look and sound like an accident. She left him after he “body slammed” her and fractured her coccyx. Her ex-husband had been a bad boy, who did not graduate from high school. “I am afraid (projective identification, of course) John will be just like him”. There was much more urgency and emotion in the doorway interaction than what had occurred during the interview.

After she left I rethought our interaction. It was obvious she was a seriously traumatized woman, she concealed the depth of her disruption by her composure during the interview. She was a dramatically different woman in the hallway afterwards. I guessed the way they told the story in the office, with John as the impossible problem, organized experience to keep anxiety away.

Several days later, she left a message canceling their appointment. No explanation. I had no further contact with them. I let the pediatrician know what had happened and encouraged him to send them back. I was disappointed they never returned. I wanted to be helpful but felt as though I let them down.

There was a great deal unsaid, but I thought through possible explanations for this experience. I have been doing this for 40 years, so I considered a number of variables to make some assumptions based on my experiences. What comes next are things I don’t know, but what I constructed out of experience with many families.

The mother had been a single parent for nearly 5 years. It is likely John, her oldest child, was her closest emotional relationship during those years after this very traumatic marriage. Like all little boys he felt responsible for his mother. Then when he was about 9, the new man showed up. It is not unusual in this situation, for a young boy to be upset, and misbehave when the new man is around, especially if the new man doesn’t know how to connect with kids. The byproduct to the misbehavior is that the new man sees how to be important to the new woman in his life. He will get this little kid under control. The mother can’t control him. He will show her how it is done.

Conjecture about the husband- man. He was a small, taciturn man with a poker face. He contributed to the conversation, but only in a limited way. He had been in the military before becoming a prison guard. I had no evidence of him being ‘abusive’. But his background suggested he was a man who knew the rules and imagesknew how to enforce them. I imagined him to have a ‘zero tolerance’ mindset. He was not good at discussion. She, with her history of abuse, was not good at challenging let alone questioning a man like him. She complied with his rule system, not only for the kids, but for her. She was careful not to challenge him, and learned to say she sees things as he does even when she wasn’t sure. She probably was not much good at “zero tolerance”. She dared not challenge his parenting pattern, it must be good, it is endorsed by the State Department of Corrections. It worked on inmates it should work on her son.

Mother altered herself to accommodate this rigidly conservative man. It is likely the man defined his chief rival, John, as misbehaving. If he didn’t call him “sir.” He was misbehaving. If his room was not up to military or prison standards he was misbehaving. John became a problem as he entered puberty—(symbolically) his manhood was emerging—and that is likely why she began to see him as “like his father”. And seeing him like his father was deeply unsettling.

Mother was grateful to have a man who was not physically threatening. But he threatened—implicitly, to be disappointed in her. She learned to accommodate his needs, his patterns. He was not physically punishing. But she did not feel the support that comes from being loved. She felt support by doing her duty which meant seeing John as bad boy. The Corrections Officer was what I call “insane”, locked inside sanity, locked in unbending, pathological sanity.

Squelching The Family Spirit: The Problem of Enforced Unity

DK: Enforced “togetherness” in families, though largely unconscious, emerges in the way a family tells its story. It is not a unity which augments family spirit, it restricts. The restriction serves a purpose for some. The need for protection is motivated by a history of trauma or too much despair. But often a family member, usually a child, may be sacrificed to maintain this appearance of group unity.

unknown-3Kurt Vonnegut gave us wry advice. He said: We become what we pretend, so be careful what you pretend. The way I look at the world, sometimes families “need” a child to be a problem. It gives them something to be mad about. There is security in having something to be mad about. But when security is rooted in anger, it limits the resilience and creativity that contribute to health. We are not only molded by history, shaped by events; we are pressured to be an extension of the history.

When a family talks about problems they try to understand them, and they often use logic to do so. Their logic shapes and restricts what they can know. The logic undergirds a narrative which helps keep uncertainty at bay. The story tends to be self justifying, eliminating the need for self questioning for some.

Experience in the present can be distorted to fit the narrative. “Making sense”of family upset seems to hold the promise of understanding, like a salve for a images-3wound. Creating a “coherent” story at first helps a family understand its experience of distress. These seemingly rational explanations for family suffering push away confusion. But reason also squelches imagination which is vital to health. Confusion creates uneasiness. Confusion in regard to personal relationships is felt by some to be dangerous, a doorway to craziness. This is especially true for families with generations of trauma. These seemingly rational group explanations provide strong security against meaninglessness and craziness.

Children’s behavior is motivated by worry about their families. Even very young children have good instincts based on their affect sensor-systems. They are like affect barometers. When the artificial “togetherness” is based on distortion or too much compromise, the children are disrupted and produce disruption, it starts with their attempt to grow.

In the next post I will illustrate what this enforced “togetherness” looks like with a clinical story…