Amy: When I began my training in family therapy nearly thirty years ago, I soon became attracted to the musical quality of this kind of therapy. These sessions involve working with couples and families who are stuck in difficult, painful patterns of living. Sometimes one member of a family is depressed, or a child’s behavior may be challenging or disturbing for the parents. As I focus on the interactional patterns of the couple or family in my office, I often feel like an orchestra conductor whose job it is to coax amateur musicians into playing like professionals

.images Of course, rhythm and timing is critical—both my own and that of the couple or family. Sometime the initial music contains too much dissonance, or too much harmony. I may need to raise up the quiet violin or tone down the overpowering trumpet. This requires that I observe the imbalances in the family music-making and be able to build on the strengths of the players.

Here’s some surprising music from my office, played by a mother-daughter duet:

Thirty-five year old Dee Dee was referred to me by her family doctor for depression. When I first met her she was steeped in the blues following the separation from the her alcoholic boyfriend, shortly after the birth of her daughter. Her mother, Janet, flew in from Florida to live with her, which Dee Dee both appreciated and feared, given her mother’s history of being critical of her.

UnknownDee Dee’s childhood was characterized by a lot of turmoil and hurt. Her parents separated, and Dee Dee’s mother moved away to try to establish a stable home for Dee Dee and her older sister. Ten-year old Dee Dee shuttled back and forth between her parents. She said she always felt fat and ugly, not able to live up to her mother’s Southern standards of beauty. The turbulence of Dee Dee’s early home life and her mother’s flight created an ever-present wound of abandonment for Dee Dee.  Even as an adult, Dee Dee often felt like she was “in the way” with her mother.

During the course of the family therapy, Dee Dee reunited with her now sober boyfriend and they were slowly working things out. Dee Dee still felt emotionally fragile with her mom, however. And Janet was a real pistol. I invited her into the therapy in hopes of addressing some of Dee Dee’s longstanding issues with her mom. We’d had several sessions where I observed how Janet still threw a few wild emotional punches without fully realizing it. This sent Dee Dee reeling, silently.

With her bright, spiky red hair, even brighter blue eyes and her rapid-fire, peppery Southern speech, Dee Dee’s mom can make you feel like you’ve run into a hurricane. She’s intelligent and kind-hearted, but doesn’t have much experience with introspection. Dee Dee has historically tip-toed around her mom emotionally, saving her “hurts” and storing them. Our therapy sessions brought some of these tensions to the surface, and their relationship improved. But I knew many of Dee Dee’s old wounds remained.

images-1One day Dee Dee surprised me by appearing for our session with her mom. I hadn’t seen them together for awhile, and gave Janet a warm greeting. She began by saying, “I thought I should come today because I want Dee Dee to know we are on the same team. Sometimes I feel like she doesn’t know we’re on the same team. And I want her to know it.” Nice opening to the tune. I encouraged her to continue.

Dee Dee opened by saying she’d been “taken aback “ that her mother decided to volunteer at a shelter on Christmas Day instead of spending the day with the family. The room grew silent. Janet said, “I could tell you were upset.” Dee Dee continued with some casual-sounding response about wanting the family to be together on Christmas. Dee Dee snuck in the phrase, “that cut deep” and then continued talking as if nothing had happened.

Her mom didn’t let it go. She said, “When you said, ‘That cut deep’, were you referring to your old hurts about me? About when I left? About those years when I wasn’t around for you?” Silence. I got a feeling in my gut that we had just entered dangerous emotional territory. I had seen Janet become explosive in previous sessions. I made sure I was solidly seated and ready to “conduct”. The tension in the room was palpable. I wanted to let it develop.

Janet turned toward her daughter and, slowly, began a nearly twenty-minute solo, as she attempted to recapture the pain of that difficult period when she separated from Dee Dee’s dad. Janet began talking about the pain of that crazy time when she left her husband and kids and moved out. Dee Dee’s mother described her blindness, her anguish , and her inability to ask for help. She said, “I never knew you could get help for problems like mine. I never knew you could go someplace and learn how to talk to people. I never knew there was a way to address pain other than to escape it.”

Janet smiled, describing her joy at now knowing you could work through problems with people you loved; you didn’t have to run away. Then she grew quiet, She looked at Dee Dee ; “I never, ever, wanted to hurt you. I was so stupid. I didn’t know how to tell you how much I loved you, that you and your sister were the most important things in the world to me. I was in so much pain, the only thing I knew how to do was to grab you by the arm (she imitates the motion) and drag you with me, instead of holding you and comforting you.”

images-2Dee Dee was looking at her mom. She said, “I don’t know what I’m supposed to say.” I shook my head, meaning, “nothing.” Then, almost in a whisper, with a smile on her face, Dee Dee said, “I want my mommy.” Her mom pulled her daughter close, cradling her in her arms. Dee Dee repeated this phrase a couple of more times. I think it felt so good for her to say it. It was long overdue.

They stayed like that for quite awhile. Janet said, “Those are the best words you can say to me.” Then referring to one of our past sessions, Janet reminded her daughter that she didn’t need to protect her. “I won’t break”, she said. I noted to myself, then out loud to Dee Dee, that she now had “a whole Mommy.

I had a strange sensation as I watched this exquisite duet. I could almost see Dee Dee’s wounds healing. It was as if I had an X-ray which showed where the empty and broken places were, and I watched as they healed. I shared this crazy image with Dee Dee and she nodded, smiling.
I mostly stayed out of the way now, only adding a small, admiring or encouraging  comment here or there. I was thinking of the great Austrian conductor Herbert Von Karajan who wrote that he understood a lot about conducting after he learned to fly a plane. He said he learned how not to get in the way when the plane was flying by itself. In this session, the plane was flying by itself.

As the session ended, I inwardly applauded these brave women. I think they felt it. Dee Dee looked stunned. I was emotionally exhausted, in a good way. I knew that I had been a part of some exquisite music— full of imagination, some risk-taking, caring and commitment. Those ingredients, so crucial in making good music. were fully on display with this duet.

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