Sunday, October 31, 2010

Family Mythology (instead of individual pathology)

Earlier today, I had a “first appointment” with a patient. Her concerns were in many respects similar to many patients but her family history is the stuff of epic stories.

I think our family histories (and herstories) are largely neglected in the way we view ourselves. In this present day, most view themselves as discrete phenomenological packages that emerged the day we were born and conclude when we die.  We have somehow become blind or conditioned to dismiss the generations that eventuated our existence. We fail to view ourselves as an extension of a lineage of lives and stories. We have been severed from our family tree or what many call their family-mythology.

Our family heritage/mythology influences us in ways that are sometimes very obvious and at times in very subtle ways. Even if the “facts” of our heritage is not clear, the stories (true or not) leave an indelible impression. Patients have told me they know nothing about their family-of-origin history but the non-verbal attitudes of their parents is as strong or stronger than known historical facts. I often have seen this when my patient is Latino. Perhaps their parents were born in the US and they believe they are thoroughly Americanized/modernized – but their parents were raised in homes that had strong traditional values – those values are powerfully transmitted from generation to generation. I have sometimes said to my Latino patients, “Your consciousness may be very American but you blood and bones (the unconscious) are still nurtured by the Soul of Mexico.”

My patient today has a family mythology going back many generations. A grandfather was a famed captain of industry; she said he was a “king” and his spouse, a “queen. The king and queen begat princes and princesses, one of which begat my patient.

When I asked my patient about their spouse’s pedigree s/he was a bit clueless. The spouse’s lineage was unclear due to a father that was mostly absent due to military duty and a mother, enchanted by wanderlust. Imagine the relational dynamics when someone descended from a long aristocracy partners with a mutt. One has well established expectations of high achievement the other has no established familial patterns for a template of personal values and behavior.

Because the contemporary culture has suggested (and most are too willing to suckle from any breast of information) that we are monads, devoid of generational influence, when conflict arises we naturally assume that the problem stems from the so called “individual pathology” of the two parties. It would be very unusual but very reasonable to suspect that the misunderstanding stems from transgenerational differences. If an Irish-Catholic partnered with North African-Muslim, I think most of us would understand that the couple would have predictable misunderstandings. In graduate-school, there are classes in cross-cultural psychology. It would be good to pay more attention to differing family mythologies.

Sometimes, though not very successfully, I ask a patient about their “family-religion”. What I am referring to is their family-mythology. In ways, it is similar to a religion. Normally when people think of a religion, they think of beliefs, commandments and creeds. A person has a family-religion. 

Part of my family-religion (imparted by my father/patriarch) were the commandments:
  • Thou shalt never draw attention to yourself.
  • Thou shalt always wear something on your feet, except when in bed.
  • Thou shalt never be late.
  • Thou shalt always behave in a manner reflecting your station in life.
  • Thou shalt always be polite.
  • At all times, be ready to stand and deliver the answers demanded of thee.
  • Never contradict thy father.

Imagine some of the misunderstandings that would develop if I partnered with someone whose family religion encouraged one to be bare-foot and where time commitments were “negotiable”. If both parties are fundamentalists with their family-religion it can lead to real acrimony.

It may be asked, “What is the solution?”

My answer is to develop an attitude of appreciative inquiry; think of yourself as a comparative mythologist.

Vive la différence

Tuesday, October 26, 2010

More of "What is this therapy thing?"

In an earlier post, I deigned to criticize “psychotherapy” because it is not an objective science. Really, psychotherapy is closer to art or theology. Allow me now to say where or how I DO find value in therapy.

I have no argument with religious beliefs. (I have a few of my own.) A religious “fact” does not depend on an objective, concrete, scientific basis. Religious facts and scientific facts are two entirely unique categories of phenomenon. People far brighter than me, who study a branch of philosophy called epistemology could doubtless explain it more clearly. For people of average intelligence (like me) allow me to offer this vernacular explanation: I can resolutely say that I love Janaki, but if asked to prove it (scientifically) I can’t offer anything. A beautiful piece of music is not beautiful due to a scientific fact. These are phenomenon of a different sort, horses of a different color.

This is where “fundamentalists” err. They try to migrate a belief (their faith), to the realm of objectivity, the category of concrete facts.

Psychotherapists can make them same error. Therapists err when they fail to appreciate that their cherished theories and belief systems are mythologems. When a therapist fails to view their belief-system or school-of-thought as just one of many possible descriptions of what may be vexing a given patient, they slip into what I view as therapeutic fundamentalism. These therapeutic fundamentalists, overtly or sometimes with greater finesse, try to make their patients life circumstances fit the parameters of their beliefs. For those unfamiliar with the concept of a “Procrustean bed”, allow me to summarize the basics:

In Greek mythology (from which much of contemporary psychology grows) Procrustes was a son of Poseidon. On the way between Athens and Eleusis. he invited every passer-by to spend the night. The traveler would find themselves restrained in a bed made of iron. Procrustes would set to work on them with his smith's hammer, to stretch them to fit. If the guest proved too tall, Procrustes would amputate the excess length; nobody ever fit the bed exactly because secretly Procrustes had two beds.

This story became the basis for the common idea of trying to make a square peg fit a round hole – or vice-versa.

Therapists make a grave error when they try to cram a patient’s situation into the therapist’s theory.

Instead of this method, therapists better serve their patient by letting the patient explain, in their own unique way, what has happened and is happening.  I prefer an appreciative inquiry approach to working with a patient. I try to understand the unique experiences of the patient as well as the patient’s unique descriptions. I ask questions so that I can better understand the patient’s languaging of the patient’s experiences.

In my experience, as the patient explains and helps me to understand, they simultaneously better appreciate, and understand more fully their experience. Often, the patient will understand something well before me. Quite honestly, it is not necessary that I understand -  but it is in the process my respectful and genuine desire to understand - reciprocated by the patients' languaging of their experiences, that patients find the process helpful. In my work, patients are not helped by me imposing my explanations, but by the patient animating understanding through languaging.

(Note: As I am writing (i.e., languaging) this blog column, I am better understanding the process. It is an in vivo example about which I have been writing.)