Book review · Red Sistémica
The presence of absence. Therapy with families and ghosts
A collection of clinical stories in which Carlos Sluzki works with what is no longer there and yet goes on acting: the dead who accompany the living, memories a regime has forbidden, dreams it is better not to kill. Salvador Minuchin, who wrote the foreword, sees in it a book to be read twice — the first time for the pleasure of the story, the second for what it gives one to think about change.
What Minuchin is prefacing
What Red Sistémica publishes is the foreword to the book, written by Salvador Minuchin in March 2011. Its main lines are given here; the text belongs to the book, and its full Spanish version remains available on the journal’s website.
The book brings together real cases and their discussion. Minuchin recommends two readings of it: the first for the pure aesthetic pleasure of the short narrative, the second in order to let these texts lead one towards a fundamental reflection on the human condition and on the process of change. What he says he felt while reading is the presence of a man who has travelled a great deal, thought about other cultures and about the consequences of his own work.
An opening scene sets the tone of the whole. In the early days of his career, Carlos Sluzki treats a psychotic patient entirely caught up in a delusional system about how to save the world. On antipsychotics the man gets better, loses his voices, becomes depressed, and ends by taking his own life. The memory of that case seems to have run through all his later work.
“Do not kill the dream; it might hurt the dreamer.”
Carlos Sluzki, quoted by Salvador Minuchin
A minimalist style, a powerful influence
Minuchin describes a clinician who regularly chooses unexpected paths. With an immigrant Muslim family several of whose members suffer from nightmares and terrifying visions, Sluzki opens a conversation about the magical power of dreams, about the difference between good and bad dreams, about what the Koran says of the qualities of the dream. At no point does he speak of the effects of migration, of the cultural clashes between generations, of the hierarchical rigidity of that family or of the place a woman holds in it: readers learn of the existence of these questions only when the author invites them to reflect along with him. The session looks more like a conversation between neighbours, the therapist always respectful and curious, helping the family to widen the range of its own stories, then letting them go without their noticing that his voice goes with them.
The influence of the narrative therapies, to which Sluzki himself has contributed, is visible; his practice is nonetheless highly singular. He deliberately lets himself be caught up in the stories he is offered, makes his way through strange territories, pays scrupulous attention to detail and adds, whenever he can, slightly discordant notes that introduce ambiguity into the family story. These interferences are friendly, familiar, respectful and optimistic: he visibly believes that the family has usable resources, and he lends it his hope. Minuchin compares the effect produced to a tale in which a traveller, having come to a fork, is invited to take both roads; they choose one, and hear the echo of their steps on the one they have not taken. The style is minimalist, the invisible influence is powerful.
What the book brings
A clinic of the presence of the absent. The message “do not kill dreams” is sometimes turned there into a positive formulation — cultivate your dreams, they will bring changes you will want to accept — as in that piece of work with an elderly woman who comes to consultation accompanied by her two dead sons, and to whom Sluzki ends by recommending that she teach her sons to respect her privacy, to which she has a right. Other situations are more complex and cross several levels of social, political, relational and individual trauma: there one sees Sluzki treating the destructive effects of a despotic regime that demands of victims and witnesses alike that they erase their memory — and, two years later, an audience coming from that same cultural experience watches the session, finds itself gripped by the memory of that fear, by the fear of remembering, and recovers in that movement its capacity to be free.
Minuchin stresses finally that Sluzki is a well-informed political observer as much as a committed activist, and that the analysis of the last case in the volume shows him once again as a masterly clinician, able to use the description of one family story to light up a whole universe of shadows. His last sentence asks readers to watch the circles widening after the pebble thrown into the social lake.
Who is Carlos Sluzki
A psychiatrist and family therapist, he edited the journals Acta Psiquiátrica de América Latina, Family Process and American Journal of Orthopsychiatry. At the time of the book’s publication he is professor of global and community health and of conflict analysis and resolution at George Mason University (Fairfax and Arlington, Virginia), as well as professor of psychiatry at George Washington University.
This book review is an English translation of “Prólogo del libro «La Presencia de la Ausencia Terapia con Familias y Fantasmas», de Carlos E. Sluzki”, published by Red Sistémica (first published in Red Sistémica). Translated and republished with the journal’s permission.
Read the original articleHow to cite this article
Minuchin, S. (2023). The presence of absence. Therapy with families and ghosts (Complexe Systémique, Trans.). Complexe Systémique. https://app.complexe-systemique.com/en_GB/articles/the-presence-of-absence-therapy-with-families-and-ghosts (Original work published in 2011 in Red Sistémica; republished in 2023 by Red Sistémica, https://redsistemica.ar/2023/01/30/prologo-del-libro-la-presencia-de-la-ausencia-terapia-con-familias-y-fantasmas-de-carlos-e-sluzki/)
To go further
- Recovered words, recovered worldsCarlos Sluzki himself, on speech made possible again after political terror.
- It’s much more complicated. Interview with Salvador MinuchinThe author of this foreword, on his own way of working with families.
- Migration, ambiguous loss and ritualsAmbiguous loss and absent presences, the central theme of the book.
Related training courses
Online course
Master the art of narrative therapy: a unique journey with Charlie Crettenand
Immersive online course: discover the narrative approach with Charlie Crettenand. A unique audiovisual journey, lifetime access, exercises. In French.
Related articles
Article How Venezuelan mothers and their young children use storytelling to process immigration journeys
Seven Venezuelan mothers tell their young children about crossing the Darién: shared memories or superhero tales, six ways of facing fear together.
Article Collaborative Polyphonic Writing as Therapeutic Practice: A Longitudinal Case Study
A patient and her therapist co-write her autobiography: the psychiatric diagnosis becomes one voice among others, coordinated by an “I as a writer”.
Article Parenting after critical illness: a biopsychosocial review of post-intensive care syndrome, family systems, and child outcomes
After post-intensive care syndrome, parenting falters, the co-parent is worn down and children help in silence. A biopsychosocial review proposes how to spot them.
Article “Tired of Being Tired”: Intergenerational Trauma and Relational Bridging Among 1.5‐Generation East African Refugees
Sixteen Somali, Oromo and Ethiopian refugees who arrived as children describe their role as bridges between generations, between inherited silences and burdened resilience.
Comments 0
Log in to join the discussion. Log in