Behind the mirror, in Washington

The metro leaves the limits of Washington D.C., the loudspeaker announces White Flint. A few blocks from the station, along sidewalks lined with snow. The stop at the supermarket for the midday snack. The huddled conversations with classmates and teachers in the classroom, the hall with the coffee machine, the lounge for therapists and students, and my curiosity about the computer and its applications. Sandwiches and sodas are laid out between two comments on the Networker conference. Endless requests for clarification from Keiichi Miyata, in his half-English, with a profusion of thanks. The protests and self-assurance of the Israeli women, whose verbal duels are rather reminiscent of discussions in Buenos Aires. The melancholy of some immigrant from Buenos Aires. The dispassionate distance of the Americans, somewhere between surprise and embarrassment at the noisy display of certain foreigners.

Cloé takes charge of the day’s supervision, settles in near the console, asks whether the camera that films what happens on this side of the mirror is on, and: “What have we got today?”

“A Black couple is consulting because they are depressed and their business is going badly,” I am told hurriedly before the second session begins. I settle into the armchair and see the therapist come in wearing an explorer’s hat; everyone laughs, I look on questioningly, and Cloé comments: “If life is worth nothing, let them at least have a bit of excitement so that it passes more quickly, let them live an adventure, let them go off to Africa while they wait for the suffering that is their due. They haven’t moved in two weeks, him in particular.” Cloé: “She protects him by being more depressed than he is, she is stronger than he is, he looks for excuses to do nothing. Be incisive — Cloé tells the therapist over the phone —, is her husband a chicken?”, when he doesn’t dare go up in a helicopter. A moment later, the couple and the therapist are discussing all sorts of alternatives, and he plans to take part in demonstrations against racism in South Africa, “because the government supports the freedom fighters (that is, the contras) and not the South African groups.” The group behind the mirror is in a ferment, with endless dangerous and exciting projects. The Japanese man asks: “What is this strategy?” and Cloé answers: “I just invented it, it has no name, it could be the Hemingway strategy,” and she starts telling us about Hemingway’s life, his depressions and his adventures. The couple had begun by talking about the wife’s bulimia, her suicidal fantasies and her depression since the age of eight; today, the problem has shifted to living an adventure, the depression has turned into boredom.

We follow the case for a few weeks and observe a few changes. They come back to the next session without having carried out any of the tasks. Each of them is asked to take responsibility for an adventure, and for a punishment for the other if they fail to carry it out. She no longer seems depressed. “For four sessions now they haven’t done any of the tasks, but they talk about them in session, and that alone is therapeutic. Saying that a woman is unsure of herself and follows her husband everywhere is different from saying that she is a spoiled child who wants her husband to entertain her. Very often, a move, a change of country, brings on a depression because you are bored, because you have nothing to do with your free time.” In the course of the interview, we learn that she is going to New York in June with a friend, so that she is no longer depressed.

“They are thinking about something else, they are thinking about projects, something is going to happen. In mind control, with children, we tell them: think of your head as a television; if monsters appear, change the channel. With adults, it’s the same. This way of thinking is connected to Buddhism. With the emphasis on interaction, now that strategic therapy is established, we can come back to the mind. Here, the mode is indirect; it’s different from saying: we are going to practice mind control. This is not a culture where mind control is encouraged.”

Tibetan Buddhism, or the foundations of strategic therapy

I know you are developing a whole series of ideas, some of which you have presented in class. Is there a project you are working on that you would like to talk about?

Many. I am writing another book; it’s the one in which the Buddhist influence on my work will be most noticeable. The first chapter is called “The foundations of therapy,” and in it I try to spell out what the basic principles of therapy are, the ones all therapists can agree on. I am speaking at a very general, very universal level, because I believe the time has come for strategic therapy to take a position on what the ideology of therapy should be, instead of continuing to behave as if what mattered was to have no particular ideology and simply solve the problem that is brought to you.

Of course, there is always an ideology: for example, the ideology that consists in solving the problem that is brought to you. What I am trying to do is make an ideology explicit. The other day, in the group, Jay and I talked about this dilemma: should one formulate an ideology or not? Jay was saying that there are schools that prefer to leave the ideology implicit, and others that prefer to make it explicit. The principles I am trying to develop are, for example, kindness and tolerance as general principles; I believe all therapists can accept the idea that nobody comes to therapy to become more aggressive, more hostile, and that if someone comes with that goal, the therapist will not go along with it.

Today in particular, with the problems of international aggression, it is important for everyone to do what they can, even on a very small scale, to encourage tolerance and kindness rather than hostility and war. So I am developing a series of principles, giving examples of situations in therapy where decisions have to be made.

You have mentioned the theme of kindness and tolerance several times, and it also comes up in the issue of the Networker devoted to you. I was wondering to what extent, when someone comes for therapy, it is because they are the victim of someone else, someone aggressive, outside: the people who come for therapy are the victims, not the aggressors.

Yes, sometimes the victim comes to see how to defend themselves, and that’s fine: help the patient defend themselves, but don’t lead them to pay the other back in kind. These are very interesting questions. Yesterday, for example, I realized something: one of my most recent techniques consists in sending people off to do good deeds. I first developed it when I was consulted about a group of Vietnam veterans who were in couples group therapy; they beat their wives, behaved terribly and justified everything by their appalling memories of Vietnam. In that case, I recommended paying no attention to those tragic memories and simply saying that what they had to do was good deeds, to make up for what they had done or what they had witnessed. If the terrible memories concerned their comrades, the soldiers, they had to do good deeds for veterans; if the memories concerned the torture of Vietnamese people, they had to do good deeds for Vietnamese families. I thought the same thing about officers of the Israeli army who, after the invasion of Lebanon, where Israel lost many men, were anguished and depressed because they thought that if they had been smarter, if they had acted differently, they would not have lost those men. I recommended accepting that, but doing good deeds for the families and orphans of the men who were lost. My main idea was that these deeds should be anonymous, that is, that there should be no risk of the person deriving any benefit from them. An anonymous good deed is much stronger and, in that sense, much more therapeutic, because it looks far more like an atonement.

I couldn’t quite see why it seemed so important to me that it be anonymous, and suddenly, yesterday, I realized that in the society we live in — and I don’t know whether this isn’t universal, valid for all societies, or whether it is also a problem for Buddhism —, the good deed is not well received. So when someone does an exaggerated good deed for a member of their family or for a friend, they provoke aggressiveness and resentment. I realize that in therapy I recommend small, explicit good deeds of a family kind: baking a cake, buying a little present. Big good deeds have to be anonymous, because they always end up in some kind of flare-up of hostility. It’s an interesting problem. One of the principles of Buddhism is that if you treat a person very well, if you do a good deed, if you sacrifice yourself for a person and that person pays you back by behaving very badly, that person is like a teacher, because it is easy to be kind and tolerant with people who are kind to you, but being kind and tolerant with people who are bad to you is not easy. I think they are mistaken: the basic idea is right, but not the punctuation of the sequence. Perhaps what happens is that the person pays back the good deed with meanness because of the very nature of the good deed.

When you do an exaggerated good deed, you throw it in the other person’s face that they are not generous. That defines a hierarchy in which the kind person is in a superior position in relation to the one receiving the favor. It’s very interesting, because I think it is this kind of observation that must have led, for so many years in psychology, to the idea that one must express one’s aggressiveness and not sacrifice oneself for others, that self-sacrifice is something pathological and guilt-inducing. This type of good deed very often provokes hostility. Those are the problems one encounters when trying to incorporate into therapy philosophical ideas that matter for the survival of the planet. Therapy is very often founded on the idea of repression, of hostility, of aggressiveness, and of the expression of hostility and aggressiveness. When I say that we must all agree that we therapists must not encourage hostility but encourage peace, many would object, wouldn’t they?

Criticisms

Yes, surely. You were saying at one point that the risk is that it would be taken for a naive position.

Two criticisms are leveled at me: people say I am too naive, or innocent, or that I am too dangerous.

Why?

Because of the indirect, manipulative techniques, because I get people to do unusual things without their having the slightest awareness of what they are doing. I find it curious to be able to be innocent and dangerous at the same time; that will be the title of my third book: The Innocent and Dangerous Therapist.

Do the criticisms come from the same people?

Yes, at different times.

What would you answer to each of them?

As for innocent, it seems to me that there is nothing… well, yes, there is something innocent about me, in the sense that, to think clearly, you sometimes have to reduce the question to its most elementary form and become very simplistic. So, understanding problems in these terms: “Do these people love each other or not? Do they want to harm each other or protect each other? Are they bad or good?”, and having a kind of simplistic reductionism of the problem in order to be able to act. In that sense, I am innocent. The therapist must see problems in the most elementary, most innocent terms of interaction. Do you know in what sense, innocent? You have to step out of the system the way children step out of the system, and look at the situation like an innocent who comes from another planet and sees it for the first time; then you understand the situation. In that sense, yes, I am innocent, and it seems good to me to be innocent.

Does this criticism come from the model of kindness?

No, because that is new, it isn’t even published. Innocent comes, for example, from my thinking that a wife who mistreats her husband actually loves and protects him, and that I address only that part of her; so I am innocent to the point of not seeing that she is competitive, that she wants to harm him. I refuse to see certain aspects that someone else, perhaps, can see. Compared with the Milan group, for example, I am not interested in contemplating everything, which is actually a very psychoanalytic way of doing things; when you do directive therapy, you are unidirectional, you are not systemic, circular; you have to say: “Here is the interpretation I choose: the wife loves and protects him,” and not: she also hates and mistreats him.

That would be the way of constructing a reality: choosing this reality and not another serves a specific goal.

Of course, in order to be able to construct a directive; otherwise, when you contemplate everything, the only thing you can do is tell the family what the Milan group says: “You are all doing the best you can, given the circumstances,” and they are in a state of balance.

Why would you choose, in the example of the couple, the reading of protection? What goal does that reading serve?

I think that in general, when you describe people as good and protective, it is easier to change them, because everyone likes to hear that they are good; so, generally, they pay you back by accepting other things you say.

Could there be a case in which you would not choose that path?

Of course. Right now we have a project on sexual offenders: we have to treat all the perpetrators of sexual abuse in the county. If we are not successful, they will be injected with drugs that suppress sexual desire. In general, I cannot see them as protective, not at all. There, another Buddhist principle I use is that of humility and forgiveness, and so I developed a method for treating them. One of the important steps of the method consists in having them kneel before the victim, who is generally a little girl, a little sister, and ask for forgiveness on their knees. Then I have the whole family kneel to ask the child’s forgiveness for not having protected her. Which is to say that I am not naive at all, in the sense that I would think everyone is good; but I believe there are extremes, and that there are a great many people, in the middle, whom one can see one way or the other.

What would happen if he didn’t kneel?

If he doesn’t kneel, the boy doesn’t go back home; we don’t give authorization, we don’t say he is ready to go home.

In other words, the usual judicial procedure takes its course.

Exactly. And you were asking why I am seen as dangerous. It’s because of the paradoxical techniques; that is the usual criticism leveled at paradoxical techniques. I am seen as dangerous because I am seen as very sophisticated in paradoxical techniques. I don’t do the typical paradox — if you have a symptom, you must try to have it more —; I do refinements, for example asking that people have the symptom in turns.

Do you have an example?

Yes, they are in Behind the One-Way Mirror. Do you remember Liferuiner, “the one who ruins lives”? A delinquent, drug-addicted, alcoholic and depressed girl, with a very well-behaved brother and sister. What we did was to say that all three of them had to take turns ruining the family’s life, because it wasn’t fair that only one of them should have that task. Of course, the family began to protest and to say that it would be better if nobody had that task. We said no, because, quite obviously, it served a function: it kept the parents focused on her and not on the siblings, it kept them busy, it gave meaning to the family’s life; but it wasn’t fair that she alone should carry that, and if each week it was another sibling’s turn, she could then devote two weeks out of three to something more constructive for her own life. The older sister volunteered; she was a schoolteacher. The identified patient started saying: “No, a schoolteacher can’t be delinquent, drug-addicted, alcoholic,” and the other was saying: “Yes she can, the therapist is right, it’s fair, it must be my turn someday.” I have several examples of this kind, very funny ones. It’s ideal when there are three or four siblings, one is the disaster and the others are perfect, because then what happens is that the system changes immediately: everyone realizes what is going on, and the delinquent drops all of it, realizing they are a kind of scapegoat, a victim of the situation.

Are your books translated into Spanish?

There is one, very badly translated.

Is the other one going to come out?

Yes.

In one of the classes, the other day, differences emerged between Jay and you. You spoke of developmental stages, of a developmental psychology of harmony, whereas Jay thought that the developmental conception, as evolution toward something better, is a 19^th-century utopia; you spoke of making explicit an ideology, a meaning of life, and Jay did not agree with generalizing the ideas linked to problem solving. He said that one cannot account for what goes on in families that do not come for therapy. Could you tell me what, from your point of view, are the most significant differences between you?

That is such a difficult question! Since I am so close to him, it is very hard for me… and then I don’t want to be unfair. I think that in many respects I am more Ericksonian than he is; I think my definition of therapy techniques is very Ericksonian. The way of working, the way of crowning the strategy, the playfulness, the spirit of play. I don’t know. I think I tend more to develop new methods for each family, and that Jay is more interested in developing methods that can be taught; what really interests Jay is teaching a way of working; as for me, it’s the cases that interest me most, and what I like most is doing therapy myself.

Do you go into sessions?

I do therapy, I have patients.

You had stopped?

Yes, for many years.

Antagonism and conciliation

In that class, you connected the ideas of Buddhism to the mass media and to normal families, as a kind of different normativity. Does a religion or a system of ideas work as a homogenizer or as a facilitator of relationships? How would that fit in with systemic theory? In which respects?

That is also difficult for me to answer; I am only just beginning to develop these ideas. At present, the main aim of Tibetan Buddhism is to encourage peace in the world. It is the only organized religion that has never waged war; in fact, it isn’t a religion either, it’s more of a philosophy. Unlike Zen Buddhism, which often serves as an excuse for withdrawing into oneself, Tibetan Buddhism is a spiritual practice based almost exclusively on interaction with others, on compassion, tolerance, forgiveness. It shares with systemic theory the idea that we are all part of a total system, that suffering in any part of the system negatively affects any other part of the system, and that thinking according to the capitalist idea, for example, of earning more, having more, having more power, makes no sense in Buddhism, because the oppressor is oppressed, and the oppressed is a prisoner of the oppressor: having to maintain that prison makes the oppressor an oppressed person. So this also connects with the idea of balance, of equilibrium. Buddhist ideas have been much criticized, just like systemic ideas, on the grounds that they would not lead to change: if you think that the whole system is one and that each part of the system affects the others, then how does change come about? In fact, that criticism is a mistake, because change comes about from the fact that we live in a universal system in which what has to be achieved is to bring relationships, at every level — couple, family, local, governmental, international —, to a more harmonious interaction.

The way to apply these ideas to therapy is to accept that you have something you promulgate, that you promote. You promote harmony, tolerance, patience, kindness, hope and a sense of humor, because a very important part of Buddhism is the sense of humor in the face of the fundamental paradox of life.

What would the fundamental paradox be?

That life is shit and in the end you die — I’m not speaking in a very Buddhist way. In Buddhist language: one thing is certain in life, and that is that there will be pain; pain is certain.

What would be the place of differences? One thing would be resolving differences through antagonism; in this conception, how would one work with differences?

What is happening is that Buddhism is very contemporary right now, because until now one could argue, for example from a Marxist position, that the only way to obtain social justice is antagonism and violence; but now, given the danger of atomic war and the end of the world, that can no longer be argued, because if you push that argument to its ultimate consequences, we all disappear. So the only rational possibility is conciliation, and that has been the Buddhist position for many centuries, in the sense that it was going to come to this. So we must all work from the point of view of conciliation, from the micro levels of society to the macro levels, because the senator, the president, the foreign minister who takes part in international negotiations is a person raised in a particular culture, with a particular point of view on negotiation. Reagan, for example, quite obviously comes from a culture that puts no emphasis at all on conciliation, but on war; the whole opportunity of Russia’s opening up is being lost, and we do nothing, we watch it go by and we say: how awful! Russia’s opening up might not happen again for two hundred years, and that is because it is a whole culture founded on oppression, antagonism, exploitation and war. So much for the general implications and politics; in terms of therapy, once you have that quite clear, you intervene in therapy to avoid any antagonism, any quarrel, oppression, expulsion. Many of Jay’s ideas have been very badly interpreted, for example the book Leaving Home, over which I would have liked to have some influence so that he would write it a little differently, softening it a little, because many people interpreted it as if what had to be done, from a certain age on, was to expel the children from the home. That is a concept totally at odds with what this therapy is; that is not what Jay proposes, it is a therapy that contains, that guides and that helps, not a therapy of separation. Another Buddhist concept is that of non-separation. Relationships change, but one does not separate.

If there were differences, would it be a matter of resolving them through negotiation?

Of course, there are always differences. We live with differences all the time, but what matters is negotiation and non-violence.

Belief systems and mass communication

Some people say that the media should not have been given information about how we work in systemic therapy, because they would misuse it. That position seems to me not very systemic; I think one should rather think about how to manage that information. It seems to me that what you are saying goes in that direction.

I think so, yes, they should be given the information; for example, what I am telling you would be very important: that one has to work at every level of society for non-violence. Violence, on the massive scale of a country, is always founded on the culture of the country it comes from. I am always in favor of giving all the information; I don’t understand why one wouldn’t, I have never heard that argument. What was the idea: that they are going to use it to manipulate?

That it would warn people about how we work; the idea is that it is manipulation, and that if people are aware of how it works…

No, because you choose the most accessible aspects of the work instead of giving difficult things. Actually, all of that is nonsense, because therapists feel so important, when in reality they are not. The basic idea of paradox has always been called “negative psychology” here: when you want someone to stop doing something, you ask them to do it more; it’s a popular thing, it’s not a sophisticated idea. Children today learn in elementary school things far more sophisticated than this whole business of strategic therapy; since they learn to use computers very early, they understand very complex relationships, far more complex than the things we are talking about. When I say that parents should have only three priorities, that they cannot be on a child’s back all the time telling them “don’t do this, do that, and then this too…”, burying the child under mountains of orders, but that parents should choose two or three things they are going to demand of the child, and nothing more, and for everything else leave the child alone — that could go out in the mass media as an appropriate way of raising children. For example, there is a very good commercial on television right now: it shows different children’s faces and the ugly faces of angry parents telling them “don’t be stupid! I wish you had never been born! I could kill you! I hate you!”, while you watch the child’s face, deeply hurt. Then comes the comment: “Don’t say things you might regret, children need affection…”

Have you heard of work going in that direction?

Yes, there is a group here that tries to influence television, it’s called the Institute for Mental Health Initiatives; they have invited me several times, they try to influence television in favor of non-violence, and I suspect that commercial is influenced by them. I would like to join them, but I have so much work!

I was thinking about something that keeps coming back to me ever since we observed the difference between the way North American families think and the way Latin American families think; one notices the tremendous influence of religion, the difference between the Catholic religion and the Protestant religion, and how completely different the kind of phenomenon it produces is.

What do you see it in?

In what Ema Genijovich, who works on this theme in New York, was telling me: how, in the Catholic family, the family is a more important value, there is acceptance of something that presents itself as “God willed it so,” acceptance of hierarchies, etc., whereas the American family has more to do with changing anything whatsoever — cancer, space, becoming president of the United States, world feats, the democracy where everyone talks at once, etc. —, and how this stems from a kind of fundamental paradigm, of ideology; it is impressive to see how a socially accepted belief system works as a self-fulfilling prophecy on a social scale.

That is why it is important to change the belief system, instead of just doing therapy all the time. If the belief system is changed, there would be less therapy to do.

Which would not suit the therapists.

Well, there is always illness, death…

Working on individual cases ends up amounting to bailing out a sinking boat with a tin can.

Exactly.

Changing the past

I wanted to ask you about the technique that consists in changing the past; I saw part of that work last year, have you developed anything further?

There is another author who actually talks about this (Whitaker, cognition…); her idea was that, in ordinary life, you tell the story of your life to your friends or your relatives with the aim of impressing them, justifying yourself or arousing sympathy, but not with the idea of changing it. In therapy, on the other hand, you tell the story of your life so that it will be changed; you tell it in the hope that the therapist will say: “No, actually it isn’t like that, that isn’t what must have happened, you should think of it differently.” So we made a comparison between Woody Allen’s film Manhattan — I don’t know if you remember, he spends the whole film trying to prevent his wife from publishing the story of his life — and a therapy by Bateson in which a couple tells him the story of their relationship so that he will change it, hoping he will change it. One way of changing the past is to say: “No, it can’t have happened like that, you have forgotten something, there must be a memory, something different that happened, because otherwise you wouldn’t be the way you are today.” Typically, a man arrives with very low self-esteem, who recounts the whole life he has lived, how he was beaten as a child, and he is told: “You must have had a grandmother or an aunt, because otherwise you wouldn’t have the qualities you have,” and then he begins to remember, he begins to reconstruct his past. Because in reality, all we have as memory is little fragments of the past that we cling to in order to construct a story that makes sense; but if you think about it, you don’t remember your whole childhood, you remember a few little scenes on the basis of which you construct the whole story. So one can think: “There must have been other scenes that aren’t remembered; if they were remembered, there might be another story.” That is one way; another way also consists in finding memorable facts, and so asking them what they remember from ten years ago; there are people who don’t remember the daily quarrels, they remember, as if in flashes, the social events, they don’t remember the sordidness of daily life, the quarrels. Then asking them why they don’t live their life in such a way as to have memories of that kind is a good way of lifting them up.

Hospitalization and medication

What do you think of the association of families of the mentally ill?

It seems to me that anyone who has done therapy with families of schizophrenics knows that the parents of schizophrenics are not the most suitable people to answer for the human rights of schizophrenics, nor to represent them politically; and what is happening here is that the parents of schizophrenics have formed an extremely powerful organization, have arrogated to themselves the right to represent the patients, and nobody has discussed whether they had that right. So they demand more hospitalization, more medication, more social isolation, more oppression, more diagnoses of schizophrenia, in order to get them out of the home so that the parents no longer have responsibility for them.

Would that be a reaction to what the first period of family therapy was?

Exactly.

But not to the current situation. And do you think the psychoeducational model plays into their hands?

Totally, the psychoeducational model is part of that. It is appalling, because strategic techniques are used to get the patient to take their medication and obey the hospital; and it’s a problem of freedom: because a person is schizophrenic, must they be forced to take medication and locked up? Why couldn’t there be more permissive environments for crazy people?

Not to mention all the non-schizophrenic people who receive this diagnosis, which is a diagnosis of incurability. There are studies, in Switzerland, according to which, after twenty-five or thirty years, 80% are normal, they normalize on their own. But the effects of the medication, the irreversible brain damage in, I believe, 50% of cases, that never heals. There is going to be an appalling epidemic here of brain damage caused by medication, which, first of all, does more harm than good.

What became of that? Because last year Jay was showing the case of a schizophrenic who was coming out of hospitalization, who was in a relationship and living with his own family. There are plenty of cases in which you have been successful. Isn’t there a convincing percentage of cases? Isn’t there enough data?

There is no data; the psychoeducational approach, on the other hand, has been very well supported financially, with data. When I saw it presented, it did not convince me, because they showed the case of a sixteen-year-old girl in psychiatric treatment who was not schizophrenic at all; she had been diagnosed as schizophrenic, she had been stuffed with drugs, and all of that was an effect of the psychoeducational approach; the poor girl was a rebellious adolescent like any other, nothing more. So this approach is very dangerous. While no two psychiatrists agree on the diagnosis of schizophrenia, they stuff them with drugs. This society has no tolerance for strange people. Many of these cases could be contained within the family, considering that you have a slightly exotic family member, like the madwoman in the attic in high-society families; it is a far more humane approach, and life there is more interesting than in the hospital.