3 ,o,r'ir,*

Rr t-.

i<u -*

erapist must, from the beginnhg, take some.sort

Theoretically, family and therapist enter thera
The family's presenceis an acknowledgment that they
want help and that they are inviting the ttrerapist, an expert, to enter
their system and help them change a situation that is maintaining or
producing stress,discomfort, or pain. In practice, however, the fannily
members and the therapist ffi&V, and usually do, differ in their under-
standing of the location of the pain, its cause,and the processof healing.
The family has generallyidentified one member as the location of the
problem. They think the causeis that individual's internalized pathol-
ogy. They expect the therapist to concentrateon that individual, work-
ist, however, the identified pa-
the cause of the problem is
the processof healingwill involve
changingthose dysfunctional family transactions.Fluctuation will have
to be amplified to move the family systemtoward a more complexform
of organization<ne that copes better with the current family circum-
stances.
, Consequently, the therapist's input m the mechanisms
within the family systdm that preservei uring the fam-
ily's common history, rules that define the- of familv mem-
28

IBY
 Joining

bers to one another have developed.Any challengeto these rules will be

countered autornatically. Furthermore, a family coming to therapy has
been struggling to resolve the problems that brought them for some
time. Their attempts to cope may have narrowed their life experience.
They tend to overfocuson the problem area,and becausethey are under
stress,they tend to overutilize familiar responses.Family membersthus
have less freedom than usual, and their capacity for exploration has
been reduced.
So family and therapist form a partnership,with a common goal that
b-mese e# hsif€ffi+ds.t€&"ts.&ee the {emibr beacerof ,$}EnaI}:
toms, to reduce conflict and stressfor the whole family, and to learn new
ways of coping. Two social systemshave joined, for a specificpurpose
and for a certain time.
Now the functions of the particitriantsin the therapeutic system must
be defined. The therapist is in the same boat with the family, but he
must be the helmsman. What are the characteristics of that helmsman?
What qualifications must he have? What implicit or explicit map of
these waters can he use to guide the craft?
The therapist does not yet know the idiosyncracies of this particular
family dance,but he has seen many family dances.He also has his own
genetic coding and his own life experience.He brings an idiosyncratic
style of contacting, and a theoretical set. The family will have to accom-
modate to this package, in some fashion or another, and the therapist
will have to accommodateto them.
In most casesthe family will accept the therapist as leader of this part-
nership. Nevertheless,he will have to earn his right to lead. Like every
leader, he will have to accommodate,seduce,submit, support, direct,
suggest,and follow in order to lead. But the therapist who has been
trained in spontaneity can feel comfortablein acceptingthe paradoxical
job of leadinga systemof which he is a member.He has developedsome
skill in using himself as an instrument of transactional change.He also
has a body of knowledgeand experiencewith families, systems,and the
processesof change.He knows that by becominga member of the thera-
peutic system,he will be subjectedto its demands.He will be channeled
into traveling certain roads in certain ways at certain times. Sometimes
he will be awareof the channeling;other times he will not evenrecognize
it. He must accept the fact that he will be buffeted by the implicit de-
mands that organizethe family members'behavior. He will tend to talk
to the central member of the family, and smile secretly at the incompe-
tence of the "schlemiel." He wilI feel the impulse to save the symptom

($6
 Family Therapy Techniques

bearer, or help in scapegoatinghim. His job as a healer requires him to

be able to join the family in this way. But he must also have the skills to
disjoin, then rejoin in a differentiated way-and there's the rub.

THERAPIST'SUSE OF SELF
There is disagreementwithin the field of family therapy on precisely
how a therapist useshimself to achievethe leadershipof the therapeutic
system.Early theoriesof therapy portrayed the therapist as an objective
data gatherer, but this myth has largely been discredited.Even io pry-
choanalysis,the understandingof the analyst's use of self in the process
of countertransferencehas sparkedgreat changesin psychoanalyticthe-
ory and practice. "It is probably true," Donald Meltzer writes, "that any
analysiswhich really taps the passionsof the patrent doesthe same for
the analyst and promotes a developmentwhich can further his own self
analysis."The necessarystate for inspired interpretation is "that type of
internal companionshipwhich promulgatesan atmosphereof adventure
in which comradeshipdevelopsbetween the adult part of the patient's
personality and the analyst as creative scientist . . . implying therapeutic
possibilitiesfor both parties to the adventure."r
Family therapists often acknowledgeonly the traditional view-sof the
psychodynamicapproachto therapy. It is interesting, therefore,to note
how closely our concernwith understandingthe therapist's use of self is
paralleled in the different paradigm of psychoanalysis.
When therapists began to see the family as a whole, their focus in
studying the therapist's use of self was tfoe,dangerthat the therapist
might be inducted into the family field to such a degreethat he would
lose therapeutic maneuverability. Lyman Wynne and others have de-
scribed the confusion and anxiety therapists experiencewhen working
with schizophrenicfamilies.2
Carl Whitaker's solution to the problem of maintaioing therapeutic
Ieverageis'to have a cotherapist:"I'don't think one therapist alonepos-
sessesthe amount of power necessaryto get in and changethe family
and get back out again , . . I don't want to stay the rest of my,life with my
finger stuck in the dike." With a cotherapist,the therapist can then solve
his "countertransferenceproblem by retreating into his relationship to
the other therapist, and the therapeutic processthen becomesa process
of the two groups relating to each other." Whitaker trusts the "we," his
cotherapist and himself, while not always trusting either of them alone;
together they have "stereoscopicvision."3 With the protection of the
cotherapist, Whitaker, whosegoal is a creative expansionfor the family

lel
 31 Joining

and for himself, enters into an intense personal involvement with the
family, accepting the family impact on the therapist as inevitable and
frequentlybeneficial.
At the opposite extreme is the Milano school, which postulatesthat
induction is inevitable whenever the therapist engagesclosely with the
family.aTo avoid induction, the therapistsinvolve themselveswith their
own group, composedof two cotherapistsobservedand supported by
two other membersof the team. The relationshipbetweenthe therapists
and family, while overtly a friendly one, is covertly an adversary rela.
ffiTshtrTft effielreFtsf,s#mffildf ifrt6Fvbltftohs-io'pFtt&iEE'ffi taiiee
I in the family, which in turn will produce behavior that the therapists
considertherapeutic. The danger that the therapists will join with the
family system and get caught in subsystemconflicts is avoided with ex-
treme care.
Somewhere toward the middle of this continuurn is Munay Bowen,
who maintains his objectivity and controls his use of self by acting as a
coach.The therapist in this position of expert is extremely central: he is
the person to whom all communicationsare directed. People are en-
couragedto talk about emotional processesrather than experiencing
them in the session The therapist strives to maintain an emotionally
calm atmosphere. What results is a ther.apeutic system quite dissimilar
from, and-lessintense than, the natural family transactions. The diluted
rules have only limited power to induct the therapist. Central but pro-
tected,the therapist conductsthe sessionvery much on his own terms.s
The authors' position on the therapist's use of self is that he must be-
come comfortable with different levels of involvement. Any technique
may be useful, depending on the therapist, the family, and the moment.
At times the therapist will want to disengagefrom the family, prescrib-
ing like a Milano expert, perhaps with a hidden agendato his program.
At other times he will take a median position, coachingh la Bowen. At
other times he will throw himself into the fray d la Whitaker, taking one
member's place in the system, allying strongly with a family underdog,
or using whatever tactic fits his therapeutic goal and his reading of the
family. There are limitations on his use of self, determined by his per-
sonal characteristics and the characteristics of the family. But within
these limits, the therapist can learn to use techniques that require differ-
ent levels of involvement.
Joining a family is more an attitude than a technique, and it is the
umbrella under which all therapeutic transactions occur. Jqping-isiet-
theranist und

t\1o
 32 Family Therapy Techniques

under his rotection can the familv have the se-

nd change.Joining is
glu ther.
How does a therapist join a family? Like the family members, the
therapist is "more human than otherwise," in Harry Stack Sullivan's
phrase.6Somewhereinside,he has resonatingchordsthat can respondto
any human frequency. In forming the therapeutic systern, aspects of
himself that facilitate the building of common ground with the family
members will be elicited. And the therapist will deliberately activate
self-segmentsthat are congruent with the family. But he will join in a I
I
way that leaveshim free to jar the family members.He will accommo-
date to the family, but he will also require the family to accommodateto
him.
The processof joining in a system goes beyond simply
"therapeutic
supporting a family. Although joining is often related fo supportive ma-
neuvers,at other times it is effectedby challengesto dysfunctional ma-
neuvers which give the family the hope that the therapist can indeed
make matters better. When a therapist like'Whitaker works with fami-
Iies with psychotic members,he frequently enters the system with the
demand that the family members accommodate to hina. This "immov-
able object" technique is a powerful joining maneuver, combining the
therapist's worldview, his understanding of the family process,and his
self-respect.Although the technique can be quite startling for observers,
it frames the therapeutic system in a way that conveysthe possibility of
help.
Since the therapist's use of himself in the therapeutic system is the
most powerful tool in the processof changing families, he needsto be
knowledgeableabout the range of his joining repertory. It will not do for
a therapist who is young and has a caressingvoice to join like an indig-
nant parent, as Minuchin sometimes does. It is important that the
therapist should use his resourceswell, not that he should imitate the
successfulexpert well. Another rule of thumb for successfuljoining is to
work with families whosestageof developmentthe therapist has experi-
enced.If he must work with situationsthat he has not experienced,join-
ing from a down position by asking for help in understanding them
would be a goodjoining maneuver,sinceit givestime for the therapeutic
system and the therapist to grow.
Like all human creations,joining is not necessarilya reasoned,delib-
erate process.Much of the joining processoccursbeneaththe surface,in
the normal processesof peoplerelating to people.It is also true that the

((t
 33 Joining

therapist's own style will be compatible with some families, with whom
he will find he can be very much himself. But in other families he may
find himself acting more boisterousthan usual, or more proper. With
somefamilies he will find himself being more verbal. With others, he will
talk less.His rhythm of speechwill change.With some'familieshe will
find himself talking more to the mother. In others,he will talk to all fam-
ily members.He should observethe changesin himself as responsesto
the family's implicit transactional patterns and should use these exter-
nal signalsas another level,of information about the family.
-+he+e+**p*e++*+ jeie fsmitbs e€'*1 di$effiE p€a*!fu*s e$"p€*i*i+y"
Specifictechniquesof joining are adapted to a close position, a median
position, and a disengagedone.

CLOSEPOSITION
In a position of proximity, the therapist can affiIiate with family mem-
I bers, perhaps even entering into coalition with soryalymberxegainst
others. Probably the most useful tool of affiliation {s c6nfirmation.}he
therapist validates the reality of holons he joins. He-E
tives and makes a point of recognizingand rewarding them. He also
identifies areas of pain, difficulty, or stress and acknowledgesthat, al-
though he will not avoid them, he will respond to them with sensitivity.
The therapist may confirm even family members he dislikes, and he
need not study the methods of Pollyanna to do so. When people like
someone,they program themselvesto attend to facets of that person
which confirm their view. The same processhappenswhen they dislike
people: they scan for negatives while ignoring positives. They shield
themselvesfrom uncertainty by focusingon those facets of a person or
group that confirm them in their own position. The structural family
therapist, knowing how people select observationsin order to reinforce
their beliefs,can direct himself to notice positives.After all, people com-
ing for therapy are doing their best, as are we a1l.
In confirming what is positive about people, the therapist becomesa
sourceof self-esteemto the family members.Furthermore, other family
members see the confirmed person in a new light. The therapist in-
creaseshis own leverageby establishinghimself as a sourceof the fam-
ily's self-esteemand status. He also amassesthe power to withdraw his
approval if the clients do not follow his lead.
Often confirmation is simply a sympathetic responseto a family mem-
ber's affective presentation of self, such aS,"You Seemto be concerned
.. . . depressed. . . angry . . . tired . . . washedout." Confirmation can also

ML
 34 Family Therapy Techniques

be a nonjudgmental descriptionof a transaction among family members,

such as, "You seem to be engagedin a continuous struggle," or, "'wtlen
you talk, he disagrees. . . grows silent . . . feels challenged."This type of'
intervention is not an interpretation. The family membersalready know
what the therapist is telling them. His statement is simply an acknowl-
edgmentthat he has gotten the messageand is willing to work with them
on the problem.
Another way of confirming is to describean obviously negative char-
acteristic of a family member while at the same time "absolving" that
person of responsibility for the behavior. To a child, the therapist might
say: "You seem to be quite childish. How did your parents manage to
keep you so young?" To an adult, the therapist could say: "You act very
dependenton your spouse.What doesshe do to keep you incompetent?"
In these techniques,the family member feels recognizedin an area of
difficulty without being criticized or made guilty about it, and he may
respond to the therapist as if personally confirmed.
Confirmation goeson throughout therapy. The therapist continually
scansfor and emphasizespositive ways of looking at the family mem-
bers' functioning while pursuing the goals of structural change. The
therapist is always a source of support and nurturance as well as the
leader and director of the therapeutic systern.
When working in proximity, the therapist must know that his freedom
of movement is being handicappedby his induction into the family sys-
tem. By functioning in proximity, he achievesintensity. But he is also a
participant caught in the rules of participation. It is important for the
therapist to be able to use himself in this modality, but it is also essential
for him to know how to disengage,after he has entered.

MEDIAN POSITION
In the median position, the therapist joins as an active, neutral lis-
tener. He helps peopletell their story. This modality of joining, which is
drilled into a therapist by the objective schoolsof dy-
is a useful way of gathering data. But it is never as
neutral and objective as the usersthink it is. And it too can hamper the
therapist's freedom of rnovement.If family members are avidly telling
their story, the therapist's attention may be locked into content. Some-
times a therapist tracks the communication of the most verbal family
members,unaware of the family life being enacted before his unseeing
eyes.
Working in the median range,the therapist can also tune into the fam-

lee
 35 Joining

ily process.If the mother is the family switchboard and the father is pe-
ripheral, the therapist may join the family first by listening respectfully
to the mother, even though his ultimate goal is to increasethe father's
power in the family.
The therapist can gather useful information about the family by ob-
serving his own way of tracking family process.Does he find himself
talking mostly to the mother? Has he neglectedto ask why the father
did not come to the session?Does he find himself feeling protective to-
ward one family member,or doeshe senseone family member as an bri-
.'-J=-
ffifiTf'THe fridi-aFisi; Ot'SeT--vifiE'
ihe* preSsurESotgerii2ifrg=fiiS n-eha-'dor,
may join by choosingto yield to those pressures.He doesnot interpret
his reactions to the family, since to do so would emphasizehis role as an
outsider, alien to the family. But he notes them to himself, both as a
t'neansof avoiding induction and as a means of becoming familiar vrith
the structure that governsthe behavior of this system's members.
The Javits family provides an example of tracking. The family came
to treatment becausethe husband,the identified patient, was depressed.
This exchangeoccurs in the middle of the first interview.

Minuchin (to mother); Do you think your houseis too much of a mess?
Mother: My house is not much of a'mess,but it could be better.
Minuchin: When your husbandthinks the houseis a mess,doeshe think
that you are not a good manager?

The therapist tracks concretely,asking,in essence,"What effect does

your behavior have on your husband'sview of you?"

Mother: Yes.
Father: Yes.
Minuchin (to mother): And can he tell you that, or does he need to
swallow it?

The tracking includes an inference about the transactional pattern

between the spousesand leads the couple to an interpersonal explora-
tion.

Mother: It varies-sometimes he can just blurt it out without its both-

ering him, and other times he keepsit in becauseI get upset when he
brings it out. It dependson whether he can cope with my being upset
at that time or not.

qEk
 36 Family Therapy Techniques

Father: I think when something like that iritates me, it builds up and I
hold it in until some little thing wil trigger it, and then I'Il be very,
very critical and get angry. Then I'll tell her that I just don't under-
stand why this has to be this way.But then I try to be very careful not
to be urueasonableor too harsh becausewhen I'rn harsh, I feel guilty
about it.
Minuchiu So, sometimesthe family feels like a trap.
Father: It's not the family so much; it's just-(/n dicates wife.\

Tracking condensesthe details of the husband's criticism into one

metaphoric statement, a "trap," which has a higher affective interisity
than feels comfortable to the mother. It forces the husband to a con-
frontation with the wife.

Minuchin (completing husband's gesture): Kit?

This simple tracking transforms a nonverbal statement into a verbal

one.

Father (looking at wifel: No, not her either. It's just the things she
doesn't do versus the things she doesin terms of how she spendsher
time. SometimesI think her priorities should be changed.
Therapisf; Kit, he is soft-pedalingmy statement.

The therapist tracks process,or the affective difference between the

first and secondstatementsby the husband,and invites the wife to com-
ment on the therapist's description of the husband'sbehavior.

Mother: About being trapped?

Minuchin: Yes, about being trapped. I think people sometimesget de-
pressedwhen they are, like your husband, unable to be direct. He's
not a straight talker. There's a tremendous amount of indirection in
your family, becauseyou are essentially very good people who are
very concernednot to hurt one another. And you need to tell white
lies a lot.

The therapist tracks by confirmation, focusing on the husband's de-

pressionin a descriptive,nonjudgmental fashion and framing a dysfunc-
tional transaction as mutual protection.

({f,
 37 Joining

Father: It isn't so much lyins as it is not saying something that should be

said.
Minuchin (to mother); And you do the samething for him.
Mother: I'm indirect?
Minuchin: Ask him?

The therapist, after joining, is in a position in which he can unjoin, by

asking the family membersto transact with eachother around the same
issue.

Mother (to husband); Am I?

Father: I don't really know. Sometimesyou seemvery direct, but I find
myself wondering if you are telling me everything about what's both-
ering you. You know, if you seem upset, I'm not always sure that I
know what's buggingyou.
Mother: That I can be upset for something like that becauseit wouldn't
upset you?
Father: Maybe that's part of it.
Mother (smiling, but ut the same time her eyesa.rewatering): Because
you always seemto know better than I do what is really upsetting me,
what my problem is at that moment.
Minuchin (to father); You see what's happening now? She's talking
straight, but she's afraid that if she talks straight, you will be hurt, so
she beginsto cry and she beginsto smile. so she'ssaying,"Don't take
my straight talk seriously, becauseit is just the product of a person
who is under stress."And that's the kind of thing you'do to eachother.
So you cannot changetoo much. Becauseyou don't tell each other in
what direction to change.

The therapist movesthe level of transactionfrom content to interper-

sonal process,keepingthe focus on the sameissue.Here the therapist is
clearly Ieading the spousesubsystemtoward a therapeutic exploration.

Father: We don't argue much.

Mother: No, we don't.
Father: Becausewhen we argue,I take a position I can defendlogically,
and that makes her feel helpless.
Mother: And I cry, and he feels helpless.
Minuchin: I want you to work on this. It's possiblethat if he can learn to
be more critical, then he doesn't need to be depressed.And it's possi-

416
 Family Therapy Techniques

ble that if you can be more critical, you won't need to cry so much.
Maybe then you can give eachother more freedom.If you can tell him
the things that bug you and he can hear it, maybe he can tell you that
he wants the house to be less of a mess.

The therapist finally takes control of the therapeutic system by re-

structuring the intervention, suggestingalternative possibilities.
This sessionshowsthe complexity of the tracking maneuvers.Track-
ing meansnot only to follow but also gently to direct explorationsof new
behavior. It means to shift levels of tracking from content, to process,
and to tie processconcretely to content. Through coaching and gentle
pushing, the therapist helps the family look at their transactions in a
new way in an atmosphereof acceptance.The tracking maneuversare
supported by confirmation techniques in which stressful transactions are
described as causedby caring. The therapist's restructuring interven-
tions are also a part of joining, since they c€ury an element of hope in
their description of alternative behavior.
Tracking demandsa knowledgeof the languagethat family members
use. Tracking young children's communications requires from the
therapist the skills of a polyglot. He needsto recognizethe different lan-
guagethat, say, a two- or four-year-olduses,and to speakit himself with
the child in the presenceof the adults in such a way that he communi-
cates also with them.
The Kuehn family is composedof the father and mother in their early
thirties, and two daughters-Patti, who is four years old, and Mimi, who
is two. The older daughter is the identified patient. Her presenting
problem is that she is "uncontrollable." In the initial interview, after the
parents have introduced themselves,the therapist talks with the identi-
ffd patient.

Minuchin: Hello, How are you?

Patti: Fine. Can we play with toys?
Minuchiu We're going to get some toys. (Kneels.)You said that your
name is Patti?
Father: Yeah.
Minuchiu Patti, what's the name of your sister?
Patti: Mimi.
Minuchin: Mimi? (Puts his thumb in his mouth like Mimi and engages
her little finger with his,) Hello, Mimi.

(e?
 Joining

Patti: Don't pick her up. Don't pick her up. Don't pick her up. Do you
know why?
Minuchin: Why?
Patti:'Cause she has a sorearm.
Minuchin: She has a what?
Patti: She has a sore arm becauseshe fell out of her crib.
Minuchin (pointing); Which arm-this one, or this one?
Patti: Which one Mommy?
Mother: The left one. Which one is that?
'tutti'@in* Stlis aune;right?
Mother: Um-hum.
Patti: This one. She crackedher-ah- (Looks ut rnother.\
Mother: Collar bone.
Patti: Collar bone.
Minuchin: Oh, my goodness!
Do you know why? She fetl out of her port-a-crib
Patti: It went ka-barrr.-!
again.
Ivlinuchin (to parercfs):Let's share that ashtray, so we need to sit to-
gether.
Father: Okay.

The therapist usestwo maneuvers here that are important when one
works with small children. One maneuver is related to size. The thera-
pist kneels in order to be at the sameheight as the child with whom he is
talking. The other maneuver is related to the appropriate level of lan-
guage.Talking with four-year-old Patti, the therapist is concretein his
communication, asking her name and the name of her sister, and then
pointing to both of Mimi's arms in his request for information. By ques-
tioning Patti, he assignsher a competentposition as the personwho re-
sponds and the older member of the sibling subsystem.With the two-
year-old, his communication is at the motoric level. He says hello by
hooking his finger to the girl's, putting his thumb in his mouth to mimic
the girl, and making facial expressionsthat she mimics.
In joining this family with very youngchildren,the therapist starts the
sessionby establishing contact through the children. This is contrary to
an approach used with families of school-ageand older children, where
the therapist would start by establishingcontact with the executivesub-
system. In families with preschoolers,it is possiblefor the therapist to
contact the family in a playful, nonverbal language.This strategy intro-

,\tL
 Family Therapy Techniques

duces a relaxation, becausethe therapist presents himself as an au-

thority who plays with children and contacts the adults as parents.

DISENGAGEDPOSITION
The therapist can also join with a family from a disengagedposition.
Now he useshis stanceas an expert,creatingtherapeuticcontextsthat
bring family membersa senseof competence,or hope for change.He
functions not as an actor, but as a director. Perceivingthe patterns of the
family dance,the therapist createsscenarios,facilitating the enactrnent
of familiar movementsor introducing novelty by forcing family rnembers
to engagewith eachother in unusual transactions.These techniquesare
changeproducing, but they are also methods of joining which increase
the therapist's leadership,since he is experiencedas the arbiter of the
session'srules.
As an expert, the therapist monltors the family's worldview. He ac-
cepts and supports some family values and myths. Others he avoids or'
deliberately ignores.He learnt how family membersframe their experi-
ence that "We are the Smith family; we should behave in such a fash-
ion." He pays dttention to the communicationalpatterns that express
and support the family experience,and he extracts the phrasesthat are
meaningful to this family. He can use these phrasesas a joining maneu-
ver either to support the family reality or to construct an expanded
worldview that will allow flexibility and change.

PROBLEMS
It may happen that a therapist needsto work with peoplewhom he
cannot easilyjoin becausethey have a different value systemor political
ideologyor different styles of contacting or just simply a different chem-
istry. If the therapist is in a situation in which he can refer the patient to
a colleaguervhomhe considersa better match for the family, that is the
best solution.But frequently this is not possible,and the therapist rnay
find that he becomesmore challengingand less effective.The result of'
his interventionsmay be more confrontationand a senseof helplessness
shared by both family and therapist.
The therapist should then remind himself that it is simply impossible
for this family to be absolutelydevoid of qualities that he shares.It rnay
be difficult to find them, but they have to be there. The problem is just
that the therapist is not sufficiently motivated to look for thern.
Minuchin oncereferred to a colleaguea family whoseyoung adult son
was a drug addict. The identified patient was dependent,selfish,self-

t{3
 47 Joining

indulgent, iresponsible-the list could go on and on-and he elicited in

my colleaguehelplesscontrolling responses.In a short consultation at
somepoint, I askedthe therapist if he knew that this patient was a very
good poet. He was startled by the realizationthat he could not conceive
this possibility.
Whenever a therapist can be helpful to a patient, he also likes that
patient, so the trick is to find a way to be helpfi.rl.If the therapist solves
that problem just once,the dfficulty in joining will disappear.
Joining with a child abuse family presents a particularly difrcutt
@'s tmsaedi*e=res+Feffie'rnaSrd'foe-,te si+s virifr
the battered child, communicatinghis senseof outrageto the adults re-
sponsible.The same problem occurs with families who are psychologi-
cally abusingtheir children, restricting their development,or expecting
behavior inappropriate to the child's developmentallevel. But in order
to change the situation, the therapist must join with the system as a
whole. The parents,too, must feel his support,as he will needtheir coop-
eration to work with the family. Finally, it behoovesthe therapist to look
carefully at the role that the injured member plays in the maintenance
of the system as a whole.
The Morris family consistsof a mother, father, and eight-year-oldson.
The family was referred from a children's hospital becausethe parents
abusedtheir child. On one occasionthey beat the boy so badly that he
required hospitalization. As the mother speaks,the boy is sitting slightly
outside the family circle. He is crying and looking at the floor.

Mother: Johnny is impossible to manage! He absolutely ruined

Christmas for me and my husband.
Minuchin (to mother); It must have been terrible for you to have your
Christmas ruined. How did your son do that?

The therapist is forcing himself to act againsthis own inclinations. It

would give the therapist great pleasure at this point to tell the mother
exactly what he thinks of peoplewho mistreat children. But if this child
is not to be removed from his parents-which is always a chancy solu-
tion-family changeis his best hope.In order to achievethat change,the
therapist must keep the family in therapy. This can be done only by
creating a therapeutic system in which the parents feel supported and
understoodbeforethere is any challenge.Furthermore, for the therapist
to support the child at the beginning would leave the boy even more
vulnerable to abuse.Whatever coursetherapy may eventually take, the

3.oo
 42 Family Therapy Techniques

first step is to join with the family experience,tracking their perception

of the problem and sympathizingwith them over their ruined Christmas.
Chronic disputes displayed in an embattled dyad present special
problems in joining, especiallybefore the therapist has achieveda learl-
ership position in the therapeutic system.To take sidesis to alienate thLe
other person;to take neither side createsthe risk of letting the conflir:t
continue out of control, increasing the conflicting members' sense of
hopelessness.
If he can, the therapist may take a distant position and wait until the
storm subsides.But sometimeshe will have to plunge into an unbalanr:-
ing technique, joining with one member against the other, and hoping
that it will not keep the family from coming again to the next session.In
another situation, he may decide that the best strategy of joining is t;o
challengeboth members' behavior on the groundsthat better function-
ing has to be possible.
In the first sessionwith an embattled couple, the therapist may saly,
"You are right," to the wife and, to a promptly irate husband,"You ale
right as well." Then he continues,"But the payment for being right and
righteous is to maintain a miserablelife together." While not a soft join-
ing maneuver,this challenge("a pox on both your houses")conveysthLe
therapist's senseof commitment to the couple.

A CASEEXAMPLE
The Bates family is composedof father, mother, and Bud, age l'4,
Bud's two sisters,ages28 and 24, having married and left home. Bud is
truanting, smoking pot, and feeling depressed.He was admitted to thre
day hospital, but he arrives late each morning, saying that he cannot
motivate himself. The next sessionis conductedas a consultation.

Minuchin; The hospitalinvited me to meet with you to seeif I can be of

help. So I will be available to you for this next hour. Can sorneof you
begin to tell me what are the issuesthat you have at this point?

The therapist beginsby taking the stanceof an expert. He invites thLe

family to use his expertise:"I will be availableto you for this next hout,"

Mother: Our big problem right now, as it was when we came here, is
Bud's reluctanceto get out of bed in the morning, to be where he's
supposedto be. Right now he should be here at nine-thirty in thre

"2c1
 43 Joining

morning.It isn't just gettinghim out of bedfor clinic, it's for anything
that he has to do. When he was goingto regularschool,he wouldn't
get up.
Minuchiu TelI me, Bud, are you a night person?Do you stay up late?
Bud: Twelveor twelve-thirty.
Minuchin; Un-huh,soit's easierfor you to beawakeat night.You know,
therearepeoplewho aremorningpeopleandtherearepeoplewho are
Iate people.You wouldsay that you are more of a night person.You
are morealive,more awake,more readyto do thingsin the evening?

When the mother plunges into a description of Bud's problem, the

therapist intemrpts her by turning to the identifiedpatient. Becausethis
doesnot follow the normal rules of courtesy,it is perceivedas the action
of an authority. His statementto Bud normalizesthe problem: "You are
more of a night person."

Bud: Not real late. It's just in the morning that I don't feel like doing
anything.
Minuchin: But that meansthat you feel more active in the evening.
Bud: No, I feel active all day, but-
Minuchin: If you had a good alarm clock, that would solve it?
Bud: Well, the alarm clock I've got now-
Minuchin: Who is the alarm clock?
Bud: Well, I've got one of my own.
Minuchin: Do you have'an alarm clock, or is mother an alarm clock?

Joining Bud by tracking what he is saying and normalizing the prob-

Iern, the therapist shifts gears, introducing a metaphor of proximity,
which implies that proximity is linked to the symptom. The therapist
has noticed that Bud is sitting close to his mother, and they are ex-
changing various nonverbal signals. Humorously, and very gently, he
challengesthe mother-sonholon.

Bud: I've got one.

Mother: And I've got one.
Minuchin; Are you certain she'snot an alarm clock, Bud?
Bud: Yes.
Minuchiu Who wakesyou up?
Bud: She doesmost of the time.

f,oL
 44 Family Therapy Techniques

Minuchin: So, she'syour alarm clock.

Mother: If you want to call it that.
Minuchin: Okay, so you have a function. You a.rean alarm clock!

In a light, bantering fashion, the therapist confirms the mother and

tracks Bud. At the same time, her relationship to her son is called into
question.

Mother: weII, at the present time, we have two alarm clocksin his bed-
room-
Minuchin: And theY don't work?
Mother: And me.

The mother joins the theraPist.

Minuchin: That means, maybe, you could put on a third alarm, stag-
gered,,like one at seven-thirty, one at seven-forty,one at seven-ffiy'
Mother: That's how I work it now.
Minuchin; My goodness!You must be a very deep sleeper,Bud.
Bud: Yeah.
Minuchin; I got up today at four o'clock in the morning. I couldn't sleep.
I wish I could get your symptom. If your three alarm clocks don't
work, you can sleep until twelve o'clock, one o'clock, two o'clock-
what's the latest that you have been able to keep sleeping?
(Bud. Iooksat mother.) Don't ask her. That is not her function. she's
an alarm clock. Is she also a memory bank?

The therapist, who is an incurable storyteller, interprets the syrnptom

to
as a good thing by commenting on his own insomnia' He also begins
monitor the proximity of mother and son. Joining and restructuring are
moving rather fast in this segmentbecausethe therapist's own senseof
comfort tells him that he is in the permissiblerange' So far the session
has focusedon concretebehavior and on small transactionsthe family
feels comfortable with. Now the therapist contactsthe silent father.

Minuchin; I bet you wish you had that capacity.when do you wake up?
Father: Me? Quarter to five, five o'clock. (Looks at wife.)
Mother (nodding): Yeah.
Father: Five o'clock.

lob
 45 Joining

Minuchin: Five o'clock in the morning? Is your wife the memory bank in
the family? Becausenot only did Bud look at her for inforrnation,
but you alsojust looked at her.

The therapist, joining all three family members,is already creating a

focus that will organizethe rest of the session.The content is daily life,
and the tone is as light as a chat about the weather.Nevertheless,to the
family, the therapist is a sorcerer:he is an expert who understandsthern.

Fttfter: Yeah.
Minuchin: She is a very busy person.She is an alarm clock and a mem-
ory bank, (To father.) When do you go to work?
Father: I leave about a quarter to six, six o'clock.
Minuchin; What's your shift?
Fq,ther: Sometimes six, sometimes seven to four-thirty, five-thirby. It
could be any time around the clock.
Minuchin: You work ten hours then?
Father: Sometimesten, sometimeseleven,sometimeseight. Most of the
time it's nine.
Minuchin: Does that give you overtime?
Father: Yeah.
Minuchin: So, when you work ten hours, you are pleasedthen because
you have a couple of hours overtime. What kind of work do you do?
Father: I am a foreman in an electronics shop. We do circuits, printing.
Minuchin: That means you must have been working there for many
years to becomea foreman.
Father: Thirty years.
Minuchin; Thirty years! How old are you now?
Father: Fifty.
Minuchin: You started at twenty and you worked all the tirne in one
job?
Father: Um-hum.
Minuchin: So you certainly have seniority at this point.
Father: Yeah.
Minuchin: How many people anein the shop?
Father: Seventeen.
Minuchin; And how many foremen?
Father: Two, but the other foreman has not been there quite as long as
me.

rOv
 46 Family Therapy Techniques

Minuchin; So, you are securein that job.

Father: Oh, yeah.

The therapist tracks the father, getting neutral information frorn him
by asking concretequestionsto maintain contact. Now the therapist will
make a conceptual jump, connecting the information with the son's
symptom.

Minuchin: So, we have a person like you who knows about time, and
knows about schedules,and knows about responsibility. You have
worked all your life?
Father: Um-hum.
Minuchin; How is it you got a kid that doesn'tknow about time, doesn't
know about schedules,doesn't know about motivation? How did you
managethis?
Father: I don't know. That's what we can't figure out.
Minuchin; Something failed.
Father: Yeah.

The therapist and father have joined in their interest in the father's
work. Now the therapist connectsthe symptom to the father's failure in
modeling. But his formulation is that "something"-no1 someonF
failed. The father agreesimmediately; he and the therapist are partners
in a goal-directedactivity.

Minuchiu Maybe you gave him the wrong model. Maybe he doesn't
want to be like you.
Father: Could be.
Minuchin: Maybe he feels you work too hard and-what do you think?
(To Bud.) You don't want to be like Father?
Bud: Yeah, I'd like to be like him.
Minuchin: To work thirty yearsin the samejob, always from six to four,
would you like that?
Bud: Yeah.
Minuchiu Most young people like you look at the old man and say,
"That's not the life for me." You really would like to be like him?
Bud: Yes, I want to work in the sameplace he does.
Minuchiu You would like to work in the same place? Have you been
there with him?
Bud: Yeah. (Mother nods agreement.)

frtr
 47 Joining

Minuchin: You see,not only do you look at Mother and you activate her,
but evenwhen you don't look at Mother, sheactivatesherself.(Euery-
one laughs.) I askedyou, and you said, "yes," and she said, .,yes.',
You know, she'swired to you people.(To Mother.) Are you so wired
that if he answers,you say it?
Mother: I guessso, yeah.

The therapist has been tracking content when suddenly a small, non-
verbal transaction provides data that supporf his focus, and he shifts
hpck.tsa-roefaFh aI. oflpresinaity. Thc :i$,Ei+&gll-sd#. i+ms#eae +ha+
the therapist normally uses;its selectionhere is related to the father's
job, and it indicates that the therapist is accommodatingto the family
language.

Minuchin; Extraordinary! Isn't that wonderful, with farnilies, how they

get wired?
Father: That's true.
Minuchin: Great! That meansthat Bud did not look at Mother. I know,
becauseyou were looking at me. Beautiful. So there are someinvisible
wires that run from you to Mom. You can hear vibes?
Mother: Um-hum.

The therapist's description of overinvolvementis presentedas an ex-

traordinary feat and something positive a family organisrn is able to ac-
complish.

Minuchin: Have you always been like that, wired to people?

Mother: Well, I guessso, yeah. BecauseI've alwaysbeen responsiblefor
people'
Minuchin; so, you two are very responsiblepeople, really. you (to fa-
therl are very responsibleto your job, and you (/o mother'yare very
responsibleto the family. Is that the way in which you divide the
work? Your responsibility is to provide for the family, and your re-
sponsibility is to care for the kids?

The therapist confirrns both parents, emphasizingpositives. Never-

theless,he is preparing to use the behaviorhe has just praised as a field
of challenge.

Mother: Yeah.
Father: Um-hum.

?o6
 48 Family Therapy Techniques

Minuchin; And this has worked?

Mother: Up to this point, fine.
Minuchin; How many years have you been married?
Mother: We were married thirty years, and we have two other children
besidesBud-two married daughters.
Minuchin (to Bud): You are the only boy in the family, and you are the
youngest.How old are your other sisters?
Bud: oh, Lana's about twenty-I don't know if it's twenty-five-(Bud
looks at father, but mother supplies the answer.)
Mother: Twenty-eight and twenty-four.
Minuchin (to Bud): You operateboth of them! Very good.Now that was
beautiful, becauseBud looked at Dad and activated him, and Mother
activated herself. Beautiful. Very invisible, but very strong wires. So,
twenty-eight and twenty-four. Your younger sister is really rnuch
older than you are. How long will you be the baby? Until you are b0?
or until you are 20?r don't know, somefamilies keep babiesfor a long
time.

Again, humor challengesthe enmeshmentwhile supportingthe family

member. The challengeis possiblebecausethis family feels quite com-
fortable with the light, bantering mood. By now, therapist and family
seemto have been friends for vears.

Bud: I don't know.

Minuchin: Ask your mother how long you will be the baby.
Bud: How long?
Mother: Until you grow up.
Minuchin: Ah, that can be a lifetime. You can be 70 yearsold and still be
the baby. You know, check to seewhat she meansby that. How long
will that take? Check up. You know, mothers have specialarithmetic.
Check up with your mother about what is her arithmetic. How long
will you be the baby?
Mother: How Iong will you be the baby? Until you accept responsibil-
ities, which I'm willing to give you, but you have to acceptthem. And
when you acceptthe responsibilityfor yourself,then I would consider
you grown.
Minuchin (to Bud): Do you agreewith that? It is only up to you to grow
up?
Bud: Why €ueyou putting all the responsibility on rne?

{p+
 49 Joining

Mother: Becauseit's yotu life. I am willing to guide, but I would like you
to assumethe responsibility.
Minuchin: Bud, I know peoplewho are wired like your mom is to you-
so closely wired that you don't get too much space.In other famili'es,
people who are wired as you are wired keep young for a long time.
the
Twenty minutes into the session,the therapist and family are con-
lud nected and working at therapy together. In the rest of the session,the
therapist electsto focus on the father. He explainsthat he is concerned
'and that
abert the mether: sfie is toc ready ffi be avadable to petryIe,
vas cannot be good for her. She is too wired to others; the father must pro-
her vide the wire cutters that will rescueher. The family finishes the session
So, with a senseof directiorr; the therapist finishes it with the sensethat he
rch has been genuinelyhelpful to peoplehe likes.
50? Joining is not a technique that can teally be separatedfrom changing
)ng a family; the therapist'sjoining changesthings. Nor is it a processcon-
fined to one part of therapy. Joining is an operation which functions in
counterpoint to every therapeuticintervention. The therapist joins and
rily joins again many times during a sessionand during the course of ther-
)m- apy.
rily The deliberation of joining decreases,however, as therapy continues.
Early in therapy, the threrapistand family must concentrate on accom-
modating to each other and to the therapist's role as the leader.But as
time goes on, these accommodationsbecome more automatic. The
therapist no longer has to think about joining, He can trust the patter:ns
of the therapeutic system to alert him if the accomrnodationswithin t;he
system need attention.
lbe Employing joining techniques,as with other therapeutic techniques,
)ng can make a therapist feel like the centipede who was immobilized by
,tic. having to decidewhich leg to move.But the therapist's effectivenessde-
lng pendson his capacity to join while challenging.Expanding his repertory
will ultimately make hirn a better therapist. And once he has becornean
bil- expert reader of family feedback,the therapist will again be able to be
\nd sponraneous,confident that his behavior falls within the therapeutic
der system'sacceptedrange.

:ow

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