Salvador Minuchin On Family Therapy: Instructor'S Manual

Instructors Manual
for
Salvador Minuchin
on family THERAPY
with
salvador minuchin, PhD

and jay lappin, lcsw
Manual by
Ali Miller, MFT
SALVADOR MINUCHIN ON FAMILY THERAPY WITH SALVADOR MINUCHIN, MD, & JAY LAPPIN, LCSW
The Instructors Manual accompanies the DVD Salvador Minuchin on Family

Therapy with Salvador Minuchin, MD, and Jay Lappin, LCSW (Institutional/
Instructors Version). Video available at www.psychotherapy.net.
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Miller, Ali, MFT

Instructors Manual for Salvador Minuchin on Family Therapy with Salvador
Minuchin, MD, and Jay Lappin, LCSW
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Instructors Manual for

SALVADOR MINUCHIN ON FAMILY
THERAPY WITH SALVADOR MINUCHIN, MD,
AND JAY LAPPIN, LCSW
Table of Contents
Tips for Making the Best Use of the DVD 4
Salvador Minuchin: A Brief Biography 5
Structural Family Therapy 8
Reaction Paper Guide for Classrooms and Training 11
Related Websites, Videos, and Further Readings 12
Discussion Questions 14
Video Transcript 18
Video Credits 44
Earn Continuing Education Credits for Watching Videos 45
About the Contributors 46
More Psychotherapy.net Videos 47
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Tips for Making the Best Use of the DVD

1. USE THE TRANSCRIPTS
Make notes in the video Transcript for future reference; the next time
you show the video, you will have them available. Highlight or notate
key moments in the video to better facilitate discussion during and after
the video.
2. FACILITATE DISCUSSION
Pause the video at different points to elicit viewers observations and
reactions to the concepts presented. The Discussion Questions section
provides ideas about key points that can stimulate rich discussions and
learning.
3. ENCOURAGE SHARING OF OPINIONS
Encourage viewers to voice their opinions; no therapist is perfect! What
are viewers impressions of what was discussed in the video? We learn as
much from our mistakes as our successes; it is crucial for students and
therapists to develop the ability to effectively critique the work of other
therapists as well as their own..
4. SUGGEST READINGS TO ENRICH VIDEO MATERIAL
Assign readings from Related Websites, Videos, and Further Reading
prior to or after viewing.
5. ASSIGN A REACTION PAPER
See suggestions in the Reaction Paper section.
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Salvador Minuchin (1921 ):

A Brief Biography*
The eldest of three children born to the children of Russian-Jewish
immigrants, Salvador Minuchin was born and raised in a closely
knit small Jewish community in rural Argentina. His father had
been a prosperous businessman until the Great Depression forced his
family into poverty. In high school, he decided he would help juvenile
delinquents after hearing his psychology teacher discuss the philosopher
Jean-Jacque Rousseaus ideas that delinquents are victims of society.
At age 18, Minuchin entered the university as a medical student. In
1944, as a student, he became active in the leftist political movement
opposing the dictator Juan Peron, who had taken control of Argentinas
universities. Minuchin was jailed for three months. Upon graduation
in 1946, he began a residency in pediatrics and took a subspecialty in
psychiatry. In 1948, as Minuchin was opening a pediatric practice, the
state of Israel was created and immediately plunged into war. He moved
to Israel and joined its army, where he treated young Jewish soldiers who
had survived the Holocaust.
Minuchin came to the United States in 1950 to study psychiatry. He
worked with psychotic children at Bellevue Hospital in New York City
as a part-time psychiatric resident. Minuchin also worked at the Jewish
Board of Guardians where he lived in its institutional housing with 20
disturbed children. His training there was psychoanalytic, which did
not seem compatible with his work with the children.
Minuchin married Patricia Pittluck, a psychologist, and emigrated
to Israel in 1951. There he co-directed five residential institutions for
disturbed children. Most of them were orphans of the Holocaust and
Jewish children from Asia and the Middle East. Here, he first began to
work therapeutically with groups instead of individuals.
Between 1954 and 1958, Minuchin trained at the William Alanson
White Institute of Psychoanalysis in New York City. He went there
because the Institute supported the ideas of Harry Stack Sullivan,
who created interpersonal psychiatry and stressed the importance of
interpersonal interaction. As he was training there, he began practicing
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family therapy at the Wiltwyck School for Boys, a school for troubled
youth and juvenile delinquents. Slowly, he began to believe that he
needed to see a clients family. In his experience, seeing them alone, as
per psychoanalysis, was not an effective treatment technique.
Minuchin and a number of other professionals began working as a
team to develop approaches to family therapy. These youths at the
Wiltwyck School and their families tended not to be very introspective,
so Minuchin and his team focused on communication and behavior,
and developed a therapy approach in which the therapist is very active,
making suggestions and directing activities.
In 1965, Minuchin, his wife, and their two children moved to
Philadelphia, where he became, at the same time, Director of Psychiatry
at Childrens Hospital of Philadelphia, Director of the Philadelphia
Child Guidance Clinic, and Professor of Child Psychiatry at the
University of Pennsylvania School of Medicine. During this time,
he began working therapeutically with children with psychosomatic
illnesses. Research with these children and families indicated that
family therapy could help these patients improve, and that maladaptive
family patterns were partly to blame for these illnesses.
During the 1960s and 1970s, Minuchin became interested in the larger
social world in which families are embedded. He and his group started
studying communities and social service agencies. In one project, he
and his colleagues, under an intensive program, trained minorities from
the community to be family therapists.
Minuchin and his colleagues, as well as a number of other groups,
struggled to understand family dynamics. He explored what other
family therapists and colleagues in the social sciences were doing, and
drew on those that seemed to work. He found Gregory Batesons systems
theory (a system is comprised of interdependent parts that mutually
affect each other) to go a long way in explaining family dynamics.
Minuchin also drew on the ideas of Nathan Ackerman, a child analyst
who began to look at the interpersonal aspects of the family unit, and
the ways individual behavior relates to that unit.
In 1975, Minuchin retired from his position as Director of the
Philadelphia Clinic. He then served as Director Emeritus of the Clinic
from until 1981m at which time he established Family Studies, Inc., in
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New York City, an organization to teach family therapists. Minuchin

left the University of Pennsylvania, Philadelphia in 1983, when he joined
New York University School of Medicine as a Research Professor. He
retired in 1996 and currently lives in Boca Raton, Florida.
Minuchin has contributed to numerous professional journals and
coauthored numerous books, many of which explore the effects of
poverty and socials systems on families.
* Adapted from Marie Doorey: http://psychology.jrank.org/pages/425/
Salvador-Minuchin.html
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Structural Family Therapy*

Structural Family Therapy (SFT) is a model of treatment that was
developed primarily at the Philadel-phia Child Guidance Clinic under
the leadership of Salvador Minuchin. Based on systems theory, the
models distinctive fea-tures are its emphases on structural change as
the main goal of therapy and on the therapist as an active agent in the
process of restructuring the family.
Structural Family Therapists strive to enter or join the family system
in therapy in order to understand the invisible rules that govern its
functioning, map the relationships between family members or between
subsets of the family, and ultimately disrupt dysfunctional relationships
within the family, causing it to stabilize into healthier patterns.
Family Rules
In SFT, family rules are defined as an invisible set of functional
demands that persistently organizes the interaction of the family.
Important rules for a therapist to study include coalitions, boundaries,
and power hierarchies between subsystems.
According to Minuchin, a family is functional or dysfunctional
based upon its ability to adapt to various stressors (extra-familial,
idiosyncratic, developmental), which, in turn, rests upon the clarity
and appropriateness of its subsystem boundaries. Boundaries are
characterized along a continuum from enmeshment through semi-
diffuse permeability to rigidity. Additionally, family subsystems are
characterized by a hierarchy of power, typically with the parental
subsystem on top vis--vis the offspring subsystem.
In this model, healthy families are comprised of parent-children
boundaries that are both clear and semi-diffuse, allowing the parents to
interact together with some degree of authority in negotiating between
themselves the methods and goals of parenting. From the childrens side,
the parents are not enmeshed with the children, allowing for the degree
of autonomous sibling and peer interactions that produce socialization,
yet not so disengaged, rigid, or aloof, ignoring childhood needs for
support, nurturance, and guidance. Dysfunctional families exhibit
mixed subsystems (i.e., coalitions) and improper power hierarchies,
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as in the example of an older child being brought in to the parental

subsystem to replace a physically or emotionally absent spouse.
Therapeutic Goals and Techniques
The basic goal of Structural Family Ther-apy is the restructuring of the
familys system of transactional rules, such that the interactional reality
of the family becomes more flexible, with an expanded availability of
alternative ways of dealing with each other. By releasing family mem-
bers from their stereotyped positions and functions, this restructuring
enables the system to mobilize its underutilized resources and to
improve its ability to cope with stress and conflict. Once the constricting
set of rules is outgrown, in-dividual dysfunctional behaviors, in-cluding
those described as the presenting problem, lose their support in the
system and become unnecessary from the point of view of homeostasis.
When the family achieves self-sufficiency in sustaining these changes
without the challenging support of the therapist, therapy comes to an
end.
To accelerate such change, Structural Family Therapists manipulate
the format of the therapy sessions, structuring desired subsystems
by isolating them from the remainder of the family, either by the
use of space and positioning (seating) within the room, or by having
nonmembers of the desired substructure leave the room (but stay
involved by viewing from behind a one-way mirror). The aim of such
interventions is often to cause the unbalancing of the family system, in
order to help the family to see the dysfunctional patterns and remain
open to restructuring.
In the interview on this DVD, Minuchin discouraged too much
emphasis on techniques. Still, over the course of many years, Structural
Family Therapists have developed and adapted a variety of techniques
to help themselves carry out their function as pre-scribed by the model.
Some of these techniques are briefly described below:
Joining is the process of coupling that occurs between the
therapist and the family, which leads to the formation of the
therapeutic system. In joining, the therapist becomes accepted as
such by the family, and remains in that position for the duration
of treatment. Although the joining process is more evident
during the initial phase of therapy, the maintenance of a working
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relationship to the family is one of the constant features in the

therapists job.
Reframing is putting the presenting problem in a perspective
that is both dif-ferent from what the family brings and more
workable. Typically this involves changing the definition of the
original complaint, from a problem of one to a problem of many.
The reframing attitude guides Struc-tural Family Therapists
in their search for structural embeddings for individual
problems. Within such a frame, the therapist can request from
the family members the enactment of alternative transactions.
Enactment is the actualization of transactional patterns under
the control of the therapist. This technique allows the thera-
pist to observe how family members mutually regulate their
behaviors, and to determine the place of the problem behav-
ior within the sequence of transactions. Enactment is also the
vehicle through which the therapist introduces disruption in the
existent patterns, probing the systems ability to accommodate
dif-ferent rules and ultimately forcing the ex-perimentation of
alternative, more func-tional rules. Change is expected to occur
as a result of dealing with the problems, rather than talking
about them.
It is important to keep in mind that the Structural Family Therapy
model is not just a cluster of techniques with specific indications, but
rather a consistent way of thinking and operating, derived from the
basic tenet that human problems can be understood and treated only in
context.
*Adapted from Wikipedia and Jorge Colapintos article, Structural
Family Therapy, on his website: www.colapinto.com, and originally
published in Arthur M. Horne and Merle M. Ohlsen (eds.) Family
Counseling and Therapy. Itasca, Illinois: F. E .Peacock, 1982.
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Reaction Paper for Classes and Training

Video: Salvador Minuchin on Family Therapy with Salvador
Minuchin, MD and Jay Lappin, LCSW
Assignment: Complete this reaction paper and return it by the
date noted by the facilitator.
Suggestions for Viewers: Take notes on these questions while
viewing the video and complete the reaction paper afterwards.
Respond to each question below.
Length and Style: 2 to 4 pages double-spaced. Be concise. Do NOT
provide a full synopsis of the video. This is meant to be a brief
response that you write soon after watching the videowe want
your ideas and reactions.
What to Write: Respond to the following questions in your reaction
paper:
1. Key points: What important points did you learn about Minuchin
and Structural Family Therapy? What stands out to you about how
Minuchin works?
2. What I found most helpful: As a therapist, what was most
beneficial to you about the approach presented? What tools or
perspectives did you find helpful and might you use in your own
work? What challenged you to think about something in a new
way?
3. What does not make sense: What principles/techniques/
interventions did not make sense to you? Did anything push your
buttons or bring about a sense of resistance in you, or just not fit
with your own style of working?
.5. How I would do it differently: What might you do differently from
what Minuchin described in the interview? Be specific about what
different approaches, interventions and techniques you would or
do apply in working with families.
6. Other Questions/Reactions: What questions or reactions did
you have as you viewed the video? Other comments, thoughts or
feelings?
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Related Websites, Videos, and

Further Reading
web Resources
The Minuchin Center for the Family
www.minuchincenter.org
Philadelphia Child and Family Therapy Training Center
www.philafamily.com
Jay Lappins website
www.jaylappin.com
Website of Jorge Colapinto, with several articles on Structural Family
Therapy
www.colapinto.com
Related Videos Available at

www.psychotherapy.net
Structural Family Therapy, with Harry J. Aponte
Family Therapy with the Experts10-DVD Series
Family Systems Therapy, with Kenneth V. Hardy
The Legacy of Unresolved Loss: A Family Systems Approach, with Monica
McGoldrick
Recommended Readings
Lappin, J. (1988). Family therapy: A structural approach. In R.A. Dorfman
(Ed). Paradigms of clinical social work. New York: Brunner/Mazel.
Minuchin, S. (1974). Families and family therapy. Cambridge, MA:
Harvard University Press.
Minuchin, P., Colapinto, J., & Minuchin, S. (2006). Working with families
of the poor (2nd ed.). New York: Guilford Press.
Minuchin, S. & Fishman, H. C. (2004). Family therapy techniques.
Cambridge, MA: Harvard University Press.
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Minuchin, S., Lee, W.Y., & Simon, G.M. (1996). Mastering family therapy:
Journeys of growth and transformation. Hoboken, NJ: John Wiley
and Sons, Inc.
Minuchin, S., Montalvo, B., Guerney, Jr., B. G., Rosman, B.L., & Schumer,
F. (1967). Families of the slums: An exploration of their structure
and treatment. New York: Basic Books.
Minuchin, S. & Nichols, M.P. (1998). Family healing: Strategies for hope
and understanding. New York: Free Press.
Minuchin, S., Nichols, M.P., & Lee, W.Y. (2006). Assessing families and
couples: From symptom to system. Boston: Allyn & Bacon.
Minuchin, S., Rosman, B.L., & Baker, L. (1978). Psychosomatic families:
Anorexia nervosa in context. Cambridge, MA: Harvard University
Press.
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Discussion Questions
Professors, training directors, and facilitators may use some or all of
these discussion questions, depending on what aspects of the video are
most relevant to the audience.
EARLY INFLUENCES
1. Being an Other: How did you react when Minuchin spoke about
the impact of being a Jew in an anti-Semitic country and how
he developed a sense of being the Other? Are there ways you
experience yourself as the Other? If so, how? How do you think
your experiences of being the Other might have impacted or
continue to impact your life, particularly your work as a therapist?
2. Social justice: What came up for you as you listened to Minuchin
discuss his interest in social justice? Is this an interest you share?
If so, how does your interest in social justice manifest in your
life? Does it impact your therapeutic work at all? How? Do you
agree with Minuchin that it was a na_ve mistake to think that
therapy could be a vehicle for social change? Why or why not?
3. Low socioeconomic status: Do you have a particular interest,
like Minuchin, in working with families with a low socio-
economic status? If so, why are you drawn to this particular
population? Can you talk about some of the rewards and
challenges of working with this population? If you are drawn
more to working with a different population, talk about why.
INVENTING FAMILY THERAPY

4. Its not working: What reactions did you have as Minuchin
spoke about his process of developing family therapy, and how
it sprang out of the sense that the psychodynamic work that he
was doing at the Wiltwyck School for Boys was not working?
Does it make sense to you why family therapy would be more
helpful than psychodynamic psychotherapy for these delinquent
boys from Harlem? If so, can you articulate why? Have you ever
considered inventing your own therapy modality, particularly
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when youre not seeing the change in your clients that youd
like to see? If so, what would your new approach look like?
5. Pivotal moment: What were your reactions when Minuchin spoke
about a pivotal moment in the development of his approach
the moment in which we realized that in order to join, we needed
to change, and that the process of joining was a process of
learning how they talk, and beginning to talk in a modality that
they could understand? Do you believe that it is important to
adjust your way of talking in order to join with a client? Why
or why not? Can you share about a case in which you changed
something about yourself in order to join with your client?
6. The one who knows: What did you think of Minuchins statement
that in order for the mother to feel competent, the therapist should
be incompetent and take a down position? What do you think
he meant by this? Do you agree with him? Why or why not?
Talk about a case youve had where you took more of a down
position and a case in which you took more of a one who knows
position. How do you think your position impacted the work?
FROM PLAYGROUND WORKER TO FAMILY THERAPIST

7. Too much emphasis on technique: How did you react when
Minuchin talked about the mistaken emphasis on techniques
when he and his colleagues were teaching family therapy early
on? As someone learning how to be a therapist, what do you
think about the balance between learning techniques and
understanding the process of therapeutic change? In your
training so far, do you think there has been too much emphasis
on technique? Not enough? Do you prefer to learn theory
first and then try it out with clients, or to jump in quickly
and learn from instant feedback? If you were to improve the
teaching methods of your training, what would you change?
8. Elements of change: Minuchin talked about enactment,
joining, and challenging as some of the essential elements
of therapeutic change. What do you consider to be the
essential elements of change? If you have been in your own
15
therapy, do you believe that it helped you to change? If so,

how? If not, what do you think your therapist could have
done that might have contributed to more change?
9. Challenge: What came up for you when Minuchin spoke about
the over-emphasis in therapist training programs on being
nice, supportive, and benign and his belief that in order to be
effective you need challenge people? Do you find that your
training has over-emphasized niceness over effectiveness?
If so, how? What are your thoughts on Minuchins concept
of challenging a familys sense of certainty in order to
help them see that they are wrong because they are richer
than they think they are? How comfortable do you feel
challenging your clients in the way Minuchin described?
INVITING THE FAMILY TO DANCE

10. Therapist evolution: What reactions did you have when Minuchin
talked about how he has evolved over his 50 years as a therapist,
and how his beliefs about families have changed? How have you
evolved over your time as a therapist, even if you have only been
in the field for a short time? What ideas/beliefs about mental
health and therapeutic change do you have now that you didnt
have when you started? How has your thinking evolved?
11. Daring: How did you react when Minuchin spoke about how he
has grown through his failures, and the importance of daring
when youre doubting? Talk about some of your therapeutic
mistakes or failures and how you have grown from them.
How do you feel about daring to try interventions out with
clients when you are uncertain whether they will be effective or
not? Can you give an example of a time when you felt you were
being particularly daring with a client and how it turned out?
12. Enactment: What do you think of the concept of enactment as
Minuchin described it? Do you agree with Minuchin that it is
desirable for the therapist to invite whatever happens at home
with the family to happen in the consultation room? What do you
think the benefits and risks of inviting the family to dance with
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the therapist might be? If you dont use the enactment technique
to gather information about a family, what other techniques
do you use to learn about how they interact with each other?
I KNOW WHERE I WANT TO GO

13. Ultimate goal: Minuchin explained that he often has an
ultimate goal in mind in his work with families, but that he
often does not know how he will reach that goal. What do you
think of this approach to goal setting? Do you usually have
an ultimate goal in mind when you work with clients? Do
you often have a sense of how you will reach that goal? How
much do you involve your clients in the goal-setting process?
What are your overall thoughts on goals in therapy?
14. Emotional responses: Minuchin spoke about a common challenge
new therapists face: figuring out when to share, and when to
withhold, their emotional responses with clients. What came
up for you when he suggested that therapists neither constrain
nor satisfy their feelings with clients? Can you talk about
some of your experiences in negotiating the balance between
constraint and satisfaction of your emotional responses to
clients? Do you tend to withhold your responses more or act on
them more? How do you determine whether acting upon your
emotional experience will be useful for your clients or not?
15. Responsibility: What reactions did you have when
Minuchin spoke about responsibility in a family? Do you
agree with him that a family is an organism in which
people are responsible for each other? Why or why not?
ATTACHMENT AND ENMESHMENT

16. Yin-yang: What did you think about how Minuchin used
the yin-yang symbol as a metaphor for systems thinking?
Does his statement, You cant change yourself, you can only
change others make sense to you? If so, how? What are your
overall thoughts on systems theory? Is this a perspective
you incorporate into your therapeutic work? If so, how
17
does it inform your ideas about therapeutic change?

17. Attachment theory: How did you react when Minuchin said
that attachment theory does not make sense to him? Were
you surprised to hear him challenge this popular theory? If
you are familiar with Bowlbys or Johnsons work, how do you
think they might have responded to what Minuchin shared
about this? Do you agree with Minuchin that the mother/
infant relationship is not necessarily the most significant
attachment? When you reflect on key relationships in your
life, are there any attachments that are/were more significant
than your attachment to your primary caregiver?
I WANTED TO BE A TANGO SINGER

18. What do you look for?: When Minuchin works with a family,
he looks at how a family is organized and is curious about
ways in which people feel rejected and/or supported, with the
goal of increasing the alternatives of relating. Is this what you
look for when you are meeting with a family? Do you, like
Minuchin, continuously make characterological assessments
of each family member? Why or why not? What else do you
pay attention to when conducting family therapy? Why?
19. Roots: Minuchin shared that his therapeutic approach is
rooted in growing up in a big family in a small village, where
he knew everybody and was a people watcher. How do you
think your approach to therapy might be rooted in aspects
of the setting or circumstances under which you grew up?
20. The approach: What are your overall thoughts on
Minuchins approach to family therapy? What aspects
of his approach can you see yourself incorporating into
your work? Are there some components of this approach
that seem incompatible with how you work?
21. Personal reactions: Was there anything that Minuchin said
that particularly surprised or inspired you? Any other reactions
to the interview that you havent shared yet? How would you
feel about having Minuchin as your therapist? Do you think
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he could build a solid therapeutic alliance with you and your

family? Would he be effective with you? Why or why not?
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Complete Transcript of
Salvador Minuchin on Family Therapy
with Salvador Minuchin, MD, and Jay
Lappin, LCSW
Early Influences
Jay Lappin: Hello, Im Jay Lappin, and Im here today with Dr.
Salvador Minuchin, one of of the foremost figures in family therapy.
Its an honor to do this interview with Sal. He is someone who has
been a huge part of the field of family therapy. He has changed the way
that we fundamentally think about individuals and families, about
foster care systems, larger systems. And it has been an absolute gift to
know him all these years and to work with him.
I wanted to start today just because so much of what you write about
seems to be embedded in your growing-up experiences. Could you say
a little bit about what it was about growing up in Argentina that has
affected your thinking and the development of your theory?
Salvador Minuchin: My goodness, to go so far back. I think one
that of the things that formed me was the fact that I was the Other
in Argentina, in the sense I was a Jewish kid in an anti-Semitic
country. And so the same things that happen to black people here
when they feel themselves excluded from the majority point of view
you develop a sense of being the Other. And you develop a sense of
injustice.
So the concept of social justice was a very important part of my
childhood. I walked to school and I passed through certain streets
where it was written on the walls, Be a patriot. Kill a Jew. And that
is a very important impact, an emotional impact in the formation of a
youngster.
So, being a Jew, being the Other, being different than the others,
wanting to pass is something that marked me.
And my work with low-socioeconomic families is very much related to
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a concept of social justice. The group of people that worked with me at

Wiltwyck were all liberal people, leftist people, thinkingincorrectly
I thinkthat through therapy we could help families to become more
competent, and that would be translated into a potential for changing
society. Its a verythe tools of family therapy, or the tools of therapy
in general, are very tiny. The ideas that we have that we can take
families from Harlem and make out of them a movement of social
liberation was part of our ideology and also our navet. That is what
started the work with the Wiltwyck families.
Lappin: And one of the things that you said early on was that this idea
of challenge has been a thread throughout your career and throughout
your life, and courage, I think, to take on bigger institutions. You
talked about a conceptand forgive me of my Spanishdesafo.
Minuchin: Yeah. It started with childhood.
Lappin: Didnt somebody get you to have a fight with somebody else?
Was it your friend?
Minuchin: Well, that experience, it was in high school, sixth grade,
and a friend came and said to me, Sal, Micas said that he wants to
kill a Jew. You go and fight him. So, very much in Argentinean style, I
went and said to Micas, I will wait for you after class.
After school, we went out of the school, we went to the street, the
classmates created a circle surrounding us, and we fought. And of
course, they were saying, Kill him. Hit him. Just like kids do.
And he hit me in the nose and my nose bled, or I hit his nose. But the
question was that according to tradition, this was a duel to first blood.
So then the fight stopped, we shake hands, and that was the end. But
its just part offor some reason or other, I was a challenger. I was a
very shy person, a very shy child. But I was also a challenger. And the
idea of challenge is reflected in all my life.
I was part of a revolutionary movement against the dictator Juan
Peron. Then in my life, I went to Israel to fight in 1948. I was a doctor
in the Israeli Army. And then I came to the United States. I studied in
the William Alanson White as an analyst. I abandoned psychoanalysis
as an orientation toward exploration that was too narrow. And the
21
working with low-socioeconomic families was part of the idea that we

need to createyou see, I was working in a school, Wiltwyck School
for Boys, where a hundred kids were taken away from Harlem, taken
to Wiltwyck, two and a half hours away from Harlem.
They spent there a year, two years. They improved. We said, Then
youre improved. It means that you accommodated to the rules of the
institution. They went back to Harlem, and they came back after a
year because in Harlem they began to steal again, to do some more
delinquency.
So the idea of doing family therapy sprang out of a sense that what we
were doing was not working. We were all very much oriented toward
psychodynamic-oriented psychological approaches. And they didnt
work. So we read one article by Don Jackson.
Lappin: The Question of Family Homeostasis?
Minuchin: Family homeostasis. And out of that article, we said, OK,
we are family therapists. And in these times, it was easy.
Inventing Family Therapy
[00:08]
We had one article and a point of view, and then we decided, We
are family therapists. From that, to become family therapists was a
process. And the process was, Okay, now we invite the families of
these children to come and have sessions with us. But we didnt know
how to interview families. So we had a group of our team behind a
one-way mirror. And in some strange ways, they were colleagues, they
were supervisors, they were teachers. They were there to observe what
we were doing, and then to tell us what we were doing. That was a way
in which we started to develop our techniques of family therapy
really by feedback. They were telling us, You did that, and we would
say, What?
And then suddenly, we developed an introjectsome kind of
homunculus here that was observing ourselves doing things. And
then, on the basis of our understanding of the characteristics of these
families, we developed a series of techniques that were specifically
related to working with a population that was not introspective, that
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was not reflective, that did not have nuances of affect. If somebody
was angry, it was that kind of thing. There was not nuance. If there
was control, it was that kind of control.
So we developed techniques of moderating affect, because the
important thing for uswe were also child-oriented psychologists
was how can we create in the family an environment in which children
found predictable responses? The responses of the parents toward the
children were unpredictable. They reflected the mood of the parents.
So modulating affect, modulating control, creating dialogues where
there was chaos or immediate responseone here, the other here, the
other here.
So the first techniques that we developed were techniques that had
a lot of elements of traffic cop. We took a pencilcan you give me a
pencil?and we would say, Okay, you want to talk? Take the pencil.
Now, when you finish talking with me, you give me the pencil and you
say, Okay, answer. So it was a strange and very simple and very nave
way of working. But it was something that really was specific to our
population.
The other thing that happened is that we started by criticizing our
population, criticizing the families. They were wrong that way, they
were wrong that way. The second step was saying, We are wrong.
Something about our reflective way of talking, our demands for
reflection were part of our needs. We were all middle-class intellectual
people who didnt have too much contact with this population.
So we began to change. And that was a pivotal momentthe moment
in which we realized that in order to join, we needed to change.
The process of joining was a process of learning how they talk, and
beginning to talk in a modality that they could understand.
That moved, then, toward an insistence of supervision. We did
things, we went back to the one-way mirrorWhat did we do? How
different should we be? and things of that sort.
Lappin: You said that youd even have families behind the mirror at
times?
Minuchin: Well, the mirror was an impermeable mirror. We were
23
seeingthe family was in the session with one of the therapists. And
lets say it was the grandmother, the mother, and the children. The
grandmother was always saying to the mother, Do that, or, How is
it that you dont control your children?
So one of the therapists would say to the mother, Why dont you
come with me behind the one-way mirror, and we will look at the
way in which your daughter treats her children? And then we had
two sessions going simultaneouslyone session of the therapist
working with the mother and the children, and the other therapy,
the other session, was a therapist beyond the one-way mirror with
the grandmother, and instructing her to see and to become more
supportive of the mother. To see that the mother was more competent
than what she gave her credit for. To see that the therapist was
incompetent as well. Issues of competence and learning how to work
from the down position were also important for us. In school, you are
trained as a psychiatrist, as a psychologist, to take the position of the
one that knows and does.
So to achieve the possibility of recognizing that in order for the
mother to feel competent, you should be incompetent, so that the
process of making the mother competent requires the therapist to take
the down position.
So, from this exploration and these mistakes and this repairing, we
then wrote the book Families of the Slums.
From Playground Worker to Family Therapist
[00:15]
And then with Braulio Montalvothat was my twinwe developed
an alphabet of skills. And that was also a very interesting and very
nave kind of approach.
Somebody says that if you put a monkey in a computer or in front of a
typewriter, and you are waiting a long time, he will write Othello. But
we thought that in some way or other if we give to people an alphabet
of skills, they will be able to write epics.
Minuchin: People get a tremendous amountthat appealed to people
because it gave them a sense of security. But it was a mistake.
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Psychotherapy.net
Lappin: How so?

Minuchin: It was a mistake because people began to think that having
an alphabet you could write a sonnet. And it is not true. You can have
an alphabet and have only an alphabet. The idea that the alphabet
was at the service of a particular communication that was part of a
process, that there were superordinates, that we had a goal. So the
alphabet was an instrument. But students took the alphabet not as an
instrument, but as the real process of therapy.
And the field of family therapy really moved from, in the beginning,
an attempt to understand families, to an attempt to expand the
techniques. And pretty much, we were all technicians, and we forgot
to think. So many, many people that were students of mine thought
that changing seats was the essence of structural family therapy. And I
would say I change seats because Im just ADHD. I cannot stand seated
in one time.
Lappin: But to be a craftsperson, dont you have to learn certain skills
and do them over and over again until you get them and they are a
part of that larger thinking?
Minuchin: Yes, but the question is, at which point? The question
of how to teach is an interesting thing. And that happenedat
some point, we were working with a population of black and Latino
families, and we had a faculty that was all white middle-class
intellectual people. And we looked at our population, we looked at the
members of the clinic, and we realized that there was a mismatch.
So we developed a program in which we went to the community,
and selected in the community a group of people that worked with
children in the playgrounds. And we invited a group of 12 people in
the beginning. We selected 10 or eight to become family therapists. We
had a grant from the National Institute of Mental Health.
Lappin: That was the IFC, Sal?
Minuchin: This was the training for paraprofessionals.
Lappin: So this was that first batch, Barbara Bryant-Forbes, Paul Riley,
Pete Urquhartthat crew?
25
Minuchin: There were eight people. And suddenly we said, You are
family therapists. And Jay Haley wrote a manual of how to conduct,
how to survive the first session. And with that manual, the people
had the first session. And Jay Haley, Braulio Montalvo, and myself
supervised each one of these sessions. So it was a very labor-intensive
program. And then it was a question of, how do you teach? You teach
deductively like the universities, in which you teach theory, and then
you teach more theory, and then you teach more theory, and then you
teach the practice.
Or you teach inductively. And that was Jays idea. Inductively, you
put people to do certain things, and they survive. Immediately after
the session, the therapists would come with us, and we would look at
the tape, and we would say, Do you see what you did? What you did
can be done in a different way, or, Can you tell me, why did you do
that? So it was a process by which people first did something, then
recognized if what they did was correct and we applauded, or we said,
Look, that is not the way of doing it. That really was a very difficult
process.
The training of paraprofessionals lasted, I think, three years. And it
was Jerry Fordnot the President but a social worker.
Lappin: He could have used the training. That would have been better.
Minuchin: The Afro-American social worker Jerry Ford was the
director of the program. And we trained, I think, 24 of these people.
Enactments, Joining and Challenge
[00:22]
So the idea of training inductively was important if you start with
people that dont have any notion. The rest of the staff had gone
through the university. They came to us trained in therapy, individual
therapy. So we needed to train them to be family therapists, and
that requires teaching some theoretical aspects of therapy, to teach
something about family organizations, and then to teach techniques.
The process should have been one in which the superordinate was
theoretical. What is our goal? What are the interventions that
facilitate change, that facilitate the development of alternative
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Psychotherapy.net
ways of being? We forgot that and moved more toward teaching

the techniques. So the idea of teaching enactment, that is, a way of
bringing the problem of the family that a family tells us, to a dance in
the session in front of us. That was what I called enactment, coming
from the theater, from being in the stage and act something.
That became a very important way of people to interview families. But
really, that was only part of the process. People at some point felt that
enactment was therapy. And enactment was not therapy. Enactment
was a step toward the process of change.
Lappin: So what would you consider to be the other essential elements
of change?
Minuchin: We started with joining. Joining is basic. Joining is to give
the family membersfirst to validate family members, and to give
them the hope that, with our help, if we dance together, there was
hope to a better life. So joining meantand that was a technique
meant to be curious, to be supportive, to work towards competence,
and to provide hope. So that was one of the techniques.
Another technique wasthere were some techniques that had to
do with challengeunbalancing. In that, we developed a series of
techniques that were different than the techniques of therapy in
general. In social work school, in psychology school, when they train
you to be a therapist, they train you about being benign. They train
you to be supportive.
We felt that there was a surplus of support, a surplus of being benign,
and that there was not enough challenge so that people would be a
kind of an alarm ring to say to people, Wait a moment. Lets try to
understand what is what you are doing. Can you do it differently?
And that comes from my Argentinean background. Desafo, the
challenge, had in Argentina an elementalyou fight with knives. But
challenge also is to challenge a conceptto challenge a mood, an
aesthetic sense. And in the working with our first families, and then
working with middle-class families, the concept of challenge was
sprung really from the idea that when families come to therapy, they
are wrong. They are wrong in the sense that they are certain. Families
27
come to you with a certainty. They have an identified patient, and

they are certain that pathology lies on the way in which this identified
patient talks, behaves, thinks, emotes.
So clearly, this is wrong. System thinking says members of a family
are constructing a way of being conjointly. And here, families come
saying, We are certain that the identified patient is like that, and it is
intrapsychic. So the idea was how to transform that into something
that is systemic. And the challenge was, in the beginning, just the
process of moving a concept that pathology is intrapsychic to the
concept that pathology is formed by the transactions among family
members.
And in the beginning, this challenge has an element of rupture,
an element of anger. Slowly, this challenge changed, and challenge
became benign. And challenge became a way of helping people to say,
Ah, is that what you mean? So, from that point of view, challenge
is something that I today do it faster, better, with humor. People
understand that Im on their side. But it is essentially the idea that
people are wrong because they are richer than what they think they
are.
So, the challenge becomes one that says, Listen, my friends. You have
alternative ways of being that are more appropriate to the human
condition and to the circumstances in which you live. So that change
from the challenge, You are wrong, to the challenge, You are wrong
because you are richer, is a major qualitative change.
Lappin: I think it is one of the hardest ones. When I teach, it is
typically one that students, new therapists, struggle with mightily. Do
you have any thoughts, ideas about how to help them make that jump?
Because they are going from this dialectic, this tension between the
familys worldview and the systemic worldview. And it is very hard,
I find, for students to do that in a way that is as smooth as you are
describing. They struggle.
Minuchin: Well, there are two ways of becoming wise. One is to
become old. And that takes a long time. But the truth is that you need
to introduce the concept thatyou see, to challenge that way, you
need to find a way of validating who they are, and then say, The way
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in which you think you are is partial. It is correct, but it is partial.

Join me in the trip to expand your alternatives. Join me in the trip to
becoming richer.
It is a shift that took many years to achieve. But once you achieve,
then your relationships with people become much easier, because you
approach them as an old uncle. You are an old uncle.
Lappin: I am.
Minuchin: And then you say, Listen, my friend. Why dont we talk
a little bit about your possibilities? And that is something that I
think should come to people early in theI know that people come
to family therapy very young, and they come without experience. So
they will need, in the beginning, to fake wisdom. But it is essential
that they should start by saying the challenge is because families are
certain in a way that is narrow.
The concept of what you think about yourself is partial. Your certainty
about this is who you are is wrong, but it is wrong because you are
richer. You add the words, Because you are richer.
Lappin: Jorge Colapinto and I used to teach a course, Introduction
to Structural Family Therapy. And we would ask people, How many
of you think that you are good at joining? And virtually the whole
class would raise their hands. And then we would say, How many
of you feel that you are good unbalancing, at challenge? And maybe
one or two people would raise their hands. And what we said to them
was that they had too narrow of a vision of joiningthat they didnt
understand that you can join by challenging. I dont know, is that a
particularly American conflict-avoiding, kind of culturally?
Minuchin: No, I think that is university. I think people are trained to
be nice, and the idea of challenge is against the concept that university
had given youthat therapists need to be benign and need to be
supportive. And suddenly you are saying, In order to be effective, you
need to challenge people to achieve a number of ways of being that are
different. And that requires that you should be nice in a different way.
The question is not, Are you nice or are you not nice? The question
is, Are you effective? Do you have a goal? And what you are doing is
29
effective in the direction of achieving that goal. So if you change the

way of teachingI really think that the way of teaching techniques
is incorrect. We started to develop something because that was a
revolution for us. We needed to move from being psychologists to
being family therapists. We didnt know how to do it. So we started,
really, from the alphabet. But the idea that once you have an alphabet,
you have tools that will allow you to be effective in changing family
systems, is a mistake.
Lappin: So this mistakeyou say one of the things that seems that
has been missed is, I see you when you challenge is there is always
a sparkthere is a twinkle. I think you are Irish and you just dont
know it. And there is this twinkle in your eye, like today on the tape,
you challenged this family and you tease them about being, the father
was a Martian. They are aliens, they were tigers. And there was a
quality of playfulness.
And I cant remember you saying too much about how play factors
into your work, or humor. Could you say something about that?
Minuchin: I have always been funny.
Lappin: I know.
Minuchin: I remember going to Yale once, and a psychiatrist came
after the talk and he says, Dr. Minuchin, do you know that you are
a very funny man? And I said, Yes, I do know it. But it is also true
that I was not a funny therapist. I was funny and I was humorous, but
I did not use that in my sessions.
You know, it is very possible that we are here, and I am 88 years old,
and I have been 50 years in the field, and I have evolved, and I have
changed. And many things that I did in the beginning are anathema to
me. The idea that I have today about the fact that family members are
responsible for each other and that family members are the healers
that was not part of my concept when I started. When I started in
the 60s, all family therapists started with the concept that families
were pathologicalthe idea, How can we save the patient from the
pathology of the family?the concept that came from the 50s, from
psychoanalytic concepts, from Frieda Fromm-Reichmann, that says
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Psychotherapy.net
mothers create schizophrenia. So Laing, the British family therapist,

he created an organization to save psychotic people from pathologic
families.
And the concept of Bowen, about rescuing patients from the
undifferentiated ego-massthat was his workfrom the family,
was anti-family. So we were all child rescuers. We were all rescuers
of the identified patient, so that, in effect, our view of the family was
that they are wrong. And at some point the NAMI, the Association of
Families of Mentally Ill Patients, challenged the Association of Family
Therapists for being anti-families. And they were right.
And slowly we moved, because the families taught us, because our
failures taught us. One of the things that is important to understand is
that we grew through failures. I had failed so many times.
Inviting the Family to Dance
[00:38]
Lappin: So, Sal, you said that you had learned by making mistakes.
Do you have any favorite mistakes?
Minuchin: Well, first I want to tell you something about the way in
which I act. I sometimes have an idea that something is necessary to
do. And I am not certain that what I will do is correct or not correct.
So continuously, I am monitoring my way of behaving. Lets sayI
can do that, let me explain to you. Lets say I think that I want to touch
your face.
You can be a man or a woman. So I said, What would you do if I
touch your face? And instead of waiting for your response, I would
do that. What would you do? And look at your nonverbals.
Lappin: Should I do this?
Minuchin: No. Well, that would be too much. Just a movement of the
face. I would then say, Well, so you mean And this idea of starting
to do something in whichto accept my doubt and to test it, and to
know that I can push you as long as you will say, It is enough. I dont
want more. So the process is an interactive process. The process is a
process in which I can say to a mother or I can say to a father, You
know, it seemed to me that the way in which you act with your child
31
is dangerous, is destructive. Well not start with, Its destructive.

Well start with, It seems to me that sometimes you do things that
you dont like to do. And then it will say, Do you know what I mean
by that? Talk with your wife about what do I mean when I say that
sometimes you treat Jimmy in ways that you dont want to treat him.
And I would push for a communication between husband and wife in
which I would sit back, move my head down, become invisible, and
push for the dialogue between the two people. Then I would say
Lappin: What happens if they stop midwayit will happen
sometimes in therapythey will turn to you because you have said
that they are coming to talk to you, not to talk to each other?
Minuchin: That happens very frequently, and I would say, Thats
true, but at this point I want you to talk with him. And I would
reject the idea that I need to talk. I am present only when I think it
is useful. When I think it is not useful, my attitude will be that
that is, avoiding eye contact. But coming back to the idea of, I said,
Sometimes you behave with Jimmy in ways that you dont want to
behave. And then I would say, Sometimes the way in which you
behave with Jimmy hurts him. And then I would say, Sometimes
you are destructive.
So there is a process of evolvement, so that by the time in which I am
saying, Sometimes you are destructivethat is a major challengeI
help the man to prepare himself to that statement and to say, Am
I destructive? And that is, I think, a talent that I have. It is a talent
that allows me then to act in ways in which there is a dance. It is like
a tango. I try a movement, and it is your response, it is the response of
the family, that will instruct me if I should continue in that way or if I
should move, and instead of being challenging, I should be supportive.
I can be very seductive. I say, I like the way in which you think. And
mostly I like a turn of phrase that you have that is kind of poetic. Did
you write poetry when you were a child?
These are techniques that have become part of me because I love to
ham up.
Lappin: So, Sal, you soundyou have this element of humor, of play,
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seduction. And there is certainty there, even in your uncertainty

about doing an enactment, when you touch the persons face and you
are going in increments. Thats you, though. You have an amazing
capacity to read people and to know those things.
If you are a new student and you are just beginning to learn about
enactments, how does one do that in it, to have that way? Because
what you are saying comesyears ago, when we were at your house
for a seminar. You were asking people about doing therapy. You
skipped me, and I came back to you later and I said, Why did you
skip me? And you said, Oh, because you dont have children yet.
And I said, Why is that important? And you said, You have to go
through those life stages first to understand some of these things.
So for people that dont have children yet, that arent married or in a
relationship, how do they adapt towards that 88 years of experience
and wisdom and humor and play, and do it themselves?
Minuchin: I dont think there is a way of skipping life. You need to
have some experience. But there are ways of teaching. Now, first, lets
start with, conceptually, what is enactment? Enactments start out of
my doubt about the meaning of language. I know that if I talk with
people, people have rehearsed speeches to certain situations they will
talk. And I never felt that what they said in their speech really gave
me an understanding of the particular way in which they relate with
spouse, child, and so on.
So if a mother says, Jimmy gets very upset and then has temper
tantrums, I would say, Well, Jimmy is here, and he is very quiet, and
he is focused, and I think he is very nice. What would you need to do
for Jimmy to become impossible?
So the younger brother would say, Well, if you take away the toys that
he has. And I said, Okay, do it. And he said, What? I said, Take
away his toy. And then the child will take away his toy, and I would
see a fight evolving between the two children. And I am interested,
and I am comfortable, quiet, observing, waiting to see what the
mother does. At this point, I have information. And the information is
via the dance.
33
I have a metaphor that family therapy is inviting the family to dance

with me. So, whatever happens at home, I want it to happen here. And
I begin to look not at communication in terms of meaning, but at the
dance. I am a choreographer. So as the mother then gets up and shakes
Jimmy or shakes the brother, I would have some information that
would direct me to the next step.
I start in the beginning with some goal. But then I have intermediate
steps. That enactment, that making the situation happen, gives me
some information about the intensity of affect of the mother, whom
she selects to punish, what is the nature of the punishment, what do
the children dodo they run away?
I Know Where I Want to Go
[00:48]
Minuchin: So I am working, in therapy, guided always by the process.
One transaction evolves a different transaction. With the case that I
presented today, I presented a case in which there is a mother who has
a child, and then she married a man. And then there is the evolvement
of the trianglemother, daughter, and stepfather. When that
happens, usually, I would look at the way in which the mother defends
her daughter against intrusion of the new spouse. And that is okay in
the beginningwhy not? There needs to be an accommodation. But
at a certain point they need to become three.
So I know that that will be my goal. My goal is that instead of being
two dyadswife-husband, mother-daughterthree dyads, father-
stepdaughterthey need to be one threesome. That is my goal. Then
I begin to say to the mother, You need to trust your husband. And
she says, I cannot trust him because he is not an authority. He is
authoritarian. Then I ask the daughter, Can you talk with your
father, or will your mother interfere?
Then she says, I cannot talk with him because both of them are
aliens. They are not humans. I feel at this point very good, because I
can now work with the language that she has. So I said to the girl, Is
he from Mars? And is she from the moon? Or he is from the moon
and she is from Mars? And you? From where are you?
Oslo. Well, I can understand, if you are from Oslo... And I develop
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Psychotherapy.net
something that is funny, from which I begin to see that the girl can
talk with the father when the mother is not around. At this point, I
say to the mother, Can you move here and let your husband and your
daughter have a dialogue? I will be here with you, and if something
happens, if he is authoritarian, if he is violent, I will stop him. So you
sit here with me. We are going to be witnesses of what I think will
happen, is that your husband and his stepdaughterdaughtercan
develop a dialogue that is harmonious. Could you deal with that? Can
you sit here with me and be with me quietly? And I have created a
stage. I have created a mini-drama.
And then I see what happens. I dont know what will happen, but I
have created a possibility of action, and a possibility of seeing some
alternative ways of relating. The goal is that she should develop some
trust that the husband can relate with her daughter in ways that are
harmonious.
At some point I will turn to her and I will say, Can you tell me
something about your childhood? And she will tell me that her father
was a drunkard, and she will tell me that her father would hit her
mother when he was drunk, and when she was two years old the father
hit the mother and the mother was unconscious. She was two years
old, and she needed to defend her mother.
At this point, I movemy heart goes to her, and I said, Who helped
you? And she says, Nobody helped me. What could you do for
your mother? Nothing. So I begin to talk with her about the effects
of abuse and trauma in young children. And I said, You know,
probably forever you will have an alertness to danger. And you see in
your husband a dangerous father, at the point in which I see him as
perfectly comfortable. So it is the creation of a story. And it is a story
in which all four of them are participants.
Lappin: So you have, in a sense, it sounds like, a map in your
head about where these people line up, where they should be, and
intermediate steps to get there.
Minuchin: No, I have the ultimate goal. I know where I want to go. I
want to go to the formation of a threesome instead of a formation of
three dyads that is the way in which they are. How I will reach that
35
goal, I dont know. And that is what I am saying is a talent that you
need to give to the students. You have a goal, and you are able to talk
with them about the goal. How they will reach that goal will vary.
I will do it in a particular way because I have hundreds of pathways
to reach that goal. But younger people would need to do it differently.
And I should not be a model of the way in which they will do it,
because they will need to do it differently. You do it very differently
than I.
Lappin: Well, it is a challenge because young people struggle with
having that certainty. And it seems to me that one of the things that
you bring into this is the metaphors of play, drama, literature. And
there is a way in which that seems to transcend the momentthat
you are always listening for the larger story. Is there any way that they
could work toward developing that skill themselves?
Minuchin: Today a doctor in psychology stood up and she said, At
certain moments, when you moved away from the mother, I felt a
sense that she was in danger, and I felt a need to support her.
And I said to her that, as a therapist, she needs to be always in
a monologue with herself. And she should have an emotional
experience. But when she has an emotional experience, she needs to
ask herself, Will it be useful for them that I should act upon what
this emotional experience means? And it is not that you should
constrain your feelings, but you need to know that you are not here to
satisfy your feelings. You are here to be a therapist. And a therapist is a
technician. A therapist is a thinker. But it is a technician.
A technician can have a number of strange responses to the process,
and the question always is to ask oneself, Is that emotional response
that I have useful for them? And then you can act, or then you
dont act. But you will be directed by that thoughtIs that useful
to them? And that is something that young therapists should
achievethis capacity to reflect upon their experiences. You said, It
is correct that you should experience that. I was rude to this woman.
This woman expressed a moment of distress. Your response to her
was correct. The question you need to ask yourself is: Should I at this
moment do something with my emotional response or not? And then
36
Psychotherapy.net
you become an expert. It is only at this point that you are an expert.
Lappin: So where does love enter into all of this? Do you factor that as
part of your thinking?
Minuchin: Love is a word that covers many, many, many things. It
is a syndromeit is not one particular action. Today when I talked
about, Can you help him?when I talk about, If Jimmy is acting
like that and you know that what you are doing is something that is
producing that action, then you are responsible for him being in pain.
I want you to take that into consideration. You are responsible. You
are adults. You are forming Jimmyso, to me, at this point, I am not
talking about love. At this point I am talking about responsibility. I
am talking about healing. I am talking about the fact that the family is
an organism in which people are responsible for each other. More than
that, I am saying, Not only are you responsible for each other, but you
have the capacity to act in ways that are healing.
So I amprobably because I am that oldI am using a lot of the
concepts of responsibility for the Other. And I am using the optimistic
view that you have resources. Aspects of you that you do not enact
are resources. I always say to people, You are richer than what you
are. You dont know that you are richer than you are, because you are
a specialist. You are a specialist in the sense that you think that that
narrow person that you are is all that you have. And I know that you
are more. And I use gestures and that kind of thing.
Attachment and Enmeshment
[01:00]
I want to ask about something that you have said a number of times.
You say, both in a family context and with a couple, that you cant
change yourselfyou can only change others.
Minuchin: Thats correct.
Lappin: And that seems to fly in the face of all traditional therapy
wisdom, that it is always about changing yourself. And it seems to
me that in order to change, like if you said that to me and I wanted
to change you, I would have to access different parts of myself. Isnt it
implicit in it that?
37
Minuchin: Of course. Its a yin-yang concept. The yin-yang has

two parts that are a unit. If I said to a spouse, You cannot change
yourself, that I really believe so. I have five years of psychoanalysis,
and it didnt change me. Probably I left there being worse than what I
started. But probably no change.
But the concept of yin-yang is a systemic concept. And it deals with
the fact that if you take unit of two and you want one to change the
other, the only way in which yin can change yang is by changing
herself. So this is just a very simple metaphor to explain system
thinking.
Lappin: Say a bit more, because we talked one time about ambiguity,
and you were saying that there is this business of certainty and
ambiguity, and you found that in China there was more of an
acceptance of this idea of ambiguity, and that people seem here to
struggle with it at times.
Minuchin: Well, I think that it has to do with that I try to challenge
the certainty by which people say, I am that, and my family is that,
and my son is the only one that is the culprit. And the challenge of
thatreally, system theory does not deal with certainties. It deals
with possibilities. It deals with ambiguities. If you have that all five
members of the family are involved in a set of transactions that really
create the way in which the family danceand, dance, I again use
thatthen you are not certain of things. You have a certain range of
possibilities.
What system theory offers you is a field of possibilities. And a field
of possibilities is not certain. It is possible to take that route to reach
that place. But it is also to take this other route. I always come to the
Borges idea that if you come to a crossroads, take both sides. And to
me, that is a statement about the fact that people are multiple. Because
the road that you take is the road that helps you to become a specialist.
But the road not taken is still part of your experience. So to me, the
concept of certaintyI yesterday was talking about the fact that in
my life, I increase my identities. I started saying that my identity was
that, and 20 years later, I had another identity that grew up in another
context. And 10 years later, I was in another.
38
Psychotherapy.net
Now then some people would ask me, Which one is your true
identity? Is your true identity the summation of all the four or five or
six identities that you have identified? And my answer is that each
one of them is my true identitythat in certain contexts, with certain
people, I can function only in certain ways. I dont have a range of
alternatives. And I feel comfortable to know that I am a multiple
personality, is that I think we all are.
And it is part of the concept of attachment, for instance. There are a
lot of people here that are talking about attachment. Susan Johnson
is one of these people. And in attachment, Bowlby said that the
relationship between the infant and the mother creates a prototype of
our ways of relating to people in the future.
So my way of relating with my wife after 58 years of marriage needs to
be looked the roots in the relationship that my infant self had with my
mother. And that doesnt make any sense. But it is something that the
Imago theory started saying, Susan Johnson, and a lot of people. And
that comes from the psychoanalytic concept that childhood creates a
model that is repeated. And it is repeated only up to a certain point.
And then it changes. And then it changes again. So the idea that we
need to look at our upbringing to understand our adulthood and our
late adulthood doesnt make sense to me.
Now it is true that we are the product of our parents upbringing, so
that when I say to someone, when I say to you, Your parents gave
you this particular type of lenses that help you to see the world in a
particular, restricted view, that is true.
But that is only one of the models. Later on, you married, and you
have a wife. And how long have you been married?
Lappin: Thirty-seven years.
Minuchin: Thirty-seven years. And your relationship with her gave
you another set of lenses. And then you had two children. And being
a father and having these two children gave you a different set of
lenses. And I dont understandwhy do we say that the original set
of lenses is primary, and the other lenses that were very significant
attachmentyou with your wife, you with your children, the way
39
in which your children changed youwhy should we dismiss these

other very significant experiences, and say the original attachment is
mother-infant? Logically that doesnt make sense.
Lappin: You are causing trouble again.
Minuchin: Well, I really think that that is something that needs to be
looked at. It is a theoretical fallacy.
Lappin: Part of it, it seems to me that one of the things that people
didnt get about structural family therapy is that boundaries actually
increase intimacy. And people always thought of boundaries, I think
perhaps from the psychosomatic types, as pulling people apart,
working with enmeshed families. And I remember looking at the
texts over the years, like from Families in the Slums in 67 and then
later, enmeshment/disengagement, those two concepts started out
very even. And then by the time it got to family therapy techniques,
disengagement was very little mentioned, and enmeshment was very
primary.
So it seemed to be an artifact of the times as well, that structural
family therapy was trying to make in inroad in traditional psychiatry.
And one of the ways we did that was through the research of the
clinic, the research that you did with the psychosomatic families, that
Stanton did with the heroin addict families. So people got the wrong
impression that structural family therapy was just about pulling
people apart. And it seems to me that you are more about putting
people together, but in a different way.
Minuchin: Someone else here said that enmeshment is only for
younger children, and when you have an adolescent, then separation
is essential. So these are concepts that evolved and at some point
lost their meaning. I dont think at all about enmeshment and
disengagement as significant conceptsnot at all.
Lappin: So what do you think of instead?
Minuchin: I know that families are enmeshed and disengaged. And I
know that at a certain particular time, I worked with a group of people
where these concepts were significant. And then I worked with a
different population in which these concepts were not significant.
40
Psychotherapy.net
One of the things that I want to convey is the fact that these concepts
evolved. And some of them are shed as irrelevant for the new time.
We have a lot of new concepts. We have an understanding of brain
function today that was completely not existing before.
So I think if there is something that I am, it is a person that evolved.
Mara Selvini-Palazzoli used to say, There is a particular way of
developing family therapy. And that certainty lasted for five years.
After the five years, she would say, Forget what I said. I have now a
new concept, and the new concept is really relevant. And five years
later she would say, Forget it. I think that this was a very good
model.
I Wanted to be a Tango Singer
[01:12]
Lappin: Sal, can you say a little bit about how you are different from
some of the founding members of family therapy? What distinguishes
you in your work?
Minuchin: Well, its a very interesting thing. It depends on the
population that you work with. Murray Bowen, Whitaker, Virginia
Satir, Jay Haley, all of the group of peopleLyman Wynnethey
were working with problems of psychosis. And then they were working
in terms of, what is the meaning of psychosis? I was working with
families from Harlem. And these families were families in which the
dialogues were chaotic, but the way in which they behaved, the way in
which they relate, was visible. So I never felt comfortable with looking
at the meaning of certain grammatical utterances. But I would be
involved
I said before that I am a choreographer. So I was always interested in,
when the mother is talking with this child, what does the other child
do, and what does the father do? And when the grandmother says
to the mother, You should be more forceful with your daughter, I
would look at the relationships, and I would look at, when I remove
the grandmother behind one-way mirror and I said, Lets look
together at your daughter and the way in which your daughter parents
her children, it is a look not at the way in which the mother was
talking with the children. I was creating two sub-systemsa sub-
41
system of grandmother with me, watching the mother relating to the

children.
So the concept of the meaning of the utterances, the meaning of the
communication, was never part of the way in which I look at people.
I look at people in terms of, what is the family organization? In what
way do people feel rejected, supported? And then I enter in terms of
increasing the alternatives of relating.
In some ways, that is not behaving like a psychiatrist. See, I was
fortunate. If I would be trained in a psychiatric hospital, my thinking
would be completely different. It was the fact that I was trained to
work with aspects of living, and then that became very important to
me, because in life I am a people watcher.
My father had 10 siblings, my mother had eight, and I lived in a tribe.
My village was a village in which, when I was walking on the streets,
there were 20 relatives looking at, what was I doing? And of course, I
learned to look at them looking at me.
My therapy, then, is really an expansion of the sense that I grew up in
a small village. And in a small village, I knew everybody. Everybody
knew me. And I became a people watcher. So I was fortunate in the
selection of the population that I worked.
Later, as I began to work with middle-class families, then my learnings
of psychoanalytic thinking, my learnings of psychodynamics, were
part of my interventions. But my beginnings were not.
Lappin: How so? How did you bring in the psychoanalytic learnings?
Minuchin: Well, when I put people interacting, I am always observing
the individual people as well as observing the dance. It is not only
the dance that I observe, but also the dancers. And I am always
doing some diagnostic assessment of each one of the people. The
diagnosis can be, Hes shy, He is controlling, She is supportive but
intrusive. These are my diagnoses. But I am continuously doing that
characterological assessment of the family members. And then I say,
And they are dancing that way. They are dancing the polka, they are
dancing the waltz, they are dancing something that is I dont know
if I ever think of people dancing rock and roll. I am too old for that.
42
Psychotherapy.net
Lappin: I think that you are a rock and rolleryou just dont know it.
Minuchin: Thats possible. Thank you.
Lappin: So over the years, I think one of the things that I always hear
you talk about is about dance and theater. So if you hadnt been a
family therapist, what would you have done?
Minuchin: The first goal as a child was to sing tangos. I knew
hundreds of tangos, and I wanted to be a tango singer. Later on, I
wanted to be a poet. Later on, I wanted to be a playwright. And I read
many plays, and I wrote three of them, but I am not very good. But
I started too late. And once I wrote a play that I showed to a director
of the National Theater in London. And he read it, and he said to
me, Sal, you are such a good family therapist. Why should you be a
mediocre playwright? So that was the end of my career.
Lappin: So any aspirations now?
Minuchin: Yes. To be able to say, like George Burns said, The first
hundred years are the difficult ones.
Lappin: I cant wait to see the next hundred years.
I think, on behalf of myself and certainly the profession, we have felt
so lucky to have had you as a mentor, as a friend. I just feel blessed to
have known you. And I continue to learn from you every day.
One of the things that is one of my favorite sayings of my father
that I think that you embody is, To thine own self be true. And I
think that that is something that myself and certainly the field has
learned from you every daythe courage to look at yourself and to do
something different, and to grow.
Minuchin: Thank you very, very much.
Lappin: You are very, very welcome.
43
Video Credits
Producer: Victor Yalom
Interviewer: Jay Lappin
Director of Photography: Corryn Cue
Post-Production & DVD Authoring: John Welch
DVD Artwork: Julie Giles
Still Photography: Rafa Mietkiewicz
Copyright 2011, Psychotherapy.net, LLC
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About the Contributors

Video Participants
Jay Lappin, LCSW, is a Structural Family Therapist, trainer, and
author. He spent 14 years at the Philadelphia Child Guidance
Clinic, where, under the direction of Dr. Salvador Minuchin, he
was a senior trainer, research therapist, and the Associate Director
of the Post-Graduate Certificate Program in Family Therapy &
Systems Consultation. His work has been published in professional
journals and texts, and he has been quoted in popular magazines
and newspapers such as Cosmopolitan, Self, and USA Today. He is a
Contributing Editor for the Psychotherapy Networker and a board
member for the Minuchin Center for the Family, and he maintains an
active clinical private practice. He is also the Family Therapy Director
for CENTRA, Comprehensive Psychotherapy Associates, Marlton,
NJ & Philadelphia, PA (www.centrapc.com). He can be reached at
jaylappin@usa.net.
Salvador Minuchin, MD, is world renowned as one of the founders of
family therapy, and is the developer of Structural Family Therapy. In
2007, a survey of 2,600 psychology practitioners named Minuchin as
one of the 10 most influential therapists of the past quarter-century.
He is the author of several books, including his classic family therapy
text, Families and Family Therapy. He is the former director of the
Philadelphia Child Guidance Clinic, which became the worlds leading
Center for family therapy and training, and was also a professor at
the University of Pennsylvania and New York University. Minuchin
currently lives in Boca Raton, Florida and serves on the board of the
Minuchin Center for the Family.
MANUAL AUTHOR
Ali Miller, MA, MFT, is a psychotherapist in private practice in San
Francisco and Berkeley, CA. She works with individuals and couples
and facilitates therapy groups for women. You can learn more about
her practice at www.AliMillerMFT.com.
46
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Salvador Minuchin (1921 ):

New York City, an organization to teach family therapists. Minuchin

Structural Family Therapy*

as in the example of an older child being brought in to the parental

relationship to the family is one of the constant features in the

Reaction Paper for Classes and Training

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INVENTING FAMILY THERAPY

FROM PLAYGROUND WORKER TO FAMILY THERAPIST

therapy, do you believe that it helped you to change? If so,

INVITING THE FAMILY TO DANCE

I KNOW WHERE I WANT TO GO

ATTACHMENT AND ENMESHMENT

does it inform your ideas about therapeutic change?

I WANTED TO BE A TANGO SINGER

he could build a solid therapeutic alliance with you and your

a concept of social justice. The group of people that worked with me at

working with low-socioeconomic families was part of the idea that we

Lappin: How so?

ways of being? We forgot that and moved more toward teaching

come to you with a certainty. They have an identified patient, and

in which you think you are is partial. It is correct, but it is partial.

effective in the direction of achieving that goal. So if you change the

mothers create schizophrenia. So Laing, the British family therapist,

is dangerous, is destructive. Well not start with, Its destructive.

seduction. And there is certainty there, even in your uncertainty

I have a metaphor that family therapy is inviting the family to dance

Minuchin: Of course. Its a yin-yang concept. The yin-yang has

in which your children changed youwhy should we dismiss these

system of grandmother with me, watching the mother relating to the

Copyright 2011, Psychotherapy.net, LLC

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