Monica McGoldrick on Family Therapy

Monica McGoldrick on Family Therapy

by Randall C. Wyatt and Victor Yalom
Renowned family therapist Monica McGoldrick reflects on the heyday of family therapy, the use of genograms, and the importance of culture, gender, and diversity.

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Monica's Coffee Shop Transformation

Randall C. Wyatt: Monica McGoldrick, LCSW, family therapist, teacher, writer, and so much more, that's what we're here to talk about. Good to have you here.
Monica McGoldrick: Glad to be here.
RW: Monica, how did you first get into the field of psychology and social work?
MM: Well, I was studying Russian in graduate school and then I kind of dead-ended because I didn't see myself becoming an academic. The day I finished the program, I met a guy in a coffee shop who was studying psychology, and I thought, "Wow. That's the perfect field for me. I could study the life of Dostoevsky, my hero, and then could do something with it." I really do think you could study Dostoevsky and learn most of what you would ever need to know about human psychology.
Victor Yalom: Who was this guy you met?
Monica McGoldrick: Yeah, actually, you probably know him. His name is Lowell Cooper.
VY: Lowell Cooper, of course. He was a professor at the California School of Professional Psychology where we both went to school. He teaches group theory and Tavistock groups.
MM: So, he was studying psychology at Yale, and we just started talking. And before the day was out, I went home and told my parents that I wanted to study psychology. My mother had always wanted to be an anthropologist but her mother wouldn't let her do it. She was otherwise very difficult but when I told her about psychology, she just said, "If that's what you want, you just have to pursue what you want. Do it."

I met with a psychologist, Jack Levine, who also part of the Yale system. And he said, "To make sure you really want to do this, why don't you go work at the mental health center?" It was 1966, and they were just opening the first community mental health center in New Haven. I went and applied for the job with a nurse named Rachel Robinson who was the wife of the first African American ballplayer named Jackie Robinson. He was my hero from childhood because I come from Brooklyn and Rachel became my first boss.

All the boundaries were down. I was a psychiatric aide working on this brand new unit in the mental health center. And during the time there were quite a few people who said, "Why don't you think about social work? It's a lot more practical."
The psychologists didn't seem to do anything very interesting. They wrote psychological reports that nobody read.
The psychologists didn't seem to do anything very interesting. They wrote psychological reports that nobody read.

VY: What do you mean nobody read them?
MM: Anytime we had a really hard patient, we'd send them to psychologists for a report. We had a really famous psychologist who did the assessments. A client would be raging around the clinic and after two weeks the psychologist would pass out the copies of the test report which said how rageful the patient was. There'd be some discussion about how messed up the client was; then the psychologist would leave and we're still be left with the raging patient. What good was that? (laughter)
VY: Right. What are you going to do now? We know he's raging? He's a 4.9 on the test and we know his IQ. Hopefully, we have come forward from those days.
MM: And the psychiatrist would be there in the morning for the sort of group psychotherapy with the patients and would act very important and we'd have big meetings discussing what that person thought. But the psychiatrist had not seen the patient all day, the psychiatrists would know very little.
RW: So the people who knew the least and did the least had the most power, the psychiatrists and the evaluating psychologist. What a system!
MM: That's right. Finally an overwhelmed social worker who had responsibility for all the clients and families on our unit, said, "Any psych aide who wants to help me, I'll supervise you." And I was like, "Me!" All afternoon and evening we would see the patient, and then we'd see the patient when the family came to visit. And it would be just unbelievable the things you would learn.

And then the next morning, the psychiatrist would appear again knowing nothing about the patient and just spout off again about what he thought was going on.
And then the next morning, the psychiatrist would appear again knowing nothing about the patient and just spout off again about what he thought was going on. And I thought, "God. I don't get it."
RW: It's obvious now why being a social worker was so attractive to you.
MM: Exactly. The social worker had the most interesting work because they got to actually work with families. So, I signed on to work with families and I just never looked back. I thought, "I'll be a social worker and I'll work with families." So, I went to Smith College for social work and I worked. But in order to stay in New Haven, I had to either be married or in therapy. And I wasn't married and had no prospects.
RW: Why did you have to be married?
MM: Well, if you were married they wouldn't separate you from your husband. If you were not married, they could send you away for a summer program and they might send you to Denver or anywhere in the country.
RW: I see, but where does therapy come in?
MM: Psychotherapy was the other best alternative. I signed up for therapy, telling the guy the very first session, "I need a letter telling them that I need at least two years of your help, and that I can't leave New Haven." He agreed to do it. And I had a great social work experience because I worked at the Yale-New Haven Hospital unit, which was absolutely fabulous. Very family oriented.
RW: At that time, what was the state in the '60s of family therapy when you entered into it?
MM: It was the most exciting time. And on this unit, probably of all the places I could have ever been, families were seen three times a week. This was for the rich and famous as well as anybody else. It was remarkable and it was totally integrated into whatever happened with the patients.

Where Have All the Families Gone?

RW: Nowadays, it seems like - at least in California, Northern California - it's not easy to get a family in. Parents, even those who are together and have kids, they're running around so much. Oftentimes it's hard to get everybody in at once. What does it mean for family therapy, that it's hard to get everybody in?
MM: I think what's really made it terribly hard for family therapy, in my own experience, is not the families themselves. It's what's happened with managed care, insurance, the drug companies. The drug companies have totally taken over psychiatry. And managed care has totally taken over how mental health services take place, and they have no interest whatsoever in family therapy because it is not as short and sweet as seeing one person three times. Or, you know, medicating them up and being done with it. Yes, it's true that we do have a high rate of divorce, and we do have parents who are working in different places. Nothing supports paying attention to the family issues that contribute to kid's problems.
RW: So it's much different than the heyday of family therapy when the idea of treating families was the way to go. There's one or two managed care companies in California that actually support couples therapy and family therapy. And they actually have it in their manuals. Basically, most companies seem to support medication or groups, many of which can be helpful, of course, but nowhere near the gold standard of caring for people. But lets move to what you love, and that is family therapy. What kind of therapy practice are you doing now?
MM: About 14 years ago, 1991, I basically got kicked out of the medical school, you might as well say. I mean, they couldn't exactly fire me because it's a faculty position I had. But they took away my secretary. They told me I was going to have to see 28 clients a week in the emergency room.

So the training program in family therapy was just basically moved out of the system. And in its own very small way, it still survives. We have a small family institute in the town where I live. A very little house in a very little town. We're a very small group, and we have very small classes also of people who want to study family therapy. And every year we wonder, "Are we going to have a class?"
RW: So, how would you characterize how your work is similar or different to other family therapists? Your approach, your ideas?
MM: Okay, well, along the way—and this is probably important in terms of where I ended up—in 1972, I went to a family therapy conference where I heard Murray Bowen. And I was completely blown away. He was talking about getting a relationship with your mother, and I just thought that was ridiculous because my mother was so impossible. Even though I was into family therapy, I wasn't into family therapy for my family. So, I really could hardly hear what he said, but he was basically saying as strongly as he could express it that you're nowhere if you haven't worked it out with your mother. And I kept thinking, you know, "This guy is a real idiot." Because he certainly never met my mother.
RW: What was your mother like?
MM: She was very difficult, very difficult. And anyway, during that conference, I met one of Bowen's students, a guy named Phil. And we hit it off very well. And he was just starting a family institute, and I asked him if he would coach me on working on my family. And he asked me if I would work at that institute. So, I really became a Bowenite and I would say that I'm still very much of a Bowenite. And there aren't too many of us. I don't think I have met any Bowenites on the West Coast. But, you know, you recognize them when you hear them talk about families.
RW: What's a giveaway?
MM: Well, they don't believe in cut-off. They pay a lot of attention to family of origin. They do genograms, for example. I mean, I'm known for genograms.
RW: Can you explain cut-offs?
MM: Cut-off.
We don't believe that if you don't like your mother you should just say, "Enough of this. I'll find somebody else." They believe that everybody should try to work it out with their mother.
We don't believe that if you don't like your mother you should just say, "Enough of this. I'll find somebody else." They believe that everybody should try to work it out with their mother. They basically believe that you never give up.
RW: So, did you work it out with your mother?
MM: I did work on it a good while. It changed my life.
RW: How so?
MM: Well, the power of being able to think systems and realize that we are all part of the system. So I kept trying to change my mother, and really, I was trying to get her to change her relationship with her mother who she had hated before. I stopped... I learned that you can't change the person. You can only change yourself. And so to change how I was in relation to her and also to change other relationships in the family... to just change.

Now I would think of it as taking my power back. That if I gave her the power to put me down and feel put down by her, that was something I actually had control over. And so if I flipped that around and did something different with it, instead of feeling wounded every time, and thought about what might lead her to do that, that it might be her problem, not my problem. It just transformed everything.

Bowen and Haley Throw Stones at McGoldrick

So I did change my relationship with my Mother. And I just saw systems through that lens. Some years later Bowen didn't like a lot of my ideas although I liked all of his ideas.
RW: Do you recall the ideas of yours that Bowen didn't like?
MM: We got into doing work on the life cycle and he didn't really think that that was a very good idea. Betty Carter and I wrote a book in 1980, The Expanded Family Life Cycle (Third Edition). And he did it sweetly, but Bowen basically said, "Eh, this is kind of an... eh idea, but hey, you could read it, whatever."
RW: Did you keep the foreword?
MM: Oh, yeah. We did. Yeah.
RW: Your ideas certainly got a reaction worth noting instead of being ignored.
MM: Well, his wasn't the worst reaction, actually. Jay Haley was even more critical. You see at that time nobody had written anything on the life cycle from a family therapy point of view. And so we searched the literature for anybody who had ever said anything about the life cycle.

But Jay Haley had written this thing about Milton Erikson (though it had little to do with the family) which was about a life cycle perspective. So we thanked Jay Haley for his contribution to our thinking in life cycle terms. And after we published that book on life cycles and families,
Haley wrote a nasty article on the right to choose your own grandchildren, saying that he rejected us as his grandchildren. He had nothing to do with us or our ideas.
Haley wrote a nasty article on the right to choose your own grandchildren, saying that he rejected us as his grandchildren. He had nothing to do with us or our ideas.
RW: You were kicked out. Seems Haley was into cut-offs.
MM: Yes, Haley kicked us out. Yeah, he was.
RW: Well, it's good to see that the old Freudian idea of just getting rid of all competition was alive and well in the family therapy world!
MM: But later on, Bowen didn't like the culture stuff, either. He didn't like the gender stuff. He didn't like any of it.

Never Run Logic Through an Emotional System

RW: Let's come back to that later, for now, lets go more into the work itself, working with families. How do you or Bowen see the idea of cut-offs with families and dealing with your parents in adult life? Should you just confront your parents like some therapists suggest?
MM: Your parents always matter. Bowen felt so strongly that it's all about getting a personal relationship with your parents. But you have to pay exquisite attention to what's going on in the emotional field, because to do exactly that, write a tell-all letter to your parents disregarding, you know, where you are with them—what's the possibility they could possibly hear such a message and not feel hurt and insulted or shot down by it? He would say that's outrageous. And you're going to cause years of conflict.
RW: That's good to hear, since I am certainly an advocate of not just wailing on parents without dealing with the complexity of the situation and the likely consequences.
MM: Well, you should read our paper that we wrote on coaching. Because we lay out Bowen's theory as well as we can. I mean, I lay it out every chance I get.
RW: Well, I want to see that. Most parents are defensive anyways, to say the least, since they often, rightly or wrongly, feel unappreciated and blamed for their kids problems.
MM:
One of the rules of thumb is never run logic through an emotional system.
One of the rules of thumb is never run logic through an emotional system. If your family is in an emotionally reactive place, why in the world would you take what we would call an "I" position and say, "This is where I stand." He would say that is outrageous and abusive to your family to do that.
RW: I may be a closet Bowenian then.
MM: Well, you just might be, so here we go. You'd be the first west coast Bowenian we ever had! (laughter)
RW: Perhaps it's because I am in California or because of my upbringing, but I have always been troubled by theories and practices of therapists who so easily suggest that clients individuate from their families, without considering the many layers and meanings of family relationships. Of course autonomy and individuation have their central place in life, but so do connection, family, community and the like. It seems western psychology too often forgets this part of the life equation.
MM: Absolutely.

Genograms: More Than Just Squares and Circles

RW: What is the importance of genograms in your work with families or individuals?
MM: A genogram is just a map. You know, squares and circles. But what's important is paying attention to where people come from, who they are, where they've been, where they're coming from. And genograms are just a way to map that. So the point is, it's important to consider people in historical context. That's why genograms are important. It's just to say, "Who are you? Where did you come from? What was it like?"
RW: What are your roots?
MM: Yes. Exactly. And to be respectful of that.
RW: And not going into one's history, what is the problem with not doing it?
MM: We would say there's no way to understand who a person is if you take an ahistorical approach to it. If you don't say, "Where have you been? Tell me about yourself. Who's your grandfather? When did your family come to this country? What struggles have you had?" To know if your father committed suicide or something. I mean, how could that not be relevant about a person?
RW: It makes sense. If somebody knew me, and they didn't know about my grandfather who came over from Italy at the turn of the century or my other family roots, then I would not feel that they really knew me well. We don't want to be reduced to our roots, but we like them to be appreciated as part of us.
MM: Exactly.
RW: It's not rocket psychology.
MM: Exactly. It's just common sense. Anybody would know that. (laughter)
VY: Monica, I want to ask about the work you did in your video. A lot of therapists focus on the past, in almost a stereotypical way, but it often stays up in the head. It stays intellectualized. And what impressed me in your video, is that you use that information, but it's all about connecting with the family in the moment.
MM: That helps change the future. I really believe it. I recall that the first time I heard Bowen speak, he said:
"It doesn't matter how much you've analyzed your mother's psychological problems or whatever, if you can't sit in a room with her and be generous, you're not there. So, don't kid yourself."
"It doesn't matter how much you've analyzed your mother's psychological problems or whatever, if you can't sit in a room with her and be generous, you're not there. So, don't kid yourself." But it is all about what are you going to do now.
RW: Right. You're saying that understanding the past can help you connect in the present and vice versa.
MM: I think so. Well, and also think about what's your responsibility to the future. It might not be too apparent on that video, but I really think that we as therapists can help people position themselves to make choices about what they are going to do in life. And that we make the best decisions if we pay attention to where we're coming from and we pay attention to what's ahead. So, you know, what do we owe to our children's children? As well as what do we owe to our ancestors who struggled before us?

Autonomy and Connection

RW: It's a very honoring position and approach, and refreshingly so.
VY: It's hard to find anybody who doesn't want to be honored.
RW: You use the concepts of love, respect, honor, forgiveness, spirituality. These aren't words that are commonly used to talk about goals in psychotherapy. Where do you come from in using these kinds of words?
MM: I think it resonated in me. I got it from Bowen. You know, the basic Bowen theory is that differentiation for the mature person means getting our connectedness to everyone and everything. And respecting that. That it's about making our own decisions about how we are going to relate. That I have to go into my heart and choose my relationship, choose how to relate to you.

But Bowen's idea was also about the autonomy part, in that you don't live your life according to anyone else's values. That you have to go into your own heart and figure out what your own values are and then live it out. But that we are all connected. I mean, that's totally basic to Bowen's theory, and it's so different from those who focus on autonomy as, " I've got to do for me." But I'm in it with you. We're in life together. That's just the deal.
RW: This is not some abstract idea, but a reality that exists in our lives. It seems every therapist we have interviewed here has approached this idea: We are connected, we are separate, both are true and how we deal with it is everything.
MM: It's not that I can only pretend that I'm not connected to you because I am actually. Something could happen right now and I could this minute be dependent on you to save my life because you'd be the one here. And if I do something to hurt you, that could come back to hurt me. Because that's just our nature, that we are interdependent.
RW: But then how does autonomy play into this for you?
MM: In a way, it is a philosophical stance that there is no such thing as autonomy. The only autonomy is about our decisions of how to live. You know? So, it's so basic to our way of thinking, systemically, about our connectedness. Respecting each other in some kind of spiritual understanding that we are a part of something larger than what we can see, including our ancestors, including those who are going to come after us, all that.
RW: This must be the kind of approach you use with clients, too. Talking this way, and sharing these things with them.
MM: It is. I do. Yeah.
RW: Do they ever want to rebel against it?
MM: Oh, sure. Yeah.
RW: Can you think of an example?
MM: Oh, not my clients. They just come in. I say, "Listen, you have to get a relationship with your mother first thing. Could you bring her in next time?" And they say, "Oh, sure. That sounds good." (laughter)

They say, "Go fuck yourself. I told you, my problem is I want you to fix my wife."
RW: Or my mother or my father or...
MM: My mother. Yeah. You get them to stop drinking, no problem.

McGoldrick's Work with Families

RW: How do you get people to turn to themselves and what they can do? Can you give an example of how a person starts with the position of "it's them, it's not me," and you get them to turn it around?
MM: Well, if you take the example of the video I did with that family. I think that's a good example where he wanted me to fix the daughter and, for many reasons, wanted to push away his part in that because of his own grief about the wife and the other things he didn't deal with in his own way. And something about getting the stepmother out of the way to focus in on the daughter, to really hear her, and then also bringing in the son because that I see as relevant, too. That sometimes, as with that guy, a person can hear it more powerfully if two of the children say that it matters. And that something makes a person hear it differently.
RW: Any other examples of this playing out in therapy?
MM: I was thinking of one guy; he was very negative, sort of talking suicidally. I raised questions about that. And he's says, "How else is there to be?" And I said something about culture, and he says,
"Oh, don't give me that bullshit. If you're going to tell me that this is about culture, then I'm out of here."
"Oh, don't give me that bullshit. If you're going to tell me that this is about culture, then I'm out of here."
RW: What was his background?
MM: Irish. And then, he said... It was all his mother's fault. Blah, blah, blah. And she was this witch who had been controlling, you know, whatever. So, I said couldn't we talk to her? Because she was alive and around. And he said, "No, we're not doing that, and I'm not coming back if we even think about that. I came here to solve my marital problems with my wife and this is it." A number of months later I was at it again: "You tie my hands behind my back and then you're frustrated that I haven't helped you yet. Bring in somebody. Who would you be willing to bring in?" So he brought in his brother, which was really interesting. I learned a lot about the family, and we talked about the sort of suicidal feelings and whatever.
RW: And what about the mother, did you ever get her in?
MM: Eventually, somewhere we had a big argument about his mother and I said, "You know, well, I hate to be a broken record, but we could go back to that?" And he says, "If you had her in, what would you say to her?"

"I don't know what I'd say to her. I'd have a chat with her about whatever's been bothering you. Or you'd have a chat with her."

"No, but I want to know what would you're say to her." "I don't know," I told him. And then I remembered. I had just been looking in this book that I wrote, You Can Go Home Again, this is a book for the public. At the end of the chapters, I actually have questions that you could ask you parents. So I said, "Well, come to think of it, you know, if you asked 100 therapists they wouldn't be able to tell you, but I actually wrote a book and there you can see the type of questions I might ask her."

"No, I want to know the exact questions."

Whatever...
RW: The whatever approach.
MM: So, I said, "You know, you do whatever you want to do." And finally he said, "Next week I'll either bring in my mother or I won't." So, I said, "Well, that'll be good. Okay." So the next week he brought in his mother, and it was the most amazing thing. I don't think I said a word the whole time, and he worked out so many things with her. It was so interesting. She was phenomenal.
RW: You being there helped. And she was phenomenal.
MM: Well, you can't count on the parent being phenomenal. But that he did it would have been good enough because he took all the responsibility. It's like he knew what he had to talk to her about. He said to her, "I'm a 51 year old man. I feel like I have to talk to you about some things that happened so long ago, and I feel like it's stupid but these things are kicking my ass, and I'm taking it out on my wife and my two year old and I don't want to be like this. I've got to talk to you." And she just listened which worked out so well.
VY: What I really like about such stories is that on so many videos or therapy stories, they show the therapist being brilliant and making great interpretations, but instead sometimes it is best to shut up and listen.
RW: Anti-brilliant. Just to be there.
MM: Get out of the way.
VY: Get out of the way. When the clients are doing the work, you don't need to be there, you go to the background.

Jackie Robinson's Wife, Culture and Family Therapy

RW: Lets go back to something you brought up earlier. What led you to get into culture and ethnicity and why are these so important in your work?
MM: I suppose at some emotional level, I was raised by an African-American caretaker who worked for our family and was the person I was closest to growing up, I am sure at some level—because I loved her—at some level what was wrong there about race was at the interior of my own family. I'm sure that had an impact. But I don't know really.
RW: You noted earlier that Bowen did not like your cultural work either. How come?
MM: Well, it was kinda surprising that Bowen did not like these new ideas about culture, but he came at it from another angle. Bowen had this idea about triangles and family. And then he took it to the level by analyzing societal level systems in terms of triangles. We feel better if the enemy's a really good enemy, but if the enemy's not a really good enemy then we start fighting with each other. This is the process by which nations and social systems basically join together and scapegoat a third party.

So culture would make great sense from that point of view. And Elaine Pendehughes, an African-American therapist, took his theory and used it to analyze slavery and how that system operated. And she did a really brilliant, basically Bowenian analysis of slavery.
RW: What was his critique of your work then?
MM: I remember one conference where he chose to speak out against my work on culture. He could be an ornery person at times. We had recently published the ethnicity book, Ethnicity and Family Therapy and Bowen said,
"Those people who want to waste their time studying, you know, the differences between the Irish and the Italian, let them waste their time."
"Those people who want to waste their time studying, you know, the differences between the Irish and the Italian, let them waste their time." And he was talking to me, clearly. And everyone in the room who knew anything about it, I'm sure, knew just who in that room was wasting their time studying the difference between Irish and Italians.
RW: Back then there were not as many ways to talk about culture in psychology. To bring this home, I'm teaching a course in ethnicity, diversity and psychotherapy next semester for the first time. What kinds of things do you think would be important to attend to? I'm going to use your book as one text, so I've got that going.
MM: Well, this is a whole subject in itself. Because I think there is a lot about white privilege, heterosexual privilege, gender privilege that really we need to pay attention to and think about how it organizes us. And that would be good to deal with in your class. I think it important to deal with it multi-dimensionally. That ethnicity most of the time, not always, helps people get centered a little bit if you urge them to think about what it means. Who we are culturally and what are the values we grew up with and so forth.

I didn't grow up thinking anything about any of that. I didn't know I was Irish, never mind, you know, white. I mean, honestly, I knew nothing. I was just a regular person, or so I thought.
RW: You found out you were white later?
MM: I found out I was white really later. I didn't know I was a woman, never mind that. I mean, I just thought I was a person. And I never thought about gender. I never thought about race. I didn't think Irish meant anything. It was not even a category.

I knew my name was Irish. If you asked me, I could have told you that my ancestors came from Ireland. But if you said, "Does that mean anything?" It's like, "No. That was like 150 years ago. It's like, it means nothing to me."

Now I would say, it has organized my family for that entire 150 years, and right now many things about how I react to a situation have to do with the power of that history. Only just recently, maybe like the past year or so, I started thinking about some of my experiences in college and realizing that I think now it probably had to do with being Irish. The ways in which being at an Ivy League school, Brown—I knew I didn't belong, and I knew I didn't fit. But I didn't know what the rules were and I didn't know that that was because I wasn't a WASP. I didn't get that. I was very naive about it. So I think there were all kinds of things that I didn't understand.
RW: And at that time there were few women in the therapy world. How did that work out for you?
MM: There were lots of things in family therapy that I didn't understand about being a woman; there was so few male mentors who could take me. I was quite a follower of Virginia Satir. She was the only woman. And I would go anytime she was going to be there.
RW: So you went from all that to writing a book on ethnic diversity in family therapy. That's quite a ways.
MM: Well, ethnicity came first. Ethnicity came in by doing my own genogram there came a point where it was like, "Yeah, but what does it mean to be Irish?" And my family never wanted to talk to about it. They could pass for the dominant group. They had gone to Ivy League schools. They were pretending they weren't Irish, you know. And so they taught us that. And so when I started asking questions, my mother, especially, was distinctly uninterested.
My mother kept saying, "We're Americans, Monica. Leave it alone. What do you care where we came fromr? We're Americans."
My mother kept saying, "We're Americans, Monica. Leave it alone. What do you care where we came fromr? We're Americans."

And because I hated her I would always pursue anything that she didn't think was good like asking her about our background. She would say, "They were just peasants. They were just peasants. Could you just leave it alone? They were nothing. Here we are. We're fine now." You know, but then that got me interested. And that book came out of going to Ireland in 1975. It totally transformed my life. I was already married to a Greek, so I knew ethnicity meant something.
RW: What do you mean about his being Greek?
MM: They do maintain it. My husband grew up in Greece, so he was seriously ethnic. But you know, that didn't relate to me. But we went to Ireland and it was like, "Oh my god. Everybody's like my family." And I had four years of psychotherapy where I had analyzed the shit out of my family of origin and thought about it differently. But nobody said, "It's culture!"

My mother would make fun of people - that was her typical way. It wasn't really an angry thing; it was subtle. So, humor was a way that she would put you down. She would make you feel stupid. She would make a joke. She'd wait for someone else to come into the room and then she would make a joke about you. So, you would just feel humiliated.

Well, going to Ireland I saw that that's what the Irish do.
The Irish wait until another person comes into the room and they make a joke at your expense. And yet, the way humor operates, I thought that that was just my fucked-up mother. But it's like, oh my God, they all do this.
The Irish wait until another person comes into the room and they make a joke at your expense. And yet, the way humor operates, I thought that that was just my fucked-up mother. But it's like, oh my God, they all do this. How come nobody talks about these things? I came back to the medical school and I couldn't stop thinking about it.

One of the First Diversity Classes

RW: Did you ever talk about culture and ethnicity in your training?
MM: Yes, we did these little presentations, six of us, 15 minutes a piece on different ethnic groups: Irish, Jewish, Italian, African American, Puerto Rican, and Asian. It was very short, 15 minutes each. And even in the 15 minutes, we're be, "Well, I can't speak for all Irish, but-" And then say a few stereotypes. And it was mind blowing to me.

I remember the Jewish one and the WASP one. The WASP one went first and she makes all the apologies and then she says, "Well, you know, if I'm going to say something about WASPs, they kind of believe everything in moderation and decorum and they're not too big on expressing any feelings too strongly. Everything in moderation. Leave a little on your plate. Never get too enthusiastic about the food."

And her best friend was this Jewish therapist who went next and she said, "Well, you know, you can't speak for all Jews because...there are German Jews and there's European Jews and anyway, you know, Hungarian Jews are completely different. Then you have Los Angeles Jews and they're different from New York Jews. And Brooklyn Jews are different from, you know, Bronx Jews," and so forth. Then she finally said, "But anyway if you are going to say something, Jews kind of believe in expressing your feelings and actually talking a lot about analyzing your feelings and expressing them. And food is very important, and guilt is very important. And eating more and getting your children to eat more is very important."

Then we had a little conversation, and so the Jewish woman said to the WASP, "I've always liked you, but I have to say that I've always found it a little irritating that you're so smart but you never speak up in a group. It's really like you are withholding. And now when you've expressed this about how, you know, in your culture, it's like in moderation and you shouldn't...it's like you hide your light under a bushel, and I never really understood that. I just found it irritating."

So the WASP woman says, "Well, okay, if we're going to be sharing like this. Actually, I've often wished you would hide your light under a bushel, because you never hesitate to say what you think in a group."
RW: And what did all this mean to you at the time?
MM: My thought was that even though I had worked with them for several years, I had reacted to them both in terms coming from my Irish point of view, which is different, and I had just judged them as if they were wrong and I was right. Why did one always speak up? And why did the other always seem to hide her light under a bushel? And I never thought before that moment, wow, this is really cultural meaning.
RW: Well, that makes sense then. What you're also saying is that it is a good idea to get in touch with your own roots. And that enlivens you and engages you.
MM: Right.
RW: I was also concerned more about how early multicultural ideas seem to use stereotypes or oversimplifications. Say Asians are just into shame or Blacks feel suspicious in society because of oppression, and so on.
MM: My thought would be to use the ethnicity book to help people understand something about where they might be coming from, because what we tried to do is lay out caricatures that help, you know, tell the story. And to try to tell it so that the characteristics are put into some kind of historical context of why Italians might be suspicious and why African-Americans might be a certain way and why the Irish might have developed the characteristics that they have.
RW: So, instead of just the trait outside of history.
MM: Right. Because if you think systemically, of course, there has to be a reason why people would develop these different ways. But one thing that I do think is very important and I think is very hard to teach about is, when you come from a place of privilege, it is so hard to be aware of what the implications are of that in the interactions with the other. It would be easier for me to tell you about the ways that I felt inadequate as a woman, and didn't know about it. Or felt inadequate as Irish and didn't realize it.

It's harder for me to talk about—which I'm struggling to be aware of—the ways in which as a white person, I have so many privileges. And feel free to talk about so many things in a context without even realizing that others don't. I don't think the issue is apologizing for it. It's getting conscious of it and the doing work and then following it through. What are the implications of that?

"I Feel Like I Fell Into Heaven"

RW: A wrap up question. You've been practicing quite awhile. What keeps you going as a therapist? What still juices you?
MM: I love it. You can probably tell. I feel like I stepped in, that day when I met Lowell Cooper, I feel like I fell into heaven. I love what I do. I love these ideas. I feel like family therapy may be dead here in this country because of all the things that we talked about, but family in all different forms is still there.
RW: And family still matters whether they all come in or one at a time.
MM: Yeah. How do you help people and what can we do and what makes a difference. And every family is a great challenge. And I love mentoring students, and trying to put ideas together... I love all of it.
RW: Well, I wish we had time to go into a lot more. Maybe another time. Some of them we only touched on, because your background is so rich and your ideas are a piece of heaven. Thanks so much for sharing them with us today.
MM: Thanks for talking to me.


Copyright © 2006 Psychotherapy.net. All rights reserved. Published January 2006.
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  • Describe the systems perspective for working with families
  • List ways in which culture and ethnicity impact family therapy
  • Explain how therapy genograms can connect family history with current issues
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Disclosures
Monica McGoldrick Monica McGoldrick, M.A., LCSW, Ph.D. (Honorary), the Director of the Multicultural Family Institute in Highland Park, New Jersey, is also Professor of Clinical Psychiatry at the Robert Wood Johnson Medical School. She received an Honorary Doctorate from Smith for her many contributions to the field. Among many other awards, she has received the American Family Therapy Academy Award for Distinguished Contribution to Family Therapy Theory and Practice. She has written and spoken widely on a variety of topics including culture, class, gender, the family life cycle, loss, genograms, remarried families, and siblings. Three of her books have become best-selling classics of their publishers: The Changing Family Life Cycle, 3rd edition; Ethnicity and Family Therapy, 3rd edition; and Genograms: Assessment and Intervention, 3rd edition. See her website for more information on Monica McGoldrick and The Multicultural Family Institute.

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Monica McGoldrick was compensated for his/her/their contribution. None of his/her/their books or additional offerings are required for any of the Psychotherapy.net content. Should such materials be references, it is as an additional resource.

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Additionally, there is no commercial support for this activity. None of the planners or any employee at Psychotherapy.net who has worked on this educational activity has relevant financial relationship(s) to disclose with ineligible companies.
Randall C. Wyatt Randall C. Wyatt, PhD is a practicing psychologist in Oakland and Dublin, California. He specializes in working with post-traumatic stress, cross-cultural therapeutic relationships and couples therapy and has extensive teaching experience.




Randall C. Wyatt was compensated for his/her/their contribution. None of his/her/their books or additional offerings are required for any of the Psychotherapy.net content. Should such materials be references, it is as an additional resource.

Psychotherapy.net defines ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. There is no minimum financial threshold; individuals must disclose all financial relationships, regardless of the amount, with ineligible companies. We ask that all contributors disclose any and all financial relationships they have with any ineligible companies whether the individual views them as relevant to the education or not.

Additionally, there is no commercial support for this activity. None of the planners or any employee at Psychotherapy.net who has worked on this educational activity has relevant financial relationship(s) to disclose with ineligible companies.
Victor Yalom Victor Yalom, PhD is the founder and resident cartoonist of Psychotherapy.net. He maintained a busy private practice in San Francisco for over 25 years, but now sees only a few clients, devoting the bulk of his time to creating new training videos for Psychotherapy.net. He has produced over 100 videos, conducted workshops in existential-humanistic and group therapy in the US, Mexico, and China, and currently leads consultation groups for therapists.  More info on Victor and his artwork and sculpture at sfpsychologist.com.



Victor Yalom was compensated for his/her/their contribution. None of his/her/their books or additional offerings are required for any of the Psychotherapy.net content. Should such materials be references, it is as an additional resource.

Psychotherapy.net defines ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. There is no minimum financial threshold; individuals must disclose all financial relationships, regardless of the amount, with ineligible companies. We ask that all contributors disclose any and all financial relationships they have with any ineligible companies whether the individual views them as relevant to the education or not.

Additionally, there is no commercial support for this activity. None of the planners or any employee at Psychotherapy.net who has worked on this educational activity has relevant financial relationship(s) to disclose with ineligible companies.

CE credits: 1

Learning Objectives:

  • Describe the systems perspective for working with families
  • List ways in which culture and ethnicity impact family therapy
  • Explain how therapy genograms can connect family history with current issues

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