Walking A Tightrope: Family Therapy with Adolescents and Their Families

Earn CE Credit

• Beyond the Comfort Zone
• It Takes a Village
• A New Conversation
• A Haunted Past
• Providing the Map

Beyond the Comfort Zone

The anguish and torment in Mrs. Gilyard’s voice over the phone grew more radiant.  Her desperation, anxiety, and fear were gripping.  Though I attempted to offer some comfort —at least as much as was possible during a 30-minute conversation between two strangers—she became increasingly agitated.  As she began to provide more detail about her only child Clyde, a fourteen-year-old son, for whom she was seeking therapy, I could hear her voice cracking with the effort of fighting back tears. 
 
“Clyde is spiraling out of control,” she cried.  “He’s begun to hang out with a bunch of do-no good, do-nothing hoodlums.” She was worried that failure—or worse, tragedy—was aggressively recruiting her only child. “He is a good kid,” she attempted to reassure me, “but I worry about him being in the wrong place at the wrong time.”  Although he’d had no brushes with the law, she was terrified of any potential encounters he might have with the police—an encounter she intuitively knew could be a matter of life or death. 
 
Mrs. Gilyard, like so many other parents of color, was raising her child with the police foremost in her thinking.  While she and her husband enjoyed a solid middleclass lifestyle, both were African American and understood all too well the rules of the streets, especially regarding young black males. Mrs. Gilyard was worried because she understood that the urban streets were unforgiving for many young black males like Clyde. Unfortunately, Clyde, according to his mother, “knows everything and won’t listen to me or his father.”  In fact, Clyde had, in a very short period of time, according to his mother, transformed from a “very respectful young man” to a disrespectful, self-centered, impulsive shadow of the human being he used to be. “He’s moody, often refusing to talk for days, and all he wants to do is sleep, text message, hang out with his friends, and download music.  To be honest with you, Dr. Hardy,” Mrs. Gilyard said, “although he is my God-given son…” She paused. “I am quickly getting to the place where I can’t stand to be in his presence. I am not sure I even like him anymore. I can’t tolerate his nasty attitude. I have no patience with him. I’m worried that I might hurt him, or someone else will, if he doesn’t get some help.”
 
As our telephone conversation progressed, it seemed to have no end in sight. Mrs. Gilyard needed to vent and was oblivious to time or circumstance. I tried numerous times to gracefully end the phone conversation that was dangerously slipping into a full-blown noncontractual, nonconsensual therapy session, but Mrs. Gilyard was too consumed by her utter sense of desperation, now flirting with panic. 
 
I commented that although she seemed to have moments where she felt disdain for Clyde’s behavior, her dominant feelings towards him seemed to be worry, fear, and a deep motherly love for him. I went on to suggest that I imagined the situation with Clyde was taking a huge toll on her, as well as the entire family, and although she was seeking treatment for Clyde, I thought it would be helpful for the entire family to attend.  My comment and suggestion apparently surprised Mrs. Gilyard and immediately earned her ire. Her tone and approach to our conversation changed instantly.
 
“Why do we need therapy?” she demanded.  “I don’t think there is anything wrong with Claude and me, and I honestly don’t know what there is for us to gain from coming into therapy. We will do whatever to help Clyde, but he has to find himself and nobody else can do that for him. As his parents, we have to provide him with love, support, and guidance, but he has to be willing to accept it. Right now, his friends and his music seem to be all he cares about!   I don’t see how us coming to therapy is going to help him get what he needs.”
 
My interaction with Mrs. Gilyard suddenly shifted from the emotionally intense, unconditionally accepting reflective listening phase of engagement to one of the most delicate and thorny areas of family therapy: problem definition and who should attend the session. These issues are always critical dimensions of family therapy treatment. Mrs. Gilyard and I suddenly found ourselves on a major collision course.  She remained convinced that Clyde was the problem and that whatever was going on with him needed to be fixed inside of him.  In her world, problems were individual and the solutions were simple: you found out what was broken and you fixed it. From her perspective, Clyde was broken, like a malfunctioning carburetor in a car, and in either case the solution was a simple matter of targeting it and repairing it.  She seemed to be oblivious to the fact that even the best mechanic in world could not repair a faulty carburetor without having access to the car! This was where our worldviews collided.
 
I believe that all problems are essentially relational and that we all are relational beings living our lives in a relational context.  As a family therapist, I believe that problems are delicately and seamlessly interwoven in a nexus of relationships.  It is difficult for me, if not impossible, to envision any human interaction problem without considering the relational context in which it is embedded. So, unlike Mrs. Gilyard, I assumed that the problems were embedded in relationships and the relationships were embedded in problems.  In this regard, in cases such as the Gilyards’, it is my contention that family members contribute to the formation of a problem, the maintenance of it, or both. And if problems are embedded in relationships, so are solutions! Thus, having the entire family participate in therapy is essential. 
 
However, from the perspective of Mrs. Gilyard, Clyde was the problem because it was his behavior that was problematic. It was he who was broken, malfunctioning, or deviating from family and societal norms. Accordingly, Mrs. Gilyard believed that the best solution to the problem was to treat the problem: Clyde! The dilemma was that if I dismissed Mrs. Gilyard’s definition in favor of mine, therapy could not occur. Yet on the other hand, if I abandoned what I believe, how could I possibly assist the family without further problematizing Clyde? Before ever meeting Clyde, it was crystal clear to me that he was considered the problem and would continue to be until his deeds, attitudes, and behaviors complied with his mother’s wishes.  So in a sense, the only problem was the problem that was asserted by the family. And, if I insisted otherwise--i.e. that my definition of the problem should overshadow the family's viewpoint--then that would only result in creating yet another problem! This is the tightrope that all family therapists have to gently and delicately traverse.
 
            Despite Mrs. Gilyard’s claim that she would do anything to assist Clyde “in getting his life back,” attending therapy with him was not on her immediate list. Because I often believe that a family’s refusal or reluctance to participate in therapy is usually a result of a tendency to think individually and not relationally, and an underlying fear of being blamed and/or exposed, I knew I had to tackle both of these issues with Mrs. Gilyard if family therapy were to ever take place.
 
I tried to reassure her that a family session would not be about finger pointing or keeping score about who did what to whom. “It will be a place where we can develop a deeper and better understanding regarding how the family operates and how each of you is affected by what everyone does,” I explained over the phone. “You know, families cannot function well when each member attempts to do what they think is right or best without considering how it affects others.”
 
At this point, although unfazed and unconvinced, she at least seemed willing to listen more carefully.
 
“You, along with your husband, seem to be concerned, involved, and loving parents. I imagine the two of you have an infinite reservoir of information about Clyde that you have been collecting since his birth. You, quite possibly unlike any other person on the planet, have cherished early life memories of Clyde that you have probably safely tucked away in the secure closets of your mind. I know you and your husband need my help, and I am honored that you are willing to trust Clyde in my hands. But I need you and your husband’s help as well. I need the infinite knowledge and wisdom that you and quite possibly only the two of you have about him as well. My time with him will be limited no matter how much time we have, and it would be great to have the two of you as resources. You know, I am sure you have heard that old African proverb expressed a million times that it ‘takes a village to raise a child.’ Well, if Clyde is struggling as much as you say he is—and I have no reason to believe otherwise at this point—he needs a village. And we will be Clyde’s village!” 
 
After an impregnated pause and a chilling silence, Mrs. Gilyard, in a much softer voice, said with a slight sigh of relief and perhaps resignation, “Yes, you’re right.  Clyde is a part of me. He is like my third arm or leg. I do know him. Or at least, I used to.  I will talk to my husband. Doctor, I hope you—er, I guess I should say, I hope we can help my son.”
 

It Takes a Village

This interaction with Mrs. Gilyard was pivotal. I attempted to use my conversation with her to validate her concerns and to provide her with a petite lecture about the importance of the family’s involvement in the treatment. Because she had made references earlier in our conversation to race, I thought it was critical to integrate race into my feedback to her; thus my reference to the African proverb.  If there were any chance of Mrs. Gilyard becoming an advocate for family therapy, it would be critical for her to end our telephone call more of a believer than she was at the beginning of it. I knew it was crucial for Mrs. Gilyard to feel heard, understood, and validated before she could hear anything I had to say to her.  As is always the case, one metric for determining whether our conversation had any lasting impact would be whether or not the family retained its appointment for our first session.  Confronting the unknown of a first therapy session can often be a daunting and nerve-wracking experience for even the most enthusiastic and resolved subscribers to family treatment.  
 
Exactly one week later following our phone conversation, Mrs. Gilyard made good on her promise. She, her husband of 30 years Claude, and their son Clyde arrived at my office for our first session. My initial interactions with the family were pleasant and polite as we engaged in light-hearted conversations about the weather and traffic. Throughout it all Clyde remained detached, appearing disinterested but respectful.  There was an understandable tightness to the family. They seemed tense. Mr. Gilyard was noticeably uncomfortable and asked several times in the first few minutes about how long the session would last and how many sessions would it take before they would “see results.”
 
I thanked the family for coming and their dedication to finding answers to issues that were plaguing them. Then I turned to Clyde. “I’ve talked to Mrs. Gilyard on the phone and know that she is worried a great deal about you.”
 
He smirked slightly but refused to bite the bait and respond to me verbally. I was encouraged by the smirk because it was a sign of responsiveness to being engaged—a private mental note I made certain to record.  I turned to Mr. Gilyard and asked, “Do you share your wife’s concerns?” Then, turning to Clyde again, “What do you think about all of this?” To increase the probability of participation throughout the therapeutic process, it is imperative in family treatment to acknowledge all family members as early as possible and to invite their participation even if and when they passionately refuse.
 
The room was quickly filled with a breathtaking silence and discomfort. Finally, perhaps as a function of her discomfort, Mrs. Gilyard broke the mounting minutes of silence that must have felt like hours to the family, by inexplicably saying: “You are so much smaller than I imagined you to be. I for some reason expected a bigger, older man.”
 
After many years of clinical practice, I am seldom surprised by the disclosures that are uttered within the private walls of therapy, but I was surprised by Mrs. Gilyard’s comment and wasn’t immediately sure what to make of it. I simply responded: ‘Oh, well… Thanks for your honesty… I always find it an interesting task to imagine what someone looks like based on their voice and telephone personality.” 
 
It was of note to me that Mrs. Gilyard elected to make me the focal point at the precise moment that I was attempting to engage Claude and Clyde about their perceptions about the family. Maybe this was coincidental, but I wondered if I was getting a snapshot of how hard Mrs. Gilyard worked in this family.  Since I had spent an appreciable amount of time with her on the phone, I really wanted to make a concerted effort to interact with Claude and Clyde. So I returned to father and son and asked, “What is going on with the family from where you sit?” 
 
Mr. Gilyard then turned to Clyde and said: ‘The doctor’s talking to you. Tell him what you think. And sit up, please. And Clyde, take off the hat. And put that thing away,” she ordered, gesturing toward his son’s iPod. Clyde sat still and stoically, dressed in a blue-and-white NY Yankee baseball cap that he had on backwards, stylishly coordinated with an elegant blue silk tee shirt, and blue-and-white Jordan sneakers.  He looked at his father and slowly removed his baseball cap, never uttering a single word. 
 
 Mr. Gilyard, after thinking for a few minutes, said he was worried about Clyde and believed it was getting harder and harder to reach him.  He noted that he didn’t share his wife’s short fuse with regards to Clyde’s antics but was bothered by his son’s lack of direction.  “He doesn’t take life seriously. He thinks it’s a joke, a game!  He has no sense of the sacrifices that his mother and I and many who came before us have made for his benefit.  He is reckless, impulsive, and irresponsible. He thinks only of today, this minute—this second!  He has no goals or interest in anything. He wants to sleep his life away,” observed Mr. Gilyard, his voice rising. “I am so afraid that he is going to wake up one day and suddenly discover that life is indeed short, precious, and waits for no one—a realization that will come much too late for him to do anything about it.” 
 
As Mr. Gilyard’s lower lip began to quiver, and his right eye began to slowly fill with a single developing tear, I asked him to turn to his son and to tell him that he loved him and that he was worried about him.  The older man seemed stunned and paralyzed by my request.  Obviously overcome and perhaps even slightly embarrassed by his emotions, he could only say to me in a tone slightly above a whisper, shaking his head slowly and affirmatively, that Clyde knew. 
 
“But can you turn to him and tell him?” I asked again, to which he responded by repeating his earlier refrain: “He knows.” 
 

A New Conversation

I then asked, “Can you be his father in this moment, turn to him and tell him that you love him and that you are worried about him?”  As the interaction intensified between us, the anxiety in the room was palpable.  Mrs. Gilyard discreetly reached for her husband’s right hand with her left hand and began to gently stroke their clasped hands with her right hand.  With her voice breaking, she softly said: “Honey, just tell him.”  She then turned to Clyde and began to tell him that she knew he must know that they both love him “to death.” 
 
Once again, Mrs. Gilyard was in her familiar role of working overtime for the family while Mr. Gilyard was working hard to emotionally retreat from the interaction. Maybe there was something to this dynamic: maybe Mr. Gilyard’s “low pulse” for engagement heightened his wife’s anxiety, which she ameliorated by becoming more actively involved in an interaction.  Her involvement in turn  reinforced his low pulse, and his low pulse heightened her anxiety and so forth and so on. 
 
Meanwhile, Clyde remained a central but peripheral figure in the family’s interaction.  He was the frequent subject of his parents’ reprimands, criticism, and attempts to speak for him. While it was Mrs. Gilyard’s good intention to make sure that Clyde was reassured of the love that his dad was having difficulty expressing directly, it was nevertheless counterproductive to what I was trying to accomplish with the family at this point. So I decided to re-engage Mr. Gilyard by simply turning my body towards him and pointing to Clyde. 
 
He started his interaction with Clyde by telling him, critically, why he needed to change. I immediately interrupted him. “I realize this is important fatherly advice you’re offering your son,” I said, “but I want you to suspend the advice giving for a moment and simply tell your son that you love him and that you’re worried about him.” 
 
For the first time during the session, Clyde looked at me and said, “Boy, you’re a trip! Just give it up. Why keep asking the same frickin’ thing over and over again? I know he loves me. There. Are you satisfied? Now can we move onto something else?” It was striking to me that this one seemingly benign and simple request sent so many reverberations through the family while giving me a front-row seat to the family drama that had necessitated the Gilyards coming to therapy.
 
I commended Clyde. “I like the fact that you’re so honest and direct. You didn’t feel like you needed to sugarcoat your feedback for me. I think I like you, Clyde!”  I hoped that my feedback would have some resonance with him and provide a small buffer against the barrage of negative feedback he was accustomed to getting from his parents.  Clyde responded with a very faint smile, a slight shrug of his left shoulder, but for the most part he continued to sit motionlessly and without much overt expression.
 
 The family’s process had been marvelously effective at maintaining their status quo. The climate in the room was much less intense and they seemed more relaxed, at least on the surface. Mrs. Gilyard scanned the room with a sense of anxious anticipation. She looked as if she was wondering, “What’s going to happen next?”  Mr. Gilyard retreated and seemed far away, while Clyde nervously patted his right foot and stared at the ceiling. I sat quietly observing the family as my eyes occasionally connected with Mrs. Gilyard’s. 
 
After a few minutes of silence, I commented to Mr. Gilyard, “It seemed like it was a little difficult for you to talk directly to Clyde a few minutes ago. Was it difficult?”  
 
“You know, Doctor,” Mr. Gilyard quickly responded,  “it is not difficult for me to talk to my son and I don’t really have a problem talking to him. It’s just sometimes it seems pointless because Clyde is going to do what Clyde wants to do. I feel like the things his mother and I say to him go through one ear and out the other. So sometimes my attitude is, ‘Why bother!’” 
 
I noted how frustrating and seemingly futile such a dynamic could be, especially when there are legitimate worries and wishes that they would like to seriously convey to Clyde. Then I made an observation to Mr. Gilyard, trusting that Clyde and Mrs. Gilyard were eavesdropping. 
 
“My early sense of Clyde so far is that he is self-reflective, contemplative, and a courageous communicator,” I said. “I have noticed the way that he has sat here very quietly but has been very attuned to what is going on here, though his words have been few.  Yet as you observed a few minutes ago, when he had something to say, boy, did he say it with force, conviction, and clarity. I think a good conversation is possible between all of you if you could each attempt to have the conversation differently. Trying to have new conversations the same old way you have been attempting to have them is not working for the family. If you continue to hold onto the old ways you have been trying to engage with each other, this process will take forever and Clyde will turn to his friends for the conversations he should be having with his parents!” 
 
Mr. Gilyard seemed intrigued, if for no other reason than my oblique reference to the timetable for treatment, which I knew was important to him. I then asked Mr. Gilyard, “So do you think taking a different approach to talking to Clyde is something that you would be willing to try?” 
 
 “I am willing to do anything that you think will help me reach my son,” he replied.  
 
“I appreciate your willingness to give this a try,” I responded.  “I would like to return to where we were earlier. When I listen to you, I feel a kind of underlying pain—almost haunt—that you have when you think about Clyde’s life. What I hear and feel from you is worry, fear, and pain, yet what gets communicated to Clyde, and probably what he hears, is criticism, rejection, and anger. I would like for us to try this differently this time around. Can you turn to your son and tell him you love him and that you’re worried about him?” 
 
Mr. Gilyard looked at me with a slight sheepish grin and nodded.  He then took a minute to collect his thoughts as he stared at something beyond the room in which we are sitting. Mrs. Gilyard fidgeted a bit and nervously rubbed her hands together.  I could tell Clyde was very tuned in, although he outwardly retained his cool pose of detached disinterest. 
 
The silence built and so did the intensity in the room. After a few more minutes, Mr. Gilyard turned to Clyde.
 
 “I don’t know why this has been so hard for me,” he said to his son. “I don’t want you to think it had anything to do with not loving you…because I do love you very much, my firstborn son.  I will always love you, and I am sorry if I have somehow ever given you the message that I don’t love you or that my love for you is conditional.”
 
“Can you also tell him about your worries?” I encouraged him.
 
Mr. Gilyard sighed. “I do worry about you.”
 
“Can you tell him about your worries?” I prodded. “The ones that keep you up at night.”
 
 “I guess I worry all the time. I worry about drugs, although I don’t think you would ever    be stupid enough to do drugs. I worry about you not giving your best in school and the ways that will hurt your future. I worry about…” Mr. Gilyard’s breathing shifted; his words suddenly seem much harder to find. His voice was beginning to break and he now seemed more hesitant to continue.
 
“You’re doing great,” I told him. “This is the type of conversation that you and Clyde have needed to have for awhile now. Please don’t hold back now. Tell him about all of the fatherly worries you have about him.”
 
 “I worry… I worry…” Mr. Gilyard began to cry. “About something awful happening to you. About you dying, and there is nothing I or your mother can do to protect you. I worry about the damn trigger-happy police. I am worried that life is short and I don’t know what I would do if anything ever happened to you,” he sobbed. “The streets are vicious. People are vicious. And no one seems to GIVE A DAMN about young black boys like you.” He pounded the coffee table with his hand. “I can’t tell you, Clyde, the number of times that I have awakened in the middle of the night sweating from the same bad dream—the same nightmare that you are lying on 22^nd Street in a pool of your own blood which is OUR blood too.” He turned to his wife. “Tell him, Geraldine, how many times you have had to comfort me from the same goddamn dream. “ Mrs. Gilyard nodded in confirmation while I gestured to her to refrain from speaking at this point. Both Mrs. Gilyard and Clyde were now beginning to cry as well.
 
Clyde spoke. “I don’t know what’s wrong with you and Mom. All you do is accuse me of doing bad things and being a bad person. I go to school, I get decent grades, and yet I all I ever hear is, ‘You didn’t do this. You didn’t do that. This is going to happen. That is going to happen.’” Clyde was more animated than I had yet seen him, and his voice was raised; he was crying profusely .
 
“Clyde,” I said, “I am so glad to hear you say how all of this affects you. I would be surprised if your parents knew that you have been affected so much by their worries and criticism of you. Thank you for again being such a courageous communicator—you know, having the courage to say what needs to be said and not just whatyou think others think you should say. Your tears—who were they for? What were they for?”
 
 “I don’t know,” Clyde said softly.
 
“Clyde, honey,” said Mrs. Gilyard, “I am sorry that I have been so caught up in my own worries that I have not taken a second to think about how all of this has been affecting you.” She began to cry even louder as she walked over and draped one arm around Clyde while reaching out with the other for Mr. Gilyard.  As she held Clyde, sobbing, she repeated, “I am so sorry. I am so sorry.” I sat quietly, observing this pivotal and sacred moment for the family, and remained appropriately peripheral for the moment.
 
Mr. Gilyard broke the momentary silence. “Son, we didn’t mean to hurt you and put so much pressure on you. We don’t think you’re bad. We just worry about you.”
 
“I honestly don’t know why you are so worried,” said Clyde. “I feel like I can’t breathe without causing somebody—you or Mom—to worry.”
 
Finally I stepped in. “I want to thank each of you for all of your hard work today, and thank you, Mrs. Gilyard, for your hard work in getting everyone here today. Mr. Gilyard, I am so pleased that you were able to tell Clyde about your worries. Now he knows that there are real heartfelt worries beneath all of the criticism. My hope is that you and Mrs. Gilyard can be more diligent in expressing your worries without the criticism, and that, Clyde, you could remind yourself that somewhere beneath their criticism is an unexpressed worry. By the way, Clyde, I share part of your curiosity regarding the roots of your parents’ worries.” I turned to the parents. “I completely understand your worries about the police, school, and what happens if Clyde ends up in the company of the wrong crowd. I think it’s great that you are concerned and involved parents. But as I mentioned earlier, there seems to be a ‘haunt’ when it comes to your efforts to parent Clyde. It is particularly poignant with you, Mr. Gilyard.”
 
As I wrapped up our first two-hour session, I reminded the family that I am a firm believer in assigning homework between sessions. Homework is a wonderful strategy for ensuring that families continue to work together outside of treatment and not rely solely on our weekly two-hour meetings to promote change. The actual tasks to be completed are seldom as important as the spirit of cooperation, collaboration, and communication that is generated (or not) as a result of the assignment. The Gilyards’ first homework assignment was for each member of the family to generate a minimum list of three beliefs each of them had regarding why there was so much worry in the family. They should generate their respective lists separately and then share their beliefs in a brief family meeting that should be scheduled by Mr. Gilyard and must take place before our next session. Clyde was assigned the task of keeping track of whether all of the rules had been followed by all members of the family, including himself, of course. And finally, Mrs. Gilyard was assigned the task of taking a vacation day from all coordinating tasks associated with the homework assignment.
 
The Gilyards showed up for our next session on time, and not only had they completed the homework assignment but had done so by rigidly adhering to all of the specified terms. While the assignment failed to produce any revelatory moments for the family, it did lay down some important groundwork for several transformative future sessions.
 

A Haunted Past

For example, during my fourth session with the family, Mr. Gilyard revealed a secret that he and his wife had lied to Clyde about for many years. Mr. Gilyard had a twin brother who was Clyde’s namesake.  Clyde never had the opportunity to meet his Uncle Clyde because he was killed in Viet Nam, as the family story was often told.  However, the truth of the matter is that Clyde was killed at a tenth-grade school dance after he allegedly threatened another student with a gun. He was fifteen years old at the time of his premature death. In fact, Clyde was the second of two brothers that Mr. Gilyard had lost “to the streets.” His youngest brother, Roger, was stabbed to death by a former family friend in an altercation over a girl. Mr. Gilyard, at age seventeen and just two years following Clyde’s murder, was the one who discovered his youngest brother’s body, with multiple stab wounds, lying in a pool of blood  in his parents’ home. Because of the tragedy and trauma of losing two brothers at such an early age, Mr. Gilyard noted that he had gone through much of his life swearing that he would never have children. 
 
“It was too much responsibility and too big of burden. How can you possibly protect your children from the perils of the world?  My parents were super parents and even they could not protect Clyde and Roger,” he often reflected.  “For many years of my life, the pain of losing my brothers was so painfully gut-wrenching, I couldn’t have imagined any greater pain had they been my children. And then Clyde was born. Everything changed. Suddenly I could imagine a greater pain than what I had already experienced. For a few years, especially the early ones, he actually helped to redirect some of the pain I felt about the loss of Clyde and Roger. Maybe he gave me something else to focus on that my own father never had after losing two sons. I know that both Mom and Dad never ever recovered from Clyde’s murder, and then when Roger was killed, they simply stopped living.” 
 
Mr. Gilyard’s protracted mourning and shame never allowed him to be honest with his son about his uncle and namesake. He created the story about Viet Nam because it allowed him to recreate his brother in an image that was more positive and less burdened by the all of the familiar stereotypes of black men. This, unfortunately, was a huge piece of his son’s burden—a burden he undoubtedly carried from birth. He was not only his fallen uncle’s namesake, but he was a psychological object of possible redemption for his father. Suddenly all of Mr. Gilyard’s worries made sense to me. How could he not possibly once again find himself facing the dawning of the period of adolescence, without re-living the traumatic loss of his two younger brothers?  How could he not worry about Clyde, the flesh of his flesh, possibly following the pathway of brothers Clyde and Roger? After all, life had taught him a brutally cold and unforgettable lesson that young black boys don’t live beyond age fifteen, and Clyde was now fourteen.
 
As our sessions continued, it was a bit unnerving to discover just how unkind the untimely death of young boys had been in the Gilyard’s family. Mrs. Gilyard also had a younger brother, Will, who was killed at age seventeen in a terrible car accident. Although Clyde knew of his Uncle Will, and the circumstances of his death, he did not know that his uncle was illegally intoxicated at the time of his death. According to Mrs. Gilyard, Will was a passenger in a car that was driven by his best friend who was also intoxicated at the time of the accident. As Mrs. Gilyard told the story of Will’s final moments, she wept as if it had just happened yesterday.  She maintained that had Will not been in a state of an alcohol-induced stupor, he could have possibly survived the tragic accident.  Clyde’s surge into adolescence had been a significant unintended catalyst for re-igniting the unresolved grief that haunted both of his parents. In a strange way, Clyde’s life was a powerful symbolic reminder of the Gilyards’ ongoing struggle to make peace with death and loss.
 
I continued to see the Gilyards for a total of eleven sessions, and I believe they made tremendous strides, though there was still additional work to be done. As a result of family therapy, the parents had a better understanding of how the tragic losses of their siblings were infiltrating and sabotaging their best efforts to be the type of parents that they ultimately wanted to be.  They were far less critical of Clyde, but still resorted to blame and criticism when they felt anxious about their son’s life.  The Gilyards had made significant progress in granting Clyde considerably more breathing room, and yet this was still a major challenge for them to completely master.  Our work together had also been instrumental in helping Clyde to see and experience his parents with far more complexity. While he strongly resented their “constant nagging,” he also now understood and felt more genuinely their love for him. From our sessions together, he had the opportunity to experience his parents as human beings with real feelings—hurt, pain, and joy—and not just as critical, robotic and detached enforcers of the rules. He was able to develop more compassion for his parents and them for him. The family sessions afforded Clyde the opportunity to both fight with them—something that the family excelled at—as well as to cry with them—something they were not very good at. Yet, on the other hand, and in spite of it all, Clyde also continued to live up to his reputation as an adolescent.  His failure to follow through with chores, spending too much time of his cell phone, and his frequent flashes of self-righteousness continued to be challenges for him and his parents. 
 

Providing the Map

The goal of family therapy is to provide families with a map—a type of navigational system that assists them in their journey to a different emotional, psychological, and interactional place. The goal of treatment is to leave families whole and hopeful—not necessarily perfect and problem-free. I think the Gilyards and I achieved this goal.
 
Both Mr. and Mrs. Gilyard terminated therapy with the understanding that the difficulties that brought us together were much bigger and more complicated than what rap music Clyde listened to or “his no-good, do-nothing hoodlum friends.” While Clyde expressed a number of troubling behaviors that at times appeared depression-like, “his” problems were much more complicated and intricately embedded in family dynamics and history than he or his parents realized Clyde’s symptomatic behavior was as much an indication of a family system that was not functioning properly as it was a sign of his individual pathology.
 
While the issues that constituted the core of Mrs. Gilyard’s early concerns about Clyde were significant issues, they paled by comparison to the complex, systemic, and intergenerational issues that made the Gilyards’ task of parenting so challenging. Through my work with the family, I was able early on to get a poignant snapshot of how the family was organized and how they interacted. I was able to rely more on what I observed than what they told me. There is something powerful and transformative about the process of witnessing—having the ability to experience and re-live the stories of another’s life with them.  Had I complied with Mrs. Gilyard’s request and “treated” Clyde independently of his family, he would have probably continued to live his life in the shadow of his Uncle Clyde without him or the family acknowledging it, while the family simultaneously and unfortunately maintained that the uncle who had been murdered unceremoniously and without distinction on the streets of the inner city, was instead a Viet Nam veteran and hero.  It was interesting and prophetic that Mrs. Gilyard, before our first session, noted passionately that Clyde had “become a shadow of the human being that he used to be.” I guess he had.
 
During this pivotal moment of therapy, Clyde was able to bear witness not only to his father’s shame, humiliation and hurt, but to his pain and humanness as well.  It changed forever how he saw his father, understood him, and more importantly, experienced and related to him.  Mr. Gilyard, in return, was able to give his beloved son and the namesake of his twin brother a gift of humility and a context for better understanding his father’s worries. And Mrs. Gilyard was finally able to “catch her breath” and exhale. She, for once, would not have to over-function to compensate for Mr. Gilyard’s reticence and emotional blockage. Finding the lovingness in him as a father also allowed her to add depth to the lovingness that she had for him as a spouse, which had the unplanned consequence of further strengthening their marital bond as well. This is the beauty of family therapy: when it works well, it helps families to recalibrate and to experience reverberations throughout the system even across generations.  If Clyde someday decides to become a father, I believe that the shifts he experienced in the relationships with his father specifically, and with his parents in general, will impact how he parents.  As a result of the family’s involvement in family therapy, the generational and relational arteries that connected the lives of Clyde, Uncles Clyde, Roger, and Will, as well Mr. and Mrs. Gilyard and many others, have been refreshingly and painstakingly unblocked, but will require ongoing work to remain so. This, too, is part of walking the tightrope: helping families find ways to celebrate newfound highs while simultaneously keeping them grounded enough to confront the next new challenge.
 
Family therapy, especially with adolescents, is often about walking on a tightrope: dangerously and delicately walking the fine line between hazard and hope. The tightrope is ultimately about encouraging and exploring that undefined, often difficult-to-measure balance between clinically taking positions and imposition, between promoting intimacy and compromising safety, and between increasing intensity and fostering comfort.  Having a willingness to tiptoe along the tightrope often means that in my work with adolescents and their families, I have to stretch myself well beyond my zone of comfort and safety. As a family therapist I have to earnestly and relentlessly push myself in treatment to ask one question more than the question I am comfortable asking, and to take risks that might expose me to failure, while at the same time offering tremendous potential for the promotion of healing and transformation.