MONICA MCGOLDRICK purpose of the genogram and the therapy session, psychology help

Assignment 1

 

Monica McGoldrick

Based on the video The Legacy of Unresolved Loss: A Family Systems Approach and your readings from the DeMaria, Weeks, and Hof text, consider the scenario presented in the video. The client, David Rogers, seemed to be getting annoyed with the questions regarding his family. He did not seem to feel the questions were a proper use of time. Address the following:

• How do you think McGoldrick explained the purpose of the genogram and the therapy session?
• How did the therapist engage each family member in the therapeutic process?
• How did she develop the clinical relationship?

 

Transcript:

I am Monica McGoldrick. When I work with families, I try to place their problems whether individual, couple or child focused into a brighter context that includes extended family, community, gender, class, ways and cultural background. I do this because believe that we are all connected to all that came before and to all the will come after. It is when these connections are severed whether through death, divorce or estrangement that a part of us also dies and that deadness can sip into all of our relationships affecting people long after the loss has occurred. Problems often evolve in a family because of their inability to adapt to or mourn in their losses.

This program presents a family in which the intergenerational ghosts of loss are hiding behind the symptoms of the present. Kathleen Rogers, the second wife of David Rogers, not their real names made the initial appointment for her family. The Guidance Counselor of her step daughter Michelle had referred them to me, because Michelle had been cutting school and generally acting remote and upset.

You must be Michelle. Hi. So, we spoke on the phone. What I would like to do is hear a little from each of you what you see as the problem and then I am going to ask you some questions. We will try to put it in some context, if that is okay? So, whoever wants to go first?

David Rogers

I guess I will begin. Well, I think you know that you were recommended to us by Michelle’s Guidance Counselor. She has been having some difficulty at school. There had been several incidents this year. The last one was her getting caught cutting classes. Additionally, we are very concerned about the group of kids that she has been hanging out with. They are sort of a fast crowd wherein never quite sure where she is and so forth. Also, she seems to have this big chip on her shoulder. A lot of anger and hostility, and we are really not sure how to deal with it and that is principally it.

Monica McGoldrick

Okay. So Kathleen, what is your view?

Kathleen Rogers

Well, I agree. I mean, there is just a lot of tension in the household and it is not very pleasant to live like that, and I have tried to help her deal with her anger.

Monica McGoldrick

Something about this family’s presentation seems very flat. I think the Guidance Counselor’s referral at an indication, there is something wrong, but so far, all I have heard is a description of a typical teenager.

What is your sense? What she is maybe angry about?

Kathleen Rogers

Well, I do not know.

Monica McGoldrick

Okay. So, what is your view, Michelle? Would you agree that there is a lot of tension in the family?

Michelle Rogers

I guess so.

Monica McGoldrick

Yeah. Are there some things about what is happening at home that are upsetting you? Do you want to talk about it?

Michelle Rogers

No.

Monica McGoldrick

How about school? You are okay with school? You like things are going?

Michelle Rogers

School is fine. It is great!

Monica McGoldrick

Yeah. So, is there anything that you think would be good for us to change about the way things are going from your point of view?

Michelle Rogers

I would not be so angry if they are not so —

Monica McGoldrick

So what?

Michelle Rogers

— so wrapped up in their own like little world. Everything has to be just so. Everything is — the baby this or the baby that. The baby needs to —

Monica McGoldrick

And how old is the baby?

Kathleen Rogers

She just turned two.

Monica McGoldrick

She just turned two. I see. You are saying what? That family revolves around the baby?

Michelle Rogers

It seems so.

Monica McGoldrick

I see. So, have things changed since the baby came, since the baby has been born?

Michelle Rogers

Yeah. It is like that is the only child in the house.

Monica McGoldrick

Well, you know what, maybe what would be good if it is okay with you is, well, I think a little background and ask a little bit so I kind of know who is who?

I like to do a genogram very early in the first session. So, the rest, I listened to details of the presenting problem. I have a context to which to put them.

Now you were married before?

David Rogers

That is right.

Monica McGoldrick

And you have an older brother. Is that?

David Rogers

Julian.

Monica McGoldrick

And how old is he?

David Rogers

Twenty-one.

Monica McGoldrick

He is 21. And Michelle, you are 15? What is your birth date exactly?

Michelle Rogers

November 5, 1979.

Monica McGoldrick

Okay. And your first wife’s name?

David Rogers

Dianne.

Monica McGoldrick

She died when?

David Rogers

She died August 15, 1991.

Monica McGoldrick

I will come back to her, but let me understand that. The two of you were married when?

Kathleen Rogers

June 10, 1992.

Monica McGoldrick

:

Okay. And you together have a daughter —

Kathleen Rogers

Jade.

Monica McGoldrick

Okay. And she was born when?

David Rogers

Excuse me –, is this really necessarily for us to kind of go to all these dates? It seems like we are here because of Michelle’s problem. And I am just wondering whether we can use the time a little better.

Monica McGoldrick

Right! Well, I will tell you. From my perspective, you never know what part of the history may turn out to be relevant to the presenting problem, but very specifically, what your daughter said was that she has been upset since Jade was born and that may — I do not know exactly what that means, but surely, the specific time when she was born would make some difference in that. You must have had to do a lot of family rearranging around her birth now. Okay. And Julian by the way, where is he?

David Rogers

He is at Colorado College.

Monica McGoldrick

And he is what year — he has been away for how long?

David Rogers

He is 21.

Monica McGoldrick

He is 21, but how many years has he been away from —

Michelle Rogers

He is a junior.

Monica McGoldrick

He is a junior. Now, let me get a little bit about your background. How many were in your family that you grew up in?

David Rogers

Well, just me and my mother and father.

Monica McGoldrick

I see, but I had no brothers or sisters?

David Rogers

No.

Monica McGoldrick

Really? They did not want to have any other children? Do you know anything about that?

David Rogers

Well, there was actually a child one before me, but he died before me.

Monica McGoldrick

Asking why a person was an only child can sometimes uncover important family history.

It was a son or daughter?

David Rogers

A son, and he was born with only a partially formed stomach and so he could not take any nutrients.

Monica McGoldrick

What was his name?

David Rogers

David.

Monica McGoldrick

In fact that he was a given the same name as his dead brother, suggested that he may have been a replacement child for his parents.

And everything kind of — I do not know, spooky or something. You have the same name and —

David Rogers

It is not really, why?

Monica McGoldrick

Although David makes a lie of this, I wonder if it intensified his role as an only child.

Now, is your father alive?

David Rogers

No.

Monica McGoldrick

When did he die?

David Rogers

He died December 30, 1977.

Monica McGoldrick

What did he do for work?

David Rogers

Banker.

Monica McGoldrick

And how did he die?

David Rogers

Well, complications due to liver disease.

Monica McGoldrick

Really? Was he a drinker?

David Rogers

Well, he is certainly was an alcoholic, but he enjoyed drinking.

Monica McGoldrick

Asking about the cause of death especially if it was premature can sometimes reveal problems such as alcoholism or suicide.

I know this is sort of hard to talk about sometimes different things in your family, but did anybody else ever think that he had an alcohol problem?

David Rogers

No.

Monica McGoldrick

No.

David Rogers

No.

Monica McGoldrick

Not your mother for example?

David Rogers

No.

Monica McGoldrick

Really?

Although David rejects the suggestion of alcoholism, I am not totally convinced. I may revisit this question once we have established the greater level of trust.

Now, is your mother alive?

David Rogers

No.

Monica McGoldrick

When did she die?

David Rogers

She died in ’87.

Monica McGoldrick

And how old was she?

David Rogers

I think she was 65.

Monica McGoldrick

What was her name?

David Rogers

Edith.

Monica McGoldrick

Edith. So, they never had any other children? Your parents — there were no miscarriages or anything?

David Rogers

Yeah. There were a couple, I think in my early childhood, mid ’50s, ’54 or ’55 something like that. I guess they wanted one more child and did not happen.

Monica McGoldrick

I see.

I asked about miscarriages and stillbirths because these losses are often glossed over with little resolution and can be more important than anyone realizes.

So now, can we talk a little bit about your family?

Kathleen Rogers

Sure. Yes.

Monica McGoldrick

I appreciate you may not know exactly where I am going with this, but to me, it is really important to kind of get a sense of who people are and where they are coming from. So, how many are in your family?

Kathleen Rogers

Just myself and I have a half-brother named Matthew. My parents are divorced.

Monica McGoldrick

In contrast to David’s rather flat description of his family, Kathleen was actively uncomfortable talking about her working class Irish-German background. The first in her family to attend college, she quit after her second year when her father died unexpectedly. She has very little contact with her mother, step-father and half-brother who moved to Florida shortly after the second marriage.

What is your family background ethnically?

David Rogers

Ethnically? I do not know. I do not have an ethnic background.

Monica McGoldrick

Where did your ancestors come from? Do you know?

David Rogers

England.

Monica McGoldrick

I believe strongly that people’s cultural background plays a profound role in how they see the world and how they define their problems. I tried always to help them locate themselves in this context since our society tries so hard to pretend that culture, what race, gender, class and sexual orientation does not matter when in fact these dimensions structure are very existence.

David Rogers

I am WASP, but I am white bread with the crust removed.

Monica McGoldrick

And where did you grow up?

David Rogers

Westport, Connecticut.

Monica McGoldrick

Uh-huh. Were you pretty close to your parents?

David Rogers

Reasonably so.

Monica McGoldrick

Who were you closer to?

David Rogers

My mother I guess.

Monica McGoldrick

Really? How would you describe your childhood in a word?

David Rogers

Well, I just describe it as a pretty, happy, upper-middle class family.

Monica McGoldrick

Yeah. Uh-huh. Okay.

David seems to have little sense of himself as an emotional being. I wonder if this is just a result of his upper-middle class WASP background or if something else is inhibiting him.

So, is Matthew married?

Kathleen Rogers

No.

Monica McGoldrick

Does he have any kids?

Kathleen Rogers

Yes.

Monica McGoldrick

How many kids?

Kathleen Rogers

One.

Monica McGoldrick

Uh-huh. How old?

Kathleen Rogers

I think he is three.

Monica McGoldrick

And where does he live?

Kathleen Rogers

He lives in Florida.

Monica McGoldrick

Uh-huh. What is his name?

Kathleen Rogers

Ethan, I think.

Monica McGoldrick

You are not in touched with them?

Kathleen Rogers

No.

Monica McGoldrick

Cut off such as this usually indicates something seriously a mess in the family process. I will explore this later with Kathleen hoping to encourage her to reconnect.

Let me go back a little bit now and ask about your mother. Now, her name was —

David Rogers

Diane.

Monica McGoldrick

— Diane and you mentioned before she died in August of ’91.

David Rogers

August of 1991.

Monica McGoldrick

Now, tell me a little bit about her background. What was her —

David Rogers

She grew up in Puerto Rico.

Monica McGoldrick

So, you look like you like that? Do you?

Michelle Rogers

Uh-hmm.

Monica McGoldrick

Do you think of yourself as part Puerto Rican?

Michelle Rogers

Absolutely!

Monica McGoldrick

Yeah?

Michelle Rogers

I am, are not I?

Monica McGoldrick

You sure are, but that is important to you, that part of your —

Michelle Rogers

Yeah.

Monica McGoldrick

Uh-huh.

This was the first sign of life in the session and I went right towards it. I was also very interested in the Puerto Rican connection since this choice of a wife seemed so out of character for David.

Have you ever been to Puerto Rico?

Michelle Rogers

Uh-hmm.

Monica McGoldrick

Really? Tell me about that.

Michelle Rogers

I went a couple of times during the summer.

Monica McGoldrick

Really? Just your whole family went or what?

Michelle Rogers

No, just me.

Monica McGoldrick

Really? How did that happen?

Michelle Rogers

Well, the first time was to visit a family stuff and then after that, my mom got sick and my parents did not think that was the best the idea for me to stick around so they sent me down there.

Monica McGoldrick

And how old were you when your mother got sick?

Michelle Rogers

Ten? Eleven?

Monica McGoldrick

So, you said you had family down there? Who is down there?

Michelle Rogers

My grandmother was down there. I use to go and visit stay with her and I also have cousins, aunts and uncles.

Monica McGoldrick

Really? What is your grandmother’s name?

Michelle Rogers

Abba.

Monica McGoldrick

Abba?

Michelle Rogers

That is what I called her anyway.

David Rogers

Carmen.

Monica McGoldrick

Carmen.

David Rogers

Her name is Carmen.

Monica McGoldrick

Okay. So, she is still in Puerto Rico?

Michelle Rogers

Yeah, but buried.

Monica McGoldrick

You mean she died?

Michelle Rogers

Uh-hmm.

Monica McGoldrick

Really? How long ago?

Michelle Rogers

Three months ago, February 15.

Monica McGoldrick

Were you close to her?

Michelle Rogers

Uh-hmm.

Monica McGoldrick

Really? How did she die?

Michelle Rogers

She just died.

Monica McGoldrick

Really? How old was she?

Michelle Rogers

I do not know.

David Rogers

She had been sick for many years. She had Alzheimer’s disease and she was old.

Monica McGoldrick

No matter how many genograms I do, I am still amazed that the hidden family issues, this technique reveals.

But, when you were younger during the time your mother was there, you were very close to her?

Michelle Rogers

Uh-hmm.

Monica McGoldrick

What was your wife’s illness?

David Rogers

Well, she had a kind of leukemia.

Monica McGoldrick

I see.

David Rogers

And so, in the beginning there was a lot of chemotherapy.

Monica McGoldrick

Really?

David Rogers

And during that period of time, first year of her illness, she would have periods where she was sort of okay.

Monica McGoldrick

Uh-hmm.

David Rogers

But at the second year, it got really bad.

Monica McGoldrick

So, you felt maybe it would be easier if Michelle were —

David Rogers

Away from her.

Monica McGoldrick

David seemed to be going along with this painful discussion of his wife’s death, so I was unprepared for his reaction to what I thought was a rather innocuous question about Michelle’s grandmother.

So, it sounds like you were very close to you grandmother, were you?

David Rogers

Excuse, Monica. I really have to ask the question again where this is leading. I mean, we pretty wasted most of the session going back in this ancient history and what I am really afraid of is that we are not going to focus on the problem that we came in here to address, which is Michelle’s misbehavior. And I am very concerned she is going to take this as acute that this is some sort of an excuse.

Monica McGoldrick

Were there something about that that got — I do not know.

David Rogers

No, it is just that she really was not very close to her grandmother. That is the point of fact and I am afraid that if we just keep harping on this stuff here, we are not going to deal with what is going on with Michelle at school. Now, I really feel like if we are going to on with this, I need to know how long this is going to take. I am lawyer and I work with contracts and we have to tell clients, we have to tell them how long some thing is going to take and what is going to cause.

Monica McGoldrick

Well, in some ways this is a little bit different situation, but it is very hard until I get a sense of what the story is, to know how to exactly help you —

David Rogers

I am thinking if you can give us some ball-park figure.

Monica McGoldrick

Sure, sure. And I feel very strongly about being accountable to you, so you are going to have to feel okay with the process in a general way, if that is going to take us a few sessions. What I would say is if after we have met three or four times, you feel as you do now that this is — what if this has to do with anything? Then, I would say let us really talk about it, but until we get a sense of what the history is and how that may relate to whatever is happening right now or in your family and for her at school, I kind of need to get oriented to this.

David Rogers

All right, well I think we have to think about it.

Kathleen Rogers

Dear, I think we should do it, all right.

David Rogers

Well, let us give it another try.

Monica McGoldrick

Okay, all right, but keep letting me know if this is not — and how are you with this idea? What do you think about coming here?

Michelle Rogers

It means being grounded.

Monica McGoldrick

In the first session, we dealt primarily with the new nuclear family and the previous nuclear family as well as with all three families of origin. We will focus on specific relationships as therapy continues.

My hypothesis at this point is that David never really mourned the loss of his first wife and rushed into a second marriage. I suspect that Michelle has not gotten over her mother’s death and does not feel a part of the new family. Perhaps, that pain is resurfacing for her triggered by her grandmother’s death. I also suspect that Kathleen has helped David in the coverup of his losses, a typical female task of protecting the husband and children. The first challenge here is to get David and Michelle to mourn Diane. I am also concerned that Kathleen’s role as caretaker will put her at risk for depression down the road.

So, how are the things?

David Rogers

Monica, I have been thinking a little bit last week and I still feel that it is important that we focus on the present and not so much on the past. We spent a good deal of the session last week as an example. Talking about Michelle’s grandmother who Michelle saw for all of about four months total in her entire life, and I really think we need focus on the present and Michelle’s behavior which is continuing to be very difficult.

Monica McGoldrick

I have to tell you that from my perspective, the past really influenced the present in such important ways that we cannot deal with that.

I have not been able to forge a connection with David yet, so I do not have a strong enough footing to confront his resistance.

David Rogers

Monica, I have been thinking a lot about last week and I still feel that it is important that we focus on the present and not so much on the past. I mean, we spent a good deal with the session last week as an example, talking about Michelle’s grandmother who Michelle saw for only about four months total in her entire life and I really think we need to focus on the present and Michelle’s behavior which was continuing to be very difficult.

Monica McGoldrick

I have to tell you that from my perspective, the past really influenced the present in such important ways that we cannot deal with that.

I have not been able to forge a connection with David yet. So I do not have a strong enough footing to confront his resistance.  Instead, I will go with his concerns and look for ways to connect them with the family history that seems to be the cause of their current distress.

But I will tell you what let us start with what is happening now that obviously there is something that you wanted me to understand that you think I do not yet understand. So would you tell me what that is?

Kathleen Rogers

May I explain?

David Rogers

Go ahead. Go ahead.

Kathleen Rogers

Thank you dear. Well this past week, Michelle has been listening to this new rap music that goes thug, thug or something and it pounds continually. I think it is these kids that she hanging out with that are —

Monica McGoldrick

Not how Kathleen jumps in to protect David from having to express his feelings. It may be that he is so disconnected from the family that he does not really know what the trouble is.

David Rogers

Kathleen really gets the ran of it because I am at work all day and I come home late and I hear these tales and it is —

Monica McGoldrick

Well I am not really clear. What is it exactly that bothers you? The music bothers you and what they wear bothers you.

There is something here that just does not wash. When parents make superficial criticisms of their children’s friends, I often find it is a code for class or culture.

Kathleen Rogers

The common area that I think is really bad for Michelle to go down to.

David Rogers

We just feel —

Kathleen Rogers

I do not — I am sorry.

David Rogers

Go ahead.

Kathleen Rogers

I just do not feel that she is safe with these kids.

Monica McGoldrick

Now is it — I know you are relatively new to this situation but is it your sense that Michelle has changed the friends she hangs out with, that she used to have a different group of friends?

Michelle Rogers

They are Black and Puerto Rican kids. That is the bottom line.

David Rogers

No, no. That is not it at all because their behavior is got nothing to do with their color or race or anything.

Kathleen Rogers

Michelle, I grew up with Black’s and Puerto Rican’s. I am used to them. No, it is not what they are. It is what they are doing that we are upset about and what concerns.

Monica McGoldrick

Tell me a little bit about your friends, what they are like.

Michelle Rogers

I met them at this summer theatre group that I was in last year and they are all into this just really cool stuff.

Monica McGoldrick

And like what?

Michelle Rogers

Carlos writes poetry. He writes some good stuff too, it is really deep. And Serena is in this Latin folk band and they mix a lot of different kinds of musics on it.

Monica McGoldrick

Do you kind of feel connected to them in some way because it is like part of your heritage we were talking about last time or no?

Michelle Rogers

Yeah. They know where I am coming from. They are my people.

Monica McGoldrick

And what do you think about your father and Kathleen’s concerns about that? I mean, obviously they care about you and they care where you are going. And it sounds like they are really worried about your connection to these friends, should they be?

Michelle Rogers

Concerned? I would think that they would want me to be happy. Hanging out with them makes me happy.

Monica McGoldrick

I am reframing the parent’s criticism as concern to see if Michelle sees any validity at all in their comments.

Kathleen Rogers

But I am not happy that Celina just got a tattoo and that you think that is very cool.

Michelle Rogers

This one does like washes off in two weeks.

Monica McGoldrick

Adolescence generally do not reveal themselves in front of their parents so, I met with Michelle alone to get to know her better.

Monica McGoldrick

I thought it would be good idea for us to get to talk alone a little bit because I am not really sure what is happening here with your parents. I talked to your guidance counselor and she says, she has known you, she thinks you are basically a terrific kid but you have really been different the past couple of months so, she was sort of worried about it. That is what she said why she had referred you and I do not know what you think about that I mean, you think she should be worried?

Michelle Rogers

I mean, I am not really doing anything major. Yeah, I cut a couple of classes here and there and yeah.

Monica McGoldrick

But what she told is different because she said, you have always been a good student, you have been really hassling some of your teachers, cutting in ways that you never did before and her sense is something is happening. Your parent’s fantasies are obviously going wild. I think it comes from really caring about you. So, you need to know that.

Michelle Rogers

I mean I know that a major thing that we are in comfort with is that they do not like the friends that I have been hanging out with lately and — but they think that — they just assume that just because they are Black and Puerto Rican that they are doing all these things like that is all that we see in the media and TV and stuff and it is not like that. They are really cool kids and know so many things that I can do with them that none of my other friends in the past they would really could understand it — I feel like I can relate to someone them in ways I was never able to relate with anybody else.

Monica McGoldrick

So you feel like you share interests like you were talking about Carlos and writing poems and your other friend Serena. So why are your parents do you think that these kids are going nowhere? Do they know these kids?

Michelle Rogers

I do not know. They have not even given them a chance.

Monica McGoldrick

Really?

Michelle Rogers

They are just going to listen to what other parents are saying or whatever. Just because they are not from the same neighborhood, and by the way, that means that there is something wrong with them.

Monica McGoldrick

But — I mean, you can understand yourself that — because you must see it with other kids that it is easy to get in with the wrong crowd, it is easy to get into a situation where peer pressure can —

Michelle Rogers

Yeah, but that is not me. That is not me.

Monica McGoldrick

Okay, well I am just asking because I do not know you.

Her reaction here seems pretty genuine. I do not think that he knew friends are the problem.

And because it sounds like there has been a recent change. And that is what I am trying to figure out is what happened recently. I mean, I know last time you were saying that at home, the focus seems to be on the baby but the baby is two not — I mean that is– not that recent. What do you think is upsetting your parents so much now?

Michelle Rogers

Just I am hanging out with Puerto Rican kids.

Monica McGoldrick

All right. Why is that so upsetting to them?

Michelle Rogers

I do not know why it is so upsetting to them but you see yourself I mean, when my father is talking about my grandmother, it was like she was nonperson.

Monica McGoldrick

He does not know how connected you are to her?

Michelle Rogers

We are her family.

Monica McGoldrick

Well, I mean, that is true but I do not know. I could not really tell what that was about. Have you ever talked to him about what that means to you?

Michelle Rogers

No. He would not understand. He would not get it.

Monica McGoldrick

Really? Do you miss your mother?

Michelle Rogers

Do I miss my mother? Yeah.

Monica McGoldrick

Was there something that was triggered when your grandmother died?

Michelle Rogers

My father like want us to ignore that and even like had any relevance in my life but –. I was with my grandmother when I found out about my mother died. She was the one that was there for me not my father. And it should have been him.

Monica McGoldrick

So have you ever talked to him about that?

Michelle Rogers

He would not –. No.

Monica McGoldrick

He would not what?

Michelle Rogers

I think he is not fit.

Monica McGoldrick

Okay. But maybe that is the issue. I mean, maybe you and he just need to get connected in a way that it has really been missing for you I do not know but that is what it sounds like, and he does not know where have you been at.

Michelle Rogers

He does not even take the time to try to find out either. So, how can he know?

Monica McGoldrick

This is a real break. So far, I have not seen any way to get David to deal with his grief. Michelle needs to confront him about he is being shutdown with her. If David sees that this is hurting their relationship, it may motivate him to face up to his own unresolved mourning.

I think maybe we need to talk about this and that some of his resistance about the relevance of your history, you can tell him about. I mean, I cannot, he is not going to hear it from me but he is going to hear it from you and he is going to know that that is what is relevant because that is history that you and he share.

Michelle Rogers

He just do not want to talk about it.

Monica McGoldrick

Well, maybe it is time to talk about it.

Michelle Rogers

No, you heard him. When he was here, he was “Why are we even talking about stuff that has to do with the past?”

Monica McGoldrick

Okay. But you can help him to understand that. And I will help you.

Because of the uneven power relationship between Michelle and her father, I wanted to make it very clear that I would lend my support to her attempt to discuss their shared history. While we were alone, I also checked about her use of drugs and alcohol and I felt reasonably confident that this was not a problem. I then met with David and Kathleen to give them my assessment of Michelle.

Monica McGoldrick

It is clear to me that she feels not as well connected to you, that she cannot really talk to you, that she has not talked to you. She said that she has never been able to talk you about her mother’s death. When you say to me, “Let us forget the history, we got to deal with this present problem.” The sense I have is that the present problem is related to the history and the fact that you and she cannot share the history matters. And I think we need to just talk to her about it.

This is David and Michelle’s history before Kathleen’s time. I want her to stay out of the discussion but I want her to be present for two reasons. It is history she should know about and I do not want her to feel excluded from the therapy.

I think this relates to a history that is before your time. If you were God, I do not think you could get right with Michelle until she feels better connected to her father and better able to deal with the loss of her mother. So I think that some of what you were very irritated about with her in terms — I mean, some of it is just being a teenager, let us face it but some of it is, that she is struggling to put together a history that was before your time. And I think she needs to work it out with her father and that is not your problem. You know what I mean?

Do you remember how you first found out that she was ill?

Michelle Rogers

She called me and so I ran to her bedroom and —

Monica McGoldrick

Your father was not there?

Michelle Rogers

No. He was working.,/

Monica McGoldrick

Really? And what did she say?

Michelle Rogers

She just said that she was — said mommy is sick and I do not know. And not to worry and that everything was going to be fine but if she was not able to do some of the things that she — some time in the near future that —

Monica McGoldrick

Have you ever talked to your father about this?

David Rogers

I was concerned about upsetting them too much. I thought that it might actually be counterproductive in terms of Diane’s wellbeing.

Monica McGoldrick

Before you made reference to how hard it was, she had a lot of pain in the last period?

David Rogers

She lost a great deal of weight and — do we really have to talk about this?

Monica McGoldrick

I think it matters a lot for you and your daughter to share. I know that it is hard.

David Rogers

She lost a great deal of weight.

Monica McGoldrick

Are you okay with that? Do you see why it matters for her?

David Rogers

In the end she was in the hospital for about three month’s total. And she gradually became weaker and of course she was connected up to IV most of the time.

Monica McGoldrick

Now you said before, Michelle, that you had actually been with your grandmother at the time your mother actually died. How did that happened?

Michelle Rogers

Well, they sent me to Puerto Rico. So I was down there when I found out that she died.

Monica McGoldrick

Really? How long have you been there?

Michelle Rogers

That point I was probably there already for almost two months, a month and a half.

Monica McGoldrick

Do you remember when you found out that she had died?

Michelle Rogers

I think it was yesterday.

Monica McGoldrick

Really? What do you remember?

I often find that asking a client to recall specific details of a painful event elicits a more genuine emotional response.

Michelle Rogers

I was in the kitchen and I was cutting up the peppers for the sofrito because she was going to make some rice and beans. And the phone rang in the living room but I could see her. It was like the kitchen and there is the living room. And I think I almost knew even when the phone rang but she picked up the phone and she stood there and she dropped the phone and she started screaming “Oh my God, Oh my God. Not my baby. Not my baby.” That is when I knew.

Monica McGoldrick

I find it is very important to give people the time to work through moments like this.

And then what? Did you and your grandmother come up together for the funeral or how did that happened?

Michelle Rogers

We stayed down there.

Monica McGoldrick

What do you mean you stayed down there?

Michelle Rogers

My father called me that you are on — that they necessarily do not — because we might as well just stay the month and wait till your flight at the end of the month to come home.

David Rogers

See I thought that — I gave some thought to whether she would come back to the funeral and for a while I thought that would be a good idea. But then after thinking about it some more, I thought well, she was going to be hanging around a funeral home for a few hours and going through all that and —

Monica McGoldrick

Can I interrupt you? Can I ask you, what are you feeling now about this?

I did not want David to distance himself from these feelings so, I tried to bring him back into the moment. His response came as a complete surprise.

David Rogers

I really had no idea Michelle that you felt so strongly —

Michelle Rogers

She was my mother.

David Rogers

Not about your mother of course but the whole thing with your grandmother. I had somehow put that behind me and it seems so long ago. And I feel very guilty that I did not tell you about your grandmother’s death.

Monica McGoldrick

What do you mean?

David Rogers

Well I just did — frankly, I just did not think it was important at the time.

Monica McGoldrick

You did not know your grandmother died?

Michelle Rogers

I sort of found out.

Monica McGoldrick

What do you mean?

David Rogers

Well there was this phone message apparently that, Alicia, my wife’s sister called from Puerto Rico telling us about Carmen’s death and —

Michelle Rogers

And then I came home from school and heard it.

Monica McGoldrick

Now this is just recently right? This is just a few months ago?

Michelle Rogers

Yeah. I came from school and I heard it and I just — I went to my room. And then Kathleen came home later on and she played the messages. And I heard her playing the messages and I expect that afterwards she was going to come say something to me or come to my room.

David Rogers

It was not her fault she talked to me about it.

Michelle Rogers

Do not be —

Monica McGoldrick

So, when did you talked about it?

Michelle Rogers

We did not.

David Rogers

Well, I was so busy that week and I just thought — I thought about Carmen as someone that Michelle had very little connection with anymore. We do not talk about Carmen. And I remembered it later in the week and we did talk briefly about it then.

Michelle Rogers

We talked about it? You said “Oh, by the way, you remember Carmen from Puerto Rico? Well, she died.” I mean, we talked about it. And so, yeah, thanks for telling me.

Monica McGoldrick

So the two of you really never talked about any of this? It sounds like —

I was impressed and I have to say astonished at how much David seemed to be connecting with his daughter in her emotional experience. You can never be to sure you know how another person will react. I would have thought it would take a lot more for David to open up like that.

And then this is making me think that maybe some of what has gotten you upset, Michelle, the past few months is really that Carmen’s death just kind of brought this whole thing back. And it maybe the lack of connection between the two of you is just gotten too big and that you really — I mean, she really needs you obviously. And maybe some of what you have said about your Puerto Rican friends is a part of something very natural really that you did not get to have your mother as long as you needed her. And so that is part of finding out who you are. What did your mother do? I mean, did she work or something?

Michelle Rogers

She used to write plays.

David Rogers

Actually, Diane and I met when I was in graduate school, I was a bit of a rebel in those days and — she was in a writing program at Columbia and —

Monica McGoldrick

Really?

David Rogers

Yeah. I mean, she wrote this political piece that I got involved in.

Monica McGoldrick

Okay.

David Rogers

I did a couple plays back then.

Monica McGoldrick

Really?

David Rogers

Yeah.

Monica McGoldrick

You do not seem like the type because you do not want to like saying stuff.

Michelle Rogers

You are really on plays dad?

David Rogers

Yeah. I did a couple of plays.

Michelle Rogers

Go figure.

Monica McGoldrick

When people disconnect because of the pain of their loses, they often bury important parts of themselves as well.

Well, I think this is really important to — that there is a lot that matters to share, that we all carry our history with us. And that — probably, there is a lot of your — of what you know about Diane that matters. Well let me ask you something, I am very conscious that Julian is not here and because he is a part of this history too. What –when — is there some possibility that we could get him in too?

David Rogers

I do not think that is possible. He is on Colorado so.

Monica McGoldrick

So to me this is the same point just as she needs you to be her father. Maybe this is important for him too. She needs her brother and he needs to be a part of this, it was his mother too.

David Rogers

I suppose that is a very expensive weekend.

Monica McGoldrick

But it is a very valuable family is it not? A part of you knows this is really crucial but I still think it really matters.

Monica McGoldrick

And Michelle shared memories of Dianne would of course disrupts the new family balance. And it was predictable that Kathleen would react, although I tried to prepare her for this, she still came in very agitated the next week.

So what is happening here?

Kathleen Rogers

Well, I will tell you what is happening here. This one two nights ago drives in at three o’clock in the morning. She was supposed to stay and baby sit for me while I go shopping. She bolts out of the door and runs down the street. I have to stay because I have got Jade in my hands. I cannot reach him. She never even called to let me know. I am up all night worrying about her. Not knowing where the hell she is. He comes in, he just sits there and says, “Well, we just wait and see what happens.” I am thinking what is wrong?

David Rogers

I did not just sit there.

Kathleen Rogers

Oh, you did not? What did you do? Did you try —

David Rogers

I told her we were going to talk about it within the next day.

Kathleen Rogers

We were going to talk about it like it was like something like she went out to have a cup of tea.

David Rogers

I was not going to have a long wrong conversation at three o’clock in the morning.

Kathleen Rogers

She is 15 years old.

Monica McGoldrick

I think Michelle is staying out until 3 a.m. and David is withdrawing, a reaction to last week’s session. But no surprisingly, it is Kathleen who accessed the lightning rod.

Michelle Rogers

Why would you ask me to baby sit? It is my date.

Kathleen Rogers

Excuse me, I am sorry. That concert is not as important as this family. And even though I am not part of the original family, I seemed to be the only one that is taking that as the priority instead of the two of you who has your brother.

Michelle Roger

How is baby sitting for Jade —

Kathleen Roger

Because I was going shopping to get ready for Julian.

David Rogers

Michelle you acted very irresponsibly, all right.

Kathleen Rogers

Oh, David! You sound like a priest.

David Rogers

Oh, come on! Come on.

Monica McGoldrick

I know you are upset. I know you are upset. And I know you have been trying to solve this. We talked about it since before you guys came here.

Michelle Rogers

She is like this all of the time.

Kathleen Rogers

Excuse me! Why do I feel all the sudden that I am being picked on. I am the mother now in charge. The other one is gone.

Michelle Rogers

You are not my mother, okay.

Kathleen Rogers

Excuse me. I am not your mother. But I am your step mother.

Monica McGoldrick

Excuse me. Kathleen, you know what I think? I think you have been trying to solve a problem that you cannot solve which is you are the one who is on the line because you are the one there. It is like you are in the role of mother and mothers are expected to take care of their children. But as we discussed before, you are not the mother, you do not have the leverage here and you cannot do it?

Kathleen Rogers

But you are not getting David to do anything about it. Things are getting worst. They are not getting better.

David Rogers

I am doing the absolute best I can right now, all right.

Monica McGoldrick

My priority here was to get David to make a firm commitment to his parenting responsibilities. But first, I wanted to talk with Michelle to make sure that her staying out late was not designed of more serious trouble. After seeing her long for a few minutes, I met with David and Kathleen.

Monica McGoldrick

Listen, I think we need to get this whole situation into some kind of perspective. If you think about Michelle in terms of what is happening, she really is a good kid. There is a lot to worry about and she is like terrific actually.

When I am trying to get a parent to change behavior towards the child, I do not want the child present because I do not want the parent to lose faith.

Let me just finish my thought here. For her stay out until three o’clock by herself is serious, because whatever kind of a good kid she is, it is dangerous. So believe me, I am not saying, “Hey, yo! Let her decide her own curfew. That is fine.” I am not saying that all. She needs to know from you that you really mean it. That you are going to know when she does not come in at eleven o’clock at night, that you really mean it when you say clock. No ifs ands or buts, and that there really are consequences. She loves you. She needs you. And I do not think you really get that. And honestly, that is why I think you are flipping out about this because I think emotionally, you are much more in touched without the real dangers with what is really going on with teenagers, with what is really going on around. And that you are the one who is going to be able to reassure her not me by making sure you really follow through.

David Rogers

You know, I think I understand you, but I just feel like I can only do this within limits. I feel in some ways that I am being drawn and quartered because I have a very, very stressful job right now.

Monica McGoldrick

But you cannot just do it to a certain extent, because Kathleen is right, she could be lost if you do not connect with her. She could well get lost. She is not lost now, she is terrific. I am saying this because I am trying to really get true to you, but I do not think you understand this. The fact that she connected with me as well as she has in so few sessions is remarkable. She is really seeking to be connected. But you got to take the opportunity. She really needs you. She needs you to do more than just sort of when you are around, sort to say half-heartedly, you are grounded or something.

David Rogers

I am — about the pressure, too you know. When we think about what has happened over the last four years, we are talking about the death of a wife, we are talking about remarried. We have just had another child.

Monica McGoldrick

But what are you saying really? Where are you going to go? She is 15. At 18, she is going to be gone. You have three years. And she is going to be gone. You can either do it or not do it. Those are the only two options that I can see.

Some therapists would take exception to my urging David like this, but I found that many clients are receptive to this kind of direct verbal intervention.

David Rogers

But all I can say is I can try to do it to the best of my ability. That is all I can say.

Monica McGoldrick

You know, work is a good excuse. And it is also frankly an excuse that a lot of menus to avoid very painful things that men in our society are not socialized to be able to deal with easily. You can use that. I am urging you to think of that doing it in a different way. And I think you can do it. I was actually very struck at how emotionally present you were last week. That you, I mean when you were able to recognize what not dealing with Carmen meant for your daughter, I mean I was really astonished actually that you are being able to be that in touched with her emotionally to realize that. But it matters.

David Rogers

Well, it is very upsetting to me because I thought we were making some progress.

Monica McGoldrick

Well, I actually think happened this week, which — it is very common to have people begin to move with something that is important and then they get scared and back off. What I think happened is for what reasons, I am not sure, something triggered Michelle to do something which it is worst than any of the acting out we have talked about before. I suspected in reaction to what happened here last week that she somehow got scared. Now, what reason? I do not exactly know. But I think it is very much in relation to what we were talking about that she really needs to deal with who her mother was for her that a lot of who she is, is tied up with all of that history that she is got to be able to deal with it.

Can we talk about the period when your mother was ill?

Julian came from Colorado for the next session. He was understandably uncomfortable especially when talking about his mother’s death.

Julian Rogers

I know she is really sick, very, very sick and I ended up in the hospital and so like we were alone by the time.

Monica McGoldrick

Do you remember when she died?

Julian Rogers

Uh-hmm.

Monica McGoldrick

Where were you? How did you find out?

Julian Rogers

The lady who sort of take care of the house and everything.

Monica McGoldrick

So your father called her or something?

Julian Rogers

I guess, yeah.

David Rogers

I called to Jackie and she was at the house and I told her to tell Julian that I will be home as soon as possible.

Monica McGoldrick

And do you remember what happened when you saw Julian?

David Rogers

I do not remember that.

Monica McGoldrick

You said before Julian, that you have never discussed a lot of this with him and you do not know what his feelings were. Are there things you would like to know that you like to ask him about?

Julian Rogers

Yeah. I just want to know if there was never, he never communicated anything to us. I mean it is like even when we are kids I mean I know who they are, but I never felt like you really were there.

Monica McGoldrick

Bringing young adult children who have left Tom into therapy can be very powerful, giving them a safe place to express difficult feelings.

Julian Rogers

You know, I mean I love you because you are my father. And sometimes, I just think — I do not know. Did you really — I mean I know you love us but like, are we a burden to you? Did we — you know when my — to make you proud who I am to it. I mean sometimes I still do not know what to think of anymore. I mean I know you love mom, but God you remarried so quickly and it is all these things. I should learn to understand it. And it is just like I want to come home but I do not want to come home. I do not feel comfortable in my own house. I do not know.

Monica McGoldrick

Note how affectively these thoughts coming from Julian get through David’s defenses. I could work with David for weeks without a listening such a deep response.

Julian Rogers

I’m sorry. I do not mean to make you feel bad or anything, but —

Monica McGoldrick

How do you express it?

David Rogers

Of course, I love you. I feel like you are talking about someone else. I mean I hear what you say, it so different. It must be true. But I feel like you are talking about someone else. Of course, I love you both.

Julian Rogers

Oh, I do not mean that. I know you love us but I mean, I do not know, what do you think?

Monica McGoldrick

For the rest of the session, David and his children shared memories of Dianne and of her death.

I mean I think that is one of the worst things you could ever go through is lose your spouse and have young children.

David Rogers

It is the worst thing ever happened through.

Monica McGoldrick

Shared rituals can help reinforce family connectedness. This was especially important in this case because Michelle had not even been in her mother’s funeral.

But you know what, I am thinking that you never talked about this and we were saying that you have never shared it, but also, the fact that Michelle was not even here when you had the funeral. Maybe, even though, that is many years ago, it would help if you would take your children to the grave now.

David Rogers

Do you think it would be helpful?

Julian Rogers

We know.

Monica McGoldrick

You know what, David, I do not think — I think he has been left too responsible here. Then maybe, it is not for him to have to decide if it would be helpful. Maybe, it is for you decide if it would be helpful. You know what I mean, because he was the kid. I am not saying this, because I think they need you to be their father more than you realize.

David Rogers

Right. So tomorrow, okay?

Julian Rogers

Yeah.

David Rogers

All right.

Monica McGoldrick

It was not surprising the things kept coming up all weekend that prevented the visit to Diane’s grave, but they did finally manage the trip just before Julian left.

Monica McGoldrick

It had a considerable impact on both father and daughter. Michelle was more connected to her parents and she even joked with Kathleen. David was quite moved by the experience. And he also remarked on how shut down he felt and expressed a desire to be more open for the sake of his children.

Tell me something. I have several times wondered.

David Rogers

Yeah.

Monica McGoldrick

How did your family feel when you got together with Diane? I cannot imagine they were too enthusiastic.

I decided to meet with David and Kathleen alone to work on David’s emotional distance.

David Rogers

What do you mean?

Monica McGoldrick

I mean, you have described yourself as coming from this sort of somewhat upper class old New England —

David Rogers

Waspie.

Monica McGoldrick

:

Waspie family? I cannot imagine they would be too enthusiastic about you are marrying somebody who was a Puerto Rican. Was that an issue?

David Rogers

Well, she have to understand about my parents is that they were very polite people.

Monica McGoldrick

Yes.

David Rogers

They did not —

Monica McGoldrick

David, we are trying to go a little underneath the politeness. We know they were polite. You are polite.

David Rogers

Right! Well, there was a problem.

Monica McGoldrick

At this point, I felt I had enough bond with David to push him a little especially since he is asking me to help him penetrate his defenses.

So, let us talk about it. How did they react?

David Rogers

:

Well, they really did not approve Diane.

Monica McGoldrick

Really? How did the wedding go?

David Rogers

Well, I have really mixed feelings about the wedding, because it was not exactly the wedding that she had in mind.

Monica McGoldrick

Really?

David Rogers

I never had thought much about exactly how I wanted to get married, but she really sort of wanted the traditional wedding with a big white gown and the church and the whole nine yards. Her mother could have not afforded that and my parents were not particularly forthcoming with support and they —

Monica McGoldrick

So, you did not do that?

David Rogers

No. What we did is we just sort of adjust some of the piece, nothing. And we had a nice little dinner afterwards and it was just us and four of our friends.

Monica McGoldrick

Really?

David Rogers

Uh-hmm.

Monica McGoldrick

So, your parents really disapproved?

David Rogers

Right. Again, it was nothing stated overtly. There were no confrontations. They never actually point blank said, “We do not want you to marry this woman.” But there was no support.

Monica McGoldrick

Note how utterly understated David is here. He describes his parents as polite and says they were not particularly forthcoming with support. When the truth is, they did not even attend their only child’s wedding.

But, let me push another side of this, because we have talked that about the kind of sense of deadness that sometimes comes through with you. I mean Kathleen’s complaint about it a good deal. Julian talked about it and Michelle talked about it. And I have told you that I sometimes experiencing that. You know, you are polite, you do the right thing, but it is really like hey, is anybody home really?

David Rogers

Right, right!

Monica McGoldrick

And the way you have talked about your family seems similar that — I mean from the first time we have talked about Diane, I could picture her. It is like the juice was there.

David Rogers

Right!

Monica McGoldrick

She came alive.

David Rogers

Right!

Monica McGoldrick

But, in the several conversations we have had about your mother and your father, I never really can picture them.

It is a sign of real progress that David is able to hear these things from me, but he is so passive and shut down about his history that I am not able to get any attraction with him.

And I mean maybe some part of your attraction to Diane was an attraction to —

David Rogers

Right! I am not sure how they answer that. I am not sure of how I feel about it. I just remember my childhood as a happy, pleasant childhood. I was very well provided for.

Monica McGoldrick

You know, that is what you always say at everything. It is really like there are many times that we have been over this is —

Perhaps, we both left awkwardly here because of the uselessness of my confrontation. I was seeking a way to get past his past answers. Perhaps, a better way would have been to join with him and say something like can we together look behind that happy childhood?

David Rogers

I do not — it is hard for me to remember.

Monica McGoldrick

Who is around now that you could ask? You do not know –.

Kathleen Rogers

Your aunt?

Monica McGoldrick

Oh, yeah. Your mother’s —

When a person is stuck like this, I find it useful to get new information from other family members instead of just pressing him to try to push his way through his block.

This is his aunt now?

David Rogers

Well, I do not know about that. See, I have not seen her for many years. I think the last time I saw her was at my mother’s funeral.

Monica McGoldrick

Really?

David Rogers

And we just — we were never really close.

Monica McGoldrick

But, I mean — come on, that she was your mother’s twin sister.

David Rogers

I know, but I am not sure that they were close. I just do not remember that. I certainly was not close to her and I just think that at this late day, it is just — would be pressing the issue to make contact with her.

Monica McGoldrick

Really? See, here is the thing. You have made good efforts, but still I get the feeling that there is a kind of a stuckness about this that — I mean, I think man in our society are raised in a way to be –to a certain degree shut down, so I think it is also a gender issue. But beyond that, because I think you are very well-intentioned, that you have been trying here, there is something that is keeping you from getting in touch with yourself.

David Rogers

The thing is Monica, I have no idea of her state of mind that consider all. I do not know if she wants me there. I do not know whether she is even mentally all there at this point.

Monica McGoldrick

Well, you know, I do not know either and that is possible that she will just act like sort of who are you and why did you come, but I kind of doubt that and I even think it is very possible that it is maybe just a whole in her heart that she does not have any contact with you, because she had no children other than you. You know? I mean, it is because you tried to talk to her.

David Rogers

Well, I do not know. I will call and see what happens.

Monica McGoldrick

Okay, great!

Although he said hew would call, I had my doubts and weeks went by with no movement. When Kathleen began to express frustration about David’s resistance, I shifted our focus to the cut-off relationships in her own family with her mother, brother and step-father and she began to work on them. While the spotlight was on Kathleen, David quietly went to see his aunt now.

So, it took you three months when you finally got to see your aunt now, right?

David Rogers

Yes, I finally saw her and it was absolutely amazing.

Monica McGoldrick

Really?

David Rogers

Yeah, I came back with this photo album — a family photo album and also my mother’s diaries, we found.

Monica McGoldrick

Oh, my God!

David Rogers

And I got to tell you, it was —

Monica McGoldrick

You knew about that? Did you know your mother —

David Rogers

It was not easy getting these things. Yeah, I knew she had them.

Monica McGoldrick

After experiencing David’s flatness for so long, it was wonderful to see him so energized.

David Rogers

She would smile, she just sort of shrugged her shoulders and then she just offered me some more iced tea. But the thing is like every other member of my family, she is very polite. So, she really could not refuse me when I asked to see these diaries and a photo album. So anyway, I got them.

Monica McGoldrick

Wow! So what is in it?

David Rogers

Well, the thing that is really amazing is — and it took a little bit of detective works here, because my mother’s writing style is very indirect. She is sort of beats around the bush. And so, really — I sort of precede this more from indirection from what she did not say and what she said. But it appeared to me that my mother actually had an affair with my father’s best friend. I see it that my parents have these two friends Bob and Sarah. And they were lik