“How About It Father, How Much Easier Would Things Be With Your Son Dead?”
Afternotes |V| I: Carl Whitaker's Radical Prescription for Change
“Have you ever thought about competing with him? You might even go into the business and offer him a chance to be Number One customer at double rates.” -To a wife whose husband was unfaithful
While I’ve already written (twice now) about the psychiatrist and OG family therapist Carl Whitaker, it wasn’t until my recent summative letters that I realized the degree to which his theory of change matched the broad pattern discussed there. It felt uncanny, and I want to spend a moment to take a more sustained look at it.
First though, Whitaker himself - no longer a household name - is owed an introduction. Not feeling quite up to the task myself however I will demure to those who knew him instead. Starting off, here's colleague and fellow proponent of 3 generation family therapy, Maurizio Andolfi:
I remember once, when he had not yet written a book by himself, he started writing something - it was the beginning of Midnight Musings [what ended up being his final book]. But, it was very disorganized, so the editor said, “You know it’s impossible to write a book with you!” Because it really was so disorganized and he was also still using handwriting. So, one time when we were at his home which was nearby a lake, his papers fell in the water. And I asked him what should we do now and he said, “Oh, it doesn’t matter; it just means I don’t have to write a book anymore”.
Milton Miller at Wisconsin speaks of Whitaker seeing a schizophrenic patient who threatened to kill him:
The patient said, “You will never know when it will happen; you could be walking down the street, sleeping, going to the bathroom, and suddenly there I’ll be!” Whitaker sincerely responded to the patient, “I want to thank you for giving me something else to think about at the urinal rather than worrying if I will get my shoes wet.”
Whitaker “specializes in pushing the unthinkable to the edge of the unimaginable.” said Lynn Hoffman. Salvador Minuchin, a strongly contrasting figure focused on order and organization, wrote in the introduction to his collected papers:
Whitaker has developed a language of discontinuity as an answer to the absurdity of life. When people insist that the reality they have learned is the only one possible, Carl’s response is an impossible question, an absurd answer, a dirty joke, a dream.
A “destroyer of crystallized forms”, he has against all odds retained a place in the hall of masters of the craft of family therapy. Unfortunately he’s been pigeon-holed in that now defunct in all but name field, and both his name and his ideas have for all practical purposes met the same fate.
Before we begin the séance, which may - if the fates be kindly - turn into a resurrection, a personal note from his wife, Muriel:
His “feel” for the lonely, the vulnerable, came out of his own experience with loneliness… In spite of the fact that his background was deeply religious—in the Methodist tradition—he was always open to inquiry, to testing those traditions. He was, by nature, a curious observer, with a yen for accuracy. Above and beyond all this, Carl had a personal warmth and comfortableness that put others at ease. Whether they were shy people, angry people, or of opposing beliefs, his simplicity drew them to him… Very simply stated from a wife’s standpoint, “to know him was to love him.”
A key commonality between his approach and that of this project is our goals. While the focus of most therapies is on adjustment, his in contrast was on growth (i.e. for him, therapy that was not subversive was for amateurs). Critiquing the common approach, he wrote “The patient whose symptom is relieved while his effort to integrate the conflicting forces in his own life experience is destroyed is an example of an operation being successful, although the patient dies.”
Whitaker had a core belief that humans are oriented towards growth but inertia and homeostasis get in the way and so often there is - at least initially - a mutually exclusive choice between feeling better and getting better. Without pain and discomfort reaching a critical point, growth is rarely possible:
“In the final analysis, the most important family factor which relates to change or failure to change is desperation. When family members are desperate, they change; when they are not desperate, they remain the same.” Therefore when patients come with a problem, “the therapist is deliberately functioning to maximize the crisis” - rather than offering reassurance and education and the like.
(Note, I use his comments on individuals and families interchangeably here because his overall model of change for both was similar)
In the language of last letter, they are working to increase stress past the point where hyperplasticity is triggered. This is viewed as crucial:
…it’s essential that the patient be given the courage and the opportunity to grow and to bear the pain that growth necessitates. I can’t imagine coaching a football team and telling them, “If you get tired don’t exercise anymore. It might hurt you.” I feel the same way in psychotherapy. Once it’s established that we are a team, I feel free to demand of them and expect them to demand of me. Life without pain is an addiction and the fantasy of perpetual happiness is [a] “delusion of fusion”
And so when patients complained about how difficult things were getting (for example a mother wanting to take her children out because they are crying and having nightmares), he’d compare the process to taking out an appendix and tell them that “if you aren’t willing to take the pain and hurt from this and lay awake and walk the floor, then don’t bother. Go on the way you have. Maybe you’ll make it right. Things change. I don’t think I have the secret of life. And I get tougher and meaner. I’m going to be tougher the more you guys come in.”
Continuing the surgery analogy, he viewed caring as the anesthesia that allows the individual or family to bear this pain and pluck the courage to undergo the procedure. And care it appears he did. In one of his rawer personal confessions, he notes:
“Perhaps the most painful experiences of my professional life are those times when the rigidity and solidity of the family leave me utterly impotent. Inside I vary from an impulse to scream in rage at their mistreatment of the scapegoat or a terrible sadness often joined with some somatic symptom or a flight into goal-directed fantasy. One such family pushed me to dream up a people-sized disposal. Lately I’ve tried to develop the freedom to superimpose my emotionally loaded caring onto their shoulders. I try not to hide any of my despair and try to avoid at all costs that casual bedside manner support which leaves the family untouched and the therapist with a colder heart and less courage to care next time.”
This “not hiding” became a key aspect of his approach:
“It is not fair to expect the family to expose itself while the therapists sit by as peeping Toms. …It is important that the therapist expose his own feelings and his own person to the family. He may do this by exposing his own loneliness at the moment, his paranoia, his feelings of aggression or of identification… ‘Dad, I agree with the doctor that when you raise your eyebrows like that it means you’re extremely angry. I have the same kind of feelings about your anger and I know it is like that with me. When I get angry, I’m like you, I just hide my feelings.’”
In the language of the last letter, what we are dealing with here is connection and ultimately, interconnectedness. It springs from a view that one’s sense of “we” must be as strong as the “I” to be fully human. It seems as if this feeling is part of what enables both the individual and the family to bear with the pain and use it for growth rather than destructiveness.
But this creating certain conditions is all the therapist can or indeed should do. At the end of the day it is up to the family where they go. He viewed his job as creating the conditions under which growth could happen, after which it was up to the family what they wanted to do with that. “The integrity of the family must be respected. They must write their own destiny. In the same sense that the individual has a right to suicide, the family has the right to self-destruct. The therapist may not, and does not, have the power to mold their system to his will. He’s their coach, but he’s not playing on the team.” He’s playing a role, and this is their life. This is one reason why he was so quick to suggest ending therapy or go along if the family suggested it - it’s up to them. And sometimes brief contact can be just the needed thing, to spur them to do what is needed. The minute they even hinted at wanting to end therapy he jumped on it. And even indeed when they didn’t. He relates a time with a particularly difficult couple at an impasse where they came in and said they had nothing to talk about. On the spur of the moment he suggested they go out for drinks instead:
“So we went out and had a beer and a hamburger and probably had the best interview we had in a long time. On the way back, dad says, ‘Well, we’ll see you next Tuesday.’ And I said, ‘Not with me you won’t,’ and he asked if I would see him again, and I said, ‘Well, I guess I can if you are convinced it is necessary, but this seemed to be such a good way of saying goodbye that I would hate to mess it up.’ That was three weeks ago and we have not heard from him. The thought that they can get along without me is shattering, but several other people have…”
He was anything but the “healer” attempting to push the “treatment” on the presumed needy and dependent “patient”, an avoidance of the paternalistic attitude that is so common nowadays. It’s a bit of a less extreme and more respectful version of Lacan’s practice of ending sessions whenever he got bored. Therapy - and indeed most anything - must have some sense of espirit to be of any benefit. And if the “authority” they are turning to doesn’t trust in their powers and agency, how will they?
And so in line with this, after setting up the structure, developing some caring and stirring things up, he sat back and waited for the family to go where they wanted to go, refusing to give advice or reassure. As Whitakers stock answer to members of a couple who asked him if they should divorce: “I’ll tell you what, I’ve been married 36 years and 10 months. I think I’ll probably stick with her. What do you want to do with yours?”
So growth (expansion and increased aliveness) is the ultimate goal, and a combination of care and a turning up of the temperature are key conditions in which it becomes more possible. But there is an important mediator here that Whitaker became increasingly focused on: new experience, which he at one point noted is “the significant objective [of therapy].”
If you can facilitate new experience, then the possibility of growth increases significantly.
So he’s creating the conditions in which the dominant top-down processing can be disrupted sufficiently that something from the bottom can emerge. But how do you do that? How, in other words, do you have a new experience?
First, recall that top-down perception tends towards certitude and rigidity. Shades of gray rarely exist in that sphere, and often there is only one right way of doing things, one right “answer” (if not on the presenting problem then on the underlying assumptions about the problem).
So what Whitaker came to find was that the way past that was not by contesting or calmly suggesting other possibilities but by pissing all over their neat and orderly universe.
“The dream of a magical cure, the conviction that all pathology is in one person, the inability to conceptualize or even accept other options that the one they have decided upon—all indicate an absurd, reality-narrowing life-style. It is absurd to argue about absurdities. Our usual response is to be absurd ourselves, to play in such a way that we counterbalance the squares in the family.”
Part of that acting absurd was unpredictability, which Whitaker was well known for. But beyond that, he hits on something I have failed to emphasize up until this point. I’ve continually harped on the importance of questions, and of experiences (like mixed emotions and strong contrasts) which stimulate questions.
But there is something important that happens between those kind of experiences and the asking of questions.
And that something was of central import to Whitaker, and played a key role in his approach. “Help the family get confused, and I frequently help them sense the fact that this is what they are there for, and I'm not trying to get them anyplace.”
More explicitly:
“Without confusion—your confusion and their confusion—there is no change. As long as what happens can be fitted into the patient’s standard life experience, operational theory, or psychological programming of thought, nothing will be different. You will be adding to his information, you will be adding to his experience, but you will not produce a change that is second-degree and, therefore, useful therapeutically.
Your own confusion is one of the parts of yourself that you can share most valuably. It really doesn’t seem to make any difference what the confusion arises from. It is as though confusion by itself has the unique value of stimulating connections within the patient’s thinking process and/or life experience. Then there is the hope that out of that stimulation of new connections will come an existential moment in which the past disappears, the future is unimportant, and the present becomes a fact rather than something that is being avoided in the usual manner.”
Confusion in both parties, one often stimulating the other, can become a means by which facades are dropped and the truth comes out as the fog of anxiety finally breaks. Stances are catching and just as craziness can rub off on patients so can confusion. “Confusion becomes profound before freedom to be open and honest is attained.”
And this is key because “They can’t change their pattern of living unless first they are what they are.” You have to first be what you are before you can be what you aren’t.
Why is confusion so key though? There are a million reasons, and they all seem to be interconnected. First, confusion (as mentioned before) is a form of suffering. People do not like to be confused, and often this is avoided at nearly all costs. So one way of reaching that critical stress point is to increase confusion.
But it is not merely “another way” - it is perhaps the most powerful way. And a significant reason for this is the nature of the realizations that typically accompany radical change.
This is put most amusingly by Edgar Levenson, who was influenced by Whitaker:
“Ask an analysand who has completed a successful analysis what it is that he/she has learned. The response tends to be rather diffident. Post facto rehashes of psychoanalysis tend to be obvious and cliché-ridden, glosses of the therapist's favorite metapsychological musings. Well, it is not very comforting for us to think that we are merely Apostles of the Obvious. We prefer to believe that, in exercising our craft, we are arriving at something really buried down deep: arcane and ominous… So, depending on our metapsychological bent, we unearth infantile experience (or fantasy of experience), early evidence of parental empathic failure, fear of separation and loss, Oedipal conflict, or, perhaps, subtle discontinuities in interpersonal experience. And when the Name is named, we expect the exorcism to occur. And yet, sometimes the magic doesn't work, even when the explanations qua interpretations seem patently true. Why not?”
This is a crucial question, not only for therapy but also anyone who reads and thinks, the latter folks who too often suffer under the (often implicit) belief that “enough knowledge, enough information, the right kind of facts will bring about the resolution of life’s doubts, the resolution of distress”.
Which is why Whitaker went another way. “..the covert message is the one that produces change and the overt message quaintly enough produces recognition and nothing else.” This is the trouble with plain-speak. It’s typically not enough. Talk plainly enough and you guarantee no one hears you (and not least because they've already heard it before). Make it a riddle and somehow you get everyone’s attention.
Not only do you gain their attention, but you avoid the kind of resistance that “Naming” often engenders. So Whitaker speaks of -
…the power of paradox… of the dialectic… of never being caught in the corner so they have to either accept what you say or fight you. If you can always leave inferences up in the air, when they decide to pull them down and insert them in their own heads, they do it on their own initiative or they can just let them float there. You’re really not set with some conviction that they have to buy. In this way the family begins to gradually take the initiative for their own living process…
And so over time the tone of the interview changes: “change seems to take place when the family stops trying. I am referring to the situation where the current of the operation or transactional process moves from a teaming effort to a flowing, nondefinable state of being.”
Another paradox, which elsewhere he puts this way - "you don't get there by trying but you can't not try.” Trying and failing is perhaps a necessary step to give up on trying, to “push [the patient] to break through into a new integration by separating him from all logical, theoretical, disciplined patterns of understanding” - patterns which shackle and narrow the self, and divorce it from the enlivening subjectivity and “craziness” that is our birthright.
Play and humor become suddenly possible. “Struggles for individuation and separateness are acceptable and exciting, and despair is not the affective undercurrent. Their freedom to regress in the service of individual egos is exciting, and their fun as a group is childlike, open, and free of the meta communicational heaviness of an intellectual orientation to life."
After which they enter the gates of Nirvana, ascend the ancestral plane, and are free forevermore of all earthly ills.
Not quite.
While Whitaker does have a developmental ideal - what he calls an existential shift to the present where one ceases to endlessly think about living and instead is able to simply be - in terminating therapy the emphasis is on “adding 10 percent to the families living”. The “massive emotional experience” which sometimes leads to that shift is not reliable enough to be the central emphasis, although that was always his hope.
And while being is the opposite of an escape from or transcendence of the terrors of life - it is the only sure way of fully enjoying its fruits. It reveals itself in a lack of double-think (i.e. not checking that what you’re saying aligns with your past statements, or with others opinions, or with the larger culture) and consequently in presence, which when encountered is “really exciting but like a sexual turn-on that you can respond to or not respond to, as you choose.”
At its peak, its intensity is such that the bearer “could say the A, B, C’s, and it would be a personally significant experience.” He mentions that he’s met 4 or 5 people in his life of which this could be said.
One of those? An old friend of the newsletter, whose work I’ve explored here a few times, and whose comments on a subject thus far unexplored we’ll take a fun detour into next.
But I don’t want to make any commentary on this for the moment, I’ll let his words and their similarity (or not) to our ongoing conversation speak for itself. Instead I will close with a passage from his last book, published just 6 years before his death in 1995. In it, at the tender age of 77, he tries to get into the mind of a young child and its navigation of the complexities of life. After a mock internal monologue, on the warmth and safety of being with those giant figures and the fun of running off and hiding, this:
The dialectic has begun: I-ness and we-ness in flux; security and exploration, each with its joys and its panic, an irresolvable dialectic. Security alone equals slavery. Exploration alone equals danger and death. The flux is always exciting but never an answer, only a courage-inducing impetus to more of the individual’s right to decide on the next move and to discover more and and dare more.
Amen.