Families

Frances Verrinder writes: Family therapy has been an important part of my work since the 1970s. I was fortunate to be in graduate school at the time when family therapy was developing as a therapeutic specialty in its own right. I have expanded my initial training at the Family Therapy Center and at the Child Study Unit at UCSF by integrating narrative family therapy and the attachment-based Circle of Security family therapy method into my therapeutic work.

I work with a wide variety of families, including divorced and stepfamilies, single parent families, immigrant families, gay and Lesbian families and families of color. Families may come in for therapy at any point in their development. I have seen parents with children as young as three. I have also worked with adult children in their 30s, 40s and 50s with parents in their 50s, 70s and 80s.

Parenting is probably the hardest job in the world. There is so much social pressure to do it perfectly, which of course is impossible. Sometimes the misfortunes of life, separation or divorce, a serious illness or an unexpected accident, prevent parents from providing “good enough” caretaking to a baby or a toddler who may develop problems later on in childhood. Often parents who were inadequately parented by intrusive, abandoning or abusive parents may find themselves being controlling and demanding; others may have trouble being assertive, maintaining reasonable limits and taking kind and firm charge of their own children.

Almost every family experiences difficulties at one stage or another. Some major traumatic experiences can bridge generations. Some grandparents and great-grand parents may have experienced war, holocausts, immigration, economic disasters, mental illness or alcoholism, and the current generation may still be expressing them as perfectionism, depression, anxiety or codependency.

Sometimes the difficulty is a child who is angry, depressed, and anxious or who has learning disabilities, ADD or ADHD; sometimes a teenager is getting out of control, refuses to go to school or is feeling suicidal. Some immigrant parents have strict, rules, which they automatically apply to their American teenagers, who are then in a cultural conflict between home and school.

Image of family's hands San Francisco Family Therapist

When I meet with a family, my aim is to establish a friendly and welcoming environment for the family, concerned, empathic not judgmental, kind and firm, serious and playful. I usually ask to see everyone who is in the house and any other significant people who are involved in the family’s life, such as grandparents, aunts and uncles, sisters, brothers. I like to hear everyone’s perspectives about the problem and see if there are any other ways family members could help with it. Sometimes, a family member is unable to show up so we designate an empty chair for that person. I always ask people to choose where to sit. Then I can get a sense of who is close to whom.

I ask every family member what other difficulties the family might be having besides the presenting problem. Often other family issues emerge. I like to hear everyone’s perspectives about the problems, ask what they have already tried to solve the difficulty and see if there are any other ways other family members can help resolve them.

I use drawings, sand tray and play in my family work, especially with younger children. I think of playfulness as the freedom to be creative, humorous, imaginative, fun loving, and to enjoy silliness. The playful person approaches daily life with a predisposition for fun and pleasure.

The ability to play is also deeply related to self esteem, which includes trusting oneself and others, a sense of safety, self acceptance and self understanding, and a sense of belonging to oneself, others and the world.

My goal is to help parents learn news ways of communicating and dealing with their children and to assist children in responding positively to the parent. For example, the largest family I’ve ever seen was eleven adults. (Identifying details have been changed to protect the family’s privacy). The presenting problem was the youngest daughter who refused to attend school. Her four older married siblings had tried unsuccessfully to take over the parents’ roles. They laughingly shared that they had banded together as teenagers to subvert and disobey their immigrant parents’ cultural expectations of obedience and respect. The parents had been completely unaware of this but they had the grace to chuckle. The deadlock resolved when, with the family’s help, the mother and daughter agreed to renegotiate a change in the mother’s strict rules.