Monday, February 27, 2012

Excerpt from Family Constellation chapter of my memoir

Here is the chapter from my book where I attempt to show how Family Constellation Therapy worked in the context of our family situation. This chapter was probably the most difficult chapter to write. It has been through many edits because it's important to explain how the therapy works as clearly and succinctly as possible. I've taken a few liberties, not many, with what actually happened, in order to make the chapter flow more smoothly. The names of the characters are fictitious. The entire book, save for the last chapter, is available, for the time being, at the authonomy website.


Dr. Thomas Szasz writes that there are two kinds of psychiatrists: the institutional ones, who bring the power of the state to bear on the individual through forced medications and coercion, and the contractual ones, who enter into a private, consensual contract with the patient. Ian and I had experienced the power of the institutional psychiatrist at CAMH, Belle-Idée, and the day program. We were eager to find a local, private doctor who would work with Chris in a more consensual arrangement.

It was perhaps a tall order, but I was hoping to find a psychiatrist who was willing to consult with Dr. Erika and who could do a few sessions of Family Constellation work with us. I was convinced Family Constellation Therapy was the missing link I had been seeking. I truly felt that if Chris were going to experience a breakthrough, then this therapy would make it happen. I took Dr. Klinghardt’s observations to heart, that schizophrenia was a manifestation of a magical belief system and had to be approached at the same intuitive level (four).

After pursuing numerous false leads, I learned that the head of the l'Espoir program, Dr. Rx, was the person to speak to who would probably know about Family Constellation Therapy. Dr. Rx? Had Dr. Rx been withholding information about the therapy from us the entire time Chris had been in the day program? What had we been doing for those twenty-two months in his program—paddling around in the shallow end of the pool for young people with psychosis? Or was Family Constellation Therapy, in his view, only reserved for old people with psychosis? The end result of my convoluted journey was humorously ironic. I had no intention of contacting Dr. Rx.

It was our old contact, Dr. Robert, who referred us to Dr. Maria Stern, a tri-lingual psychiatrist and Family Constellation therapist practicing in Geneva. I telephoned Dr. Stern and explained why I thought Family Constellation Therapy might help Chris. Dr. Stern listened very carefully to what I had to say and suggested that we schedule an initial appointment for the end of June.

On the morning of the appointment, Ian, Chris and I drove to Dr. Stern's office, which was located on the first floor of a small residential building near the Hôpital Cantonal de Genève. We circled her street several times before we managed to find a parking spot. We rang her office door bell promptly at 8 a.m. and waited. We rang again. After what seemed like hours, not seconds, Dr. Stern unlocked the door and ushered us in. “Please come and sit down,” she said, steering us towards a loveseat and two chairs grouped around a small glass table in one corner of the room. From my vantage point on the loveseat, I looked out at the rest of the room, which was enormous and devoid of furnishings save for three large Oriental carpets on top of the parquet floor.

While Ian and Dr. Stern talked about where in future to find parking space closer to the office, I sized up Dr. Stern, who I guessed to be in her late forties. Excellent English, slight German accent. She wore no jewelry or make-up and was conservatively dressed in a pearl gray jacket and skirt and light-blue blouse. She seemed like a sincere person. I hoped she would also prove to be a good psychiatrist for Chris.

Dr. Stern wanted to make sure that not just Ian and me, but Chris, too, was willing to participate in the therapy and after more small talk with all of us, she spent several minutes focused on Chris, trying to get him to talk a little about himself. She often had to ask him to repeat what he’d said because he spoke so softly.

When Dr. Stern finished speaking with Chris, I surprised her by handing her a Family Constellation version of our family tree, starting with Chris and his brothers and working back four generations on both sides of the family, up to and including Ian’s and my grandparents. I’d included short descriptions of each ancestor, detailing what appeared to be the central disappointment or tragedy of their lives.

“My clients aren't usually so well-prepared,” she said with a smile, promising to familiarize herself with our family history before our next appointment.

“Normally,” she explained, “I conduct my Family Constellation therapy in French on the weekends with several families at once. The participants act as stand-ins for the ancestors of other families present, and I introduce them to their roles and observe the interactions when they are in their roles. Since French is not your family's first language, I’ll schedule an appointment during the week with just your family. Instead of having each of you play different roles within a family grouping, I'll ask either you or Ian to place paper outlines of shoes on the floor to represent your particular group of ancestors.”

Ian and I stared at her. Shoes?

“Wait here,” said Dr. Stern, getting up and disappearing through a door into her inner office. She soon reappeared with a file folder and held up a piece of A4 paper labeled “CHILD” with the outlines of two tiny shoes that represented a young child.

“I'd best show you what I mean,” she said, walking to the center of the room, whereupon she quickly began placing the file's contents on the floor. “This constellation represents the family of a man I saw last month. The man placed the shoeprints on the floor in the way I am showing you now. He put his father's shoeprints here, and his mother's shoeprints here. His grandmother was very interfering and you can see from her shoeprints that she is blocking the space between her son and his wife.”

Dr. Stern paused. “That's all I'm going to say about this constellation. I think it's enough to show you how we use shoes in this therapy.

“Let's say that Ian chooses to do his side of the family,” she continued. “Ian will place the shoeprints on the floor and resume his seat and then I take over as the actor.” Dr. Stern took a couple of steps backward and stood on the paper representing the grandmother of the man she saw the previous month.

“The actor absorbs and reveals the hidden connections, issues and confusions of the family energy field. Whether I am acting or facilitating, I may sometimes interject to ask questions of myself or the actor about the spatial orientation and distancing of where the shoes are placed; when I am acting, I may simply move my body in a way that shows how I feel impacted by the energy of the other members of the ancestor family. “Eventually, we come to a resolution. I ask the person whose family constellation was acted out to take over from me and position the family members in their rightful places in the constellation. Having placed ourselves in the drama by observing or by acting, we can sense how and where the injustices or exclusions have occurred, and the family member symbolically changes the pattern of the family dynamics by physically moving the shoeprints into a more harmonious grouping. Healing can now happen because the energy of the constellation begins to flow naturally.”

Ian and I looked at each other and nodded. What Dr. Stern explained to us made sense. I pushed up my sleeve to check my watch. Two and a half hours had elapsed and it was time to go. Before we left her office, we booked two appointments for the whole family in the first week of July as Dr. Stern would be leaving for summer vacation almost immediately after.

On the morning of the first appointment, our family gathered in Dr. Stern's therapy room at 8 o'clock. Ian and I deliberately shared only basic information in advance with Alex and Taylor about what the therapy entailed. I had insisted that they read the short descriptions of our family tree that I had given to Dr. Stern. I knew that they were not especially curious about their ancestors and were unhappy about the turmoil our family had gone through over Chris. They attended the appointment under duress.

“I'm quite busy and I don't think I can make it to all the sessions,” Alex announced to Dr. Stern, in a tone of voice that implied, “Don't bother trying to convince me otherwise.” Alex was friendly with Dr. Stern, even though he had already made up his mind that he wasn't planning to stick around for future sessions, but Taylor was aloof and remained so throughout the session. Chris, as usual, was quiet. He spoke only when spoken to.

Chris was more knowledgeable about his ancestors than his brothers were because he had helped me construct our family tree over the course of the previous year. Finding the birth dates and deaths of our ancestors through family records and Internet searches and entering the information into a database gave him and me a new pastime and a chance to talk about what our ancestors’ lives may have been like.

Dr. Stern issued us a short set of instructions. “Decide which set of ancestors you would like the Constellation to be about. If it's the maternal side then Rossa will put the shoes on the floor; if it's the paternal side, then Ian will do it.”

Ian and I had agreed in advance of our meeting that Ian would start with his father's side of the family. Ian's parents went through an acrimonious divorce when Ian was a teenager and he is not close to either parent. He has a tense relationship with both his father and his mother. Ian feels that his father, Bill, has never acknowledged his part in the family breakup and should have apologized to his children for the misery they suffered.

Ian is named after his paternal grandfather. Ian John Forbes left Aberdeen, Scotland at the age of seventeen and arrived in Toronto just before the First World War broke. He joined a local regiment, whereupon he was shipped first to England then to France. His military records indicate that he was in hospital most of the time he was in France, suffering from pyrexia of unknown origin (PUO) or what was commonly called trench fever. A patient usually recovered from trench fever in less than a month, but in rare cases, the continuing after-effects of the fever included fatigue, anxiety, headache, neuralgia and depressed mood.

We knew very little about Ian's grandfather other than that he spent the rest of his life after returning to Toronto as a semi-invalid, and an alcoholic as the years went by. His children were all born several years after the war ended. Ian John's wife, Emma, was an English nurse, so there is a good possibility that she met her husband when he was a patient in her hospital. Bill (full name David William), rarely offers much information about his parents, even when we ask about them. Ian John's children and grandchildren were always under the impression that his health troubles stemmed from being gassed during the war, but his military records revealed no further information.

Dr. Stern told Ian to be spontaneous in placing the shoe outlines on the floor. “The placement should be intuitive, not logical,” she explained. “Don't think about it too much.”

Ian placed six pairs of shoes, for his grandparents, and their four children: Bill, and Bill's twin sister, Bill's older sister, and a firstborn child with the same first and middle name as Bill's. “David William” died of leukemia at the age of three, before the rest of the siblings were born.

After Ian finished laying out the shoes, he sat down beside me on the loveseat. We waited nervously to see what would happen next.

Dr. Stern then began a mesmerizing narrative dance, stepping first into the shoes of Ian’s grandfather. She stood quietly, with her head bowed, her eyes looking down at, but not focused on, her shoes, and her arms hung limply by her side, as if she were a marionette loosely dangling from an invisible string. Her breathing caused her shoulders to rise ever so slightly and her stomach to expand and contract.

“Hmmph,” said Dr. Stern, inhaling a sharp intake of air through her nostrils while still keeping her head bowed. Her marionette shoulders shivered ever so slightly. There was complete silence in the room; all eyes were focused on Dr. Stern. After what seemed an eternity, she shook herself a little and began to speak. “I can see I have three lovely children,” the grandfather continued, but I am not close to them. I have a fine wife, but I can only see part of her from where I am standing. Where is my first born son, David William?” With her feet planted firmly, Dr. Stern rotated her body, her feet not moving, to gaze over her left shoulder.

“Oh, I see; there he is,” spoke the grandfather, in the voice of Dr. Stern. “He died young, didn't he? I thought I had forgotten him. But you didn't, did you, my dear,” he said softly to Emma. “You are standing by him.”

Ian and I had grabbed a couple of tissues from a large dispenser on the glass table and began wiping our eyes. As the drama progressed further, we wept more openly. We were heartbroken about how the grandfather's ill health, death of his first born child, and personal demons had estranged him from Emma, Bill and his two daughters.

Dr. Stern wept, too. There were at least four dry eyes in the room. Taylor and Alex looked bored, occasionally exchanging suppressed smiles.

Every so often, Dr. Stern would glance sideways at Chris, to see how he was following the unfolding drama and to watch his reactions. Chris was too far into his protective shell to cry, but he was riveted by the drama. His eyes never strayed from Dr. Stern. He seemed to understand the dynamics of the constellation, and sense the burden carried by its family members.

Dr. Stern was finally finished with her acting role. “Ian,” she said, “let's trade places. Now it's your turn to stand in the shoes of each family member and to express any emotions or wishes you may have about where you would now like to place the shoes.” When Ian stood in his father's shoes he realized he couldn't see David William, his older brother, from where he was standing. Ian suggested that he should be included in the same line as the other three children. So, Ian moved David William, the almost forgotten child, next to his younger brother and namesake, Bill. Then Ian, standing in his grandfather's shoes, expressed that he would like to feel closer to his wife, so he moved Emma's shoes close to Ian John's.

“How do you feel about the family?” Dr. Stern asked Ian, then each of us in turn.

Ian felt immensely sad, so did I, so did Chris. Taylor and Alex, still resistant to being involved in the therapy, mechanically stated that they felt a bit sad, too. I'm sure that what they said was true; it was hard not be affected by the energy in the room.

After three hours, we were all totally tired and grateful to leave.

“Now, just remember,” said Dr. Stern. “Don't analyze what you have seen and done today and try not to speak to each other or to other people about it. Whatever comes out of these sessions will happen at an emotional level and will take time.”

Two days later we were back in Dr. Stern's office, save for Alex who had suddenly discovered commitments he could not possibly break. All the pleading in the world got us nowhere.

“Alex is tough like that,” I remarked to Dr. Stern.

“Being tough is probably a good way to be,” she replied.

In reviewing the outcomes of the previous session with Dr. Stern, Ian and I agreed that we felt saddened but closer to Ian's family on his father's side. Chris, ever so slightly nodded his head in agreement.

This time, it was my turn. I chose my mother’s side of the family because of the impact that the early death of my grandmother had on my mother. My father lost his father when he was eight, so I could have started with his side of the family, but I knew that losing her mother when she was only four years old had a huge effect on my mother, Lily.

I remember meeting my grandfather, Kurt, on two occasions only—once when I was about three years old, and once when I was a teenager. Lily didn't like Kurt, and so our family rarely saw him. Towards the end of her life, my mother told me that she’d felt her father blamed her for her mother’s death. My grandmother, Anna, died of scarlet fever, which she’d caught from Lily in 1924. While I was growing up what I heard from my mother was not that her father blamed her directly for her mother's death, but that he penalized her by forcing her to quit high school, despite the fact that she was at the top of her class, and refused to buy her new clothes. In her teen years she also had to cope with his third wife, whom he divorced, and his marriage to his fourth wife, who was only slightly older than my mother.

I quickly laid out the shoe patterns for my grandparents, Anna and Kurt, my mother, Lily, and her older brother. I also included in the Constellation grandfather Kurt's first wife, who was his second cousin. She died while still a teenager, leaving him a widower for the first time. Family Constellation therapists would say that her death enabled my grandmother to marry my grandfather, and that's why she should be included in the family grouping.

The pattern was rather conventional ―grandmother and grandfather on the same linear path, shoes facing their children, but not spaced close together, children placed below and parallel to the parents, facing them, and the first wife behind my grandfather but far away.

Dr. Stern took her position as interpreter of personal dramas. She started by stepping into my mother's shoes, and in a plaintive voice asked, “Where is my mother?” As Lily continued to speak, I acknowledged to myself that, as a child, I had never given much thought to the impact my grandmother's death had on four-year-old Lily. To my way of thinking, she died — that was all — and I accepted her early death as just one of those things that so often happened to people of my parents' generation. I knew it was a defining event for my mother, but I didn't dwell on it when I was growing up. Today, in this room, the effect of my grandmother's death would starkly reveal the impact on her immediate family. I sensed I was about to find out some disturbing truth that I had chosen to ignore until now. I felt cold, despite the warm summer air wafting in through the open window.

Next, Dr. Stern took the place of my grandfather. She hung her head and dropped her shoulders in the marionette position, and for a few minutes, she said nothing; then, slowly, horror seemed to pervade her body. She put her hands over her cheeks and shook her head in dismay while rocking slightly back and forth. She said nothing. She didn't need to say anything. Our knowing about the death of his first wife and the death of his second wife who left him with two young children didn't need an explanation.

As I watched Dr. Stern alternate between my grandfather, grandmother and his two wives, I thought despairingly about my mother. My mother was a kind and giving person, but she lived most of her life with three daughters who wouldn't touch her unless they absolutely had to do it. I now began to wonder if there was more to our lack of physical affection than just the societal norms of the era when I was growing up. I remembered how my sisters and I also hated to play with dolls. I thought of an old black and white photograph of my sisters and me on Christmas Day, looking sullen, our faces dark as thunderclouds. My parents had bought us all kinds of dolls as Christmas presents ―Tiny Tears baby dolls and glamorous fashion dolls with frothy tulle skirts. These gifts would have thrilled lots of other girls, but not us. Not one of us at that age wanted to nurture. Of the three sisters, I am the only one of us today who has children. My sisters chose to remain childless.

Dr. Stern paused in her role playing. “I sense a chill in the room. It feels like death.” She pulled her light, cotton cardigan a little closer to her body. I reached for a tissue and wiped my eyes, suddenly recalling that there was another family member who died early, and that was Anna’s mother, Clara. Clara died when Anna was only ten. When I was three years old I almost died from a blood-related disorder. Family Constellation Therapy might say that I was trying to sacrifice myself to fulfill this particular family curse.

Random thoughts popped into my head as I watched the drama unfold.

Perhaps my sisters and I feared getting too close to my mother meant we risked early death, almost as if early death is something we could "catch” from her, and that's why we refused to show her physical affection.

Have I unconsciously withheld affection from Chris because I feared that he would die, too? Did he withhold affection from me because he, too, sensed the contagion of death?

All those sleepless nights after he was born when he cried and cried because I had no breast milk. Chris was literally starving by being denied the most nurturing food of all.

This latest revelation about Chris made me feel sick with remorse.

During this Constellation, the same as in the first one, Dr. Stern again looked at Chris to gauge his reaction. Chris was still keenly following the drama without saying much.

Dr. Stern caught something in Chris’s reaction that she thought was important.

“I think I’ve got it!” she said at the end of the session. She turned to Chris and said, “You should not have to carry this burden any longer.” Without offering any explanation, she announced that the session was over. Each of us was left to find meaning in what we had witnessed, in our own way.

For the second time, we left Dr. Stern’s office, exhausted and deeply aware of the sacrifices that had been made by those who went before us. Again, abiding by Dr. Stern's instructions, we did not discuss what took place in the room.

Chris's illness had already taught me not to take parenting for granted. There are hidden and not so hidden dramas going on in all families despite parents loving their children and trying to do the best for them. Some especially sensitive children may fail to blossom—even though they are loved—if they sense a hidden undercurrent of tension which they will try to correct in their own way. Family Constellation Therapy taught me that to be a parent is to accept one's part in a sacred journey, a journey that began generations before. As parents, we profoundly influence the lives of our children and our children's children, for better and for worse.

By participating in the Family Constellation sessions, I believed that each member of our family, not only Chris, would undergo an energy transference that would positively affect any healing that needed to occur in the present. Healing the present generation would have a positive impact on future generations of our family tree.

In the meantime, we had to wait and let the magic happen.


  1. This is powerful and simple writing. You have done well!

    There are ghosts in all our families that are still on the emotional stage pf our present lives.

    I find it very interesting that I am the child in my own family of origin who was always going back, again and again, to seek new insight into the family story on my mom's side. My dad told us kids nearly nothing about his family.

  2. Thanks, Smitty. This therapy is not for the faint of heart. Digging into one's inherited emotional energy is quite scary. It's also amazing to me that while in many ways I felt I had a "normal" childhood, there are also big voids, such as not knowing much about certain branches of the family. It sounds like your experience as well.


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