I was saddened to hear that one of my early professional heroes died yesterday. Salvador Minuchin passed at the age of 96 after a long and prolific career as a founder of marriage and family therapy.
While I didn’t know Minuchin like some of the first generation of CFHA leaders, he did have a deep impact on my career and my decision to embrace medical family therapy as my preferred lens. His conceptualizations of family structure were elegant and imminently applicable in family work. I come from a structurally complex family that was impacted by childhood diabetes, so I eagerly consumed all of his seminal works on “psychosomatic families” and “brittle diabetics”.
It is definitely fair to say that some of his ideas have started to show their age, and his language reflected an earlier and less other-aware era. And, in the hustle and bustle of integrated behavioral health, we’re often not afforded time for structural interventions with families.
And yet, in this regard, our integrated models are also starting to show their age. We are now acutely aware of the impact of social determinants of health and adverse childhood experiences. Families-of-origin are the near universal first exposure to both of these health stressors. We recognize relationships as the root cause of the symptoms that we attempt to manage in on-the-fly encounters. We live with the dreadful awareness that our referrals to other systems often fall through the cracks. With the young and the aging, our societies benefit from the dedication of time, love, and resources that come from families and other loved ones. Yet, behavioral health consultants in highly restricted settings often feel hobbled in their ability to fully engage the strengths of these systemic supports.
I only had the chance to meet Minuchin once. He presented at the Erickson Foundation’s Evolution of Psychotherapy conference in 2000. I drove from Colorado to California to see him during my doctoral internship in Grand Junction. He wore a baseball cap on-stage because his aging eyes couldn’t tolerate the spotlight. I found him to be humble and self-reflective. He advocated for the continued relevance of his theories while also tipping his hat to the post-modern critiques that were de rigueur at the time. He was gracious in tolerating a picture with me and a line of others after his remarks.
At last month’s CFHA conference I had a similar fanboy experience while sharing dinner with Susan McDaniel, Larry Mauksch, and Barry Jacobs. Presciently, they shared their own experiences with and affection for Minuchin. I count myself as blessed to be part of our movement while it is still new enough and intimate enough to rub shoulders with our visionary founders. It is our challenge to bring forward the legacy of their best ideas, while modernizing them to align with the ever-changing contexts in which we implement them.
Randall Reitz, PhD, LMFT, is director of behavioral sciences at St. Mary's Family Medicine Residency Program in Grand Junction, CO.