Clinical Commentary

CLINICAL COMMENTARY XXVI

The material commentated upon in this issue is work with a family by a pair oftherapists working psychodynamically. The commentaries are by three systemic therapistsworking in different settings, and one psychiatrist specializing in working with couplesand families. We seem to be considering the interface between analytically orientedtherapies and approaches which see themselves as drawing upon different traditions. Inthis way these commentaries widen the circumference of our knowledge.

As always we are very grateful to the contributors for giving their time to sharethoughts. This is my last clinical commentary so I want to thank again all the contributorsover the years, and the Editor and her Deputy for all I have learnt from the opportunity towork with them. I look forward to my successor's development of the commentary space.

Katherine Arnold

CLINICAL MATERIAL: THE X FAMILY

The reason for the referral by the general practitioner of the X family were that fatherhad sought help for the `highly disturbed psychodynamics' within his family - mostnotably the difficult relationship which existed between his 17-year-old son, Martin, andthe mother. The family had had minimal previous Health Service contact. The X familyconsisted of father, an academic, who was probably in his early 50s from a middle-classEnglish family, and mother of a similar age from a middle-class Argentinian family.There were two sons, Martin aged 17 and Miguel aged 14.

Our first encounter was with the whole family and a precis of this first session isgiven for it seems to encapsulate some of the themes that we were to experience moredirectly in the course of the work with the family.

Father started almost immediately we were seated in the therapy room, prior to anyintroductions having been made, telling us about Martin's behavioural problems whichseem to have gone on over the years and were causing a lot of unhappiness in the family,but mostly between Martin and mother. He added, `this might be only my view, everyonewill have different perceptions', and then went on to say how he and his wife had differentviews as to how to address the problem of Martin and that this was a specific point ofconflict between them. The problem seemed to have been one for ever and was somethingthat had never been sorted out. The young man whom we take to be Martin was noddingat his father's account although still no introductions had been made. Mother then seemedto spill out, and spoke passionately about her husband never backing her up and that shecould not stand this sort of thing, i.e. bad behaviour, particularly when it was displayedon the streets. She told us that she would fight to stop this sort of thing. Eventually one ofthe therapists managed to say that it was not clear who was who, the other noting theforeverness of feeling expressed in connection with the problem.