(lively piano music)
- Hi there everybody.
- [Woman] There's a lot.
I knew there was a lot of people involved
but gosh, they got the room,
a crowd of people sitting on the floors,
people coming out of the woodwork
looking for (mumbles).
- Yeah.
- (baby jabbers)
- The question is that, your family
has at least 20 people involved with you,
and so, they are all there.
- I see.
And all of them are people
that in some way or another
have been involved with you.
- True.
But see, this is where
the questions come in.
- What I don't know, is if all these
many people are, it is good to have
all these many people.
How many of them are good
and how many of them are not good?
- [Voiceover] It is common for
poor families to be involved
with a multitude of helpers.
This tape will examine this phenomenon.
It will highlight the kind of thinking
that gives rise to the proliferation
of disconnected services and it will
explore the frequently unfortunate effects
this proliferation has on families.
The tape is based on a consultation
of Doctor Salvador Minuchin,
with the family of Marci and Wilfredo.
Marci and Wilfredo have two children,
both of whom are in foster care.
The social worker assigned to the case
by the foster care agency,
introduces us to the family members.
- [Voiceover] Wilfredo I know best.
He has brought himself through a lot.
His legs are very small.
He has this brittle bone syndrome
and he's gone through a lot of suffering
physically and he has developed
a kind of physical will power.
He gets himself around with a wheelchair.
He gets money from begging
and performing a kind
of lap dancing thing on subways.
He's very, kind of, bonded very, very
strongly with the older child,
who is the sick one, has the same
disease he has.
The other child went right into
foster care from the hospital.
So there's almost no
bonding with that child.
That's a real problem.
Mother has been into three drug programs
and she has not stayed with any of them
for the length of time that she needed to.
The last two she was in, she went right
back onto the street.
- [Voiceover] Present in
the consultation room with the family,
was one of Marci's therapist's
from her most recent
drug treatment program,
seated here on the left.
The foster mother of Abril,
Marci and Wilfredo's youngest child.
The foster mother of Jasmine on the left
and the foster care social worker.
Prior to the consultation, Dr. Minuchin
met with the staff of the foster care agency
and with three member s of the staff
of the drug treatment program
to discuss the case.
Minuchin opened the discussion
with a question to the drug treatment staff.
- [Minuchin] So you have this woman
for three months and you have Martin,
this social worker of this family
and you have these two children
and you have these two foster mothers,
so we have a very complex model.
How do you fit in that model?
- Really, on the outside.
- [Minuchin] On the outside.
- A sense of trying to coordinate
Marci's treatment for her own
individual growth and attempting
to find ways of getting her back into
a family if that's what she chooses to do.
- [Minuchin] You're focusing only on her?
- Uh-huh.
- [Minuchin] And you want her
to focus only on you?
- No, Marci needs to focus really
on her own individual needs.
All we do is try to facilitate that process.
- Key piece is that she's no longer
our client because she left
the program of her own accord.
- [Voiceover] Treatment in this perspective
requires that Marci explore
her individual self and address
her individual needs.
This perspective place the drug
treatment staff at odds with
the agenda of the foster care agency.
- [Minuchin] When you said you were
a source of (mumbles),
what does it mean? What do you do?
- That's a good question.
I would like to be a helper in joining
the family back together.
The situation is that this family
has a reach to come back together.
They have lots of things pulling them apart.
- Do you want to say something?
- Yes, I would think that it seems
that the main issue which is--
- [Minuchin] Just a bit louder please.
- I would think, it seems that one
of the main issues which would be
a difference perhaps between
when we saw the family (mumbles)
perhaps you're seeing her on here
and you describe her.
Whether the family should actually
stay together or not stay together.
And we've, through our assessment,
in terms of Marci's drug history
and so on, it seems that Wilfredo
and Marci have a very difficult relationship
that is at times abusive.
- [Minuchin] (mumbles)
- He is abusive to her, physically abusive.
- [Minuchin] Physically abusive, oh.
- And I think Marci is very ambivolant
as to whether she wants to go back
whether she wants even to have
her children back, whether she feels
capable as a mother for these children.
And I think it's a big issue for her.
And I think in a lot of ways,
she's working from a fear base.
- Prior to Marci's leaving our program,
I know that she was being confronted
by other members of the program
on her attitude about her family
and her place in her family
and how responsible she felt
for the family and that she needed
to protect them but then again,
she didn't want to protect them,
she wanted her own life but then again,
and they were saying, hey wait a minute
and a lot of residents in the program
were really pushing her to be honest
about how she was feeling and to try
and come to less of a juggling act
of all these things and my impression
is perhaps that, that conflict in her
of whether to go back to the family
and be a mother and a wife in that family
or to be an independent person
which would mean that she would
put that family aside.
That conflict was coming up.
- [Minuchin] And when would you present
these things and I see them with
a different perspective.
- [Woman] Okay.
- See, you see the struggle inside of her
and I see the struggle between
these two pages.
- [Woman] That's what I was going
to point out is I was thinking that.
- Maybe what I am asking is,
what I am asking is, (mumbles)
are you working in your position?
- [Woman] I believe that we were.
I believe that ultimately we were
and that that's where the conflict arose
although we didn't realize that it was
happening at the level that Marci
was feeling it.
Is that Variety House is saying,
let's get these roots together,
meet you with your family
and ultimately have you return
to your home and be a mother
to your children and on the project
return end, Marci's really grappling
with that as something that she
possibly really doesn't want to do.
- [Voiceover] So from the perspective
of the drug treatment staff,
individual integrity has precedence
over and is frequently in conflict with,
being a relationship.
This outlook placed the drug treatment
program at odds with the foster
care agency which assigns priority
to being a relationship.
The need to accommodate to these
different perspectives stressed Marci.
- She initially was to go to Variety House
to have her visits with her children.
However, when she went to Variety House
for the first visit, she had this very
emotional reaction whereby when was
just in a terrible panic and hysterically
crying and I spoke to her on the phone
and tried to get her to come back
and ultimately she said she would only
come back if Wilfredo told her
she should go back which he did
and she decided to come back.
- We were supposed to have a meeting
at our place and Marci got very emotional,
she started crying, she didn't want
to go back to the program.
It was quite a strong, emotional reaction.
She did not want to go back.
She did not care if she couldn't see
her kids again,
she didn't care about anything.
But she did go back.
She claims she went back for Wilfredo,
the man, the father.
- [Minuchin] You would say as she
left your place, is that because she
is pulled by things out of your place
or is that she was rejecting your place?
- I think she was really rejecting it.
What I seen is that whole battle,
I think she was doing a lot better
than she gave herself credit for
and I think that scared her.
- [Voiceover] Within the drug program's
individual prospective, Marci's eventual
dropping out of the program is to be
attributed to her individual pathology.
Her internal ambivalence and conflict.
Doctor Minuchin systemic prospective
provides an alternative explanation.
- [Minuchin] You see I think that I am
exploring the collaboration
of the two places and the synergy
or opposition of the forces because
you are working in terms of increasing
her confidence and participant
in this world that is the world
of the foster parent to children
and her boyfriend and your working
in terms of increasing her sense
of confidence and her ability to survive.
- [Voiceover] The individual prospective
shared by the drug treatment staff
is the prevailing prospective among
the institutions and agencies
that deliver services to poor families.
It is this perspective that leads
these agencies to refer individual
family members to a new helper
every time a new problem is defined.
And it is this perspective
that frequently leads the multiple helpers
to make a multitude of competing
demands on poor families.
- I was just thinking, when you were
talking about this, that the conflict (mumbles)
even further between us
and Variety House, it goes between
the couple themselves and also
between the foster family
and (mumbles) family because
it seems like if you're saying
the foster is doing so well
with the children, they may have
a vested interested in wanting
to keep the children there.
- [Minuchin] So you're saying,
it is a serious, it's like a (mumbles)?
- Yes.
- [Minuchin] And everybody is pulling
on Marci and she cracks.
- [Woman] Yeah and she cracks
by returning to--
- [Minuchin] Are we doing
this family some good?
You have here,
a family that is quite fragmented.
You have, her name is?
- [Woman] Abril - Abril.
- [Minuchin] Abril and Jasmine.
Hello sweetheart.
And she lives with?
- Her.
- [Minuchin] You.
And Jasmine lives with you.
And you were living in the program.
And you were?
- I was living in my own mist.
- [Minuchin] In your own mist.
- On my own, yeah.
- [Minuchin] And she sometimes.
- What do you mean she lives?
- I mean that sometimes you don't
have a permanent address.
- No, see I had a permanent but because
things went the way it went,
I wind up losing it .
Now, according to the way things
supposed to be, I am looking forward
to having my own place again
and being with the family.
In the Lord's name.
The confusion is that she was in
the state of drugs and it put us apart.
Other than not being with the girls,
we do not want that.
We want them to be with us.
I want the family to be once again a family.
Like her, which is the mother
of our daughter.
(mumbles) as it is
that she's with her and she's with her.
To tell you the truth, they're both
supposed to be together not apart.
As bad as it is that we apart.
- [Minuchin] I agree with you.
I agree with you.
I think that it's incorrect.
- See, with that it's just like this.
Because of what Jasmine has
and for the facilities
that Variety House has,
that's why she's there.
- [Minuchin] And it was necessary.
- And the way I feel, I feel like this.
Okay, they're not together, granted,
but she's with Chris, I trust Chris.
The things that I have been through
with foster mothers, with me being
an adopted child.
- [Minuchin] You have been adopted child?
- Yes.
And with that situation,
there's a part of me that's very skeptical
about them being there but as of them
being with her, she has my trust
and Jasmine's happy with Mary.
- [Minuchin] And that means you know
very well they're not with some other?
- Excuse me.
It's not saying that we would actually
say, okay they can live with them for good
because we didn't
create them for nothing.
- [Minuchin] I just want to say something
so that you will know from where I come?
- Oh good, (mumbles)
- John, John.
- [Minuchin] I want you to know
from where I come.
I come from a position in which
I am trying understand.
And I'm trying to see if we can make
some sense that this happened for.
And I'm not an authoritive.
I'm not judicial.
I'm not with Department of Welfare.
I'm with nobody.
I'm really, in some way, with the people
behind the one way mirror trying to see
can we think clearer?
That's all, so my point.
- Wait.
- No, no I am (mumbles) myself
because maybe my question sounded
like aggressive or controlling.
If it was, I apologize.
- See to me it's, I'm going to say
because it could have
been all ready addressed.
When it comes to my family,
I become very defensive.
I become defensive.
- [Minuchin] Of course, that's why
I'm explaining myself because
I realized that I'm shouting to you
without wanting to.
I didn't want to. It was a question.
It was a question because your family
is so fragmented and so to reunify
a family that has been now what?
Three or four months separate.
- No, we put my children with them
because see, when she was born,
when I was pregnant
and I was getting high.
Okay, so when she was born,
I went into the hospital,
when it was time for me to give birth
and I told them, I said, "I would like
"for her to be in foster care."
Because I knew what I was doing.
And for it not to effect her or for her
to be dragged down with me.
I made that decision.
That decision is eating me up.
I feel terrible because of that.
Because as a relationship and a bond
between a mother and a daughter,
me and her do not have.
Now me and Jasmine have a bond.
But see, I want to have
a bond with her too.
- [Minuchin] Now you just left a week ago.
- Wednesday it'll be a week.
- [Minuchin] What?
- Wednesday it will be a week.
- [Minuchin] And when you left,
did you know that she was--
- No I did not.
- Until I called because (mumbles)
where I was staying at,
that's supposed to be Abril's God Mother
and everything, don't give me that face.
I was staying there, I found out from them.
I was, wait a minute, let me see if it's true.
Because I even told her I want her
to continue to do what you got to do
to be with us again.
- [Minuchin] Can I ask you Marci
and if I am intrusive or if I am perverted
if you'll just tell me and I'll change okay?
So I want to ask you straight questions
and you tell me butt out, I butt out okay?
- Like now, I'm open to suggestions.
So, go ahead.
- [Minuchin] When you left,
you took that decision on your own.
It was a decision that
you would have disagreed?
- [Woman] I would have
probably encouraged her to stay.
- [Minuchin] You don't think that is--
- It wasn't the right moment.
- [Minuchin] That was the right moment.
But you thought that was
the right move?
Is that correct?
- Yes and your next question is why?
- [Minuchin] No, no, no, no.
You took that decision and you took
that decision on your own.
You didn't ask him, the children.
Did you talk to Martin about it?
- I seen Martin the day after I came home.
- [Minuchin] Huh?
- The day after I left.
- [Minuchin] You went and told him
that you did it.
And can you share with us your reasons?
- My reasons for leaving?
- [Minuchin] Yeah.
Maybe you are the wiser--
- He's an undercover right?
- [Minuchin] Maybe you are wiser
in this that you know about yourself
more than anybody else so.
- (mumbles)
(baby jabbers)
- Okay they said keep it simple
so I'll keep my answer simple.
I left because--
- [Minuchin] You can make it complicated.
- No, no, complicates, I have a habit
of taking people a long for
a very confusing ride. (laughs)
Kate has experienced one of my rides so.
I'm going to keep it simple.
I left because of everything
that what happened up there.
Part of me feels that because
if I had stayed in there,
I'd a learned that I could live without him.
That I could learn to just be my own person
and to take care of me but I'm not
one of my concerns.
My concerns is towards him
and towards my children and being there
it was head on dealing with me.
- [Minuchin] That's beautiful.
- And, you told me to finish,
let me finish.
- [Minuchin] I can say it's beautiful.
- (Woman] He's giving you a compliment.
- You know that's hard for me. - [Woman] I know it's hard.
- Thank you. Let's see.
Another thing for leaving is because
a lot of issues in my life.
I dealt with them that it happened, it happened.
And I was kind of not so much
dealing with it but excepting it.
And up there, it was opening up
a lot of things and a lot of pain
and a lot of anger.
And it came to a point that up there,
I couldn't see my father because
of the things that happened between
me and him and of the conversations
that we had.
So they said that I couldn't see him.
And through the things that have
happened between me and him,
sooner or later that would have
popped up too.
So I felt, not fully out of balance
without my father because I'm used to
my old man, him and my father in my life
and I lost one of my legs there.
And I'm not used to that.
- [Voiceover] Marci finds herself
and her connections with others
as difficult as those connections might be.
As a result, she experienced the drug
treatment program's individual focus
as foreign and toxic.
Her departure from the program
was an act of self affirmation.
- [Marci] Give mommy the ring. Thank you.
- Wilfredo, in just talking with Marci
but I really want to include you into it.
In my way of thinking,
to be part of a family is a very
important feeling to feel competent
and not to feel depressed
and not to need drugs.
- [Minuchin] I think that you say,
I think very strongly
that programs that take you away
from your family may not be as selfish
as other people think.
That's my opinion. It's a private opinion.
- Pardon me, I know how to (mumbles).
She thinks how she feels because
I've tooken care of her and partly I put it,
it's like taking care of him.
I have to deal with the moodiness.
- [Minuchin] You are a caretaker.
- Hmm?
- [Minuchin] You are a caretaker.
- They think they're my responsibility.
- [Minuchin] Yes, all three of them.
- Yeah.
- [Minuchin] You are a strong woman.
- I don't see strong, I just see (mumbles)
- [Minuchin] You are a strong woman.
- I just endure because
everyone's relationship is not something
that we sat fully and talk about.
It was a relationship we jumped into
and throughout this relationship
of four years, we got two children.
So it's not only me and him anymore, it's us.
So I have to take care and protect them.
- [Minuchin] And is it sometimes heavy?
- Hmm?
- Is it sometimes very heavy?
- Very hairy? Hectic?
- Heavy yeah heavy.
- See, that's we he mean by deep right?
- [Woman] Put a load on you.
- [Minuchin] This feeling that you
need to take care of all these people.
- No, because I've tooken care
of my four brothers, my father,
I've tooken care of them.
And just with them, this is just my family
I have to take care of now.
- You know something?
As I hear Marci, I hear a caretaker.
She's a caretaker.
She has been a caretaker all her life.
- You want some?
- [Minuchin] Say hello candid camera.
You can not unemployed a caretaker.
- You can not unemploy.
You can not have a caretaker
that doesn't have a job.
There's always somebody there
for them to take care of.
- And Marci is an unemployed caretaker.
- [Marcy] How am I
I an unemployed caretaker?
Oh because I don't have my kids
with me right now.
- [Minuchin] When a caretaker
is unemployed, it gets very depressed.
It gets a sense of worthlessness.
If she has decided that she can not
be in your place and don't do her job.
Her job is to take care.
You in your place, you said to her,
caretaker, take care of yourself--
- First.
And it came a point in which
she disagreed with you.
- [Marci] There came a point
and it was something that
I fully disagreed with.
It's okay for a person to feel
that they work to take care of,
that it's okay for them to take care
of themselves, that they got
that selflessness about them,
then that program is for them
but it's not for me because
I can not.
- I think like you.
- Why?
- I think like you. I think like you.
And I (mumbles) you.
- Not me because it was to the point
it's something that was drilling
into my head for me to put it to me.
I don't feel like it's for me right now.
- [Minuchin] (mumbles) now Marci.
How can you--
- Where are you going? Mamma.
- Excuse me, it ain't check out time yet.
- [Minuchin] The question is,
how can you make these things
that you want happen? Really happen.
How can you have a life in which
you can take care of them
and of yourself also because
when she's a caretaker,
she's also taking care of herself.
There is something about the job
of caretaking that is
And so this is important (mumbles)
should help her but sometimes
that becomes too heavy and then
she goes to drugs.
She want avoid that.
He wants avoid that.
How can you use the helpers now
and life becomes easier for you Martin.
It's also for you Mary and it's also for you.
How can these people (mumbles)
outside of an institution and drug free?
It starts with her wish but she needs help.
Is that what you want to work with her.
- Yeah.
- [Minuchin] You want to work because
she need connections.
If she doesn't fill the connections
with her children, if she doesn't have
the connection with her (mumbles),
then she is taking care of.
she will be the first
and she will go to drugs.
So you need to use the foster parents
to help her to have the sense
that she's having now.
That Jasmine and her are connected.
- Give me a kiss.
- [Minuchin] And Abril and her
begin to be connected,
they are not connected yet.
They are not connected yet.
You need to help that connection.
It may be too difficult for you, I don't know.
Because you are very connected with her.
I know that.
So would it be very difficult for you
to help Marci to connect
with her daughter?
- [Woman] Difficult?
- Yes. Yes.
Because you love her.
- Yeah but I understand that being
a foster mother.
I love her just like I do if she
were one of mine but still,
I'm not her real mother.
- [Minuchin] But it's very difficult?
- Yes it is.
Because I'll have a child leave me.
- [Minuchin] Yeah.
- Very hard.
- [Minuchin] Very, very hard.
I think I will stop because I don't
have anything more to say except
that I agree with you.
Oh, I agree with you.
- [Marci] About what?
- I agree with you about you need
to be connected.
And that this is essential in your life.
- It is.
Because certain times that I have
to talk to him or I even have time
to talk with him,
it felt like something was missing.
Being there and been outside,
there was no balance for me there.
- [Minuchin] Tell me something.
Where are you staying now?
- Me?
I'm going to go stay at a man's house.
- [Minuchin] And?
- A man's house.
- [Minuchin] What's that?
- That's the outpatient program.
We've talked about it.
It's like a program.
- And I'm going to go stay there.
- [Minuchin] And they give you shelter?
- They give me something but I have time
from let's see.
From a certain amount of time
in the morning to certain amount
of time in the night,
I have that time up until to take care
of my outside business which is my
outside businesses.
- [Minuchin] Maybe you are much smarter
then the rest of us.
- No, if that's the case this would
be my office. (laughs)
- [Minuchin] Maybe you're finding
a place you need.
Maybe she'll find now, a place that
is more appropriate for her--
- I agree.
- [Minuchin] Than your place.
- [Voiceover] An individual perspective
on how to help poor families leads
to the proliferation of helpers
and with alarming frequency
to the fragmentation of families.
A systemic perspective which recognizes
and values the connection
between people as a healing resource
provides an alternative that unfortunately,
remains largely unexplored.
(lively piano music)