IC04 Workshop 09 - Mission Impossible - Cloe Madanes

Description:

Cloe Madanes will present new conceptual models for understanding the most difficult problems presented to therapy and step-by-step procedures for resolving them. The workshop will include the presentation of videotapes of real therapy sessions with individuals, couples and families. There will be opportunity for discussion.

Educational Objectives:

1. To describe one new conceptual model for understanding the most difficult therapy problems.
2. Given a problem, describe the step-by-step procedures necessary for resolving it.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Strategies for Working with Difficult Cases

• Cloe Madanes starts by tailoring content to audience experience.

• Introduces “Take Three Issues” strategy to help parents focus on key child behaviors.

• Child keeps a diary of parental mistakes to hold parents accountable.

• Describes “Stalinist parents” who overwhelm therapy with too many complaints.

Divorce and Its Impact on Children

• Highlights how children often act out, hoping to reunite separated parents.

• Recommends bringing parents together to explain that their relationship is over and the child is not responsible.

• Helps free children from the illusion of control over parental relationships.

Adolescents and Family Dynamics

• Teens want to feel competent—helping their parents is one outlet.

• Describes case where a child inappropriately hospitalized for tantrums benefited from maternal connection.

• Warns that some adolescents may manipulate by claiming to want nothing.

• Encourages parents to show appreciation and create things for teens to look forward to.

Gifts and Motivation

• Explains how gifts can create long-term expectations.

• Cautions against using gifts as punishment, which can reinforce power through detachment.

• Parents should acknowledge children for who they are, not just behaviors.

Preventing Suicide in Adolescents

• Suggests giving youth something to look forward to (future-oriented goals).

• Describes supervising two suicidal teens given creative opportunities in music and drama.

• Simple, hopeful interventions can yield big results.

Using Extended Family in Therapy

• Involving extended family brings resources, perspectives, and support.

• Recounts using teachers, police officers, and clergy in helping families.

Marital Violence and Family Involvement

• Makes violence public in family therapy and involves older relatives.

• Emphasizes consequences of violence and rejecting provocation as an excuse.

• In severe cases, recommends temporary separation and extended family protection.

Separation and Protective Steps

• References Milton Erickson’s method: separate violent couples and house victims safely.

• Abusive partners need support to prevent suicide; extended family can help.

• Therapist must sometimes commit intensive time to prevent harm.

Case Example: Young Woman’s Abuse

• Woman minimized abuse; therapist involved her family to uncover truth.

• Young man initially resisted apology, later gave one in French during family session.

• Men in the family shared stories of managing anger; gradual reintegration followed.

Reintegration and Reparations

• Gradual reentry: visits to see baby, acts of reparation (e.g., buying gifts).

• A protector (like a brother) ensures the victim’s safety.

• Transition into regular therapy once crisis is managed.

Sexual Issues in Therapy

• Addressed through metaphor or books (e.g., Kaplan’s New Sex Therapy).

• Reframing infidelity and encouraging conversation around difficult topics.

Cultural and Legal Considerations

• Must appeal to family values in resistant cultural contexts.

• If needed, involve authorities (police, lawyers) to ensure safety.

• Acknowledge that anger may be part of the problem dynamic.

Extreme Cases and Legal Action

• In Argentina, a man signed a confession (with ID number) to prevent future violence.

• Empathy and a structured approach led to behavior change.

• Man did not reoffend after confession.

Intergenerational Violence and Abuse

• Therapist should disrupt cycles by involving family and authorities.

• Sexual abuse cases require police and full system intervention.

• Family therapy, legal accountability, and outside support must work in tandem.

Therapist’s Role and Responsibility

• Therapist must take active responsibility—can’t remain passive in abuse cases.

• Must balance therapy with legal and protective measures.

• Believe in change and stand by victims, even when it's hard.