A clinical vignette
The clinical vignette I am presenting shows the presence of the transmission process of a dysfunctional relational pattern across three generations, demonstrating that the compulsion to the repetition can, in particular cases, spread over the following generations. It is about the event of a pregnancy out of a stable relationship and of the psychological obligation to keep secret the child’s origin, event that it was repeated in three following generations.s.
The clinical hypothesis I worked about is the presence of a not-to be told trauma at the beginning of the family repetition mechanism.
A young lady, which we can call Meg, asks for a psychotherapist because her younger child, four years old, at the maternal school draws his family as composed by himself, his older brother, ten years old, his mother and two fathers. The school educators call his mother, who is frightened and asks for an help.
During the first interview with both the parents, emerges that it is true that two fathers exist, because their family is a reconstituted family.
Meg, when she was nineteen years old, had her first son, Alex, by a young boy, who, after her pregnancy, abandoned her without acknowledging their child.
Two years later, Meg meets her present husband, who after their marriage, adopted his wife’s son.
After four years of marriage, a child of the new couple was born, but husband and wife agree to not disclose Alex’s different origin to their children. However, as we can see, the presence of two fathers circulates in some mysterious way.
Meg’s husband explicitly declares he is not available to reflect about the complexity of family situation – in his opinion very simple and even completely resolved – and he says he will not participate to any following interview.
Than the therapist proposes the mother to continue the work alone to try to comprehend better what is happening in their family and, in particular, why she was so frightened by her younger child’s drawing. During the individual interviews her enormous sense of guilt emerge towards her first son.
Her sense of guilt increased along the years, because seeing the greater resources and opportunities present for her second child makes her feel a terrible sorrow, and she doesn’t set her mind at rest because of her youth mistake. Her sense of guilt and her sorrow make it impossible for her to think to eventually tell her children what really happened in the past.
During her psychotherapy, Meg begins to tell about her only sister, Rose, who continued to give hospitality to her after her pregnancy and after her first baby’s birth, until Meg’s marriage.
So the therapist hears a very particular family situation, why, when Meg was about eighteen years old and her sister Rose about thirty, in few months both their father (before) and mother (after) died.
Her sister Rose, married at the age of eighteen and with a daughter eleven years old, gives her hospitality and Meg lives with her sister, her brother in law and her nephew.
Meg, telling about her parents’ death, expresses the lot of pain and confusion she felt, also because, few days after their mother’s death, her sister Rose reveals her that the dead father was only Meg’s father, not also hers own.
The news shocks Meg, but the concrete problems are so pressing that the two sisters had no time to talk together, to wonder about their family story and to help each other.
A year later, Meg becomes pregnant and Alex will born.
At the moment, Meg appears not conscious to have repeated her mother’s (Ann) story.
When the therapist asks Meg to tell better about her mother Ann’s story, she tells she would invite her sister Rose to the interviews, to talk with her about all the story, at the end!
Rose agrees with her sister, and a family phase of psychotherapy begins.
Rose assumes immediately her role of the older sister, who guides Meg, knows a lot of things more than her and, moreover, overcame the sorrows of the past, among which her divorce from her husband.
Rose tells that in the fifties, in a little village in the country of Veneto, to have a child without being married was a terrible shame for her mother and the whole family, so her mother and the child (herself, Rose) remained closed at home until her mother met a man that fell in love with Ann and married her, taking with him also Rose, already eleven years old. Meg asks her sister if it was difficult for her to live with a man that was not her father, but Rose doesn’t want to tell about her experience and replies she is available to tell about the pure events. There is something that cannot go out, like Ann e Rose closed at home in the fifties.
Then the therapist proposes the two sisters to draw their Genogram (Watchel, E., F., 1982), following the hypothesis that the use of a graphic- projective instrument, apparently less direct, may open a breach in the defences constructed by the two sisters along the years and makes it possible the access to a metavision of the family history.
Meg seems to appreciate the proposal, while Rose tells she only helps her sister, because she doesn’t like “children things”, like the drawings. At the end Rose will sign only herself, her ex-husband and her daughter, now twenty one years old and, at the end, she will sign their only aunt, perhaps a figure more far from her internal conflict.
Is Meg who draws family structure, asking her sister for an help, when she doesn’t remember names or dates.
It is during the slow construction of their Genogram and the laborious use of the symbols suggested by the therapist that Meg has a sudden insight and exclaims: “but in our family it happens always the same events!” and Rose whispers: “it seems a curse to me!”
The psychotherapist finds so a space to introduce a thinking about the fact that is not a destiny or a guilt, but perhaps a pain, which no one could talk about along the years, looked for a way to be expressed more and more along the time. So the following generations remained blocked in a certain sense into the area of the primary trauma, that is repeated it, trying to become conscious about it.
Then Meg plucks up her courage and tells her sister: “then also the abortion of your daughter is the same repetition”
Also Rose’s child, Mary, in fact, became pregnant in a precarious relationship, ended at the moment of her pregnancy, and the family dysfunctional pattern did not repeated only because she aborted. According to the family rule, this abortion is kept secret, besides outsiders, also to Rose’s ex- husband.
While Meg is looking for the way to represent this last event, Rose suddenly begins crying, wondering if this litany of painful events at the end may stop.
For the first time she lets herself talk with Meg about humiliations lived when she was a child “ I had to go to school!” and she adds that it was impossible for her to tell her mother about it, moreover after her marriage with Meg’s father. “Now a new life begins for you all” tells her grandmother when the new family moves to another village, a hundred kilometres far from their house. So Rose could not express her trouble because of leaving her grandparents house, until this moment her loved home, neither her difficult in accepting a new father. Moreover, she never could tell someone about it, because all the story had to be kept secret, not only to the outsiders, but to Meg too.
Meg tells Rose she was very angry when, at their parents’ death, Rose told her the true, leaving her alone with the added pain to have been betrayed by her father, her mother and her sister. But Meg also recognizes that Rose helped her so much, doing all she could.
Rose replied that, after their parents’ death, she for the first time felt free to reveal Meg the truth, in the hope to share the past with her sister, but Meg’s reaction made her understand?? It would be impossible for them to support each other, also because Meg was more lucky than her, because her sister was grown up with both her parents!
“I lived the same story of our mother. I don’t feel so lucky, also because my children are living my own history, because they are kept out of a secret that concern them! Perhaps I am tired to lie! ”
Rose takes leave of the therapist, telling she told about herself more she had ever hoped. But she wants to leave the decision to reveal the truth to Meg’s children to her sister and to Meg’s husband and tells she doesn’t want to be involved about this.
It is possible that Rose doesn’t want to live again the same emotions and feelings lived talking with Meg, but this one can be sure that Rose will welcome her nephews as always she did, in particular Alex, very closed to her, because he lived with her the first two years of his life.
A new phase of individual therapy begins, during which Meg reflects about her first pregnancy. She arrives to understand that, before her pregnancy, the relationship with her partner was very bad, she often wondered if it would have been better to leave him and she clearly had thought that he did not absolutely wanted a baby, and in case of a pregnancy, he would have gone away… nevertheless, she did all she could to become pregnant, as if she had an unconscious need to repeat her mother story, just known.
The second theme explored is her decision of marrying, dictated more by her need of repairing her difficult situation (as a mother alone, without a house and a partner) than by a real choice.
After some months of therapy, Meg asks the therapist to come with her husband, because of her decision to tell the true to their children, also because Alex tells his brother “I was adopted, because there are not photographs with me when I was very young and Daddy”. In Meg’s opinion, it is impossible to be passive in this situation.
But her husband is absolutely unavailable to reveal the real story to their children and tells Meg she is completely mad to risk to danger the equilibrium of their family. So another problem opens and the therapist tries to support Meg to involve her husband in finding an acceptable modality to talk together to their children.
One day, Meg tells the therapist she talked with Alex during last weekend and the child, with Meg’s great surprise, was not so shocked. “I understood because of the photographs that Daddy there was not, when I was very young.”
Crying, Meg says she could tell Alex how much she wanted him, how much she loved him and that she looked for a partner to give him a father, so that he could grow up like all other children.
Alex asks his mother to not tell anything to his younger brother, but Meg now is not available to live in a area full of secrets. After few days, also the youngest child is told about it.
Meg’s husband, after having refused to tell their children the truth together with his wife, is very angry with her and threatens the divorce. At the end he accepts to come to some couple interviews, only to repeat that Meg has serious psychological problem and that his family had advised him that it would have been better to not marry her.
It seems to the therapist that this marriage, born in a rigid complementary relationship (with the husband in a up position, powerful and generous; and the wife in a down position, guilty and needy), cannot support the evident Meg’s individuation process and a different reading of the whole history.
Meg’s husband decides to divorce and the couple is sent to a mediation service.
Even if in a very difficult situation, Meg seems to have acquired the capacity to do self- governing choices and to cope openly with the problems, refusing the old modalities of concealement.
Theoretical considerations
This complex situation reminds the concept of the intergenerational transmission of “non transformable objects” (Kaes, R., 1993). These objects (in this case a dysfunctional pattern that repeats through the generations a scenario in which always fathers go away and always women remain alone and, for this reason itself, become too much powerful) seem to have had a “non – inscription” (Winnicott, d., w., 1974), that is to have constituted a share of life not lived and therefore to be lived again and again, because the following generations cannot “think” what was lived from the beginning without being thought.
This is a case of trans-subjective transmission, that is of something that could not be transmitted at the symbolic level of thinking and word (Kaes, R., 1993) or, in Cigoli (Cigoli, V., 2005) words, a case in which it is impossible the passage of the trust and hope after a mistake lived as unpardonable trough the generations.
Further, the repetition of a secret is involved in this situation. We know (Imber- Black, E., 1993) that in the families there are positive secrets, that contribute to a functional distinction both between the individuals and the generations. But in this case, the secret seems to be a pathological one, because it is aimed to exclude a child from a knowledge of importance to him. The exclusion provokes difficulties in the family relationships, because it separates the siblings and bonds the dyad mother – first child in a very dysfunctional way: in the first generation “against” the second child; in the third generation “against” the divorced father, excluded from the pregnancy of his child, and from the following abortion. In the second generation the secret that excludes both the children seems to have also a different hidden aim: keeping the power imbalance between husband and wife. In this case, the husband opposed the revelation of the secret with all his strengths, until choosing the divorce.
Methodological considerations
From a methodological point of view, it’s very interesting to underline that a “mobile setting” promoted the individuation process of Meg, helping her to separate the different problematic questions that at the beginning formed a unique and indissoluble crux.
It was possible for her to work for only an interview with her husband (couple setting), understanding that it was impossible for him to follow her along the path of better understanding what had happened in the past.
After a period of individual work (individual setting), just Meg asked the therapist her sister’s help for outlining their family history. The therapist accepted, realizing that the problem was to offer a new setting in which it can be easier for her at the same time speaking openly about an old secret and putting a new basis for a closer and freer relationship between her and her sister (intragenerational sisters’ couple setting).
During the sisters’ couple interviews, they could, also through the support of a graphic-projective instrument, the Genogram, to talk openly about what had happened along the generations, helping each other to arrive to the crucial questions in a really dual-built drawing and speech. This setting at the end lets Meg’s sister to express her very old pain, which had been remained buried for a very long time and let Meg to realize the existent ties among the different events and generations.
A new phase of individual setting lets Meg to decide what she wants to do with the secret about her first son origin, while with her husband (couple setting) is focused the impossibility to change the initial hidden couple pact, which provided the generous intervention of her husband to support his unlucky/ imprudent wife.
The breaking of this pact lead the couple to a mediation service for preparing their divorce.
A final individual setting will help Meg to cope with the first phases after divorce.
We can say that a “variable geometry setting” (Drigo, L., Monari, C., Taccani, S., 2005) can promote the individuation process of family members, calling to work step by step the individuals that are involved ina specific relational bond, helping the family members to resolve the problems within a adequate tie setting.
Further, is important to underline that the secret disclosure is not a part of the therapy initial aim, because the disclosure is not therapeutic in itself (Imber- Black, E., 1993), but it became a patient’s need at a certain point of her work. Then the therapist tries to support her in looking for a tolerable way (first of all for herself), to disclose her old secret and in coping with the consequences of the secret disclosure (the opposition of her husband until his choice of divorce).
Finally, it is useful underline the possibility of using some non-verbal instrument, as a graphic-projective one, during the therapeutic work at the moments of impasse, with the aim of getting over “old” defences built along the years. This type of instruments may facilitate the emerging of preconscious elements, that would have requested more time to emerge at a only verbal level. Nevertheless, the choice of using these instruments depends on both the characteristics of the single clinical situation and the individual style of the psychotherapist, as the “right” recipe for all the situations and all the families does’nt exist.
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REFERENCES
Cigoli V., (2005) Di generazione in generazione. Trasmettere, tramandare, trasferire, in Nicolò A.M., Trapanese G. Quale psicoanalisi per la famiglia? Franco Angeli, Milano, 217-245.
Drigo M. L., Monari C., Taccani S., (2005), Coppie, famiglie e segreti transgenerazionali, A.M. Nicolò, G. Trapanese Quale psicoanalisi per la famiglia? Franco Angeli, Milano, 246-252.
Imber-Black E. (1993) Secrets in Families and Family Therapy, Norton, New York.
Kaës R., Faimberg H., Enriquez M., Baranes J.-J. (1993) Transmission de la vie psychique entre générations, Dunod, Paris.
Wachtel E. F. (1982) The Family Psyche Over Three Generation. The Genogram Revisited in Journal of Marital and Family Therapy , 8, 335-343.
Winnicott D.W. (1974), Fear of breakdown in International Review of Psychoanalysis, 1:103-107, trad. fr. La crainte de l’effondrement inNouvelle revue de psychanalyse 11, 1977, 35-44
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Summary
This vignette shows the compulsion to the repetition of a dysfunctional relational pattern across three generations: a pregnancy out of a marital relationship and keeping it secret.
The repetition of the same dysfunctional pattern through three generations emerges openly through the Genogram built during a step of the family psychotherapy.
From a theoretical point of view, this case shows the great automatic influence of the history of the past generations on the new one, when it was not possible to elaborate and to express openly the sorrow about what had happened.
Key words
Repetition- dysfunctional pattern- transgenerational transmission
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Resúmen
El caso clínico aquí presentado muestra la coacción a repetir de un esquema relacional disfuncional durante tres generaciones: un embarazo fuera de una relación estable y el mantenimiento del secreto respecto a los orígenes del hijo.
La repetición del mismo esquema disfuncional durante tres generaciones emerge abiertamente a través del Genograma construido durante una fase de la terapia familiar. Desde un punto di vista teòrico, este caso muestra la gran influencia automàtica de la historia de las generaciones pasadas sobre las sucesivas, cuando no es posible expresar abiertamente el dolor que provoca cuanto ha sucedido en el pasado.
Palabras clave
Repeticiòn- esquema disfuncional- transmisiòn transgeneracional
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Résumé
Le cas clinique ici présenté montre la coaction à répéter d’un pattern relationnel dysfonctionnel le long de trois générations: une grossesse au dehors d’une rélation stable et le maintien du secret regard à l’origine de l’enfant.
La répétition du meme pattern dysfonctionnel le long de trois générations, ressort clairement à travers le Génogramme construit pendant une phase de la thérapie familiale. Au point de vue théorique, ce cas montre la grande influence « automatique» de l’histoire des générations passées sur les suivantes, lorsqu’il n’est pas possible de mettre à thème et manifester ouvertément le chagrin rélatif à ce qui est arrivé dans le passé.
Mots clé
Répétition- pattern dysfonctionnel- transmission transgénérationelle
Los elementos parciales del genograma de Meg y Rosa
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El genograma de Meg y Rosa
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Ondina Greco
Couple and Family Psychotherapist, Clinical Service for The Couple and the Family, Catholic University, Milano, Italia