>> Salvador Minuchin and his associates made organization, power and function in the family a central focus for both assessment and intervention. In this model much of the language that has defined family systems therapy was initially developed and used. In this model we are introduced to the concepts of hierarchy, macro systems and subsystems, boundaries, disengagement and enmeshment as well as the therapeutic processes of joining and accommodating, structural mapping, unbalancing, enactments and setting boundaries. Structural family therapists, perhaps more than most models, focused on working with the poor and disenfranchised. Their work with different cultures reflected an awareness of cultural diversity present in the actual lives of Minuchin and some of his closest colleagues. The work of Harry Aponte is especially representative in this model's dedication to a multi-cultural perspective. This video is based on an early therapy session conducted by Salvador Minuchin. The presenting problem is slightly different, and of course the people involved are different, but both this session and the original addressed issues related to an eating disorder in a large enmeshed family headed by a mother who had to be involved in every aspect of her children's lives. This video focuses on boundary setting in therapy, using both verbal and physical interventions to establish and maintain an appropriate subsystem boundary in the family. >> Well, even though I haven't met all of you before, there's a few things that I know ahead of time, and I just want to make sure that I have them correct. So I think, Jeanie, you were the one who called in initially, and you have, I guess, four children, all of whom were adapted. >> Yes. >> And I guess you were referred here because one of the children have been diagnosed with bulimia? >> Yes, it was because of something we saw in Megan's room, and we have, as you said, we have four children. We have Aaron and Emily and Megan and John. >> Okay. So what would you like me to know about what's going on in your family with this? >> Well, basically we're relatively, I think, a happy family. We get along pretty well, and we try to make the home life very happy for the children because we feel like they were a blessing for us, you know, but we were concerned about Megan. She gets up and leaves real quick. But the biggest problem is when we found her in her closet, and it seems like it wasn't the first time, and there was -- we're just kind of concerned about the way that she's been acting. >> Just kind of concerned? >> No, we're really concerned about it. >> Okay, >> Very concerned. >> And who's we? >> Well, I think her father and I are very concerned about it. >> Are you concerned about it too, Ed? >> Yeah. Yeah, I am. I think so. >> You think so? >> Remember, we were talking about it. >> Yeah. >> And different things that we've been -- >> Yeah, I think Jeanie's closer to the situation. >> Well, it's just because I probably check on them. I check on them to make sure everything's going all right and that they're happy and things are, you know, going even and they're getting a long. Because there are different personalities. They're basically very good children. >> Yeah. So I'd like to at least meet the other kids. Who's the oldest of the four of you? >> I am. >> Emily. >> Okay so, Emily, what's your perspective on all of this? >> I think Megan has a problem, and I think that she needs help, but that it's something that maybe we all -- >> Remember, you came and told me you were worried about some things that you were seeing? >> Let's just see if Megan -- I'm sorry, not Megan, but Emily can tell me what's going on. >> Well, I think it's something that we all need to kind of pull together and help her with. Because I think that it's not just her but something that we can all pull together with because we are a family. >> Okay. So all of you, from your perspective, there really is a problem, and you would like to see everybody kind of help out with it? >> Yeah. >> Okay; and, Aaron, how about you? >> I'm concerned for Meagan, but I can see why she might have a problem. I think this family is kind of crazy sometimes. >> Well, you've never said anything about it until now. >> Well, you haven't really given us a chance. You've done all the problem solving before and never really asked for our input. >> We just wanted to make it a little easier because we've lived a longer time than you have and used to different things happening, and wanted to make it go right for you. >> Ed, I'm interested in knowing, is mom the person in this family who is mostly in charge of everything? >> I think so. >> We do talk about things. >> Well, she, you know, takes care of the house, makes sure everything is in order, you know. >> Yeah. >> I think so. >> She seems to be able to have an idea about anything someone is saying. Is that true with you too, that she can kind of direct what you're thinking and saying? >> I think Jeanie's a really -- she has a feel for what's going on, I think, in the family. >> But I don't put things in your mouth. I don't tell you the things to think. >> No. >> I don't think so. >> I wouldn't say that either, you know. >> Okay, so what do you think? Let's just hear from you and what you think. >> Well, I think that Jeanie's pretty much -- she knows what's going on in the family and she -- You know, when the children were adopted, she kind of was very, very, caught up especially, during the younger years, in helping them to develop, and I wasn't really there as much. So I think she has more insight. >> Do you know what's going on right now? >> Well, Jeanie brought up to me the fact that she was really concerned about Megan and this issue called bulimia. I checked it on the Internet, and it seems like it could be a real problem. >> You found out, and I didn't find out about that. >> Well -- >> That it was called bulimia. >> Yeah, I'm not sure of all the things that happened, but I think, in talking too with the other children, we all thought this is something that should be dealt with. >> Yes. >> So what's your ideas about how you might deal with this? >> I don't really know. That's kind of why we're here, and Jeanie suggested, you know, calling and getting us all together. >> Well -- >> I thought that was a good idea. >> Well, I just wanted us to be a happy family and a good family together, and this is unusual, and they don't talk about -- I just noticed that they were close, John and Megan are pretty close, and I thought maybe they could help, and they would notice more, but -- I try to be there when they need me and try to anticipate problems or, you know, just make sure that everything's going all right, they're happy and they, you know, get what they need. 7 We try to be a loving family. We love them very much. >> Right. I hear that. I'm wondering, you said earlier that they don't talk very much about any of it. >> No, they've gotten very, I don't want to say secretive, but just very quiet at times, and when they're quiet I worry that something's wrong and that maybe I need to find out what's going on. So I try to see what's going on in their life. You know, if they're seeing different people, if there's a problem there. If it's school, college or, you know, just their friends. >> Right. >> Or, you know, just something we're not doing. We want everything to be perfect for them. >> Yeah. Well, maybe one of the reasons that they don't talk so much is that it's hard to get a word in edgewise. >> Well, I didn't realize I was talking that much. I guess I'm so used to doing it and making sure, that it's part of taking care of them. >> Yeah. So who of the kids would you most like to hear from? >> Well, I'd like to know what's bothering Megan. >> You know, it seems at the moment that Megan is having -- to be able to do something like this to herself is worrying us, worrying me greatly. So I'd really like to know what's wrong with Megan. I thought maybe John could be a little -- he's closer to Megan in age and they're -- >> Why do you just ask Megan what is going on with her? >> Well, I've tried, but she always just says there's nothing, that everything's fine. You know, everything's fine, mother. Everything's fine. So I keep trying to find out more things about her. I talked to Aaron and Emily and John, and they all just seem that she's fine. >> Except that Aaron was saying earlier that he actually thought he understood what was going on with Meagan. >> Well, he hasn't really said anything to me about it. >> Okay. >> Has he said anything to you about it? >> [Inaudible]. >> We've always tried to be really free, you know, that they could come and talk to us. We've always brought them into our lives. Every time something's going on, we make sure they're a part of it. We don't want to leave them out. We don't leave them out of our lives. >> So maybe what would be really good is for the two of you to be able to hear what your children are thinking, including Megan. Would that be true? >> It would be nice. >> Yeah, I think so too. Now, one of the things that we could do is we could just ask the kids to talk together. >> That would be nice to hear. >> Okay. Do you think you would be able to just listen without actually interrupting them? >> Well, I didn't think I was doing that, but I'll sure try if that's what you think I'm doing. >> Okay. >> I just was concerned about what was going on. >> I understand your concern. I'd just like to be able to hear what they have to say. Would that be of interest to you? >> Yes, it would. >> Okay. So maybe we could simply work this out by having the two of you switch places with your two oldest kids, and we'll let the four kids talk with each other. So, Aaron and Emily, thanks for switching places with your mom and dad. Aaron, you were saying earlier that you thought you had some idea about what was going on. I don't know a lot about bulimia. My experience with it tells me that sometimes when people are engaging in that kind of behavior, they are feeling both a little anxious and also a little angry. I don't know if that fits with what the four of you are knowing about it, but what I'd really like to do is have just the four of you have a chance to talk. So, Emily, Aaron, John, Megan, why don't you just talk this over, and let's see what you come up with with it. >> Well, I hope that Megan can benefit from today. But, like I said before, I can see why she may be having a problem, because we have a private investigator for a mom, essentially. It feels like, you know, she goes over everything with a fine tooth comb, has to know about everything, and it sucks. I get sick of it too, and I bet the rest of us have. >> I just get sick of all the questions. When mom wants to know something, she doesn't go to the person that it's about, she goes to the rest of us and asks, and that can get really tiring after a while and really frustrating. >> Yeah. Remember, she used to bribe us with quarters? >> I want to know what's going on with Megan. Like what she has to say about what's going on. >> I don't know. I just -- I just feel like I can't ever just say what I want to say. It's never the right thing, and mom just never accepts anything that I say for just what it is. She always digs. >> Megan, you're always so quiet. >> No, wait. She's doing okay. >> Well, what is the point in talking when you always interrupt -- >> Just stay talking with your brothers and sisters. Tell them what's on your mind. >> I don't know what's on my mind. I just know that -- it's just really hard to talk in this family, and I don't think that anybody really cares how I feel. They just want me to be fixed because it's embarrassing to them. >> We all care about how you feel. We all care a lot. >> I don't think we'd be here if we weren't worried about what was going on. >> I think you're worried, but I think that you all are just worried about other people knowing or the fact that I'm an embarrassment to you all. Everything's my fault. You've all just been talking about me like I'm not even here the whole time we've been here. >> What do you want us to do? >> I don't know, treat me like I'm a person instead of like this thing that you keep talking about.