K's Reviews > If You Love Me, Don't Love Me: Undoing Reciprocal Double Binds and Other Methods of Change in Couple and Family Therapy

If You Love Me, Don't Love Me by Mony Elkaim
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's review
Feb 25, 2010

it was ok
bookshelves: professionallit, readablenonfiction, lord-help-me-im-just-not-that-brigh

An Imagined Interview with Mony Elkaim, conducted by Khaya, a novice psychologist:

Khaya: Dr. Elkaim, before I discuss some of the criticisms I have of your book, I want to say that I really loved the first page.

Mony: Well, thank you, Khaya, for offering us a classic illustration of a double bind. I love your book, but I don’t love your book. This is exactly what I’m trying to discuss.

Khaya: Uh, aren’t you defining a double bind a bit broadly? I mean, why is it a double bind if I say that I liked some things and not others?

Mony: Hmm, it sounds to me like with that challenge, you are trying to maintain homeostasis in our relationship. I get it, I get it.

Khaya: Well, let’s get back to the first page then. There's a situation where a husband is bringing his wife flowers, and his wife's response is critical and rejecting: "Since when do you want to give me flowers? If you really cared, you'd have remembered that I like lilacs instead of grabbing a few roses at the first florist you saw..."

This interaction describes a dynamic I often see in couples, and I struggle with how to intervene. I was especially excited when I read your view on the next page that, while this dialogue suggests that the wife is the one with the problem, you plan to show us how the husband perpetuates this cycle as well.

Mony: Yes. This is an important issue for couples therapists.

Khaya: But then, after promising something so great, you don’t deliver! You describe double binds for a while, and then you go into this hugely long discussion of systems and equilibrium, and you don't get back to the topic until way later.

Mony: Well, I think those theoretical concepts are important as a basis for what I’m going to say.

Khaya: Termites? Hot plates? Retinal activity? How much detail do we need here? And then – and this is what really got on my nerves – you include these letters you exchanged with the father of a family after you saw them in therapy for a few sessions. The father’s first letter states that, as a devoutly religious Catholic, the father needs to know whether you, too, are Catholic in order to decide whether to continue in therapy with you. In your response – and this, I feel, is what gives therapists a bad name – you reframe the father’s request to know more about your beliefs as a desire to keep his son mentally ill so that things don’t have to change in the family!

Mony: Khaya, you are clearly a novice. Any seasoned family therapist would have viewed it the way I did.

Khaya: Well, I don’t think the family saw it the way you did. Not surprisingly, the father’s response begins by noting that you have not answered his question and asking you once more whether you believe in the Revelation. You, of course, come up with this elaborate reframe for the father's requesting this information and the function that this serves in the family. Instead of leading to an aha moment for the father, the correspondence eventually dead-ends as you continually refuse to give the father the information he's requesting. Supposedly the family gets better, but I'm not nearly as convinced as you are of the role of your highly creative reframes, which were ostensibly rejected outright by the father. Maybe they just got better on their own, or more likely, found a different therapist.

Moreover, Dr. Elkaim, as a religious person myself, I can understand another religious person’s preference for a religious therapist from his own belief system. It’s not something I would insist on personally, but I also wouldn’t necessarily assume that this preference is serving some convoluted resistance function.

Mony: Well, I think there’s a deeper meaning to everything in therapy.

Khaya: And I think that sometimes a cigar is just a cigar. But let’s move on. I didn’t get the whole dialogue with the family about water, fire, etc.

Mony: Well, here’s what I said in the book: “…as I was amplifying the singularity water, I set in motion a whole series of elements on the level of assemblages of singularities – the connection of the therapist and the family around a common culture, the relationship with the Bible…These elements can be seen as having a meaning and function in the context of our usual explanatory frameworks, but they can likewise be looked on as assemblages of singularities with a meaningful existence outside our normal way of understanding things. Thus the theme of water can be seen as a metaphor with a meaning, and at the same time it can have a life of its own.”

Khaya: Say what?

Mony: Well, I think that was pretty clear. If you have a problem, blame the translator. It certainly sounded good in French.

Khaya: How about this one (and I’m vastly condensing this): “Rule Number One: when you see a couple or a family, listen to what arises inside you, lend your ear to that. Rule Number Two: don’t use it as it is, because what you feel at that moment will very often lead you toward an even greater homeostasis of the therapeutic system…We can tell ourselves this: ‘What I am feeling is important…but I have to use it differently.’”

Aren’t you really just saying that we should use our countertransference, but at the same time not fall prey to it?

Mony: Didn’t you read the book? Later, on page 88, I explain that there is a lot more at work than transference and countertransference. The therapist’s supervisor’s issues, the clinic’s issues, everything! It’s all about the intersection of each individual’s construction of reality.

Khaya: NO! Not postmodernism!

Mony: Why not? C’est la mode, you know.

Khaya: Yeah, tell me about it. There’s so much reference in your book to individual constructions of reality that I have trouble figuring out where the actual therapy comes in.

Mony: But therapy is simply another construction, you know.

Khaya: (groans, rolls eyes) Geez. Maybe that explains why some of these family therapy sessions seem so weird, especially as explained by the therapists. Some of the wilder interventions you describe do seem to work well with your personality. But what I didn’t get from the book is how someone like me, who can’t see herself doing anything remotely like that, could be as effective. It was hard for me to extrapolate from your clinical examples into my own therapy practice.

Mony: Patience, patience. It will all come in time. Keep reading, keep practicing, keep growing, and you’ll find your way. I think you need to start by not taking things so literally. And stop being so damn linear! I'm sure I'm not the first person who's told you that.

Khaya: You know, Dr. Elkaim, my sense is that if I had had the opportunity to watch you in practice, I would have understood a lot of this much better. Somehow it was just too difficult to get it all from a book. I think this was one of those times where I just had to be there.

Mony: A book may in fact be an inherently limiting medium.

Khaya: Although I’ve read many other books on therapy which I found exceedingly helpful. So I’m not sure the problem is all me.

Mony: Hey – I got some fantastic reviews, accolades from greats like Paul Watzlawick no less.

Khaya: I know. I think this was just over my head. Maybe someday I’ll get there…
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Comments (showing 1-8 of 8) (8 new)

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message 1: by rivka (new)

Khaya: Say what?

Mony: Well, I think that was pretty clear. If you have a problem, blame the translator. It certainly sounded good in French.


message 2: by K (new) - rated it 2 stars

K Thanks, Rivka! If I brought a smile to your face, then it was all worth it. :D

message 3: by rivka (new)

rivka I loved the whole review! :D Not a book I would ever have read, but nonetheless.

message 4: by K (new) - rated it 2 stars

K Well, the most flattering feedback I can get on a review is when someone reads through the whole long thing even though they have no interest in the book! Thanks for brightening my evening as I try to deal with my messy kitchen.

message 5: by rivka (new)

rivka I'm glad. :)

(You can come fix my kitchen when you're done with yours, if you like. ;) )

message 6: by Rebecca (new)

Rebecca Now that's an original way to write a review, though personally I would have burnt the book to ashes after he keeps refusing to answer the father's question.

message 7: by K (new) - rated it 2 stars

K Rivka, I will never be done with my kitchen! (But thanks for the offer...)

Rebecca, thanks. Alas, burning it wasn't an option -- it's a library book.

message 8: by rivka (new)

rivka Khaya wrote: "Rivka, I will never be done with my kitchen!"

I know the feeling!

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