H. Peter Laqueur - - An Appreciation
By Donald A. Bloch, MD
H. Peter Laqueur, MD, June 29, 1909 to March 15, 1979, the Father of Multiple Family Therapy.
Peter Laqueur enhanced all contexts; it was always good to see him. He could be counted on -- to have an interesting point of view, and independent position, a softening effect, to do his share and more. His presence was distinctive; the adjectives that come to mind are competent, rumpled, hesitant, European -- the last because of his accent and manner, which retained, after many years, the quality of different intellectuality characteristics of so many of his fellows who were uprooted by World War II.
There is a story about him I have told at least a hundred times and hope to tell a hundred more. It concerns his definition of a family therapist. As background, one should know that as a young man Peter was a Dutch agent during the German invasion of the Lowlands and continued his espionage activities for a time after the occupation and later on in south America, where there were important Nazi commercial and military activities. Tense and dangerous work indeed. The Laqueur definition of a family therapist ((by one who knew): a double agent trapped behind enemy lines.
Laqueur's contribution to family therapy was original and important. In 1951, while he was working at Creedmoor State Hospital, he observed, "Patients became upset when I talked about them to their families during Sunday visiting hours. Shortly afterwards, families became angry about their patients' upstanding and unexpected self-reliant behavior after the doctor (HPL) held group meetings with these patients. Therefore, it was a logical and very rewarding experience when I met, for the next nine years, every Sunday during visiting hours with the patients and their relatives." "logical," yes, but the logic in those years seemed to have escaped most of us. "rewarding," indeed, but the gratification is not necessarily strong enough to induce many of us to give up every Sunday.
Multiple family therapy began thus. It is important to note that this was at all times, then and later, a sophisticated enterprise. Laqueur had not merely stumbled into a format; he thought about it long and hard and to good effect. As a theoretician, he operated under the banner of general systems theory, not always the easiest point of view to explain to others. He was a sensitive and gifted and dedicated clinician, and an imaginative and resourceful teacher.
The following quotes are taken from some notes of mine. He is responding to a question about the phases of multiple family therapy:
In the first phase individuals are only vaguely aware of the fact that their own behavior may have invited response patterns that caused them to become fearful, disgusted, rejected and emotionally abandoned. In the group members come to see each other as suffering or joyful human beings, rather than as walking, but rather cruel, information centers. To some degree there is a kind of magical relief due to unreal expectations. But there is also a chance to observe other suffering (and improving) families at first hand.
The second phase (resistance to treatment) occurs when a creeping understanding appears on the horizon, that change of attitude and behavior is required not only in those who misunderstand and reject, but also in the individual himself who (for 1001 good reasons) behaves in such a way that misunderstanding and rejection come about. Depending upon the severity of interactional disturbance patterns e duration in previous life over which they developed, the second or resistance phase may take anywhere from one to 24 months (with an average required period from 12 to 14 months) before change in the emotional response patterns, based on something more than willingness to give lip service to therapeutic suggestions, can be obtained.
When all concerned with previous negative behavior have thus gained more courage (and have become willing to be less "innocent" and "good", while making the other person look like a "villain"), then slowly Phase 2 can slide into Phase 3, where people begin to teach others by model and analogy. The need for constant defense and sabotage of the therapeutic process subsides. Learning by analogy, by modeling and indirect interpretation occur.
Finally, I would like to comment on Peter as a teacher. He had a profound sense about life that can only be called deeply systemic and contextual. This, of course, was what attracted him to general systems theory. Thus, he would teach multiple family therapy by having several students participate as observers, or video camera operators (his devotion to and innovative use of video are legendary), or as assistants. They would both in and out, part of the system being treated and yet context for it as well, a vantage point of exceptional educational value.
In more recent years, in his effort to spread the word beyond the confines of his own shop, he undertook the heroic task of constituting workshop groups into simulated multiple family therapy groups and of actually carrying this process on over several days. I used the word "heroic" advisedly, since these simulations often had a painful and dramatic verisimilitude, creating crises that could not be abandoned, but had to be responsibly worked through. We can count on the fat that Peter did what was needed.
It is not surprising to know that Peter worked as part of a dyadic team; the other half was his wife, Victoria, who was fully and deeply a partner in this lifetime of productive work. It is fitting that we honor and are grateful to both of them.
A one-hour lecture lie this must remain somewhat on the surface a subject that involves 26 years of experience with about 1500 families in New York and about 250 families in Vermont, and with some 200 students and co-workers who have learned and observed this treatment approach and subsequently used it.
We believe we have an approach that can help many families to do better, and our goals are as follows:
Results of MFT:
1) Less frequent and less prolonged hospitalizations, or need for attendance in clinics and doctor's offices.
2) Greater mutual understanding, less tune-out and communication gap between family members and between generations; less despair and hopelessness.
3) Finding resolutions for pathological symbioses and control tower situations (control by dominant or depressive behavior).
4) More efficient use of therapeutic manpower.
5) Increasing preventive potential for major new crises.
Benefits of MFT:
For the patient (subsystem) -- immediate relief.
For the family (system) -- reaching higher functioning and mutual perceptivity through therapy and education.
For society (suprasystem) -- Improved social function; restoration to productivity; efficiency and effectiveness of mental health delivery.
Wolberg, L. R., Aronson, M. L. Group and Family Therapy 1980. New York: Brunner/Mazel, 1980. p.p. 6 and 7, and p.p. 15-23.