February 21, 2016

10:12 a.m.

Reflection on a family meeting

I didn’t really know what to expect going in to the family session. As the parents walked in with a handful of the son’s unpaid legal bills, I could feel the tension, the pain, and the love. Parents sat down on one side, patient sat next to them. The psychiatrist began the session. I was relieved when he started the conversation with an overview of how the session is structured and the general goals for the session. I have never seen a doctor do that in the beginning of a session before, and it’s clear that this brief introduction provides structure and focus throughout the entire session. The session began with the patient telling the family what he has experienced in treatment. I observe the parents as the patient is speaking. They listen respectfully, they want to believe his change-talk, yet they had reservations. I can feel the pain that they are going through. They are educated, well-spoken, thoughtful people who have been successful in raising children and planning for retirement. They never thought that drug addiction would ever be part of the family. They are struggling with this as a family and as a couple. The parents get to speak next. The father is thoughtful but mostly silent. The mother immediately begins to cry. Her story is similar to many suffering family members of addiction. They love the patient, and they are helping and enabling him for some time now. They are looking for permission to be able to say not their son. They know that if they don’t start setting up boundaries now, they will not be able to take care of themselves in old age.

The psychiatrist is in control of the dialogue between the two parties the entire time. He is able to empower the patient, place the responsibility for his actions on him and no one else. He also knows that he may have to face the consequences for his actions. The parents also feel empowered. They have received permission to star the conversation about the type of boundaries they need to set up with their son. Both parties feel in charge of their own actions. The psychiatrist was able to stay away from accusations and confrontations to achieve this. I was shocked that this was possible. My natural human instinct would be to allow the parents to confront and express their grievance. However, what would that accomplish? What is done is done. The family and the patient need to focus on the next step. As they all got up to leave, there is a hope amongst them that wasn’t there before. I felt it too, and I was shocked that I had felt this.

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