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The Real Poop

"Hey, Doc. My wife and I have a problem, and we were wondering if you could help us."


"Well, Sarah wants to go back to work now that the kids are grown, but I think she should stay at home, cooking my meals, cleaning my clothes, and otherwise waiting on me hand and foot.”

"Sarah—what is it that you did for work before you had the boys?"

"I taught Women's Lib at a local college. As you can see, I'm out of practice."

Like other therapists, those specializing in the arena of marriage and family therapy work with patients to sort out their emotional issues, face them head on, and hopefully overcome them. Or at least find a way to live with them from day to day without going nuts. ("Nuts" is not a professionally PC term, by the way.) However, whereas most other therapists meet with a single individual in an effort to work through their problems, marriage and family therapists are more concerned with fixing the interpersonal relationships between their patients, and identifying anything that may potentially be straining them.

It is not an M&F therapist's job to take sides. Two siblings may not be getting along because one of them insists on continually setting the other's dolls on fire—entirely unprovoked, mind you—but it is up to the therapist to help them work through their issue without making the juvenile delinquent in this scenario feel attacked or ganged up on. They must find a way to speak in a human, caring way to the little brat, and make it seem as if his reprehensible actions might derive from some real place that is deserving of compassion. "Has your sister done something to hurt you?" "Is it because you feel she gets more attention than you do, or because your parents buy her more gifts?" "Is this your way of reaching out to her?" Etc. It may be utter hogwash—or it might not—but the important thing is to get your patients to open up and talk; to discuss their innermost feelings with one another so that they can gain some insight into their respective psyches, and ideally understand each other a bit better. Sadly, nothing is going to bring all those dolls back from the dead.

An M&F therapist needs to diagnose a problem before they can make it better. It won't do any good to encourage one of your patients to lighten up and not take things so seriously if they're clinically depressed. Part of a therapist's training prepares them to identify a host of emotional and psychological disorders. The beginning stages of a patient's relationship with their therapist is often an effort to better understand the root of the problem; then, later sessions can be devoted to actually healing whatever emotional scars need to be healed. If there are also physical scars…they may need to bring in another doctor. Another valuable skill the therapist must possess is the ability to bring people out of their shells. (You can imagine what a difficult time turtle therapists have dealing with their patients. Although even turtles aren't half as tight-lipped as clams. You can't get them to talk about anything.) Many people aren't exactly an open book when it comes to their emotional life, and they need a little poking and prodding before they will relax enough to reveal personal tidbits. The therapist is responsible for making them feel that relaxed and comfortable. Generally speaking, popping in an Enya CD isn't enough.

An M&F therapist will also have to be prepared to help patients through some pretty major ordeals. It isn’t always just "we wish we spent more time together at the dinner table." Divorce, death, layoffs…all of these are big time responsible for creating emotional turmoil. The therapist will have to know how to broach the subject and ask the patient deep, penetrating questions about their feelings without setting off a time bomb. The idea is to make things better, remember—not simply to remind your patients about all the crappy things going on in their lives. That's what a visit to their mother-in-law is for.

Sometimes a problem will be beyond the scope of your expertise. Your puppet show may work wonders on the kids, but it may not help the Johnsons deal with Mr. Johnson's impotence issue. (Besides, that particular puppet show would likely be extremely inappropriate.) A therapist has to know when a patient needs to be referred to another health professional—possibly a social worker or psychologist. Or maybe they just need a little extra emotional care, such as in the form of a support group. They ca''t be swayed, however, by their patient’s own estimation of what will cure their ails. A therapist must be very sparing when it comes to writing out prescriptions for weekly rounds of golf.

If you're interested in becoming a marriage and family therapist, know that it can drain you emotionally as well as your patients. There is more crying in your job than in that of a chef, for example, no matter how many onions he likes to chop up and put into his beef stew. You will hear the saddest, most sobful stories, and you won't just be able to get up and change the channel, or check out mentally. You will have to head up every depression —you may even have to break up a fist fight or two. Not many families use their therapy sessions to talk about how happy they all are and then join hands and sing "Kumbaya."

But you are helping—most of the time—so it is a rewarding career as well. And the money ain't bad.