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Characters: Commentary From a Psychiatrist

The Center for Family Life: Challenging social paradigms

By: Paul Browde M.D.

I was asked to reflect on the film A BROOKLYN FAMILY TALE from a psychiatrist's perspective. I knew beforehand it told the story of the complex relationships and struggles of the Santiagos, a family from Sunset Park Brooklyn, dealing on a daily basis with crime, gangs, drugs, and teenage pregnancy. I watched the film equipped with a body of knowledge, a way of understanding this family's challenges that included my psychiatric training, and more than a decade of working as a psychiatrist in New York City. However, as the film progressed, the interactions between the Santiagos and The Center for Family Life affected me and I am reluctant to continue seeing them in purely psychiatric terms.

I began my inquiry by imagining how I, as a psychiatrist, would approach members of the Santiago family walking through my office door. Having worked at a public hospital in the inner city, that scenario is familiar. Told of their problems, I would be expected to make diagnoses, which could include depression, oppositional defiant disorder, substance abuse, and parent-child conflict to name just a few. My interventions would include individual and family therapy, referral to twelve-step programs and medication management. From the very outset I would expect my involvement to be moderately helpful at best, for I would know that after leaving my office they would return home to an environment more complex than I could even imagine.

The Center for Family Life, founded twenty years before this film was made, plays an integral part in the lives of the Santiago family members. In the film, Sister Geraldine, who embodies the work of The Center, interacts with the family both at times of great difficulty and immense joy. To Sister Geraldine, the Santiagos form a courageous and powerful family that has become far too "comfortable with negative identities." She prefers to accentuate the positive, believing that when you really know people you see their strengths, and Sister Geraldine really knows them. The Santiagos have been affiliated with The Center for Family Life for twenty years. They participate in the after school programs, in community arts projects, and allow social workers from The Center to enter their home, to counsel and guide them; sometimes gently, sometimes with confrontation, but always with palpable love and respect.

Sister Geraldine's refusal to see teenage pregnancy as a problem impacted me. She would find it disrespectful to view it that way. Rather than accepting a received view on the subject, she genuinely does not know whether the adolescents having children will help the family, or sink it into poverty. She says, "it is not my role to define or prescribe."
This leads me to question my own psychiatric approach, which to a great extent relies on defining, and prescribing.

To Sister Geraldine, gangs constitute the normal "street life" that these teenagers long for. The Center aims to bring that "street life" indoors, allowing young people to contribute powerfully in a social environment. The view of young people as responsible, powerful people in the face of drug use, violence, and teen pregnancy transformed me. I found myself contrasting that view with my medical armamentarium of attention deficit disorder, conduct disorder, and antisocial personality disorder, and wondering whether such descriptions could further damage the fragile self-esteem of these young people.

As I witnessed the Santiago family reflected in the eyes of The Center for Family Life, I relinquished some of my pathological descriptions of this family. Instead, I began embracing a more generous, textured view in which the problems and difficulties of the Santiago family co-exist with their triumphs and celebrations, thus constituting a multi-faceted, complex family.

It is no surprise to me that there has been a significant reduction in felonies in Sunset Park, and that the number of community members in the workforce is on the rise. I can only imagine how this country might look if every community had access to such a center, a place where people can express themselves and be heard; a center whose philosophy is not to judge or assess, but to listen, and, as Sister Geraldine says, "to be there in the journey."

A BROOKLYN FAMILY TALE challenged me to question my own assumptions and stereotypes. Ultimately, it made me reluctant to give my expert opinion on the Santiago family. Instead, I find myself humbled, having learned a great deal from the Santiagos and the way in which The Center for Family Life interacted with them. I think this approach is an extremely valuable one for helping professionals and communities everywhere.

Paul Browde M.D. is a psychiatrist in private practice in New York City. He is Assistant Professor of psychiatry at NYU Medical School, and is Director of Narativ Inc., a consulting company dedicated to the healing power of stories.

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