>> ON THIS EPISODE OF CYCLE OF HEALTH, FAMILY THERAPY.

FAMILIES ARE COMPLEX SYSTEMS WITH EACH MEMBER PLAYING THEIR OWN INTERCONNECTING ROLE.

WHEN THE SYSTEM IS DISRUPTED, FAMILY THERAPY CAN SHIFT THE DYNAMICS AND FREE THE MEMBERS.

WE HOPE YOU'LL JOIN THE CONVERSATION AS OUR PANEL OF EXPERTS EXPLORES THE PSYCHOLOGY OF FAMILIES AND FAMILY THERAPY.

COMING UP ON CYCLE OF HEALTH.

♪ ♪ >> HELLO AND WELCOME TO CYCLE OF HEALTH, I'M DOCTOR RICH O'NEILL.

TONIGHT'S TOPIC, FAMILY THERAPY.

FAMILY SYSTEMS ARE COMPLEX, WITH EACH MEMBER PLAYING THEIR OWN ROLE, INFLUENCING EACH OTHER'S BEHAVIORS, AND ALL REFLECTING GENERATIONS OF FAMILY HISTORY AND THE BROADER CULTURE.

SO WHEN FAMILY MEMBERS STRUGGLE, FAMILY THERAPY AIMS TO SHIFT THE SYSTEM DYNAMICS AND FREE THE STRUGGLING MEMBERS.

TONIGHT WE'LL EXPLORE HOW FAMILIES AND FAMILY THERAPY WORK.

LET'S MEET OUR PANEL OF EXPERTS.

SOME OF MY FAVORITE COLLEAGUES FROM SUNY UPSTATE.

DR. DAVE KEITH, FAMILY SYSTEMS PSYCHIATRIST AT SUNY UPSTATE MEDICAL UNIVERSITY DR. LUBOV LEONTIEVA, DIRECTOR OF INPATIENT PSYCHIATRIC SERVICES AT UPSTATE AND DR. JOHN MANRING, PROFESSOR OF PSYCHIATRY AT UPSTATE THANK YOU ALL FOR BEING HERE.

LET'S START WITH A QUOTE FROM THE WOMAN WHO WAS MY MENTOR AS EARLY ON IN MY CAREER IN PSYCHOLOGY, Dr. YVONNE WHO WAS FOND OF SAYING FAMILIES IMPORT BABIES AND EXPORT SOCIALIZED ADULTS.

OFF WE G. LET'S TAKE THAT TO LEAP OFORLEA-- TO LEAP FROM.

>> A COUPLE MONTHS AGO THERE WAS A CHILD MENTAL HEALTH CRISIS DURING THE PANDEMIC.

>> YES.

>> AND SO THERE WAS A LOT OF ATTENTION BEING GIVEN TO KIDS AND I WAS CONCERNED THAT THE REASON MY VIEW-- THIS IS WHAT I TEACH, IS THAT THE REASON KIDS ARE DISTRESSED IS BECAUSE THEIR FAMILIES ARE DISTRESSED.

WE TEND TO UNDERESTIMATE THIS.

BUT CHILDREN WORRY ABOUT THEIR FAMILIES.

WHEN MOTHER AND DAD HAPPY ONE ANOTHER HERE IS THE ADDITIONAL 10%.

WHO IS GOING TO DIE FIRST?

AND WHEN?

AND WHEN IS THE DIVORCE?

NOW THESE ARE IMPLICIT WORRIES FOR KIDS THEY DON'T ARTICULATE THEM.

THEY DON'T SAY THEM OUT LOUD.

AND-- >> I NEVER SAID THEM BUT I KNOW I HAD SOME OF THOSE IN MY HEAD WHEN I WAS A KID.

>> OKAY.

>> AND THE REASON KIDS DON'T SAY THEM OUT LOUD IS THEY KNOW IF THE PARENTS FIND OUT THEY'RE WORRIED ABOUT THEM, THEY WILL WORRY MORE.

SO KIDS-- IT'S DIFFICULT TO GET KIDS TO TALK ABOUT THEIR CONCERNS.

BUT I ASSUME IT'S ALWAYS THERE.

SO WHEN I SAY TO THE CHILD, SO WHEN YOU WORRY ABOUT YOUR MOM AND DAD, WHAT DO YOU WORRY ABOUT?

THEY SAY I DON'T WORRY ABOUT THEM.

AND I SAY I GOT BAD NEWS FOR YOU.

I DON'T BELIEVE YOU.

I NEVER HEARD OF A KID WHO DOESN'T WORRY ABOUT HIS PARENTS.

ANYWAY.

THAT'S THE BEGINNING OF A FAMILY THERAPY SESSION.

THE PARENTS ARE THERE BECAUSE THEY'RE WORRIED ABOUT THE KIDS BUT I DON'T TAKE THAT ON AS THE INITIAL PROBLEM.

I START WITH THE FACT THAT THE KID IS WORRYING ABOUT THEIR PARENTS, BUT DON'T HAVE A LANGUAGE TO TALK ABOUT IT.

>> SO GIVING THEM SOME LANGUAGE OR SPACE TO TALK ABOUT IT.

>> THAT'S RIGHT.

>> IT MIGHT ACTUALLY OPEN UP DISCUSSION IN THE FAMILY AS A WHOLE TO SOME THINGS THAT ARE GOING ON THAT ARE AFFECTING THE KID.

>> THAT'S RIGHT.

>> THINGS MAY BE GOING ON BETWEEN MOM AND DAD THAT AREN'T SO GOOD.

>> YEAH.

>> I WANT TO BUILD ON THIS, BECAUSE IN FACT, WHEN WE SEE KIDS IN THE EMERGENCY ROOM AND PARENTS OF BOTH PARENTS, SOMETIMES WE TAKE THE WHOLE FAMILY INTO THE FAMILY ROOM AND TALK ABOUT WHAT IS GOING ON WITHIN THE FAMILY.

AND THE KID WHO IS THE IDENTIFIED PATIENT IS KIND OF LISTENING AND THEN WHAT HAPPENS DURING THIS INTERACTION, SOMETIMES THE FAMILY DECIDED THAT, YOU KNOW, THEY'RE GOING TO SOLVE THIS AND TAKE THE CHILD HOME.

AND FIGURE OUT WHAT TO DO.

NOT ALWAYS.

YOU KNOW, TALKING WITH THE FAMILY, NOT WITH IDENTIFIED PATIENT WITH A CHILD, HELPS.

>> SO, IN A SENSE, IT KIND OF AWAKENS THEIR CONSCIOUSNESS OF WHAT IS POSSIBLE.

>> COULD BE.

>> I THINK THE OTHER THING THAT IT DOES FOR INDIVIDUAL MEMBERS OF THE FAMILY IS IT HELPS MAKE VERY CLEAR THAT EVEN THOUGH EVERYBODY'S IN THIS FAMILY, NO TWO OF THEM HAS THE SAME EXPERIENCE IN THAT FAMILY; THAT EACH PERSON'S EXPERIENCE OF THE FAMILY IS DIFFERENT BECAUSE THEY ARE ALL IN DIFFERENT POSITIONS, WHETHER IT'S FIRST BORN OR MIDDLE BORN OR LAST BORN OR THE DAD OR THE MOM.

EACH ONE FILLS A DIFFERENT ROLE.

AND I THINK TO HAVE SOMEONE IN POWER, SOMEBODY OF AUTHORITY, ASK EACH ONE WHAT HIS OR HER EXPERIENCE OF THAT FAMILY HAS BEEN, REALLY CAN FREE UP A LOT OF A SENSE OF YES, I BELONG.

BUT I'M UNIQUE.

I'M A DIFFERENT FROM MY SISTER.

I'M DIFFERENT FROM MY BROTHER.

>> AND GIVE THEM SOME SPACE TO-- >> AND GIVE THEM SOME SPACE TO BE.

AND TO TALK ABOUT WHO THEY ARE IN THAT FAMILY.

AS DAVE POINTS OUT, THEY DON'T-- LITTLE KIDS OFTEN DON'T JUMP INTO IT.

YOU HAVE TO INVITE THEM IN.

LIKE WELL, I DON'T BELIEVE THAT YOU ARE NOT WORRIED.

EVERY KID IS WORRIED.

EVERY PARENT IS WORRIED.

>> YEAH, I THINK, YOU KNOW, WHEN A FAMILY GETS INSIDE OF A CERTAIN BOX, THAT IS KIND OF TOO TIGHT FOR THE FAMILY AND SOMEBODY IS STARTING TO SAY OUCH AND SOUNDS LIKE WHAT YOU GUYS ARE TALKING ABOUT IS MAKING A SPACE FOR PEOPLE TO START TO THINK AND TALK ABOUT THINGS IN A NEW WAY TO GET OUTSIDE THE BOX.

>> AND IT'S COMPLEX.

I MEAN SO THAT MOTHER THINKS THERE IS A PROBLEM AND SHE HAS HEARD ABOUT THESE DOCTORS WHO WORK WITH THE FAMILIES SO THAT THEY CAN WORK WITH HER SON.

SO SHE BRINGS HIM IN, BUT THE DOCTOR SAID YOU NEED TO BRING YOUR HUSBAND.

AND SHE SAID OH, WELL HE CAN'T COME.

OH REALLY?

WHY IS THAT?

BECAUSE I DON'T WANT TO SEE IF HE HE IS NOT GOING TO COME.

WELL, HE WORKS.

OH HOW UNUSUAL.

WELL, TELL YOU WHAT.

WHY DON'T YOU BRING HIM AND I'LL WRITE A NOTE TO HIS BOSS EXPLAINING WHY HE IS NEEDED.

AND SO THIS IS-- LET'S SEE, IT'S COMPLEX WORKING WITH FAMILIES BECAUSE EVERYBODY ISN'T WILLING TO COME.

OFTEN TIMES FATHERS THINK, I DON'T NEED THERAPY.

I MEAN THERE IS NOTHING WRONG WITH ME EXCEPT THAT I MADE A MISTAKE ONCE AND MARRIED YOU AND I GIST HAD NO IDEA HOW COMPLICATED IT WAS MARRYING A WOMAN.

ANYWAY, SOMETIMES IF YOU CAN'T TELL, I'M BEING HUMERUS-- HUMOROUS HERE.

BUT IT IS VERY DIFFICULT.

I TRY TO GET PEOPLE TO WORK WITH FAMILIES.

THIS IS PRACTICING PROFESSIONALS AND THEY LIKE THE IDEA.

IT MAKES A WHOLE LOT OF SENSE UNTIL THE FAMILY SHOWS UP.

AND THEN THEY DON'T KNOW WHAT TO DO.

AND ONE OF THE REASONS THAT DEFEATS THERAPISTS IS THAT THE FATHER WON'T COME.

AND SO IF HE IS NOT THERE, THE FAMILY IS NOT THERE.

>> THAT REALLY SHIFTS THE DYNAMICS OF THE FAMILY RIGHT THERE.

>> THAT'S RIGHT.

>> IT SAYS HE IS IMPORTANT TO HAVE HERE.

>> THAT'S RIGHT.

>> AND THAT MAY BE NEWS TO THEM.

SO OKAY, HE AGREES TO COME AND SO HE COMES IN AND I SAY, ALL RIGHT.

SO THIS WILL BE BAD NEWS FOR YOU, DAD, BUT I LIKE TO PICK ON FATHERS.

SO I'M GOING TO ASK YOU THIS QUESTION FIRST.

TELL ME WHAT IS YOUR FAMILY LIKE?

HOW DOES IT OPERATE?

WELL, WHAT DO YOU WANT ME TO SAY?

WELL, YOU COULD TRY ANSWERING THE QUESTION I JUST ASKED YOU.

WELL, THAT'S A DIFFICULT QUESTION.

DID SOMEBODY TELL YOU THIS WAS GOING TO BE EASY?

BECAUSE IT'S NOT.

AND SO HE SAYS OKAY, THEN HE STARTS TALKING ABOUT THE FAMILY AND HIS WIFE SAYS, NO, IT WASN'T THEN.

IT STARTED ABOUT TWO MONTHS AGO, AND I SAY MOM, I GOT BAD NEWS FOR YOU.

I'M NOT TALKING TO YOU.

I KNOW YOU KNOW ALL THIS STUFF.

I WANT TO HEAR HIM TALK ABOUT IT.

OKAY.

THIS IS THE THERAPY HASN'T STARTED YET BUT THE INTERACTION IS STARTING.

AND THAT'S-- SO IT'S DIFFICULT TO TEACH PEOPLE HOW TO DO THIS BECAUSE THEY HAVE TO BEHAVE IN A WAY THAT ISN'T CORDIAL,.

>> ISN'T DIRECTED AT KEEPING THE CUSTOMER SATISFIED.

AND WE ALL KNOW HOW IMPORTANT THAT IS IN THIS DAY AND AGE; THAT IF I DON'T DO A GOOD JOB THEY WRITE ME UP ON THE INTERNET AND EVERYBODY FINDS OUT WHAT A RAT DAVE KEITH IS.

>> I'VE SEEN A FEW OF THOSE THINGS ABOUT YOU, DAVE.

[LAUGHTER] >> I THINK WE DO OURSELVES OR THE PEOPLE WE ARE TRYING TO HELP A DISSERVICE BY DESCRIBING WHAT WE DO AS FAMILY THERAPY AS IF THERE IS SOMETHING WE HAVE TO FIX ABOUT THIS FAMILY.

AND WHEN PEOPLE HEAR I GOT TO COME IN FOR THERAPY, THEY ALMOST AUTOMATIC REACTION IS.

>> SURE.

>> I DON'T NEED TO BE FIXED.

>> I'M NOT SICK.

>> I'M NOT SICK.

NOTHING WRONG WITH ME.

>> AND SO WE PROBABLY NEED A BETTER WORD FOR IT.

BECAUSE WHAT WE REALLY DO IS MEET WITH FAMILIES AND FIND OUT WHAT THEIR STRENGTHS ARE.

FIND OUT WHAT WORKS FOR THEM AND HOPEFULLY HELP THEM GET TO THEIR STRENGTHS.

>> BUILD ON THAT.

>> WE USED TO CALL IT FAMILY CONSULTATION WHEN DAVE KEITH CONSULTED.

>> YOUR SERVICES UPSTATE.

>> IT'S A PSYCHIATRIC UNIT AT UPSTATE.

SO WE CALL IT FAMILY CONSULTATION.

>> SO TO TRY TO TAKE THE STIGMA OUT OF IT WHERE PEOPLE THINK YOU HAVE TO BE SICK.

>> I WOULD TALK TO Dr. KEITH AND HE WOULD CONSULT AND DO THIS HUMOROUS NON-TRADITIONAL THING WITH THE FAMILY.

SOMETIMES FAMILY WOULD GET MAD BUT THEN IT GENERATES THINKING ABOUT CHANGE.

>> AND THEY TEND TO BE MORE AVAILABLE BECAUSE I'M NOT GOING TO FIX THE FAMILY.

THEIR SON HAS A SERIOUS MENTAL DISORDER.

THEY KNOW THAT.

AND I'M GOING TO TRY TO HELP THE FAMILY DEAL WITH THIS DISORDER.

SO THAT CHANGES THE GROUND A LITTLE BIT.

>> IT WAS A HELPFUL THING BECAUSE THE SON, FOR EXAMPLE, WASN'T THE IDENTIFIED PATIENT AND THE CONVERSATION WAS MORE WITH THE FAMILY WITH THE PARENTS, WITH THE SIBLINGS, SOMETIMES GRAND PARENTS.

AND IT HELPED THE SON TO BE QUIET AND LISTEN.

>> THAT'S RIGHT.

>> SOMETIMES IT HELPS.

>> I INVITE HIM TO TALK ABOUT HIS FAMILY.

AND FOR A GUY WHO IS A CHRONIC-- HAS A CHRONIC MENTAL ILLNESS, THAT'S AN UNUSUAL EXPERIENCE.

>> TO BE EXPERIENCED AS IF YOU ARE BEING VALUED RATHER THAN THAT YOU-- >> THAT YOU HAVE OPINIONS AND I'D LIKE TO KNOW WHAT THEY ARE.

>> AND FOR THE FAMILIES, MOST OF THEM DON'T HAVE A SCRIPT OR A MANUAL ABOUT HOW YOU BE A PARENT.

THEY SIMPLY CHANNEL HOW THEY WERE PARENTED, WHICH IS A CHANNELING OF HOW THEIR PARENTS WERE PARENTED, AND IT LEADS US BACK TO DAVIES DAVE'S DEFEND SIGNIFICANTS, THAT WE HELP THEM RECOGNIZE THE STUFF THAT THEY GOT FROM PARENTS AND GRAND PARENTS AND GREAT GRAND PARENTS ON WHICH THEY'RE ACTING AND WHICH THEY CAN CHOOSE NOT TO ACT.

THEY CAN DECIDE TO TRY TO DO IT DIFFERENTLY.

IN FACT, WE HAVE FAMILIES THAT TRY TO BE JUST THE OPPOSITE OF THEIR FAMILIES GROWING UP BECAUSE THEY DIDN'T LIKE IT.

AND THAT ENDS UP SHAPING THEM ALMOST AS CERTAINLY AS IF THEY WERE DOING EVERYTHING THEIR FAMILY DID.

BUT THE INFLUENCE IS KIND OF AN UNMISTAKABLE THING IN EVERYBODY'S LIFE AND THE MORE WE KNOW ABOUT IT, AND THE MORE WE CAN TALK ABOUT IT, THE MORE CONSCIOUS WE ARE OF THE DECISIONS WE ARE MAKING AND THE BEHAVIOR THAT WE ARE EXHIBITING.

>> I WAS TALKING BEFORE ABOUT HOW I REMEMBER JUST THE OTHER DAY WHEN WE WERE TALKING ABOUT COMING ON THE SHOW, THAT MY FATHER AT ONE POINT-- I THINK I WAS A TEENAGER, SAID TO ME, WE WERE WATCHING TV, AND HE SAID TO ME, WHY DON'T YOU BE ONE OF THOSE TV NEWS GUYS.

AND I DIDN'T REMEMBER IT UNTIL JUST RECENTLY.

AND THOSE KIND OF SMALL INFLUENCES THAT LIKE I KEEP DISCOVERING THEM OVER MY LIFE.

IT'S KIND OF AMAZING TO SEE HOW THOSE INFLUENCES FROM THE FAMILY ARE SO PROFOUND.

>> IN FACT, UP WITH OF THE ACTIVITIES OR EXERCISES THAT WE DO WITH TRAINEES AND WE GET AT THE BEGINNING OF THEIR THREE-- FOUR OR FIVE-YEAR TRAINING IS TO HAVE THEM DESCRIBE THEIR OWN FAMILIES AND HOW THAT FAMILY HELPED THEM TO BECOME A DOCTOR OR BECOME A SOCIAL WORKER OR BECOME A PSYCHOLOGIST; THAT SOMETIMES IT'S IN OPPOSITION TO THEIR FAMILY.

SOMETIMES THEY'RE THE FIRST ONE TO HAVE GONE TO COLLEGE AND GONE ON TO GRADUATE SCHOOL.

BUT SIMPLY ACKNOWLEDGING THAT YOUR FAMILY HAD SOMETHING TO DO WITH IT HELPS THEM GET USED TO THE IDEA THAT A.

THEY'RE HUMAN AND B: THEY WERE PART OF THIS FAMILY BEFORE THEY LEARNED ALL OF THAT GARGANTUAN AMOUNT OF MATERIAL THEY NEED TO LEARN TO GET THROUGH ALL THE THE FACTS.

WE SOMETIMES TALK ABOUT TRYING TO REHUMANIZE PEOPLE WHO HAVE BECOME EXTRAORDINARILY COMPETENT SCIENTISTS SO THAT THEY CAN BE NORMAL PEOPLE AGAIN.

>> I JUST HAD A THOUGHT ABOUT SOMETHING INTERESTING THAT YOU WERE TALKING ABOUT.

SO MY MOM WAS A PHYSICIAN AND SHE WANTED ME TO BE A DOCTOR.

SHE WAS INTERNAL MEDICINE DOCTOR.

SO IT WAS IN RUSSIA IN ST. PETERSBURG MANY YEARS AGO SO I WENT TO MEDICAL SCHOOL, BUT I DIDN'T WANT TO BE INTERNAL MEDICINE DOCTOR SO I WAS A REBEL SO I DECIDED TO GO TO PSYCHIATRY BECAUSE PATIENTS WERE SO INTERESTING.

AND SHE WAS LIKE, WHAT IS A PSYCHIATRIST GOING TO CHANGE?

AT THAT TIME THERE WAS A THOUGHT THAT PSYCHIATRISTS DON'T REALLY CURE ANYBODY.

SO YOU KNOW, I STICK TO MY IDEA AND BECAME A PSYCHIATRIST AND, YOU KNOW, SHE WAS FINE WITH THAT LATER ON.

BUT SHE WAS-- YOU WERE SAYING THAT YOU KNOW, YOUR DAD SAID THAT YOU CAN BE A TV PERSONALITY.

SO AND YOU ARE, RIGHT?

SO MY MOM WAS A UNIT DIRECTOR FOR MANY, MANY YEARS.

BUT INTERNAL MEDICINE.

SOMETIMES I'M LIKE, OKAY, HERE I AM.

BASICALLY THE SAME ROLE.

SO INTERESTING.

>> SAME BUT DIFFERENT.

>> SAME BUT DIFFERENT.

>> SAME BUT YOURS.

>> INTERESTING.

GOES THROUGH GENERATIONS.

>> I KNOW I HAD A GRANDFATHER WHO WAS AN ALCOHOLIC, WHO IS A VERY MEAN DRUNK.

AND I, WHEN I HEARD THAT, I USED TO THINK WHEN I WAS A KID, AM I GOING TO BECOME AN AND THAT WE RECOGNIZE AS BEING THE WAYS THAT FAMILIES PASS ON THEIR HERITAGE IS THROUGH THESE STORIES.

AND SOME OF THEM ARE HEROIC STORIES ABOUT WHAT GREAT, GREAT GRANDPA WENT THROUGH TO GET US HERE.

AND SOME OF THEM ARE SORT OF MEAN AND HURTFUL STORIES ABOUT HOW DON'T YOU EVER MARRY SOMEONE LIKE MY MOTHER OR MY FATHER.

THEY ALL HAVE POWER IN OUR LIVES WITHOUT US ACTIVELY THINKING ABOUT THEM ALL THE TIME.

>> I'M STRUCK, AS WE ARE TALKING ABOUT THIS, ABOUT HOW LIKE WITH DAVE, YOU WERE SAYING AND TAKING THE FAMILY INTO THE FAMILY CONSULTATION ROOM, IN A WAY, YOU ARE TALKING ABOUT A DIFFERENT WAY OF IMAGINING OURSELVES AND KIND OF PLAYING WITH THE WAY WE ARE AS A FAMILY AND THE WAY WE THINK OF OURSELVES.

>> RIGHT.

>> I THINK IT HAS THE CAPACITY TO OPEN US UP TO OTHER POSSIBILITIES THAN WHAT WE ASSUMED WE WERE HEADED FOR.

>> UH-HUH.

>> I REMEMBER NEVER BEING A TERRIBLY OUTSTANDING STUDENT BECAUSE I NEVER LEARNED HOW TO STUDY PARTICULARLY WELL.

AND WAS GOING TO BE AN ENGLISH MAJOR UNTIL I GOT TO COLLEGE AND MAJORED IN ENGLISH AND PROMPTLY FAILED MY FIRST FRESHMAN COURSE IN ENGLISH.

SO I LOOKED AROUND AND DISCOVERED, WELL, THERE IS THIS PSYCHOLOGY THING GOING ON OVER HERE THAT'S PRETTY INTERESTING.

NO IDEA AT THE TIME WHY THAT WOULD BE SO, BUT IT JUST KEPT ABSORBING MY INTEREST.

AND I HAD THE FREEDOM, FORTUNATELY, TO PURSUE THAT.

AND NOT EVERYBODY HAS THAT.

AND IT'S ONLY WITH A NUMBER OF YEARS OF TALKING ABOUT MY FAMILY WITH TRAINEES THAT IT BEGAN TO OCCUR DO TO ME THAT I HAD NOT BEEN THROUGH NEARLY WHAT MANY OF THEM HAD BEEN THROUGH TO GET TO THIS STAGE IN THEIR LIVES, TO GET TO BE PROFESSIONALS.

LICENSED PHYSICIANS IN MOST CASES THAT WE ARE WORKING WITH AND SOCIAL WORKERS AND PSYCHOLOGISTS.

>> SO I HEAR WHAT YOU ARE SAYING ABOUT TRAINING PSYCHIATRY RESIDENTS, ASKING THEM TO THINK ABOUT THEIR FAMILIES AND THINK ABOUT WHAT THEIR FAMILIES STORIES ARE, WHAT THE HISTORY IS UP THE GENERATIONS.

I'M WONDERING LIKE, WHAT WOULD YOU FOLKS SUGGEST TO VIEWERS, YOU KNOW, LIKE IF SOMEONE IS GOING-- SOMETHING IS GOING ON IN THE FAMILY THAT YOU DON'T LIKE, AND YOU DON'T WANT TO GO TO FAMILY THERAPY BECAUSE IT'S TOO-- >> BECAUSE YOU ARE NOT BROKEN.

>> I DON'T WANT TO GET FIXED.

WHAT DO YOU DO AS A FAMILY MEMBER TO KIND OF TRY TO HEAL THINGS FOR YOURSELF AND OTHER FOLKS?

WHAT DO YOU DO?

>> YOU GO SEE THE MINISTER.

I MEAN AT LEAST MANY MODERN-DAY PASTORS HAVE HAD SOME TRAINING, THEY ARE TAUGHT TO THINK LIKE PSYCHOLOGISTS IF NOT FAMILY THERAPISTS.

>> SO IF A MINISTER IS SOMEBODY WHO IS ACCEPTABLE TO THE FAMILY... >> USUALLY, YES.

>> START TALKING ABOUT WHAT IS HAPPENING.

I THINK THAT MIGHT HELP.

I DON'T THINK MANY FAMILIES TALK ABOUT-- >> I THINK YOU ARE SPOT ON AND I THINK THAT'S ANOTHER THING THAT OCCURRED TO ME WHILE DAVE WAS TALKING, WHICH IS THAT MEETING AS A FAMILY OFTEN IS THE FIRST TIME SOME MEMBERS OF THE FAMILY HAVE HEARD OTHER MEMBERS SAY WHAT THEY'RE THINKING.

LIKE WHAT DAD THINKS GOES ON IN THE FAMILY.

OR WHAT MY BIG BROTHER THINKS OF ME BEING A CHEERLEADER OR THINGS THAT WE DON'T USUALLY HEAR OR OFTEN DON'T HEAR.

AND WHEN YOU TALK AS A FAMILY, YOU HAVE THAT OPPORTUNITY.

ONE OF THE THINGS I TEACH IS ABOUT SOMETHING CALLED BOWEN THEORY WHICH IS AN EFFORT TO CODIFY OR PUT SOME RULES IN PLACE FOR THE OBSERVATIONS HE MADE ABOUT HOW FAMILIES OPERATE.

AND HIS BASIC NOTION WAS THAT IF YOU CAN DEVELOP A RELATIONSHIP WITH EACH LIVING MEMBER OF YOUR FAMILY, THE ANXIETY IN THE WHOLE FAMILY SYSTEM WILL DROP.

>> JUST CONNECTING WITH MORE AND MORE PEOPLE IN THE FAMILY.

>> YOU DON'T HAVE TO LIKE THEM.

YOU DON'T HAVE TO APPROVE OF THEM.

BUT IF YOU JUST KNOW WHO THEY ARE, WHAT THEY'RE ABOUT AND WHAT THEY'RE DOING, AND THEY KNOW YOU, THAT THE ANXIETY IN THE FAMILY HAS A WHOLE WILL REDUCE.

WILL DIMINISH.

>> AND EVERYBODY WHEN WE ARE LESS ACHES, WE WORK BETTER.

UNFORTUNATELY.

THAT'S ALL THE TIME WE HAVE TODAY.

I WANT TO THANK OUR GUESTS FOR JOINING US AGAIN.

MY FAVORITE COLLEAGUES AT UPSTATE DR. DAVE KEITH, FAMILY SYSTEMS PSYCHIATRIST AT SUNY UPSTATE MEDICAL UNIVERSITY RETIRED.

DR. LUBOV LEONTIEVA, DIRECTOR OF INPATIENT PSYCHIATRIC SERVICES AT UPSTATE AND DR. JOHN MANRING, PROFESSOR OF PSYCHIATRY AT UPSTATE BE SURE TO VISIT WCNY.ORG/CYCLEOFHEALTH TO SEE ADDITIONAL CONTENT, PRIOR EPISODES, AND OUR WEB SERIES CHECKUP FROM OUR NECKUP.

FOR CYCLE OF HEALTH, I'M PSYCHOLOGIST DOCTOR RICH O'NEILL.

THANKS FOR CHECKING IN.

ON THE NEXT "CYCLE OF HEALTH," NURSING TODAY.

THE COVID PANDEMIC HAS PUT INTENSE PRESSURE ON NURSES AND IS JUST ONE OF MANY REASONS FOR THE CRITICAL SHORTAGE IN THE PROFESSION.

JOIN US AS WE TALK WITH FOUR NURSES ON THE FRONT LINES ABOUT THE STRATEGIES IN PLACE TO REVERSE THAT TREND AND MUCH MORE NEXT ON "CYCLE OF HEALTH."