Human Systems: The Journal of Systemic Consultation & Management

Communication Through Stories to Promote Differentiation of Enmeshed Family Groups

Sociedad Argentina de Terapia Familiar
Abstract This paper addresses an original approach to family therapy employing metaphoric language of storytelling and story creation in parent/ child communication, as a means of encouraging childrens learning of autonomous behaviour in families with insulin dependent diabetic children that failed in the learning of diabetes self care. Family groups attending medical diabetes care meetings were invited to participate in two different narrative treatment schemes: 1) a four family interview therapy schedule [FT] using storytelling and 2) a multiple family bibliotherapeutic program based on storytelling workshops. Only two families attending these meetings fulfilled the FT schedule, one of them attending a workshop of the latter program. Three years later mothers reported sustained changes in childrens learning of diabetic control. These issues are discussed in the framework of a possible role of narrative therapy in shaping family communication by establishing narrative spaces for every family member, together to help them in the sharing of grief by selecting mourning themes in the stories. Storytelling used in Family Therapy seems legitimised as a relevant method for designing new relational structures in enmeshed families, enhancing learning skills in the family process of adaptation to serious illness.

Julio Enrique Correa1

Introduction We have previously shown that structural family therapy using storytelling may help children in their school learning troubles together to correct other learning habits, especially those linked to psychosomatic symptoms (Correa, Gonzlez & Weber, 1991). Such potentiality can be summarized in two features: 1) its capacity to establish new channels of communication within the family that helps both parents and children: the former may ease through it on the accomplishment of parental orientation and guidance roles, while children are to incorporate new learning behaviors leading to autonomous self care and at the same time may express their own emotional needs with parents -which they are not always able to express in the ordinary language (Correa, u.p.)-, therefore enhancing parental recognition of childrens emotional needs; 2) helps to shape the structure of the family by differentiating relationships of parents with children, establishing a close relationship without entanglement, (permitting) a common shared and differentiated space for each member. All this applies to the structure of families that maintain learning symptoms in children, characterized by over-involvement of one very close parent and distance from the other one (Correa, Gonzlez & Weber, 1991). Therefore, it seemed useful to apply this narrative therapy outlook in diabetic Type I childrens families, whose structure frequently corresponds to enmeshed patterns and whose children show well known problems in psychosomatic and habits learning (Minuchin, Rosman & Baker, 1978). The failure in childrens learning of diabetes self care currently relies on the specific nutritional control and treatment requirements that are necessary for adjusting to the serious disease control and treatment.
1 This paper corresponds to work made as Coordinator of rea Creatividad y Comunicacin familiar:, Sociedad Argentina de Terapia Familiar (SATF), when located at Julin Alvarez 239, Buenos Aires, Argentina.

LFTRC & KCC

Volume No. 17, 2006, pp.67-80

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The aim of this study was to look for a possible therapeutic effect of storytelling and story creation on the enmeshed family structure, improving family members communication and favouring children to differentiate and succeed in the childrens learning of those habits necessary for diabetes care. Method Family referral Diabetic Type I children families attending a diabetic self care education program alongside psycho-educational multiple family meetings (Anderson, Grifn, Rossi, A. et al, 1986), conjointly conducted by the medical specialist and the family therapist at a hospital in the Buenos Aires outskirts [Hospital Posadas, Ramos Mejia], were invited to participate in a narrative storytelling schedule developed in a Family Therapy institution located in the city [Sociedad Argentina de Terapia Familiar]. Unlike a matched group non attending to multiple family meetings, children from the multiple family groups showed almost no hospitalization for diabetic acidosis (Doval, Correa & Stuhlman,1988), but not because of a better self monitoring behavior (unpublished results). It was suggested that possibly the attendance at these groups could have achieved a gain in the family diabetic control skills, but no signicant change in the childrens diabetic self care learning. Only occasionally did both parents attend groups or accompany children to workshops,. Over involvement of one parent in symptom control and diabetic monitoring (generally the mother) and neglect by the other peripheral parent (generally the father, justied for occupational reasons) may have been enhanced by these meetings, reinforcing the childs dependence on the over-involved parent and thus not acquiring new behaviours necessary for diabetes self care himself. Only three of these families with children in middle/ late childhood, all of them sharing a family relationship structure that tted the aims of our study over-involvement of one parent [generally the mother] and disengagement of the other one [generally the father]-, attended our program. Family Therapy Program In this program, families participated in multiple family meetings with a storytelling workshop format. Here the therapist told stories selected from story books which were recreated focusing on diabetes care/ related family issues (Correa & Doval, 1989). Afterwards, families were invited to further participate at two different narrative treatment schemes: 1) a four family interview therapy schedule [FT] using storytelling tasks and 2) a multiple family bibliotherapeutic program based on storytelling workshops. This family therapy program was directed to enhance communication skills among parents and children, and was framed within a family storytelling model which equips family members to handle grief matters such as those that arise with serious illnesses of children, that are understood to impede the family learning of new behaviours and may interweave with family pathological mourning as that one from parents families of origin. Just two of the three families complied in receiving the FT scheme, one attending the

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multiple family bibliotherapeutic workshop. Their children (girls in both cases) had no school learning difculties (Kovacs, Goldston & Iyengar, 1992), achieving good performances at their levels, but showed problems in learning new habits concerning diabetes symptoms treatment and metabolic control as hypoglycemia management [D] and glycemia self monitoring [P]. The full correcton of these learning difculties was assessed with mothers three years after this study started through questions exploring their satisfaction with their girls and own outcomes. Mothers were interviewed personally (R case) or by telephone (G case). Family Therapy Treatment Scheme Two families attended family sessions during a similar period of time, the frequency of the four interviews being between a fortnight to four months. In the rst interview, the therapeutic aim of the family, genogram and diabetic onset and evolution in the child were explored. Hypothesis were formed about the family malfunction related to the childs problem and the associated most relevant family events. The structural strategy for change was then planned using storytelling/ writing tasks (Correa, Gonzlez & Weber, 1991). The storytelling prescription was given in the second interview in order to design a new relational structure where the father or the therapist himself in the latters absence told the story to the child independent from the mothers presence -Figure 1a-.

Fig. 1a

T/F

ST

The storytelling performance/ task was assessed on the third interview and looking to challenge the family communication pattern; in the fourth interview the child was asked to tell the story to her mother [G case, -Figure 1b-], or else to all members in the whole family group [R case, -Figure 1c-]. Storytelling was encouraged to be followed by dialogue aiming to enhance communication of personal views of those contents in the stories that addressed differentiation in the child-parent close emotional system. With the same aim, an interview was held with parents alone while other therapist interviewed the children in a separate room exploring and endorsing story work capabilities (G Family, 1st session) or assessing response to storytelling (R Family, 3rd session).

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Story Selection Two folk stories were selected for a message helping parents and children with a close relationship to separate from it by endowing children with learning self care behaviours. These were stories with a similar ctional plot to that of the marvellous kind, in which small children that are abandoned by their parents nd protection on parental substitutes (Correa & Vazquez 1982). Following a previous paper in which stories were classied according to the strategies of change in the family relations (Correa, Gonzlez & Weber, 1991), stories were matched isomorphically to families for which they were selected: 1) for heightening the individual values for conict resolution in a highly enmeshed system of a single daughter and a single mother, was chosen The enchanted stork, a Japanese folk story, in which the individual is moved to be freed from parental disrespect for personal privacy; 2) for questioning the family functioning and opening new subsystems in a family with a peripheral father and an over involved mother in the care of childrens ailments, was selected The Moor Queen, Spanish folk story where the building of a new subsystem is able to change the original family structure of dependency. Multiple family bibliotherapy program The procedure followed a previously described therapeutc intervention where the storyteller therapist and siblings displaced an over involved parent in symptom control (Correa, Gonzlez & Weber, 1991). Sessions were programmed for family like storytellers acting as a substitute granny role [G], to tell stories to children coming from different families [Ch], that would be dramatized in order to recreate them (Correa & Hobbs, 2007). At the same time parents [P] -mostly mothers- observed from another room through a one way mirror See Figure 4-. In this way a therapeutic substitute replaced the childrens over involved parents, providing opportunity to learn from the child/ substitute granny interaction under the therapists observation and guidance. This format differed from the FT scheme, since using the one way mirror made it possible to separate at the same time that keep together either children and parents in both rooms. Such a communication exercise was thought to train children in the communicative skills in order to help them in moving from an enmeshed relationship with a parent, while keep together parents in a separate room: when the storytelling session was over, parents made comments under the therapists supervision, making it possible to realize that they had healthier children than they had previously realized.
Fig.2

ST

Ch

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Results Family Therapy sessions: The G and R family cases The G family This family was composed by two members: a single mother [M 54 yrs of age ] and a 12 years old girl [D], who had her rst diabetic episode at the age of six. Both attended a diabetic education camp during the summer before therapy took place, there the girl learned self glucose monitoring, while her mother, along with other parents, was guided by the family therapist to reinforce such training in the children. The girl showed great dependency to her mother, who responded with high emotional fragility to several hypoglycemic episodes of her daughter. The mother showed vulnerability to separation events, ascribing her own parental neglect to impel her to have had this child as a single woman: Dad didnt invest at the right time the money he obtained from selling the house, and so he built us a new one that didnt have the same good things of the former in which we lived...I didnt like it...its like nothing was possible for me...well, D brought all my happiness!. When the therapist hinted not her parents blame but pointed to her own difculties for working at her adjustment to reality, M detoured again by talking about the accomplishments she obtained with her daughter: Its true, anyway I could stand when D had to begin to cross avenues by herself, although I was afraid about it. Using this mechanism leading to comment on the girls achievements in self control, M seemed to nd a way to overcome her own seperation anxiety. Moreover, signs of emotional fusion arose when the girl began to talk about her diet concerns, starting the mother then to talk about herself, stopping in listening to the girl: Now that controls are all right and I have no reason for feeling anguished, still Im always restless...if she is sleeping well, if her breath is OK...her hypoglycemic convulsions are always in my mind-. Correspondingly, the girl worried for her mothers health (digestive ailments), undergoing high glycemia levels during the same time her mother was sick. In this way mother and daughter appeared to appertain to the same emotional system. Interviews with both family members supported such a strong connection amongst them on: 1) the mothers and girls fears [M: Im afraid for D not being able to defend herself as I wasnt able either/ D: I am afraid of being expelled from the group...fearful of the other children getting annoyed with me]; 2) the mothers own complaints and the girls report about past parting experiences [while on one hand the mother emphasized on her loneliness -I was very happy when I had D, but later I remained alone...I lived with my parents until she was 16 months old, then we went to live alone.../ Diabetes was awful...I didnt knew how the girl would do...I didnt feel backed... I felt alone-, the girl on her side talked particularly about separation events -i.e.: she mentioned separating from pets, when she was about nine or ten years old, as the most dreadful moment she ever lived; also when the teacher left her grade she remained very sad, which was coincident to obtain higher glycemia levels-].

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Storytelling was pursued to differentiate the mother/ child emotionally overinvolved pair by generating differentiated imaginary spaces: in the second interview [Figure 1a], while the mother was interviewed in a separate room, the therapist told the girl a story describing the need for own space and intimacy by an orphan girl sheltered by an old couple -The enchanted stork-. In this story, when the girl closes the door of her room, a wonderful music is heard, and when its over the girl comes out presenting creative handy work to the couple. When her privacy is interrupted -because the old landlady spies the girl by opening the door slightly-, the secret concealed by the girl comes to light: actually she is a stork weaving a beautiful tapestry with her feathers. The girl-stork then announces that she can no longer remain living with the couple, so she leaves for good. A plain storys moral seems to underscore the need of privacy to develop personal autonomy and creativity. A task was given to the girl, that the mother would not see until the next interview in which she had to draw and comment on the story in a notebook that was given to her. The girl performed the task and in the third interview she was asked to show and tell about it to her mother, that in turn expressed interest for it although her daughter exhibited the work she did, not to her but to the therapist. When the girls comments were over, the mother spoke of her dislike of the original story because of the severe punishment to the parents it addressed [separation from the girl]. When she was asked to tell how she would like the story to be, she guessed how the girls feelings would turn if the parents were to go to the garden from 5 to 6 p.m. and stayed there listening to music, eating, reading and enjoying work together, while the daughter wouldnt share nothing of it at all. D responded by admitting that she would remain indeed curious, while saying this -as the session was over- she unexpectedly entered into the next room where the rest of the therapeutic team was and greeted them. The mother child emotional fusion was then enacted into the story the mother told. Following such displacement to narrative, mother and child were asked to bring stories for the next interview: the girl had to continue the original story stating where the girlstork was to stay and live; while the mother would write down her own recreation of the story. With this intervention, both girl and mother were asked to continue to create boundaries between themselves and learn to talk through them [Figure 1b].
Fig. 1b

ST

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In the fourth session it was striking to see how they both sat remarkably distant, three chairs between them. The mother read her story rst, performing it as if it was only for herself; her daughter in the meantime looked at her own notebook. When it was her turn, D told her story, this time she looked at her mother and showed her drawings to her, making the latter get closer. While D read, the mother advised her to read in the rst place, showing the drawings to her later, but when the grl nished the reading, she didnt ask for them. In the girls continuation of the story, a girl-stork with blue melancholic eyes felt lonely, making her parents reunite, so they could remain together at last. As a response to it, the mother recalled her family of origin in relation to a role of money in distorting family relations, claiming instead: I would like stories to be made to unite both parents and their children. D tells me everything...I trust her...although she may meet grown up girls...with their habits...at the time I went to school my mother had no fears, there were no dangers. As a boundary between mother and child was established both would pretend to ignore it maintaining fear issues they shared. In order to show the differences between both mother and child rather than to stress the complementaritys of their stories the therapist started commenting on the mothers storytelling role as well at her listening during the girls story-telling: While you read your story you read it for yourself, you didnt look at your daughter, you stayed far from her; and after, when she told you her story, you interrupted her, you didnt ask her to show you the drawings you told her you would, nor made comments on her story. You are so caught up in your own imagination that it is hard for you to enrich yourself with what your daughter offers you. This made the mother ask the girl if she had disliked her story, and if she acted wrongly by not telling the therapists something about her nger punctures the girl didnt tell Heavens, no!replied D at the time some concealed conict in their relation with glycemia control procedure seemed to emerge. After this experience ended, in fact the mother didnt allow the child to go for a trip with her companions at the end of the primary school nor to a new diabetic education camp as the one they had come to attend, in which family psychogical education on specic matters dealing with disease and treatment was provided. Moreover they interrupted medical assistance with the hospital doctor with whom initially they had woven a very close relationship, feeling rather disappointed at this time. Since then, medical controls were kept only by the paediatrician who assisted the girl since diabetes had started. The girl was recommended to continue story writing by herself as it was understood that by such means she would reinforce autonomy in the control of hypoglycemia instead maintaining dependent from her mothers worries on her uncertain self control of diabetes. Three years later the mother reported not fearing anymore for the girls hypoglycemic episodes, since D was controlling her diabetes well. She also agreed that she herself needed some kind of psychological support, but from a psychologist that at the same time would be a friend for her. Her main concern about the girl seemed now to center upon the diagnosis of medical complications of diabetes (i.e. kidney involvement), and where and how would D live after her own death..

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The R family. The diabetc girl [P] was eight years old and carried a continuous insulin infusion-pump, since then having to be hospitalized for ketoacydosis in three different occasions. Her mother [33] showed extreme anguish for the childs lack of interest in caring for her own health; so she had to continuously watch after the childs control as if she was doing it on her own body: As she doesnt care, my fear is if something happens to her... What will take place in the case I cant be there when she needs to have me?. When the therapist asked the girl how she managed diabetes control, she remained silent and started to weep, so the mother also started weeping and explained that the girl wanted their house to be sold, in order to have enough money to travel to the US for a bone marrow transplant. The father [34 ], although showing empathic understanding and worrying for his wife, seemed rather distant from the girl. He then explained that diabetes appeared in the girl two days after his wife was discharged from a Clinic because of a minor gynaecological surgery. His wife needed to be hospitalized again when their daughter got ill, becoming so shocked with the unexpected diagnosis that she needed further psychological aid during three years. Parents also shared some worries on the lack of control of their son [11], who started somnambulism when he was nine years old -the father being a somnambulist in his own childhood too. At home both siblings fought continuously, blaming each other and frequently upsetting the father. The parents also quarreled about the education of their children. The enmeshed parent/ child relationships further seemed to update both parents own childhood relationships with their mothers: both realized they have had always a very close relationship to them from whom it was difcult to part. This enmeshment seemed to continue without noticeable modications among both members in the couple and with their children, fed by the same parting anxieties. Concerning the couple she explained on her husbands behalf: As he was the rst son to get married, his mother used to cry a lot, making me feel responsible for it, as if I were stealing him from her...she had suffered very much in her own childhood, becoming an orphan at the age of six; she had to be raised by her aunt. With respect to the girl, when she started to claim about her fears of being injected as the fundamental reason for refusing assistance from the hospital, the mother interrupted her: ...It seems to me that her real fear is that she would be left alone by us at the hospital. As both parents said they used to read and tell stories to P in order to get her to sleep, in the second interview the therapist instructed the father only to tell to the girl a story every night, during a week, while the mother would not. This was done as a means of improving his closeness with the girl independent from the mothers presence [Figure 1a]. The selected story was a recreated version of a Spanish folk tale [The moor queen], which tells about a girl that is to be taken by the king into his palace when she becomes replaced by a moor girl that transforms her into a pigeon, although nally nds a way to approach the king again under such appearance and get released by him. Also a separate task was given the father to do with the boy at the week-end. In the third interview, when the father was asked about his own and daughters comments on the story, he didnt show any hint of emotional understanding of the plot nor could he answer the

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girls questions she made about it. At this moment the mother told Ps brother to stop mocking the girl saying she was the moor queen herself. In this way, the actual interactions of the father and children in the family were displaced into storytelling. In order to detach the girl from her mothers fears and sorrows by training on a different narrative of her own, the girl [D] was asked to learn and tell the story heard from her father to the family group in the fourth interview [Figure 1c].

ST

The girl told the story remarkably well without needing any help, but while she was telling it her parents interrupted her twice. In the rst occasion the father corrected her volume of voice and speed, but the girl rejected the correction saying: I cant, and continued to tell the story on her own way. The mother interrupted her later, making a comment on the girl being abandoned by the king: The king didnt love her because she was poor. -Yes, he loved her-, replied P. The mother explained then: I dont trust her because she lies to me very often. When P was supposed to answer, the father moved the girl from her chair and made her sit in the one next to the mother. Such a parental distance regulation behaviour reinforcing closeness when the mother and child emotional fusion was at stake, was explained by their denial to accept the girls growth and differentiation from the mother. The undergoing therapeutic hypothesis made the therapist invite the family to participate in a workshop programmed for later in the afternoon, where two older women were prepared to tell a story they had produced This story, entitled The toad and the dog, told how these two characters met and helped a crippled child to recover from disability[See Method: Multiple family bibliotherapy program]. After P joined the group, she got completely involved in the activity, actively telling and dramatizing the stories together with the other children and the grannies, following a play format by which the original story was recreated into a new one (Correa & Hobbs, 2007). P expressed that she liked to participate, whereas her mother said she liked best granny Soas toad. Parents realized how the girl showed uninhibited behaviour under such special circumstances, similarly to when visiting somebody elses house. Such appraisal made it probable that both parents start praising the girls skills and responsibility at school. This new approach permitted the girl to be valued by her parents in a new situation where she could act in an independent fashion with no need of her parents help.

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Three years later, mother and child were interviewed after attendance to a multiple family education meeting: both mother and girl showed this time in a happy mood; the girl told she was doing well with diabetic control, not having shown any other troubles with pump management again; the mother felt the girls self care and evolution was OK. She said she had consulted a new doctor specialising in pumps, while continuing the diabetic controls with the hospital doctor. Discussion Family Therapy storytelling was here employed to differentiate narrative spaces of children entrapped within mother child overinvolved emotional bonds that seemed enhanced by type I diabetes difculties in symptom and metabolic control. This approach helped family members to detach from enmeshment, showing girls from both families that the storytelling interventions increased their self afrmation in their relationship with their parents, nally resulting in improvement in their diabetic care performance. Specic therapeutic interventions with stories were designed to shape the structure of the family: 1) settling boundaries by promoting new conversational settings between members, in which learned or self created stories could be further listened by parents in the family session or observed under the therapists guidance at the one way mirror room; 2) displacing the family members relations to the stories metaphoric structure -as i.e.: to childrens created or recreated stories or to comments and interactions on storytelling performances-, or else permitting parents and children to argue or to be confronted by the therapist on the storytelling roles instead of directly on their parental disfunction-. We had previously claimed that in telling stories to the family, children build up their own imaginary space that has to be respected by parents and children; and this relates to develop their autonomy and development of symbolic thought in order to learn new behaviors (Correa, Gonzlez & Weber, 1991). By telling, creating and recreating stories, children may nd a way to decentralize from an enmeshed relation with a parent, replacing it with an imaginary one that becomes a companion in the learning process. This scope supports narrative tasks to be given to children in order to build up a separated environment for the childs creativity with the story. Furthermore by opening up new narrative channels among members (Bowen, 1991), differentiation is promoted also in parents helping them to enlighten their orientation and guidance roles (Correa, Gonzalez and Weber, 1991). In order to achieve differentiation for both members of the dyad with high emotional fusion, it is necessary to consider that if over-involved children are to detach, parents also need a gain for achieving a successful disengagement. B. Bettelheim (1988) quoted T.S. Elliots advice to parents to use childrens nightmares as an opportunity to explore their own, which would benet both. Accomplishing a com mon positive emotional experience has, therefore, a two-fold effect, and Bettelheim claims the same for story reading by parents: through it, the latter could get better understanding of their own childhood, while children might nd a way of communicating with parents as well as sharing with them (Shrank, 1979). In this paper the aim of creating an enriched setting for emotional interaction would meet those mothers needs of sharing with their children actual emotional experiences that they didnt

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have an opportunity to practice with their own mothers. Bowen (1989) states that developing person-to-person relations is a rst step in differentiating from the parental family. He proposed to tell the secret family stories to the involved relatives and to ask recollections of past events with the families of origin as opportunities for starting it. We claim these same features make storytelling suitable for helping families under bereavement. Storytelling indeed is a cultural habit of recalling past events or ancient social and family myths, that survive under different group storytelling settings following a family narrative model that nurtures from a close and differentiated relationship between individuals -which could be properly characterized as inter-personal- and maintains an intimate environment for sharing conversations with deep emotional content amongst the family members at the same time that promote individuation/ differentiation in each of them. When families and other social groups undergo bereavement experiences are challenged to recreate their stories about loss (Correa, 1993a; Correa & Hobbs, 2007), that otherwise will remain the same. Inability to cope with loss and disease as well as belated mourning processes indeed are family patterns transmitted from parents to children (Paul & Grosser, 1965). M. Selvini Palazzoli et al (1982) described a clinic case where a child displayed psychotic symptoms in order to replace his grandfathers interaction with his daughter after his death. Bowen (1980) mentions among several examples the very intense emotional relationship between the mother and her schizophrenic child, whose birth happened a short time after the mothers mother death. The childs symptoms may then play a substitute for a lost family member, helping parents to avoid accomplishing difcult separation tasks from their families of origin. In the present study the two diabetic girls showed how to replace an intense and lost bond of the over-involved mothers with their own parents. Therefore vulnerability to separation stemmed from the same difculty the latter had with their own parents, being detoured through intensive control of the childs illness and treatment. Children responded with a similar behavioural pattern to parents vulnerability, fearing their own parents loss. If this is so, replacing an absent family member with another one, would aim not only to cope with loss (Paul & Grosser, 1965, Simon, Stierlin & Wynne, 1988), but to continue to be linked to the family of origin. In this experience we selected specic stories for parting experiences to be used with families dealing with unresolved longstanding grief. Also we built a bibliotherapeutic multiple family format with substitute grannies that may be seen a replicate of a natural family pathway to help children in their process of differentiating from parents, supporting a deep person to person relation with the former. Moreover mothers attending such workshops nd on storyteller grandparents substitures to play a function with their children their parents couldnt play (Correa, u.p.). Maintaining and recreating in memory specially made stories with a therapeutic objective -as literature specially selected or made for coping with separation and loss in the therapeutic aid

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of mourning (Bernstein, 1988; Gersie, 1991; Correa, 1992), as well as folk stories (Hagglund, 1976)-, may help those under bereavement to cope with desertion, creating an intimate sense of protection or everlasting closeness (Correa, Lema, de Artiagoitia et al., 1979; Correa & Vazquez, 1982).We had proposed a psychotherapeutic model for treating both the terminal patient in the dying process and his/ her family group, supporting the use of storytelling and body contact techniques as based on the natural learning of detachment in the early mother-child bond (Correa, 2006), hence providing relief from fears of unfavourable outcome and death (Correa, 1993b). Helping children to speak with their own family through literary imagination -whose narrative structure mirrors the storyteller (Correa, 1982) or the story writer (Correa, u.p.)-, at the same time that encouraging parents to understand children through their own storytelling and play languages, may prove a path for children and parents to respectively develop and respect such narrative spaces. This family narrative model helps family groups to differentiate and nd their own responses to difcult human situations as the ones of grief, by establishing and sharing narrative spaces for dealing with mourning themes and empowering every family constituent members to nd storytelling roles in order to differently express the telling of their own stories. Acknowledgements To Dr D. Schvarzer**, Lic. M. del C. Hidalgo** and Sofa Rosenfeld for helping me in auxiliar therapeutic roles. Also I wish to express my gratitude to Dr M.Giterman in reviewing the family study and to I.Glisic and M. Flesc for their help in the English writing or the paper. * Members of Area Creatividd y Comunicacin Familiar, SATF: Bs. As., Argentina. Please addresss correspondence about this paper to: Julio Enrique Correa M.D. Direcc.: Pacheco de Melo 2949 2oD (1425), Buenos Aires, ARGENTINA e-mail: jecorrea@mail.retina.ar / jezhivago@yahoo.com.ar References Anderson, C.M., Grifn, S., Rossi, A. et al. (1986), A comparative study of the impact  of education vs. process groups for families of patients with affective disorders, Family Process., 25, 185-205. Bernstein, J.E. (1988), Books to help children cope with separation and Loss, New York: R.R.Bowker. Bettelheim, B. (1988), A good enough parent, New York: Vintage Books Bowen, M. (1980), Esquizofrenia y familia, in D. Jackson, Etiologia de la esquizofrenia, Buenos Aires: Amorrortu (The Etiology.of Schizophrenia, N.York: Basic Books, 1960). Bowen, M. (1989), Sobre la diferenciacin del self, in M. Bowen, La terapia familiar en la  prctica clnica, Bilbao: Biblioteca de Psicologia Dscle de Brouwer, Vol. 2: 185- 242. (Family Therapy in Clinical Practice, N.York: Jason Aronson, 1978). Correa, J.E., Lema A.E., de Artiagoitia M, et al. (1979), Bereavement in the cancer patient  history: the story tellin attendance (Abstract), Advances in Medical Oncology, Research and

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Education, 12: 580. Oxford: Pergamon Press. Correa, J.E. y Vzquez, O.R. de: (1980), Los dos cuentos: una investigacin psicoanaltica del cuento de estructura maravillosa, Ludo : 4- 5: 10-29. Correa, J.E. & Vzquez O.R. (1982b), Telling stories to terminal cancer patients, XIII International Cancer Congress (Seattle), .Abstracts: 497. Correa, J.E. & Doval,A. (1989), La narracin de cuentos dirigida a la educacin diabetolgica  de familias de diabticos infanto-juveniles. XXI Interamerican Congress of Psychology, Buenos Aires, Abstracts: 99.E. Correa, J.E., Gonzlez, O.B. & Weber, M. S. (1991), Story telling in families with children: A therapeutic approach to learning problems, Contemp.Fam.Ther., 13 (1), 33-59. Correa, J.E. (1992), Story telling for the family of a dead child, 11th International Congress of Group Psychotherapy, Montral, August 22-28, Abstracts: D3.02b. Correa, J.E. (1993a), Story telling to the bereaved group and group recreation of the story,  Rsums des communications du 10 Colloque de lAssociatin des art-thrapeutes du Qubec, Montral: 8. Correa, J.E. (1993b), Facing fear of cancer and unfavourable prognosis: creation of stories  together with ill children and their families, Rsums des communications du 10 Colloque de lAssociatin des art-thrapeutes du Qubec, Montral: 7. Correa, J. E. (2006), Modelo de terapia familiar en pacientes terminales: las tcnicas del  aprendizaje natural de la separacin materno-lial, Acta Psiquitrica y Psicolgica de Amrica Latina, 52 (2): 127-135. Correa, J.E, Childrens literary imagination: a hidden language leading to communication with  the family, (Unpublished paper). Correa, J.E. & Hobbs N. (2007) Story telling to the group and group recreation of the story/Rcit  dun contes groupe et recration du conte un le groupe, Interfaces Brasil/Canada [in press: 7]. Doval, A., Correa, J.E. & Stuhlman, S. (1988), Diabetes y Grupos Multifamiliares, Rev. Soc. Argentina de Diabetes, 22 (Supl. Ot.), 64. Gersie, A. (1991), Story making in bereavement, London: Jessica Kingsley Publishers. Hagglund,  T-B. (1976), Dying. A psychoanalytical study with special reference to individual creativity and defensive organization, Monographs from the Psychiatric Clinic of the Helsinki University Central Hospital, 6. Kovacs, M., Goldston, D., & Iyengar, S. (1992), Intellectual development and academic  performance of children with insulindependent diabetes mellitus: a longitudinal study, Developm. Psychol, 28 (4), 676-684. Minuchin, S., Rosman, B.L., & Baker, L. (1978), Psychosomatic Families: Anorexa Nervosa in  Context. Cambridge, MA: Harvard University Press. Paul, N.L. & Grosser, G.H. (1965). Operational mourning and its role in conjoint family therapy, Comm. Mental Health J., 1 (4), 339-345. Selvini Palazzoli,M., Boscolo L., Cecchn G., et al. (1982), Paradoja y Contraparadoja, Buenos Aires: A.C.E.

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Simon, F.B,, Stierln, H., Wynne, L.C. Vocabulario de Terapia Familiar, Buenos Aires: Gedisa,  1988. (The Language of Family Therapy, Stuttgart: Ernst Klett Verlag GmbH & Co. KG, 1984). Shrank, A.B. (1979), Fairy tales for father and children, Brit. Med, J., 2, 119-120.