Finding Our Place in the System
Since 1983, Dr. Sara Genstil, Ph.D. has been practicing psychology using the Intersubjective Systems Theory. She uses this treatment modality for individuals with various conditions, such as depression, anxiety, eating disorders, trauma, relationship issues, etc. Dr. Genstil is available to see couples and families privately as well. In addition, she treats bereaved families through the Ministry of Defense and terror victims through National Insurance (Bituach Leumi).
What is your background?
After completing my B.A. and M.A. in Social Work at the University of Southern California (USC), I became actively involved in the Jewish and Israeli communities in Los Angeles, which was a very rewarding experience. I felt I was contributing to the bonding of the two communities. However, in my work with patients in the Jewish Family Service of Los Angeles, I felt that I hadn’t the extensive knowledge required to really bring about change. Therefore, I decided to continue my education toward a Ph.D. in Clinical Psychology at the California Graduate Institute (CGI) with a psychoanalytic orientation.
After completion of my Ph.D., I did a post-doctorate with Robert Stolorow, Ph.D., the global leading authority in Intersubjective Systems Theory. The knowledge that I gained from him made me feel that I had finally acquired the depth and expertise that would enable me to truly help patients achieve the changes they desired. Over the years, Dr. Stolorow became my supervisor and mentor and is my guiding voice to this very day, especially when I am dealing with a patient with deep psychological issues. My relationship with him enables us to consult and brainstorm together on appropriate therapeutic interventions.
What is the Intersubjective Systems Theory?
The basic idea is that no person lives in isolation. Every individual is part of a system, and in fact, of many systems, defined by various common terms such as family, couple, mother-child, teacher-student, to name a few. In order to understand an individual’s behavior, we must understand the systems in which the individual functions, together with the subjective experience of each member within each system. The degree to which a system is healthy or unhealthy results from the role of each part of the system (i.e., each individual in the system).
This means that a healthy system can only be established by each individual examining themselves and their behavior within the system, “Am I responding adequately to my (spouse, child, friend, employer, etc.)?” In other words, we must focus on ourselves and try to adapt our behavior in relation to other individual(s) in the system.
It’s important to emphasize that every individual’s perception of the world is based on experiences from early infancy and throughout life, which shapes their individual world view (defined as their “organizing principles”). In order to improve a system, we need to identify the organizing principles that influence their behavior, especially in cases when this behavior causes friction or conflict. In other words, the ideal way to improve a system is for each member to take responsibility for his or her own actions. When one part of the system changes, the entire system will change as a result.
In therapy, the implication of this approach is to understand a patient’s organizing principles. For example, I had a patient who all her life had been told she was stupid. Her parents and teachers expected very little from her and thought she was incapable of achieving anything. These messages affected her to the point where she believed that she was incapable. This became her organizing principle. Until her early 40s, she did not pursue higher education and accomplished very little professionally, working as a sales person in a clothing store, and living her life in the belief that she was worthless. She came to therapy as a result of depression, difficulties in relationships and low self-esteem. During the course of treatment, once we had identified the subjective system in which she was entrapped, we were able to make changes. Of course, sifting through all the emotional baggage she had accumulated during her lifetime made it a long process. Gradually she began to connect with her true self and true abilities, and became aware that her former perceptions were false. Subsequently, she not only went to college, but succeeded in obtaining an M.A. in Education with high honors. Her goal was to make an impact on the educational system that had failed her.
Can problems arise due to unknown trauma?
Over the years, I have worked with numerous women who had trouble connecting with men and consequently hadn’t married. For example, I had a patient who was 32 years old and unmarried. Through the process of therapy, she revealed that she had been molested when she was about 10 years old and had never disclosed the secret to anyone. She had formed the perception that “men are dangerous.” Anytime she tried to connect with a man, she subconsciously sabotaged the relationship and backed off. Once we identified the trauma and its impact on her behavior, and confronted her fear, anger, misery and the secret that she’d kept even from her mother, we managed to work through it and enabled her to realize that the person who had molested her was dangerous, but that this was not true for all men. In other words, she replaced her former organizing principle with a new one. Eighteen months later, she married.
Are there traumas that cannot be overcome?
Generally speaking, the earlier a trauma occurs, the harder it is to overcome. A 26-year-old female medical student came to me for treatment as a result of anxiety and an inability to connect with men. During the course of treatment, she revealed that her infant and toddler years were spent on a kibbutz, and as was mandatory at the time, all children slept every night in the designated children’s house. Her caregivers reported that every night she had protested and cried. Being forced to separate from her particularly loving and caring parents for those first three years of her life led to severe trauma, which developed into anxiety and an eating disorder. This trauma left such an indelible mark on her being, that even after working together for years, she is still unable to fully connect with men. She was able to resolve her anxiety and eating disorder and recently sent me an e-mail saying that she holds the position of head of a department in an Israeli hospital. However, she has never married.
Do you have any parenting tips for our readers?
Winnicott, a great psychoanalyst, answered this question by saying that the best tip for parents is to provide “a relatively good environment.” Obviously, parents aren’t able to be present at all times and all parents make mistakes. It’s enough if parents meet a child’s basic needs most of the time, but only if both physical and emotional needs are met. It is critical to build “basic trust” by creating as solid an attachment as possible between a parent and child, but within the framework of a family set of boundaries. Another major tip is to encourage a child’s development in physical or motor, sensory and emotional areas.
Any final words of wisdom?
Every client is like a puzzle. And every client brings a new piece of their puzzle to each session. My role is to assist patients to fit the pieces together and see the whole picture – an entire being that makes a whole, complete puzzle.