Fam Proc 38:391-398, 1999

IN MEMORIAM: Mara Selvini-Palazzoli, M.D. (1916-1999)

CarlosE.Sluzki, MD
The news of the death of Mara Selvini evokes in so many of us memories of the emotional intensity and the conceptual
challenge that her participation would generate in any professional event. A true diva in the best Italian tradition, she was
original, joyful, opinionated, the center of attention wherever she went, regal in the way she carried her short frame, humane
in her personal contact, and stubborn in her public attitudes. And all that while not taking the world too seriously: she was
as prone to laugh wholeheartedly at her own intensity as at others' reaction to it.
Mara Selvini-Palazzoli has been the leader of one of theif not themost influential "second generation" teams in the
field of family therapy. Her team, which included her close associates Luigi Boscolo, Gianfranco Cecchin, and Giuliana
Prata, became mesmerized by the novel paradigm conveyed by Watzlawick, Jackson, and Beavin's "Pragmatics of Human
Communication," and seduced by the work that inspired it, that of Gregory Bateson and his co-workers Jackson, Haley, and
Weakland. And breaking rank from the Italian psychoanalytic establishment, they defined themselves as systemic
(cybernetic, Batesonian) family therapists. They carried that definition into their daily practice as a team and their constant
reevaluation of their models. In 1980, they took the world of family therapy by storm with the publication in Family
Process (19:3-19) of their landmark paper: "Hypothesizing, Circularity, Neutrality: Three Guidelines for the Conductor of
the Session." (That team's first paper in English"The Treatment of Children Through Brief Therapy of Their
Parents"had also been published by this journal in 197413:429-442.) From then on, the visibility of what became
known as the Milan team grew exponentially. They became the most influentialtraining team in Europe, and in the United
States after an early visit to the Ackerman Institute and to the Mental Research Institute (MRI). In the years that followed,
the team split in two and Mara continued her work with Giuliana Prata; it split again years later and Mara reorganized her
team with a younger group that included her son Mateo, Stefano Cirillo, and Anna Maria Sorrentino.Mara called what she
was doing "research," and with reason: she would take a viewpoint and explore it clinically to its ultimate consequences.
Over and over again she would catch her audience and followers by surprise by stating in major conferences and in
important articles that the beliefs she had held until that moment as truth were totally erroneous ("How could I have been so
blind," she would exclaim), and that another angle of attack was "the correct one"again, a way of guiding her own
explorations with as little ambivalence as possible. So, in different periods of her evolution she was totally immersed in the
treatment of anorectic patients, in paradoxes and counter-paradoxes, in the invariant prescription, in psychotic and other
family games, and in new explorations of the inner space.
The influence of Mara Selvini is lasting. Suffice to say that she and her team's 1980 emphasis on what are the operations
that guide the systemic therapist's behavior shifted the attention of the field away from the family-as-object-of-observation
to include the therapist and his or her operations; and by those means they opened an early door to the conceptual process
that allowed postmodernism and narrative approaches to enter into the field of family therapy. Interestingly enough, Mara
professed herself to be rather anti-postmodern. Indeed, this traditional, conservative lady in her daily life, would (using an
expression she recommended we use) behave as if she would believe each time that whatever she was describing was not a
construct but a thing-out-there. But, let's face it, that "thing" would be once and again treated first as holy and then with
irreverence, revealing her view of the world of ideas as an evolving, never-ending process. She contributed to this process
with powerful, rich, challenging modelsand modeling. For, in addition to the above, she was a nice, warm, caring, loyal
human being.
We may all join in telling her: "Addio, cara diva, e tantissime grazie!"
Carlos E. Sluzki, M.D.
* * *
Mara Selvini died last July 1999 in Milan. When a significant person leaves us forever, a series of images go through
your mind. If she is still alive, you think, you will have the chance to check your fantasy with reality. But we can't do this
again with Mara.
Then who was Mara Selvini? The first Images that come to my mind are of a loving and friendly Mara behaving like a
peer with whom it was fun to spend time. There were other moments, however, when she would suddenly appear rather
distant as if she were part of an aristocratic circle. In our working time together, she was the one who mostly decided the
rules of relationship. Then she would behave in a bossy way. But, again, at times, you could suddenly notice in her a meek
and obedient attitude, ready to put herself completely in your hands. She loved to perform in front of hundreds of people,but
at other times she was very shy and looking for protection. One thing was always very clear: nobody could ignore her
presence.
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The last time I had a chance to work with her was in the fall of 1999, a few months before she fell sick. We were part of
a committee set up by the city of Milan to decide now to organize some services for the increasing number of anorectic girls
flooding the different clinics, which the press had begun to notice because some deaths had been reported. The other
members of the committee were mostly psychiatrists who were in charge of different psychiatric services in the region. It
was clear from the beginning that their interest was to get funds to enlarge their services of inpatient treatment to include
anorectic patients, clearly defined as a organic syndrome. (Most of their temporary assistants were waiting for a permanent
job.) As in most Italian stories, everything seemed to have been decided beforehand.
When Mara got a chance to speak, which was not easy, she began to explain that anorexia has mainly sociocultural in
origin, and that the family was crucial in helping to cure the disease. To lock up a girl in a hospital and inundate her with
medications, which she would refuse to take anyway, was totally useless. To organize small units, 2 or 3 professionals
already in the area, ready to receive calls from anyone in touch with the eventual anorectic girl, or the girl herself, and ready
to talk to the people involved, was a better preventive measure. To hire a psychiatrist, a social worker, a dietician, a
psychologist, a number of nurses, and to build a new unit was a pure waste of money.
People were listening, apparently amused by her performance, but immediately changed the subject when she stopped
talking. When she again had a chance to talk, she would find new arguments to defend her ideas, but the result was the
same. During a break I asked her, "Don't you see that they have no intention of listening to what you say?" She said, "I don't
care, I have to say what I think. Someone will listen sooner or later."
That was Mara, at age 83, behaving as she used to 25 years earlier when with Boscolo, Prata, and myself, she was
convinced she had to create a Family Therapy Research Center in Milan. Not intimidated at all by any critical comments,
she took great pleasure in fighting for what she thought was a good idea.
People were fascinated by her or totally annoyed. Therefore, she had many friends, especially young women who saw in
her a powerful role model, but also many enemies who could not tolerate her flamboyance (especially the politically correct
doctors and psychologists of the establishment. Her trust in her capacity to think clearly was contagious, especially with our
team. She could overcome our tendency to doubt and to procrastinate, and would inspire in us a sense that change is
possible in ourselves and therefore in our clients.
Her faith in her ideas did not mean she was a fanatic. In fact, every few years she would declare that everything she did
until then was to be forgotten and a new phase had to begin. She did that when she started the team with us and she left
behind psychoanalysis. She did that again when our team broke up. She started a new one declaring that she had left behind
systemic and paradoxical therapy (whatever that meant). This, of course, created a lot of confusion in her followers. As
soon as they felt at ease with an approach, she would declare it pass. For me, she provided a good example of the concept
of "temporary truth." One is very loyal to one idea as long as it fits the social, therapeutic situation. Then a new idea would
appear that makes the old and the new circumstances, which invariably develop, more coherent with each other.
Mara had no doubts about her strong sense of who she was. That came, I think, from her strong religious beliefs. We
family therapists who practice the so-called Milan model, would not do what we are doing without her powerful influence.
Gianfranco Cecehin, M.D.
* * *
Meeting Mara was one of the happiest and most important events of my personal and professional life. She was an
extraordinary woman, full of passion for living, learning, teaching, and understanding others. Her authentic religious faith
permeated her whole existence. I remember that whenever we were travelling as a team, she would ask us to help her find a
church for the Sunday Mass. Mara's self confidence and optimistic view of the future made her the driving force of our
work as a team, along with G.F. Cecchin and G. Prata.
Her enthusiasm and fertile curiosity were contagious. The climate at our Center was one of optimism and expectation of
important results. She had the rare gift of combining an innate aptitude for leadership with a respect and consideration for
the contribution of her colleagues. As a matter of fact, the team's relations were characterized by a spirit of mutual esteem
and productive collaboration. I was always fascinated by the many aspects of Mara's personality: the serious "professor"
and researcher, the joyful colleague, the ordinary housewife who went every morning to buy food for her family, and, lately,
the lovely grandmother.
Her scientific interest and her strong professionalism combined harmoniously with her profound humanity and her
capacity to enter in contact with people, either with clients who often remained hypnotized by her rich personality, or with
colleagues.
I remember how, when conducting a family therapy with her, the women in the family "would have eyes and ears only for
her," and the father and I would feel completely left out. When I tried to talk, the women would shut me off, the same way
one flicks off a bug from one's shoulders. After two or three sessions of this, I would look at Mara and say in a loud voice:
"Mara, I don't agree with what you are doing. Let's get out!
"The women would look at me as they would at an unwelcome intruder, while Mara, suddenly, would look at me with the
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expression like that of a little girl in awe in front of her father. The father in the family would wake up and straighten
himself on his chair, looking at me with an expression of approval. Mara and I would join the colleagues behind the mirror
and just chat for a few minutes. As we rejoined the family, with a dramatic tone I would reveal why I was disagreeing with,
Mara, who silently agreed. From then on, men became as present and important as the women!
Working in a team enriched all of us personally and professionally. It created a bond that made us become a kind of
"family" that found great pleasure in working and discovering together new ways of helping people.
Luigi Boscolo, M.D.
* * *
Mara Selvini-Palazzoli died in July of this year. She was born on August 15, 1916, the youngest of four siblings. Her
father was a wealthy factory owner and a lover of racehorses. In one race he even won the Grate Prize of Paris. But since
his passion for horseraces and the demands of a large company were apparently too much for one person, Mara's mother
increasingly substituted as the business manager. She was a very religious woman and totally devoted to her husband. This
resulted in her having relatively little time left to take care of Mara. Therefore, Mara was given to a wet nurse by the name
of Balia Rosa who was living in the country. Mara spent the first 3 years of her life in her care. At age 3, around the end of
the first world war when she was returned to her parents, she wanted to run away and would ask the people on the street to
bring her home to her wet nurse in the country.
She studied medicine at a state university against the wish of her mother. Mara's parents expected her to marry, have
children, and stay at home. Instead, she became one of four women out of a hundred medical students. In 1947 she finished
her specialty training in internal medicine and soon thereafter married Aldo Selvini, who later became well known as a
cardiologist. A little later she turned to psychiatry, and finally found her way to family therapy, again and again surprising
her many friends and acquaintances because of her determination to do her own thing, her high energy level, her curiosity,
and her readiness to take risks.
I remember meeting Mara for the first time in the early sixties on the occasion of a small psychiatric symposium in Rive
de Prangins in the French part of Switzerland. At that time she worked as a psychoanalyst and was passionately involved
with young girls and women who suffered from anorexia nervosa. At this time, she was already becoming curious about
what was going on in the United States where authors such as Gregory Bateson, Lyman Wynne, and Ivan
Boszormenyi-Nagy had began to initiate and revolutionize the field of systemic and family therapy. From that time on I met
with her repeatedly.I remember vividly a speech she gave in the early seventies at an international psychotherapy congress
in Oslo. And I remember also the disbelief and skepticism with which the attending psychotherapiststhe majority of them
probably psychoanalystsresponded to her discourse. She reported how she had made an 180-degree turnabout in her
understanding and treatment of anorectic women. She had changed from a psychoanalytic to a systemic approach. There
were several similar turnabouts in her subsequent psychiatric career. Such was the case when she turned away from
paradoxic prescription to the invariant prescription, or when she, in the last years of her career, moved again closer to
psychoanalysis, thus, as it were, completing the circle.
One could ask whether Mara's urge to be innovative and provocative has always served the cause of family therapy. I
remember how, in 1985 in New York, she was awarded the Annual Research Prize of the American Association of Marital
and Family Therapy, and how in her acceptance speech she described the parents of schizophrenics as players in a dirty
game in which their schizophrenic offspring was the loser. That speech then got a lot of media coverage and most likely
caused a good many parents of schizophrenics to stay away from family therapists.And yet: How much poorer would we all
have been without her intelligence, without her vitality, her Italian temperament, her joy of life, and her dare-devil
provocativeness. I shall never forget how she, at the occasion of one of our big Heidelberg congresses, played Gertrude in
the theatre sketch "Instant Hamlet." Her counterpartwas Paul Watzlawick as Claudius. Both made an unforgettable pair. I
remember also how Mara at the same congress was, with six men, the only woman at the concluding panel. This then led to
complaints from some of the attending feminists, to which Jrg Willi, the moderator of the panel responded, "A woman like
Mara easily outweighs six men." And should there be a heaven, in which Mara as a devout Catholic perhaps believed, we
would like to send you this message: "Dear Mara, we shall greatly miss you!"
Helm Stierlin, M.D., Ph.D.
* * *
It's hard for me to remember what family therapy was like before Mara Selvini-Palazzoli came on the scene. Coming
East from California in 1965, I found a strangely innocent field, untouched by the insights of systemic thinking and circular
causation that I had found so compelling in Palo Alto. When I first read Paradox and Counterparadox in 1978, in a rough
translation done by a colleague at the Ackerman Institute, Gillian Walker, I was electrified. Here at last was a new approach
that built upon the ideas of the Bateson group. Better yet, here was a setting that welcomed them. My colleagues, Peggy
Papp and Olga Silverstein, who had brought brief therapy to Ackerman, had seen Selvini's team in action the year before
and lost no time in getting them to demonstrate their work in person.
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You have to imagine a tiny viewing room packed with people sitting on bleachers and waiting for the Milan Team
members to appear. They did not disappoint. Selvini came in with what I could only think of as her retinue; despite her
short stature, she held herself as regally as Queen Elizabeth. Treating us to her famous throaty laugh, she introduced the
team and spoke a bit about the way they would conduct the interview. From my reading of their book, I assumed that they
were going to take the paradoxical intervention of the MRI group one step further. Instead of merely "prescribing the
symptom," they were going to prescribe the entire relationship system that upheld it.
Family therapy at that time included the symptomatic person and relevant family members. Breaking with this tradition,
the Milan group also included any closely attached helper. In this case, Joel Bergman was to bring in the family of a young
man who was severely agoraphogic, together with a social worker we called the "Significant Other." The receptionist
phoned the therapist to say that they had arrived and were on the way upstairs.
So we waited. And waited. And waited. I remember Mara sitting cooly expectant, with her trademark large purse on her
lap, while the watchers fretted and muttered behind the screen. Finally a disappointed Bergman came into the interviewing
room. The family was stalled on the second floor. The young man had sat down in the middle of the staircase, despite the
exhortations of his parents and the social worker, and refused to go any farther.
In the case of a no-show, we usually just swallowed our disappointment and spent the time analyzing the family's
"resistance." Imagine our surprise when Selvini took thenews with apparent relish. Addressing Bergman, she said, "Very
good! Tell the family that the Milan Team will hold a consultation anyway. They can go now, but we will compose a
message for you to give to them the next time you meet." We all watched, dumbstruck and fascinated. The team then
proceeded to have a discussion about the contents of this message would be.
I remember being most struck by the way the group included its own situation. In the message they crafted they said,
"Here is the message from the experts from Milan: In Milan, we see many, many young people who cannot leave home, but
they live with their parents or remain supported by them, not leaving their room, not getting a job, not having friends. In
most cases, the reason for this is the fear that if they did so, they would leave their parents in a state of intolerable
loneliness. In Milan, we have found that 85 percent of these young people eventually get a job, move out, and so forth, but
15 percent cannot. If we were in Milan, we would know what to say, but here, as we cannot predict which group this
particular young man might fall into, we cannot make any further statement. Thank you very much. The Milan Team."
I don't remember what effect this intervention had on the family, but its effect on the community of therapists who
witnessed it was profound. I began to make an annual pilgrimage to Milan to watch Selvini and the team, and after Luigi
Boscolo and Gianfranco Cecchin began a training institute, I would attend their yearly "team's meeting." I think it was
Selvini who first used Bateson's word "systemic" to describe their work, and I picked it up and pushed it. Eventually, Milan
Systemic Therapy established itself as the main family therapy approach in many countries in Europe and the U.K.
Through all these years, even after I moved on to other points of view, Selvini remained an enthusiastic and endearing
friend. She was one of those unusual women in our field I now call "scholar-therapists," innovative practitioners who
valued ideas as much as techniques and whose work was as much a research calling as a profession. Cecchin used to say,
"Never marry your hypotheses," and Selvini was a remarkable example of a person who came up with brilliant ideas,
probed them assiduously, and dropped them when experience proved her wrong. Her fascinated pursuit of the secrets of
family therapy resembled that of a big game hunter stalking his prey, and this spirit was contagious. It also inspired a rare
affection. Unlike other therapeutic research teams, which often broke apart with acrimony, Selvini's former partners never
stopped loving and respecting her, nor did any of her students and colleagues, including myself.
Let me share one more example of her vivid presence. On one of my early pilgrimages to Milan, in 1978, I was sitting
behind the screen with Cecchin and Selvini while Prata interviewed the mother of a 6-year-old boy. He was referred to the
team because he had stopped talking since the previous Christmas. He would run around the room, and if anyone addressed
him he would stop, nod, and say, "Si." Prata was trying to find out what had happened during that Christmas time and had
found out that the family had spent their Christmas alone. Back stage, I noticed Selvini get up to watch more closely. Then
she said, "A family, in Italy, having their Christmas dinner alone? Without their relatives? Impossible." Then she intoned,
sounding much like the Giant in "Jack and the Beanstalk:" "I smell the rotten meat." And she suggested to Prata that she
find out more about the parents' families.
Prata discovered that, before Christmas, the couple had moved from an apartment that was near the wife's mother to an
apartment near the father's mother. As a result,the wife's mother refused to join them for Christmas dinner. On Christmas
Eve, after a horrible quarrel, the wife had put the little boy in bed between her and her husband and since that time had
refused to have sex with him. In the final message, Giuliana asked the little boy if he knew how important it was for him to
keep his parents from being angry with each other at night by getting into bed with them. The little boy looked up and said,
"Si," with such a knowing smile that I was sure he understood.
I don't remember if the child then started to talk, but the parents certainly did. And I took away, and still keep, such a
strong impression of Selvini's active mind, her generous presence, her expansiveness, her humor. Someone once said that
Picasso was a "discontinuous genius." In the field of family therapy, Mara was the same. I shall miss her.
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Lynn Hoffman, M.S.W.