Introduction by Meena Mahey

It was scheduled as a day long workshop run by the program director, Caroline Lieber and a professor, Marvin Frankel. Having been out of a school context for two years I was apprehensive on my reentry to a graduate program. I was put somewhat at ease as I took my place at a round table with my peers and noted that Caroline had brought some fresh foodstuff for us. That consideration touched me and as we each took our turn, paper plate in hand, getting our muffins and yogurts, I was able to relax even more.

Caroline spoke first, welcoming us once again and then introduced Marvin. It was evident to me that the two of them were very fond and comfortable with one another though each spoke in a different voice. Caroline spoke to us as a group and I enjoyed the satisfaction of taking in her words without feeling any obligation to respond. Marvin’s approach was the opposite. Though we sat as a group around the table he spoke to each and every one of us as if each of us were alone with him in that room. It was an eerie feeling.

He was both welcoming and challenging as he described his course as a practicum on the communication of an empathic understanding. I knew somehow that this word was going to have a much more profound meaning for me as a result of this course. I had this trust because of the way Marvin seemed to be talking us into his confidence. It was evident that he wanted to know us but not as objects to be analyzed but known on our own terms.

I sensed the potential for creating relationships rather than discovering them or accepting them in conventional categories such as teacher and student. Consequently, I was challenged and apprehensive. I was not particularly reassured when he informed us that it was impossible to fail his course and that no one in fact ever had.

I was especially intrigued when Marvin announced that the course would not involve role playing as it had traditionally. Instead we were going to learn how to speak to one another in challenging and yet empathic ways. It was to be a seminarcentered educational experience. Could we create a community borne of a shared sense of our differences with one another? Each of us, including Marvin was at once a helper and one being helped; a teacher one moment and a student the other; a speaker and listener. I was captured on that first day. The faces of my peers revealed to me expressions of wonder, curiosity and yes, irritation.

Unfortunately, the class as a whole failed in this endeavor though for me the failure and the reasons for it were as instructive as any success could have been and that is the ultimate tribute that I can give to a teacher.

Word has it the next year’s class was a total success.

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Meena Mahey's Interview with Marvin Frankel

When did you start teaching in the Human Genetics Program?

In the mid 70s I think

In teaching genetic counseling students, what is it you hope for them to learn?

How to demonstrate an empathic understanding of another person by remaining entirely within their narrative framework and I wish to emphasize the word “entirely.” In general conversation people must show some degree of empathic understanding of one another; otherwise communication is not possible. At this moment I am giving you answers to questions that I believe you will understand. Another person asking the same questions might get somewhat different answers. But— am speaking out of my framework and you are speaking out of your framework and our empathic understanding of one another is implicit rather than explicit. You have these questions that you think are important that you want me to consider. I am teaching students not to ask such questions but to rely entirely on the narrative of the counselee for whatever questions might arise.

Can you give an example?

Yes, I can. When I was interning as a client-centered therapist I had a client who had sensual attachment to leather handbags. Mind you that was not the reason he came into therapy but in the course of my empathic responses he decided to let me know that. I responded empathically. He informed me of the differences in the tactile feel of different leathers and how suede just didn’t do it for him. He informed me of the anatomy of different materials. As I listened to him I wasn’t thinking: does he realize how crazy this is? I wonder why he rejects women. What is his relationship to his mother? Instead, I gave responses like: “ That handbag was expensive but for you it was well worth it.” Or, “Even though you had a cover story you were frightened the salesgirl would somehow know you had a “thing” for handbags.” I remained entirely within his narrative framework. I never analyzed the healthy or unhealthy aspects of it. I related to his narrative in the same way as I would if he were talking about a woman.

Did it work?

(laughs) Did it get him off handbags?

Yes but why did you laugh?

Because that is the normative judgment and would have been my judgment if I were being trained in a different school of thought. But, no, not while he saw me, but he did, without my asking a single question, talk about women, his mother and his sister. He did talk about why he preferred his handbags to women. He spoke about broken marriages, shallow love relationships, the normal deceit between people, pornography and concluded that he had none of these problems with his handbags. So, did it work—yes, he decided to stick with handbags and realized in a clearer way why he had better keep his sexual orientation in the closet. He thought the therapy was successful.

Why do think this is a good approach for genetic counselors?

There are a number of reasons. First, the relationship of a genetic counselor to the counselee is a very brief one-a single appointment much of the time and lasting about an hour. During that time the genetic counselor is giving hard and at times threatening information that is difficult to understand. During this stage of the interview the counselor is being implicitly empathic by adjusting her vocabulary and intonation in a way that relates to the counselee’s questions and demeanor. However, there comes a time when counselees react to the meaning the information has for them. How do they feel about it? Do they feel challenged? Depressed? Anxious? Angry? Frustrated? Intrigued? Guilty? Anguished? Each of these responses frames a very different narrative, a different story. The first reaction people of good will have is to fix things—say something that alleviates the distress or stand helplessly by and watch wanting to help but not knowing how. Teachers are often confronted with a student crying and I believe that recently some got together to discuss what should be done. The point of my course is to follow the trajectory of the distress by your manner and words and to offer solace only by means of acceptance. By accepting that narrative and demonstrating that acceptance through empathy the genetic counselor is a major catalyst in instigating the self-examination that is required for the counselee to come to his or her own understanding and resolution. The genetic counselor can I believe short circuit this introspective process by offering conventional clinical insights or advice.

Can you give an example?

Yes, some genetic counselors suggest a counselee who may be wondering about terminating a pregnancy because the fetus shows a particular abnormality read a book about people who chose to have children with severe birth defects. These narratives describe the difficulties and expense attached to the raising of such children and that is informative but the parents are invariably glad they did not terminate their pregnancy. I don’t know of a compilation of narratives of parents who chose to terminate their pregnancy. In other words, the counselor who suggests such a reading is unwittingly propagandizing one resolution over another. A key element of the course is to inform the future counselor that even if they had the wisdom to give it is unlikely to transform the counselee. Billy Graham may get many people in his audience on their knees at the end of his sermon but I doubt more than a few of the hundreds who have come before him remain in that humble posture for very long. I can pep talk just about anyone but sermons, wisdom just doesn’t work. If it did philosophy professors would be wiser than the rest of us but I would bet more than a dollar that if any one of them reads this interview they are smiling.

Are there obstacles that make it difficult for the student to accepting this perspective?

There is first the belief that if you provide a certain insight—something from your own frame of reference-you can profoundly help a stranger. Unfortunately, the genetic counseling literature encourages such a view.

But you don’t believe it?

Utter nonsense—People who write such stuff must have brains of mush.

You seem a bit upset by this—

People do not change their perspectives easily. Just look around you—every obese person you see has probably been told by a doctor the consequences of their obesity; every smoker the consequences of their smoking. The early promise of psychotherapy has failed---I was watching the Importance of Being Earnest the other day and the young woman Gwendolyn is in love with a man because his name, she believes is–Ernest—Here is Wilde poking fun at the superficial trappings that capture our passions. The play is so witty that you can only imagine that the author could never himself be drawn to a shallow, superficial person but it was his downfall that he was—I am convinced that the wisdom we proclaim to have is invariably a wisdom we are, ourselves, reaching for.

How do students react to this perspective?

I don’t know.

How can you not know?

Well, the students can learn to impersonate me and respond empathically in a role playing situation—I am not saying they would do this in a premeditative and cynical way but may simply do it because they are in a course that requires it. My sense is that I touch very few students and I say this because as I read the literature my approach has been ignored and I have had my hand in training many of the genetic counseling students in the country.

Have you written about this?

I have published these views in psychology journals and books but never for a genetic counseling audience. I have a first draft of a book on this subject but it requires another draft.

Aside from the doing of empathy what other obstacles are there to this approach?

I have alluded to one obstacle before and that is the desire to make people feel better and offer verbal bromides to accomplish this goal. A second obstacle is facing just how difficult changing is—we are not as free as we wish to be. We are in bondage to the knowledge that we possess.

In bondage to knowledge?

Isn’t it generally assumed knowledge liberates us—Well it doesn’t—The more knowledge we have the longer may be our leash but you have to distinguish between information and knowledge.

Can you explain?

When you get a PhD you have amassed a great deal of information but in my terms it becomes knowledge only when it is integrated with action.

We seem to have gotten far from the subject

Not really—the course focuses on genetic counseling but it is also about attitudes towards with the issue of what constitutes knowledge and wisdom and untoward power. After all, to be a counselor you must have something to offer by way of counsel—

Where does power come in?

Every authority figure has the power to affect the shape of the narrative of a person who is under that authority. Just as a teacher should disempower themselves to their students so must a counselor disempower themselves to their counselees.

But they look up to you as their professor—how do you get off that throne?

Not easy. I tell them what I tell the undergraduates—I cannot be relied upon for any special wisdom any special maturity. I don’t know what it means to be an adult in a teacher student relationship, and I don’t have more information, but if they met without me in class and discuss the readings by themselves they might learn a hell of a lot more without having to worry about my evaluations. The good normal class is from my perspective an educational prison cell.

That’s putting it pretty strongly.

Can’t be strong enough. I have had students tell me what their professor said-a professor they liked and respected and I would suggest a question they might put to the professor-I have one in mind right now—The student loved the question but when asked if he would raise it said he wouldn’t because it would undermine that professor’s entire perspective on literature. I agreed that if that professor actually said what the student claimed he said the professor would have a difficult or fun time answering. But my point was that this student who claimed to be comfortable with this professor discovered that he wasn’t; he discovered that his questions were shaped by a sensitive and inappropriate concern for his authority. Now I know this particular professor would welcome the question and I told the student that but he never asked the question and this professor never learned the student was afraid of him and yet they have a perfectly ‘normal’ healthy relationship. In any case, the students in genetic counseling must realize that they like MDs have too much power in the sense that they can unwittingly intimidate and force the counselees to unwittingly censor themselves, their concerns and vulnerabilities.

Do you succeed in disempowering yourself as a teacher?

I don’t know but I do display how burdened I am by such presumptions. Certainly I am successful with students when I convince them that words such as maturity, wisdom simply do not apply to me any more than it may or may not apply to them and when they realize the same dim illumination that guides them guides me as well and like them often I live in the dark I do feel there is an openness between us that didn’t exist before, an openness that allows for mutual learning. Of course, this process is on a continuum. I more or less succeed with each student. But there are students who insist I be parental and wise and protective of them from themselves.

Do you generally know who they are?

They are usually humorless.

That’s funny.

I think so but they don’t.

So you are not the teacher for all students.

Not anymore than the friend of all strangers.

You’ve explained how the empathy you teach is different from the everyday implicit empathy that takes place in conversation and you have explained how this requires the counselor to realize the limits of externally conveyed “insight” or “advice”, and finally how the counselor, and for that matter the teacher, must disempower him or herself to liberate the narrative of the counselee or student. Have I understood you?

That was rather remarkable, but I realize on hearing me through you what I left out. When you follow a person empathically as I am suggesting you must be willing to be utterly transparent. Empathy can be effective with people and by effective I mean people can be comfortably self-critical and open to what otherwise might be very threatening material only if they feel completely accepted by the counselor or teacher, friend or parent. One way to convey such acceptance is to convince the person you are speaking to that you would be quite willing if you can to be transparent. In this regard I suggest a thought experiment to students. If there was a button on their elbow that they can press and in doing so allow the full text of their thoughts and feelings to appear on their forehead would they press that button when speaking to a counselee? The counselor who is prepared to remain entirely within the framework of the counselee would be happy to do so. Many students have told me that they would not want to be transparent like that with anyone. They rationalize their conviction by stating everyone needs their privacy. But they know that is a rationalization because it is obvious to them that they give many people in their lives the definite impression that they are trying to be transparent when in fact they have qualifying and even hostile thoughts when in the company of others. In the counseling or educational context the more willing I am to be transparent the more accepted the counselee or student may feel.

You seem to be saying that the course has significant implications for everyday life beyond the genetic counseling context.

It does if you want it to. The course does provide the student with an option they might not have had before. That option could be threatening.

Why?

Imagine you are in a conflict with your husband. You believe you are right and he is wrong. Now suppose you decide to follow your husband empathically for about an hour instead of debating him. What may well happen is that you begin to appreciate the full complexity of his perspective and in doing so right and wrong seem like superficial categories or you can discover that he is indeed right—two out of three times your righteous stand can be undermined. Depending on how much you need to be right this outcome can be threatening.

Has your approach to teaching this course changed through the years?

Up until a few years ago I concentrated on the hypothetical genetic counseling interview and role-playing was a principle vehicle for teaching empathic listening. I was always dissatisfied with the make-believe quality of that kind of learning and I didn’t think too much was learned. A few years ago, I decided to make the seminar, the relationship between the students and the students with me the laboratory for discovering the power of empathy as well as the unwanted censorious power of the authority figure, the teacher, me.

How did you do that?

I announced my goals at the beginning of the semester. I explained how I wanted the class to be the laboratory for understanding the themes of the course but their understanding was more apparent than real. One week later I showed the class a film that I knew would inspire very different heartfelt reactions and asked the class to speak about it, offering their views only after empathically stating the view of the student who spoke before them.

Did this work?

No. The students were protective of each other and so diluted their reactions to the film to the extent that it was one of the dullest classes in my experience. These students take the same classes for two entire years and a passionate debate on their take of a film was too threatening to their affiliative bond to the group. Rather than face that issue, the students wondered why they were discussing a film that took place in Ireland and had on the face of it nothing whatsoever to do with genetic counseling. The film had much to say about anguish, sadness, loss and grief but they didn’t see it that way. What did you do? I would explain that when they were in the first grade and the teacher said one apple and one apple makes two apples they weren’t talking about apples.

That’s funny. Did they laugh?

Oh no, my attempt at humor backfired. The wit of that example only distanced them from me. But two weeks later I happen to be walking by the pub before the class was to begin. Anyway, they were so jubilant they were utterly unrecognizable to me. I knew in one hour they would show me a rather different face. When I came class that day they were what they been-a typical warm friendly class but the possibility of jubilance did not exist. I turned to one student and took a chance. I informed her in front of the whole class how utterly free and relaxed she looked just one hour before. I described he posture on the chair and her posture in the class. At first she was puzzled and I could see the rest of the class postured to come to her defense as if she was being attacked. A classmate protested that she was having lunch and was with her friends. It was after all a different situation. Why can’t a student experience joy when learning about empathy? I asked. That classmate was not satisfied with my reply. But the student I had turned to originally cocked her head by way of appreciating what I said and explained herself. I empathized with her for about ten minutes—never once inserting a thought from my frame of reference-and her narrative grew richer and richer and more complex and she could see without the conventional help a teacher might give—that she didn’t have to view learning the way she did---from that moment the class was able to speak in a different way, though one student in that group found the empathic framework alienating and for the most part sullenly watched. I have always wondered what would have happened if I had picked that student instead of the one that I did—-However that first year was fairly successful—the second year less so—but this past year as I see it was a huge success.

How do you know when the class is succeeding?

The students were very interested in each other—as interested in each other as they in what I may have to say. They show too much engagement to take notes. The class generally ends in the middle of a sentence.

What about the profession of genetic counseling interests you?

The challenge of knowing that you are helping people to make major decisions today that they may well regret tomorrow and to help them understand that there is no one to blame for the mistake.

How do the students take to that?

Some students such as yourself are intrigued and even inspired. Others see it as an example of what they construe to be my eccentric personality or dark humor and others a terribly destructive way to view the human condition.

Are there any stories you would like to share about yourself or your experiences in teaching at Sarah Lawrence?

When I was in junior high school my teacher kept me after class and told me he will not permit me to make a farce of school. I was not at all too familiar with the full implications of that word but I knew I found too much to laugh about. It is 60 years later and I’m afraid my stories have not ceased to be offensive to the vast majority so—the stories are for a select few.

What have you learned from your genetic counseling students over the years of teaching?

I have discovered the enormous resistance to listening to another person from their point of view for more than a minute or so. I don’t think it is a property of genetic counseling students but people in general. I have given you some of the reasons but one I left out. When you listen to someone in this way it is like reading a great novel. The character is nothing but the locus of forces acting on him, a mere voice for these forces. In Anna Karanin, one character, Oblonsky, tried to explain to another character, Levin his need for sexual affairs even though he may just have had sex with his wife. Levin cannot grasp this need. They happen to walk by a bakery after breakfasting together and Oblonsky draws Levin’s attention to the scent of the freshly baked bread. Come now, Levin, he says, you’ve just had bread but wouldn’t you want another taste just now. Levin simply says –no–. Suddenly Oblonsky is blameless and just as suddenly Levin is praise-less. They are just who they are. Empathy and righteousness are generally on a collision course. It is easy to see why empathy is so resisted.

This can get us into the subject of responsibility-pride and shame because you are saying Oblonsky should not be ashamed of himself. I can see why you think that but I am saying much less. I am saying that when you understand someone empathically you are not likely to praise or blame them.

What do you find most challenging in teaching genetic counseling students?

Having them accept me as their equal and accepting each other so that they do not worry about whatever differences may emerge in the course of the seminar.

What do you find most facile in teaching genetic counseling students?

Nothing at all when you attempt to teach the course I am describing—The seminar is like a conversational Ouija — unpredictable. The end of the class comes at 3:30, often right in the middle of a sentence but I said that before.

Over the years of involvement in the program how has your perception of the genetic counseling profession changed; and how has this influenced the course you teach?

The field has become less non-directive—Counselors are often encouraged to express their moral position and so I spend more time questioning the wisdom of such a practice.

How do you feel about this interview?

Since I have felt from the beginning that you were happy to know me as an equal I have enjoyed speaking to you this time as I have in the past and as I hope in the future.