As reported by The Hartford Courant, April 19, 2005.

Brawl in the Family

The Schiavo Case Demonstrates How Brutal a Rift Among Relatives Can Be When Both Sides Dig In

By Kathleen Megan

One of the saddest images of the Terri Schiavo case was Michael Schiavo at his wife's deathbed, barring other members of her family from entering the hospice room.

This clearly was a family feud marked by a bitterness and vitriol beyond reconciliation. And while life and death issues such those in the Schiavo case certainly can divide relatives, often the issues that trigger family explosions are comparatively trivial.

Michelle Callahan, a Manhattan psychologist and "life coach," has seen families fall apart over issues as small as an unpaid $50 loan, a refusal by one adult sibling to baby-sit for another, or even a conversation between a sibling and his brother's ex-girlfriend.

"A lot of times the most heinous issues are not the things they stop talking over," Callahan said.

In many cases, of course, the surface issue that triggers the rift is not the real cause. Usually, a stew of underlying issues - competition, unkindness, actual or perceived betrayals, double-speak, innuendo - have put family relations at a steady simmer. It doesn't take much to make it boil.

Erik Fisher, an Atlanta psychologist and author of "The Art of Managing Everyday Conflict," said that in some families the pressure to be "good" on the surface may be so high that family members develop passive aggressive ways to hurt each other.

"They'll say these little snippy things to each other," said Fisher. "This can be more draining than if they were screaming and yelling. The underhanded comments, the indirect stabs ..."

One tactic is the sarcastic insult that's passed off as "just kidding," Fisher said.

Fisher experienced a situation like this himself. His grandmother, who felt threatened by his mother, would always maintain a pleasant, even ingratiating demeanor toward her. However, behind his mother's back, grandma would try to undermine her.

"A person who draws someone in, acting as if they want to be loved and accepted and then destroys them - that's toxic," he said.

Fisher distinguishes between a "conflicted family" and a "toxic family," saying a conflicted family may have a misunderstanding, and they don't have the communications skills to solve it.

A toxic family, on the other hand, is wrestling with deeper, more complex issues that snuff the life out of family relationships. It's less about a particular disagreement and more about unhealthy patterns of relationships.

Fisher said that in a toxic family, for example, a parent might say to a son, who has brought a date home: "Oh isn't that a nice girl? But did you notice how she dressed funny, or did you know her mother ... Little comments so that the child is forced to choose between Mom or the girl.

"The mother knows that if she forthrightly says, `I don't like [her],' the child might be gone."

Dr. Robert Trestman, a professor of psychiatry at the University of Connecticut Health Center, said a typically toxic situation may develop when a husband and wife, who married early, grow disillusioned a dozen or so years later. "The kids are there causing all the normal challenges," said Trestman. "There was never quite enough money and a lot of anger and frustration. The husband certainly didn't achieve in the way the wife wanted him to."

Rather than discuss their feelings, the couple becomes angry and bitter. "All of their communication includes sarcasm and anger," said Trestman. "Frequently, there is a lot of abuse or neglect. It may or may not trigger calls to the police."

The relationship may simply simmer along that way for decades, or there may be an explosion, or the kids may turn up troubled in Trestman's office.

"The kids may suffer silently," said Trestman. "They learn this is the way life is supposed to be. They learn that this is the normal way to interact, to expect people to disappoint you."

The vulnerable among them may become depressed or suicidal or abusive of drugs or alcohol. If such a child comes in for help, Trestman said, he would usually want to see the entire family.

If the couple does stay together, Trestman said, "many don't face horrific disasters, in which case this kind of toxicity can exist without causing front-page news. Rather, it's the cause of a great deal of sadness, frustration, loss, joy and lost productivity."

If family members can admit that they are unhappy and are willing to try to change, he said, there is a chance to undo some of the patterns.

Andra Medea, a psychologist and author of "Conflict Unraveled: Fixing Problems at Work and in Families," said that when toxic families are faced with a problem, instead of trying to work together to solve it, they tend to fight each other.

"The core issue is that they focus on trying to dominate each other," said Medea, "rather than on solving their problems."

Often this means that families cast conflicts in terms of victims, villains and heroes. Declaring one person the villain may make the other family members feel in control. However, Medea said, "being a hero often involves punishing somebody else - not just asserting yourself, but really throwing your weight around.

"Instead of buying into the adrenaline" of the fight, she said, family members should "take a step back and decide if there really is an enemy here. This is your family. Maybe the problem is not coming from a willful person doing evil."

Of course, divorce and the intervention of in-laws also lend themselves toward creating toxic situations.

John Mayoue, a divorce lawyer from Atlanta, said too often he has seen in-laws step in on the side of their child when trouble brews in a marriage. "Someone's child, even if an adult, is always their child," said Mayoue. Like Mayoue, there are many observers who say Terri Schiavo's parents were out of line when they stepped in to take a role in their child's care. "No one fights like in-laws," said Mayoue.

So what's the answer to family harmony?

The key seems to be understanding others' perspective and letting them know you understand how they are feeling. If the various sides feel as if they have been understood, it's more likely that family members will be able to engage in a healthy discussion that will lead to good solutions.

Callahan said it is important always to be respectful and to avoid swearing. If the conversation grows too heated, she suggests politely excusing yourself - making up an excuse, if necessary, to avoid confrontation - and walking away for a time.

If a family is facing a disagreement based on fundamental beliefs that are hugely different - as was the case for Terri Schiavo's family - it may be that there is no compromise. In such cases, experts say the family has to agree that they don't want to fall apart over this issue and they will have to agree to disagree. Ultimately, someone will have to back down.

Fisher said the message to family members should be: "You disagree with me, but that doesn't mean I stop loving you."