Ryuko Ishikawa

Andrea Schara: So this is October the 17th, and we’re here in San Francisco and I’m interviewing Ryuko Ishikawa, who I met in 1978 in Washington at the Georgetown Family Center. And I’m going to let you tell the story of how you met Dr. Bowen and how you became interested in Bowen theory, and what difference that might have made in your life. And how you see Bowen theory in terms psychiatry itself, or in terms of maybe a theory that would be useful to people outside of psychiatry.

Andrea Schara: And you can just start anywhere you want with the story where you first met Bowen or however you want to do it.

Ryuko Ishikawa: I think, since we have to leave soon, so we may have only 30 minutes, I’m thinking how to organize this question to answer, to Punkin, you know. To start with, Dr. Bowen and me-

Andrea Schara: It’s too close to you. Cause you can see the…

Ryuko Ishikawa: Well, it started with his voice. I called him from San Francisco, if I could come and join and learn Family System Theory with him and there with his people.

Ryuko Ishikawa: But that was my very difficult time in my life which was to be sort of separating myself from my second marriage.

Andrea Schara: Had you read about Dr Bowen, or what made you call him?

Ryuko Ishikawa: To be honest with, while I was in Japan we were studying the parents of autistic children. I got the grant from our government to study about, because we just opened the children’s clinic and hospital by Tokyo government. We only had a big adult mental hospital, but no treatment facility for children. My professor said that I should go and join with them to create a new clinic. While we’re doing it, we had many autistic kids came from all over Japan. But I had no clue to be able to really face with those difficult parents.

Ryuko Ishikawa: I read Dr. Bowen and also some other peoples. That was the beginning. I wasn’t really interesting what he was talking about, about these family systems. But I had interest of this Georgetown Bowen Center, so I thought I should visit.

Ryuko Ishikawa: Returning to what I was telling you, I called him, I think Ruth Sagar answered in the first place. I explained who I was, then suddenly, kind of voice came onto the phone and said, “Who are you?”

Andrea Schara: [laughs] That’s beautiful.

Ryuko Ishikawa: I said I am interested to come and learn about the family systems. He said, “Why?” No, he didn’t say why, but I think he’s really good to catch what was my intention, because I think he caught my fragmented situation and my anxiety, high anxiety.

Ryuko Ishikawa: He was interested because I was in the midst of separation from my husband. He said, “Oh, you can come.” [laughs] That was the first time I met him.

Ryuko Ishikawa: Then when I came I remember, he said he was going to give me $10,000 per year to survive in Washington DC, which was his research money that he got from his client or whoever, supporter I think. I said, oh that was very, very thankful because I thought I should have paid. Because I was learning something. But it was very nice for him to say. Since then I think he was almost like my father or grandfather. Because I was very comfortable with his big blanket.

Andrea Schara: He was like a big blanket?

Ryuko Ishikawa: Yes.

Andrea Schara: Dr. Bowen the Blanket.

Ryuko Ishikawa: Kind of wrapped me inside and also in my training I think I stayed there about two years as a fellow in family psychiatry and then about two years as a sort of clinical staff at the Family Center.

Ryuko Ishikawa: But I was given three supervisors, one was Singleton…

Andrea Schara: Gary Singleton.

Ryuko Ishikawa: Yeah, Gary Singleton, who was a very, kind of interesting guy. I think he got some heart attack later on and I think maybe I can imagine that he did, because I thought he wasn’t really kind of guy, openly related to me. He was always asking me about my own family constellation, but not so much more than that.

Ryuko Ishikawa: And then Dr. Paddock, is that right?

Andrea Schara: Paddock, yes Charlie Paddock.

Ryuko Ishikawa: Charlie Paddock, he was kind of a weird supervisor for me. He asked me from the second day after I arrived to Family Center, he asked me to move into one of his client… the mother was his client, and the son, the big son is a schizophrenic guy. But I thought was children, he was a child, because Paddock said, “Are you interested to do sort of like a babysitting?”

Andrea Schara: Babysit a schizophrenic?

Ryuko Ishikawa: Yes. I said this must be like a five or six year old. He said, “While the mother is gone, it’s about one month, would you like to be with him?” So I said okay, yeah. I accepted. I leave towards this, supposed to be little boy, but then I discovered next day, at night, around 2 am. There was someone laughing with a big voice, crazily. That was across from my door, his bedroom was across from my door, but I couldn’t see him because when I knocked no one answered, no one opened. I thought that’s not a boy’s voice.

Ryuko Ishikawa: Anyway I was hungry, so I was cooking in the kitchen and there was some kind of little approach, but I still couldn’t see him. I left the chicken in the kitchen. The next day the chicken was gone. This is my relationship with him and Dr. Paddock.

Ryuko Ishikawa: I had to report about this family to him once in the week. Finally after four days or five days I saw the shadow of this little boy who was a big, gigantic American, his hair was really stinking and kind of weird guy. I got really scared, you know?

Andrea Schara: You told Dr. Paddock about it.

Ryuko Ishikawa: Yes, I told Dr. Paddock about it. This was a strange house, there are no keys in my room and of course entrance as well. No keys. Everything is open.

Andrea Schara: Did you get any ideas from Dr. Paddock about how to manage yourself a little bit with this?

Ryuko Ishikawa: Nothing.

Andrea Schara: He gave you no ideas.

Ryuko Ishikawa: No idea, no clue. Even I was not able to have any kind of idea about this house and people.

Andrea Schara: He just threw you in there, see if you survive.

Ryuko Ishikawa: Ghost house.

Andrea Schara: Go to the house and see if you survive. You didn’t meet the mother?

Ryuko Ishikawa: Later on, yes I did. After she came back, a month later.

Andrea Schara: You stayed there a month?

Ryuko Ishikawa: Yeah, that was my training [laughs]. It was a very rare experience for me in my life. You want to know more about it?

Andrea Schara: It’s up to you. I’m thinking, did you talk to Dr. Bowen about this ever? I was remembering that he asked you something at a clinical conference one day, would you like to go live with a schizophrenic, he asked you.

Ryuko Ishikawa: Yes, I think so. Because in a kind of way, we had an attachment. He approached me, and finally I think this chicken was effective that I gave to him and he began to trust me I think. And began to approach into my system. One day, he played the beautiful piano downstairs. That was Für Elise. I was very much attracted and I was sure that he was playing this for me. I secretly down from the stairs, you know, got down and I saw him, just his shadow. He disappeared.

Andrea Schara: He disappeared when he heard you.

Ryuko Ishikawa: Yeah. But then a few weeks later, we became good friends. And then he invited me to go to McDonald’s.

Andrea Schara: To get a chicken sandwich?

Ryuko Ishikawa: I don’t know what. But when we approached at the entrance, the manager came out and said, “You have to go.” Because he was barefoot and he was stinking and he was terrible looking.

Andrea Schara: Did he say anything to you about it, or you say anything to him, or-?

Ryuko Ishikawa: He said, “Let’s go.” But finally, I think he really came to close to me. He was interesting, he sat beside me and then he put his head on my lap. I think I became used to not to smell his stinking smell, we became good friends. We fused.

Andrea Schara: Were you fused or that takes me back to… if you read Bowen’s book and his description of his training of the staff at the National Institute of Mental Health, where he told the staff people, “I don’t want you to diagnose people. And I don’t want you to tell them what to do. Like take a bath or clean up or sit here or go there. Or it’s time to go to bed-”

Ryuko Ishikawa: Is that right?

Andrea Schara: Or any of the things that you get in a normal psychiatric hospital. In a normal hospital setting, the staff is the mother, but it’s the controlling mother and the ego of the other is destroyed in the obedience to the mother, who becomes the bad mother and then the child becomes passive aggressive or whatever. And then there’s the struggle between the parent and the child.

Andrea Schara: And without either being overtly taught about this, how Dr. Bowen had managed his earlier research, you knew nothing about the NIH project or what he had done with families? Did you have any idea that you would want to be able to connect with people without controlling them?

Ryuko Ishikawa: No, at that time I had no idea about that. But I had quite interesting experience with schizophrenic children and their mother. Supposed to be double bind. Also with-

Andrea Schara: What’s an example of a double bind?

Ryuko Ishikawa: Like you.

Andrea Schara: I do double binds, yes I do. I do them on purpose.

Ryuko Ishikawa: Exactly. Those schizophrenic mother doesn’t do it purposefully. They give you smile, but then they say go away. So the child will be confused.

Andrea Schara: Right, so the body language and the verbal language are two different messages.

Ryuko Ishikawa: Yes, is a different message the child get. But I didn’t give this kind of stuff to this weird man.

Andrea Schara: So from your own experience, you were operating, not so much through the lens of Bowen theory, because you didn’t know the theory well enough. You knew something about the theory.

Ryuko Ishikawa: No, I didn’t know it at all.

Andrea Schara: You read something.

Ryuko Ishikawa: I read, but that was difficult for me to comprehend. That’s why I think I was there.

Andrea Schara: So out of your own experience you knew not to do the double bind or to try to control this man.

Ryuko Ishikawa: No, I was really genuine kind of therapist. I just wanted to know who he was.

Andrea Schara: Without trying to control.

Ryuko Ishikawa: No, even I didn’t know what the control meant, in American way.

Andrea Schara: In the American way. But somehow you managed to live that, or be that.

Ryuko Ishikawa: I was just curious. This was my life and I’m always curious.

Andrea Schara: So then you told Dr. Paddock, did you ever tell Dr. Bowen about this?

Ryuko Ishikawa: Yes, I think I told him about it. He didn’t say anything, if I remember. He was just smiling. And I discovered, this really pure, kind of genuine man. Very sensitive, very scared. He thought maybe I was not scared of him, that’s why he was able to approach me. And I was careful, very much careful not to scare him. So, we became good friend.

Andrea Schara: Would this be a different outcome that you would find than if you operated as trained psychiatrist and he came to see you as his patient? Would you strive for these same kinds of qualities in the relationship?

Ryuko Ishikawa: The bottom line is yes. I always do this. I don’t see, well even after I went through Bowen System Theory, learned. But I think my pure myself, is more of to respect your client as equal to you. I hate to diagnose. I hate the routine psychiatric training.

Andrea Schara: That’s a difference where you would naturally be aligned with Bowen theory in how-

Ryuko Ishikawa: I think so, yeah.

Andrea Schara: You operate, what you’ve learned from conventional. And I know you had training in psychoanalysis.

Ryuko Ishikawa: Yes I did. Of course it was my genuine interest. I was always good to accept what they were going to train me. However, I think the psychoanalytic theory and approach, I was trained as a child psychiatrist at the UC San Francisco and at that time was purely analytical institute. Langley Porter Neuropsychiatric Institute in San Francisco. It was well known and the children’s service was well known for Dr. Zurek, who was a well-known psychoanalytic professor. Was his training.

Andrea Schara: How did you see these two bodies of knowledge differing, between psychoanalysis, what did family systems theory offer you that was different from psychoanalysis that caught your attention?

Ryuko Ishikawa: I think psychoanalysis, the theory itself is very interesting. Beautiful on the surface. But while you are in training, you get more confused, and I was furious. Because they focus on your feelings, and then if feeling is exposed without really limit or control, you get more crazy. And I was quite honest and not guarded, so I think I felt like I was in a kind of fireball.

Andrea Schara: In your psychoanalytic training? And how did family systems theory, did it dampen the fireball, or what was the difference?

Ryuko Ishikawa: No. I think after my training… I had to go back to Japan, because they gave me two year’s training fund from Yale. I got that one from Yale University that I could go anywhere in the United States to study about child psychiatry. But the obligation was I had to do something to teach, when after two years, I had to go back to Japan to teach what I learned.

Ryuko Ishikawa: That was a good time that I was able to reset myself, going back to my own native country. And then after I told you that about my needs to study about how to look at the parents and family, without knowing this… differences between psychoanalysis and the Bowen theory, I just jumped into the family systems. The mecca of the family systems. Because I was attracted by Dr. Bowen.

Ryuko Ishikawa: That was a sort of concern about Dr. Paddock and Dr. Singleton, and I cannot recall… one more, my supervisor’s name… I’m getting old I think.

Andrea Schara: It will probably come back to you.

Ryuko Ishikawa: Not Frank Giove, but something like that, similar. He’s a kind of short guy, kind of square, he retired about five years ago.

Andrea Schara: Phil Lorio was another psychiatrist.

Ryuko Ishikawa: Yeah, yeah perhaps that’s… a very quiet man.

Andrea Schara: Ted Biel would be the other psychiatrist on that.

Ryuko Ishikawa: No, not Ted Biel, he wasn’t there when I was there. He came later on.

Andrea Schara: I think he was there but he wasn’t maybe on the staff to supervise. He only supervised medical students I believe. But he was there on the faculty, but I think he only supervised the medical students. You never had Michael Kerr as a supervisor.

Ryuko Ishikawa: No, I never have. Of course I met him on and off.

Andrea Schara: How has that relationship with Dr. Bowen, how would you say that it’s continued, or has it continued to influence your work? The theory versus the relationship, I’m trying to be clear. It sounds more like the relationship with Dr. Bowen influenced your work. And you used the theory.

Ryuko Ishikawa: I have. I think I’m still learning theory. And I have something in my mind: that my experience with people are more important than theory. I mean, I create relationship, I mean a kind of, I don’t know, how do I explain? If I go with the theory, the theory comes in front of me, I would become more rigid, in a way, because theory tells you to send that. I have to go with it. So I try to be more of… digesting theory into myself. I think I am living with theory. Not because separating theory from me as a kind of, how do you say in English, like my placard or something.

Andrea Schara: I thought about it as a compass, the theory offers you a compass. A way to look that perhaps individual or psychoanalysis didn’t offer you that way to look. It looked at the feelings inside the person, but it didn’t particularly wonder about what the nuclear family relationships were like and how that was connected to the extended family. And it didn’t tell you to look to the importance of, I think, sibling position and emotional cut off. And these kinds of mechanisms that manage anxiety-

Ryuko Ishikawa: Yes, of course, of course.

Andrea Schara: You wouldn’t look there particularly.

Ryuko Ishikawa: I understand, your brain and my structure of brain is different. You are more like scientific way of putting things around you and then you go from there. But my way is to experience myself into the world and via my experience I analyze and then to create the… I mean try to meet my experience with the theory. And then compose.

Ryuko Ishikawa: When I went back to Japan, for instance, my mother has been expecting me to be this and that. The previous Ryuko, but I was entirely different after Systems baptism and my mother didn’t like my change. All my family members were against me and I tried to re-change myself. Tried to put myself into their own kind of format. And I was not aware that what they were doing, but I was thinking, “It is hard! Why they do this?” Then I went back to theory. I learned, so I was able to see it. This is the way I fit my experience into the family systems theory.

Andrea Schara: If you had your experience and you go back to psychoanalytic theory you end up like a fireball in all your feelings about what went on. And if you go back to family systems theory you see it differently somehow.

Ryuko Ishikawa: Right, more you can be calmer to see it and not reactive. Not reactive, you can talk to yourself, that this is happening around you. What are you going to do about it. You can see it.

Andrea Schara: Do you find that family systems theory is useful to other people in Japan? Is it a small group of people who are interested in the theory there, or has it grown?

Ryuko Ishikawa: Everything that happen in this country would be transmitted to Japan. After the… minimum would be, it takes about five years, maybe ten years. Then the things will come into Japan. Now, Bowen theory, and Michael, is began to know in Japan. People are writing the thesis, PhD thesis about Bowen theory. But that will be very small amount of people. Population is still very small. Not in the field of psychiatry. They read. Any kind of psychoanalysis, or any kind of minuting method, whatever, the family therapy. They say some of them are doing it, but I don’t think the theory is really understood in Japan.

Ryuko Ishikawa: One day, I talked about family systems, Bowen kind of experience at one of the conference where psychiatrists and also educators came. There were about 80 people. And I started to talk, it was about a one-hour speech, about how you would see symptom emerge in the family, and the response of the audience was remarkable. They said they never heard about it, they are very much interested to know about it, because they are very intelligent people, and I had lots of questions.

Ryuko Ishikawa: I think if it is transmitted and exposed to people who don’t know anything about family systems, I think Japanese would understand this pretty well, quickly as possible.

Andrea Schara: Are you saying that there’s probably a potential for family systems theory to be understood, even by lay teachers, by people who are not involved in the medical system, in Japan?

Ryuko Ishikawa: Anybody, anybody. Because I am doing this to organization, such as elderly care facility, where I consult with. I am consulting to the leaders of this facility. They have ears to listen and they are learning right now. Also, I am targeting all my clients at my clinic. This is organization where about a hundred people work and I am a division director, Clinical Outpatient Division, and I am teaching a staff, small staff of Clinical Outpatient staff. And also, I’m kind of coaching all my patients and they understand, how do I say.

Ryuko Ishikawa: I have one man who is about in his early 40s. He was dependent on benzodiazepines. Because Japanese doctors are very eager to use all kind of medicine and they see their patient only for like 10 minutes and they don’t know how to provide good psychotherapy. But they are all, the patients are all drugged.

Ryuko Ishikawa: I saw this man, George or in Japanese we would say Taro, on and off, and I encouraged him to be creating his own differentiation from his mother, even his wife, and people at work because the culture norm is entirely different from what Dr. Bowen says is “differentiation.” Because Japanese would encourage the more dependency.

Andrea Schara: Togetherness is a drug, it’s like a drug.

Ryuko Ishikawa: That’s a sweet drug, you cannot really… you would be addicted and you cannot really separate yourself. He was drugged with this kind of love from his mother and from his wife. Anyway-

Andrea Schara: You still get symptoms, unfortunately. It’s like if you overdose on a drug you get symptoms. And if you overdose on togetherness, you have drug overdose and you have relationship overdose. And you have a lot of symptoms.

Andrea Schara: But to get out of it, as you pointed out, with your own family, when you tried to separate from them. You still can get all this tension and all this anxiety that comes back as you try-

Ryuko Ishikawa: It’s so difficult.

Andrea Schara: To grow away from these attachments. The growth away is also difficult.

Ryuko Ishikawa: And not to react to it, is the most difficult thing. I have that one with my youngest half-sister. I was so furiously angry, I don’t know how to do with it.

Andrea Schara: What do you do with all that? It’s easy to drug it, but it’s hard to deal with it. To be more integrated with your anger is quite a… I guess it requires triangles.

Ryuko Ishikawa: What do you mean?

Andrea Schara: That somehow or another triangles are a way through the “stuckness” with the one person in the system. If I go back to Dr. Bowen’s early paper on Differentiation of Self, it was just full of triangles. None were quite as clear full of double binds. But yes, there were a lot of reversals and double binds in that paper.

Ryuko Ishikawa: Yes, it was hard for me, so I tried pull in my daughter, into that. And she’s very clever. She says, “Don’t give me stress,” and she try to shut me off.

Andrea Schara: Absolutely.

Ryuko Ishikawa: That’s what she is doing. You saw that.

Andrea Schara: Yes I did, I did see that.

Ryuko Ishikawa: So I did pull you in. Because you are stronger than other people. And I am very thankful for that.

Andrea Schara: And I enjoy it. I will cook you some chicken.

Ryuko Ishikawa: Thank you, is that addictive?

Andrea Schara: Barely. But when you see the theory I think you can laugh about the way that we’re so involved with each other and have such a difficult time setting each other free. It’s fascinating, it truly is fascinating.

Ryuko Ishikawa: Wonderful. You know to learn family systems theory, is the one to free yourself from anything, and you would love the freedom of your own self.

Andrea Schara: Yes, very accurate. Well, I remember how tricky Dr. Bowen was. I used to travel with him as you know and sometimes he would say these outrageous things to me, and he’d say… we were driving to Pittsburgh one day and he saw this yellow bush that was blooming in the spring and he said, “That’s a foresight bush.” A foresight bush. I said, “Dr. Bowen, I think it’s called Forsythia.” “Oh no, I have told my children that is the foresight bush, and I’d tell them that every year that is the foresight bush.”

Ryuko Ishikawa: I think he’s really foresight, I’m amazed.

Andrea Schara: And so, I said, “Well, in the spring perhaps that is the beginning of foresight.”

Ryuko Ishikawa: Wonderful, beautiful. We are always going to have a new era.

Andrea Schara: Yes and it’s slightly informed by the past and we hope that it’s not so informed by the past that we have to repeat it in a lopsided life. Following along, and you can’t have the freedom to think or be for ourselves.

Andrea Schara: I appreciate the time today and the interview, that was so much fun. Thank you very much.

Ryuko Ishikawa: Thank you very much, Punkin.

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