Couple Therapy: A Contemporary Psychoanalytic Sensibility
The primary goal of couple therapy is a deepening of the bonds of intimacy between partners. The typical aim is to repair, revitalize, and strengthen ongoing relationships, although it may instead be to help a relationship end so both partners maintain a sense of personal integrity and hope, in moving toward separate futures. How is all of this done, in clinical practice, and what does contemporary psychoanalytic theory have to offer in the way understanding intimate connections, why they might falter, and what the therapist’s role is in a healing process?
These questions and others will be considered in the light of contemporary self psychology, intersubjective systems theory (phenomenological contextualism), and relational analysis, with particular attention to empathy, dialogue, and mutual recognition. Working with couples will be seen to follow organically from analytic theories in which self experience is considered to be radically embedded in constitutive relational ties. Case vignettes and readings will be used to explore a variety of practical and theoretical topics involving intimacy, sexuality, and vital, enduring relationships.
After taking this course, students will be able to:
1. Undertake an empathic inquiry to assess individual partner perspectives and the couple's fundamental relational dynamics. 2. Explore partners' developmental issues and current interactions that shape difficulties in the relationship. 3. Promote partners' empathic regard for each other's perspectives, and encourage mutual recognition. 4. Recognize areas in which the therapist's own emotional convictions limit or shape understanding of the couple's issues. 5. Promote the establishment of a safe environment and a dialogue, in which partners can be more honest, more vulnerable, more trusting. 6. Relate clinical intervention to theoretical rationale.
Readings (in suggested order):
Greenspon, T.S., (2007). Desire, vulnerability, and interweaving worlds of experience: An intersubjective systems sensibility in couples’ therapy. Group, 31 (3), 153-170. This paper will be a central focus of the course and will be a take-off point for discussion of theory and clinical sensibility. The following short pieces will help solidify some of the main concepts:
Shaddock, D. (2000). The Myth of Isolated Therapy. In: Shaddock, D. (2000) Contexts and connections: An intersubjective systems approach to couples therapy. New York: Basic Books. Chapter 1, pp. 1-15. Leone, C., (2008). Couple therapy from the perspective of self psychology and intersubjectivity theory. Psychoanalytic Psychology, 25(1), 79-98.
Shaddock, D. (2000). Process and Cure in Couples Therapy. In: Shaddock, D. (2000) Contexts and connections: An intersubjective systems approach to couples therapy. New York: Basic Books. Chapter 7, pp. 109-126.
Ringstrom, P.A., (2013). Narrative overview of three theme, six step model of relational couples therapy. (Handout). Ringstrom’s summary of his contribution to an IAPSP listserve discussion of couple therapy prior to the release of his book.
In addition to these brief summaries of the theoretical and clinical issues covered in this course, here are some resources for deeper study:
Shaddock, D., (2000). Contexts and connections: An intersubjective systems approach to couples therapy. New York: Basic Books. (The entire book from which the assigned chapters were taken).
Ringstrom, P.A., (2014). A Relational Psychoanalytic Approach To Couples Therapy. New York: Routledge. Required reading for a very approachable, thoughtful, and thoroughgoing overview of the contemporary relational analytic approach to couple therapy.
… Keep your eyes open for a forthcoming book on couple therapy by Carla Leone!
Livingston, M.S., (2007). Sustained empathic focus, intersubjectivity, and intimacy in the treatment of couples. International Journal of Psychoanalytic Self Psychology, 2 (3), 315-338.
Trop, J.L. (1994), Conjoint therapy: An intersubjective approach. Progress in Self Psychology, 10, 147-158.
Beebe, B. & Lachmann, F.M. (2002). Infant Research and Adult Treatment: Co-Constructing Interactions. Hillsdale, NJ: The Analytic Press. A preeminent resource for research on parent-infant interactions and the resulting contextual and dialogic origins of self experience. Not a book about couple therapy, but crucial to understanding the development and nature of interacting subjectivities in ongoing, intimate relationships.
Gerson, M-J. (2010). The Embedded Self: An Integrative Psychodynamic and Systemic Perspective on Couples and Family Therapy. (Second Edition). New York: Routledge. A classic. Melds psychodynamic and family systems approaches to couple therapy, and includes a discussion of recent contributions of attachment theory and neurobiology. Goldner, V. (2004). Attachment and eros: Opposed or synergistic? Psychoanalytic dialogues, 14 (3), 381-396.
Jaenicke, C. (2008). The Risk of Relatedness: Intersubjectivity Theory in Clinical Practice. New York: Jason Aronson. A profound, plainly-stated treatment of intersubjectivity and the risk inherent in intimate relationships, between patient and analyst, or between intimate partners.
Mitchell, S.A. (2001). Can love last? New York: Norton.
Scharff, D.E., & Scharff, J.S. (2000). Object Relations Couple Therapy. New York: Jason Aronson. The gold standard for presentation of an approach to couple therapy outside the sphere of relational psychoanalysis.
Stern, D. (2004). The present moment in psychotherapy and everyday life. New York: Norton. Excellent summary of the work of the Boston Change Process Study Group, discussing the micro-interactions, now moments, and intention unfolding processes that characterize and shape every relationship. Illuminates the ways in which intimate relationships can go off track in moments, providing a key to understanding and repair.
International Journal of Psychoanalytic Self Psychology, 2008, 5 (3), pp. 223-306. While not specifically about couple therapy, “Expanding Recognition” is the title of a segment of this journal issue devoted to a superb dialogue concerning the relational analytic concept of mutual recognition. Includes a paper by Donna Orange, with responses by Jessica Benjamin, Phil Ringstrom, and Mal Slavin, and a concluding response by Donna Orange.
Other ideas:
Have a look at the website for the Couple and Family Therapy and Psychoanalysis section of the Division of Psychoanalysis of the American Psychological Association, known more simply as “Section VIII”:
If you are a member of IAPSP, the International Association for Psychoanalytic Self Psychology, there is a forum organized by Carla Leone, David Shaddock, and Steven Stern, for ongoing discussions of couple therapy issues. IAPSP is in general an exciting and interesting group:
For an interesting popular media take on couple therapy, have a look at the HBO series “In Treatment