SPECIAL SECTION: COUPLES THERAPY AND MARY JOAN GERSON, PHD, EDITOR

am extremely pleased to sponsor a series ofarticles on pist. For Goldklank, the fulcrum ofcouples treatment is lcouples therapy for the -Psychoanalyst. In a shared conflict, masked in the couple's initial attraction the following three essays we will try to provide a glimpse by different and often opposing defensive styles. When the ofthe richness of working with couples from an integrated therapist is drdwn into the conflict, and investigates it with systemic and psychoanalytic perspective. the couples, each partner has "the opportunity to find the Psychoanalysts are interested in couples therapy analog" of their own, personal and restricted solution. today, for a variety of reasons. It is a therapeutic modality I find that couples work is often described as plea­ that has acquired a new acceptability-even attractiveness sumble by analysts. A classically oriented colleague ofmine in the general population. (Gerson, 1996). Why is this once suggested it to a class rwas teaching that couples so? For one thing, sweeping changes in social ideology therapy provides a wonderful release for the "aggression" (represented most forcibly in the feminist revolution) has one can't express in individual treatment An interesting deconstructed time-honored assumptions and expectations idea, but not one I would personally proffer. Rather I think regarding structure. What is commitment in post­ that working with dynamics in "real relationships," adds modem culture? [s exclusivity possible in an age ofdis­ a different kind of vitality to our therapeutic experience. tracted consumerism? Each couple has to cobble together We are all generally more informal, more overtly "active," its own schema. It probably has never been easy to share and more playful in couples work partly because our unit your life with someone. However, the psychic challenge oftreatment-the couple-shares a life beyond us which is of"togetherness," i.e., integrating developmental anxiet­ bounded and somewhat exclusive of us. We are offered a ies, issues of separation, unresolved identifications, with­ different set ofdegrees offreedom in couples treatment. out clear consensual guideposts, becomes overwhelming There is a panoply ofapproaches to couples work for many couples. Analysts are more frequently asked for and every orientation within psychoanalysis-from the clas­ referrals to couples therapists or more readily consider sical to the existential-offers unique possibilities for explo­ making a referral themselves. Thus developing a personal ration and expansion ofexperience. In a subsequent issue, grasp of the therapeutic action of this form of therapy is an integrative perspective will be presented in relation to useful, even if one has little personal interest in conduct­ other clinical situations and problems. Most ofall, I hope ing it. these articles invite you to think with us, and perhaps join Sheila Sharpe's article, The Development of us in Section VIII, Couples and and Psy­ Couple Relationships is a rich presentation of the patterns choanalysis, founded in 1996, to house this challenging and that facilitate connection as well as separation. For Sharpe, enriching area of clinical thinking. our culture's mythology of"romantic love" has inhibited attention to the necessary adult developmental processes References that allow for the enhancement oflifelong needs, such as the reception ofnurturing. Sharpe stresses that certain pat­ Gerson, M.J. (1996). The embedded self: a psychoanalytic gUide terns can become rigid or defensive and dominate mature to family therapy Hillsdale, N.J.: The Analytic Press. relating. The therapist, aware ofa collusive construction, Le. to a benevolent or controlling parent, and her attendant reaction, can help dis­ solve the rigidity ofthe pattern. I have always believed that working with couples invites us to reconsider many of our assumptions regarding transference, countertransference, and self-formation-prac­ tically every important concept we work with. The shift in context genemtes questions that lead to new perspectives and discoveries. In Shelly Goldklank's article, Couples and Countertransference, we are presented with a creative look at transference and countertransference. Goldklank broad­ ens her geometry of these concepts to include their action between members ofthe couple as well as with the thera- THE THERAPEUTIC ACl'ION OF COUPLES THERAPY MARY JOAN GERSON, PHD

n this article, I'd like to think about the following ques­ rience has become a hallmark of postmodem psychoana­ Ition: What is unique about the process ofcouples ther­ lytic theory, and both Mitchell (1993) and Bromberg (1999) apy? For one thing, I think that the lens ofcouples therapy have emphasized shifting boundaries, our culture privileges offers a sharp clarity about one's "personified self," in self-definition and self-eontainment. Couples therapy pro­ Sullivanian terms. Sullivan (1950) described the envelope vides the arena for perhaps our most challenging existential ofthe "personified self," a reified, sanitized version of task-that of articulating ourselves while recognizing that oneself, which remains unaffected by interpersonal feed­ we are inexorably embedded and defined by the reflections, back because of the protective radar of security operations. the longings and the of significant others. Inti­ When partners are facing-not imagining or recollecting macy is the natural habitat of our psychoanalytic "two each other-- and the therapist helps penetrate the collusive person psychology." shield of anxiety, self-protection is buffeted. The effect can I've felt the need as I've worked with couples to be one ofacute and fresh self-recognition and expansion. find a representation, an arbor to house the co-construction I am working with a couple that includes a wife of two lives, of two sensibilities. Our therapeutic language who chronically and poignantly wonders whether she has of "self' and "other" constrains, rather than expresses, this any powerful towards her husband. Was their union psychic reality. Minuchin (1981) suggests that our language exclusively a pronatal venture, a wish to share parenthood system generally fails us in capturing this reality, proposing, and little else? Ofcourse there exists a plethora of relevant for example, the term "mochild" or "chother" to signify issues: her childhood history of physical abuse; his nurtur­ the mother-child unit. For a long time, my experience of ance which is parentally healing but inevitably desexual­ witnessing the psychological mesh of a couples relationship ized; his compulsive caretaking which blindsides him to exposed and unraveling in my office has felt inherently other of her needs, etc. In their most recent session she said dramatic to me, a slice of life consumed before me as she felt she had to raise -though with reluctance to hurt-the well as served up, presented to me as witness (Gerson, fact that she no longer currently desired him at all. Because 200Ia). When I researched the roots of drama, I became this followed another session in which she had questioned more and more interested in its origin as cultural ritual; her basic love for him, her husband became utterly defeated drama has always provided a means of providing spectacle and hopeless. I asked him whether he could, in spite of and intensity to strengthen prevailing belief systems or his distress, recognize her revelatory statements as possibly articulate newly arisen conflicts. Ultimately, it seems to me expressing commitment and concern for their marriage ­ that the dramatic impact ofa couples session emerges from after her own fashion. She truly believes, as she has said its power as ritual (Gerson, 200 Ib). In the case ofcouples in in our sessions, that one must "clean wounds" before they a post-modem, secular and hyper-autonomous culture, the can heal. He is so non-confrontational and solicitous that ritual power ofcouples therapy lies in its subversion ofthe entertaining this hypothesis took every bit ofhis effort, and prevailing ideology that "I should be my own person," or in doing so he inevitably had to face his own restricted "I can reinvent myself' to an experience that our identities repertoire of"loving." I didn't have to urge her to reflect are co-mingled and, yes, co-dependent. How each partner on her behavior. She was visibly alarmed and shocked at co-constructs each other's reality becomes a new field of the wake ofdevastation her remarks produced. She had exploration, akin to Ogden's (1994) "third" in dyadic treat­ lost sight of his raw and real emotional attachment to her. ment. Because she always had her saber drawn, she assumed he Here's the rub. I think that psychoanalysts who was merely frightened of her. She had felt unlovable, which work with couples experience disequilibrium as well. I only made her more strident. believe that since we can't unpack the transference experi­ This material lends itself to what I am most inter­ ence ofeach member of the couple fully (it is complicated ested in conveying as the essence ofthe "good enough" enough with the individuals we work with!), and because couples therapy hour. For me, the therapeutic action of our own counter-transference experience cannot be ade­ couples therapy lies between the couple, generally carrying quately decoded in a true analytic sense (to each person? with it heightened emotionality (though with highly reac­ with the couple as unit?), we index these crucial dimensions tive couples, a moment ofcooled-down irony can be most in our work but we inevitably develop a different stance mutative). It is a moment in which each person temporarily towards therapeutic action. For ifthe couple is to interact loses his/her moorings of personified self, and reemerges with fluid boundaries, the therapist has to move out oftheir with a reshaped contour. Though the plasticity ofself-expe­ field, at least temporarily, and we are u~ed to being at the center, the fulcrum of change. Psychoanalysts, who have what he is doing by what he is saying, which is enough developed some of the richest developmental theories, can ofa symbolic loss for us as psychoanalysts, there is a neces­ help couples find their intersubjectivity by zooming into sary minimalism in successful couples work. We know to present experience, and granting it as much drama as how complicated one psyche is, and how exponentially genetic connections. Psychoanalysts often find that they complicated looking at our interaction with someone is. have to focus on the pragmatics of communication, what Two people? Impossible ifthe lens stays fully open all the individuals are doing with each other, how they are using time. We inevitably will overexpose our image. I think that language, as much as on the symbolic meaning of commu­ following one reciprocal image, one theme, one surprising nication. When a husband says, "I'm damaged goods," to discovery of the other for a period oftime, a number his wife, a supervisee feels enormous compassion towards of sessions, provides a transitional space for a couple to him. But his statement preempts his wife from making any expand their relationship. Being fully open to emotional demands on him! And, lastly, we have to tolerate and psychic meandering, the pleasure of analytic work, individuals being central protagonists of change for each often leads to exhaustion, discouragement and entropy in other, when we have been drawn to this work because of its couples therapy. possibilities for a kind of wrestling intensity. I truly see this field as open-to new movements and How to proceed? Let me sketch some of the new compositions. In fact our analytic efforts would benefit approaches I take in my couples work. After all, I began from new couples choreographers. with a proposal about the "uniqueness" ofcouples therapy. It's a choreography of multiple possibilities, but let me give References you a sense of my own notation. Bromberg, P.M. (1999), Playing with boundaries. Contemporary I. I think that on present circularity intensi­ Psychoanalysis. 35, 54-66. fies therapeutic exploration. The classic circle is distance/ Gerson, MJ. (200 Ia). The drama ofcouples therapy. Journal of pursuer (generally he runs and she chases). But circles have Integration, 11,333-347. infinite variety, e.g., he is innocent because she is accusing; Gerson, MJ. (200 Ib). The ritual ofcouples therapy. she is evasive because he is invasive, she loves his "holier Contemporary Psychoana(vsis, 3,453-470. than thou-ness," because she can withdraw to more sinful Minuchin S. & Fishman, H.C. (1981). Family therapy techniques. distractions. There are obvious and veiled circles, primary Cambridge: Harvard University Press. and secondary loops. Often the most generative way to Mitchell, S.A. (1993). Hope and dread in psychoanalysis. identify a circular dynamic is so let an image or metaphor New York: Basic Books. Ogden, T. (1994). Subjects ofana(vsis. Northvale, N.J.: float into awareness. Jason Aronson. 2. I am always interested in past experience, Stern, D.B. (1997). Unformulated experience. Hillsdale, N.J: and in fact take a genogram history ofeach partner (lasting Analytic Press. for one session), in approximately the third or fourth ses­ Sullivan, H.S. (1950). The illusion of personal individuality. In: sion. However, here I fuse my systemic and psychoanalytic The jUs ion ofpsychiatry and social science. pp.198-226. approaches and follow a line of spontaneous inquiry, "Do New York: Norton (Reprinted in 1964). you think that your mother was so hysterical (or nasty, or alcoholic) partly because your father dismissed her? People Mary-Joan Gerson, PhD is a faculty member and a supervi­ rarely think of their parents as co-constructors! I generally sor in the N Y. U. Postdoctoral Program in Psychotherapy try to interrupt what Donnell Stem (1997) calls "narrative and Psychoanalysis, where she co-directs the Project in rigidity" (p. 129), and formulate the "unformulated" which Family Theory and Therapy. She directedfamity therapy will hopefully then extend to looking at surprising interper­ training in the PhD program in clinical psychology at sonal influence within the couple's relationship. NY. U. for fifteen years, serves on the Board ofDirectors 3. I think that we as psychoanalysts, whose founding ofthe Minuchin Centerfor the Family, and is afaculty father was a renegade trained in the medical model, still member ofMount Sinai Medical School. Dr. Gerson is carry remnants of that tradition in our clinical approach. We the author ofThe Embedded Self: A Psychoanalytic Guide simply don't pause often enough to ask, "What's right about to Family Therapy (The Analytic Press. 1996), as well their relationship?" "What's resilient. or even admirable as many articles on psychoanalytic/systemic integration, about their relationship configuration?" Removing the filter chronic medical illness and coping, and parenthood moti­ of pathology often liberates new thinking and new experi­ vation. She is the Founding President ofSection VIII (Cou­ ence. ples and Family Therapy and Psychoanalysis) and now 4. I think that in addition to focusing on serves as Member-at-Large on the Division 39 Board of the pragmatic of communication between the couples, i.e., Directors.