Working with Couples by Ronit Bichler

Working with Couples by Ronit Bichler

What makes a couple, a couple? Therapists all over the world are struggling with this question.

This paper came about from my own struggle to understand the nature of the work with couples. I have been working with couples for a number of years. Soon after beginning that work, I realized that something was not working – that the couple and I were stuck somewhere. So I started seeing another supervisor, different from the one who supervised me for my individual work; a supervisor, who could help me in understanding the couple work. I furthered that with one year training in psychodynamic couples work through the Drummond St Relationship Centre.

I do not delude myself that I have found all the answers to the issues I am struggling with. However I would like to share with you my thoughts and the ways that I try to make sense of what I struggle with.

I am talking about some theoretical concepts and I will bring some clinical examples to substantiate the concepts. These examples are generalized and do not refer to any particular couple. In these examples I will be focusing somewhat superficially, on a specific dynamic as if it is not relating to the other couple dynamics. It is a little bit like pulling a single thread from the fabric and ignoring the fact that the thread is connected to the other threads that make the whole garment.

First, It is very interesting to think what influences the therapist’s freedom in the consideration and the assessment process that brings about the decision to work with certain clients.

The Tavistock Marital Studies Institute came up with an assessment process to determine the suitability of a couple to work with their psychodynamic model. According to the Institute the assessed couple has to display an understanding that their problem is a shared problem rather than one partner being the holder of the problem in the relationship. Secondly they have to demonstrate an ability to think psychologically. (Mary Morgan). The Tavistock Institute operates under the government medical scheme in the UK and their therapists are not working in private practices. This fact allows them to hold a more pure theoretical approach and accept to the program only the suitable people. Due to the situation where the therapist does not handle the payment they miss out on the rich work of the pay/pain relationship. I work from a private practice so the money side of things is a factor in my consideration of working with certain clients. However it is not the only or main consideration. When I assess a couple I think of two questions, the first one is: – do I think I can help this couple and the second one is: – do I think this couple can take and use what I have to offer.

When I started working with the first couple I looked at them as two individuals who are sitting in the room with me and who are seeking improvement in their relationship. I basically entered into individual therapy multiplied by two. What I did not understand at the time was that couples bring the relationship into therapy and that the real client is the space in between them namely the relationship. What does that mean in real terms? It means that couples bring dynamics that are intersubjectively constructed between them and that are holding the two individuals in the relationship.

Enid Balint writes that the relationship between the couple is looked at as an entity rather than two separated and individual people. The relationship is the client. She wants to look and understand what shapes and influences this client. She wants to investigate the internalized model of marriage or couple that each partner carries in their minds. This model had been constructed during their childhood absorbing the relationship between their parents or the people that brought them up. This model is showing itself in the dynamics between the two partners.

Clinical example

Mrs. and Mr. A have been married for 3 years. Mrs. A describes her father as a wonderful man, she is close to him and loves him dearly. But unfortunately he could not take responsibilities. He gambled heavily and could not settle in a job. He had made huge financial losses and it was her mother who shouldered the burden of providing for the family. Mrs. A chose her husband who, she says is a lovely guy but keeps changing jobs and often is without a job. He is a heavy drinker and cannot handle money. She has to work long hours in order to earn the bulk of the couples’ income.

Mr. A comes from a family with an authoritative father who was very strict and critical. He was not very involved with the running of the household. Mr. A’s mum was the one who had to find the solutions for every problem within the family. It is not hard to see the repetition of the internalized model of their parents’ marriages in their own relationship.

Peter Fullerton calls the couple space, the space in between. He says that the space in between acts as a container that is similar to the container that the mother offers her baby. The purpose of the couple container is not only to hold the individuals but to digest and make sense of the couple’s life. However, often the needs of the individuals clash with the “couple body”. Hence couples will blame each other, argue a lot, they will be very occupied by whose fault it is and keep an account of all the bad things that he or she did to him or her. They do not see their own part in what is going on and often are angry when the therapist points out their part.

Clinical example

Mr. and Mrs. B have been married for many years. They are in their early forties. They are frequently separating and coming back together. When they are getting along they are very happy and feel that the sky is the limit. All they want is for the other to understand them and see their point of view.However in the happy phase, there comes a time when one of them does not understand the other and that is not tolerable.

Thus, begins of the downfall; they start criticizing each other and escalate to blaming and destroying all the happiness that they previously felt. These cycles are repetitive and often end with separation. They blame the other for all the problems in the relationship and become quite angry or shut down when I wonder about their respective part in the crisis.

The “couple body” offers them a critical and blaming container that clashes with their individual need for understanding.

The dynamic between this couple is termed by Henry Dicks as the dominance submission conflicts, whereby the only way that one can avoid being controlled, devoured or annihilated is by attacking the other.

Couple work is different from individual work in the intensity and the nature of the transference. With individuals the transference exists between the therapist and the client. This tension is held between both of them. In couple therapy the transference happens mainly between the couple and less so between the therapist and the couple. In individual therapy we do not get to see the dynamics acted out between the client and someone else, though we can get sucked into the dynamics and act them out ourselves. With couples, the dynamics get played out in front of our eyes. However some dynamics are so powerful that the therapist can become stuck in them together with the clients.

Bion says that the mothering function is about the mother receiving from the baby the difficult emotional bits, the baby’s anxieties, that he cannot contain and that fragment him. Bion calls these bits the Beta elements. The thinking mother receives the bits and mentally digests them, makes sense of the anxieties and gives back to the baby her understanding by the way of soothing and relaxing him. In her mind she transformed the Beta elements through her ability to think emotionally. She contains the baby, his affects are now regulated. Overtime the baby internalizes the affect regulation and can start soothing and relaxing himself in times when the Beta elements or the disturbing bits of raw experience are felt.

When this mothering functioning is problematic in the early child’s life, that unfulfilled need is often carried over to the marriage. Couples give each other some parenting needs and there is more sense of balance and flexibility when these needs are shifting between the two of them. Often there is rigidity in the dynamic and one partner finds himself in a permanent role of the parent and the other one is stuck in the role of the child. Both partners will get something out of the situation. On one hand they will get a “goodie” out of it and on the other hand it can cost them dearly.

Carol Ride observes that the dynamics are held and maintained by both partners. Often one partner holds the dynamic consciously whilst the other holds it unconsciously. What is conscious is known and what has to be discovered in the process of therapy is the unconscious – hidden and unknown- part of the dynamic.

Balint talks about another dynamic whereby couples put parts of themselves into the other one. Without this projected part they can feel angry, lost, or envious towards their partner for having this part. Henry Dicks adds to that, that couples project into the other, the part of themselves that they do not like about themselves. Now the receiving partner becomes the bearer of the unwanted part. The partner that projected the unwanted part may feel attacked by this projected part, which now resides with his partner, and often attacks back the receiving partner for having this part that originally was part of him. He cannot accept that part in himself so cannot accept that part in the other.

In this paper I aimed to gain more understanding with regards to the task of the entity called “a couple”. In a good enough case the couple space acts as a container for the individuals’ anxieties and difficulties. The container digests, understands and makes sense of the difficulties; therefore the individuals feel held in understanding, they feel validated and their affects are managed. When that occurs then the closeness and intimacy between the individuals is growing. With regards to the couple examples that I have written about here we can see that they experience failures in the functioning of their couple container. The intersubjective construction of a failing container may be influenced by a repetition of the internalized parents’ model of marriage, and/ or, suffused with projections and overall clashes with the needs of the individuals.

Bibliography

Balint E, 1993, Unconscious communications between husband and wife. In Psychotherapy with Couples, Ed. Ruszczynski S, Karnac

Colman W, 1993, Marriage as a psychological container, in Psychotherapy with Couples, Ed. Ruszczynski S, Karnac

Dicks H, 1967, Marital tensions, clinical studies towards a psychological theory of interaction, Karnac

Fullerton P, 1999, Who or What Animates the ‘Marital Body’, Aspects of the space between, in Couples States of Mind, Drummond Street Relationships Centre, vol.1 no.1

Morgan M, 1994, Some Aspects of Assessment for Couple Psychotherapy within the Setting of the Tavistock Marital Studies Institute, in Couples States of Mind, Drummond Street Relationship Centre, vol. 1 no. 1

Ride C, 2005, Couple State of Mind, communication in course, Drummond Street Relationships Centre