Working with Developmental Anxieties in Couple and Family Psychotherapy

The Family Within

Penny Jools, Noela Byrne, Jenny Berg

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351627009
• Edition: 1
• Topic: Psicología
• Subtopic: Psicoanálisis

The family begins with the parental couple; it is they who create the family. This book explores the way in which the child or any member of the family can carry unresolved projections arising from the parents' families of origin: their family within, and the difficulties this internal family presents for the therapist.

The model developed in this book explores psychoanalytically based ideas about infant development and applies them to the internal world of couples and families. It presents both a clear explanation of these theories as well as case histories that show how these ideas work in practice. The developmental model presented offers an original perspective on the wide range of problems that many couple and family therapists struggle with. These problems can be understood in the context of the family within, the way in which the family of origin dynamics have been internalised. This shared understanding between the couple and family and the therapist provides a path to greater maturity and therefore a greater capacity to cope with life's vicissitudes.

Working with Developmental Anxieties in Couple and Family Psychotherapy presents both a clear theoretical framework for understanding the development of the couple and family, and a practical application for these ideas. Case studies bring the model to life through illustrating both the problems of the family or couple and the difficulties of the work. It will appeal to psychoanalysts, psychotherapists, couples and family therapists.

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Part I

Theory and practice

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Introduction

The family within: a developmental focus on family and couple psychotherapy

Penny Jools

This book is for psychotherapists who work with couples and families. The work of eight practitioners in this field will be presented. Each chapter will give examples from clinical practice. Some chapters are written by one person and some by two. This reflects the collaborative nature of our work. We see couples and families on our own, but we think about them together. We will also explain how we work with the people who come to us seeking help. The first five chapters describe the thinking and the theory that underpin our practice, building on ideas that are already current in the international discourse on couple and family psychoanalysis from an object relations perspective. The second part of the book provides detailed case studies that illustrate these ideas.

When working with couples and families the notion of ‘the family within’ is of central importance. ‘The family within’ refers to the way our significant relationships are profoundly determined by our family of origin. We all, for better or for worse, internalise a sense of the family we have come from. And it continues to live within each of us. When we establish a relationship with another and form a couple, and when a new family is formed, the nature of the new entity is shaped by what we bring from our past.

The notion of ‘the family within’ that is used by the practitioners who have contributed to this book is heavily influenced by psychoanalysis. Psychoanalysis was created out of an understanding of what takes place in a consulting room between two people. The theories and the technique that were initially developed in the field of psychoanalysis focused strongly on that dyad. While a person’s family of origin was considered important, it took some time before a couple or a family were thought of as ‘the patient’ or ‘patients’.

It is perhaps surprising that the psychoanalytic enterprise took so long to consider the couple and family as worthy of analysis in its own right, since, as Britton (1995, p. xi) pointed out more than twenty years ago:

The family remains the locus in quo of individual development and the unit of social expectation: ‘marriage’, whether celebrated or uncelebrated, socially contracted or uncontracted, or simply conspicuous by its absence, remains at the centre of ‘family life’. I think it does so because the idea of a couple coming together to produce a child is central in our psychic life, whether we aspire to it, object to it, realise we are produced by it, deny it, relish it, or hate it.

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This volume reflects our own clinical experience, which has been discussed at length over many years in seminars and papers: we offer our experiences and our thoughts for discussion in the hope that it will make an important contribution to our knowledge of the psychic life of couples and families, building on an international tradition of psychoanalytically-based couple and family therapy.

All eight practitioners are psychoanalytically-trained psychotherapists. A training in psychoanalytical psychotherapy with its three components, a personal analysis, theoretical lectures and seminars, and clinical experience, provides a solid foundation to progress to work with couples and families. Our contributors continue an interdisciplinary tradition which has always been an important way of working for most of us with a background of working in the government sector. The contributors include a child psychiatrist, two social workers, three clinical psychologists, a couple psychotherapist and a Jungian analyst. All of us have experienced an infant observation as part of our training. Most of us have worked with young children. Both these experiences give us access to the primitive feelings, sometimes difficult to express in words, that are an important part of the child’s experience. These feelings can be distressingly re-evoked in the intimate relationship with a partner and lead to a request for help.

Working with couples and families makes a considerable initial challenge to anyone, even the person trained to work with the individual: the couple or the family, not the individual, is the patient. We often sit in the consulting room with warring people. Their hurt and rage threatens our capacity to think. Sometimes, the atmosphere they create is so intense we wonder how they got together, why they stay together. When we can think we have to understand what this conflict means to each of the participants. We draw on our knowledge of the couple’s history and the theoretical maps available to navigate the complex interactions before us. We are able to think about the family each has developed within and the way it has shaped their emotional development. We notice that they are seeing each other in black and white terms, and cast each other in roles, plays and scripts which have histories that determine how they experience each other.

In this book we pay considerable attention to the emotional impact on the therapist of destructive behaviour in the consulting room. We may have ‘forgotten’ our childhood experiences, but witnessing conflict in our patients can resonate painfully with our own early traumatic experiences. Therapists have to be aware of their own ‘family within’. Much of the work of therapy is understood through the transference and counter-transference experiences of the therapist and how the projective identification distorts relationships. In work with couples and families, theses transferences, counter-transferences and projective identifications are more complex than in a dyadic relationship. Hence we underline the importance of the use of the self in this work and therefore the importance of supervision and a larger community of like-minded therapists to support the therapist in carrying these toxic emotions without enacting them in an unhelpful way. We are then in a better position to alleviate the suffering of those who seek our help and assist them to lead more fulfilling lives.

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As psychotherapists we understand that it is our most intimate relationships that evoke and frequently provoke our sense of vulnerability, dependence and anxiety. Many of the parents in this volume seem to function well in the real world, hold down jobs, have friends, but find themselves dismayed at the emotional minefield unleashed in their relationships with their partners and families.

While Freud (1916/1917) acknowledged the impact on the unconscious of childhood experience and how it affected the adult psyche, it was later psychoanalysts, like Klein (1946) and Fairbairn (1952) who shifted the focus to very early experience. It is these very early primitive feelings that often create painful conflict in couples, but also affect us as therapists. The case studies in this book attempt to describe and understand these primitive feelings in our patients and in ourselves, and make clearer the family within that creates the dilemmas we are witnessing in the consulting room.

The theoretical material in the first five chapters will, we hope, provide a map that can assist in charting a passage through these often stormy waters. Our theoretical map or model is a developmental one. What does this mean? Our argument in these chapters is that the emotional growth of a couple or family can usefully be explored using a model of the emotional growth of an infant. For example, the infant’s first experience in the world is sensory: feelings provoked by touch and being held and our other senses too, hearing, sight and taste. These sensory experiences are important in a couple’s relationship, particularly their sexual relationship: couples’ difficulties in touching and holding each other, we suggest, may arise from compromised early experiences. Does an infant raised in an orphanage have an adequate experience of touching and being held? What might this do to the same person’s capacity to be available in an intimate sexual relationship in adulthood?

We know the world of the child is also full of conflicted emotions, tears one minute, laughter the next: many parents have had the experience of an enraged 2-year-old, faced with a frustration of their desires, who, hands on hips, yells ‘I hate you’. This can also be the response of an adult partner to the ordinary frustrations of an intimate relationship. Families and couples, (unlike the 2-year-old) can be dismayed when the restraint they are able to show in their working lives, disintegrates at home, where at times hate can prevail over love, and restraint and reflection can go out the window.

While the young child may move quickly and painlessly from hate to love in the space of a few minutes, the ambivalent nature of any intimate relationship is harder for the adult to understand and accept. Holding the tensions between love and hate, where love can prevail, is one of the tasks of marriage, which sounds easy but isn’t.

Family life is intense. The older child can exhibit jealousy and rage at the sense of exclusion from the parental relationship and become distressed and angry at the arrival of a new sibling. A 3-year-old may jump into bed on Sunday morning and insinuate himself between the parents. These manifestations of Oedipal issues can be difficult for a family to manage, especially if they resonate with the parents’ own unresolved Oedipal anxieties.

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Family life is also full of acceptance and love, and a bit like democracy, is a flawed system for raising children, but is one we value, notwithstanding, or perhaps because of, the variety of relationships the family now encompasses. As E.M. Forster said in 1938, as war was approaching: ‘So two cheers for Democracy: one because it admits variety and two because it permits criticism. Two cheers are quite enough: there is no occasion to give three.’

Our argument in this book is that the very intensity of family life, the anxiety that these intense feelings provoke and the defences than can be mobilised against safely experiencing and understanding these feelings, is at the very core of our therapeutic work. Our task has been to provide a map to chart a way through the human dilemmas we encounter in our work, and thus help our couple to understand their family within, and how that is affecting the real life family they are trying to create.

In the thirty years our group has been working in the field, we find that it is often concerns about the child that bring the couple or family into seeking some form of therapy. Most parents want the best for their children and will seek help for them if they feel they are distressed. A focus on the couple often frees the child to get on with the normal developmental task of childhood. Crucial to the work is the idea that the couple/family is able to develop a reflective space to think about itself. We argue that this occurs through the emotional containment the therapist provides within the predictable safe space of the consulting room. The latter part of the book provides case studies that illustrate the developmental model, and the work of the therapist in helping couples and families to move on.

As someone who is intending to do this work, you may be wondering what kind of frame couple and family psychotherapy requires. Is it the same or does it differ from other therapy modes? Generally the frame refers to the contract that has been established with the patient (individual, couple or family) about how often they will meet, for how long and for how much. Mostly couple or family psychotherapy is shorter in duration than psychoanalytic psychotherapy; two to three years is a common time for therapy to last. We usually see the couple or the family weekly, for one hour, with therapeutic breaks often during school holidays. As an example of the way we work, one question that is often raised is: what happens when only one member of the couple turns up for therapy? You will probably want a strict rule about this, but in reality, like in most situations in therapy, the reason for the absence has first to be understood. Why is the other person not there, what is the absence expressing? What impact on the relationship will it have if only one of the couple is seen? The important thing here is to be able to think about the meaning of the situation, remembering that the couple or family is the patient.

How the book is organised

The book falls into three parts.

The first five chapters present our theoretical model for working with couples and families together with the application of these ideas to the work. This section crystallises our object relations model of psychic development in couples and families, as well as how we work using this model.

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The second part of the book presents case studies by seven of the contributors, amplifying the concepts outlined in the first five chapters. These chapters highlight, as does the theoretical model, the role of early neglect, deprivation and abuse, and the impact of this on the couple relationship, particularly the sexual relationship.

In the final section we include a case study and discussion of attachment and its relationship to object relations theories. Finally we look at the use of affective learning groups as a way of helping attendees at a conference experience and process the material presented. The volume concludes with some clinical and theoretical questions that remain unanswered, questions that will hopefully lead to further discussions and thinking in this field.

Confidentiality

Couples and families whose cases have been cited in the following chapters have given permission for the use of their material. The identities of the participants have been disguised and in some instances the case material is a composite of several cases.

References

Britton, R. (1995). Foreword. In S. Ruszczynski and J. Fisher (Eds.) Intrusiveness and Intimacy in the Couple (p. xi). London: Karnac.

Fairbairn, R. (1952). Psychoanalytic Studies of the Personality. London: Routledge.

Forster, E.M. (1951) What I Believe. London: Harvest Book. First published in The Nation, 16 July 16, 1938.

Freud, S. (1916/1917). Introductory Lectures on Psycho-Analysis. Lecture XXXVIII: Analytic Therapy. S.E., Vol.16 (pp. 448–463). London: Hogarth Press.

Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psycho-Analysis, 27, 99–110 [Reprinted in M. Klein, Envy and Gratitude and Other Works 1946–1963. London: Hogarth Press, 1980].

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Chapter 1

The couple and family in mind

Jenny Berg

Just as children change with age and experience, so do couples and families. Every couple and family face challenges in their development; the birth of a child, the loss of parents, retrenchment, and the ‘empty nest’ when children leave home are some usual examples. But not all couples and families have the capacity to deal with these changes.

In this chapter we examine how early experiences shape the minds of the individuals that later form the couple, and how this early experience then affects the couple’s combined capacity to negotiate change. Common to all psychoanalytic theories is the idea that we are formed by our experiences as infants and children. The focus in object relations theory is on the impact on the personality of the earliest relationship between the mother and infant...

Table of contents

• Cover Page
• Working with Developmental Anxieties in Couple and Family Psychotherapy
• Title
• Copyright
• Contents
• Preface
• Acknowledgements
• Notes on Contributors
• Part I Theory and Practice
• Part II Case Studies in Developmental Anxieties
• Part III Attachment Theory and Affective Learning Groups: Applications of Our Model
• Concluding Thoughts
• Glossary Meaning of Terms and Application to Couple and Family Work
• Index