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Nr 12. 2005 sid.
25–39
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How couples present for psychotherapyAlthough couples and individuals seeking therapeutic help share similar dilemmas, there are some general characteristics of couples seeking help that call for a slightly different approach to the assessment. Firstly couples coming for help are very often in a crisis, with anxieties about family life falling apart. They often don’t have any idea about how psychotherapy works or how it could help them, they just want help. They can exert massive pressure on the therapist to take action to hold things together or to support precipitate action. Secondly it is quite frequent that only one partner, at least consciously, wants to come and the other feels they have no choice, as one husband put it to me recently: “I’ve come with a gun to my head”. It is clear that some partners would never seek therapy if they felt they had a choice. Typically a couple coming for an assessment will bring lot of anxiety, uncertainty and often, in one partner at least, resistance. Thirdly many partners convey in different ways how excruciatingly embarrassing and humiliating it feels to be coming for help with the private arena of their intimate adult relationship. Some patients feel very exposed and fear further exposure, or they feel ashamed or guilty or have feelings of failure. For these reasons assessment for couple psychotherapy is a very particular activity, not simply a different context for a psychoanalytical assessment. As well as assessing the couple for psychotherapy, in the sense of formulating a diagnosis and considering suitability for treatment, a lot of attention usually needs to be given to the containment of these anxieties. This is also important if they are to have any chance of making the transition to couple psychotherapy if this is appropriate. While the anxieties described above may be part of that which any patient brings to any psychoanalytic assessment, these particular kinds of anxieties and impulses are predominant in the couple presenting for help. In assessing couples for ‘couple psychotherapy’ I do think of this as a discrete form of psychoanalytic psychotherapy, not an adjunct to individual psychotherapy or psychoanalysis. In my view it is the treatment of choice for some patients. Many patients who present for help as a couple, as described above, would not consider seeking help on their own and it is through coming with their partner that they get help for themselves as well as for the relationship. Alongside the conscious reasons for which couples seek help, they are usually motivated unconsciously to seek help together because their intrapsychic conflicts are projected into and experienced within the arena of their interpersonal relationship and this is sometimes the only arena in which they can be explored. ...
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Copyright: Allt material ©
MELLANRUMMET 2011-10-29 |
Mary Morgan arbetar i privat praktik och sedan många år vid Tavistock
Centre for Couple Relationships i London, där hon är Senior Couple
Psychoanalytic Psychotherapist. Hon har också undervisat i ämnet såväl i
England som utomlands, speciellt i USA och i Skandinavien. 1992–95 var
hon behjälplig med att anordna den första utbildningen i parterapi på
psykoanalytisk grund i Sverige. I artikeln belyses hur par som söker
hjälp ofta är i kris, och inte sällan är det bara den ena partnern som
önskar hjälp. Hur terapeuten under bedömningsfasen måste ”containa”
paret på olika sätt, och hur de svarar på detta är en väsentlig del i
bedömningen av parets problem. Detta illustreras i denna artikel som är
skriven direkt för Mellanrummet.
