Same-Gender Couple Therapy: Creating New Objects in Intimacy and Parenehood Transition

The formation of same-gender couple and parental relationships is described and analyzed from a combined relational and couple therapy. The parenthood transition of a homosexual couple into a family structure, that includes two biological parents and a stepfather, creates tremendous turbulence and crises. The couple link is transformed throughout critical and major changes from a two-ness unit into a four- one, which develops unique relationships with the mother and the baby. This paper presents how therapists can treat and intervene in both intra-psychic gender crises as well as inter-psychic breakdowns of the couple shared reality. The therapeutic processes highlight the transformative changes that the homosexual couple has to experience in order to accept the loss of previous accomplishments in gender identity and love relationships. In addition, therapy helps to disentangle co-joint couple objects while creating new shared spaces.Aviva Mazor, PhD, is at the Bob Shapell School of Social Work, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, 69978, Israel (A-mazor@netvision.net.il). She received a PhD from University of Wisconsin-Madison. Her current research is in combined relational and family therapy with alternative families, separation processes from multigenerational perspective, and the post-traumatic effects of holocaust child-survivors.     

Embodying the Couple Relationship: Kinesthetic Empathy and Somatic Mirroring in Couples Therapy

Kinesthetic sensitivity plays a central role in the development of empathy and in understanding others’ intentions, skills that greatly affect spousal satisfaction. The present study examines how, in the couple relationship, somatic mirroring of the other’s physical expressions creates an emotional experience in the relationship, and in couples therapy, sets processes in motion. Such understanding is critical in couples therapy to harness the embodied knowledge needed to address issues in areas where verbal discussion is insufficient. Nine couples (n?=?18) participated in 12 couples therapy sessions that incorporated somatic mirroring. The sessions were documented on video and through the personal diaries kept by the therapists and patients. The participants related to four main themes: Somatic mirroring (a) creates comfort and emotional availability, (b) contributes to identifying and labeling feeling, (c) contributes to arousing intimacy and desire, and (d) avoiding somatic mirroring is characteristic of moments of conflict in the relationship. To create a bridge between the research and the clinic, in the Discussion section methods for connecting with embodied knowledge in couples therapy are examined, with the implications of having familiarity with such knowledge on the intimate relationship and the couple’s communication.     

Empathy,Vulnerability and Anxiety

ABSTRACT

A concept of empathy as openness to the emotional perspective of another is developed in opposition to a concept of sympathy as agreement with the emotional perspective of another. Empathy involves knowledge of how things are emotionally for the other person, which is not the same thing as knowledge of the other person’s emotions. Being open to another perspective requires the capacity to hold two perspectives in mind simultaneously – one that is one’s own perspective and at the same time the adopted perspective. This is why empathy can be so challenging for someone suffering from some kinds of anxiety.     

Empathy,Respect, and Vulnerability

ABSTRACT

This paper reconsiders Heather Battaly’s argument that empathy is not a virtue. Like Battaly, I argue that empathy is a disposition that includes elements of virtue acquisition, but is not in itself a virtue in the Aristotelian sense. Unlike Battaly, however, I propose a distinction between care and respect. Drawing on Darwall’s view of recognition respect as well as on phenomenologically inspired views of empathy, I argue that respect can be regarded as the moral feeling that is distinctive of empathy. In my view, the feeling of respect towards another’s situated experience grants epistemic dignity, which is the recognition of the intrinsic significance of subjective experience. By way of conclusion, I suggest that the relation between empathy and respect can be relevant for an account of vulnerability that is not opposed to autonomy.     

Beyond Empathy: Vulnerability,Relationality and Dementia

ABSTRACT

This paper brings together a phenomenological and vulnerability-theoretic approach to dementia. The paper challenges the view that subjects with dementia can simply be understood in terms of diminished cognitive capacities or that they have lost all vestiges of personhood or the capacity for meaningful interaction. Instead, drawing on vulnerability theory and the phenomenological work of Kristin Zeiler and Lisa Käll, an alternative view of persons with dementia is offered that is based on intersubjective and intercorporeal relations and accomplishments. A vulnerability approach to dementia is developed that not only provides the basis for empathetic responses to illnesses such as dementia but also points to the intersubjective constitution of subjects more generally. The argument developed is that the notion of vulnerability designates a form of openness to others and that such openness is a precondition for empathy.     

Mutual Vulnerability: Intimacy,Psychic Collisions,and the Shards of Trauma

In this paper, I explore the profound potential, and the challenges, of mutual vulnerability in psychoanalysis. I describe ways in which analysts are penetrated by shards of our patients’ trauma, and how this interpenetrates with our own vulnerabilities and ungrieved losses (Harris, 2009; Levine, 2016). In my patient Lisa’s fierce determination to come into being, and in our mutual efforts to survive each other’s ruthlessness (Winnicott, 1969) we each struggle to recognize and own malignant “not-me” versions of ourselves (Bromberg, 1998), as we reach toward reparation, mutual recognition, and healing.     

Multi-Level Couple Therapy: Applying a Metacommunicational Framework of Couple Interactions

Excerpts from a couple therapy case are cited to illustrate the practical significance of a multi-level framework in understanding couple interactions. The clinical implications of the metacommunicational framework, as a metaphor for examining and understanding relational processes, are discussed. Also, the pragmatics of following “process” at a variety of levels when working with punctuational differences, developing therapy strategies and goals, and measuring the progress of couple therapy are discussed.     

From Couple Therapy 1.0 to a Comprehensive Model: A Roadmap for Sequencing and Integrating Systemic,Psychodynamic, and Behavioral Approaches in Couple Therapy

Couple therapy is a complex undertaking that proceeds best by integrating various schools of thought. Grounded in an in‐depth review of the clinical and research literature, and drawing on the author's 40‐plus years of experience, this paper presents a comprehensive, flexible, and user‐friendly roadmap for conducting couple therapy. It begins by describing “Couple Therapy 1.0,” the basic conjoint couple therapy format in which partners talk to each other with the help of the therapist. After noting the limitations of this model, the paper introduces upgrades derived from systemic, psychodynamic, and behavioral/educational approaches, and shows how to combine and sequence them. The most important upgrade is the early focus on the couple's negative interaction cycle, which causes them pain and impedes their ability to address it. Using a clinical case example, the paper shows how all three approaches can improve couple process as a prerequisite for better problem solving. Additional modules and sequencing choice points are also discussed, including discernment counseling and encouraging positive couple experiences.     

Sexuality and Intimacy in Couples Therapy

SUMMARY

In ages past, spiritual seekers left their close relationships for the seclusion of a monastery or a solitary journey, facing their dragons essentially alone. Today, however, many of us face the dragons within us as we undertake the tasks of differentiation and individuation. Thus, our relationships, if we allow them, can become the loci of our deepest self-exploration, leading to deepening intimacy with our partners.     

Identification as a Focal Point in Couple Therapy

It is impossible to speak meaningfully about a couple's relationship without giving full consideration to the way the partners' childhood experiences have influenced their identities. Each partner is affected by his or her relationships with both parents and by intimacy beliefs shaped through observations of the parents' marriage. Often, unconscious identifications underlie the interactions that lead distressed couples to seek therapy. This paper explores two concepts that can assist therapists in repairing the present in the context of the past—projective identification and disidentification. Consideration is given to the power of the parents' marriage and to identifications based on individual parents.     

Random Thoughts on Couple Therapy in a Postmodern Society

The postmodern period in psychoanalysis has had a considerable impact and influence on the psychotherapeutic process in both psychoanalysis and psychotherapy. The paradigm shift, reflected in the work of the intersubjectivists, rationalists, and social constructivists, has shifted emphasis from a one-person psychology to a two-person psychology. Implications for treatment are numerous. The change in emphasis affects not only how individual treatment is conducted but also couple therapy and group therapy. In considering the impact of these recent changes, the author notes the wide range of influences that inform her couple and group therapy. Although the current paradigm shift offers much, it seems to be an extension of earlier influences from self psychology, motivational systems, and attachment theory and of findings from neuropsychology. The author concludes that her couple work has also been intuitively informed by the implicit experience of the intersubjective field of group therapy.     

Screening for Physical Violence in Couple Therapy: Methodological,Practical, and Ethical Considerations

Over two-thirds of clients in family therapy clinics engage in some form of physical violence against their partners within the year prior to the initiation of therapy. However, family therapists are aware of only a small proportion of these cases. The purpose of this article is to enhance the ability of family therapists to detect marital violence. We examine client and therapist reasons for why physical violence is not detected. We then review various methods to screen for the presence of physical violence, especially the Conflict Tactics Scales. Finally, indicators of life-threatening violence are presented to help family therapists detect cases that require immediate intervention to protect the partner whose life may be in danger.     

New Sexism in Couple Therapy: A Discursive Analysis

The persistence of gender inequality in postindustrial societies is puzzling in light of a plethora of changes that destabilize it, including shifts in economy, legislation, and the proliferation of feminist politics. In family relations, such persistence manifests as a disconnect between couples aspiring to be more egalitarian yet continuing to enact traditional gender roles and hierarchies. There is an emerging consensus that gender inequality persists because of people's continued reliance on sexist ideology or gendered assumptions that constitute women as innately distinct from and inferior to men. Sexist ideology changes its form to accommodate to changing socio‐economic conditions. Contemporary forms of sexism are old ways of legitimizing male power articulated in new and creative ways, often by incorporating feminist arguments. To effectively recognize and address “new sexism,” scholars and practitioners require new, innovative research frameworks. Our objective in writing this article is two‐fold. First, we seek to advance discursive (i.e., focused on language in use) approaches to the study of sexism. Second, we present the results of a discursive analysis of “new” sexist discourse in the context of couple therapy. The study provides preliminary evidence that, despite endorsing egalitarian norms, couples studied continue to rely on gender binaries and remain entrenched in old‐fashioned patterns of gender inequality. Implications of these results for the practice of couple therapy and for future research are discussed.     

Secrets or No Secrets: Confidentiality in Couple Therapy

This paper discusses secrecy in couple therapy from ethical and clinical perspectives. The author explains what secrets mean in terms of therapy and then moves to what controversies are raised by revealing or withholding secrets. The author reviews and evaluates current approaches to handling secrets in couple therapy regarding the use of informed consent. Additionally, the manner of implementation serves as another variable. In this paper, the author presents several scenarios which are widely used. The article ends with a call for further research on how the change of formats in therapy affects confidentiality.