The impossible reparation

This article discusses the phantasy of returning to the past and symbiotically merging with the mother, which, in an autistic patient, constituted an attempt of impossible reparation. This mode of reparation resulted in a cycle in which any attempt to repair the inner experience by contact with an external object was destined to be disappointing because of the desire for an infantile connection without separateness. The author reviews the literature on reparation and emphasises recent developments resulting from work with Autism Spectrum Disorder children who are far from the depressive position and who have difficulty bearing separateness. The author recognises an essential positive aspect of reparation independent of the ability to perceive the object as separate and suggests that when working with very primitive emotional states, it seems suitable to use a wider definition for what can be considered essentially a primitive reparative act or a precursor for reparation. Next, the author discusses the significance of a phantasy of impossible reparation in an autistic girl with emphasis on the importance of considering the reparative aspects of this defensive phantasy to enable development. Finally, the author relates to the despair that occurs in both analyst and patient when the phantasy is not transformed.     

Treating Fused Couples

SUMMARY

Marital therapy with couples in which the partners are undifferentiated and highly fused entails attention to both individual and interpersonal dynamics. Individual structural problems such as insufficient sense of self, poor self-other differentiation, primitive defenses, and incomplete object constancy tend to co-occur with couples issues such as anxious attachment, possessiveness, jealousy, and patterns of reactivity and explosive fighting. A model for dealing with fusion in couples is presented that demonstrates how constructs and techniques of object relations theory serve to inform and to enhance the practice of Bowenian systems therapy.     

Aesthetic experience

An initial clinical question, ‘Why does an analysand talk about his/her relationship with an aesthetic object?’ opens an investigation into the nature of aesthetic experience. Three principal aspects of the psychoanalytic approach are presented: sublimation, a Freudian concept concerning the vicissitudes of the drives; reparation, a Kleinian concept linked to depressive anxiety; and transformation, a concept of object‐relations theory about primitive ego‐states. The article discusses the psychic function of aesthetic feelings in mastering anxiety as related to ego, id and superego. The transformation of the experience of passivity is a common link underlying these aspects. Such transformation relies on tolerating ambiguous and contrary feelings within the self, fostered by contact with an aesthetic object. This balance can, however, be upset: two excessive forms of aesthetic experience ensue, namely, fascination and bewitchment. The first belongs to the experience of awe; the second can lead to claustrophobic anxiety. The initial clinical question requires an elaboration of aesthetic transference, a variant of the narcissistic transference, whereby the analysand invites the analyst to share his/her internal state as a common unspoken object.     

The role of attachment‐related individual differences in goal adoption for serial arguments

This study investigated the relations between attachment‐related individual differences and the adoption of interpersonal goals for conflict in romantic relationships. Additionally, it used the truth and bias model to examine how biased and accurate people are in judging their partner's endorsement of conflict goals, as well as how attachment‐related individual differences moderate this bias and accuracy. Ninety‐four romantic couples completed a measure of attachment‐related individual differences and self ‐ and informant reports of interpersonal conflict goals. Results revealed that individuals endorsed conflict goals consistent with their attachment orientations. Furthermore, they displayed biases when estimating their partner's goals, with some of these biases relating to attachment orientations. These results suggest that attachment‐related individual differences may partially guide conflict‐related goals and partner perceptions.     

More than One Way to be Happy: A Typology of Marital Happiness

This study utilized observational and self‐report data from 57 happily married couples to explore assumptions regarding marital happiness. Suggesting that happily married couples are not a homogeneous group, cluster analyses revealed the existence of three types of couples based on their observed behaviors in a problem‐solving task: (1) mutually engaged couples (characterized by both spouses' higher negative and positive problem‐solving); (2) mutually supportive couples (characterized by both spouses' higher positivity and support); and (3) wife compensation couples (characterized by high wife positivity). Although couples in all three clusters were equally happy with and committed to their marriages, these clusters were differentially associated with spouses' evaluations of their marriage. Spouses in the mutually supportive cluster reported greater intimacy and maintenance and less conflict and ambivalence, although this was more consistently the case in comparison to the wife compensation cluster, as opposed to the mutually engaged cluster. The implications of these typologies are discussed as they pertain to efforts on the part of both practitioners to promote marital happiness and repair marital relations when couples are faced with difficulties.     

Love in Action: An Integrative Approach to Last Chance Couple Therapy

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce—who often describe this therapy as their “last chance.” In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high‐conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three “primary colors” of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language‐based and action‐based practices, suggesting that meaning is held and expressed as much through interaction or “relational motion” as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action‐based interventions in early stages of therapy, by engaging couples in “experiments in possibility.” Typical action approaches are described. An extended vignette follows.     

Knowledge and experience of time in primitive mental states2

The author proposes that time be considered an object of working through during the psychoanalysis of patients whose mental functioning reveals distinct primitive aspects. These so‐called ‘difficult patients’ are particularly intolerant of the temporal limits of analytic sessions and often attempt to undermine the analytic setting. He presents some hypotheses about time and the mind's depth levels. A series of clinical vignettes taken from the analysis of adolescent, borderline and psychotic patients shows several ways in which the analysand's perception of and relation to time surfaces and is worked through in the course of analysis. Analyzing the relationship with time and the conflict between denial and acceptance of temporality proved a significant catalyst in the development of cases that had tenaciously impeded progress. It thus became possible to bring about important changes in the ways such patients experienced affect in the analytic relationship and in object relations, not by acting directly upon these relationships but by working instead on the formal parameters that organize the mind–and primarily on its spatio‐temporal organization.     

Relational aggression in marriage

Drawing from developmental theories of relational aggression, this article reports on a study designed to identify if spouses use relationally aggressive tactics when dealing with conflict in their marriage and the association of these behaviors with marital outcomes. Using a sample of 336 married couples (672 spouses), results revealed that the majority of couples reported that relationally aggressive behaviors, such as social sabotage and love withdrawal, were a part of their marital dynamics, at least to some degree. Gender comparisons of partner reports of their spouse's behavior revealed that wives were significantly more likely to be relationally aggressive than husbands. Structural equation modeling demonstrated that relational aggression is associated with lower levels of marital quality and greater marital instability for both husbands and wives. Implications are drawn for the use of relational aggression theory in the future study of couple conflict and marital aggression Aggr. Behav. 36:315–329, 2010. © 2010 Wiley‐Liss, Inc.     

Shifting expectations of partners' responsiveness changes outcomes of conflict discussions

Expecting responsiveness from a partner may increase the chance of successful conflict resolution through a self‐fulfilling prophecy. Such expectations derive in part from people's history of receiving responsiveness and from their belief that their partner values them (S. L. Murray, J. G. Holmes, & N. L. Collins, 2006). This belief can be fostered by having individuals reframe a partner's compliment in an abstract way (D. C. Marigold, J. G. Holmes, & M. Ross, 2007). In this study, 96 dating couples were randomly assigned to complete a compliment reframing intervention (or not) prior to discussing a conflict. Without intervention, couples who typically had a lot of conflict reported less positive expectations of their partner for the upcoming discussion and subsequently worse outcomes than low‐conflict couples; these differences were eliminated in the compliment reframing condition. This research demonstrates the importance of perceived value and expectations of responsiveness in shaping the outcomes of conflict discussions, suggesting additional points of intervention beyond communication skills for high‐conflict couples.     

Treating Faith‐Based Infertile Couples Using Cognitive‐Behavioral Counseling Strategies: A Preliminary Investigation

The authors have found no study that addressed the influence of religious practices, biblical texts, and a spiritual environment on the dynamics of coping with crises often experienced by couples who are infertile and who transition into childlessness. Twenty‐five couples from the greater New York area who were referred by religious leaders participated in an in‐depth interview to share their experiences. This study is a preliminary investigation of the experiences and emotional dynamics of infertile couples. It further illustrates how cognitive‐behavioral approaches may be used as possible intervention strategies.     

Commitment

SUMMARY

This article addresses the issue of commitment and its importance in developing and sustaining an enriching relationship. The author describes commitment, its dynamics, and its implications for treating couples in conflict. The author also describes the conditions in which the issue of commitment is addressed in therapy and treatment interventions that can be used to help couples resolve their differences.     

More than One Way to Get There: Pathways of Change in Coparenting Conflict after a Preventive Intervention

This study explored pathways of change in the levels of conflict couples experienced after Supporting Father Involvement, an evidence‐based, prevention‐oriented couples and parenting intervention that included a diverse low‐income and working class group of participants. Pathways of change were examined for couples with baseline conflict scores that were initially low, medium, and high. The growth mixture model analysis found that the best‐fitting model for change in couples' conflict was represented by three distinctly different change patterns. The intervention was most successful for High‐Conflict couples. This finding contributes to a growing literature examining variations in how relationships change over time and the process of change, especially for couples in distress. This study supports further investigation into the impact and costs associated with universal interventions versus those that target specific groups of higher risk families.     

The division of labor in close relationships: An asymmetrical conflict issue

This research addresses couples’reports of their (hypothetical) attempts to maintain or change a gendered division of labor through conflict interactions. Two experiments in which spouses responded to scenarios showed that spouses reported more conflict over the division of housework than conflict over paid work and child care, and that wives more often than husbands desired a change in their spouses’contribution. Spouses reported more wife‐demand/husband‐withdraw than husband‐demand/wife‐withdraw interaction during hypothetical conflict over the division of labor, but only when the wife desired a change in her spouse's contribution. Together, the data imply that wife‐demand/husband‐withdraw interaction is a likely response to the asymmetrically structured conflict situation in which the wife is discontent with her husband's contribution to housework, while her husband wants to maintain the status quo. We further showed that defenders of the status quo were more likely expected to reach their goal than complainants. In the role of complainant, wives were more likely expected to reach their goal than were their husbands, but only when the conflict issue concerned their own gender stereotypical domain (i.e., family work).     

Contemporary art and Hanna Segal's thinking on aesthetics

From the point of view of the history of ideas in psychoanalysis, a major shift may be described from Freud's starting point considering art as sublimation of sexual desires on a largely objectal level to later developments emphasizing the presence in art of destructiveness and narcissistic conflicts. Segal's contribution represents a watershed in this evolution. Following Klein, Hanna Segal suggests considering art in relation to depressive anxieties and reparation in such a way that artistic activity may be seen as an attempt 'to restore and re-create the loved object outside and inside the ego' which implies a successful work of mourning accompanied by symbol formation. For Segal, these reparative processes are conveyed through formal beauty which represents the victory of reparation over destruction. Nevertheless, contemporary art demands that we consider the intervention, in art, of more raw and less symbolized/sublimated processes, including acting-out in often primitive, psychotic or perverse ways. Thus this paper unfolds in two directions: on the one hand, it examines the differences and continuities between Freud's and Segal's thinking whilst, on the other, the author presents some alternative ideas which stress the search for truth and new thinking in contemporary art.     

The ‘uncanny’, the sacred and the narcissism of culture: The development of the ego and the progress of civilization1

The report by a member of the Brazilian parliament that the rejection of physical deformity is natural and instinctive, and the Muslim reaction to the publication in the Western press of cartoons considered to be offensive to their religion, serve as an introduction to the examination of conflicts in human relations. The two episodes may be classified as representing the sense of the ‘uncanny’, attributed by Freud to the narcissism that remained from primitive cultures, in which the shadow cast by the body and the mirrored reflection of the latter probably generated the idea of soul‐which would be the narcissistic phenomenon causing the illusion of immortality. The presence of this illusion as a support for the beliefs of present‐day civilized peoples makes clear the inopportune influence of primitive mental states in areas where more developed ones should prevail. The persistence of the omnipotent thinking derived from these states provides the possibility of drawing a parallel between the development of the ego‐evolution from narcissism to object relation‐and the progress of civilization. In this context, the majority of social conflicts can be attributed to the deficient object relation resulting from the strength of primary narcissism, which generates a tendency to reject that which is different and to facilitate the emergence of destructive aggressiveness. The progress of civilization would then occur by means of a development of the ego compatible with object relations that lead to a drastic reduction in destructiveness.     

Demeter's Compromise: Separation,Loss, and Reconnection in Mothers with Daughters Entering Adulthood

Drawing on contemporary theory of female development that focuses on the dynamics of the mother/daughter relationship regarding issues of separation and individuation, this article examines the treatment of a middle aged mother as she navigates her way through her daughter's adolescence and early adulthood. Psychoanalytic object relations, psychoanalytic relational theory, and feminist theory serve to frame an understanding of the case material in terms of developmental challenges that are uniquely female. Issues around mother/daughter attachment, separation, competition, conflict, and love are explored in the relationships between the patient and her mother, the patient and her daughter, and the patient and the therapist. The therapist's countertransference, intensified by her relationships with her own mother and daughter, suggests the possibility of both pitfalls and opportunities in the treatment. The article attempts to address a gap in psychoanalytic developmental theory, which offers little understanding of the challenges for women in midlife.     

Introduction to object relations group psychotherapy.

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or "basic assumptions group." Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

The distribution of influence in purchase decisions by male homosexual couples

The purchase decisions of families are of great interest to marketing researchers, yet families also have become increasingly multi‐faceted, especially in Western societies, where non‐traditional families are far more prevalent and evident in public and business life than they once were. Even as it attempts to adapt to some changes, marketing has not kept up with every development; homosexual couples in particular remain poorly researched. This article therefore examines which factors affect the distribution of influence between partners in male homosexual, long‐term relationships when they make purchase decisions. In line with some extant predictions, male homosexual families tend to use highly egalitarian processes to make purchase decisions. Sex‐role orientation generally does not significantly affect the distribution of influence. In contrast with prior work, this study also shows that a partner's resources affect his relative influence. The investigation demonstrates that some conflict resolution styles employed by partners have significant effects on influence distribution in the context of purchase decisions by male homosexual couples. By providing insights into the purchase decision‐making of male homosexual couples, this research broadens the understanding of homosexual consumers in general. Moreover, the findings about the effect of conflict resolution styles on the influence distribution in male homosexual couples adds significantly to consumer research. Copyright © 2013 John Wiley & Sons, Ltd.     

The Patient-Staff Community Meeting: A Tea Party with the Mad Hatter

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or “basic assumptions group.” Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

Integrating Sex and Couples Therapy: A Multifaceted Case History

Traditionally, sexuality has not been a focus in couples therapy training, research, or practice, although it is an important, often complex issue for many couples. This article tells the story of a couple presenting for sex therapy due to their unconsummated marriage, and is told to exemplify how sex therapy and couples therapy can be integrated in order to best meet the needs of couples. As the story unfolds, the multilayered facets of the presenting issue are revealed. The therapy incorporates and weaves together family of origin history, intrapsychic and cognitive issues, relational dynamics, patterns of interaction, and physiological/medical concerns into a postmodern couples therapy with behavioral interventions. This combined approach recognizes the value of each method on its own and their greater usefulness when blended together.