Vznik a historie Institutu psychoanalytické párové a rodinné psychoterapie (IPPART)
V oblasti manželské a rodinné problematiky u nás dlouho dominovaly tzv. poradenské, instruktivní přístupy zaměřené na chování ( z nich nejpopulárnějším se stal přístup M.Plzáka). Fantazie o vševědoucím odborníkovi, jenž po způsobu medicíny diagnostikuje a poradí správné postupy chování, jejichž dodržování povede ke štěstí, je pro řadu lidí velmi přitažlivá. Lidé kteří navštívili poradnu, nebo si přečetli rady odborníka v knize, nebo časopisu, vědí, že dodržení takových rad není jednoduché a dlouhodobě možné. Nerespektuje individuální odlišnosti a často se zcela příčí hodnotám a pocitům jedince. Jde o iluzi, že je možné najít vědoucího odborníka, který "objektivně" diagnostikuje (jako lékař) problém klienta a poskytne správnou radu (lék). Poradce, který nechápe nevědomé významy a nevědomou emoční dynamiku vztahu klientů, "střílí" nazdařbůh podle své osobní zkušenosti a povrchního porozumění.
Karel Kopřiva (Praha 1988), vystihl naše motivace k terapii takto: " Nezřídka však cítíme, že klientovi nechybí inteligence, nebo životní zkušenost, že by si dovedl poradit sám ještě lépe než to můžeme dokázat my za něj - kdyby mu v orientaci nebránil vnitřní zmatek, či kdyby jeho snaha po realizaci zvoleného přístupu nenarážela na vnitřní překážky."
Psychoterapeuté různého zaměření (na rozdíl od poradců) se většinou shodují v tom, že nikdo jiný nemůže být větším odborníkem na život klientů než pacienti a klienti sami. Oni sami nejlépe znají svoji situaci, své životní zkušenosti, své hodnoty. Oni jsou zodpovědní za svůj život. Psychoterapeuté, místo aby klienta nutili žít podle terapeutových hodnot a názorů, projevujících se radami a instrukcemi, pomáhají klientům využít jejich vlastních sil a najít jejich vlastní cestu k řešení problému. Zatímco dříve byla psychoanalýza komunistickým režimem u nás odsuzována a potlačována, v lepším případě tiše tolerována, dnes mnoho psychoterapeutů i manželských a rodinných poradců přijímá mnohé psychoanalytické koncepty jako samozřejmé a užitečné, někdy dokonce, aniž by si uvědomovali, že je objevili a popularizovali původně psychoanalytici.
Začátky psychoanalytické párové terapie jsou u nás spojeny se jmény psychologů : Slavoje Titla, Jaromíra Teichmana, Vratislava Strnada a Karla Kopřivy. Všechny nás spojovala hluboká nespokojenost se stavem manželského a rodinného poradenství v té době (70 - 90 léta) a intenzivní pozitivní osobní zkušenost z vlastních psychoanalytických tréninků a také první zkušenosti s léčbou neurotických a hraničních pacientů. Tzv. manželské poradenství (párová terapie se prakticky neprováděla) bylo charakterizováno povrchností nepochopením nevědomých souvislostí, zaměřeností na změnu chování a instruktivitou či direktivitou .V odborných i přátelských diskuzích se jmenovanými kolegy jsme společně hledali jiné možnosti v práci s páry. Hledali jsme psychoterapeutické přístupy založené na psychoanalytickém chápání a porozumění klientům a tedy porozumění vnitřní emoční dynamice jejich potíží, kterou si oni sami neuvědomují.
Karel Kopřiva a Vratislav Strnad byli již delší dobu v oblasti manželského a rodinného poradenství. Kliničtí psychologové J.Teichman a S.Titl pracovali v psychiatrické léčebně Bohnice. V manželském poradenství jsme fungovali zpočátku externě. Koncem 80. let S. Titl přešel z psychiatrické léčebny Bohnice do Manželské a předmanželské poradny ( později Poradny pro rodinu, manželství a mezilidské vztahy).
Zejména zásluhou Karla Kopřivy, psychoanalytického psychoterapeuta a erudovaného manželského poradce se podařilo vytvořit detašované pracoviště manželské poradny zaměřené na psychoterapeutické služby klientům. Dalšími členy pracoviště z řad psychologů byli tehdy Slavoj Titl a Vratislav Strnad. Všichni jsme se nacházeli v různých fázích psychoanalytického výcviku a na našich pracovně - přátelských setkáních jsme hledali nové možnosti přístupu ke klientům. Hledali jsme takové možnosti, které by byly založeny na nových poznatcích a zkušenostech s psychoanalýzou. Všichni jsme intenzivně studovali moderní psychoanalytickou teorii a techniky terapie . Naše pracoviště uspořádalo řadu seminářů s cílem seznámit odbornou veřejnost s psychoanalytickým přístupem a především díky Karlu Kopřivovi se podařila, na danou dobu a poměry (komunistický režim psychoanalýzu nepodporoval) neobvyklá věc, publikovat "Sborník - Moderní psychoanalýza a manželské poradenství" (Praha 1988), který obsahuje psychoanalytické příspěvky V. Mikoty, S.Titla, K.Kopřivy . Ty se staly základem budoucích aplikací do párové a rodinné terapie.
Postupem času se V.Strnad i Karel Kopřiva začali stále více zaměřovat na rozvíjení systemického přístupu k párové a rodinné terapii. S. Titl hledal cesty, jak pracovat s párem a rodinou psychoanalyticky. Vedle sebe pak na pracovišti koexistovala dvě zaměření - systemické i psychoanalytické a vzájemně se obohacovaly. Spolu s dalšími kolegy z poradny, kteří nastoupili psychoanalytický výcvik - Lucií Luckou, Lídou Padevětovou a Pavlem Horčákem, jsme začali s kazuistickými semináři, z nichž se později, s příchodem dalších kolegů, vyvinuly intervizní "peer group" setkání. Tyto semináře stále kontinuálně i po více než 20 letech pokračují obohacena novými, mladšími kolegy z řad psychologů a psychiatrů. Cílem seminářů byla a je vzájemná pomoc s komplikovanými párovými, později i individuálními psychoterapeutickými případy.
Aktivně pracující, psychoterapeuticky orientované, pracoviště v rámci poradny bylo po několika letech , z rozhodnutí vedení poradny, zrušeno a to odstartovalo postupný odchod všech analyticky orientovaných odborníků pražské poradny do soukromých praxí. Založení soukromé praxe neomezilo osobní kontakty, plodné diskuze a ani nezbrzdilo rozvíjení párové a rodinné terapie, naopak je podpořilo.
Rozvíjení psychoanalytického přístupu napomáhal od počátku svou inspirativní, inteligentní skepsí,
také Jaromír Teichman, který až do počátku 90.let zůstával jako klinický psycholog v Psychiatrické léčebně v Bohnicích a externě pracoval v Poradně pro rodinu a manželství. Počátkem 90. let pomáhal při vytváření základní techniky psychoanalytické párové terapie. Tato počáteční technika byla výrazně inspirována knihou D.Wille -"Couples Therapy; A Nontraditional Approach" (1981) a pracemi Jurga Wiliho (1990..)
V r.1993 jsme s kolegou J.Teichmanem otevřeli první trénink v psychoanalytické párové terapii. Byl to vůbec první výcvik v psychoanalyticky orientované párové a rodinné psychoterapii na území České republiky. Jeho frekventanty byly například Eva Bicanová, Lucie Lucká, Lípa Padevětová, Vlasta Plášková, Pavla Sokalská a další kolegové, z nichž někteří se stali postupně členy týmu IPPART nebo blízkými spolupracovníky. Tento trénink byl zaměřen především na pomoc poradcům manželských a rodinných poraden, kteří vnímali potřebu mít užitečnější psychoterapeutické nástroje pro svoji každodenní práci. Později do výcviků přicházeli i lékaři a kliničtí psychologové, což obohatilo výcviky o nové myšlenky a zkušenosti. Frekventanti za sebou měli většinou výcvik v SURu, tedy zkušenost se skupinovou terapií. Výcvik se odehrával ve 2 dnech (pátek, sobota) 1x v měsíci. Program tehdy sestával z asi 60 hodin obecné psychoanalytické teorie a z 60 hodin specifické teorie párové terapie a asi ze 120 hodin supervizí ve skupinovém uspořádání tzv. bálintovským způsobem. Poslední supervizní semináře byly věnovány případům frekventantů a přípravě závěrečných kazuistik. Podmínkou certifikátu bylo úspěšné vedení alespoň jedné psychoanalyticky orientované párové terapie.
Jak se naše aktivity rozšiřovaly cítili jsme větší potřebu organizační zakotvenosti. 10.3.2004 jsme (Slavoj Titl, Jaromír Teichman, Lucie Lucká, Lída Padevětová) založili Institut psychoanalytické párové a rodinné terapie ( IPPART) jehož hlavním úkolem bylo a je vzdělávání psychoanalyticky netrénovaných kolegů. Institutem postupně prochází řada kolegů psychologů a psychiatrů zajímajících se o psychoanalytické porozumění klientům s potížemi v párovém a rodinném životě. Někteří z nich např. Renata Doležalová, David Holub, Eva Junková, Martin Magula, Jiřina Melzer, Silvia Nurnberger, Petra Pokorná se stávají dalšími členy výcvikového týmu institutu IPPART nebo blízkými spolupracovníky. Později byl IPPART vybrán také tréninkovým institutem čtvrté sekce (sekce párové a rodinné terapie) České společnosti pro psychoanalytickou psychoterapii (ČSPAP), což je odborná psychoterapeutická společnost akreditovaná Ministerstvem zdravotnictví ČR a poskytující kredity celoživotního vzdělávání psychologů a lékařů. ČSPAP je členem Evropské asociace pro psychoanalytickou psychoterapii (EFPP). Na založení a rozvinutí čtvrté sekce ČSPAP pro párovou a rodinnou terapii, určenou především pro erudované, v psychoanalytické terapii již cvičené, terapeuty se velkou měrou podílela právě Lucie Lucká a Slavoj Titl.
V přístupu, který i nadále propagujeme, vycházíme ze základních principů psychoanalytické psychoterapie za něž považujeme zaměření na intrapsychickou realitu klientů, naslouchání a reagování na nevědomý materiál, práce na přenosu a protipřenosu, rozvíjení vhledu a porozumění v situaci terapeutické neutrality, anonymity a abstinence. V současné době tedy existují v ČR dva psychoanalytické instituty věnující se tréninku párových a rodinných terapeutů, pro oba zařizuje odbornou část tréninku kandidátů IPPART. Prvním je IPPART jako samostatný subjekt pro trénink terapeutů se zkušenostmi z různých modalit tzv. dynamických terapií (skupinových terapií, geshtalt terapie, apod.). Druhým je rodinná a párová sekce ČSPAP a jde o trénink erudovaných psychoanalytických terapeutů, kteří jsou členy ČSPAP.
Dalším významným krokem institutu IPPART v oblasti párové a rodinné psychoterapie v ČR bylo v roce 2010 založení Skupiny pro studium psychoanalytické rodinné a párové terapie, která sdružuje odborníky z ČR i zahraničí zabývající se daným tématem.
PhDr. Slavoj Titl Ředitel IPPART
AN OUTLINE OF THE PSYCHOANALYTIC COUPLES AND FAMILY THERAPY IN THE CZECH REPUBLICSlavoj TitlInstitutional development:After World War II, the state of Czechoslovakia ran a network of counselling centres for married couples. They employed above all psychologists, social workers, medical doctors (psychiatrists and sexologists), but also lawyers. Private practice was forbidden by the communist regime, psychoanalysis was practiced in secret. Official circles denied its existence, did not know about it or criticized it without knowing anything about it.In the area of management of married couples and family problems, for a long period of time these were handled by so called advisory instructive methods, centred on behaviour. These methods were based on the personal experience of the advisors. Even today people find the fantasy about the know-it-all expert very appealing. As in medicine, this expert would determine the diagnosis, give advice about the right behaviour and following this advice would then lead to happiness. Even though the communist regime in former Czechoslovakia disapproved of and repressed psychoanalysis and, at best silently tolerated it, many psychotherapists, marriage and family counsellors today consider psychoanalytic concepts useful and a matter of course without being aware, in most cases, that the theories and concepts they use, were discovered and popularised by psychoanalysts.In the Czech Republic today it is a requirement for a practitioner of psychoanalysis to have a qualification from one of the official institutions. In the first place the training is possible within the CPS (The Czech Psychoanalytic Society) which is a member if IPA; it prepares the trainees for individual psychoanalysis. Secondly there is the CSPAP (Institute of the Czech Society for Psychoanalytic Psychotherapy), established in 1993, which offers training in different forms of psychoanalytic psychotherapy. It has four sections: individual, child, group, and couples and family. The last one is possible to follow only during or after training in one of the first three, as a complementary training. In CSPAP the trainee must undergo about four years compulsory analysis, at least twice a week, 360 hours of seminars and at least 200 hours of supervised sessions. (In CPS, the conditions are even more demanding, in accord with the regulations of IPA). Those who have not finished their studies in one of these two institutes do not have the right to call themselves psychoanalysts or psychoanalytic therapists and if they do so, they deceive their clients.
The preference of psychotherapeutic understanding of family and couples relationships started in our country in the 80ies mainly thanks to Petr Boš and his work in Dubí, in the vicinity of Teplice as well as his inspiring conferences on family therapy (non psychoanalytic) in Teplice. This opened new possibilities for the creation of new family therapy institutes, new centres dedicated to family therapy and an array of new ideas in the field. Nevertheless, psychoanalytic couples and family therapy did not exist at that time.Some of the Czech psychoanalysts, in addition to their individual analytic practice, sometimes conducted consultations with couples. Unfortunately, I have no information to share about their experience, since there are no documents, articles or other material about their work. Maybe they did not consider it as valid as the classical long term psychoanalysis.The beginnings of a systematic psychoanalytic couples and family therapy in our country are associated with the following practitioners: Slavoj Titl, Jaromír Teichman, Vratislav Strnad and Karel Kopřiva. In the 70ies and 80ies, we were all very unhappy with the state of marriage and family counselling practices in the time of totalitarian communist regime but on the other hand we had intense personal and positive experiences during our psychoanalytic training and our first experience with treating neurotic and borderline patients. What was then called marital therapy (couples therapy did not exist at that time) was largely characterized by misunderstanding the unconscious processes, it was superficial, with emphasis on behaviour. The instructive attitudes, manipulation or authoritarian directivity were deeply dissatisfying. During friendly discussions with the above mentioned colleagues we attempted to seek new options -psychotherapy approaches based on psychoanalytic understanding.Karel Kopřiva and Vratislav Strnad worked at that time in the Prague Marriage counselling centre and in the 80ies they had accumulated a great amount of experience in marriage and family guidance. Clinical psychologists J. Teichman and S. Titl, were employed by the psychiatric hospital Bohnice in Prague and had a great deal of trouble with their psychoanalytic psychotherapy amidst the ruling psychiatric norms of the hospital. So, during the 80ies they became interested in working as marriage counsellors. Here they found more tolerance for their work. At first they were employed externally. Towards the end of the 80ies Slavoj Titl left the psychiatric hospital Bohnice and started working in the marriage counselling centre (later called Centre for Marriage, Family and Interpersonal Relationships).Karel Kopřiva, psychoanalytic psychotherapist and expert marriage counsellor led the way to the establishment of an independent Centre for Psychotherapy. The other members of the staff were Slavoj Titl, Vratislav Strnad and the social worker Lenka Konečná-Šimková. With the exception of Lenka Konečná-Šimková, we were all at one stage or other of our psychoanalytic training. At our friendly work meetings we were searching for new possibilities of approaching clients. We were studying hard and translating modern psychoanalytic literature and its possible applications in helping couples and families. Together we were seeking for techniques which we could apply to couple and family therapy. Our Centre also organized a series of seminars to familiarize other therapists with the psychoanalytic approach which was then almost unknown. First and foremost thanks to Karel Kopřiva we managed to publish a collection of psychoanalytic texts by V. Mikota, S. Titl and K. Kopřiva, "Modern Psychoanalysis and Marriage Counselling (Prague 1988), which was a very unusual asset as the totalitarian ideology did not favour psychoanalysis at all. However, toward the end of the 80ies the regime was more tolerant. This publication became the basis for future couples and family therapy and many other therapists adopted this approach.Unfortunately, Vratislav Strnad, Lenka Konečná-Šimková and Karel Kopřiva became more interested in developing the systemic approach to couples and family therapy. In 1989, Vratislav Strnad travelled to the then "western" Germany, where he became interested in systemic therapy and what he then learned, he started applying -together with other colleagues- in their work with families. He kept in close touch with the German Institut für systemische Studien Hamburg and with Kurt Ludewig.Slavoj Titl continued looking for ways to work with couples and families psychoanalytically. Since the counselling conditions did not allow open-ended therapies (there was a lot of administrative pressure to keep down the number of consultations and most of these amounted to 3-5 sessions because of limited budgets these counselling centres had) So, S. Titl developed a short version therapy for couples, where he used his experience from short focal individual therapy (20 to 30 consultations) which was in comparison to the counselling approaches still too long, but it was tolerated. In a parallel way there coexisted two approaches at the "psychotherapy" centre: systemic therapy and psychoanalytic therapy and they mutually enhanced each other. My colleagues and I often conducted long passionate and very useful discussions or analysed video recordings of couples and family therapy. Later, along with other colleagues from the centre, who were at that time finishing psychoanalytic training - Lucie Lucká, Lída Padevětová and Pavel Horčák, we began to organize case seminars and as others joined in later, these became regular peer group encounters. Later on, these peer group encounters started focusing more and more on individual therapy. Those who were interested in psychoanalytic couples therapy constituted a separate peer group. Unfortunately, the active, psychotherapeutically oriented centres within the network of counselling had to be closed for administrative reasons and this caused a gradual exit of all analytically oriented colleagues from the Prague consulting group into private practice. Luckily, this did not end personal friendly contacts and fertile discussions, nor did it hinder the development of couples and family therapy; on the contrary, it furthered it.Right from the beginning, during the friendly discussions, it was Jaromír Teichman with his inspiring, intelligent and ironic scepticism who helped to develop the psychoanalytic approach. Until the beginning of 90ies he worked as a clinical psychologist in the Psychiatric Hospital Bohnice but he also worked externally as a counsellor for family and married couples. At the beginning of the 90ies, largely inspired by D. Wille´s book, by the collusion theory of Jurg Willi and by the egoanalysis of Gertrude and Rubin Blanck, he helped to create the basic technique for psychoanalytical couples therapy.In 1993, my colleague J. Teichman and I opened the first training in psychoanalytic couples and family therapy. It aimed to help above all counsellors in marriage and family counselling who had gone through the experiential part of their training in one of the modalities of psychodynamic therapy (Gestalt, Rogers therapy, Jungian therapy, group therapy and rarely individual psychoanalysis) but who were unhappy with the kind of approach practiced in their working places. Later, the training became popular with medical doctors and clinical psychologists and this added new ideas and experience to the training. It was scheduled as two day seminars, on Fridays and Saturdays, once a month. The programme comprised of about 60 hours of general psychoanalytic theory, about 60 hours of specific theory of couple therapy and about 120 hours of supervisions in groups according to so called "Balint" mode. The last supervision seminars were dedicated to the cases of the participants and support was offered with their final case work. The condition for getting the Certificate was a successful conclusion of at least one couples therapy.
As our activities grew, we felt the need for a better organized structure. On 10th March 2004, we (Slavoj Titl, Jaromír Teichman, Lucie Lucká, Lída Padevětová)
founded The Institute for Psychoanalytic Couples and Family Therapy (IPPART in Czech) whose main task was and still is to offer education not only to psychoanalytically trained colleagues but also to those who have gone through some other modality of training in psychotherapy (e.g. "psychodynamic therapy") and who felt the need to understand the unconscious contexts in the way in which it is understood by contemporary psychoanalysis. Many of these, after finishing the course, began a systematic psychoanalytic training.Then Lucie Lucká and Slavoj Titl, within the CSPAP, the Czech Society for Psychoanalytic Psychotherapy, alongside the sections for group therapy, individual therapy and child therapy, opened a section for couples and family therapy, designed for erudite therapists trained in psychoanalytic psychotherapy. This happened in agreement with EFPP (European Federation for Psychoanalytic Psychotherapy) of which CSPAP is a member. In our approach we build on the basic principles of psychoanalytic therapy by which we understand the unconscious and internal reality of clients, the work with transference and counter transference and the development of insight and understanding within a situation of therapeutic safety. In the process of therapy we put emphasis on holding and containing, trying to find a non pathological view of the clients´ suffering and the management of the unconscious relationship tests of our clients.Currently in the Czech Republic there are two institutes dedicated to the training of couples therapists. One is for training erudite psychoanalytic therapists who are members of The Czech Society for Psychoanalytic Psychotherapy (CSPAP) and have basic training (experiential therapy, theory, supervision) in one of the sections of CSPAP and the other, IPPART, dedicated to the training of therapists with experience in different modalities of so called dynamic therapies (group therapy, Gestalt therapy, Jungian, etc.). The institute for psychoanalytical couple and family therapy (IPPART) does also training within CSPAP but also independently.In 2010, we founded a group for the study of psychoanalytic couples and family therapy. Lucie Lucká and myself (Slavoj Titl) regularly offer supervision "Seminars for experienced couples therapists", where we help erudite couples and family therapists who have finished training and practice as counsellors to develop understanding and work techniques. As a group of supervisors IPPART (S. Titl, L. Lucká, L. Padevětová, K. Kopřivová, V. Plášková, P. Sokalská) we also regularly meet for peer groups.Theoretical development:The training in psychoanalysis in CPS (Czech Psychoanalytical Society) in 80ies and 90ies put emphasis above all on classical Freudian theory. However, the instinctual theory of Freud was not very useful for couples and family therapy. It did not sufficiently reflect the meaning of object relationships and it put too much emphasis on instinctual satisfaction. As soon as we started working with groups, couples and families, we had to look for other psychoanalytic theories which would improve the understanding of relationships. Right from the beginning our approach was guided by the opinion that different theories can be helpful in our work because they enable us to better understand certain phenomena we encounter during psychoanalysis. In 80ies and 90ies we were greatly influenced by the American literature, especially ego psychology. The approach of A. Freud on the functions of ego, the theoretical contributions of Hartman, child studies of Spitz and especially the observation studies by Margaret S. Mahler, Fred Pine, Annie Bergman, who studied the separation-individuation process and its culmination while reaching intra-psychic object constancy on which Gertrude and Rubin Blanck built their theories. We found their idea of differentiation according to the ego development level and the different techniques for supporting defences instead of trying to eliminate them very useful. They provided psychoanalysis with new views of personality development and useful techniques for the work of what is called pre-structural patients. At that time we were impressed by their books on couples therapy. Among the contemporary American psychoanalysts, there is one who deals with ego psychology: Otto F. Kernberg, whose book Love Relations: Normality and Pathology is widely read by our non psychoanalysts. In Kernberg´s books we find some outstanding reflections on the issue of passion and love in love relationships. However, his concept of relationships deals largely with individual approach and tends to stress pathologies.
As far as the couples therapy technique, we do not consider it correct to separate the couple and work with each as individuals, which is what ego analysts recommend. Similarly, we find a great deal of inspiration in Gertrude and Rubin Blanck and unfortunately, it seems to me, the modern psychoanalytic and couples literature does not quote them as much as they deserve. Especially inspiring is their conception of development lines, the effort to therapeutically support the development process and the conception of marriage (a long term partnership) as a development phase in object relations. However, we disagree with their therapy technique in which they recommend to separate the couple in two individual expert therapies because we think that it is the couple together who is responsible for their life together and who needs to learn to live together and communicate with each other.Ables and Brandsma, Nadelson and Meissner who continued the work of the Blancks emphasize the failure of the process of separation-individuation during early childhood of either the husband or the wife or both, which according to them is the root of most marital problems.It seems that in the past, psychoanalytic literature on couples relationships believed that if both partners were mature and solved their personal problems, they would then be able to be together in a happy relationship. The assumption that more mature people will make happy partnerships is only partially true. Maturity means a better ability to communicate and cooperate but, on its own, does not lead to a mutual (erotic, passionate) attraction between two persons. This fact must be taken into consideration above all in the therapy of sexual problems.Daniel Wile, a Californian couples therapist (Phases of relationship development, 1985) whose ideas greatly influenced our techniques in couple therapy in 90ies, made a point of the fact that interpretations of clients´ childhood, customary at that time, may become problematic because they draw attention away from the present (here and now) i.e. from what clients are most interested in - their present conflictual relationship which they wish to improve. Besides, it often gives the impression that partners are strongly attracted to their infantile conflicts and therefore have no interest to change. The approach which stresses the past and infantile satisfaction can also diminish the importance of feelings and reactions of the individual (it attributes them to fixations, regressions or development failure) and does not take into consideration important factors of the present reality of clients (as if the past was the answer to everything), as well as the interconnectedness and mutual conditioning of their reactions. Wile pointed out that it can be convenient to see clients as frustrated and depressed and looking for a normal satisfaction as adult people.We were also significantly influenced by the theories of Heinz Kohut and his followers, their study on the meaning of empathy, the development of narcissism, the attitude to narcissistic disorders and narcissistic wounds as well as the attitude to aggressive behaviour, which we sometimes had had the opportunity to see in marital counselling (aggressive conflict resolutions in couples or family).The analysts of 70ies tried to solve the problem of mutual conditioning by partner reaction. The theory of Martin and Sager stresses the unconscious marital contract and Dicks introduced the concept of "collusion" which was later, in 90ies, elaborated by the psychoanalyst Jurg Willi in his attractive books translated even into the Czech language. According to this author, both partners try to solve the same psychological problem, i.e. their mutual relationship, but in a contrary, polarized way. While one partner´s solution is hyper-compensating, "progressive" manner, the other acts in a regressive manner. That is why they cannot live together but neither can they live without each other. His theory of collusion strongly influenced our conception of couples therapy and we still consider it as very useful in order to understand the dynamics in couples and in the family.Later on the couples therapy in our country was more under the influence of the British psychoanalytic theories. Melanie Klein describes how a child uses its mother as an inner object and the mechanisms of projection and introjection. Especially the mechanism of projective identification we found very useful in understanding relationships among people. We were influenced by the contributions of John Bowlby who pointed out the meaning of attachment for personal development, Mary Main speaks of "internal working models", D. W. Winnicott introduces an extremely useful concept of "holding" into psychoanalysis, by which he understood not only the physical holding of the child by his mother, but also a symbolical support by for example the therapist of his patient. However, he introduced other important concepts such as "transitional object" and the process of "destroying the object", etc. Wilfred Bion enriched psychoanalysis with the concept of container/contained. Then followed the theory of Ronald Fairbairn, Ogden and there were many others.The development of the Tavistock Institute introduces names such as Enid Eichholz-Balint, Menzies Lyth, Elizabeth Bott-Spilius, J. D. Sutherland, Geoffrey Thomson, L. Pincus, etc. The Tavistock Institute greatly influenced the development of couples therapy at least in Europe. Currently the TIMS is represented by several outstanding experts whose work we find very inspiring due to the influence on our reflections on couples and family therapy. Just to mention a few of them: S. Ruszczynski, A. Lyons, E. Cleavely, W. Colman, C. Clolow, etc.
Still later we started to feel the need to understand also the genealogical dimension of what happens in a family- how identifications are passed from one generation to the next. The work of Abraham and Torok, Faimberg and others stressed the significance of trans-generational transferences. Psychoanalysts discovered that people can suffer not only as a consequence of repressing instinctual impulses or unsatisfactory relationships to mother or parents in early childhood, but also as a consequence of traumatizing events in the deeper past of previous generations. It was discovered that against his/her will, a person can act under the influence of a family secret and distressing events that were not grieved for and which happened to long past generations.
This directed our interest not only to the horizontal social dimension but also to the vertical dimension. We were influenced by the theories of e.g. Hoper (theory of groups), Volkan (trans-generational transferences and "selected" traumas from the inheritance of large groups such as nations), Ferro and Basile, who speak of social fields, etc. To interconnect the intra-psychic theories (above all the object relations) with theories on interpersonal relationships and also vertically with the genealogical theories was attempted by the linking theory studied by the Argentine and French analysts such as Pichon-Riviere, Losso, Berenstein, Kaes and others. Especially the family therapists found the works of P. Benghozi and of the Scharffs very enriching.Since we attempted to create the technique of short couples therapy, we also used the theories of short psychoanalytic therapy, mainly the work of Ballak and Small, D. H. Mallan, D. Beck. The Californian school of Mount Zion (J. Weiss, H. Samson and others (1956-1986) must be also mentioned mainly due to the fact that their followers attempted to experimentally test some psychotherapeutic hypothesis (within short individual therapy). Most of their contribution can be very well used in couples therapy since they do no contradict a more ample psychoanalytic theory. We were also influenced by the concept of "pathogenic beliefs" and "testing". The technique of short therapy also proved very useful, above all in institutions which limit the length of therapy. Most of our private practice therapists however work without the formal time limitation of therapy.S. Titl in his book in preparation has newly introduced the theory of unconscious relational belief (axiom). It is based on working with the linking elements of couples and family.
He recommends distinguishing between "the unconscious individual beliefs" (UIB) which are the essence of an individual´s belief of "what must be done to maintain a relationship" and "the unconscious relational beliefs" (URB) which are the result of the couples´ shared fantasies about the link between them. Precisely because the individual separate beliefs "fit together" (solving the same or similar relational problem), that both partners "found each other" in the first place, and created an unconscious relational belief which links them together. It is these fantasies which make the rules of the relationship.
After some time or under certain conditions, can the unconscious relational beliefs which at first united the couple, begin to limit one or both partners or the family. In such cases they start testing possibilities of change of the unconscious relational beliefs.We ask what partners have in common, what links them. According to the projection theory we looked at the couples as two individual psychologies, but in this approach we are more interested in the newly created common ground. It is not possible to describe the couple relationship as a sum of two individual psychologies. Every couple creates a new common psychosocial reality which incessantly changes them as a couple and as individuals. This is valid also for the family or any other group.Thus S. Titl introduces three new concepts: unconscious individual belief, unconscious relational beliefs and thirdly basic complementary sexual fantasies. The unconscious individual belief (UIB) came into existence during early years of life as a consequence of "procedures" - a matter of course, repeated, often ritualized handling of the child and relating to it. Some others were created as internal, unconscious and matter of course patterns of behaviour and relating. Many came into existence in situations when it was necessary to adapt to deprivation, repeated frustration, traumatizing situations or it was imperative to solve an inner conflict: theory of the researchers from Mount Zion -Weiss, Samson, etc. Sometimes or under certain conditions, these beliefs help in the process of adaptation and sometimes they do not. For example, people with not good enough relationship with mother in early childhood can live with the belief that other people are not to be trusted and one has to expect the worst from them. Such people are probably better prepared to survive wartimes, totalitarian regimes and crises in general, they can be more successful as soldiers, policemen, etc. than those who "naively" believe that it is possible to explain things to others and expect understanding. But it is less likely that the former ones will establish safe relationships or be capable of love.
We all have such unconscious beliefs, which make us act and relate in a certain way but unless we go through a psychoanalytic therapy we remain wholly unconscious of them. We act with the best of our intentions and in spite of that we often do not know how to adapt, and we react out of proportion in the face to reality (but in accordance with our inner experience and matter of course conception of reality -unconscious individual belief - UIB).The couple but also the family or group, are linked through a shared unconscious belief - URB, which is being frequently dealt with by the members of the couple/family /group through contradictory-complementary means. Even though the ways of realization of the unconscious relational belief (URB) differ and are sometimes apparently wholly contradictory, they contribute to sustaining the relationship system URB (linkage).
Linkage is understood as a relational belief-axiom, which links relationships of couples, family or a group/team of any sort and which they unconsciously share ("what is right in a relationship..."). It seems that members of such linkage share beliefs - ("if we insist we want this or that...then such and such unpleasant consequence will follow..." or "in order to sustain the relationship, we must..."). And together they try to carry it out, solve it, test it, change it or correct it. The URB created together implies basic rules of functioning of the relationship linkage ("the rules of the system" as the systemic family therapists call it). Respecting these rules gives partners a feeling of safety, but it also represents limitations and lack of freedom. Human systems based on friendship and love are linked and sustained by such relational beliefs. Members are drawn into coalitions because together they share and try to solve unconscious beliefs. The group (in our case the couple) is satisfying and promises even more satisfaction either by confirming the validity of the URB or by enabling a rebellion against the rules implied by URB or offering hope of it. In formal groups such as work teams or therapy groups, certain "relational issues" arise- URB as well, and having to solve them often complicates the functioning of the groups. Similarly marriages, which were established through non romantic or love basis (for example by a marriage contract/agreement by the parents, as it used to be in the past) can, with the time, produce a collusion based on URB. What happens is that the partners mutually "pull the strings" which link them together. A similar thing happens in individual therapy, where the patient, by virtue of his/her presence, brings to life the therapist´s fantasies, conflicts and anxieties which the therapist thought he had solved long ago and between him and the patient arises a collusive acting out motivated by a common URB. It is characterized by the bilateral efforts to resolve unconscious relational linkage.
In therapy, the URB is expressed by a specific transference of the relationship system to the therapist who might perceive or might act out a specific, complementary countertransference onto the couple (in family therapy onto the family, in group therapy onto the group as a whole, etc.). As if he/she had the tendency to function according to the same belief (URB) which "drives" the couple/family. This countertransference, if we become aware of it, can then become the fundamental solution to becoming aware of what it is that links this concrete couple we are working with. That is the reason why we recommend differentiating between a "countertransference to a relationship" from a "countertransference to an individual patient" with which analytic therapists usually work in individual therapies.Currently there are 4 basic aspects of therapy which we are interested in:A. Mutual conditioning of reactions- namely "couples links"
B. Traditional approach- attraction as a consequence of mutual projections of cast away (split) parts of self
C. Relationships from trans-generational point of view
D. Attraction as a result of common unconscious beliefs about relationshipsList of some of the literature used for our purposes of training and mentioned in the outline:Benghozi, P. (2005) Family and couples psychoanalytic psychotherapy - in Czech in Revue psychoanalytická psychoterapie, 2009Berenstein, I. (1995) Psychotherapy of family and couples - in Czech in Revue psychoanalytická psychoterapie, 2002Bion, W.R. (1962) A theory of thinking. Int. J. of Psycho-Anal., 43, 306-310Bion, W.R. (1959) Attacks on linking. Int. J. of Psycho-Anal., 40, (5-6-) 308Blanck, R.G. (1968) Marriage and Personal Development, New York, Columbia UniversityBritton, R. (1989) The Missing Link: Parental Sexuality in the Oedipus Complex. In: The Oedipus Complex Today Clinical Implications, London: Karnac BooksCleavely, E. (1993) Relationships: interaction, defences and transformation. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac BooksColman, W. (1993) The Individual and the Couple. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac BooksColman, W. (2007) Symbolic conception. Idea of the third. Journal of Analytic Psychology, 50(5)Dicks, H. (1067) marital tensions New York: Basic BooksFisher, H. (1994) Anatomy of Love: A Natural History of Mating, Marriage and Why We Stray. New York: Ballantine BooksFisher, H. (2004) Why We Love: The Nature and Chemistry of Romantic Love, New York: Holt PaperbacksFisher H. (2013-11-02) https://www.ted.com/talks/helen-fisher-tells-us-why-we-love-cheat.htmlFreud S. (1914) On narcissism: an introduction - in Czech: K uvedení narcismu Avicenum Praha, 1971Grier, F. (2001) No sex couples, catastrophic changes and the primal scene. In. Oedipus and the Couple, London: Karnac BooksKernberg, O. F. (1995) Love relations: normality and pathology. London:Yale University PressLaplanche, J., Pontalis, J.B. (1973) The Language of Psychoanalysis. New York: NortonLyons, A. (1993) Husbands and Wives: thy mysterious choice. In: Psychotherapy with couples : Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac BooksMahler, M.S. (1968) On Human Symbiosis and the Vicissitudes of Individuation - in Czech Psychologický zrod dítěte, Praha: Triton, 2006Martin, P.A. (1976) A marital therapy manual. New York: Bruner/MazelMitchell, S.A. (2002) Can love last? The fate of romance over time. New York, London: W.W. Norton and comp.Morgan, M. (1995) The projective Gridlock: A form of projective identification in couple relationship. In: Intrusiveness and Intimacy in the Couple London: Karnac BooksOgden, T.H. (1991) Projective Identification Psychotherapeutic Technique. New York: Jason Aronson, Inc.Pickering, J, (2011) Being in Love. Therapeutic Pathways Through Psychological Obstacles to Love. London: RoutledgePincus, L. (1960) Marriage: Studies in Emotional Conflict and Growth. London: Methuen/Institute of Marital StudiesRuszczynski, S. (Editor) (1993) Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac BooksSager, C.J. (1076) Marriage contracts and couple therapy: Hidden forces in intimate
relationships. New York, Brunner/MazelScharff, D.E. and Scharff J.S. (1991) Object Relations Couples Therapy. Jason Aronson, New JerseyScharff, D.E. and Scharff J.S. (991) Object relations Family Therapy. Jason Aronson, New JerseySharpe, S.A. (2000) The ways we love: a developmental approach to treating couples. New York: Guilford PressTitl, S. (2002) Terapeutická hypotéza a intervence v párové a rodinné terapii. In. Revue psychoanalytická psychoterapie IV-2Usher, S.F. (2008) What is This Thing Called Love? A Guide to Psychoanalytic Psychotherapy with Couples London: RoutledgeWeiss, L.. Sampson, H et al. (1986) The Psychoanalytic Process, Theory, Clonical Observations and Empiric Research. New York: Guilford PressWile, D.,B. (1981) Couples Therapy: A Nontraditional Approach. New york: John Willey and SonsWilli, J. (1990) Was Halt Paare Zusammen? Reinebek:RowoltWilli, J. (1991) Párová terapie. Curych: KonfrontaceWinnicott D.W. (1968) The use of an object. Int. J. of Psycho-Anal. 50