English language
Unconscious relationship beliefs in couples and family therapy
Slavoj Titl, Lucie Lucká
IFP-State-of-the-Art-Symposium 30.4. - 2.5.21
I would like to share with you a few ideas that we apply at the Institute of Psychoanalytic Couples and Family Therapy (IPPART), primarily the concept of unconscious relationship beliefs. This concept has proved to be very useful in our work with couples and families, helping us to better understand why certain people are attracted to each other; why other two people never start living together, even though they can have great sex; why, after a certain period of living together, some people start to have disputes and eventually break up, or vice versa, why some couples stay together despite suffering, arguing, attacking and destroying each others life. What is it, then, the mysterious “chemistry of love”? Similar questions are asked by our clients.
I shall try to address this issue, even if I speak somewhat more broadly at first.
XXXXXXXXXXXXXXXXXXX
At the Institute of Psychoanalytic Couples and Family Therapy, we consider it important to learn from a range of psychoanalytic theories. We believe that each psychoanalytic theory provides a different advantage in understanding the problems of couples and families, thus helping us to look at the issue of the couple, or the family from different perspectives.
Freud’s theory helped us to understand the intrapsychic functioning of the individual mind, but it was difficult to apply it to understand problems in relations. Margaret Mahler’s developmental theory (and others’ such as René Spitz’s) drew attention to the importance of relationships (mainly the mother-child relationship) for the development of identity in the separation-individuation process, the importance of so-called object constancy, as a precondition for the successful experience of the Oedipal stage. Ego psychology emphasised the early developmental phases of the ego and preoedipal development, while also providing an understanding of preoedipal, so-called functional relationships, often encountered in couples and family therapy.
Heinz Kohut and other self analysts taught us about the catastrophic effects of microtraumatisation in the form of lack of empathy. Basic forms of narcissistic transference – idealising, mirroring and twin transference – can often be seen in couples and families therapy. Various object relations theories, brought about by the development of psychoanalysis in the United Kingdom, have proved extremely fruitful for the psychoanalysis of couples and families. Bowlby’s attachment theory, and especially its elaboration by his followers, enabled a new understanding of the importance of early attachment formulas in building adult relationships. Klein’s approach to early pathology, splitting, understanding infantile phantasies, envy, jealousy etc. was not only important for individual psychoanalysis, but also provided an understanding of the many phenomena we see in couples and family relationships. For us couples therapists, however, perhaps the most important thing was the recognition of projective identification, which as a very early way of communication and influencing relationships applies when choosing a partner, the elimination of unbearable and unacceptable affects by projecting them onto a partner where they can be controlled or annihilated. Winnicott drew our attention to the importance of holding in therapy, the importance of transitional objects and transitional object relationships, and the conditions for the creation of the false Self vs. true Self.
Bion opened up a new perspective on therapy with his concept of container, alpha and beta function, and other ideas about the patient-analyst relationship and therapy. It turned out that his ideas could be very well applied to couples and family therapy. We started talking about a paired container, a family container, an unbalanced container, a container for transgenerational material, etc. The wide range of Bion’s useful ideas is beyond the scope of this paper.
Intersubjectivists alerted us to the unconscious experience of INTER. What arises between us, whether we are a patient and a therapist, or partners, friends, parents and children, colleagues at work, etc. We at IPPART believe that work with intersubjective reality should be the main goal of couples and/or family therapy. This means helping the couple or family to understand the unconscious that is co-created by both partners. The unconscious that can either unite people or divide them. This can be understood as a link (vinculo), but also in other ways for instance field theory.
In couples and family therapy, the therapist is confronted with a large number of externalised and acted out conflicts and has to resolve them in a relatively very limited time (compared to individual psychoanalysis). The couples or family therapist is constantly drawn into coalitions and, through the process of projective identification, into unconscious communication and acting out, being subjected to pressure by manipulation. In addition, there are at least two people and a therapist (sometimes a therapeutic couple) in the consultation room and each of them should have the opportunity to voice their respective opinions. Each of them should be able to get an empathic response from the therapist and his or her containment. But it is also important that the therapist provides container to the specific link (vinculo) of this particular relationship. Perhaps we could say to the intersubjective third, which is neither wife nor husband, but something between them. Such conditions place great demands on a therapist’s ability to hold boundaries and work with transference and countertransference, but also on his ability to think, dream, and hypothesise. Somewhat radically speaking, therapy arises in the mind of a therapist, with the help of his theories. In our opinion, various theories illuminate the extremely complex issue of couples and family relationships from various advantageous points of view. We do not see them as competing, but rather as complementary and enriching our overall understanding of our clients. At times, we probably all work by helping either partner to mentalise, to support the maturation of his ego functions, to support his separation-individuation process, to allow insight into internalised object relationships and their projection, to gain insight into repetition, or acting out, to allow better mutual containment, to help overcome the client’s inhibitions and thus to facilitate the development of self-reflection and at least around those aspects which allow the clients to work on their relationship at the end of therapy without our help. The goal of couples therapy, however, is to help with the intersubjective connection of the relationship. With what is created BETWEEN them and what maintains a specific relationship of the couple, or family, or sometimes even a non-relationship. What connects partners (or a family as a whole, but also a therapeutic group, or working groups). Our experience has led us to believe that couples are united by an unconscious phantasy about the nature of relationships, love and sex. “Phantasy” which we call “unconscious relationship belief”. Both partners agree on this belief, even if they sometimes act in seemingly opposite ways (e.g. a teetotaller and an alcoholic).
In our work we build primarily on 3 sources. The first is the theory of the link, (vinculo) as developed by Isidoro Berenstein (2005, 2010), who followed the Spanish and French psychoanalytic tradition, mainly the ideas of René Kaes as well as those of André Rufiot and Didier Anzieu.
Secondly, we build on theories of Californian scientists from Mount Zion (Joseph Weiss, Harold Sampson and others /1956–1986), who examined the process of short term psychotherapy and,
thirdly, on the theory of collusion, as suggested by Jürg Willi.
Jürg Willi (1975,1978,1985,1990) developed the concept of Henry Dicks on the “collusion” of spouses. It is based on the observation that couples bring different conflicts as variations on a single theme. Conflicts mostly involve a particular topic that makes a couple uneasy and creates a sort of “common unconscious of a couple”. This interplay created by a common unconscious is called collusion. A collusive relationship is one where, for unconscious reasons, the partners maintain and reinforce each other in a particular pair pattern. According to Willi’s concept of collusion, while individual behaviour is determined substantially by the individual history of the individual, in its manifest form it is essentially co-determined by the empowering or dampening behaviour of the partner, while his or her behaviour is again determined by their own individual history. (It is therefore a circular strengthening or damping.) Willi showed that both partners exhibit a disorder of the same kind, only manifested in the opposite way. These are polarised variants of the same psychological problem. However, in one partner it is manifested in a progressive-hypercompensatory form, while in the other in a regressive form of behaviour. (In therapy, for example, it can happen that the jealous one becomes the persecuted and the persecuted one becomes the jealous, the alcoholic becomes the teetotaler and the teetotaler becomes the alcoholic, the bully becomes the abused, while the abused turns into a bully, etc. So the two – unconsciously – share the same problem.
The Mount Zion Psychotherapy Research Group (Joseph Weiss, Harold Sampson and others (1956–1986) examined the process of short-term individual therapy (not couples or family therapy). But their ideas seems to be usefull also for couples therapy.
The conclusions of the research of the California school can be briefly summarised as follows (according to Weiss, 1990; Mikota, 1995, pp.105–108, Titl, S. 2014, p. 124–127):
1. „Psychological problems are rooted not in repressed impulses that maladaptively seek gratification (as suggested by the dynamic hypothesis) but in painful ideas known as ‘pathogenic beliefs’ (Weiss, 1990) that are maladaptive, i.e they present complications in adaptation to current adult conditions. In childhood, however, they helped the adaptation (or such was the patient’s childhood experience). Pathogenic beliefs are kinds of beliefs or axioms (or infantile fantasies) created by a child about how relationships function. They are unconscious, but they significantly affect people’s experience and behavior.
Several examples of pathogenic beliefs:
“If I want to be autonomous, I’ll hurt someone.”
“Other people don't like happy people. If I am happy, I will hurt or be punished.”
“If I want more from people, I’ll bother them, suck them dry.”
“I will be shamed for my desire to succeed.”
“For sexual desire I will be punished or shamed.”
Such beliefs developed in childhood as ways of adapting to very difficult or traumatic situations in relations with the most important people.
2. Patients in therapy, but also in certain situations of everyday life, (unconsciously) try not to confirm these maladaptive beliefs and disprove them – correct them because they complicate their lives. For this reason, they unconsciously test whether the situation in the relationship is safe enough, sometimes by provoking situations in which the other (therapist, partner) has to react to show that the tester (patient/client) has nothing to fear. For example, they make “excessive” demands on the therapist (or on the partner in the relationship), unconsciously observing how the other will behave. If the other (therapist, partner, friend, etc.) behaves by demonstrating that there is no risk of confirmation of PB, that there will be no repetition of the childhood trauma, the testing patient (partner) temporarily experiences reduced anxiety and feels more comfortable (safer) in the relationship. But this relief is only temporary as long as the tester does not realise what unconscious PB is at work and how he is testing. Unless he gains an insight (via interpretation), he is doomed to repeat, forced to repeat the tests again and again, often in a more dramatic way. As if unconsciously saying to oneself, “I hope it doesn't happen, but I'm not sure that in this new situation the other one won’t fail and it won't turn out to be as bad as in relationships I experienced in my childhood.” It is only when the patient gains an insight into pathogenic beliefs that he/she feels relieved and does not have to repeat the tests.
For example, a male patient who had an experience with his mother that she became seriously ill at the time of his separation from her (causing her illness in a child's phantasy) was terrified that his independence would hurt or annihilate his loved ones (hurt his mother). In therapy, he experimented with separation. He tried various forms and gradations of independence (from skipping sessions, to expressing disapproval, criticism to therapist/partner, threats to end therapy, etc. At the same time, he unconsciously watched and checked to see if he was injuring the objects of love (therapist, partner, etc.) when he allowed himself to be separated. The therapist must pass the patient test (he is not hurt by separation) and provide insight into the pathogenic beliefs tested (interpret the PB).
If the test subject (therapist in therapy/partner in a relationship) fails the test, the correction of PB fails, the test subject (e.g. patient in therapy) withdraws, her/his anxiety and discomfort in the relationship increase. Her/his testing stops (because she/he feels it is not safe enough), or becomes much more cautious, or ends the relationship (patient wants to leave therapy early, marriage is falling apart).
In our work with clients in couple and family therapies, we prefer not to use the term “pathogenic belief” because the issue is not that of pathology but of relationship problems. We prefer to use the notion of unconscious individual beliefs (UIB).
When two individuals of the opposite sex meet and start dating, from the very beginning, they communicate through many channels. Only some of them are conscious. Characteristic attractive body odour, movement, gestures, sound of voice, memories and hopes the other evokes in us etc. All these manifestations are the result not only of biological factors, but also of a certain basic attitudes, fantasies that “If I will in relationships desire about this….than happens that...” We call these basic attitudes “beliefs”, or “unconscious individual beliefes”.
Unconscious individual beliefs (UIB) develop at a very early age as a result of “procedures – natural, repetitive, often ritualised handling of and relating to the child. They have formed as inner, unconscious and self-evident patterns of action and relating to others and to the world, being completely unconscious, stored in implicit unconscious memory. This is also why they are unquestionable and manifested in acting out. Others arose defensively in situations where it was necessary to adapt to deprivation, repeated frustrations, traumatic situations, or to resolve internal conflict. These therefore have a defensive character and as they are stored in a declarative (explicit) memory, they can be remembered if patient’s defences are properly interpreted.
I consider this “shared problem” to be the result of an unconscious relationship belief that connects the two partners. This is why the two partners unconsciously chose each other in the first place. Unconsciously, they felt that they could solve or consolidate something of their own past with the other. If it works, collusion works. Conflicts, quarrels, or alienation result from the frustration of deep-seated unconscious beliefs about how relationships should work, both confronted with the great anxiety of repeating childhood threats. Both partners hope (unconsciously) to fight off their deep anxieties with the help of the other and ensure that their needs are met to an extent that has hitherto been unattainable and impossible.
When potential partners meet, they also test each other (deliberately and unconsciously). But they do not care about fixing their UIB (unlike patients in therapy). They seek a match or complementarity.
If people start dating, it is when they have very similar or complementary unconscious beliefs. This is why partners communicate intensively at the beginning of a relationship, sharing their experiences and plans, consciously and unconsciously observing and evaluating each other. Unconsciously, they test whether the other is a suitable object to help them remove deep anxiety and possibly achieve more satisfaction than if they were alone. If this process of mutual testing goes well, more security arises in the relationship, and partners begin to – unconsciously – create and form their common unconscious relationship beliefs, which bind (link) them together and by which they function without consciously realising it. Even later, they pass on this shared relationship belief to their children. Unconscious relationship beliefs thus initially organises the couple and later the whole family. Unconscious belief acts as a paradigm that determines the “rules of the game” – what is allowed and what is not allowed in a relationship, and what threats arise when rules (unconscious) are transgressed. Such beliefs may initially bring the couple/family together and create feelings of security, but after a certain period of time they may no longer apply – after a change in internal conditions, e.g. in an uneven progress of maturing in partners over the course of a lifetime (when one has been through successful psychotherapy, the birth of children may lead to different maturation of partners, the illness of one partner or even after a change in external conditions (getting poor or rich, shift of one or both on the social ladder, etc.) Life brings certain crossroads that confront the couple/family with the fact that the unconscious belief that used to unite them no longer suits them (creates the “problem” of the couple/family) and it is necessary to find a new one. Helping to find a new unconscious relationship belief is, in our opinion, the therapist's most important task.
When looking for an URB of couples, we ask ourselves (we create a hypothesis) what the partners/family –unconsciously– have (or had) in common. What unites them both (the whole family).
How to find unconscious relationship beliefs (URB) ?
1. In therapy, URB is manifested by a specific transference of the relationship system to the therapist. Therapist tends to function (think, experience) in countertransference, based on the same belief (URB) according to which the couple (family) operates.
2. “In relationships it goes like this: if we want this desirable thing... then a threat like this... happens.”
3. The partners share a common unconscious belief: “This is how relationships are supposed to be...”
4. “Love is when … .”
5. “In order to have a relationship, we have to experience... do...”
6. “ shared problem that partners solve is...”
Ad 1)
In therapy, URB is manifested by a specific transference and countertransference of the relationship system (partners/spouses/family) to the therapist. Berenstein refers to “imposition”, which is based on the link. “Imposition” acts on connected entities as if imprinting its stamp on them, which is independent of the will of the recipient and changes their subjectivity simply by belonging to the link. In our experience, the therapist then tends to function (think) according to the same paradigm-belief (URB) according to which the couple (family) operates
Vignette A:
A very handsome, wealthy couple were referred to my consulting room. They had serious conflicts in which they physically assaulted each other, threatened suicide, often being unfaithful so that the other would find out– – “in return” for her or his infidelity, competing to see who was more popular and who made more money. They abused each other, but they were unable to break up.
Before each session, I pored over their documentation, and in therapy I competitively searched for the best interpretations. When I noticed my unusual behaviour, I began to wonder why I functioned in this particular way. I became aware of the feelings of shame for my “imperfection” in front of this “amazing couple” and it was only then that I realised this was also their common way of functioning. I realised that both suffer from URB, which can be formulated as: “Only one of us can be perfect! The other is absolutely valueless! I must try to be perfect in order to impress the other, or I will sink into feelings of shame for my worthlessness and be abandoned. When the other is perfect, I am worthless.” I said aloud: “It seems to be a question of who will be better because it is only she or he who deserves love.” The gradual reflection of this narcissistic unconscious belief, which leads to a constant rotation of the position of euphoric winner-disgraced loser, gradually helped to calm down their relationship.
Ad 2)
Another way to find URB: This paradigm can also be used in such a way, where the dots are meant to be substituted for a specific couple, or family fantasy: “In relationships it goes like this: “If we want this desirable thing ... then such a threat will arise ... “
Vignette B
A couple of “eco-warriors” came into therapy. As soon as they entered my consulting room, they were indignant that I was using palm oil candles and had a synthetic carpet, and they kindly advised me that such things were not eco-friendly. They had serious problems with both their teenage children, who started using drugs and lived very provocative, “extravagant” lives.
In the course of the family therapy, I felt irritated by both partners. My feelings of irritation resulted in my countertransference tendency to adopt very modest attitudes or, on the contrary, defiantly emphasise my difference and hedonism. As it transpired, the husband lived in his first marriage with a very creative woman who died of hard drug abuse. But he loved her very much, and until she completely destroyed herself, they lived a rich, social life full of drugs, alcohol, food, group sex, and many different experiments.
After her death, he changed completely. He found a “humble” woman with rigid environmentalist views, and together they lived a very austere life with a contemptuous attitude toward the “material, self-indulgent world”. They raised their children “rationally” – in a cold, depriving way. For example, their children were not allowed to have any soft toys, so that they would not be spoiled. I formulated their family relationship beliefs for myself as follows: “In relationships it goes like this: if you want pleasant things and enjoy yourself . . . you become addicted to and dependent on pleasant things, spoiled and unable to regulate it, because we are all very ‘hungry’. When we talked about their belief, we arrived at a different formulation: “One can be proud of oneself if one overcomes one’s hunger and can abstain from the things one desires, and that will eventually save one's life.” The children functioned according to the same belief, only rebelling against it.
Ad 3)
Vignette C
A couple whose children were suffering from psychosomatic illness was referred to me by a psychiatrist. Although they were handsome, gifted and well-educated people, misfortune seemed to haunt them at every turn. The wife was recently raped, their car was stolen, her husband’s company was put under distraint, everyone was often ill... I was surprised how “easily” they seemed to be coping with such adversity. They seemed to be at peace with everything. Once, when they came to the session, the remote door control did not work, and I had to go and open the door for them in the house where I work. I opened the door and, after a day of sitting in my chair, I was happy to run up the stairs to get some exercise. When I turned around, I saw the family downstairs, watching me with an air of disgust. As soon as they entered my office, they commented ironically on the “unseemly athletic temperament”. When I pointed this out to them, they answered in unison with pride in their voices: “Whoever God loves, He visits them with a cross!”
I formulated their URB for myself as follows: “The more suffering and damage we experience and endure without objection, the more God (frustrating parent) will love us, and we can have respect for ourselves. The more we abstain from things, the more we deserve love. If we experienced health, success and happiness we would be without the right to love (self-respect).” Over the course of the session and in the following sessions, we discussed this belief in various contexts. After a few sessions, they came up with the idea that they spent their whole lives solving the question: “Can we be loved by God (by ourselves) if we experience happiness, energy and success in our lives?” Afterwards, there was a change in their mutual ability to contain and provide containment to their children, even if they live happily, with vigour.
Another paradigm they themselves later came up with was: “In order to have a relationship, love, self-respect, we must suffer!” In further therapy, it was confirmed that they had learned to adapt to the very depriving and frustrating tyrannical environment of their original families by repressing their anger in the hope that they would then be better treated and, in addition, earn a reward –the feeling that they are strong, good children who do not make things complicated for their parents.
Ad 4)
In the case of an (A) narcissistic couple, there may be a shared problem that they solve “How to be loved and valuable when it can only be one of us – either you or me.” Hence a number of other beliefs such as “If I show how great I am, you will want to humiliate me” etc.
In the second case, (B), the common linking problem the partners dealt with was oral phantasy: “Is it possible to live a comfortable life without becoming dependent on it?” Kleinian psychoanalysis would speak of the phantasy of fear of dependence on a good breast.
In the third case, (C), they dealt with the belief “We will only receive love if we suffer.”
Beginning of a couple’s relationship:
While in a therapeutic relationship we need a relationship as secure as possible in order to correct object representations, in love relationships, most people need an object safe enough to share and create unconscious relationship beliefs in an intersubjective space, but threatening enough to make sense and appeal. In an overly safe relationship, where it is obvious that their testing would pass very easily they would (mostly) not feel the requisite certainty that the other really perceives them, that they are important to him/her. It would be too boring.
But if the relationship is too threatening, because it is obvious that it will not be possible to pass the testing successfully, one does not (with exceptions) enter it at all, or (in most cases) cannot tolerate it. Thus, neither the first nor the second instance produces the right “chemistry of love”.
When Mrs. Jana got married she considered her husband Mirek a “"miracle. Mirek was her boss, educated, sophisticated, wealthy CEO. She needed to test then if she could be of value to others, if she were natural and autonomous. If anyone could ever love her like that, and Mirek admired her for her liveliness and spontaneity.
Jana did not get along with her mother, and her father constantly criticised her for not doing something right. Both parents fought violently, affectively throughout her childhood, and her father eventually left. She had a turbulent and rebellious adolescence, with drugs and petty crime. When Jana met Mirek, she was thrilled to find such a calm and stable man. She wanted him to “raise” her to “behave properly” because she had learned from her childhood that she was bad.
Mirek was a reasonable, well-mannered, calm but depressive man who tried to do things “the right way” so that Jana would be satisfied. Mirek came from a family where it was important to “behave properly”. He had always felt that it was completely unacceptable, or even embarrassing, to act unreasonably, or emotionally. Feelings, or even affectations, were never expressed at home. He said: “My parents never argued. My father just got up and left one day.” (Mirek was 6 at the time.) His mother suffered from long-term depression and commited suicide shortly thereafter. He was raised by a “good” grandmother. Unconsciously, Mirek understood his mother’s suicide as his guilt and spent his life undoing it.
It was only after the birth of her children that Jana became dissatisfied. She reproached her husband for never giving her a passionate hug, never having romantic “crazy” ideas and never getting angry. Mirek was deeply hurt and angered. After all, he tried so hard to be reasonable and affectless, as his parents and grandmother wanted him to be, and as Jana liked it at first. At the beginning of their therapy, he was unaware of his own feelings of hurt and anger. Instead of emotion, he began to have sexual and other difficulties. First he tried to ”learn” the way Jana wanted him to behave and then “enact” the emotions for her. But they were both disappointed. Jana saw his “affective and romantic” reactions as fake and insincere, and she was disgusted. Mirek tried hard to fulfil her demands, but his endeavour was not appreciated, which he did not understand and he was very troubled by it even though he did not let it on. His unconscious feelings of guilt and repressed anger manifested themselves in disorders of potency, which further complicated the relationship.
Initially, Jana needed a safe relationship, but later she began testing her own UIB that she was not worthy enough to be loved. It was no longer enough that Mirek was calm and stable. She needed to see if he would love her, even if she expressed her critical side, not just a sweet, submissive “spontaneity”.
Their shared URB could be formulated as: “If we show emotions, spontaneity and do not behave as expected by others/partners, we will be wrong, criticised and rejected.” They tried to repair this belief in their marriage.
Unconscious beliefs are often passed down through generations in families and intertwined in different generations. Sometimes the URB of the two partners reinforce each other, sometimes compensate, sometimes transform and influence each other, or form “holes” in the family matrix (e.g. when the parties keep secrets they cannot talk about) as described by Pierre Benghozi (2009, 2010) (Titl, 2016). While in some generations they may manifest themselves in the form of resilience and protect or support, in another generation they may manifest themselves maladaptively as mental illness, psychosomatic illness, or behavioural disturbances. In one generation, as something that unites relationships, at other times as something that breaks and divides them. The URB thus connects individuals both horizontally (in partnership, family, friendship and other relationships) and vertically (with past generations). It acts as a kind of psychological DNA that contains information about the traumas of the individual as well as those of past generations.
17.2. 2021 Prague
Slavoj Titl, Lucie Lucká
IFP-State-of-the-Art-Symposium 30.4. - 2.5.21
I would like to share with you a few ideas that we apply at the Institute of Psychoanalytic Couples and Family Therapy (IPPART), primarily the concept of unconscious relationship beliefs. This concept has proved to be very useful in our work with couples and families, helping us to better understand why certain people are attracted to each other; why other two people never start living together, even though they can have great sex; why, after a certain period of living together, some people start to have disputes and eventually break up, or vice versa, why some couples stay together despite suffering, arguing, attacking and destroying each others life. What is it, then, the mysterious “chemistry of love”? Similar questions are asked by our clients.
I shall try to address this issue, even if I speak somewhat more broadly at first.
XXXXXXXXXXXXXXXXXXX
At the Institute of Psychoanalytic Couples and Family Therapy, we consider it important to learn from a range of psychoanalytic theories. We believe that each psychoanalytic theory provides a different advantage in understanding the problems of couples and families, thus helping us to look at the issue of the couple, or the family from different perspectives.
Freud’s theory helped us to understand the intrapsychic functioning of the individual mind, but it was difficult to apply it to understand problems in relations. Margaret Mahler’s developmental theory (and others’ such as René Spitz’s) drew attention to the importance of relationships (mainly the mother-child relationship) for the development of identity in the separation-individuation process, the importance of so-called object constancy, as a precondition for the successful experience of the Oedipal stage. Ego psychology emphasised the early developmental phases of the ego and preoedipal development, while also providing an understanding of preoedipal, so-called functional relationships, often encountered in couples and family therapy.
Heinz Kohut and other self analysts taught us about the catastrophic effects of microtraumatisation in the form of lack of empathy. Basic forms of narcissistic transference – idealising, mirroring and twin transference – can often be seen in couples and families therapy. Various object relations theories, brought about by the development of psychoanalysis in the United Kingdom, have proved extremely fruitful for the psychoanalysis of couples and families. Bowlby’s attachment theory, and especially its elaboration by his followers, enabled a new understanding of the importance of early attachment formulas in building adult relationships. Klein’s approach to early pathology, splitting, understanding infantile phantasies, envy, jealousy etc. was not only important for individual psychoanalysis, but also provided an understanding of the many phenomena we see in couples and family relationships. For us couples therapists, however, perhaps the most important thing was the recognition of projective identification, which as a very early way of communication and influencing relationships applies when choosing a partner, the elimination of unbearable and unacceptable affects by projecting them onto a partner where they can be controlled or annihilated. Winnicott drew our attention to the importance of holding in therapy, the importance of transitional objects and transitional object relationships, and the conditions for the creation of the false Self vs. true Self.
Bion opened up a new perspective on therapy with his concept of container, alpha and beta function, and other ideas about the patient-analyst relationship and therapy. It turned out that his ideas could be very well applied to couples and family therapy. We started talking about a paired container, a family container, an unbalanced container, a container for transgenerational material, etc. The wide range of Bion’s useful ideas is beyond the scope of this paper.
Intersubjectivists alerted us to the unconscious experience of INTER. What arises between us, whether we are a patient and a therapist, or partners, friends, parents and children, colleagues at work, etc. We at IPPART believe that work with intersubjective reality should be the main goal of couples and/or family therapy. This means helping the couple or family to understand the unconscious that is co-created by both partners. The unconscious that can either unite people or divide them. This can be understood as a link (vinculo), but also in other ways for instance field theory.
In couples and family therapy, the therapist is confronted with a large number of externalised and acted out conflicts and has to resolve them in a relatively very limited time (compared to individual psychoanalysis). The couples or family therapist is constantly drawn into coalitions and, through the process of projective identification, into unconscious communication and acting out, being subjected to pressure by manipulation. In addition, there are at least two people and a therapist (sometimes a therapeutic couple) in the consultation room and each of them should have the opportunity to voice their respective opinions. Each of them should be able to get an empathic response from the therapist and his or her containment. But it is also important that the therapist provides container to the specific link (vinculo) of this particular relationship. Perhaps we could say to the intersubjective third, which is neither wife nor husband, but something between them. Such conditions place great demands on a therapist’s ability to hold boundaries and work with transference and countertransference, but also on his ability to think, dream, and hypothesise. Somewhat radically speaking, therapy arises in the mind of a therapist, with the help of his theories. In our opinion, various theories illuminate the extremely complex issue of couples and family relationships from various advantageous points of view. We do not see them as competing, but rather as complementary and enriching our overall understanding of our clients. At times, we probably all work by helping either partner to mentalise, to support the maturation of his ego functions, to support his separation-individuation process, to allow insight into internalised object relationships and their projection, to gain insight into repetition, or acting out, to allow better mutual containment, to help overcome the client’s inhibitions and thus to facilitate the development of self-reflection and at least around those aspects which allow the clients to work on their relationship at the end of therapy without our help. The goal of couples therapy, however, is to help with the intersubjective connection of the relationship. With what is created BETWEEN them and what maintains a specific relationship of the couple, or family, or sometimes even a non-relationship. What connects partners (or a family as a whole, but also a therapeutic group, or working groups). Our experience has led us to believe that couples are united by an unconscious phantasy about the nature of relationships, love and sex. “Phantasy” which we call “unconscious relationship belief”. Both partners agree on this belief, even if they sometimes act in seemingly opposite ways (e.g. a teetotaller and an alcoholic).
In our work we build primarily on 3 sources. The first is the theory of the link, (vinculo) as developed by Isidoro Berenstein (2005, 2010), who followed the Spanish and French psychoanalytic tradition, mainly the ideas of René Kaes as well as those of André Rufiot and Didier Anzieu.
Secondly, we build on theories of Californian scientists from Mount Zion (Joseph Weiss, Harold Sampson and others /1956–1986), who examined the process of short term psychotherapy and,
thirdly, on the theory of collusion, as suggested by Jürg Willi.
Jürg Willi (1975,1978,1985,1990) developed the concept of Henry Dicks on the “collusion” of spouses. It is based on the observation that couples bring different conflicts as variations on a single theme. Conflicts mostly involve a particular topic that makes a couple uneasy and creates a sort of “common unconscious of a couple”. This interplay created by a common unconscious is called collusion. A collusive relationship is one where, for unconscious reasons, the partners maintain and reinforce each other in a particular pair pattern. According to Willi’s concept of collusion, while individual behaviour is determined substantially by the individual history of the individual, in its manifest form it is essentially co-determined by the empowering or dampening behaviour of the partner, while his or her behaviour is again determined by their own individual history. (It is therefore a circular strengthening or damping.) Willi showed that both partners exhibit a disorder of the same kind, only manifested in the opposite way. These are polarised variants of the same psychological problem. However, in one partner it is manifested in a progressive-hypercompensatory form, while in the other in a regressive form of behaviour. (In therapy, for example, it can happen that the jealous one becomes the persecuted and the persecuted one becomes the jealous, the alcoholic becomes the teetotaler and the teetotaler becomes the alcoholic, the bully becomes the abused, while the abused turns into a bully, etc. So the two – unconsciously – share the same problem.
The Mount Zion Psychotherapy Research Group (Joseph Weiss, Harold Sampson and others (1956–1986) examined the process of short-term individual therapy (not couples or family therapy). But their ideas seems to be usefull also for couples therapy.
The conclusions of the research of the California school can be briefly summarised as follows (according to Weiss, 1990; Mikota, 1995, pp.105–108, Titl, S. 2014, p. 124–127):
1. „Psychological problems are rooted not in repressed impulses that maladaptively seek gratification (as suggested by the dynamic hypothesis) but in painful ideas known as ‘pathogenic beliefs’ (Weiss, 1990) that are maladaptive, i.e they present complications in adaptation to current adult conditions. In childhood, however, they helped the adaptation (or such was the patient’s childhood experience). Pathogenic beliefs are kinds of beliefs or axioms (or infantile fantasies) created by a child about how relationships function. They are unconscious, but they significantly affect people’s experience and behavior.
Several examples of pathogenic beliefs:
“If I want to be autonomous, I’ll hurt someone.”
“Other people don't like happy people. If I am happy, I will hurt or be punished.”
“If I want more from people, I’ll bother them, suck them dry.”
“I will be shamed for my desire to succeed.”
“For sexual desire I will be punished or shamed.”
Such beliefs developed in childhood as ways of adapting to very difficult or traumatic situations in relations with the most important people.
2. Patients in therapy, but also in certain situations of everyday life, (unconsciously) try not to confirm these maladaptive beliefs and disprove them – correct them because they complicate their lives. For this reason, they unconsciously test whether the situation in the relationship is safe enough, sometimes by provoking situations in which the other (therapist, partner) has to react to show that the tester (patient/client) has nothing to fear. For example, they make “excessive” demands on the therapist (or on the partner in the relationship), unconsciously observing how the other will behave. If the other (therapist, partner, friend, etc.) behaves by demonstrating that there is no risk of confirmation of PB, that there will be no repetition of the childhood trauma, the testing patient (partner) temporarily experiences reduced anxiety and feels more comfortable (safer) in the relationship. But this relief is only temporary as long as the tester does not realise what unconscious PB is at work and how he is testing. Unless he gains an insight (via interpretation), he is doomed to repeat, forced to repeat the tests again and again, often in a more dramatic way. As if unconsciously saying to oneself, “I hope it doesn't happen, but I'm not sure that in this new situation the other one won’t fail and it won't turn out to be as bad as in relationships I experienced in my childhood.” It is only when the patient gains an insight into pathogenic beliefs that he/she feels relieved and does not have to repeat the tests.
For example, a male patient who had an experience with his mother that she became seriously ill at the time of his separation from her (causing her illness in a child's phantasy) was terrified that his independence would hurt or annihilate his loved ones (hurt his mother). In therapy, he experimented with separation. He tried various forms and gradations of independence (from skipping sessions, to expressing disapproval, criticism to therapist/partner, threats to end therapy, etc. At the same time, he unconsciously watched and checked to see if he was injuring the objects of love (therapist, partner, etc.) when he allowed himself to be separated. The therapist must pass the patient test (he is not hurt by separation) and provide insight into the pathogenic beliefs tested (interpret the PB).
If the test subject (therapist in therapy/partner in a relationship) fails the test, the correction of PB fails, the test subject (e.g. patient in therapy) withdraws, her/his anxiety and discomfort in the relationship increase. Her/his testing stops (because she/he feels it is not safe enough), or becomes much more cautious, or ends the relationship (patient wants to leave therapy early, marriage is falling apart).
In our work with clients in couple and family therapies, we prefer not to use the term “pathogenic belief” because the issue is not that of pathology but of relationship problems. We prefer to use the notion of unconscious individual beliefs (UIB).
When two individuals of the opposite sex meet and start dating, from the very beginning, they communicate through many channels. Only some of them are conscious. Characteristic attractive body odour, movement, gestures, sound of voice, memories and hopes the other evokes in us etc. All these manifestations are the result not only of biological factors, but also of a certain basic attitudes, fantasies that “If I will in relationships desire about this….than happens that...” We call these basic attitudes “beliefs”, or “unconscious individual beliefes”.
Unconscious individual beliefs (UIB) develop at a very early age as a result of “procedures – natural, repetitive, often ritualised handling of and relating to the child. They have formed as inner, unconscious and self-evident patterns of action and relating to others and to the world, being completely unconscious, stored in implicit unconscious memory. This is also why they are unquestionable and manifested in acting out. Others arose defensively in situations where it was necessary to adapt to deprivation, repeated frustrations, traumatic situations, or to resolve internal conflict. These therefore have a defensive character and as they are stored in a declarative (explicit) memory, they can be remembered if patient’s defences are properly interpreted.
I consider this “shared problem” to be the result of an unconscious relationship belief that connects the two partners. This is why the two partners unconsciously chose each other in the first place. Unconsciously, they felt that they could solve or consolidate something of their own past with the other. If it works, collusion works. Conflicts, quarrels, or alienation result from the frustration of deep-seated unconscious beliefs about how relationships should work, both confronted with the great anxiety of repeating childhood threats. Both partners hope (unconsciously) to fight off their deep anxieties with the help of the other and ensure that their needs are met to an extent that has hitherto been unattainable and impossible.
When potential partners meet, they also test each other (deliberately and unconsciously). But they do not care about fixing their UIB (unlike patients in therapy). They seek a match or complementarity.
If people start dating, it is when they have very similar or complementary unconscious beliefs. This is why partners communicate intensively at the beginning of a relationship, sharing their experiences and plans, consciously and unconsciously observing and evaluating each other. Unconsciously, they test whether the other is a suitable object to help them remove deep anxiety and possibly achieve more satisfaction than if they were alone. If this process of mutual testing goes well, more security arises in the relationship, and partners begin to – unconsciously – create and form their common unconscious relationship beliefs, which bind (link) them together and by which they function without consciously realising it. Even later, they pass on this shared relationship belief to their children. Unconscious relationship beliefs thus initially organises the couple and later the whole family. Unconscious belief acts as a paradigm that determines the “rules of the game” – what is allowed and what is not allowed in a relationship, and what threats arise when rules (unconscious) are transgressed. Such beliefs may initially bring the couple/family together and create feelings of security, but after a certain period of time they may no longer apply – after a change in internal conditions, e.g. in an uneven progress of maturing in partners over the course of a lifetime (when one has been through successful psychotherapy, the birth of children may lead to different maturation of partners, the illness of one partner or even after a change in external conditions (getting poor or rich, shift of one or both on the social ladder, etc.) Life brings certain crossroads that confront the couple/family with the fact that the unconscious belief that used to unite them no longer suits them (creates the “problem” of the couple/family) and it is necessary to find a new one. Helping to find a new unconscious relationship belief is, in our opinion, the therapist's most important task.
When looking for an URB of couples, we ask ourselves (we create a hypothesis) what the partners/family –unconsciously– have (or had) in common. What unites them both (the whole family).
How to find unconscious relationship beliefs (URB) ?
1. In therapy, URB is manifested by a specific transference of the relationship system to the therapist. Therapist tends to function (think, experience) in countertransference, based on the same belief (URB) according to which the couple (family) operates.
2. “In relationships it goes like this: if we want this desirable thing... then a threat like this... happens.”
3. The partners share a common unconscious belief: “This is how relationships are supposed to be...”
4. “Love is when … .”
5. “In order to have a relationship, we have to experience... do...”
6. “ shared problem that partners solve is...”
Ad 1)
In therapy, URB is manifested by a specific transference and countertransference of the relationship system (partners/spouses/family) to the therapist. Berenstein refers to “imposition”, which is based on the link. “Imposition” acts on connected entities as if imprinting its stamp on them, which is independent of the will of the recipient and changes their subjectivity simply by belonging to the link. In our experience, the therapist then tends to function (think) according to the same paradigm-belief (URB) according to which the couple (family) operates
Vignette A:
A very handsome, wealthy couple were referred to my consulting room. They had serious conflicts in which they physically assaulted each other, threatened suicide, often being unfaithful so that the other would find out– – “in return” for her or his infidelity, competing to see who was more popular and who made more money. They abused each other, but they were unable to break up.
Before each session, I pored over their documentation, and in therapy I competitively searched for the best interpretations. When I noticed my unusual behaviour, I began to wonder why I functioned in this particular way. I became aware of the feelings of shame for my “imperfection” in front of this “amazing couple” and it was only then that I realised this was also their common way of functioning. I realised that both suffer from URB, which can be formulated as: “Only one of us can be perfect! The other is absolutely valueless! I must try to be perfect in order to impress the other, or I will sink into feelings of shame for my worthlessness and be abandoned. When the other is perfect, I am worthless.” I said aloud: “It seems to be a question of who will be better because it is only she or he who deserves love.” The gradual reflection of this narcissistic unconscious belief, which leads to a constant rotation of the position of euphoric winner-disgraced loser, gradually helped to calm down their relationship.
Ad 2)
Another way to find URB: This paradigm can also be used in such a way, where the dots are meant to be substituted for a specific couple, or family fantasy: “In relationships it goes like this: “If we want this desirable thing ... then such a threat will arise ... “
Vignette B
A couple of “eco-warriors” came into therapy. As soon as they entered my consulting room, they were indignant that I was using palm oil candles and had a synthetic carpet, and they kindly advised me that such things were not eco-friendly. They had serious problems with both their teenage children, who started using drugs and lived very provocative, “extravagant” lives.
In the course of the family therapy, I felt irritated by both partners. My feelings of irritation resulted in my countertransference tendency to adopt very modest attitudes or, on the contrary, defiantly emphasise my difference and hedonism. As it transpired, the husband lived in his first marriage with a very creative woman who died of hard drug abuse. But he loved her very much, and until she completely destroyed herself, they lived a rich, social life full of drugs, alcohol, food, group sex, and many different experiments.
After her death, he changed completely. He found a “humble” woman with rigid environmentalist views, and together they lived a very austere life with a contemptuous attitude toward the “material, self-indulgent world”. They raised their children “rationally” – in a cold, depriving way. For example, their children were not allowed to have any soft toys, so that they would not be spoiled. I formulated their family relationship beliefs for myself as follows: “In relationships it goes like this: if you want pleasant things and enjoy yourself . . . you become addicted to and dependent on pleasant things, spoiled and unable to regulate it, because we are all very ‘hungry’. When we talked about their belief, we arrived at a different formulation: “One can be proud of oneself if one overcomes one’s hunger and can abstain from the things one desires, and that will eventually save one's life.” The children functioned according to the same belief, only rebelling against it.
Ad 3)
Vignette C
A couple whose children were suffering from psychosomatic illness was referred to me by a psychiatrist. Although they were handsome, gifted and well-educated people, misfortune seemed to haunt them at every turn. The wife was recently raped, their car was stolen, her husband’s company was put under distraint, everyone was often ill... I was surprised how “easily” they seemed to be coping with such adversity. They seemed to be at peace with everything. Once, when they came to the session, the remote door control did not work, and I had to go and open the door for them in the house where I work. I opened the door and, after a day of sitting in my chair, I was happy to run up the stairs to get some exercise. When I turned around, I saw the family downstairs, watching me with an air of disgust. As soon as they entered my office, they commented ironically on the “unseemly athletic temperament”. When I pointed this out to them, they answered in unison with pride in their voices: “Whoever God loves, He visits them with a cross!”
I formulated their URB for myself as follows: “The more suffering and damage we experience and endure without objection, the more God (frustrating parent) will love us, and we can have respect for ourselves. The more we abstain from things, the more we deserve love. If we experienced health, success and happiness we would be without the right to love (self-respect).” Over the course of the session and in the following sessions, we discussed this belief in various contexts. After a few sessions, they came up with the idea that they spent their whole lives solving the question: “Can we be loved by God (by ourselves) if we experience happiness, energy and success in our lives?” Afterwards, there was a change in their mutual ability to contain and provide containment to their children, even if they live happily, with vigour.
Another paradigm they themselves later came up with was: “In order to have a relationship, love, self-respect, we must suffer!” In further therapy, it was confirmed that they had learned to adapt to the very depriving and frustrating tyrannical environment of their original families by repressing their anger in the hope that they would then be better treated and, in addition, earn a reward –the feeling that they are strong, good children who do not make things complicated for their parents.
Ad 4)
In the case of an (A) narcissistic couple, there may be a shared problem that they solve “How to be loved and valuable when it can only be one of us – either you or me.” Hence a number of other beliefs such as “If I show how great I am, you will want to humiliate me” etc.
In the second case, (B), the common linking problem the partners dealt with was oral phantasy: “Is it possible to live a comfortable life without becoming dependent on it?” Kleinian psychoanalysis would speak of the phantasy of fear of dependence on a good breast.
In the third case, (C), they dealt with the belief “We will only receive love if we suffer.”
Beginning of a couple’s relationship:
While in a therapeutic relationship we need a relationship as secure as possible in order to correct object representations, in love relationships, most people need an object safe enough to share and create unconscious relationship beliefs in an intersubjective space, but threatening enough to make sense and appeal. In an overly safe relationship, where it is obvious that their testing would pass very easily they would (mostly) not feel the requisite certainty that the other really perceives them, that they are important to him/her. It would be too boring.
But if the relationship is too threatening, because it is obvious that it will not be possible to pass the testing successfully, one does not (with exceptions) enter it at all, or (in most cases) cannot tolerate it. Thus, neither the first nor the second instance produces the right “chemistry of love”.
When Mrs. Jana got married she considered her husband Mirek a “"miracle. Mirek was her boss, educated, sophisticated, wealthy CEO. She needed to test then if she could be of value to others, if she were natural and autonomous. If anyone could ever love her like that, and Mirek admired her for her liveliness and spontaneity.
Jana did not get along with her mother, and her father constantly criticised her for not doing something right. Both parents fought violently, affectively throughout her childhood, and her father eventually left. She had a turbulent and rebellious adolescence, with drugs and petty crime. When Jana met Mirek, she was thrilled to find such a calm and stable man. She wanted him to “raise” her to “behave properly” because she had learned from her childhood that she was bad.
Mirek was a reasonable, well-mannered, calm but depressive man who tried to do things “the right way” so that Jana would be satisfied. Mirek came from a family where it was important to “behave properly”. He had always felt that it was completely unacceptable, or even embarrassing, to act unreasonably, or emotionally. Feelings, or even affectations, were never expressed at home. He said: “My parents never argued. My father just got up and left one day.” (Mirek was 6 at the time.) His mother suffered from long-term depression and commited suicide shortly thereafter. He was raised by a “good” grandmother. Unconsciously, Mirek understood his mother’s suicide as his guilt and spent his life undoing it.
It was only after the birth of her children that Jana became dissatisfied. She reproached her husband for never giving her a passionate hug, never having romantic “crazy” ideas and never getting angry. Mirek was deeply hurt and angered. After all, he tried so hard to be reasonable and affectless, as his parents and grandmother wanted him to be, and as Jana liked it at first. At the beginning of their therapy, he was unaware of his own feelings of hurt and anger. Instead of emotion, he began to have sexual and other difficulties. First he tried to ”learn” the way Jana wanted him to behave and then “enact” the emotions for her. But they were both disappointed. Jana saw his “affective and romantic” reactions as fake and insincere, and she was disgusted. Mirek tried hard to fulfil her demands, but his endeavour was not appreciated, which he did not understand and he was very troubled by it even though he did not let it on. His unconscious feelings of guilt and repressed anger manifested themselves in disorders of potency, which further complicated the relationship.
Initially, Jana needed a safe relationship, but later she began testing her own UIB that she was not worthy enough to be loved. It was no longer enough that Mirek was calm and stable. She needed to see if he would love her, even if she expressed her critical side, not just a sweet, submissive “spontaneity”.
Their shared URB could be formulated as: “If we show emotions, spontaneity and do not behave as expected by others/partners, we will be wrong, criticised and rejected.” They tried to repair this belief in their marriage.
Unconscious beliefs are often passed down through generations in families and intertwined in different generations. Sometimes the URB of the two partners reinforce each other, sometimes compensate, sometimes transform and influence each other, or form “holes” in the family matrix (e.g. when the parties keep secrets they cannot talk about) as described by Pierre Benghozi (2009, 2010) (Titl, 2016). While in some generations they may manifest themselves in the form of resilience and protect or support, in another generation they may manifest themselves maladaptively as mental illness, psychosomatic illness, or behavioural disturbances. In one generation, as something that unites relationships, at other times as something that breaks and divides them. The URB thus connects individuals both horizontally (in partnership, family, friendship and other relationships) and vertically (with past generations). It acts as a kind of psychological DNA that contains information about the traumas of the individual as well as those of past generations.
17.2. 2021 Prague
AN OUTLINE OF THE PSYCHOANALYTIC COUPLES AND FAMILY THERAPY IN THE CZECH REPUBLIC
Slavoj Titl
Institutional 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 relationships
List 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, 2009
Berenstein, I. (1995) Psychotherapy of family and couples – in Czech in Revue psychoanalytická psychoterapie, 2002
Bion, W.R. (1962) A theory of thinking. Int. J. of Psycho-Anal., 43, 306-310
Bion, W.R. (1959) Attacks on linking. Int. J. of Psycho-Anal., 40, (5-6-) 308
Blanck, R.G. (1968) Marriage and Personal Development, New York, Columbia University
Britton, R. (1989) The Missing Link: Parental Sexuality in the Oedipus Complex. In: The Oedipus Complex Today Clinical Implications, London: Karnac Books
Cleavely, E. (1993) Relationships: interaction, defences and transformation. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac Books
Colman, W. (1993) The Individual and the Couple. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac Books
Colman, W. (2007) Symbolic conception. Idea of the third. Journal of Analytic Psychology, 50(5)
Dicks, H. (1067) marital tensions New York: Basic Books
Fisher, H. (1994) Anatomy of Love: A Natural History of Mating, Marriage and Why We Stray. New York: Ballantine Books
Fisher, H. (2004) Why We Love: The Nature and Chemistry of Romantic Love, New York: Holt Paperbacks
Fisher H. (2013-11-02) http://www.ted.com/talks/helen-fisher-tells-us-why-we-love-cheat.html
Freud S. (1914) On narcissism: an introduction – in Czech: K uvedení narcismu Avicenum Praha, 1971
Grier, F. (2001) No sex couples, catastrophic changes and the primal scene. In. Oedipus and the Couple, London: Karnac Books
Kernberg, O. F. (1995) Love relations: normality and pathology. London:Yale University Press
Laplanche, J., Pontalis, J.B. (1973) The Language of Psychoanalysis. New York: Norton
Lyons, A. (1993) Husbands and Wives: thy mysterious choice. In: Psychotherapy with couples : Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac Books
Mahler, M.S. (1968) On Human Symbiosis and the Vicissitudes of Individuation – in Czech Psychologický zrod dítěte, Praha: Triton, 2006
Martin, P.A. (1976) A marital therapy manual. New York: Bruner/Mazel
Mitchell, 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 Books
Ogden, 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: Routledge
Pincus, L. (1960) Marriage: Studies in Emotional Conflict and Growth. London: Methuen/Institute of Marital Studies
Ruszczynski, S. (Editor) (1993) Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac Books
Sager, C.J. (1076) Marriage contracts and couple therapy: Hidden forces in intimate
relationships. New York, Brunner/Mazel
Scharff, D.E. and Scharff J.S. (1991) Object Relations Couples Therapy. Jason Aronson, New Jersey
Scharff, D.E. and Scharff J.S. (991) Object relations Family Therapy. Jason Aronson, New Jersey
Sharpe, S.A. (2000) The ways we love: a developmental approach to treating couples. New York: Guilford Press
Titl, S. (2002) Terapeutická hypotéza a intervence v párové a rodinné terapii. In. Revue psychoanalytická psychoterapie IV-2
Usher, S.F. (2008) What is This Thing Called Love? A Guide to Psychoanalytic Psychotherapy with Couples London: Routledge
Weiss, L.. Sampson, H et al. (1986) The Psychoanalytic Process, Theory, Clonical Observations and Empiric Research. New York: Guilford Press
Wile, D.,B. (1981) Couples Therapy: A Nontraditional Approach. New york: John Willey and Sons
Willi, J. (1990) Was Halt Paare Zusammen? Reinebek:Rowolt
Willi, J. (1991) Párová terapie. Curych: Konfrontace
Winnicott D.W. (1968) The use of an object. Int. J. of Psycho-Anal. 50
Slavoj Titl
Institutional 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 relationships
List 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, 2009
Berenstein, I. (1995) Psychotherapy of family and couples – in Czech in Revue psychoanalytická psychoterapie, 2002
Bion, W.R. (1962) A theory of thinking. Int. J. of Psycho-Anal., 43, 306-310
Bion, W.R. (1959) Attacks on linking. Int. J. of Psycho-Anal., 40, (5-6-) 308
Blanck, R.G. (1968) Marriage and Personal Development, New York, Columbia University
Britton, R. (1989) The Missing Link: Parental Sexuality in the Oedipus Complex. In: The Oedipus Complex Today Clinical Implications, London: Karnac Books
Cleavely, E. (1993) Relationships: interaction, defences and transformation. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac Books
Colman, W. (1993) The Individual and the Couple. In: Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies, London: Karnac Books
Colman, W. (2007) Symbolic conception. Idea of the third. Journal of Analytic Psychology, 50(5)
Dicks, H. (1067) marital tensions New York: Basic Books
Fisher, H. (1994) Anatomy of Love: A Natural History of Mating, Marriage and Why We Stray. New York: Ballantine Books
Fisher, H. (2004) Why We Love: The Nature and Chemistry of Romantic Love, New York: Holt Paperbacks
Fisher H. (2013-11-02) http://www.ted.com/talks/helen-fisher-tells-us-why-we-love-cheat.html
Freud S. (1914) On narcissism: an introduction – in Czech: K uvedení narcismu Avicenum Praha, 1971
Grier, F. (2001) No sex couples, catastrophic changes and the primal scene. In. Oedipus and the Couple, London: Karnac Books
Kernberg, O. F. (1995) Love relations: normality and pathology. London:Yale University Press
Laplanche, J., Pontalis, J.B. (1973) The Language of Psychoanalysis. New York: Norton
Lyons, A. (1993) Husbands and Wives: thy mysterious choice. In: Psychotherapy with couples : Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac Books
Mahler, M.S. (1968) On Human Symbiosis and the Vicissitudes of Individuation – in Czech Psychologický zrod dítěte, Praha: Triton, 2006
Martin, P.A. (1976) A marital therapy manual. New York: Bruner/Mazel
Mitchell, 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 Books
Ogden, 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: Routledge
Pincus, L. (1960) Marriage: Studies in Emotional Conflict and Growth. London: Methuen/Institute of Marital Studies
Ruszczynski, S. (Editor) (1993) Psychotherapy with Couples: Theory and Practice at the Tavistock Institute of Marital Studies. London: Karnac Books
Sager, C.J. (1076) Marriage contracts and couple therapy: Hidden forces in intimate
relationships. New York, Brunner/Mazel
Scharff, D.E. and Scharff J.S. (1991) Object Relations Couples Therapy. Jason Aronson, New Jersey
Scharff, D.E. and Scharff J.S. (991) Object relations Family Therapy. Jason Aronson, New Jersey
Sharpe, S.A. (2000) The ways we love: a developmental approach to treating couples. New York: Guilford Press
Titl, S. (2002) Terapeutická hypotéza a intervence v párové a rodinné terapii. In. Revue psychoanalytická psychoterapie IV-2
Usher, S.F. (2008) What is This Thing Called Love? A Guide to Psychoanalytic Psychotherapy with Couples London: Routledge
Weiss, L.. Sampson, H et al. (1986) The Psychoanalytic Process, Theory, Clonical Observations and Empiric Research. New York: Guilford Press
Wile, D.,B. (1981) Couples Therapy: A Nontraditional Approach. New york: John Willey and Sons
Willi, J. (1990) Was Halt Paare Zusammen? Reinebek:Rowolt
Willi, J. (1991) Párová terapie. Curych: Konfrontace
Winnicott D.W. (1968) The use of an object. Int. J. of Psycho-Anal. 50
INTERVIZE PRO VŠECHNY ABSOLVENTY KURZŮ IPPART
25.září 2020
30.října 2020
4.prosince 2020
IPPART VII/ I. blok
25.září 2020
30.října 2020
4.prosince 2020
IPPART VII/ I. blok
10.ledna VII-1-1
14.února VII-1-2
13.března VII-1-3
24.dubna VII-1-4
22.května vii-1-5 (čtvrtý pátek)
12.června VII-1-6
11.září VII-1-7- POZOR ! Termín se ruší a překládá se na 4.září
IPPART VI/ III. blok v roce 20201) 21.února VI-3-1
2) 20.března VI-3-2
3) 17.dubna VI-3-3
4) 15.května VI-3-4
5) 19.června VI-3-5
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