TALKING WITH COUPLES

TALKING WITH COUPLES

PSYCHOANALYTIC PSYCHOTHERAPY
OF THE COUPLE RELATIONSHIP

by

Giulio Cesare Zavattini, Barbara Bianchini,

Marina Capello, Laura Dallanegra,
Maria Adelaide Lupinacci, Fabio Monguzzi,
and Lidia Vitalini

published for
The Harris Meltzer Trust
by
KARNAC
Published for The Harris Meltzer Trust by
Karnac Books Ltd, 118 Finchley Road, London NW3 5HT

First published in Italian as Parlando con la Coppia: Psicoterapia Psicoanalitica della

Relazione di Coppia by Edizioni Borla, Rome.
Copyright © 2013 Edizioni Borla with Giulio Cesare Zavattini, Barbara
Bianchini, Marina Capello, Laura Dallanegra, Maria Adelaide Lupinacci, Fabio
Monguzzi, Lidia Vitalini

Copyright © 2015 The Harris Meltzer Trust

Translation by Giuliana Majo

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asserted in accordance with §§ 77 and 78 of the Copyright Design and Patent Act
1988.

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vi CONTENTS

5 The meeting of couple psychoanalysis with

the intersubjective viewpoint
Fabio Monguzzi 89

References 103
Index 117

INTRODUCTION
ABOUT THE AUTHORS

Barbara Bianchini is a psychologist and psychoanalytic psycho-

therapist, working privately with individuals, couples and
groups. She is a full member of the British Society of Couple
Psychotherapists and Counsellors (BSCPC), a member of the
International Association of Couple and Family Psychoanalysis
(IACFP), the Associazione di Psicoterapia Psicoanalitica di Gruppo
(APG), and the Confederazione delle Organizzazioni Italiane per
la ricerca Analitica sui Gruppi (COIRAG), where she teaches
psychotherapy. She has been honorary judge at the Milan Court
of Appeal in the children and minors section, and a consultant
at the ASL Couple and Family Centre in Milan.
Marina Capello is a psychologist and psychoanalytic psycho-
therapist, working privately with adults, adolescents, and
couples. She works in the legal field as outpatient psychologist
at the Servizio Dipendenze nella Casa di Reclusione di Milano-
Opera and as external advisor for the Ministry of Justice at the
Ufficio Esecuzione Penale Esterna (UEPE) of Milan and Lodi,
where she conducts training courses and supervision groups
with psychologists and social workers.
vii
viii ABOUT THE AUTHORS

Laura Dallanegra is a psychologist and psychoanalytic psycho-

therapist, working privately with adults, adolescents, and
couples, and as a supervisor of clinical cases. She teaches the
theory and clinical technique of couple psychotherapy. She was
a founder member of the Ambulatorio dell’Associazione (Area G)
in Milan, and a member of the training committee of the Scuola
di Psicoterapia (Area G). She has been a consultant at the Couple
and Family Centre (ASL) in Milan.
Maria Adelaide Lupinacci is a psychoanalyst and psychiatrist,
a member of the Italian Psychoanalytic Society (SPI) and the
IPA. She specialises in the psychoanalysis of children and adoles-
cents. She was secretary of the SPI commission on the analysis
of children and adolescents, and of the Centri di Psicoanalisi
in Rome. She is author of many papers on the early Oedipus
complex, countertransference, guilt, the mind’s space-time, and
psychoanalytic psychotherapy of the couple. She works privately
in Rome with adults, adolescents, children and couples.
Fabio Monguzzi is a psychologist and psychoanalytic psycho-
therapist, now in private practice after working with various
health institutions in the public sector. He is affiliated to the
Associazione per la Ricerca in Psicologia Clinica (ARP) and honor-
ary Judge at the Milan juvenile court. He is a full member of
the British Society of Couple Psychotherapists and Counsellors
(BSCPC) and a member of the International Association of
Couple and Family Psychoanalysis (IACFP).
Lidia Vitalini is a psychologist and psychoanalytic psychothera-
pist, and a member of Metandro, which provides medical and
psychological services for children from the age of one to four.
She works privately with adults, adolescents and couples.
Giulio Cesare Zavattini is professor of assessment and interven-
tion in clinical psychodynamic work with couples at the Sapienza
University of Rome. He is a full member of the British Society of
Couple Psychotherapists and Counsellors (BSCPC) and of the
International Association of Couple and Family Psychoanalysis
(IACFP), and a member of the international advisory board
of the journal Couple and Family Psychoanalysis. With Renata
Tambelli he is editor of the Borla series Psicoanalisi e Relazioni:
Studi su Individuo, Coppia e Famiglia.
T
he purpose of this book is to share the educational
and experiential journey of a group of psychoanalytic
psychotherapists who have for some years been work-
ing with families and individuals in both the private and the
public sector. The members of the group, who come from
similar theoretical perspectives (in object relations), share
the view that clinical experience is the fundamental point of
departure for their own professional and personal develop-
ment. The group was designed to create an environment for
study, debate and comparison of the psychological, relational
and social dynamics that contribute to the functioning of a
couple or a family.
The activities of the group take place on two fronts: on the
one hand, clinical work with couples and families, and on the
other, theoretical formulation and review in study and super-
vision groups, professional development courses, and seminars
hosting visiting experts from Italy and other countries. An
educational programme has become established which includes
professional development courses lasting up to four years, that
are open also to professionals in the psychology sector, and facili-
tated and supported by Professor Giulio Cesare Zavattini, direc-
tor of the clinical course on psychodynamic work with couples at
the Sapienza University in Rome. These courses have stimulated
a gradual and progressive interest in the deeper understanding
of the theoretical basis and clinical functioning of such work,
which in turn has inspired the writing of this book.
The programme has led to a rewarding exchange with other
researchers and interpreters of couple and family psychoanalytic
dynamics, such as members of the Italian Psychoanalytic Society
(SPI) and the British Society of Couple Psychotherapists and

ix
xviii INTRODUCTION

Counsellors (BSCPC) in London. Many experienced colleagues

have been invited to become involved with the Centre’s work
groups, and their contributions in organising seminars and
professional training have been invaluable. In this respect we
particularly thank our guests Diana Norsa, Carlos Tabbia, and
David Hewison.
The collaboration with foreign researchers has revealed dispa-
rate, though not opposing, theoretical languages and points of
view. Extending our contacts to other groups and perspectives
has been fruitful in expanding our knowledge and in defining
a theoretical–technical working model for couples and families
that we find useful in our relationship with our patients.
The psychotherapeutic and consultative experience that we
have had within the public sector, working in Milan, has proved
very important at a clinical level. The experience of our group
members in consultations over a long period at family therapy
centres, which encompass a wide spectrum of encounters and
relationships, indicated a need to expand the field of operation
and availability, especially since in times of crisis the demand
for help increases. Moreover the limitations imposed by the
resources of the public health sector have led therapists to find
new ways of adapting their psychoanalytic techniques and meth-
ods to suit the realistic capacities of these institutions.
Another important contribution to the experience of the
members has been the opportunity to be part of a legal envi-
ronment – a multitude of difficulties associated with different
types of families resulting at times in the role of honorary judge.
In recent times, families have evolved within a diverse social
landscape: mixed couples, different cultures, and also, extended
family systems or single parent situations which can make social
integration harder. The responsibility, although shared, to choose
and think of the best way to resolve legal issues, has made us
acutely aware of the powerful impact which these choices can
have on the life of the people involved. Members have become
much more aware of the complexity of their professional role
in enabling the process of separation or divorce, which is often
riddled with controversies and sometimes become quite violent,
 INTRODUCTION xi

but also entails witnessing the delicacy of the nature of child care
decisions and parenting.
In addition to this, some members have accrued a great deal
of experience from many years of teaching theory and tech-
niques of psychoanalytic psychotherapy with couples in training
institutions. The experience of transmitting knowledge to new
generations of psychologists and keeping an eye on the evolu-
tion of theoretical models has allowed continuous exchange and
feedback. It has demonstrated to us the extent of the interest in
the subject and the relevance of achieving a serious and adequate
understanding of the couple relationship in its varying contexts.
The interchange between the areas of work and the work
discussion groups has shown itself to be of fundamental impor-
tance in stimulating not only professional but also the personal
development of each member. This has inspired the desire for
an ongoing collaboration between colleagues with a view also to
reinforcing the therapist’s individual experience.
This book is intended therefore to share the findings of our
journey so far, and the knowledge we have gained during the past
years, in the hope that still unresolved thoughts and questions
will inspire further engagement and exchange on both a clinical
and a technical-theoretical level, with those who on a daily basis
come across the same doubts and difficulties. We hope it will be
useful in strengthening the basis from which we can build better
relationships with our patients. We hope also to contribute to the
ever more topical debate on how better to use psychoanalytic tech-
nique and theory in meeting the increasing demand for interven-
tion with couples and families, and to delineate the unique value
of psychoanalytic work in a territory that is still so little explored.

Theoretical background

The theoretical aspect of this volume highlights the relational

aspects of psychoanalysis, alongside its intrapsychic dynam-
ics, which together form the basis of a therapeutic approach to
couples. The development of psychoanalytical theory within a
model of the mind that envisions the acquiring of an identity
xii INTRODUCTION

and a sense of self, has given more relevance to understanding

the personality in terms of its interaction with its significant
emotional relationships. This is by contrast with the idea of
developmental stages seen solely in relation to internal forces,
as earlier envisaged in the structural model of urges and desires
(Zavattini, 2008). With this in mind we have referred to
concepts expressed by Melanie Klein (1963), Winnicott (1958),
and Britton (1989). Winnicott was one of the first to emphasise
the relational nature of human personality development and the
significance from birth of the mother’s specific and concrete care.
He also stressed the importance of the adequacy of the mother’s
responsiveness to the baby’s needs, for the child to develop conti-
nuity and integrity of being. Winnicott acknowledged that the
real self of the child originates in and develops from the qual-
ity of this primary relationship. The development of the self is
marked out by the growth of the affective sphere, which needs to
be protected by the caregiver from the intrusion of inadequate
environments. This is especially relevant to couple therapy given
that each member of the couple is shifting between their indi-
vidual goals and the desire to communicate and be understood
within the relationship with the partner.
Britton reminds us of the importance not only of the moth-
er’s role but also of the relationship between the parents. The
emotional environment they provide allows the child to engage
in relationships where he is both observed by another (a third
person, or two people) and also the external observer of a rela-
tionship between two people (the parents). If the relationship
between the parents is founded on love, the child is helped to
imagine a psychological space which is caring and accepting, and
which is fundamental to secure and stable growth.
Many different approaches to psychological research have
stemmed from such ideas, increasingly highlighting the impor-
tance of sharing, exchanging, and engaging in experiences with
others, in order to develop adequately. This focus on relation-
ships inspires the aim of enabling a mutual give-and-take
with the partner. In optimal conditions the exchange allows
 INTRODUCTION xiii

self-regulation and reciprocal regulation, creating a balance that

is flexible and dynamic (Beebe & Lachman, 2002).
In the realm of object relations theory, the mind is viewed
as internalising not only objects but also relations and func-
tions. Our understanding of the bond with the object and the
ways in which this bond is sought has gained in complexity.
Psychoanalytical research and theories originally concerned
primarily with the individual, have developed this interest in
the relational framework, focusing on how the individual inter-
acts with other significant subjects (Bezoari & Ferro, 1991;
Ruszczynski, 1993; Norsa & Zavattini, 1997; Fisher, 1999;
Clulow, 2001, 2009; Manguzzi, 2010).
There are many references in this volume to the reconceptu-
alisation of the idea of projective identification as both an intra-
psychic and an interpersonal process. This allows light to be shed
light on the shift of psychoanalytic approaches towards intersub-
jective interpretations of the couple relationship. It takes more
than one person throughout the life of an individual to help him
achieve ‘unit status’ in his psychological space (see Winnicott,
1958; Loewald, 1979; Gabbard & Ogden, 2009). In terms of
the inner world, we see the connection with Bion’s view of how
the individual develops in the presence of a maternal mind that,
especially in infancy, provides through a state of ‘reverie’ a think-
ing function in relation to its experienced emotions.
This volume refers to the concept of ‘field’ in two chapters:
one in relation to theory, and another in relation to method.
This concept was introduced by the Barangers (1961–1962) and
was articulated in more depth in Bion’s theories where, within
the setting, it becomes a space between the patient and the thera-
pist in which the relational dynamics between the characters of
the story can take place. Many of psychoanalysis’ concepts find
expression in this area, oscillating between emotional movement
and the construction of a new thought, a new story that is more
adequate to the necessities of the relationship. Thus the search
for concepts and theories that explain interpersonal dynamics,
including those within adults, takes place in a scenario in which
the relationship with the other is a necessary condition that
xiv INTRODUCTION

persists throughout life (Norsa & Zavattini, 1997). The couple

in this general sense can be seen as an essential core component
of everyone’s psychic life; and in our culture it is often consid-
ered (sometimes only implicitly) as a special, unique and original
place that has its own identity alongside the individual identi-
ties of the partners, and that might therefore interfere with their
personal aims and interests.
The research we present here aims to indicate hypotheses that
embrace the many different psychopathologies we encounter
in our studies and in real life. We would like to contribute to
making sense of the disturbances that arise from the couple and
family contexts and that have repercussions on a personal and
a social level. Our approach is to concentrate on applying the
specifics derived from individual psychoanalysis in a way that is
feasible with couples and families. Working psychoanalytically,
we are part of an ongoing process in which everything brought
to the session needs to be welcomed and considered as poten-
tially a source of development.
Last but not least, we would like to cite Thomas Ogden on
how we may need help in making our experience dreamable and
therefore thinkable:
Beyond a certain point (a point that varies for each individual),
we find it unbearable to think/dream our experience. Under
such circumstances, if we are fortunate, there is another person
(perhaps a mother or father, an analyst, a supervisor, a spouse, a
sibling, a close friend) who is willing and able to engage with us
in a process of dreaming our formerly undreamable experience.
(Ogden, 2009, p. 113)
Every day in our work with couples it is our hope that this may
happen.

Contents of the book

This book begins by considering how classical psychoanalytic

theory has been developed into new models with methods
that can welcome more than one individual personality into
 INTRODUCTION xv

psychoanalytical territory: the couple, the family, the group. The

first chapter, ‘Psychoanalytic history and the couple relationship’,
reviews the psychoanalytic journey that has allowed its focus to
extend from the mind of the individual to what happens when
the minds of two individuals come into contact. Theoretical
development has enabled the employment of some psychoana-
lytic tools in new therapeutic fields, such as the dynamics of
couple relationships.
From the Kleinian school of thought onwards, psychic life
has come to be seen as relational from its very beginning. The
concept of projective identification opened up new ways of
understanding how individuals enter into relation to the world
and with that which is other than the self – extraneous, external,
and a source of help but also of distress. The communicative func-
tion of this mechanism requires a responsive object (Campora
& Zavattini, 2011). The many theoretical developments have
taken different routes from this basic standpoint, using a variety
of languages that are not always analogous. Nevertheless there
are some points of contact in concepts such as Bion’s container–
contained, Bowlby’s attachment and bonding, or Winnicott’s
‘holding’ and environmental mother. In terms of clinical theory,
we find that the listening role of the analyst fits well with the
more recent relational viewpoints in which the therapy is seen
not as a decoding process, but as a field in which the transforma-
tional experience can unfold (Kernberg, 2011).
In the second chapter, ‘Theoretical foundations of psychoana-
lytic psychotherapy with couples’, are described the theoretical
concepts that have grown out of the formulations used in indi-
vidual therapy and have been employed to construct the basis of
couple psychotherapy. Links are made to show how the classic
theories designed to describe the intrapsychic life of the indi-
vidual merge into subsequent object relations theories that deal
with psychic identity in terms of interpersonal relations (Dicks,
1967; Ruszcynski, 1995; Fisher, 1999). The concepts are noted
which are most fruitful for working with couples, such as Bion’s
container–contained, communicative projective identifica-
tion, and ‘transformation’; and which can be used as a basis for
xvi INTRODUCTION

identifying the contributions of both subject and object toward

forming individual development. With regard to the concept of
transformation, which has complicated implications in therapy,
we make use of Ferro’s (2002a, 2005) exposition of Bion’s idea,
which stresses not only the therapist’s verbalisations but also the
quality of his listening and the depth of his availability to the
processes of psychic configuration taking place in the mind of
the patient. The patient’s transformative journey depends on
all these factors. Indeed it has only become possible to work
psychoanalytically with couples owing to this explicit acknowl-
edgement of the total ensemble of influences that enable psychic
distress to be reconsidered in its entirety. So in this chapter the
dynamics of couple relationships, both functional and dysfunc-
tional ones, are laid out, and some clinical examples are given
for clarification.
In the third chapter, ‘Equilaterality: the structure of the couple
and the mental state of the therapist’, the role of the therapist is
highlighted together with his or her subjectivity and resonance
on a countertransference level. In fact, dealing with the couple
relation creates a situation in which none of the members of the
relation (either the partners or the therapist) can be understood
without the other since the dynamics emerging in the session
depend on mutual interaction. The concept of relation itself
implies the amplification of the psychic space, meaning that we
are not dealing only with the individual’s psychic space but also
with the imaginary (not material) space in which the relation-
ship takes place and where their internal worlds encounter each
other and their emotions and objects intertwine. Owing to this
the basic structures of the couple relationship are best repre-
sented by a triangle. Studying the transference–countertransfer-
ence dynamics in a clinical case we recognise that the quality
of triangularity can evolve, crystallise, and oscillate during the
life cycle of a couple, assuming equilateral or scalene forms. The
‘equilateral’ function of the therapist is discussed in depth. This
function describes how the relationship between the two part-
ners is itself the patient. If a third party is present in an obser-
vational capacity, it is possible for projections to be withdrawn,
 INTRODUCTION xvii

leaving space for a more satisfying relationship. A triangular

space has been created in which each partner can reflect on their
own needs, on the needs of the other, and on the requirements
of their relationship.
The fourth chapter, ‘The therapist at work: technical matters’,
describes the methodology of psychoanalytic treatment of the
couple, with reference to the theoretical models mentioned
above. The joint setting is a space in which the actual partners,
the imaginary partners that exist in one another’s minds, and the
relationship itself, are all present. In this chapter the transference
and countertransference movements and the different levels of
intervention carried out by the therapist are discussed through
clinical examples. The shift is highlighted from ‘reconstructive’
models of the mind to those that emphasise the possibilities of
change sparked off by new experiences. As a consequence it is
clear how interpretation (in the classical sense) is only one aspect
of our work, which mostly focuses on the emotional atmosphere
and the psychic dynamics that emerge during the session itself.
In order to keep in context the implications of different
psychoanalytical approaches, and to enrich the landscape of
contributions through an ongoing exchange of ideas, the fifth
chapter, ‘The meeting of couple psychoanalysis with the inter-
subjective viewpoint’, explores the technical and theoretical
basis of the relational intersubjective approach to couple ther-
apy. This model asserts the need to increase the relationship’s
ability to contain, support and adjust the disturbing elements.
The accent is on the ability to regulate emotion, meaning the
proximity–distance tension between the partners, with the aim
of improving its transformative potential. Through interpreta-
tion, the quality of connectivity and attunement with the other
is highlighted. The aim, both implicit and explicit, is therefore
to find methods of regulating feelings. The therapist’s function
is to become involved in the intersubjective relation, available
through his engagement to offer a new, alternative experience
which can be memorised by the patient. The patient is given
the opportunity to explore the subjectivity of the therapist and
to improve their ability to recognise the other’s mental state,
xviii INTRODUCTION

intentions and emotions. They can then apply this experience to

the situation with their partner, and the therapeutic transforma-
tion consists in this improvement in empathic understanding.
Finally, we would like to thank Professor Giulio Cesare
Zavattini, for his availability and generosity in sharing his wealth
of experience and knowledge and in supervising the coming-
together of this book. And we dedicate this book to all our
couples and patients.
Barbara Bianchini, Marina Capello, Laura Dallanegra,
Maria Adelaide Lupinacci, Fabio Monguzzi, and Lidia Vitalini
CHAPTER ONE

Psychoanalytic history and the

couple relationship

Laura Dallanegra

It requires two minds to think one’s most disturbing thoughts.

(Thomas Ogden, 2009, p. 100)

I
n order to illustrate our approach to this work, before we
discuss the couple relationship as such, we would like to
reflect on the historical development of psychoanalytic
thinking and some of the rich, complex, and diverse contri-
butions that are relevant to our theme. The aim of this first
chapter is to highlight concepts that, though they may come
from different theoretical perspectives, offer us useful tools for
understanding the complex dynamics within the couple rela-
tionship. As when we visit an unfamiliar city, we can find our
way with the help of a map, so in the same way, thanks to the
advance of psychoanalytical thinking, we now have enough
tools to undertake the exploration of new avenues. The
dialogue that psychoanalysis has maintained with philosoph-
ical and scientific thinking has influenced its development
on both a clinical and theoretical level. The constructivist

1
2 TALKING WITH COUPLES

epistemological approach, for example, has questioned the

possibility of objective scientific knowledge in the sense of
the representation of an external order independent of the
observer. Even the observation of phenomena is considered
an unreliable source for objective understanding, and has to
take the observer into account.
Philosophical theories of knowledge dependent on a notion
of scientific realism have by now faded, and theories maintain-
ing that the subject plays an active role in construing its view
of ‘reality’ are now dominant. Yet our subjective understand-
ing is continuously adjusted through encounters with exter-
nal reality. In psychoanalysis, we are now most interested in
discovering what is happening in the relationship between two
minds, rather than in the mind of the patient alone or believ-
ing that the analyst’s information is objective. Various authors,
from different schools of thought, have coined new terms to
express the process whereby the analyst actively engages with
the mind of the patient (see Bordi, 1995). Concepts such as
‘holding’ (Winnicott, 1961), ‘role-responsiveness’ (Sandler,
1976), ‘enactment’ (Filippini and Ponsi, 1993), ‘intersubjec-
tive third’ (Ogden, 1994), describe the contemporary view of
the therapist, who is these days recognised as being an active
participator in therapeutic change.
The matter of the relationship between the individual’s
psychic organisation and his external relational sphere is
fundamental to the psychoanalytical debate, encouraging
comparisons between different theories and opening up clini-
cal experience to new avenues of intervention. In some cases
the subject is not treated individually but in relation to a
parent, a partner, a group. The relationship ‘I–world, I–you’
has been fundamental to the psychoanalytic panorama ever
since the development of object relations theory, highlight-
ing the profound influence of early emotional relationships in
shaping personality structure. This has expanded the horizon
of knowledge by clarifying the limitations of focusing solely
on an individual mind when hoping to sufficiently under-
stand a personality.
 PSYCHOANALYTIC HISTORY 3

Internal world and external reality

Within the couple relationship, internal world and external

reality intertwine in a particularly complex way. From its very
outset psychoanalysis has looked at the relationship between
internal and external realities with great interest, allowing
within its clinical circumference a glimpse in the direction of
the individual’s other relationships. Some good examples are
therapy with children or adolescents and their parents; group
analysis; and most recently, the interest in the couple rela-
tionship. The following brief survey of the direction psycho-
analytical research has taken is inevitably limited in scope, but
necessary for our project.
Psychoanalysis’ initial interest in the mind as a home for
impulses, denial, and the unconscious, has evolved into the
investigation of internal relational dynamics. In 1921 Freud
described the individual mind’s potential to either reach out
or to close itself to the other: ‘In the individual’s mental life
someone else is invariably involved, as a model, as an object, as
a helper, as an opponent; and so from the very first individual
psychology, in this extended but entirely justifiable sense of the
words, is at the same time social psychology as well’ (p. 69).
All these relations are to be distinguished from the narcissistic
‘satisfaction of the instincts’ in which the personality is with-
drawn from communication with others.
The way in which individuals deal with the relationship
between exterior and interior has been at the heart of psycho-
analytical inquiry (Velotti & Zavattini, 2008). Both internal and
external reality can be sources of either support or disturbance
for the individual. Freud’s first model saw the individual’s past
traumas as being unearthed from the unconscious and thereby
relieved. ‘Trauma’ implies an excessive influx of excitement aris-
ing from an event whose impact was such that the individual was
not able to process it adequately, resulting in psychopathology.
Freud’s second (structural) model considered how the elements
that compose the psychic apparatus function, and outlined how
the ego mediates between the id and the external world (Mangini,
2003). The mechanisms of introjection and projection provide
4 TALKING WITH COUPLES

the foundation for articulating the link between subject (internal

organisation) and external reality:
Under conditions whose nature has not yet been sufficiently
established, internal perceptions of emotional and thought
processes can be projected outwards in the same way as sense
perceptions; they are thus employed for building up the
external world, though they should by rights remain part of
the internal world. (Freud, 1913, p. 64)
Although projection could also be involved in seeking relief
from conflict, defence was not its original purpose. Freud’s
description of the core concept of projection led to Klein’s
slightly different formulation of projective identification. Klein
developed Freud’s idea about the transforming power of inter-
nal perception in terms of how a child’s developing personal-
ity is shaped by projecting externally frightening figures and
introjecting positive figures. Her theory, although originating
in Freud’s energy model, clearly departs from it. By contrast
with the Freudian model where the object is just an endpoint
for impulses, Klein’s intuitions enabled the assignation of a
more relevant role to the object. Through projective identifica-
tion, the person could not only modify internal reality but also
modify the reality of the other, who is invested with a need to
think and respond accordingly. Both self and object construct
themselves on the basis of continuous processes of projection
and introjection.
For Klein, projective identification was essentially an intra-
psychic phenomenon, although her phrasing does suggest an
interpersonal interpretation of this mechanism: ‘Identification
by projection implies a combination of splitting off parts of the
self and projecting them on to (or rather into) another person.
These processes have many ramifications and fundamentally
influence object relations’ (Klein, 1955, p. 143). For Klein, the
main role is always that of the internal world; emotional expe-
riences, love and hate, are at the heart of human motivation.
Although she focuses on the mechanisms employed by the indi-
vidual to filter the external world, her concept of projective iden-
tification opened new perspectives onto the relation between self
 PSYCHOANALYTIC HISTORY 5

and external object. The ‘depressive position’ acknowledges the

ambivalent emotions aroused by an object which is external and
independent of the self.
In recent years Britton, reconsidering Klein’s thinking, has
described the child’s acknowledgment and acceptance of the
relationship between its parents in terms of a ‘triangular space’
that enables three types of experience: namely belonging to a
relationship, being observed in a relationship, and observing the
relationship between two people. He writes: ‘The capacity to
envisage a benign parental relationship influences the develop-
ment of a space outside the self capable of being observed and
thought about, which provides the basis for a belief in a secure
and stable world’ (Britton, 1989, p. 87).
One of the most significant movements in the develop-
ment of psychoanalytical thinking is the shift from the idea of
a unified mind, imagined like a written text although not easily
interpretable, to the idea of a mind that develops owing to the
nourishment and care of another mind – a relationship. Therapy
is an encounter between two minds in which the analytic process
makes the previously unconceivable, conceivable.

The significance of relationships

In Klein’s model, projective identification cannot exist in rela-

tion to nothingness: the presence of an object is necessary in
order to project. It is Bion, however, who points out explic-
itly that this mechanism has not only a defensive but also a
communicative function. This communicative function is
based on the presence of a containing maternal mind equipped
with a capacity for reverie and receptive to the child’s projec-
tion (Bion, 1959). Reverie allows the projection to enter the
mind of the object, which responds actively, comprehending
and containing. The object of projection is not indifferent but
on the contrary, functions by metabolising emotional ‘elements’
through ‘alpha-function’. This allows for greater articulation of
the relationship between subject and object, introducing what
has been called the ‘principle of circularity’ (Velotti & Zavattini,
2008). Grotstein (1981) explains that this model of projection
6 TALKING WITH COUPLES

and containment forms the basis of normal thinking and is

usually internalised by the child.
Different conceptual models arise from this, leading to
different ways of perceiving the psychoanalytical process.
For the sake of simplicity we can say that one model is based
on the concept of instinct, another model on the concept of
relationship. The first model aims to bring to consciousness
the pathogenic intrapsychic conflicts by reconstructing the
patient’s experiences; the second creates a dyadic analytical
situation. What emerges in the consulting room is the prod-
uct of the interaction between therapist and patient (Jiménez,
2006). On the other hand the classic concepts of transference
and countertransference, projective identification, object
relations theory, introjection and projection, the Oedipus
complex, and the formation of the superego, are foundational
also to a relational outlook. Indeed many different post-
Freudian approaches, in a variety of languages and settings,
use the idea of ‘relational’. As Jiménez writes: ‘It is not an
exaggeration to say that, each time clinicians with differ-
ent psychoanalytical cultures try to communicate with one
another, the “Babelisation” of psychoanalysis is reproduced’
(2006, p. 146). While in the classical Freudian view the analy-
sis aims to uncover historical events in the patient’s life, in the
Kleinian, the therapist’s task is to aid the patient to deal with
the internal ghosts by interpreting and analysing the defences
surrounding separation and projection.
In Bion’s model, the analyst–patient relationship takes
precedence. In his theory of infant development, and conse-
quently of the psychic processes of the individual mind, all new
experiences are disturbing. At birth the infant is overwhelmed
by new sensations deriving from both interior and exterior
reality, which then generate ‘beta-elements’, being ‘sense-
impressions linked to an emotional experience’ (Bion, 1962,
p. 17). In this initial phase of life such overpowering stimuli
can only be evacuated through projective identification until
another mind transforms them into thoughts (symbols, dream-
thoughts) by means of alpha-function. Bion’s model does not
focus on denial, splitting, or traumatic events that have taken
 PSYCHOANALYTIC HISTORY 7

place in the past or that are unconsciously phantasised; instead

it emphasises the specific and characteristic ability of human
beings to ‘think thoughts, feel emotions, dream dreams’ (Ferro
& Vender, 2010). This ability forms and develops through the
relationship between two minds and through the primitive,
unconscious channel of communication which is projective
identification. As with alpha-function, Bion’s concept of the
container-contained relationship is fundamental to the devel-
opment of a theory of couple analysis. Elements of emotional
experiences, arousing anxiety and requiring containment,
are shaped within the container into dreams and thoughts.
In favourable conditions, the relationship between container
and contained enables growth of both aspects: the ability to
carry out unconscious thinking expands and the thoughts are
deepened and enriched. Pathology results when this psychic
relationship fails. This relationship – the process of thinking
– develops in order to digest disturbing emotional elements,
and the interaction between thoughts and thinking persists
throughout the individual’s life. In a clinical situation, the
aim is to help the patient to observe his own emotions and
to develop his own capacity to think, through working with
another mind in a process of continuing projection and
introjection.
Since every stage in our development involves confronting
new emotional experiences for which we are unprepared, we
never lose this need to involve ourselves intimately with people
with whom we can engage in thinking. Ogden writes: ‘The two
minds engaged in thinking may be those of the mother and
infant, the group leader and group member, the patient and
analyst, the supervisor and supervisee, the husband and wife,
and so on’ (2009, p.100). Bion’s view of the mother–infant
couple as container–contained has analogies with Winnicott’s
assertion (1961) that there is no such thing as a baby, only a
baby and mother. Although coming from a different theoreti-
cal standpoint, Winnicott emphasises the need for a facilitating
human environment – in the first instance the mother; the
mother’s ability to put herself in the child’s place and under-
stand its needs protects the child from the unthinkable fear of
8 TALKING WITH COUPLES

‘falling to pieces’. Whilst agreeing in part with Klein on object

relations, Winnicott differs in his view that it is the quality
of the environmental object that determines the self ’s devel-
opment; this is something that also appears to connect with
Bion’s emphasis on maternal reverie as a service for processing
the baby’s emotional experiences.
Winnicott bases his view of the development of human
personality entirely on relational grounds. He sees the essence
of the child’s developmental experience as its dependence on
the supportive ‘holding’ environment provided by the mother.
This is a natural function in the ‘ordinary’ mother whose
‘primary maternal preoccupation’ is based on empathy and
does not require analytical reasoning. Yet although the baby
is entirely dependent on his mother he can nevertheless be
‘alone’ in her presence (Winnicott, 1957, p. 418), and this is
the nucleus of his true self and provides ‘continuity of being’
against a background of constant threat from what seems an
intrusive and unsatisfying environment. He maintains that the
self ’s ability to be alone is one of the most important indica-
tions of emotional maturity, and is the result of initial ‘good
enough’ maternal care. He writes that ‘The capacity to be
alone is either a highly sophisticated phenomenon, one that
may arrive in a person’s development after the establishment
of three-body relationships, or else it is a phenomenon of early
life which deserves special study because it is the foundation on
which sophisticated aloneness is built’ (1957, p. 416). So for
Winnicott there exists a paradox between the need of the true
self to remain concealed and isolated for its own preservation,
and the desire and necessity of every individual to communi-
cate and be understood within a relationship.
We believe that Winnicott’s idea of the self needing another
distinct and separate self in order to fully exist, even when at
the same time feeling threatened by anxiety about intrusion or
a lack of correspondence in the other, is an appropriate nexus
for examining the problems that arise in couple relationships.
A facilitating environment should allow each partner to be
alone in the presence of the other. We will investigate this in
the following chapters.
 PSYCHOANALYTIC HISTORY 9

The contribution of relational theories

Current psychoanalytical thinking, although influenced by

different approaches, imagines there to be a continuous fluc-
tuation between the intrapsychic and inter-psychic dimensions
(Bolognini, 2004). The focus has shifted from the belief that
psychic reality evolves in successive predetermined stages to the
idea that it continuously reorganises itself on the basis of what
is registered and experienced by the subject. This includes the
continuous interaction with other minds. The encounter with
the other (which may also be another part of the self ) gives
rise to a third, mutually constructed element. In the clinical
setting, the focus is on what happens in the ‘here and now’ of
the analytic encounter, rather than on research and reconstruc-
tion of the patient’s past. The analysis becomes about finding a
‘narrative truth’ rather than an objective truth, picturing how the
patient organises his or her experiences. This brings us closer to
an ‘authentic subjectivity in which a fluid identity is able accept
unpredictability and cope with uncertainty’ (Bordi, 1996, p. 24).
For a long time the dialogue between theorists, therapists
and researchers was limited by the belief that their methods
were antithetical. Their working environments were certainly a
main point of difference: ‘As practitioners we deal in complexity;
as scientists we strive to simplify’ (Bowlby, 1979, p. 5). Infant
research has demonstrated that the child is biologically equipped
to establish an active interaction with the surrounding environ-
ment, discovering patterns and thereby establishing expectations
(Emde, 1988). As has often been observed, children discover
very quickly the correlation between their activities and their
mother’s immediate reaction, resulting in a sense of effective-
ness. The interpersonal relations of infancy are the foundation
for relational psychoanalytic theories (Stern, 1985; Kernberg,
2011). Mother and child observation and research underlies the
development of evolutionary theories such as attachment theory,
highlighting the continuous process of co-regulation carried out
by the child and caregiver in tandem. All of these conclusions
boosted the general definition of intersubjectivity as something
that enables a capacity to emphasise and resonate with someone
10 TALKING WITH COUPLES

else’s experience. Each partner in a dyad (mother–child, analyst–

patient, etc) can only be fully depicted in relation to the other.
Self-regulation and interactive regulation are mutual and simul-
taneous processes that in ideal conditions exist in flexible and
dynamic equilibrium (Beebe & Lachmann, 2002).
Bowlby was one of the first commentators to elaborate on
how the quality of a primary attachment in early years is funda-
mental to the individual’s development. His findings strength-
ened the bond between psychoanalysis and empirical research.
According to Bowlby (1969–1982), a sense of trust built up by
experience with the early caregiver can then be extended to other
relationships; but if this fails, the object can become a source
of fear and insecurity rather than of protection and reassur-
ance. Although during infancy the attachment of child-adult is
asymmetric, in adulthood attachment should manifest itself at
a mutual level. When Bowlby refers to a ‘sense of security’ in
the children observed, he means that they show they can admit
dependence on the parents, but at the same time, that they feel
themselves to be an independent entity. Relationships indicating
distance, unresponsiveness, anxiety and ambivalence are insecure
attachments. Insecurity, in this view, is not a personality trait but
a feature of the particular relationship, and can vary according
to circumstance.
Further evidence suggested it was not just the early years’
experience as such, but the mental representations of it, that
were significant in defining adult interpersonal relations.
Internal working models are established on the basis of the reit-
erated experiences shared by the baby and the attachment figure,
and are subsequently generalised. These are mental structures,
configurations of the world that can be modified throughout
life. They enable the person to plan, make decisions, interpret,
anticipate, and thus to react appropriately to situations.
It is well known that Bowlby hypothesised that internal
working models constructed in early life influenced the future
success of a couple relationship. The difference of course is that
in the adult couple each partner becomes an attachment figure
for the other, trying to cope with the anxieties of being both
dependent and an object of dependence (Fisher & Crandell,
 PSYCHOANALYTIC HISTORY 11

2001). Ideally the fluctuation of inter-dependence in the course

of responding to life’s demands (childbirth, mourning, illness,
work issues, etc) secures the smooth functionality of the rela-
tionship. Representational models that have proved to be secure
in childhood enable the adult attachment relationship to be flex-
ible, while an insecure childhood provokes rigid responses.
These ideas have influenced more recent formulations such as
Fonagy’s that the essential role of interpersonal experiences is to
enable the individual to ‘mentalise’ (cited in Velotti & Zavattini,
2008). This entails an ability to regulate one’s own emotional
state in association with that of the other. It is a mechanism by
which the child adjusts their emotional state in response to the
caregiver’s reactions, a sort of circular reflective process, named
by Fonagy the ‘reflective function’. It does not belong to the
cognitive sphere but mainly to relational skills acquired through
reoccurrence and an awareness of time – past, present, future –
that enable the person to interpret their own experience and that
which exists beyond themselves. Clearly the reflective function is
necessary for the harmonious development of the individual in
relation to the external world.
In recent years, the topic of intersubjectivity has become
prominent in many branches of psychoanalysis, with a wide
spectrum of theories (Zaccagnini et al., 2008). The ‘intersub-
jective matrix’ (Stern, 2004) denotes a process in which the
mechanisms for identifying the mental states (intentions and
emotions) of the other are innate. From early on the child is
richly supplied with a variety of mental states that are accessible
and recognisable as similar to the mental state of the other, and
can be shared within the relational exchange. One intersubjective
approach believes that the early imitational and emotional inter-
actions are the result of human biological adaptation towards
empathising with other fellow human beings; experience and
maturation refine the individual’s capacity for awareness of the
other’s emotional state. Fonagy and others (2002), however,
insist the infant is biologically orientated towards the external
world and its exploration, and the parents’ empathic reflection
evokes an imitative response in the baby; the term coined for this
is ‘objective intersubjectivity’.
12 TALKING WITH COUPLES

Stern (1985), who has greatly informed this field, developed

his thinking from a dual standpoint: evolutionary research and
child development on the one hand, and psychoanalysis on the
other. Observation demonstrates how from early on the infant
has the capacity to interact with the real world and to establish
social relationships with other human beings. As with psycho-
analysis, research shifts its focus from the child to the relationship
between mother and child. Stern’s model is one of continuous
development in the face of interaction between the individual
and the environment. He observed that this does not refer neces-
sarily to events as such, but rather, to our ‘psychic reconstruction
of what has happened’ (1995, p. 83). These successive subjective
experiences form the basis for the organisational principles of
development. Stern believes the stages of development are not
fixed, but are different ways of experiencing the social life of
the self, and therefore it is not possible to undergo a regression
in the traditional sense. He uses the term ‘reflective conscience’
to denote that which derives from interaction with the other;
and intersubjective motivation arises from the need to work out
‘where we stand’ and ‘what is going on’ (Stern, 2005, p. 133).
This monitoring is continuously updated during the dyadic
encounter. Stern defines as ‘intersubjective desire’ one of the
reasons for which therapy may be sought – that is, the patient’s
desire to be known and to find mental intimacy. ‘Intersubjective
consciousness’ is the reflective form through which we can
become conscious of our mental contents once they are handed
back to us by the other.
The above-mentioned theories are some of those that have
arisen from infant research and have had a strong influence on
the clinical field. The focus on the intersubjective exchange
supports the ‘here and now’ of the psychoanalytic encounter and
the search for new creative pathways; and also, gives space for
the emergence of a nonverbal emotional narrative, owing to its
emphasis on intuitive sharing and emotional attunement.
I will conclude this section with a reference to the theoreti-
cal model developed in the last twenty years by the American
relational psychoanalysts (Mitchell & Aron, 1999; Bromberg,
1993, 1998; Stern, 1985, 1989), and that links the idea of a
 PSYCHOANALYTIC HISTORY 13

continuous relations–dialogue with that of a non-unified self.

In particular Bromberg, following Sullivan (1940, 1953), has
a vision of the psyche as something which is not necessarily
fragmented by pathological processes, but rather has never been
unified; its sense of identity derives from a multiplicity of partial
self–other configurations that are continuously negotiating with
one another. From this perspective, the intrapsychic and the
interpsychic realms (internal and external realities) can penetrate
one another. This is relevant to working with couples as it envi-
sions the need to seek for an equilibrium between personal feel-
ings (the existing self ) and the search to build new meanings, to
achieve the stance that Sullivan defined as good interpersonal
adaptation. Here again the goal of psychoanalysis is not to
reconstruct the patient’s past to achieve an insight into it, but to
construct new connections between the many aspects of the self
and internal and external reality.

The concept of field

In the relational models of psychoanalysis, as we have seen, the

analyst is seen as a co-author rather than spectator of the change
happening within the analytic relationship. As the Barangers
put it: ‘Each unit of the couple is unreadable without the other’
(Baranger & Baranger, 1961–1962, p. 27). The ‘field’ concept
introduced by them is inspired by Merleau-Ponty (1951), and
describes neither individual but rather the situation in which
the relationship is immersed. This becomes a third element with
independent qualities and dynamics and is defined by the time
and space in which the session takes place. In the analytic field,
both analyst and patient form bastions, pockets of resistance,
that are overcome only by the analyst’s ‘second look’ which
provides a detached view of what is going on. The analyst, while
contributing to the formation of the field, is considered also to
be able to observe and interpret the functional or dysfunctional
operations taking place.
The field theory suggests that the encounter between indi-
viduals creates a new psychic space; subject and object are not
always distinct and may be reversible (Neri, 2007). In other
14 TALKING WITH COUPLES

words, as Ferro says (2007, 2009), the field concept amplifies

the definition of ‘relation’ by extending its constituents to the
analytical situation itself. From a clinical point of view this
creates a link with Klein’s projective identification and Bion’s
alpha-function, reverie, and container–contained, and with the
recent ideas about narrative and how the transformative func-
tion of the analytical experience takes place.
In Bion’s revision of the concept of projective identifica-
tion, which is reflected in most current theoretical and clinical
approaches, the mother’s role in the child’s development is crucial,
since she is unconsciously capable of ‘dreaming’ the experiences
that the child cannot cope with, making them available ‘in a
form that he is able to utilise in dreaming his own experience’
(Ogden, 2004, p.1357). The container and contained describes
a process, not simply the objects that are relating to one another.
The content is continuously changing and expanding in response
to undigested sense experiences (beta-elements). Projective iden-
tification, viewed in this way, becomes the universal communi-
cation channel that activates the function of the container and
reverie. A failure of communication in either partner can result
in development being blocked and a feeling of being surrounded
by an external world which is unmoving and sterile.
Each member of a psychoanalytical relationship carries
their own psychic field into the session, inhabited by all sorts
of turbulences and intrapsychic possibilities; but when these are
immersed in the setting, the mental mating between analyst and
patient creates a third field, an intermediate space where charac-
ters and dramas map out a matrix of relational movements. The
field includes the setting, the relationship operating through
projective identification, the transference and countertransfer-
ence. It has an oscillating nature, and is ‘the place where all the
potentialities and the worlds emerging from the relationship
between analyst and patient can take place’ (Ferro, 2007, p. 65).
According to Bion (1962), in the case of patients whose alpha-
function is deficient, it may be necessary to build the container
before the disturbing content can be accessed and the story can
be told. The workshop-mind is not automatic; the field can
generate the development of the container.
 PSYCHOANALYTIC HISTORY 15

In conclusion, we have tried to delineate how psychoanalysis

has moved from its original exclusive interest in the intrapsychic
world, in the direction of the relational or interpsychic worlds
that are formed by the interaction between minds and their envi-
ronments. The evolution of the individual is not seen as having
a set pattern, but instead, the therapeutic interest is dedicated
to the acquiring of tools and experiences ‘that make the subject
more equipped to encounter what is not yet known about the
self and the other’ (Ferruta, 2011). In working with couples,
similarly, we do not wish to propose a series of problems and
answers but rather to illustrate the complexity of the forces that
are involved in this kind of work. To quote Bolognini:
It is up to us to allow connections that appear unexpected or
incoherent to co-exist, in a middle ground. Sometimes with
patience these connections become less contradictory than
was initially thought, just as in a family or group environ-
ment certain contributions may seem to undermine the
coherence of the general attitude but eventually prove to be
very fertile. (Bolognini, 2008, p. 22)
CHAPTER TWO

Theoretical foundations of psycho-

analytic psychotherapy with couples

Barbara Bianchini and Lidia Vitalini

The problem is how to let the germ of an idea, or the germ of

an interpretation, have a chance of developing.
(Wilfred Bion, 1985, p.12)

T
he previous chapter has shown that the theoretical
developments behind the move from a reconstructional
approach to an object relations approach in psychoa-
nalysis are complex and diverse. The latter are based on the
belief that the relation between object and subject regulates the
emotional and developmental state of the individual. Thus the
focus shifts to the quality and characteristics of the encounter
with the other. From this perspective, the therapeutic task is
an evolutionary journey of co-construction by therapist and
patient, that utilises interpersonal relationships to link with the
relationships of the patient’s inner world.
The pioneers of psychoanalytical psychotherapy with couples
began with their knowledge of the clinical methodology of indi-
vidual psychoanalysis, and therefore used individual sessions
as the setting for each member of the couple. The practice of
undertaking joint sessions with both partners present came into

17
18 TALKING WITH COUPLES

being as a result of the increasing use of interpersonal approaches

to psychoanalysis. The couple and the therapist all participate
in the rhythm and cycle of the exchanges (Dicks, 1967; Fisher,
1999). This approach proved to lead to more satisfactory
communication between all the participants, and also to a better
understanding of the emotional experiences of the couple. A new
field of research and a new theoretical and clinical debate took
shape, at present still growing, owing to the gradual increase in
demand for crisis therapy for both couples and families. In the
course of this, joint sessions have become the favourite setting
for couple therapy.
Couple therapy as it currently stands has been shaped by the
work of its clinical pioneers (Pincus, 1960; Teruel, 1966; Dicks,
1967) and by the additional assimilation of contributions from
other fields of research, such as developmental psychology and
group psychotherapy, which have emphasised new theoretical
ideas regarding ways of self-discovery and investigation. We will
note some of these concepts and their use.

Individual development, the role of the other, and the discovery of the
analytic third

We would like first to detail in more depth certain important

aspects of personality development that are relevant to couple
therapy, highlighting in particular the function of the ‘other’
in the development of the individual. Our theoretical frame-
work is based on the development of object relations and the
mechanisms of projection and projective identification. For
the passage of emotions from within to outside the self, in
order to cope with conflict and anxiety, determines and condi-
tions all our relationships and is the primary mover in person-
ality development. Hence the importance of the quality of the
exchange with the caregiver within the emotional sphere, the
feelings of love and hate which are foundational to human
motivation. From birth, the child seeks to establish emotional
links with an object and starts to make sense of experience as
a result of the responsiveness and effectiveness of this dyadic
relation.
 THEORETICAL FOUNDATIONS 19

Grotstein (1981) writes that the ability of the child’s self to

exist within the world relies on functions that contain, filter,
dilute and diminish the intensity of his or her emotional expe-
riences. Together with the establishing of this initial maternal
bond, family life confronts the child with another transition:
the discovery of the father. The mother–father–baby trio that
marks out the child’s developmental environment was denomi-
nated by Britton (1989) as a ‘triangular space’, in which the
child has the opportunity to take part in the family relationship
but also to observe the parents’ relationship. The idea of a third
place comes into being – a place in which the child can observe
object relations. The acceptance of the existence of a special
bond between the parents gives the child’s psychic world coher-
ence and promotes development. He is aware of the separate
bonds with each parent and also of the union between them of
which he is only witness not protagonist; he is both included and
excluded; aware of different types of relationship and of genera-
tional boundaries.
The unconscious introjection of the parental figures as a couple
(via the triangular configuration) underlies the child’s ability to
understand his mind and body during the major psychophysical
changes of adolescence. Perceiving, though with ambivalence, the
need for greater separation and exclusion from the parental couple,
he or she will seek new types of emotional bonds with them in the
course of trying to develop an individual identity.
Everyone agrees on the importance of working through
the Oedipus complex, which goes with the relinquishment of
phantasies of omnipotence, and is the emotional foundation for
the experience of loss and separation needed to reach maturity.
Nevertheless, working through the Oedipus complex does not
necessarily mean that it is dealt with once and for all; the diffi-
culties that derive from being part of a couple, and therefore the
difficulties of a triangular situation, persist within the dynamics
of adult life and can emerge with a substantial presence at certain
points in life.
As an example we would like to present Carlo and Franca. We
can see in the relational difficulties of the new couple how the unre-
solved ghosts of their past lives in their families of origin re-emerge.
20 TALKING WITH COUPLES

Carlo is aged 40 and Franca is 30. It is the second relation-

ship for each of them. During our first meetings they recounted
how they both came from disturbed family backgrounds marked
by intense grievances and illness. They both seemed in need of
finding a container figure in each other, that could offer stability
and security in the face of any external disruption. They met,
they fell in love, they had a child fairly quickly, so as to affirm the
good nature of their relationship. After the birth of their child,
they felt that all their time was taken up with their new parental
role and their main complaint was that they never had any time
for themselves.
Their relationship seems to be founded not on an adult object
partnership, but on an idealised phantasy that demands a type
of reciprocal fusion aimed at helping their own individual devel-
opment. The container provided by falling in love had broken
down after the swift arrival of the third element – their child.
Carlo is very preoccupied with work, which is a source of stabil-
ity and safety for him, and in his little free time he concentrates
on taking care of his child. Franca, who had been charmed by
Carlo’s long and intense courtship, feels betrayed and abandoned,
lonely and frustrated. She continues to demand attention and
protection from her partner, she is unconsciously jealous of the
attention that they both give their child, and feels antagonistic
to the demands of everyday life, which has become for her a
fulltime prison that prevents her professional development.
A vicious circle has established itself, such that the greater
Franca’s requirements and dissatisfactions, the more Carlo fears
for the child’s adequate care, so he dedicates even more of his time
to the child and excludes his partner. So at present they are both
frustrated, distressed, and disappointed, and this has obscured any
feelings of tolerance and empathy towards each other.
The therapeutic exchanges brought out the existence of
intense, mutual and interlocking projective intrusions, based
not on the understanding of each other’s existing needs, but
translated subconsciously into a belief in the other’s power to
repair the past by building their own family: a new family which
would be proof of their victory over the past traumas caused
by their families of origin, and give them a legitimate sense of
 THEORETICAL FOUNDATIONS 21

personal adequacy and efficacy by showing they are better than

their parents.
The intensity of this internal emotional propulsion has been
so strong in each of them that at first it interfered with their
undertaking a personal investigation into their own disturbance,
their feeling of being unable to repair damage and to cope with
frightening experiences. This personal responsibility had been
unloaded onto the other in the expectation of a communal
reparative process that would take shape in the form of their
project of creating a family. The pre-eminence of these reciprocal
needs, and the consequent anxiety and emotional fragility, seems
to have induced the illusion they could bypass the necessary
formative stages of the couple relationship, and to have made
the concrete realities of everyday family life a focus for their fear
of losing their own identity.
The mind of the therapist provides an opportunity to create
a space for thinking and understanding the self that has not
yet found a place within their relationship, and the therapeutic
function consists in the opportunity to experience an object that
is able to take care of them adequately.
We can summarise that the sense of being a couple, and the
presence and employment of the third figure, relate both to the
processing of the Oedipus complex and to a type of mating that
satisfies the needs of both minds involved, as Bion has said.
There is a constructive encounter between the person’s devel-
opmental requirements and a facilitating environment, and the
reciprocal exchange produces growth. In a healthy context, this
is a process that continues from the early primal relationship
of the dyadic/triadic exchange. The exchange needs to support
awareness, identity and continuity in the sense of self, but also
the possibility of being dependent in the sense of trusting in the
relationship with the other.

Why together?

The 1970 reform of the divorce laws in Italy were part of a

new socio-cultural environment which helped to make couple
therapy possible. The atmosphere allowed for more awareness of
22 TALKING WITH COUPLES

the difficulties that may exist within couples, and therefore more
freedom in expressing and attempting to resolve these difficul-
ties; hence the demand for joint couple therapy has soared. A
‘sick’ relationship may be improved if difficulties can be faced
and acknowledged; or if necessary, it can be guided through the
process of separation in less conflictual and destructive ways.
Being together is not an inevitable fixed condition, and blood
ties are less paramount in families and parenthood. The reality
of today’s nuclear families includes a social network and affec-
tive bonds with people outside the family – neighbours, friends,
parents of children’s friends – often for logistical reasons, since
they are living the same lifestyle and can concretely share help
and support. The question of personal wellbeing therefore arises
more easily, with each partner able to ask themselves: ‘Would I
be better on my own? With someone else?’
In the process of questioning why there is such a high demand
for couple therapy we find that the distress is generally a commu-
nal one, projected onto the relationship itself, in the form of ‘not
feeling happy together’. The relationship tends to define itself in
two-dimensional terms of ‘I–him’ and ‘I–her’ that flatten it to a
series of purely functional exchanges serving to maintain a status
quo. Therapeutic help is sought when reciprocal communica-
tion has failed and when it is not possible to cultivate a ‘third
function’, so the analyst becomes the third figure, arbitrator
of the disputes. We have described this function in terms of
a stage in the child’s development (Britton, 1989). If it is not
fulfilled within the couple relationship itself, the therapist can
serve a similar function, by offering a thinking viewpoint on the
dynamics of the relationship.
This meant that requesting individual help was less construc-
tive and it became requisite to bring the partner to join the
analyst-stranger in trying to find a way out of the impasse. Often
the partners come to therapy in the belief that the other is in the
wrong and the source of their personal distress, hoping that if
the other can change, the relationship can be repaired. This insis-
tence on the need for the other to change expresses implicitly a
lack of volition to change themselves. What also appears, even
if subconsciously, is the search for absolution from one’s own
 THEORETICAL FOUNDATIONS 23

responsibilities. Often the awareness of a mutual responsibility

is not present in the request for help, nor is the ability to reflect
on communal problems, or to imagine the different possibilities
that might exist within each partner’s role and that might help
to improve the existing situation. The analyst needs to become
the analyst of both individuals in order to fulfil impartially and
equidistantly the missing role of the ‘third’.
In answer to the question of why they ask for joint help, Fisher
says that in the couple situation, the splitting can exist either
between the partners (within the couple) or internally (within
each partner): ‘The difference with a couple is that the splitting
can be between the partners as well as internal to them – the split-
ting between the self who will under no circumstances seek out
a therapist, and the self who is desperate for help’ (Fisher, 1999,
p. 209). Fisher differentiates between elements belonging to the
self and elements of internal objects. Both types can be intru-
sively split and projected toward the other (p. 142). Some of these
projective movements can concern both self (such as emotions)
and the self ’s internal objects (such as, a loved object) (p. 119).
This is why we welcome proposals for joint couple therapies,
considering how difficult, in fact impossible, it is to separate these
various elements at the beginning.
As in individual therapy, the therapist plays a parental role,
creating a harmonious and safe relationship with each partner
such that they feel understood first as individual people and then
as a couple. ‘Being understood’ is often given as the most impor-
tant factor in coming to therapy. Ambivalent feelings are often
brought when there is a request for joint therapy: on the one hand
a wish for change is expressed; on the other, a demand is evident
for the display of defensive emotions. What seems most desired
is to legitimise the reason for their emotional state – to hand the
patient a ‘receipt’ (Ferro, 2009). Feeling personally understood
helps in understanding the other, and in developing a new bond.

The joint session model and ‘unconscious fit’

The middle of the last century in London saw many develop-

ments in the psychoanalytical field, including Bion’s work on
24 TALKING WITH COUPLES

group psychotherapy, from which was derived the definition of

a setting suitable for couple psychotherapy. In 1949, working
under the auspices of the Tavistock Clinic, Henry Dicks selected
a number of couples for psychotherapy and studied them with a
view to understanding how to help alleviate marital distress. He
tried to understand the significance of unconscious communica-
tion, the quality of the bonding, and the characteristics of the
emotional involvement. Dicks chose a methodology that focused
on the investigation of ‘internal worlds shared in common’ by
the partners. Initially, believing in the need to establish a safe rela-
tionship between patient and therapist, Dicks devised a method
where each patient underwent individual sessions with their own
therapist, followed by discussion between the therapists. Before
long however he decided to take on joint sessions in order to
achieve a better understanding of what each spouse meant when
they referred to one other. This method meant it was possible
to address the conflicts deriving from the socio-cultural roles of
each partner, their personalities, and the unconscious intertwin-
ing of their developmental and emotional stories.
In joint sessions we witness the internal relational dynam-
ics of each patient, and at the same time the unfolding of the
couple relationship; then with the addition of the therapist we
see the symbolic representations of the triangular exchange.
The complexities that emerge from this encounter legitimise
the relevance of joint therapy for couples. In Marital Tensions,
published in 1967, Dicks referred to object relations theory and
defined the significant affective relationships as ‘neutral thera-
peutic relations’. He used concepts derived from Klein, such
as projective identification and splitting, in order to suggest
that the partner becomes the ‘holder’ of the other’s projected
and split features. Furthermore he highlighted the multiform
structure of the couple relationship and formulated concepts
such as ‘unconscious fit’ and ‘collusion’. Unconscious fit is the
third dimension resulting from two adjoining independent
worlds. It indicates finding an emotional reciprocity in which
the boundaries of the individual ego fade. Collusion is the term
used to describe the unconscious defence mechanism which
maintains an equilibrium in which intolerable features of each
 THEORETICAL FOUNDATIONS 25

partner’s self are inseparable from the functioning of the rela-

tionship itself.
In the beginning psychoanalytic psychotherapy was based
on reconstructive logic: trying to understand how, within their
personal history, each party’s organisation interwove with the
other; and within the history of the couple, what led to their
choice and why they have stayed together. Later however, in line
with the psychoanalytic model of the ‘here and now’ and the view
that psychic life is a continuous scanning of the mental states
of the self and the other (Beebe & Lachmann, 2002), couple
therapy came to focus on the live process of the third dimension
produced by the encounter between the two people. Unconscious
fit refers to the mutual flux of identifications continuously
taking place in the present. The relationship is the expression of
many variables based on the individual and mutual regulation
of these identifications. In addition to unconscious fit, the most
recent developments of the ‘field’ theory (as mentioned in the
last chapter) are also useful in understanding the complexity of
the unconscious functioning during the session: these include
not only the internal worlds of each partner and their interrela-
tion but also the mind of the analyst, his reverie, internal objects,
and countertransference.
Dicks noted that a shared ego-boundary is formed by the
unconscious bonds of the couple unit; he called this a ‘dyadic
membrane’, a kind of skin enveloping and protecting the rela-
tionship from intrusions from the external world. The quality of
this membrane and the forms that it takes inform the therapist
about the functioning of the conjugal relationship. When it is
sufficiently flexible and permeable to external influx, the dyadic
membrane can be a tool for intimacy and the protection of
privacy, and it contributes to the growth and enrichment of the
relationship. The dyadic membrane may become too porous, so
ineffective in filtering out the external intrusions that jeopardise
the necessary ‘sense of us’ (G. S. Klein, 1976) that is fundamental
for the couple’s functioning. On the other hand, the membrane
may also become so rigid that it completely excludes the external
world, resulting in a dyadic fusion with a shared and undifferen-
tiated self (Giannakoulas, 1992). The definition of the concept
26 TALKING WITH COUPLES

of projective identification given by Ogden (1979) is useful in

this context for understanding the reciprocal identifications
present in the couple. It affirms projective identification to be
something that really takes place between two people who are
closely linked, not just the omnipotent phantasy of an indi-
vidual. Ogden summarises this psychological process as, simul-
taneously, a method of defence, a way of communicating, a
primitive form of object relation, and a journey of psychological
change in which difficult feelings may be handed to the other
and thus become ‘available for a new internalisation’ (Caporali,
2010, p. 847).
Dicks also depicts the strong conflicts and reciprocal frustra-
tion present in many couples when they use the relationship
as a means of creating their own wished-for world of object
relations. The need to idealise or denigrate parts of the self or of
the other often originates in the attempt to avoid the sense of
confusion produced by the ambivalent feelings of love and hate
which are always part of a relationship.
Unconscious fit is not therefore the sum of two partners’
individual characteristics but an entity in itself. Dicks focuses
interest on the transference between the partners and suggests
that re-balancing defence mechanisms such as projective
identification and idealisation play their part in the process
of choosing the partner. Projective identification attributes to
the other unwanted parts of the self, unrecognised expecta-
tions, and illusions linked to the idealised roles often assigned
to internal parents. Choice of partner is precise, not casual;
the other has to prove themselves an adequate container of
uncomfortable feelings and also custodian of that which needs
to be protected.

Romantic love and infantile identifications

Developing these points further, in the light of psychoanalytic

thinking since Bion, we can say that we choose our partner as if
in a dream, assigning him or her the role of a character that suits
our own desire, and when this is reciprocated we become fasci-
nated as if by a magic spell (Dallanegra, 2007). The unconscious
 THEORETICAL FOUNDATIONS 27

creates a phantasy or dream involving the other person, the

stranger, giving one another leading roles in the way that a direc-
tor casts a play. Our minds are full of characters and actors, but
they are not full of authors: we are the one and only author.
It becomes very difficult for us to change the narrative. The
story becomes repetitive, static, always the same; if the actors
never become tired of their role, they will continue to live the
same narrative, the same conflicts and the same stresses. Then
sometimes, as the actors become tired of their given roles, we
may wish to redistribute the roles or find others to play them.
However if one is lucky, the person who is prepared to grow
and ‘learn from experience’ (in Bion’s sense) may find his or her
actors helpful in the playing out of new narratives.
The phenomenon of romantic love is based on a dream
of love and it is a transference phenomenon, that is, it is the
externalisation of an internal object or situation. In order to
shift from infantile transference (in touch with physiological
needs) to adult transference (in touch with internal objects)
it is necessary to relinquish omnipotent expectations of one’s
parents, by understanding that they could not do everything
and didn’t know everything, but that they did what they could,
and not allowing this to dampen the love on both sides. In the
same way, the elements of infantile transference that are part
of the experience of falling in love inevitably cease following a
process of disillusion, and may then be replaced by the adven-
turous process of learning to accept and understand one’s own
love object in depth.
When Dicks describes love relationships as ‘natural therapeu-
tical relationships’ he means that they are a place where early
unresolved object relations find expression: in particular, in
the concept of ‘holding partner’, someone takes on the role of
container of certain infantile aspects of the other partner’s self
that they have been assigned. Thus the concept of reciprocity is
seen as essential in human relations. We use interpersonal rela-
tions as an opportunity to repair unresolved aspects of our object
relations or to find new ways of adapting and developing them.
Thus the linear model of psychological disturbance gives way to
a reciprocal one in interpersonal relationships.
28 TALKING WITH COUPLES

Couple therapy aims to help each partner regain their own

lost (projected) features in order to promote the emotional
maturity that will allow them to live in affective intimacy with
another person. This will enable them not to hold grudges in
the face of frustration but to tolerate ambivalent feelings and
abandon the urge for revenge, and instead to achieve an atti-
tude of respect towards the other partner and their individual
identity. During the therapeutic process unresolved emotional
crises in the development of each partner emerge together with
the primitive defence mechanisms that attack the relationship.
A couple may nonetheless continue to stay together even in a
state of pain and conflict, in the hope that the part of their inner
world entrusted to the other will still eventually find its primary
regressive needs for object love satisfied.
We have to consider therefore whether the internal problems
of one partner have found responsiveness in the internal world
of the other, or whether they have entered into collusion.

Collusion

The concept of collusion was developed by Dicks to indicate the

negative aspects of the relationship maintained between part-
ners through the roles unconsciously assigned to one another.
Collusion is an active process that occurs during the formation of
the couple and it is the expression of the persistent involvement
of previous unresolved object relations that block the develop-
mental process and the achievement of adult maturity. Often
both partners wait for an answer to their needs without even
articulating a proper request to the other: thus what happens is
that one partner starts to represent the potential and the func-
tions that the other is lacking. The term ‘collusion’ derives from
ludere (to play), but also from illudere (to deceive): collusion is,
by nature, a shared illusion, a deception.
In this respect, Laing (1961) has noted how in the other
person we not only seek a hook on which to hang all our projec-
tions, but we may also try to force him or her to embody the
object we wish to complete some particular identification. He
defines collusion as a march between two personalities on the
 THEORETICAL FOUNDATIONS 29

basis of shared primitive anxieties and object needs. According

to Losso and Packciarz: ‘Collusion is the result of two infantile
scenarios that reinforce each other and create a new scenario
using current representations: a contemporary comedy with
themes that belong to the past is re-enacted’ (2000, p. 80).
In an interview with Fisher, Meltzer defines collusion as an
alliance towards a shared aim that has to do only with survival;
it is ‘a political relation, characterised by grandiosity and abso-
lutely egocentric’ (Ruszczynski & Fisher, 1995). Norsa and
Zavattini define collusion as a type of negative unconscious fit in
which ‘what emerges is a distorted interpretation of the partner’s
communication, one that highlights the negative aspects of the
communication and of the feelings of the other person insofar
as these represent the confirmation of expectations and nega-
tive convictions linked to internal relational contexts’ (Norsa &
Zavattini, 1997, p. 100). They continue:
We can therefore define collusion as a defensive organisation
built by two in which aspects of both partners that are split,
perverse, superegoistic, are strengthened, creating an envi-
ronment which is rigid, anti-libidinal, frustrating, but cor-
responds to the defensive necessities of each partner. (Norsa
and Zavattini, 1997, p. 101)
In collusion, therefore, each partner makes some of the character-
istics of the other partner their own and imprints on them rigid
aspects deriving from parts of themselves or their internal object,
parts which are despised or idealised. In this way neither of them
recognise themselves as contributing to the state of distress that
they consciously want to avoid, and they both blame each other.
Over time such an organisation within the couple tends to
create rigid modalities of operation that inhibit other parts of
the self or of the internal objects from expressing themselves.
Thus collusion is a double defensive organisation that can be
compared to other individual defence mechanisms (splitting,
denial, idealisation) that protect against the anxiety of loss and
separation, and leads toward the projection and evacuation of
the unwanted aspects of one’s own internal world (Norsa &
Baldassarre, 2007). It also prevents the reintegration of split
30 TALKING WITH COUPLES

aspects deposited into the other. Collusion in couples thus has

an adaptive function in relation to the complexity of adult life,
entailing a loss of awareness of pain and the price to be paid. In
using an enormous amount of energy just to maintain the status
quo in the relationship it can also become an obstacle to each
individual’s potential development.
By contrast, intimacy between partners entails them each
becoming a container for the other through reciprocal reverie.
A bond develops that enables them to grow both as individuals
and as a couple. According to Meltzer (in Ruszczynski & Fisher,
1995), intimacy differs from casual or contractual relationships;
it derives from the appreciation, gratefulness, and understanding
of being treated according to one’s own needs and not according
to one’s external value.
We believe that in couple life there is a constant oscillation
between an adult level of integration and enrichment, uncon-
scious complementarity and intimacy, and an infantile level of
idealisation, expectation, evacuation, and reciprocal tyranny.
Both these possibilities form a continuum that modulates and
changes with the varying requests with which the life cycle
confronts the couple.
One of the therapeutic objectives of couple psychotherapy is
de-collusion and differentiation so that each partner can become
aware of their own unconscious motivations as re-enacted
through the relationship. Enhancing the capacity to take care of
the fragile aspects of one’s own personality has positive repercus-
sions on the capacity to take care of the other, in the recognition
that they are different and separate from one’s self. On the other
hand the therapist can also try to make use of the important role
that collusion plays in keeping partners together, but working
through it in order to unravel its negative bonds.

Concrete and representational

Something that differentiates a joint session from individual

therapy is the welcoming of each partner both as a real person
and in their role as an internal object for the other person. A
person who is concretely present, not just represented (as in
 THEORETICAL FOUNDATIONS 31

individual therapy), requires an extension of our thinking; we

are in the presence of the actual relationship itself. It is different
also from a group setting in which the encounter is between
strangers. Work with couples is complicated also by the fact that
among many other roles, the therapist is also playing that of
the outsider: the ‘relational territory’ of the couple precedes the
analytical encounter, has an existence of its own, and returns to
its routines outside the setting.
To return to the example of Carlo and Franca. The sessions
with this couple have followed a repetitive pattern for a long time.
In the initial stages Franca blamed Carlo for refusing to discuss
things with her, always saying dismissively ‘Lets talk about it
on Thursday’ (meaning during the session). Carlo blamed the
little time that he has and his tiredness after a full day at work.
Nevertheless it is not long before his need emerges for strong
emotional control. He is afraid of exaggerating, exploding, and
therefore being dangerous; he is afraid of hurting Franca if he
expresses what he feels. It becomes clear that the continuous
complaints and requests of Franca remind him of the pattern of
his relationship with his mother, to whom he used to reply when
annoyed by leaving the house and slamming the door.
For Carlo, the therapist becomes the concrete object: the
outsider whose mediating function enables communication with
his partner, creating a boundary safe from possible emotional
excesses – his fears of communication degenerating into some-
thing uncontrolled and explosive. But Franca’s evacuations also
need to be received and contained by the therapist, who is care-
ful to create a boundary for reciprocal projections and possible
reassignments of personal responsibility.
The therapeutic function involves helping them to express
their emotions, both the ones held back and the ones evacuated,
modulating them, and translating them in the form of emotional
states that are tolerable to them. The relational exchange will be
less burdensome if a way can be found for the acknowledge-
ment and gradual reappropriation of aspects that belong to the
emotional nexus of each partner.
Fisher (1999) emphasises how a clinical situation such as this
one can be very delicate and he points out how movements of
32 TALKING WITH COUPLES

pathological complicity between the partners become manifest,

unconsciously designed to maintain cohesion between the couple
and to exclude the ‘outsider’, who takes the form of both the
analyst in person and of the relationship that emerges from the
scenario of the setting. Fisher also points out that, although it
is not possible to make a clear differentiation between couple
therapy and individual therapy, it is the psychic reality of the rela-
tion between the therapist and the couple that forces all three to
confront their imagination and their own intuition. During the
session one should never dismiss the importance of two aspects:
the fact that every relational movement happens in the presence
of the other, whether phantasised and internal or real and exter-
nal, so this nourishes feelings of being extraneous and excluded of
which the analyst needs to be aware and take into account.
We believe that we need to make it part of our therapeuti-
cal competence to appreciate this concreteness, and interpret it
into representational terms of the life of the couple. We need to
build safety nets that can support feelings of emptiness within
the couple and the inability to think about themselves, in order
to find the specific qualities of each personality. This will help
each partner to free themselves from the confusion of non-
specific and undifferentiated attributes that have been produced
by excessive projective identification, preventing a ‘couple state
of mind’ from forming (Morgan, 2005).
Although we agree with the difficulty of differentiating the
real object from the psychological representation, given the sense
of reality that the external presence of a person brings, we believe
that it is best to consider the meaning of behaviour in terms
of internal functioning, unconscious phantasies and emotional
states. As Bion affirms, it is the emotional experience of the inti-
mate relationship that needs to be understood in order for the
mind to develop. Ferro (2007) likewise emphasises the difficulty
of confronting the intensity and quantity of emotions in mental
structures which are never adequate enough to modulate those
emotions. We need to be aware of the strategies that we use to
hide and protect ourselves from the difficulties that emotional
reality presents us with – our own, and in relation to that of the
other. The interplay of intrapsychic and interpersonal movements
 THEORETICAL FOUNDATIONS 33

means that the shared emotional experience becomes a tempo-

rary confused barrier where each partner is unable to recognise
their individual sources of anxiety.

Relational territory of the couple – the setting

We would now like to introduce the notion of the ‘relational

territory of the couple’. By this we mean the territory constructed
and inhabited throughout the relationship, a shared territory
where the reality of the internal world and the reality of the
external world intertwine. Here, in the transitional space of ‘us’
(Kaës, 2001), an intersubjective space supported by the realities
of everyday life, the project of forming a relationship is planted
by the couple and grows. The analyst is excluded from this terri-
tory but the couple return to it after each session. Kaës relates
relational theory to the mental functioning of the couple in the
double sense of group work and of unconscious basic assump-
tions, which brings us back to Bion’s idea of group mentality
(1961, 1970) in which the hope for a work group composed of
individual risks being sabotaged owing to an uncontainable flux
of proto-emotions. Ferro (2007) defines as proto-emotions the
non-metabolised precursors of the emotions from which the self
needs to be freed since they obstruct the minds.
Bion describes various forms of relationship, including
healthy (symbiotic or commensal) ones which produce growth,
and destructive ‘parasitic’ ones (1970, pp. 78, 95). When there
is psychic disturbance in the relational territory of a couple, a
pathological functioning can form even without their awareness
and have repercussions for all involved. In seeking for equilib-
rium, couples oscillate between these two types of relationship
– the growth-producing and the parasitic – and the relational
territory is a place, imaginary but real at the same time, where life
unfolds and where both healthy and pathological couple interac-
tions occur (Rouchy, 1998). It can also happen that the couple,
unable to manage itself on an emotional level, bonds in a project
that is entirely concrete, relevant only to the practical functional-
ity of everyday life. This leads to the creation of an exclusively
operational relationship.
34 TALKING WITH COUPLES

As an example of such a relationship, we refer to the case of

Mr and Mrs F, a couple in their forties who have known each
other since adolescence. They say that they have realised their
goals: marriage, family, professional achievement. But now
they are not happy together and are contemplating separation,
and ask for help. For the first time they realise that what they
thought they wanted to build together has not brought them
happiness. Driven by their family project they operated solely
on a concrete level, neglecting to listen to their emotional
world; they just dedicated themselves to the project. Middle-
age, for him, and the growing up of their children, for her,
confront them with a sense of superfluity and loneliness. They
realise that they haven’t been bound by an emotional project
based on accepting each other’s needs and desires and therefore
in continuous development. On the contrary, their bond took
on definition more socially than personally, requiring only a
prescriptive functioning without listening to emotions. They
find that over time they have avoided confronting what they
have unconsciously found upsetting and unsatisfying in each
other, in the fear that this might get in the way of their stated
programme and make them question whether they had got
everything wrong.
This couple in effect asked the analyst to take on the role
of judge in order to verify their failure and the impossibility of
being happy together. They deemed it too late to reconsider their
relationship at their age, and thought it best to end it and go
their own ways. Their relational territory is one which has always
paralysed any thinking about emotions and therefore stifled their
development both as individuals and as a couple.
The recognition of the nature of the couple’s relational terri-
tory, as it proceeds over time, is a necessary foundation for the
work of revealing the unconscious and reciprocal emotional
movements and the meanings that emerge. It is also necessary
to be aware of how the demands of ‘parasitic’ bonds, lacking
in thought, can become dominant in just one of the partners
and have repercussions on the couple. They can also block the
therapist’s capacity for thought and the transformational possi-
bilities of the field, resulting in an impasse in the therapy.
 THEORETICAL FOUNDATIONS 35

The relationship is the patient

As we have seen, the development of a theoretical model for

couple therapy, with both intrapsychic and interpsychic elements,
has been founded on Klein’s concept of projective identification
and Bion’s of container–contained, which have been elaborated
by many authors in this context (for example Ruszczynski, 1993,
1996; Fisher, 1999). We have seen how each partner can use the
other to project undesired parts of the self, or to become a source
of containment and development of the individual self (or even,
both at the same time). This is why Ruszczynski (1996) asserts
that ‘the relationship is the patient’, not simply the individual
mind. In the couple relationship the ‘marital triangle’ can be
thought of as created by both partners, with their relationship
as the third element.
In couple therapy we are dealing with two individuals with
distinct emotional worlds, but we also deal with the relation
that the two individuals have created and that is in a state of
disorder. During the joint session in the presence of both part-
ners, the therapist embodies a parental role for the couple but
also the role of third person, by entering into relation with the
internal world of each partner. By creating a ‘marital triangle’
both partners have the opportunity to promote each other’s
psychological development; and it is in the triangular space that
observation and containment can take place in order to reflect
and formulate thoughts.
As Bion said (1959), the containment process is a function
of the relationship, not just of one person or the other. The
couple relationship has been envisioned by Colman (1993) as a
container with both a spatial and temporal dimension; it is about
the experience of being contained by the relationship during a
process that evolves through time:
The relationship itself becomes the container, the creative out-
come of the couple’s union, to which both partners can
relate. It is an image of something the couple are continually
in the process of creating, sustaining, and maintaining, while
at the same time feeling that they exist within it – are con-
tained by it. (Colman, 1993, p. 89)
36 TALKING WITH COUPLES

The containing function needs to be able to absorb the tension

born from the need to develop both inside and outside the
relationship; being totally contained within the relationship
would mean the annulment of individual autonomy and separa-
tion. The container should however guarantee acceptance and
welcoming of each partner’s potential, drawing on their preced-
ing experience of being contained by the primary object.
Often couples look for help because the relationship they are
currently building has become not a container but more like a
suffocating prison. Meltzer (1992) defines as a ‘claustrum’ a rela-
tionship that is characterised by reciprocal projections deriving
from an omnipotent phantasy of intrusion into another person.
It is thus desirable for the relationship to be flexible enough to
enable the necessary transformations of the couple and of the
individuals that comprise it, and to be stable enough to protect
it from the anxieties of change, and to have boundaries, privacy
and exclusivity.
Mary Morgan (2005) defines as a ‘creative couple’ a situation
in which the psychic development of each member finds itself at
a stage leading to the development of something new, even exter-
nal to themselves. The relationship becomes experienced subjec-
tively as a source of support and a resource, something that can
be transformed, resulting in a third thing that is bigger than the
sum of its parts.: ‘The partners feel that they have something
that links them, something they can go back to and that contains
them as individuals, something that they are able to take care of,
and at the same time they can imagine it taking care of them’
(Morgan, 2005, p. 48).
If, in couple therapy, the relationship itself is the patient, the
separate identity of each partner will establish itself, while at the
same time a third presence will be sensed that is not dominated
by that of either. Pickering (2011), referring to Ogden’s concept
of ‘analytical third’, writes of this intersubjective third that:
In a couple relationship, there is a way in which the coming
together of two individuals gives rise to a third form of
subjectivity, which emerges through their coupling. A couple
contains the two individuals, each with their separate
 THEORETICAL FOUNDATIONS 37

personality, but there is a sense of a third presence circling

around the two partners, revealed (or concealed) by the
communications of the individuals, but controlled by
neither. (Pickering, 2011, p. 55)
This new aspect is located in the dialectical tension between
individual subjectivities and is not a static entity; it is an evolv-
ing experience, both conscious and unconscious, in a state of
continuous change. It is perceived differently by each partner,
though each (partially) entrusts their own separate individual-
ity to it.
Bion’s dynamic theory of thinking offers a very fertile model
here (Bianchini & Dallanegra, 2010, 2011). The containment
of the relationship allows the reconfiguration of raw unprocessed
proto-emotions, in unconscious phantasies, myths, reconstruc-
tions, changes of perspective, receiving the thought that is outside
the thinker. In order for this to happen it is necessary that each
partner be prepared to tolerate the vacuum of un-thinkableness
so that beta-elements can be decompressed through receptive-
dreaming abilities – the reverie of the other. The function of the
container is to share the emotional experience with the other
loved person; the act of caring makes the emotions more toler-
able. This process develops in both directions: container and
contained work reciprocally, in a state of mutual tension. In the
couple, its functions are symmetrical, reversible, and in continu-
ous reciprocal co-construction. When there is reciprocation, a
couple can function creatively in a continuing expansion of new
containers and contents. The roles of container and contained
alternate between the pair, so each gains enrichment by new
qualities and truths, nourishing their own development through
this constant dialogue. It can only be done by the acceptance of
aspects of one’s self and the other which may be deeply disturb-
ing (Gabbard & Ogden, 2009).
When contact and proximity arouse excessive quantities
of proto-emotional states in the partners, an unbalance may
be created between the development of the container and the
growth of its contents. In the following example we may see a
possible case of this happening.
38 TALKING WITH COUPLES

Claudio and Daniela argue all the time and they are always
on the brink of splitting up. Their one-year-old daughter cries
incessantly and does not let them sleep. It seems impossible to
find a container for their anger and for the inconsolable crying
of Rosita. There is never a moment of calm. Claudio attacks
Daniela aggressively, even in front of the therapist, by insulting
her in demeaning and mortifying ways; Daniela weeps, releasing
all her desperation. In this way Claudio uses the space to vent his
anger while the therapist tries to contain him and make contact
with Daniela again.
Claudio belongs to a wealthy family where the environment
was always troubled by rivalry with his brother who was eighteen
years older than him, a dictatorial father, and a weak mother
who sought refuge in her headaches. Daniela left her family at
fourteen in order to study in another city and could never rely
on any emotional or financial support. She managed to achieve
a good professional level of which she is proud.
The couple came to us because they were not able to manage
their child’s crying and in order to understand how this
increases the emotional conflict between them. It emerged how
in the history of both they lacked the experience of excessive
and intolerable emotions being contained. Within the couple,
Claudio always tries to take command, and Daniela can only
withdraw desperate and wounded, leaving him lonely, which
makes Claudio’s anger even more violent and Daniela’s with-
drawal even deeper.
The request for help to learn how to deal with Rosita’s crying
corresponds to an unconscious and parallel request to under-
stand and console the personal suffering that they are only
able to express through his shouting and her silence. We are
presented with two ‘contents’ that both need containing. The
configuration emerges of a psychic functioning characterised by
hyper-contents that try to find acceptance in a hypo-container:
a situation that harms the relationship and each partner because
neither of them is receptive to the other.
We believe therefore that the couple therapist’s role is to
facilitate the expansion of the relation container<–>contained
in order to augment its capacity and equilibrium, so that the
 THEORETICAL FOUNDATIONS 39

exchange between the partners can become more thinkable, and

emotions able to find a place in a reciprocal (even if precarious)
dynamic of mutual dependence.

Conclusion

It becomes apparent how the map of personal development

drawn up by an individual is liable to be sprinkled with blind
spots, which resurface during the failure of any of the projects
of adulthood. In the case of the couple relationship, each part-
ner needs to work on both their internal dynamics and on the
dynamic created by the partnership: the interweaving of the
‘sense of self ’ and the ‘sense of us’ (Norsa & Zavattini, 1997).
However this interweaving does not imply confusion or blurring.
The model we use in therapy is based on the idea that the
meeting of two people creates a different ‘third reality’, and the
goal is to inspire the emergence of a ‘marital self ’ (Eiguer, 2008),
in which the partners, alongside the therapist, learn to observe
their own specific attributes and how these can contribute to a
reciprocal, active interchange. New ways of thinking, enabled
by the therapist, enable a reconstruction or reformulation of the
self, the internal objects, and the relationship with the other.
Although in certain cases individual therapy might be recom-
mended, a joint encounter favours a wider vision, taking into
account interactive dynamics, and gives unknown parts of the
self an opportunity to find a voice which might otherwise go
undetected.
We can therefore imagine the therapy as a transformative
fly-wheel, concentrating on balance and fluctuation, in which
the relation becomes generative if it is successful in providing
the patients with certain tools that are lacking. Through our
observational capacity we try to note and make contact with
unrecognised emotions and contain them through a new lens
(Gabbard, 2003), based on a shared moment of thought in
which even painful emotion becomes tolerable to all, by means
of this constructive exchange.
To a certain extent the analyst’s mind must experience the
same illness as the patient, as it is the keystone of the analytic
40 TALKING WITH COUPLES

field that comprises all the dynamic elements. His or her own
inner world must be actively engaged. The couple’s distress
affects us and we cannot avoid it; it is only eased by help-
ing patients acquire the tools to transform it for themselves
(Civitarese, 2008; Ferro & Vender, 2010). The equipment of
the analyst needs to include, according to Grotstein, ‘a function
of passion, the analyst’s submersion into his own subjectivity to
locate matching experiences and emotions that resonate with the
analysand’s emotional experience and convey credible patterns
and configurations’ (2007, p. 91)
For the joint couple session is shaped by the receptivity of
the therapist-as-object. The ‘circularity principle’ (as seen in the
primary relationship when there is an appropriate response from
the maternal object) creates a space in which the self, the other,
the couple, and the therapist can be thought about and spoken
of together. A group comes into existence in the room which
takes note of many different points of view, that can enter into
dialogue rather than excluding one other. The therapist has to
take care particularly that no impasse occurs, as happens when
participants cease to listen to each other and resort to blaming the
other. A special type of commitment and availability is required,
as with all these sources of conflict, doubts and questions are
multiplied and it is difficult to create a developmental space.
As will be discussed in the next chapter, the therapist needs
to take an equilateral approach, meaning that engagement is
necessary but from an appropriate and impartial distance. This
is necessary because the intensity of the emotional flux and the
complexity of the dynamics that arise during the session entail
a strong risk of creating confusion and becoming involved in
collusion with one partner or the other.
CHAPTER THREE

Equilaterality: the structure of the

couple and the mental state of the
therapist

Maria Adelaide Lupinacci and Giulio Cesare Zavattini

Each personality is a world in himself, a company of many.

(Joan Riviere, 1952, p. 317)

O
bserving the couple relationship in the privileged
context of psychoanalytical psychotherapy, one is
from the beginning struck by the substantiality and
extent of the spatial element. The concept of relationship itself
implies the extension of psychic space, since we don’t deal
only with the internal space of the individual but also with the
imaginary non-sensuous place where the relationship unfolds
and the internal worlds with their objects and emotions meet
and interlink.
We think the best metaphor proposed so far for describing
the spatial structure of the couple, allowing us to follow its
fluctuations and dynamics, is the triangle. Naturally the idea of
triangularity and of the third person immediately brings to mind
the oedipal conflict, and we will try to use this in our explana-
tion of the metaphor.
After Melanie Klein (1928) pointed out how one of the
fundamental components of the oedipal conflict in the child

41
42 TALKING WITH COUPLES

was the sense of exclusion from the parents (in addition to the
desire for possession of the mother, and rivalry with the father,
as noted by Freud), other authors have taken up this topic and
have emphasised the sense of exclusion (Britton 1989, 2000;
Emde, 1991). The complex of emotions that awaken in the
child when he begins to realise that the two most important
people in his life are engaged in an intimacy that excludes him,
stimulates his curiosity. This acts as a catalyst in his psychic
development because it enables him to view himself in relation
to others outside himself.
We find Britton’s (1989) elaboration of the oedipal conflict
as a ‘triangular space’ to be particularly useful. Britton describes
how the child faced by a difficult oedipal complex has a double
developmental challenge: to tolerate the pain of recognising the
intimate sexual bond between the parents, from which he is
excluded, and at the same time to preserve the different quality
of his own love for each individual parent, in this way process-
ing the loss of his omnipotent phantasy of total possession. This
double process has many consequences that can help emotional
growth and extend mental and imaginary space. If the child
can accept the privacy of his parents’ relationship he can begin
to understand different types of relationships, some of which
he might always be excluded from, but in others he will be
included; and others again he will be able to initiate himself. A
special type of object relation is formed in which one is not a
protagonist, and a ‘third position’ is gained ‘from which object
relationships can be observed. This provides us with a capacity
for seeing ourselves in interaction with others and for entertain-
ing another point of view whilst retaining our own, for reflect-
ing on ourselves whilst being ourselves’ (Britton, 1989, p. 86).
The triangular space thus opens the way to a more complex
dimensionality of the mind that is co-extensive with an expanded
container–contained model (Bion, 1963): the contained, bene-
fiting from containment, is able to take on new contents. The
child, though pained by the realisation that he is excluded, can
envisage a mother separate from himself, and the separateness
of the parental relationship on which he depends physically
and emotionally. This extended model implies that in an adult
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 43

relationship, especially a couple relationship, a person does not

only benefit himself from containment, but can also become
a better container. Britton linked the failure to internalise the
oedipal triangle to a prior failure to make a significant dyadic
bond with the mother, even if separation is tolerated. In the
worst cases this results from a failure of maternal containment,
with the father perceived as a persecutor that keeps attacking
the dyadic relationship. In more benign situations, defensive
illusions deny the creativity of the parental couple and obscure
psychic reality. With couples, it is therefore important to under-
stand what internal structures have already been established and
what relationships have been internalised when the child moves
on from the primal relationship and later the oedipal situation.
The person’s later relationships are founded on the paradigm of
these unconscious internal object relations.
For example, it might happen that a woman scarred by a pain-
ful childhood experience of abandonment may unconsciously
search for a partner who can offer a stable and faithful refuge,
but all her life tries to find in him a secret tendency to betray or
disappoint, so that she can reaffirm her masochistic fears, with
the secondary triumph of being able to unmask him. Equally,
a man who is daily accused of this might have the unconscious
phantasy that his wife is a castrating and suffocating mother,
reaffirming his own deep fears and re-enacting a disappointing
internal relationship.
In terms of adult relationships, the partners in a couple depend
emotionally not only on the reciprocal containment they each
offer the other (Lupinacci 1994; Lupinacci & Zavattini 2002,
2004), but also on the state of the relationship created between
them. We think all this needs to be seen in a more complex
way than Freud’s classical delineation of partners being chosen
according to similarity or contrast, and is more complex even
than Klein’s view of projective identification. Both these views
imply a too linear reading, with the other as a space into which
aspects of the self are put for containment. The picture in which
each partner uses the other to project idealised or persecutory
aspects represents an important aspect of psychic reality, however
it lacks the idea of the availability of a mutual object held between
44 TALKING WITH COUPLES

them (Puget, 2010; Zavattini & Gigli, 2010; Gigli, Velotti &
Zavattini, 2012a, 2012b). It is necessary to understand the inter-
twining and mutuality in terms of a shared psychic reality, as was
very well described by Dicks in his seminal study (1967).
The basis of the analyst–patient relationship with couples
therefore posits the existence of a third entity that is created by
both partners, but that doesn’t exhaust their potentialities. As
Ruszczynski suggests (1996, 2005) we can think of the marital
triangle itself as something created by both partners with their
relationship as the third element, a symbolic product of their
coupling, with its own identity. This idea is already present in
Bion’s (1970) container–contained model, with its potential for
creating either a constructive or a destructive third entity. We
will return to this later in the negative relationship (–R).
So it is necessary to see the marital relationship (or any other
intimate long-lasting relationship) not as a simple addition of
the internal worlds of each partner but as a new production
born from an unconscious interlocking. The logic of the inter-
vention with couples requires us to go beyond the interpretation
directed at the individual, following the idea that the dynam-
ics need to be read in terms of a bipersonal field (Baringer &
Baringer, 1969; Ferro, 2002b) shared between the partners,
that influences the here-and-now of the session (Zavattini &
Lupinacci, 2004). The setting creates a scenario in which a
pattern of meaning can emerge from this virtual space, with the
characteristics of that particular field (Zavattini, 2006).
The specialist literature on couple therapy on an object–rela-
tions basis holds that the transference between the members
of a couple is the central complex feature to be examined,
and is characterised by a fluctuating tendency that makes it
particularly difficult to comprehend (Scharff & Scharff, 1991;
Ruszczynski & Fisher, 1995, Norsa & Zavattini, 1997; Fisher,
1999; Clulow, 2001, 2009; Velotti & Zavattini, 2008; Scharff,
2011; Gigli, Velotti & Zavattini, 2012a). The psychoanalysis
of couples has shown that the interlocking of internal worlds
can be considered a type of natural transference relationship.
As Gosling (1968) puts it, ‘falling in love is one of the most
surprising examples of transference’.
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 45

It has been suggested that we can usefully see work with

couples as taking place on two levels: the transference between the
couple, and their transference to the therapist, both as a couple
and as individuals. The presence of both levels makes particular
the work with couples compared to that with individual patients.
In particular it can make it harder for the psychoanalyst to main-
tain a position of separateness and equilibrium (Morgan, 2001)
when interpreting the internal state of the patient. The risk is of
emotional collusion with one or the other partner thereby falling
into confusion over their motivation, and owing to conscious or
unconscious bias, slip into errors of judgement.

The marital triangle: equilateral and scalene

We would like to consider the couple relationship as one which

is symmetric rather than asymmetric as between child and
mother (or caregiver). There are two equals who each expect to
benefit from mutual containment and enrichment, thus forming
a conjugal ‘triangle’ together with their relationship which can
be seen as a discreet entity (Ruszczynski, 1993) – an identity
that might interfere with the individual desires or needs of any
individual partner. To become aware of this third entity or vertex
can be disturbing, as it brings to view both separateness from the
other, and dependency on the relationship. There may be anxiety
that the triangular space may destroy phantasies of ideal union
or twinship.
Or there may be a suspicion that the triangular space is
unbalanced: that one of the partners dominates the space. When
a narcissistic relationship blocks the image of the other, what
is unrecognised or denied is also the sense of the value of the
relationship itself as the third element in the conjugal triangle.
Lacking a third position, individual and couple growth is diffi-
cult to achieve (Morgan, 2001). Or the conjugal triangle may
itself become pathological or dysfunctional in itself: negated,
or idealized, or unbalanced, to the detriment of one of the
members – for example, the downtrodden wife of a husband
who is violent, or always absent at the pub, or a workaholic.
Or the intimacy of the conjugal relationship can be dependent
46 TALKING WITH COUPLES

on a child who is given the role of keeping the couple together;

in this case the triangle is flattened – the child disappears as a
person in himself and becomes an adjunct to the couple, who are
adhesively joined. The aim is to preserve habits and continuity
without engaging in any productive exchange.
The quality of triangularity can also oscillate within the life
cycle of the marital couple, or of any intimate emotional relation-
ship. For example as Freud (1921) revealed, the classic theme of
the honeymoon period is nearly psychotic in terms of its mutual
idealisation and will later need to be modified by a vision that
is more realistic and based on the work done by the interlinking
of the partners. When one person is dominant there is a linear
relationship; when two are equal, the situation is more complex,
hence its representation by a triangle. The triangle covers the
changing couple dynamics very well since when any of the
vertices changes so does the value of the figure as a whole. We
therefore have equilateral or scalene (unequal-sided) triangles,
depending on the position of the vertices A and B (the partners)
in relation to the vertex of reference (R, the relationship).

This means that there may be a balance; or that one or other

of the couple may dominate or absorb the relationship (R) to
the detriment of the other partner, maybe partially or temporar-
ily, or in relation to an individual problem. For example, in the
relatively benign case of a well-matched middle-aged couple, Mr
and Mrs T, a serious illness of his mother (a dominating woman)
invaded the space of their relationship, moving the vertex of their
interests towards placating the husband’s damaged and greedy
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 47

maternal object. This event disturbed the distance the husband

had maintained towards his persecutory object, inducing him
to marginalise the needs of his wife and the relationship. So the
triangle had become scalene, risking a crisis in the couple. In this
case the pathology of the conjugal triangle could be explained
quite easily, and the tension be resolved in a fairly short time.
In other cases the unbalance may be more rigid; the other can
unconsciously collude in the face of internal or external events,
creating a condition of stable but chronic suffering. This is the
case of Emma and Giorgio whom we will discuss later.
As observed by many authors (Ruszczynski & Fisher, 1995;
Fisher, 1999; Ruszczynski, 2005; Zavattini, 2006) another possi-
ble third is the couple’s analyst: and someone who can observe
the relationship from another vertex whilst at the same time
being part of it in so far as the couple transference (the product
of the relationship) is gathered to him. When the couple become
aware of the importance of the analyst’s role in maintaining the
equilaterality of the triangle, they also become aware of their
dependence on the therapist and the therapeutic situation for the
quality of their relationship and also up to a point for the pursuit
of their individual destinies within the relationship itself. This
dependency can be feared and arouse hostile emotions towards
the therapist. Another fear is that the analyst may not be able to
ensure equal weight and recognition to both partners, but may
bias his vertex towards one or the other. This is one of the most
common fears of patients engaging in couple therapy, felt at the
commencement and also as it continues.

Changing triangularity in a couple

We would like to give an example of the nature of triangularity

in a couple, Emma and Giorgio. The relationship had initially
found a symbolic container in the place of their first meeting
where they fell in love, the city in the north where they both
worked. Often couples have a very clear vision of the place
where they first noticed the other. This memory and/or phantasy
involves expectations not only of the other person but of ‘us’, the
two together.
48 TALKING WITH COUPLES

Emma and Giorgio were united by lively intelligence and

interests, an unconventional vision of the world, and the desire
to get away from their own families whom they both regarded
as difficult. They were both aged 30 and so far had not found
their own sense of identity outside their families. They realised
they shared similar anxieties and defences. So from their first
meeting they were both convinced there should be an emotional
bond between them. Giorgio had always avoided committing to
a longterm relationship, then rejection by a woman made him
both more needy and less defensive. Giorgio’s courtship attracted
Emma, who was very insecure in her relationships with the oppo-
site sex, and needy for affection. So Emma’s hunger for affection
and Giorgio’s need (mixed with fear and hostility) for a serious
relationship came together to create the unconscious psychic
space of their relationship. But there was more to it than that.
Emma’s availability, which attracted the disappointed and
frustrated Giorgio, was linked to an unconscious tendency to
identify herself with an indulgent mother (very different from
her own mother whom she found mean, tyrannical and violent).
Giorgio was very practical and appreciated Emma’s direct and
unconventional manners and intellectual qualities. Emma hoped
that he would be an ideal figure (not necessarily masculine, in
fact at the end of the day quite asexual), who would support her
in shaking off this terrible mother; she also blamed her father for
not defending her and leaving her to her mother’s caprices.
Emma’s vitality and outspokenness, coming from a rough
family background, reassured Giorgio since she seemed so
different from the conventional mother to whom he had had
a very strong bond in his early childhood, but from whom he
separated quite dramatically later. In fact Giorgio accused his
mother of being a bourgeois conformist who was crushed by
the demands of his bullying and unfaithful father. However on
the unconscious level, what emerged during the therapy was a
deeper, ancient resentment that his mother had not really been
affectionate or really understood him as a child: that she had
replaced him with his brothers. Emma was sufficiently different
from this maternal image; she was not bound by conventional
limitations. Unconsciously Giorgio asked Emma not to impose
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 49

any boundaries on him, not even those of a tender mother or

father as required by the oedipal situation. Exuberant and eager
Emma, who also disliked boundaries and had her own problems
with them, seemed the perfect match.
In this partly conscious, partly unconscious intertwining
of expectations, relational models, shared issues and defence
mechanisms, the hostile relationship of both of them with their
mother and their own ‘difficult’ families – the fractured parental
couple for Emma and the denied (negated) parents for Giorgio
– neither of them could internally locate a sufficiently good and
stable internal triangle.
For Emma and Giorgio the triangle of their initial relationship
seemed to maintain an equilateral position in the sense that the
relationship between them seemed to contain the rationale, the
need, and potential power to rebalance old object relation prob-
lems. Nevertheless their union, despite some solid and realistic
libidinous features, was mainly based on the expectation of using
the other to escape (and eventually conquer) their own infantile
persecutory object. They felt themselves to be in an idealised
twinship that unified them against a common enemy but that
(as shown later on) couldn’t tolerate an object other than the
self or genuinely separate. The phantasy of twinship is different
from an equilibrium which is sufficiently solid for an equilateral
triangle to exist. The unresolved internal relationship with the
primal objects, above all the failed maternal containment, espe-
cially in Emma, contributed to making the narcissistic aspects
of the partners (Fisher 1999) very strong. ‘This is what I’m like!’
had become Emma’s assertion on many occasions. ‘You can’t tell
me what to do!’ Giorgio would thunder threateningly when he
heard his wife demanding more respect for their relationship,
protesting against his unfaithfulness which had become habitual.
This narcissistic structure of internal relations made aware-
ness of the third dimension tenuous. The precarious equilibrium
of the conjugal triangle was disturbed by the impact of the ‘facts
of life’ (Money-Kyrle, 1961): living together, birth of children,
awareness of time passing, and by the demands of the inner
world. At this point, given the great complexity to be found in
every interlocking couple, we will mention some features of the
50 TALKING WITH COUPLES

conjugal triangle that will help us understand better the increas-

ingly scalene configuration of Giorgio and Emma’s relationship.
From the time the children were born, Emma’s infantile
voracious emotionality, intolerant of separation, led her into a
partial female identity, founded on being a completely available
mother, geared totally to bringing up the children, on whom
she projected all her own needy infantile but also bullying parts,
whilst becoming less sensitive to the requirements of the husband
and their relationship.
Giorgio remained partially excluded from this reconfigura-
tion of the couple after the arrival of the children. He had never
coped very well with having a close relationship and now he
started a series of affairs, identifying with a partial masculinity,
phallic and narcissistic, in the meantime building up a violent
bitterness toward Emma in whom he felt extremely disappointed.
In his view she turned from being a quickwitted nonconform-
ist adolescent partner to being a suffocating mother or needy
dependent child. As an alternative to this Giorgio imposed an
alternative structure on the couple, locating his phallic sexuality
outside the marriage. Through his unfaithfulness he attacked not
only his wife but through her his idea of his own mother; and
also set up a rivalry with the bullying father whom he feared,
whilst at the same time trying to distance himself from a rela-
tionship in which he felt himself the weaker partner.
In this way they both installed a scalene relationship, each
claiming the balance of power for themselves. By the time they
contacted the psychoanalyst – a woman – the situation between
them had totally collapsed; he had lovers; they continuously
argued bitterly about everything; however they still didn’t
consider separating. ‘The discussions between us always arrive
at a dead end. We need a third.’ Intuitively Emma and Giorgio
were handing over their relationship to a third – the analyst.

Variations on triangularity in therapy

We would like now to consider further the ‘R’ (relationship)

vertex, with R represented by the therapist. In particular we
would like to examine how R may become distorted during
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 51

psychoanalytic psychotherapy, owing to the pressures on the

countertransference of a narcissistic coupling between the A and
B vertices (the partners). This can create a situation we might
call –R, using the minus sign in the same way that Bion does,
borrowing it from algebra, in which ‘a change of sign, say for a
line AB, represents a change in sense of the line’ (Bion, 1962, p.
52). The meaning of an emotional link becomes inverted, that
is, negated. Bion considered the fundamental developmental
emotional links to be love, hate, and knowledge (LHK), and the
defences against this emotionality to be seen as negative links (–
LHK). Analogously, we propose that within the conjugal triangle
there can exist a –R vertex, when the triangle is equilateral, but
the joint interaction of the partners is one of silent mutual agree-
ment to attack and negate the relationship. The anti-libidinous
orientation in which they jointly move is upheld by a confirmed
misunderstanding. In couple therapy this condition manifests
itself in a joint attack on the therapist’s function and capacity to
think, and on the therapeutic setting.

To clarify this configuration we will return to Emma and

Giorgio. One time the psychoanalyst arrived five minutes late
and commented on the unease they felt at her delay. The two
partners minimised what happened but in the form of an ironic
attack, devaluing the analyst’s function. They said they didn’t
mind, but in a way that made the importance of the punctuality
of the therapist seem ridiculous. Emma, who gives piano lessons,
says that even with the children she is very flexible about time;
and she looks at the analyst as if she were very narrow-minded.
Giorgio becomes very ironic and says it’s not a problem for him:
‘But maybe it is for you, doctor.’ They both laugh.
52 TALKING WITH COUPLES

The problem of time, owing to their own habitual lateness,

was a longstanding bone of contention. The therapist is annoyed
but also a little dazed. For a moment she feels she is not quite sure
what her ideas are; she feels a sense of humiliation like a child
exposed to the mocking laughter of insensitive adults. However
she manages to comment on the fact they really can’t bear to
be precise about time, and maybe they feel about their own
relationship in the same way, like a constriction. Both of them
deny this, and Giorgio is particularly entrenched in his position.
There is a deep silence. After a while, nonchalantly, they both say
they were thinking about their own preoccupations. So they had
returned to their own little narcissistic worlds; their dependence
on each other and on the therapeutical relationship for the solv-
ing of their problems is denied and dropped.
The simplest and most common situation in which a trian-
gle stays balanced but negative is when the couple collude to
exclude the psychoanalyst from the situation, often catching him
or her in a tricky dialogue or argument which prevents him from
thinking about what is going on between the three of them.
What we wish to illustrate is how the narcissism of the two
partners can collude to keep their relationship out of the picture,
or to move it away from intimacy and thought in a direction
of –R. And as here, the therapist and the analytic relationship
are also excluded by this narcissistic alliance. This movement
towards misunderstanding is quite different from an adult
mutual decision between the couple to split up. The therapist’s
function is to ensure the relationship can be thought about and
kept in equilibrium; and sometimes a successful therapy can take
the form of helping the partners to dissolve an unsustainable and
imprisoning bond from which they need to free themselves. In
the case of an unbalanced ‘scalene’ couple such a decision could
paradoxically be considered both the first and the last co-opera-
tive, positive one of their relationship.
To continue with the account of the ‘–R’ session with Emma
and Giorgio. After the silence, Giorgio teases his wife about her
intention to visit some friends in the north. It is the first time she
has been away from the family on her own and in a sense it is an
achievement. Emma replies by complaining about Romans and
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 53

the ‘messy’ life in the city where they live (he is from Rome, she
is from the north), says she is very tired of taking care of every-
one – they all depend on her and she is not that strong. Giorgio
replies ‘Well stay there then – and stop complaining.’ There is
a harsh contrast between her sad, depressed look and his ironic,
triumphant one. The painful matters of separation, exclusion,
and neediness, are evident.
These matters were earlier projected into the therapist and
could not be processed because of their mutual collusion; still
linger and are tossed between the partners. However Emma’s
complaint that everyone depends on her tells us something
more. The therapist knows that probably it is a reference to
the last few sessions, when they had touched a deeply hidden
area in their relationship, in which Giorgio’s secret phantasies
emerged in a dream of a harem courtyard, of unrestricted phal-
lic excitement and wild sexuality, a phantasy that was also a
defence against his anxieties in his relations with women.
The theme of a secret space, introduced by Giorgio, brought
to light Emma’s own hidden phantasy space, as manager of
the ‘children’s room’. This clarified her identification with a
warm, welcoming, idealised mother, who indulged everyone’s
demands and desires. Into her children Emma projected her
own angry, depressed and greedy child self, cooking and eating
huge quantities of food. Giorgio also found refuge in this secret
part of Emma for his own depressed and frozen child self, as
an alternative to the phallic father to whom he had turned in
adolescence, and who had been unfaithful to his mother. In this
identification, Giorgio had seen him as an accomplice in his
own adolescent exploits, and at the same time a man-to-man
supporter of his work and studies.
Part of Emma’s unconscious phantasy was reparative,
another part represented an omnipotent belief in being stronger
than the women of the harem and than Giorgio’s bad mother,
believing therefore she would be able to rescue him. For both
of them the secret imaginary space (the harem, the children’s
room) got in the way of intimacy in their relationship. Emma
had become more mother than wife, neglecting herself physi-
cally; her ambitions were all directed towards motherhood not
54 TALKING WITH COUPLES

to marital relations. Outside this ambit, Giorgio searched for

sexual adventures, finding partners who were often weak or
subjugated.
The analyst, bearing in mind this recent material, then
observes that maybe the city in which Emma is no longer happy
is also a mental space in which she doesn’t feel comfortable: it
refers to her emotional state and relationships. The phantasy is
of rescuing her husband from the harem, since she is the one
who takes care of everyone. Giorgio, pointing out everything he
does for his wife, quickly attacks the analyst and she immediately
realises that her intervention was unbalanced and incomplete.
She had let herself be seduced into Emma’s orbit, identifying
with her omnipotent phantasy of rescuer, imagining that she
could herself rescue Emma from her secret ‘room’ where she
exhausts herself in taking care of everyone. In this way, we lost
sight of the actual relationship, in which the couple colluded in
a mutual exploitation.
Giorgio exploits Emma through seeking excitement in his
adventures with groups of ‘boys’ who humiliate women; yet
at the same time wanting the maternal warmth of a home and
family, to which he always returns. Emma exploits Giorgio by
projecting her ‘mean’ mother into him, yet she derives secu-
rity and material benefits from him, and children whom he
didn’t want. She uses him to feel superior to her own mother
and the analyst, neglecting the relationship and Giorgio’s wish
that she take care of her femininity and physical appearance.
Giorgio’s sexual vagaries thus also function as part of Emma’s
identifications: specifically, her narcissistic identification with
the super-indulgent ideal mother who forgives all trespasses.
All this had not been perceived or understood by the therapist
at this point, and the triangle had become scalene owing to her
interpretative imbalance which leaned more towards one of the
couple, Emma.
Going back to the material, we could have interpreted that
Emma was trying to distance herself from the shared or recipro-
cal disorder in the relationship – the ‘messy city’ in which they
both live – and from the disorder of an attack on the ‘here and
now’ of the psychoanalytic session in which the whole sequence
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 55

started. How to explain this momentary loss of equilibrium in

the therapist? In part, Emma with her overtired, dishevelled
appearance aroused a maternal instinct in the therapist, and it
could have been useful to have investigated further the topic of
the ‘children’s room’ at that point, not just the ‘harem court-
yard’. In addition, the analyst had been disturbed by the initial
joint attack on the therapeutic setting after she arrived late. The
couple’s hypocritical reaction to this revealed that they were
attacking the relationship by means of an attack on the analyst’s
capacity for thought, an example of –K. The analyst needs to be
in a position of observing rather than participating in the rela-
tionship, and she temporarily lost her equidistant objectivity
and pushed the triangle into a scalene shape. By momentarily
losing this position the thinking function was dislodged and
the analyst was attracted to the defensive configuration put in
place by the couple to conserve their mutual dependency, hence
resulting in an unbalanced interpretation.
Both members of the couple had an unbalanced internal
triangulation in their masculine and feminine qualities, in their
picture of the parental couple. We have seen how Giorgio had
gradually distanced himself from his wife as a woman in the
same way that he internally distanced himself from his mother,
despising her whilst idealising the father as a comrade, an inter-
nal accomplice. For Emma, the mother was internally split into
persecutory and idealised, while the father was a weak and absent
figure in the family picture, disconnected from the mother, so
that Emma’s own femininity was completely absorbed in and
limited to the idea of an overabundant, unbounded mater-
nity. In Emma’s mind the role of the male had become one of
compensating for what her mother had not given her.
Emma and Giorgio thus colluded in leaving the other to live
in a world made of either phallic males or over-maternal women,
rather than being an authentically creative couple. Their respec-
tive narcissism prompted an evacuation of anxiety, triumphing
over persecutory internal objects, especially the mother, rather
than uniting in a positive way. A scalene configuration was
then intensely projected into the psychoanalytic situation and
momentarily not contained in the transference by the analyst.
56 TALKING WITH COUPLES

We also need to remember that the mocked and excluded child

was also projected into the analyst as if by destructive parents,
re-enacting the ‘parasitic’ or lying relationship spoken of by Bion
(1970). They enacted a phantasy like the myth of Oedipus’ killer
parents, who do not wish to be disturbed by infantile dependency
(Lupinacci, 1994). All this contributed to the analyst’s projective
counter-identification with Emma’s ‘children’s room’ and a solely
‘feminine’ view of the couple relationship.

Conclusions

As we have seen, analytic work with couples is distinctive in

that it deals with two people involved in an equal relationship.
For the therapist it is therefore important to pay attention to
the balance of interventions, whether in the form of interpreta-
tions, questions or comments. We call this a triangular space in
which every member can reflect on their own needs in relation
to the other, and on the requirements of the relationship. The
aim is to make the space positive and equilateral rather than
scalene or negatively equilateral (–R).
The triangularity also refers to the quality of the unconscious
interlock between two internal worlds, and the mirror of its
dynamics. There may always be psychic forces within one or
the other partner, or both, that will try to destroy any resolu-
tion and damage the relationship. This entails the possibility
of the analyst being drawn in and overwhelmed by the uncon-
scious forces. Taking care of the triangular space means dealing
with moments of crisis or unbalance, and lack of emotional
synchronicity, that need further reflection and a capacity to
tolerate ambivalence. Whatever the outcome it will provide an
important source of information at countertransference level.
There is a fear that even in the therapeutic session the
triangle can become scalene. This needs to be at the forefront
of observing the interactions of the transference and one’s
own countertransference, and in the way interpretations are
presented (Zavattini, 2001a, 2001b; Santona & Zavattini,
2005). Although the masculine and feminine in psychological
makeup are strong organisers of a capacity to tolerate difference
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 57

and otherness, a long training and deep reflection are necessary

to cope with the anxieties that are stirred up in the sessions, and
that may result in partiality. The repercussions on technique
of the strong emotions aroused by the two triangular shapes
in couple therapy represent one of the main challenges to the
therapist. We need to consider with great care the timing and
delivery of interventions in the session, discarding the logic of
blame and evoking rather the phantasies and anxieties regard-
ing the link between the couple: for example, the anxiety that
each partner has of being eaten up, used or obliterated not only
by the other but by the relationship itself. The technique of
interpretation should be able to include both shared and indi-
vidual dynamics, and put the couple in a position to experience
aspects of their own subjectivity which they have split off into
the relationship.
We believe that equilaterality goes beyond the important
concept of neutrality, to also involve taking care of the third
element called into being by the partners. Couples in therapy
recognise the special nature of the experience they encounter,
very different from the claustrophobic, irrational atmosphere
that is generally created by couples in crisis. They believe they
have found a place and time where they can at least present what
they think and feel, guaranteed by the functioning of the analyst.
In this space, talking – which often has an evacuative, projective
and manipulative quality – regains the quality of communica-
tion, about the self and above all the relationship. An equilateral
as distinct from linear functioning is one in which each partner
contributes an aspect of their internal object and their associ-
ated phantasies about the internal couple. It is enabled by the
presence of the third party, the analyst, who through the setting
offers containment for these complex dynamics.
But as we have seen the analyst can unconsciously take
on an unbalanced position within his own countertransfer-
ence and act out within the setting, and this in fact frequently
happens. So it is important to have a suitable theoretical model
to comprehend it clinically and deal with it technically, which
means the analyst needs to continuously examine his personal
oedipal conflict, and be conscious of the anxieties aroused by
58 TALKING WITH COUPLES

the pressure made on the countertransference. This is an task

that continues lifelong (Lupinacci & Zabbatini, 2004). Doing
this, he can ensure not just neutrality but the equanimity that
ensures adequate recognition of the couple itself as the patient.
He must continually try to seek out and maintain the ‘third
position’ (Britton, 1989) from which to observe the interac-
tions. This fundamental element allows the unfolding of the
transference and provides the conditions suitable for interpre-
tation. Mary Morgan (2001) describes this orientation of the
analyst as having a ‘couple state of mind’. This refers to a capac-
ity to keep in mind the relationship as an entity in itself, not
just keeping in mind both partners. It can then inspire a similar
state of mind in the couple themselves, so that for each of them
there will be a chance of perceiving simultaneously themselves,
the needs of the other, and the relationship between them. This
can alleviate the reciprocal projective identification that would
have brought an element of paralysis to the relationship and
that would also interfere with the psychic state of any children
there may be.
The couple relationship thus organises two internal worlds
by means of an inter- and intra-subjective dimension, forming
not only a couple but also the basis for a complete restructuring
of the personality. However this does not mean (especially in
psychopathology) that there could not also be a rigid, adherent
aspect carried over from the previous experience, hard to trans-
form, that we attempt to resolve by delegating the problem to
the relationship. In such a case the couple relationship is given
responsibility for resolving the self ’s incoherence (an illusion).
Thus we need to understand what structures have been set up
in the relationship, which is being used by both to fight old
wars but with a new enemy, their partner. Without either being
aware, they can end up in a new intersubjective collusion, a
folie à deux generated by the encounter of their two internal
organisations. The therapeutic objective requires each partner
to recognise their projections, to find out how these aspects
of themselves are experienced, and how they may be tolerated
(Fisher, 1999), so that we can encourage the development in
each of a more coherent, integrated and autonomous self.
 EQUILATERALITY: THE COUPLE AND THE THERAPIST 59

The triangular model has many useful possibilities for

expansion. Many variations can occur in the triple setting (the
couple with one therapist), and further possibilities arise with a
quadruple setting (with two therapists) as shall be discussed in
the next chapter.
CHAPTER FOUR

The therapist at work: technical

matters

Marina Capello

Human beings build too many walls and not enough bridges.
(Isaac Newton)

I
n the previous chapters we highlighted the theoretical
elements that are specific to couple therapy. The change in
point of view, compared to individual psychoanalysis, influ-
ences the technique which needs to change in line with it. In
this chapter we will explore this extension. Whilst in individual
therapy only one person can talk about the absent partner, as an
internal object, in the couple setting the therapist has to concern
himself with both actual partners, and to distinguish the real
object from the represented (internalised) object. It is not easy to
see the boundary between the two realities, as one may be faced
with a very strong projective identification, in which an aspect of
the self – either idealised or negated – is handed over very force-
fully to the other, who finds himself becoming like the picture
that the partner has of him. The realistic aspect of the partner is
confused by the projections that enter into him or her.

61
62 TALKING WITH COUPLES

This significant change of viewpoint is the real subject foun-

dation of couple therapy technique, implying a different vision
of the setting and of transference–countertransference dynam-
ics. The work with couples or families has traditionally been the
territory of systems theory, especially with regard to real modes
of behaviour and interaction. The systems school starts from
the premise that the family is the object of observation, and the
interactions the object of intervention (M. Selvini Palazzoli et
al., 1975); therefore it uses a type of setting whose theoretical
model is based on real interactions and hence seeks objectivity
as far as is possible. He who uses a psychoanalytical model on
the other hand, works from a viewpoint that values subjectivity,
using countertransference as a work tool. When a therapist works
in a couple setting a series of wide and complex intersubjective
phenomena are aroused – feelings, phantasies, and thoughts – on
which he is required to reflect. He therefore needs to maintain
a model in which the focus is on intersubjectivity rather than
on behaviour, but which still observes real interactions between
the people who are present. Listening to accounts of dreams and
descriptions of events, he needs to build a series of hypotheses
about the internal worlds of each partner, and constantly shift
attention between his observations and his hypotheses about
their internal organisations.
In psychoanalytic theory the setting is considered the first
and most important factor. It is the framework in which psycho-
analytic practice is enabled to unfold and develop in a logical
way. To briefly recapitulate its history: the reconstructive model,
based on the analysis of the past experience of the patient, privi-
leged a setting that allowed regression and the emergence of
transference. The concept of the analyst as mirror (Freud, 1912)
arose as a result of Freud’s need to give scientific legitimacy to
the theory he was building, and his worry that the analyst could
be influenced by his own subjectivity. However this orienta-
tion often ended up encouraging a cold and detached attitude
in the analyst. With the development of object relations theory,
psychoanalysis shifted from a reconstructive to a constructive
view which is aware of the ‘here and now’ and of intersubjective
relationships. The task of the analyst therefore is not only to
 THE THERAPIST AT WORK: TECHNICAL MATTERS 63

maintain the setting, but also to facilitate its emergence. We can

distinguish between the external setting (rules about place, time
and transactions between patient and therapist) and the internal
setting, given by the mental attitude of the analyst, which consti-
tutes the basic logic of the relationship.
While the external setting describes the conditions which
are suitable for events to unfold between analyst and patient,
and which allow the emergence of phantasies, identifications,
defences and emotions, the analyst is the dynamic containing
structure that enables the transformation. So the task of the
therapist is to refine and maintain the mental state that allows
him to listen to the patient and himself and to confront the
pain. It should be noted that this view does not give the frame-
work secondary importance; indeed some authors believe that it
makes it more rigorous and at the same time more problematic
because it is not just given, it is continuously recreated. Thus
Grinberg (1981) maintains the setting has to be recreated at
every session. Recreating and preserving is very different from
automatically following the rules or re-establishing it after rules
have been transgressed. The creation of the setting, which is the
first phase of the therapy, is not only about dictating the meth-
ods and rules to be followed, but also about the patient’s live
emotional experience through which their co-operation in this
process is engaged. We can see how the idea of the mirror-analyst
is fading before the reality of two people reflecting together on
the relationship: ‘a couple engaged on a developmental task
that is based on containing and transforming the emotional
exchanges’ (Zavattini, 1988).

The internal setting and the ‘couple state of mind’

It is necessary to be precise about the specific mental orienta-

tion required for work with couples: that is, to be suitable for
containing both the respective partners and their relationship.
To recapitulate what has been described in previous chapters:
Dicks’ (1967) hypothesis of ‘unconscious fit’ allows the therapist
to envisage how the internal world of each partner fits with that
of the other, so to work on promoting reciprocity (Vellotti &
64 TALKING WITH COUPLES

Zavattini, 2008). According to Ruszczynksi & Fisher (1995) ‘the

relationship itself ’ is the patient, and the therapist is the guaran-
tor of the dimension shared between the two partners.

FIGURE I: The relationship as the third element

Particularly illuminating is Mary Morgan’s (2001) useful

concept of the ‘couple state of mind’. This is a state which (as
with Klein’s ‘positions’) does not follow a rigidly linear course
of either progression or regression, but fluctuates from one
direction to another. Similar formulations are Colman’s (1993)
concept of ‘marriage as psychological container’; Ruszczynksi’s
(2005) ‘marital triangle’; and the creative relationship as
described by Morgan & Ruszczynksi (1998). Morgan connects
her own theory of the couple state of mind with Britton’s
(1989) ‘third position’, from which a more complex view of the
relationship as a whole may be observed. This is the therapist’s
specific challenge. From the viewpoint of the ‘couple state of
mind’ the therapist can empathise with each partner’s posi-
tion in an intimate relationship, whilst remaining sufficiently
outside to reflect on the relationship itself. The couple state of
mind is also the necessary condition in each partner for their
relationship to function – to think as a unit whilst respecting
their separateness. In some couples this may never have suffi-
ciently developed; in others it may have become temporarily
lost, as can happen in transitional or stressful times such as the
birth of a child, adolescent changes, moving house, illness, or
mourning – events that might put at risk a weak or insuffi-
ciently mature couple state of mind. So when this state of mind
 THE THERAPIST AT WORK: TECHNICAL MATTERS 65

does not exist in the couple, it is the aim of the therapy to help
try to establish and support it.
When couples come to therapy it is usually because they feel
the lack of this third dimension, and they hope unconsciously
that it may be found in the person of the therapist. They seek
for a figure who is objective and who can help the partners to
see each other and, at the same time, represent the relationship
itself. It is very important in the evaluation of a couple if the idea
of ‘us’ is present, as something added to each of their subjectivi-
ties, and to note whether this is felt to be an enrichment or a
threat to the individuals. There are other couples, such as the
following one, in which the idea of a couple does not exist; they
demand of the therapist that he or she settle their arguments
and it is very difficult to show that it is not just about arbitra-
tion. It is important to notice if what one person says is taken
into account by the other, or if the capacity to listen is blocked
off. For example a rationale on the lines of ‘what she does’ or
‘what he does’ indicates a linear causal link rather than a trian-
gular or circular one, both of which acknowledge a wider system
of causality in which all the elements modify or influence one
another. The term ‘circular causality’ is derived from systems
theory, and refers to the continual reciprocal influences between
partners that affect the ground of all their relational transactions.
We will now look at the cases of two couples: one of them
approaching a couple state of mind, and the other in whom it
is absent.

Couple A
Mr and Mrs A got to know each other as teenagers. When they
come to therapy they are 35 and 40 years old and have a child of
seven. Mrs A says she asked for therapy because she wants to ‘do
anything that is possible to save their marriage in crisis’. Mr A
says he resists the idea of psychological treatment but has come
in order to please her. From these opening statements we see
that for both, the relationship is present as a reality; the marriage
is in crisis but they both believe it is possible to do something
for it. It is the wife who proposes, but the husband accepts her
66 TALKING WITH COUPLES

proposal and follows her. They say that their difficulties arise
because they can’t agree on anything. They have found a method
to not confront the problem: first they do what he proposes,
then next time they do what she proposes. In this way they avoid
confronting the real issues. Mr A hates discussions because they
make him anxious. Mrs A feels him to be distant because they
never discuss. She needs some response from him to feel she is
part of his consideration. She would rather he criticised her so
then the situation could be improved. The strategy they have
adopted creates a precarious equilibrium in which they would
like to find a meeting point but are not able to do so. So Mr and
Mrs A are looking for a more than individualistic aspect in their
relationship. Both of them understand that the relationship is a
third entity and that they can contribute to make it work, but
they both find it inaccessible. When they talk about one another
they often use the word ‘different’.

Couple B
The case of Mr and Mrs B is very different. They have much
more difficulty in accessing a couple state of mind. They are
middle-aged, have been married for 25 years, and have a teenage
son. Their relationship after a series of difficulties has entered a
state of crisis. They decided to separate, but after getting a legal
separation they have nonetheless continued to live together for
logistical reasons.
After a while Mrs B observed some signs in her husband that
made her think of trying again; he agreed and thus they came to
therapy. One thing that led to their separation was their son; he
was a rebel and liked to disobey all their rules. Over him their
differences regarding educational methods emerged. Mrs B
explained the son was very aggressive toward her and she accused
her husband of ignoring it. Mr B says this is not true, she is too
rigid. They argue a lot about educational methods, criticising
and blaming one another harshly. They cannot understand how
the other does not agree with matters that to them appear obvi-
ous. Indeed they seem unable to believe that any opinion other
than their own could even exist. Both appear disappointed in
 THE THERAPIST AT WORK: TECHNICAL MATTERS 67

one another. When Mrs B used to recount the son’s misdeeds

not only did she feel misunderstood and unsupported by her
husband but she also felt he did not even believe her. He felt
offended because his wife used to assert that her father would
never have permitted this kind of behaviour and therefore he
felt humiliated. Both insist all their difficulties result from the
other, and their happiness depends on the changes they desire.
This is an example of there being no ‘couple state of mind’.
They don’t have the idea that the relationship is an entity in
itself. They don’t think in terms of circular causality, that is, that
what they say influences the other and has an impact on the
other’s way of behaving. Their need for a guarantor, a third party,
takes the form of looking for a judge. The sessions are invaded
by aggressiveness and neither knows how to control their own.
Mr B’s aggression is not direct but is delegated to his son. The
therapist feels she is expected to put order into this confused
situation, contain all this aggression, whilst trying to reflect on
the relationship and establish in herself a couple state of mind.
The couple state of mind is what helps the therapist to
confront the pressures that induce collusion – as, for example,
when one of the partners tries to give the therapist information
that they are trying to keep secret from the other; this happens
very frequently, but focussing on the setting, both psychological
and formal, has a surprising effect on the couple, as it demon-
strates the therapist’s attempt not to collude with either party
and his or her ability to keep within his mind a space for the
other even whilst engaged with one (Morgan, 2001).
In the previous chapter describing the triangular space and
how the relationship is built as a third entity alongside the two
partners, we have seen how the healthy relationship can be
represented by an equilateral triangle, an unbalanced relation-
ship by a scalene triangle, and in some cases it can be consid-
ered a non-relationship (–R) and therefore be represented by
an upside-down equilateral triangle. I would now like to point
out some different ways in which the unbalanced (scalene) rela-
tionship may appear in clinical practice. It is by examining the
countertransference that the therapist can ask himself to what
extent he can maintain an equilateral state of mind, paying equal
68 TALKING WITH COUPLES

attention to both partners and to the relationship, or whether

he cannot do this and therefore his transference becomes biased
(‘scalenised’). A slight bias during a session can be considered
normal. In fact it is important for empathy that the therapist
can be permeated by the projections and therefore lean towards
one or other of the partners. This can happen in different ways.
Some are easier to identify than others: for example, the subject
of the session might lead one of the partners to talk more than
the other; if this happens it is important to highlight with a
comment what is happening. The scalenisation may happen in
less objectifiable ways, more related to the countertransference.
The therapist may sympathise with one more than the other,
feel one is more credible than the other, or have difficulties with
one or the other, or might be able to create hypothesis of the
internal world, the reasons, and the objects that organise the
internal world of one in particular. It is the partners themselves
that create this imbalance, for example by trying to shift the
attention of the therapist or by trying to make him feel he hasn’t
understood anything, marginalising him, or inducing the thera-
pist to act, or to have specific desires that he wants fulfilled.
When these things happen it is important that the thera-
pist ask himself if a scalene configuration is being created, if
his mind has been captured by one of the partners. We believe
these facts need to be read in terms of empathy which means in
terms of communication and enable us to reflect on the state of
mind and atmosphere of the session.
We will go back to Mr and Mrs B to illustrate the concepts
of equilaterality and of scalenisation, adding some features of
their personal history. The father of Mrs B is a strong man with
strong emotions but also sexist and a bully. The mother of Mrs
B is subjugated and Mrs B always thought she didn’t want to
be like her; although she had many quarrels with her father she
always valued him. Her mother was so upset by the crisis in the
daughter’s marriage she even tried to kill herself. For a long time
she was severely ill, in danger of death, and is even now bear-
ing the consequences. It was at that point that Mrs B felt the
husband still had some feelings towards here, and this was why
she proposed to him that they try again; on the other hand she
 THE THERAPIST AT WORK: TECHNICAL MATTERS 69

is very scared and does not want to put trust in him and then be
disappointed again. Mr B has a brother two years younger than
him; when he was born Mr B was sent to stay with his aunt.
During one session, Mrs B started again to give the reasons
for her unhappiness: the husband always pretended not to see
the behaviour of the son and she was not supported. Mr B again
says it is not true, and that he simply felt her educational meth-
ods were mistaken. He blamed her for insisting too much, being
too aggressive with the son, and says he had warned her that the
boy wouldn’t tolerate this. He related an episode that he believed
showed the beginning of the breakdown between mother and
son: one day whilst the son was ‘chatting’ on the computer she
gave him a slap, and Mr B still remembers the son’s scream.
The therapist feels shocked. She says he must have felt very
scared by his wife’s violent action. Mrs B changes the subject,
and in a monotone she starts on the same recriminations. The
therapist at this point sympathised with the husband; inside, she
felt he was right, and realises she had internally scalenised, and
she questions herself: is a personal comment towards one of the
partners acceptable? It would be important that such a comment
be balanced by a comment towards the other. This is why she
tries to recover the situation by sympathising with the suffering
of Mrs B; she addresses her saying it must be really difficult for
her to think back on that episode. Mrs B says she had been so
stressed that evening – she had gone out in the car, imagined
she had bumped into something, and came back in a state not
entirely normal. At this point we believe she is getting more in
contact with her internal world, and the equilateral approach of
the therapist allows her to keep both partners in mind and not
collude with one of them.
In the session just depicted we can see how the re-balancing
of equilateral behaviour on the part of the therapist after slight
distortion has allowed Mrs B to develop her own reflective
capacities.
We agree with Morgan (2001) who believes the couple state
of mind is necessary even during brief consultations because it
is the only containing factor that exists before the relationship
with the therapist has formed. We suggest that the couple state
70 TALKING WITH COUPLES

of mind should continue throughout the therapy. The interpre-

tations of the relationship that will be given later on (see the
paragraph on joint interpretation) will be affected by the mental
state of the therapist as he tries to understand what are the joint
anxieties and unconscious phantasies.

The external setting

We have arrived now at what is usually referred to as the ‘setting’

but which we prefer to call ‘external setting’. In couple therapy
this will be in continuous dialogue with the internal setting of
the therapist, namely his couple state of mind. Such a scenario
can only be formed in the presence of a neutral external figure.
Some of the variables integral to couple therapy are: stability;
frequency and length of sessions; seeing the couple together; and
the number of therapists.

Stability
We already know the reasons for stability in the individual ther-
apy setting. In couple therapy too, the guarantee of regularity in
the variables provides containment and an opportunity to talk
about feelings. We also need to be aware that the development
of a couple state of mind within our patients requires a lot of
work, and in trying to achieve this one encounters many difficul-
ties and resistances. For this reason the therapist will often have
recourse to imposing a stricter type of setting than that in indi-
vidual therapy, in order to enable the regulation of exchanges
and reflections, as in the previous example.
In one session, after an initial prolonged silence, Mr B said
with a lot of self-control that he didn’t have anything important
to say and it was just the usual things. After a while he became
irritated, said he couldn’t be bothered anymore, the therapy was
useless, and he didn’t want to live like this any more. All this
because of a load of rubbish he left in a box! His wife had wanted
him to apologise and admit his mistake in front of their son.
After this outburst he got up and asked the therapist to
prepare the bill for next time. The therapist felt very disturbed
 THE THERAPIST AT WORK: TECHNICAL MATTERS 71

and said she would wait for them. Meanwhile the wife too got
up, grumbling.
The couple often test the therapist’s patience in this way.
A great effort of containment is needed to stop the situation
from degenerating as it is here. One might think that in order
to re-establish channels of communication, the therapist should
have said ‘I understand your need to deposit somewhere all the
ugly stuff you have accumulated throughout the marriage, and
you’d feel better if someone else took on the burden. However
these problems will always be there if they are not confronted.’
As mentioned earlier, argument between the couple during the
session constitutes an attack on the analyst’s ability to think: she
therefore needs first to re-establish the possibility of communica-
tion, and then will be able to deal with the negative transference.

Frequency and length of sessions

Usually the frequency of sessions is weekly and the ideal length
is 70–75 minutes, a time which is considered sufficient for both
partners to express themselves but without accumulating more
material than it is possible to discuss in one session.
In the model that we follow the ‘here and now’ and the
matter of mental states and the emotions that circulate during
the session are more important than attention to the internal
worlds of one or other partner. There is less possibility of reach-
ing the deep symbolic material than in individual therapy,
because what is of prime importance is the concrete unfolding
of relational facts during the session. Later we will go in more
depth into how couple therapy finds its base in countertransfer-
ence, moderate interpretation, and its gradual elaboration. The
therapist’s mental state differs from that of the classic listening
position, since this could hinder the chance of allowing circular-
ity (mutual influences) to arise within the equilaterality.

Joint sessions
We have already seen that in work conducted at the Tavistock
Clinic, couples have in the past been dealt with separately,
and only more recently has the joint session model been used
72 TALKING WITH COUPLES

by the Marital Studies Institute (now the Centre for Couple

Relationships). In the early 1950s the joint session was consid-
ered risky and described by Balint as inducing an ‘explosive situa-
tion’. Nevertheless Dicks experimented with joint couple sessions
and described methods and objectives. The joint session allows
us to confront in a more direct way the divisions between the
couple and to reconstitute them. On top of that if there are two
therapists they may be seen as co-therapist, meaning a couple
that invites symbolisation at an unconscious level of the internal
parental couple (Fisher, 1999). Fisher asserts it is important to
give each partner the ability to unify in reality all their divisions
and contradictions. Naturally the joint session does not deter-
mine this in itself, but we know that when all the split parts of the
self are recognised and named, anxiety diminishes.
Moving to the practice of joint sessions also meant a shift in the
theoretical model. We believe that this option allows us to under-
stand contemporaneously the presence of both real partners, but
also, their presence in the mind of the other, and the relationship
itself, which is the real object of the therapeutical work.
Given this, it is an interesting question whether one always
has to see the couple together. What would happen if the part-
ners were seen separately, or if only one of them turned up to
the session?

Couple C
Mr and Mrs C came to therapy at the suggestion of the thera-
pist of their ten year old daughter (the girl has difficulty relating
to her peers). Mrs C has a collaborative demeanour but very
formal such that the therapist finds it essentially defensive and
devaluing. Mr C seems bland and clumsy, talks little and stutters
when he does speak. It was a great effort for them to come to
talk about their marital crisis. They both had other relationships
though at first they do not talk about these. In the past, Mr C
had had a confrontation with his own mother when he had a
relationship with a girl of whom she did not approve; he even
thought of leaving home. At that point he had begun to confide
in his present wife and slowly this relationship had taken over.
 THE THERAPIST AT WORK: TECHNICAL MATTERS 73

When their daughter was two she was the victim of an

accident; though both parents were present they were unable
to prevent it, and both felt guilty though there is no objective
justification for this. There are now no lasting physical conse-
quences but the trauma of the past event has endured. After it
Mrs C fell into a light depression and became distanced from her
husband. She locked herself in her room and cried; Mr C did
not understand what was going on and started to confide in a
female colleague. So we have Mr C as an ‘absent’ father, and Mrs
C as an efficient and domineering mother. When they speak of
the girl’s school, Mrs C criticises the teachers, holding as a model
in her head the example of her mother who was a teacher, always
very busy preparing lessons and always showing her own daugh-
ter what she was going to do in class. Mrs C, trapped by her
picture of a narcissistic faultless attentive mother, is oppressed by
the idea that she was not sufficiently alert with her own daugh-
ter, and seems persecuted by this hypercritical internal object.
Mr C, who has difficulties with this type of female figure, turns
to another type, escaping into an adolescent mental state very
far from that of a couple: threatening to leave, attacking the
relationship searching indirectly for revenge. As much as Mrs C
shifts towards parenthood, Mr C shifts to childish attitudes and
behaviour.
At the fourth meeting, after the therapist had said she was
prepared to offer therapy to the couple, though had not yet
explained all the aspects of the setting including that of the joint
session, Mr C arrived for the appointment, more lively than usual.
He says his wife is not very well, has flu, and it is better to have
some sessions by himself so the therapist can understand certain
things better. He can’t say everything while his wife is present. He
also thinks the wife might need this type of session. Unexpectedly
he starts to talk incessantly, first about the relationship with the
colleague – which never turned into an affair – and now they are
just friends. However there had been other women ‘even a little
harem’ as he puts it, and he talks about them in a scattered way
for a long time, ‘like a teenager’ he says; he talks of confidences,
intimacy, attraction, but not actually sexual consummation. His
wife had been very jealous of some of these women.
74 TALKING WITH COUPLES

With this couple, we are faced with an unconscious agreement

that Mr C always uses the same mechanism: when he has diffi-
culty with a woman (the first girlfriend, the ill wife) he substitutes
by finding another – the colleague, the therapist. If this is Mr
C’s way of attacking the couple relationship, Mrs C does it by
falling ill, undermining the proposition of therapy by removing
herself from it. Mrs C is involved in the triad of mother, herself,
daughter; this is why she desexualises herself and removes herself
from the couple relationship. Mr C tries to re-involve her but
through provocation. He tries to re-sexualise her by means of
arousing jealousy. He attacks the therapy as well, by trapping the
therapist in a secret confidence that unbalances the equilateral
setting because this means there is an a certain psychic reality
shared between them that the therapist cannot use.
In order to defend the therapeutical project and not collude
with the patients’ attempts to distract it, we think it is best to
avoid having sessions with only one partner. If only one arrives,
it is a good idea to sit them down, apologise about not having
been clear about the working method, explain why the session
is joint, then send them away. Only later can one see how to
get to interpret these negative aspects of their unconscious fit.
In the first instance it is necessary not to collude in attempts
to undermine the therapeutic dynamics, and instead to redirect
focus towards the couple relationship as an entity.

One or two therapists?

Both options are possible; but they build two different scenarios.
The two-therapist option is particularly complex because many
relationships intertwine: the transference between the members
of the couple, and that to the therapists, which will deepen. The
therapists will have to be aware of all these inter-relationships.
The two therapists need to be able to work well together, discuss
each session afterwards, confront reciprocal feelings, analysing
their respective countertransference; at the same time it allows
them to explore better the multiple aspects of the couple rela-
tionship via the game of identification and criss-crossed transfer-
ences. The variable that is linked to the gender of the therapists
 THE THERAPIST AT WORK: TECHNICAL MATTERS 75

is significant, because it affects identification, alliances, sense of

exclusion, and highlights more the dynamics between the part-
ners; and of course it has a heavier role when there are two thera-
pists, so it is best if one therapist is male and the other female.
Various different situations can emerge and manifest themselves.
A patient for example may seek an alliance with the therapist of
the same gender, seeking for support through gender identity.
Another may seek an alliance with the therapist of the opposite
sex, relying on an oedipal situation. Or the two partners can
create a solidarity between them in a kind of teenage opposi-
tion to the couple of parental therapists. All this may allow the
therapists to understand better the patients and their couple
organisation.

The transference

The literature on couple psychoanalytical psychology which has

stressed that the fit between internal worlds can be considered a
type of natural transference refers tot eh gheory of object rela-
tions (D. & J. Scharff, 1991; Ruszczynski & Fisher, 1995; Fisher,
1999). From these studies one deduces that the transference
between the members of the couple is a crucial and particularly
complex matter with which the therapist has to deal.
This requires a big shift from work with individuals. While
the individual patient brings to the session a representation of
their partner, and of themselves in relation to the partner, these
two dimensions slowly slide into the transference relationship
with the therapist.
The couple also brings their couple transference. So there are
two types of transference: the couple transference (the uncon-
scious fit between partners) and the transference onto the thera-
pist or therapist-couple that emerges during the session.
To understand this it is helpful to envisage a vertical dimen-
sion (the organisation of each partner’s internal world) and a
horizontal dimension (how the expectations of one fit with the
expectations of the other). As we saw in Chapter 2, in their
choice of partner, each seeks to match their own internal world;
this is what constitutes the couple transference. Understanding
76 TALKING WITH COUPLES

the couple transference therefore means to have a working

hypothesis not only of the relationship but also of its respon-
siveness, meaning, how the internal world of one partner tunes
into and makes contact with the internal world of the other.
The therapist’s couple state of mind involves thinking in terms
of circular rather than linear causality. It is different from indi-
vidual therapy and allows him to confront the partners’ couple
transference.
The Scharffs (1991) refer to the differences that Winnicott
describes between mother–environment and mother–object;
they talk about ‘contextual transference’ as a sustaining struc-
ture, and about ‘focal transference’ to that particular therapist
– the latter being what Norsa & Zavattini (1997) call ‘differenti-
ated transference’. The contextual transference aroused by the
setting is the response of the patients to the encounter with the
therapist, a person offering help, and has to do with availability
more than with unconscious resistance. The focal transference
concerns the relationship with that particular therapist. Both
types of transference include trust, idealisation, hopes, fears,
and distrust. They can be harmonious when the partners share
the same feeling, or disturbed when the partners have different
feelings.
One also needs to specify that within the transference to the
therapist will be found both the individual transference from
each partner, and the transference that they place on it as a
couple, in relation to the function of the therapist as a shared
object (Eiguer, 1996). In this case each partner can be a carrier
of one of the different aspects of the transference especially when
this is imbued with ambivalence (Monguzzi, 2010). In fact the
couple becomes a unified psychic organisation, an intermediate
space between the partners for shared phantasies, feelings, needs,
defences, and they redistribute all these mental contents through
their reciprocal projective identifications.
It can happen therefore that if two aspects of the couple’s
psychic organisation are in conflict, one becomes the prerogative
of one of the partners, and the other, the prerogative of the other
partner. The two partners become representatives of two differ-
ent aspects of their unconscious fit or collusion.
 THE THERAPIST AT WORK: TECHNICAL MATTERS 77

The transference to the therapist can include some very entan-

gled intertwinings. Norsa and Zavattini (1997) have referred to
dyads and triads of possible collusions, and to configurations in
which one or both therapists are cut out of the conversation, or
one of the two partners is marginalised.
The concept of ‘field’ comes in here, being the way in which
the organisation of the couple makes contact with the organ-
isation of the setting constructed by the therapist and there-
fore with the therapist’s couple mental state of mind. Bezoari
and Ferro (1991) have proposed the oscillatory nature of the
transference relationship. In a new experience the transference
does not merely repeat predetermined patterns induced by
unconscious phantasies and projective identification. The field
approach amplifies the psychoanalytic perspective from a study
of contents to a study of the transformational potential of the
analytical environment. In the session, the therapist listens to
the various interventions, reflects on his own, and asks what
is the general direction and what underlying psychoanalytical
object is organising the exchanges between the participants.
Post-Bionian authors such as Ferro and Ogden see the characters
who are described in the session neither as realistic ones from the
past, nor solely as internal objects or part-objects, but as created
by the dreamlike contact between the analyst and analysand –
the latter, in the case of couple therapy, being the relationship
between the partners.
In synthesis: during the session the couple transference and
the transference to the therapist intertwine continuously. The
therapist needs to distinguish them only for clarity. The couple
psychotherapist does not work solely with the couple transfer-
ence which is always a construction; he works rather with the
way this mixes with the transference to the therapist, and with
their present relationship with him. He needs to ask himself
how each partner reacts to the first psychoanalytic object that
emerges, and how he himself feels in his countertransference, so
he can understand what is the dominant feature of the session,
its ‘atmosphere’, organising all its phenomenology. Hypotheses
are constructed not only about the individuals’ internal worlds
and their interaction, but about the dynamics of the new field
78 TALKING WITH COUPLES

that is created by the meeting of their couple ‘organiser’ and the

setting given by the analyst.
To illustrate how the couple transference onto the therapist
may manifest itself, I will return to the example of Couple A.
A short while into the course of the therapy, a very difficult
question for them to confront emerges. Mrs A talks about how
he masturbates; he has always done it, but now she can’t stand it
any more. Before, she thought it was her fault and she was not
sufficiently sexually available; then she though this was not the
case because he assured her she had nothing to do with it. Mr A
says everyone does it and it has nothing to do with their relation-
ship and he doesn’t understand why it disturbs her so much.
So we can see how here is a situation in which the woman
does not feel acknowledged by the husband and feels neglected,
while the husband feels controlled by her. We know from their
personal histories that they both had a difficult relationship with
their own mothers. Mrs A was born a year after the death of a
little sister. Her life’s experience was that of feeling a substitute
child, always filling the vacuum. She never felt loved by her
mother who always remembered with nostalgia and regret the
perfection of the other daughter. Mr A has an authoritarian and
controlling mother which he suffered; as a teenager he rebelled
but there were terrible quarrels, after which his mother would
not speak to him for days on end. She was jealous of the girls
with whom he had relationships. Both fathers (of Mr and Mrs
A) left the protagonist’s role to their wives and leaned on them.
Both Mr and Mrs A relive in their couple relationship
the bad relationship with their mothers. Mrs A finds it in the
husband’s masturbation and lack of interest in her and feels
mortified. Mr A projects on the wife a controlling figure and his
masturbation signifies his assertion of his autonomy, to extract
himself from domination and redeem his independence. Both
would like their partner to offer them a different experience
from one which they are unable to work through and which
leaves them feeling wounded and powerless. Mrs A would
like to feel interest and appreciation; Mr A would like to feel
respected in his autonomy. This is what their couple transfer-
ence consists of, which also determines their unconscious fit.
 THE THERAPIST AT WORK: TECHNICAL MATTERS 79

At one session, they arrive punctually and are immediately

invited into the room. Mr A says, ‘You don’t even let us go
to the toilet.’ From this we see how Mr A projects onto the
therapist the controlling figure of his mother, against whom
he feels the need to retaliate, in order to carve an intimate
and private space. He fears the therapist might prevent this
(she does not allow him to go to the toilet) and he wants to
assert the legitimacy of his need. We notice also that he speaks
in the plural (‘us’). He involves the wife, asking her to be his
ally and to leave this authoritarian figure outside the couple.
This happened even more clearly at another time. One day the
therapist heard them laughing in the waiting room. When they
enter, happy and relaxed, they say they were asking themselves
what homework they were supposed to do: ‘Well they haven’t
done it!’ The therapist observes how they find togetherness
and complicity, happiness, only when in a teenage frame of
mind: having projected onto her the role of authority figure,
they feel liberated. For the therapist it is therefore necessary
to live with a relationship in which, although accepting the
role given her of castrating and mortifying maternal figure, she
somehow has to transform the role into one that is encouraging
and appreciative.

Interpretations and other interventions

The therapeutic work with couples can include interventions at

various levels. Some may be more direct, to facilitate and main-
tain the logic of the setting, as described above. Or there may
be interpretations on deeper aspects. Interpretations themselves
should be divided into those which are about the needs, rela-
tions, internal objects of one or other of the partners; and those
that refer to the joint phantasy logic of the couple in terms of
their unconscious fit or collusion.

The transformative function of the setting

As we have seen, the joint setting creates a shared physical and
mental space for the couple’s relationship in the presence of a
80 TALKING WITH COUPLES

therapist with a couple state of mind and equilateral mental

aspect. All this creates a containment that makes thinkable and
communicable the emotions that are aroused. At first, and for a
while, the therapist will limit him or herself to guaranteeing this
setting, taking care of the marital triangle created by the couple
and their relationship (Ruszczynski, 2005).
In the case of Mr and Mrs B, for example: this couple came
to therapy after a legal separation. They had therefore tried with
a judge and court to find a container for their emotional emer-
gency and to find an intermediary who could give some guaran-
tee of protection from which they could tackle and resolve their
mutual aggressiveness. For couples like this with a really disturbed
relationship with sparse means of working through it, and with
whom it is not possible to reach high levels of symbolisation, it
is necessary to confront the most primal toxic contents. In such
cases it is already a big achievement to re-establish equilaterality,
a non-biased perspective, and to draw attention to circularity, to
mutual causation.

Confrontation or comment
Demonstrating circularity of behaviour is the first stage in
therapy, and the only one possible in cases such as this. To inter-
pret more directly any feature of either partner’s internal world
may be too precocious an approach to the intersubjective aspect
underlying the interaction. Often the therapist’s function is to
regulate the conversation so they contribute in turns, even if
(as we have seen) it means that he needs to be more directo-
rial and take charge of the orchestration of the shared space. He
allows both partners to express their own rationale, and creates a
context for better communication. In theoretical terms, this type
of structure emphasises the function of containment, facilitating
the development of premises for a reflective function (Allen &
Fonagy, 2006). Fundamental milestones for this development
are: the ability to observe the effect of one’s own behaviour and
subjectivity on the other, and observation of the circularity of
actions with their opposing reactions. This helps the growth of
a capacity to look from the outside at what is happening within
 THE THERAPIST AT WORK: TECHNICAL MATTERS 81

the relationship. It favours the highest level of symbolisation

possible at that moment for that couple.

Interpretation
The question of interpretation, even before being a matter of
technique, is a matter of how one sees the nature of interpreta-
tion. This is what inspires us to read in a particular way the
quality of the exchanges in the session and then to adopt an
appropriate technique.
To recapitulate: the classic or reconstructive view of inter-
pretation sees unconscious fit as the meeting point of two fixa-
tions or unresolved elements from the past that re-emerge in the
present. It is also the theory most commonly used (Castellano,
Velotti, & Zavattini, 2010; Zavattini, 2010). The other tradi-
tional view, followed especially in the 1960s and 1970s, consid-
ers that concord may fail owing to disappointment when one
partner does not match up to an idealised projection of the
other’s own personal history, or finds themselves the receptacle
of a rejected part of the self projected into them, not at an
intrapsychic level but at an interpersonal level. Both these lines
of interpretation are limited by being reconstructive: the pres-
ent unconscious fit occurs as a result of unresolved elements
from the past.
In the intersubjective model, unconscious fit is not fully
explained by history but depends on the ‘here and now’ of
the present relationship. As Bowlby (1988) said, the modes
of internal operation constructed by childhood history are
reprocessed throughout life, especially in less pathological
situations, not just in infancy but through adolescence, and
not just with other caregivers (parents, teachers, family) but
with other significant relationships. We believe that in fact
everyone uses their relationships with others to re-set their
internal organisation, and that the individual’s present mode
of internal operation is based partly on past history and partly
on the present. Memory is not archival as Freud thought but is
continually reprocessed with each new experience (Zavattini,
Pace, Santona, 2010).
82 TALKING WITH COUPLES

So a couple that comes to therapy is at least partially aware

that their project is in crisis and they have not been able to resolve
sufficiently the defects of their personal history. Their previous
significant relationships can be considered as testing grounds
but each relationship is different, including that of the therapy.
From the therapist’s point of view, having an interest in what
each patient has learned from each relationship helps to access
the script which is created from the encounter of two internal
worlds but does not explain completely the present meaning of
the relationship (Velotti & Zavattini, 2008).
Further, Rudzinsky’s proposal that the patient is the relation-
ship itself rather than either or both of the individuals involved
(Rudzinsky & Fisher, 1995) brings out the vertical and horizon-
tal dimensions of this interpretative model (see figure below).
The horizontal dimension represents the organisation of the self
within the couple – how the internal of one fits with the internal
world of the other. Norsa and Zavattini (1997), following this
model, have distinguished between ‘differentiating interpreta-
tions’ and ‘joint interpretation’. Differentiating interpretations
refer to the part-identifications of each partner and risk reducing
the problems to influences from the past. Joint interpretations,
discussed below, focus on the relationship as it presents itself in
the session.

FIGURE 2: Vertical and horizontal dimensions

Essentially when one positions the relationship as the object

of interpretation, one can investigate the collusion and the shared
aspects, but without sacrificing the more individual aspects. The
 THE THERAPIST AT WORK: TECHNICAL MATTERS 83

interpretation should privilege the horizontal but not exclude

the vertical, that is, what one is projecting onto the other. Thus
there should never be any session where only one partner is pres-
ent as this would not favour circularity and equilaterality.

Joint interpretations
This method consists in seeking for the couple’s ‘organising
theme’ or ‘shared internal object’ (Norsa & Zavattini, 1997).
Being together produces a new reality and a new subject, the
relationship itself, which becomes the patient. The field model
is relevant here. As in individual therapy, in couple therapy the
aim is to mobilise the field and as a consequence to reactivate the
paralysed projective and introjective processes which lie behind
the suffering (Neri, 2007). This experience allows the circula-
tion of emotional states, affections, thoughts, and characters,
with the analyst who is also in the field, and who guarantees and
safeguards the setting; this promotes a thinking activity in both
patients and therapist.
For all the analyst’s perceptions can be communicated either
as observations or, through reverie, transformed into images or
narratives (Ferro, 2005). The latter may be considered as being
in a sense beyond interpretation, but rather, show the analyst as
a dynamic element in the space built by identifications between
characters.
According to Ferro (2006, 2007, 2020) the analytical jour-
ney offers a space in which whatever the analytical couple
brings to it finds welcome. Development happens through
micro-experiences of being on the same wavelength rather than
by decodifying interpretations. The function is to create a new
transformative relation. Ferro talks of ‘co-narrative transforma-
tion’, dialogic co-operation, referring to the way in which the
therapist engages with the patient’s discourse rather than simply
commenting on it from outside. Excessive precision and detail
may block the process.
However many couples in fact bring to the session very
mundane concerns, so that even before thinking of a transforma-
tive therapeutic relationship, we have to think of an earlier phase
84 TALKING WITH COUPLES

in which a container is formed which can confront evacuative

necessities, tolerate tensions and excesses, and allow the experi-
ence of a welcoming space (Bolognini, 2008). As in individual
therapeutic work, containment is expressed first of all by shar-
ing the meaning that appears in the patient’s communication.
The fact of being able to perceive and share the meaning leads
to more trustful communications with the therapist. In couple
therapy this occurs through the equilateral receptive function,
which means conflict within the relationship may diminish and
reflective capacity may be increased.
We can imagine the couple as an ensemble in which in some
cases the splitting and projection allots to each partner an aspect
of the couple’s mental functioning. No matter who expresses
it, the couple can evacuate in this way emotions which are
uncontainable, in the form of acting out (Santona & Zavattini,
2008). As previously suggested, one of the reasons for doing
joint couple therapy is to confront differences: to try to rebal-
ance the splitting through which each person is glued to just
one point of view. In this way emotional communication will
be re-established, split parts will be reappropriated, and ambiva-
lence and contradictions will be confronted. What one sees all
the time is the therapist containing primitive or split emotions
that are felt to be too aggressive or dangerous for the relation-
ship to acknowledge. When the relationship disappoints this
expectation of containment, the therapy then becomes the place
that offers an opportunity to receive unwanted emotions; this is
necessary for transformation.
Mr and Mrs C, whom we talked about earlier, argue about
the mess in their house. They relate this in a strongly contrast-
ing yet collusive manner. Mrs C has not yet unpacked boxes
from their move to that house, and in addition is always making
new purchases in the hope of renovating but is unable to get
rid of anything. Mr C too is always buying abundant quantities
of various items and in order to clear up he seals everything in
plastic bags that he accumulates in piles. They both forget what
they have put away and where, and both seem unable to use the
gadgets they have acquired, and ask the therapist to convince
the other to change their ways. The therapist thinks about the
 THE THERAPIST AT WORK: TECHNICAL MATTERS 85

difficulty of understanding emotional experiences that have

accumulated in a messy way and which they cannot transform,
like the objects in the house. If they both have difficulty in
putting things in order, and experience each other as an invasion
in their personal sphere, they at the same time find an accom-
plice in each other in the process of making the house unlivable
in so they are unable to enjoy the things that they have.
In the preceding session, the therapist had a sudden emer-
gency and was unable to let the patients know as they had
already left. When she phoned in the evening, Mrs C was glad
to hear from her as she had been worried. She said they had not
gone to the session because they had forgotten. She said ‘actually
they had even forgotten to take their child to her therapist, and
this is even worse!’ In the next session, they again blamed each
other for the messy accumulation of objects that they buy. Mrs
C understands it all needs to be put in order, but she has to
re-examine each object one by one, but Mr C refuses to help her
because he sees this method as too time-consuming. He thinks
everything should just be thrown away and complains there are
hundreds of boxes. Mrs C says the boxes are hers, but the plastic
bags are his.
They continue this exchange of accusations, while the thera-
pist reflects these inanimate characters that are so burdensome
and yet nameless are impossible to deal with. She also thinks
about her own function as a form of environment officer, who
tries to declutter and create boundaries of thought in which
names can be given to confused and unrecognised emotions. At
this point she stops them by saying that what they want her
to do is to be a referee in a situation they find confusing; each
attributes to the other things that they cannot recognise in them-
selves. Maybe what they are saying is that they feel they have
cluttering emotional experiences, with which they have difficulty
and which they cannot reorganise. They need to understand
what is whose. They feel invaded by each others’ boxes and bags.
In the face of the burden and effort and time-consumption of
this reordering work, they would just prefer to throw everything
away. However if one just eliminates things, one has the sensa-
tion of losing something important from one’s self.
86 TALKING WITH COUPLES

Mrs C responds that it is easier to order more recent stuff,

since one remembers what is in the containers. Amongst all the
intervention possibilities the therapist chose to focus on that
of internal objects, the joint interpretation of unconscious fit,
and the role that Mr and Mrs C have assigned her. However
this attempt to try to dig for deeper symbolic material is not
accepted; Mr and Mrs C find it hard to understand the symbol-
ism of their boxes and bags.
The therapist tries to stay within the here and now of the
field, acknowledging Mrs C’s last observation. She asks, what
have they done with what they felt the previous week when
they did not find her at the session at their appointment. She
observes that because they don’t talk about it, maybe they have
closed this episode in a box or a bag. Mrs C responds promptly,
shifting the discussion onto her own forgetfulness, referring to
the time when they forgot to take their daughter to her analyst.
After that however she declares she was very worried, since
usually the therapist is very precise and she must have had a
setback; she even starts to talk about the possibility of an acci-
dent. The therapist says maybe the thought of an accident was
too much, so at first she just thought of a setback. But another
thought was more painful: that she might have forgotten. She
talks of her own forgetfulness, but maybe is thinking that even
the therapist might have forgotten. Mrs C acknowledges this.
But then she felt relieved, thinking it was not so bad and the
therapist was human and could also make a mistake. Mr C says
he did not believe the therapist could have forgotten, he only
imagined an accident and that perhaps she was dead, as she had
not even phoned. But when she phoned he was relieved so he no
longer thought about it. The therapist observes that it would be
ideal if everything could be resolved like this: just a phone call
and there’s an end to it. Even the resentment that the therapist
had not even phoned had disappeared (unacknowledged). In
fact however, only had she been dead would they really have
accepted it. (They all laugh even to crying.)
Mrs C said in fact she had managed to get rid of some stuff,
and had put some still new items in boxes for a charity fair run
by a relative. She felt happy as it was true she felt the need to
 THE THERAPIST AT WORK: TECHNICAL MATTERS 87

revitalise things; the relief was so strong one did feel like crying.
That time she had the help of her aunt. She needed the help
of her husband. Mr C replies that he is trying to do something
to help her. After the therapist with her joke demonstrated she
was able to accept their anxiety, the atmosphere became lighter
and something new appeared in the field. Mr and Mrs C passed
from mundane realities to something closer to symbolic narra-
tive, which was liberating. The therapist had not thrown away
the contents of the box and the emotions could be confronted.
Mr and Mrs C had been trying to use one another as container,
blaming one other for not being good enough for that func-
tion. They are invaded by strong emotions that they cannot
process, and the temptation to use one another to evacuate these
emotions has failed. Only the experience of a large, solid, but
flexible container (the therapist) is able to offload the emotional
weight without rancour towards their partner, allowing them
to think that they can perform this decluttering and recycling
operation with the help of the therapist who is not afraid to get
her hands dirty. The final statements of Mr and Mrs C indicate
that they can foresee this possibility at last.

Conclusion

This chapter has considered theory and techniques in the devel-

opment of couple therapy: concluding in particular that it needs
to be based on a specific state of mind in the therapist, the couple
state of mind. This triangular space is what allows the patients,
following the example of the therapist, to feel part of the rela-
tionship yet observe it from outside.
In the studies in this book we find most useful models which
encourage the therapy to move forward experientially in the
field created by the participants, rather than solely unravelling
the past of individual partners, as projected into their choice of
partner in mutual collusion. The focus is on the ‘here and now’
and on the demands of ‘welcoming’ and understanding the
emotions circulating throughout the session. Interpretation in
the traditional sense is only one of the tools available in conduct-
ing the session, and is used sparingly. Every communication
88 TALKING WITH COUPLES

made during the session is in fact relevant to the therapeuti-

cal dynamic. Couple therapy practiced in this way has shifted
from a reconstructive to a constructive model of the process, in
which the relationship between patient(s) and therapist(s) is an
interactive one. As we shall see in the next chapter, emotional
patterns and positions that are implicit but not fully known can
be brought into being within the therapy and new developmen-
tal scenarios can be envisaged.
CHAPTER FIVE

Couple psychoanalysis and

intersubjectivity

Fabio Monguzzi

‘Nemo solus satis sapit [No single person knows enough]’

(Plautus, Miles Gloriosus, 885)

T
his chapter is by way of conclusion and theoreti-
cal summary of our approach to couple therapy as
described in this book, based as it is on developments
in the current psychoanalytical landscape that combine the
relational paradigm (as described by Mitchell, 1988, 2000)
with the intersubjective paradigm (Stolorow & Atwood, 1992;
Stolorow et al., 1994), and that has been defined by some as
‘postmodern’ (Fallone, 2004): that is, that values relativity,
context, the co-existence of different truths, and takes a non-
linear view of progress. This landscape is a fertile one but seems
to have been developed more in individual psychotherapy than
in work with couples, where as we have said, the real patient is
the relationship between the partners.
Because couple therapy specifically manages the unified
psychic processes of both partners, we consider it not merely a

89
90 TALKING WITH COUPLES

format but a genre with its own distinctive characteristics. The

intersubjective school of thought facilitates the definition of
these characteristics, since it focuses on the reciprocal influence
of patient and analyst, and legitimises the role of the analyst in
becoming one of the determinants of psychic change between
the two. It prioritises the increase of containment abilities,
more than the attempt to reintegrate split-off emotions. Couple
therapy based solely on object relations looks at the psychic
complementarity of the partners, their shared internal objects,
and communal phantasies crisscrossing a network of projections
and identifications. The aim is to release the grip of these intru-
sive processes, to reintegrate emotions, and to achieve adequate
psychic separation between the partners (Scharff & Scharff,
1991; Ruszczynski, 1993; Rusczczynski & Fisher, 1995; Norsa
& Zavattini, 1997; Corigliano, 1999). Couple therapy that
embraces an intersubjective model emphasises the management,
regulation, and balancing of feelings, holding them on behalf of
each partner, known as hetero-regulation; it pays less attention
to the degree of separateness and autonomy which is offered by a
stable recognition of the boundaries of self and other (Shaddoc,
2000). In addition to acknowledging the relevance of problems
from the past, the transformative potential of the here and now
is given particular value.

Regulation of emotions within the couple relationship

The recent theoretical models for couple therapy have been influ-
enced by research in the field of child development and inter-
personal relationships. The couple relationship is the emotional
bond most close to childhood relationships, configuring itself
as a new caregiving environment. Early interactive processes
between caretaker and infant are the basis for self–other regula-
tion and for (mutual) hetero-regulation within couple relation-
ships (Beebe & Lachmann, 2002; Clulow, 2007). This important
paradigm for understanding adult relationships supposes that
partners should be able to regulate emotional proximity and
distance, and manage moments of loss of contact that occur
owing to incomprehension or splits; they can create reparational
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 91

strategies to reintroduce harmony and enable continuation of

the relationship (Carli, Cavanna, & Zavattini, 2009). For the
sense of emotional proximity and intimacy partners can experi-
ence seems deeply correlated to functions and mechanisms that
regulate reciprocity in childhood caregiving. The qualities and
nature of dependency, the oscillation between belonging and
separation, the negotiation of differences, all have their first
investigations in this developmental period.
Thus when interpreting a couple’s difficulties in connecting
with one another we need to analyse their emotional understand-
ing and attunement and the quality of reciprocity in the contain-
ment they can offer. We need to put the analysis first in the sense of
being a space where mutual regulation can create an equilibrium
that facilitates developmental processes. In this space emotional
disconnections and unregulated dyadic states will appear that
have ignited situations of crisis in the past. These are features not
of the individual partners and their personal ability to symbolise
their phantasies but of the relationship itself, which stimulates
new directions and also new problems. The encounter between
individual characteristics does not only bring up new editions of
existing models that were developed in the primal relationships,
but also creates new experiences, since the relationship is subject
to the usual changes and vicissitudes of life.
We find that often one of the partners initiates and supports
the transformation whilst the other embodies the fears and anxi-
eties: ‘You are pushing me to become something I can’t.’ Each
person’s potentialities and predispositions find expression in a
shared process of becoming, on different levels and in differ-
ent ways (Monguzzi, 2010). Their individual past histories are
a necessary condition but not sufficient for understanding the
current couple relationship. New relational modes will also have
been acquired through their experiences as a couple in the near
past, leading to better or worse forms of linkage (Castellano,
Velotti & Zavattini, 2010).
As shown in previous chapters we can see that the couple
relationship acts as itself a psychic container (Colman, 2003)
so the containment is not created only by alternating balanced
reciprocity between each partner. The outcome of the union is
92 TALKING WITH COUPLES

seen as a process of creation to be supported, arousing aspira-

tions for its identity, not just desire for containment (Zavattini,
2006). It is important that the partners understand that it is in
this psychic space with its aspirations to expansion and repara-
tion that the therapist will invest his efforts, attempting to heal
the narcissistic wound that has broken out as a result of the crisis
between them and to restore a positive gaze between one and the
other (Lemaire, 1979).
Having a sufficiently complex view of the relationship guar-
antees a level of psychic functioning where a different or even
opposite perspective in the other is not seen as invalidating one’s
own, but can be tolerated and kept in mind so it can enter in
dialogue with one’s own thoughts and emotions. If these condi-
tions exist, one feels the relationship may survive the arguments,
in hope that there can be reciprocal understanding even where
there is a difference of opinion. The relationship can be expe-
rienced as a resource, a mental space for objectively observing
the orientation of each individual. This position allows the rela-
tionship in its entirety to be thought about, not just its separate
components. If such a space does not exist, the strength of the
emotions in play between the partners becomes overwhelming
and a primitive state of mind inimical to mentalisation (Allen
& Fonagy, 2006) may set in, characterised by positions of attack
and defence; the reflective function that endows one’s own and
others’ feelings with meaning has been incapacitated.
For many couples the determining agent in therapy is not
only the specific response to their own problems, but the pres-
ence of the therapist as a responsive subject, whose responsive
mental states seem to offer a mirror for their own. The informa-
tive role of words is less important than their function as reveal-
ing mental states (Steiner, 1993). The ‘what’ of the experience
prevails over the ‘why’ (Monguzzi, 2010). In these situations it
seems that containment has priority over the need to understand
specific interpretations. The therapist’s participatory role in the
here and now of the session offers a perspective through which
expectations and roles can be renegotiated (Bromberg 1998).
From the intersubjective perspective, we consider the
processes that engage and interest the partners and the therapist
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 93

reciprocally, in the field that exists between them, rather than

how phantasies and defences operate in the individual worlds of
the partners. The therapist himself is part of this field: considering
not only the phantasy life of the couple but how it is organised
in relation to himself and to the world. The emotional aspect of
the present situation has more importance than the unresolved
knots of the past, even though they still play a role in generat-
ing the difficulties that emerge into view. We consider the way
discourse is articulated, and the dynamics of reciprocal influence.
One partner’s story always includes some emotional reflexes of
the other. In a situation where one thing leads to another, each
partner can learn to recognise themselves in the other’s narrative.
Both doubts and confirmations keep the discourse rolling rather
than interrupting it. A new form with a shared thread of mean-
ing can shape itself.
The premise of the intersubjective approach is that the
therapist can know only when he contributes to creating. What
impact will all these complex resonances have on the mind of
the therapist? He will bring his own associations, thoughts and
phantasies, and be more attuned to some themes than others,
either consciously or unconsciously. Which pathways will he
choose to pursue and which to bypass? These are the sorts of
questions we ask ourselves. The therapist has to be careful in his
countertransference, since not only his explicit behaviour but
also his implicit mentalisations have considerable influence on
the transferential field between the participants (Zucconi, 2004).

Silvia and Giovanni – working towards intersubjectivity

I shall now describe some of the problems encountered in work-

ing towards intersubjectivity, with the help of vignettes from
work with one couple, Silvia and Giovanni.
In the first scenario, at the start of the treatment, Silvia
phones to arrange a first consultation together with her husband.
A few days later her husband Giovanni rings to try to change the
date of the appointment. I phone him the same day and get no
answer, so leave a message on the machine giving my availability
and adding that I will be reachable on the phone for the next
94 TALKING WITH COUPLES

few hours, otherwise we could speak the next morning. I get no

answer. On the day of the original appointment Silvia calls me
in a hurry asking for the address of the consulting room, without
mentioning her husband’s phonecall.
When I meet them in the waiting room I am surprised to meet
a terse and gloomy woman who seems very different from the
one on the phone, and a man with a very paranoid demeanour.
Once they are seated comfortably I briefly mention the phone
communications and am immediately interrupted by Giovanni
who says peremptorily that he has never received any messages
from me. I say I am sorry to hear this and tell them the content
of the message I left. He looks at me in a threatening way and
says that if I had left a message he would have received it because
his phone is a very reliable worktool.
In the following minutes other elements emerge. I learn that
Silvia perceives her husband as excessively controlling, and it
arouses her resentment. She says she is exasperated by Giovanni
telling her all the time she is inadequate. Giovanni says his wife
is indifferent, not interested in him, engaged only in her own
activities, work, friendships, and children; he feels excluded and
this provokes aggressive reactions and sometimes violence.
Witnessing all this, I wonder what interpretive level I should
be using. Should I analyse the circuit of high emotional reso-
nance which emerges, asking what are the meanings of Silvia’s
need for autonomy – what projected movements are happening
and therefore what does the husband represent for her at this
moment in time. I could also ask where, for Giovanni, do the
feelings of exclusion come from – what past patterns are called
up to take shape in the present context. These are the questions
posed by a historical reconstructive point of view, where what
happens in the session in the couple’s interactions is given mean-
ing in terms of reliving the past in the present. The stories and
beliefs that unfold in the transference and countertransference
set off associations through phrase and phantasy, in the form of
analogies and differentiations. However following this associative
approach exclusively, with its research into wider connections of
the individual partners, might detract from concentrating on the
present experience.
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 95

From an intersubjective perspective, I had to consider not

only projections that may be in operation but also what in my
own behaviour and attitude had contributed to creating the
phenomena observed. Could the resentment and rage of the
partners could be linked to feelings of inadequacy sparked by
my not being able to answer their request (the phonecall) and
also to their not being able to make contact in a convenient or
appropriate way, both in the time of the appointment, and in
locating the consulting room. Speaking to Giovanni, I said it
was a real pity we were not able to speak on the phone and agree
on a more convenient time. I added also that I asked why we
had not been able to speak and that maybe it was because it was
not after all necessary to change the time. Silvia, after listening
in silence, said the matter of the appointment caused a quarrel
between them: Giovanni had been upset, saying that she had
fixed it after consulting only her own timetable and not his, but,
she says, this is not true. Then Giovanni, in a resentful tone, says
she always does what she wants without considering his needs,
thinking he is always available. What I tried to do therefore was
to empathise with the patients’ more vulnerable and disturbing
emotions, their rage and disappointment, to help regulate the
emerging state of mind, and avoid letting the confusion impede
the intersubjective exploration (Hughes 2007).

Negotiating the therapeutic climate

In recent years much attention has shifted onto non-interpretive

factors in creating change, in particular onto the relationship as
a vehicle for therapeutic action. The concept of negotiating the
therapeutic climate refers to a wellknown article of Gabbard and
Westen (2003) in which they address the subject of multiple
modes of therapeutic action and the strategies for fostering
therapeutic change. They stress the need for synergy between
the modes available. These include: fostering insight, the nature
of reciprocity, and viewing the relationship itself as a vehicle of
therapeutic action.
Authors on intersubjectivity (Stolorow, Atwood, Lachmann,
Orange) hold that the patient involves the therapist in a
96 TALKING WITH COUPLES

relationship in which his participation in the process of

co-constructing the intersubjective experience, which becomes
the object of ‘negotiation’ or exploration, is evident. The thera-
pist therefore becomes drawn in to a ‘minimal level of collusion’
(Carli, 1993). He intentionally yields in order to participate
emotionally through the only interactive mode which seems
possible. The transformational aspect then lies in the possibility
that a negotiation takes place in which the therapist, although
apparently adhering to the relational suppositions of the patient,
also distances himself, in order to suggest a new mode of inter-
acting from within that position, and to expand the repertoire
of emotional possibilities that are available. What is being nego-
tiated are the meanings of the mutual experiences, the quality
of the emotional participation, the interactive configurations,
the ongoing construction of the therapeutic narrative (Albasi,
2007). The therapist’s engagement in this process can be an
important therapeutic factor because he is seen as a figure who
is available to become involved in the intersubjective field; from
this position he can actively propose a new experience that can
then be memorised as an alternative relational proposition to
the ones already known. The negotiation of the therapeutic
environment therefore entails the involvement of a shared expe-
riential dimension, at a level of implicit interaction that then
becomes explicit, in which the aim is to find functional modes
of affect regulation.
The consultation with Silvia and Giovanni that began so
brusquely with the quarrel over the date of the appointment
continued with them speaking of their jobs. Giovanni says: ‘She
manages a business; I sell, sell, sell.’ Silvia in turn explains how
in her business, no-one takes responsibility for their task. This
obliges her to take care of everything. This makes her feel tired
and oppressed. Giovanni, we learn, has never felt sufficiently
valued by his parents, especially his father who imposed a tyran-
nical control over both his wife and children; he was always filled
with anger and frustration, feelings which are still very active. He
has a needy aspect, owing to lack of attention, which is expressed
in ‘sell, sell, sell’, the insistence on obtruding his own products.
Silvia too has experienced a lack of emotional recognition in her
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 97

family environment, so as if to compensate for this she has built

up a central role as director in which she makes herself indis-
pensable, as if this were the only way to ensure her parents would
notice her.
So what are the couple actually talking about? Integrating my
own reflections with certain personal notes in each of theirs, we
can understand the tensions in the relationship in terms of the
psychic organisation of the couple, which has taken on a certain
shape as a result of the bonding of their individual scenarios.
We can perceive the crisscrossed circuit of projective identifica-
tion in which each is engaged in living out a part of the other.
For Giovanni, his wife seems to represent a primary object,
organising him, putting him in the uncomfortable position of
always having to ask for things. Silvia in a complementary way
seems to accept this directorial role, moved by the fear that if she
stopped she would be neglected and abandoned by her husband.
For him, this confirms the idea of a constricting and suffocating
figure who projects her own aggressiveness onto him.
This brief glimpse of a session illustrates what is an underlying
theme in their roleplay. The couple’s emotional bond is character-
ised by anxiety, by wanting recognition, and by impressionable
and depressed aspects linked to the fear of not obtaining it. Later
on during the therapy, our couple talk about how their quarrels
take the form of provocations, threats, even physical violence,
not unusually in front of the children. Giovanni recounts an
episode in which he left a drawer open on purpose so his wife
would hurt herself, which then actually happened. Another time
Giovanni was told off by Silvia because the bread he was eating
was placed too close to the edge of the table; he reacted by fling-
ing the bread on the floor, treading on it and swearing with rage.
Both episodes describe a reaction of uncontained violence. They
seem to have no strategy of recovery; the arguments end up in
the deepest reciprocal misunderstanding, with no subsequent
moments of emotional recollection and digestion.
At one point in the session an opportunity emerged to
make a comment about the shared dimension of the experi-
ences being recounted. So I had the chance to make explicit
how the moments of rage bring them in spite of themselves to
98 TALKING WITH COUPLES

crumble uncontrollably without finding anything to stop the

avalanche, a condition which frightens them. I explained we
need to appreciate and understand the feelings of rage and frus-
tration but also make sure we limit their inappropropriate and
destructive expression.
Silvia and Giovanni have a hostile and violent relationship
which they put me in a position of observing, indeed involving
me more directly, by communicating their experiences of being
threatened and their fear of their stress and suffering not being
recognised. They make an impelling demand for answers, and
ask in ways that seem to be defensive deformations of their orig-
inal needs. The participatory role of the therapist thus comes
under strain. My own transference experience is tense in char-
acter and I find myself needing to be very careful and cautious
with my interventions. Sometimes there is even a collapse in my
empathic abilities and I realise I am losing attention not only
in relation to the argument but also in relation to the feelings
of the couple. I wonder if this might be connected to aspects of
my own family experience in which I frequently lived through
situations of tension, conflict and direct aggression, against
which I used to react by cutting off communication and blank-
ing out the relationship as a method of defending myself. These
defensive modes may have re-emerged in the intersubjective
field of the couple therapy in the form of a partial or temporary
disalignment, generating even more explosiveness in the part-
ners, thereby perpetuating the absence of empathic response
which is in fact the couple’s primary anxiety.
Clinical work in this phase therefore lay in the regulation
of explosive emotional tensions not only between them but
between the three of us. In this situation of strong conflict,
where signs of mentalisation were scarce, I felt it necessary in
the first instance to establish emotional contact with the couple
to understand the forces with which they were struggling, in
order to begin to attempt to orchestrate the atmosphere in the
field. Interpretation was from the beginning oriented towards
their interactive dynamic as it presented itself during the session
– to the reciprocity and quality of exchanges, including physi-
cal and nonverbal modes. Since within violent relationships the
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 99

partners act out their own states of mind, and are also far from
recognising them, it is necessary for the therapist to conduct his
work with caution, identifying the appropriate level which the
patients can access, whilst understanding the origin and signifi-
cance of their actions. In this case I tried first to ‘be with’ the
partners, engaging them in our shared task, and also to make
sure they found a place as a couple in my own mind, seeing
them as a joint entity who were in a continual state of fear of
not being responded to in a punctual and appropriate manner.
The syntonic responsiveness of the therapist is different in
the context of different treatments; it also varies within differ-
ent sessions. The therapist, whose aim is to present the idea of
a conjugal relationship, is engaged in managing his triangular
situation, re-establishing contact or repairing ruptures between
himself and the other, individually or together. He may welcome
and legitimise the position of one partner, whilst limiting inap-
propriate expression, and always remaining in contact with the
other. He translates the communication of the most vulner-
able language of needs and desires, and he offers an empathic,
calming containment of spontaneous expressions of emotion.
He welcomes both differences and similarities between the
partners, as capable of contributing usefully to the idea of the
conjugal couple.
It becomes clearer to the couple that the object of their
work is that of ‘making an experience’ of their own subjective
reactions in conjunction with the therapist, who helps bring
diverse interactive configurations into view. What happens in
the session’s mise en scène is a continuous roleplay (Sandler,
1976), through observation and experimentation, in which the
therapist strategically offers his own reflective awareness to be
explored in the service of a therapeutical process. To find oneself
reflected in the mind of the therapist is an experience that for
patients who have limited emotional repertoires (very frequent
in the couples we meet these days) favours the development
of integrational types of mental representation. Patients learn
to experience themselves as subjects, whilst enhancing their
self-reflective function as objects (Aron, 1996), thus integrating
observational and experiential functions.
100 TALKING WITH COUPLES

To take a final vignette from the work with Silvia and

Giovanni: at the beginning of one of the later sessions, Giovanni
starts by saying they arrived late because the wife hadn’t turned
up; he phoned but she didn’t answer and this really irritated him.
Silvia explains that because she didn’t find her husband where
they had agreed to meet, she became anxious and went away
for a short time; she thought she had left her phone at home,
but that if it came to the worst, they would just meet at the
consulting room. She then added that looking in her pocket she
realised she did have her phone in fact; in this way she was able
to contact her husband to let him know the situation and thus
calm him down.
This last scenario seems to delineate a transformational
movement. The finding of an unexpected means of contact (the
phone) seems to be mediated and promoted by the background
of a therapeutical context, an environment where minds meet.
This seems to refer back to the initial difficulty in making contact
that was the background to the first session, and suggests the
possibility of a more hopeful outcome.

Conclusions

The combined contribution of the English school of object rela-

tions and of American self-psychology has enabled the devel-
opment of a psychoanalytic approach centred principally on
the study of the processes that revolve around the partners not
just between themselves but with their therapist, and which is
defined as ‘intersubjectivity’. Owing to continuing research into
modes of affect regulation, the individuals have made available
to them a spectrum of ways of engagement that can help them
to give shape to the specific meanings of a relational situation.
The intrapsychic phenomena are therefore inseparable from the
process of relational influence and mutual regulation of affects.
The affective strategies of each partner may have their genesis in
the story of their own primal relations, but the mode in which
the dyadic system unfolds and is restructured in the process of
the circumstances of the relationship, is understandable only
within their interaction at the present time. From a clinical point
 COUPLE PSYCHOANALYSIS AND SUBJECTIVITY 101

of the view the centre of gravity of observation has progressively

shifted from individual psyches to what is happening between
them in the intersubjective field, and this is determined also by
the therapist, whose subjective response helps to construct an
alternative system, orchestrating the meanings that arise during
the session.
Different authors at different times have referred to the
concept of ‘interactive field’ to highlight the usefulness of
dynamic processes such as ‘transactions’, ‘coupling’, ‘consonance’,
or ‘reversible sequences and exchanges’. The concept of field is an
attempt to overcome more static categories of objects and their
representation, enriching the basic premises of the relational
models and showing that they are still in process of construction
within their diversified applications. Dynamic processes high-
lighted by more heterogeneous therapeutic situations nonethe-
less converge with their originating models. In our experience
the convergence of the two schools provides a methodology of
great usefulness for the psychoanalytical treatment of couples,
focusing as it does on the composition of the story during the
sessions, by exploring the impact of emotional positions and
narratives that are more adequate and functional than those
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INDEX

affect regulation see emotions, Carli, R. 91, 96

regulation of Castellano, R. 81, 91
Albasi, C. 96 circular causality 65, 67
Allen, J. G. 80, 92 Civitarese, G. 40
alpha-function 5–7, 14 claustrum 36
analytic third xii, 2, 18, 42, 57, 67 Clulow, C. xiii, 44, 90
see also triangle, equilateral collusion 24, 28ff, 45, 53, 58, 67,
Aron, L. 12, 99 77ff, 9
Atwood, G. 89, 95 Colman, W. 35, 64, 91
Baranger, M. and W. xiii, 13 container–contained xv, 7, 14,
Beebe, B. xiii, 10, 25, 90 35, 42, 44
Bezoari, M. xiii, 77 Corigliano, N. 90
Bianchini, B. 37 countertransference xvi, 6, 14,
Bion, W. R. xiii, xv, 5, 14, 21, 27, 25, 51, 56, 62, 67, 71, 74,
35ff, 51, 56 77, 93, 94
Bolognini, S. 9, 15, 84 couple cases
Bordi, S. 2, 9 Carlo and Franca 19ff
Bowlby, J. xv, 9, 10, 81 Claudio and Daniela 38ff
Britton, R. xii, 5, 19, 22, 42, 58, Emma and Giorgio 47ff
64 Mr and Mrs F 34ff
Bromberg, P. M. 12, 92 Mr and Mrs T 46ff
Caporali, P. 26 Mr and Mrs C 72ff

117
118 INDEX

Silvia and Giovanni 93ff infantile anxiety/states 6ff, 11, 26,

couple state of mind 32, 58, 64ff 29, 30, 49, 56, 90
Crandell, L. 10 internal world xvi, 3, 24, 33, 41,
crisis therapy 18 56, 62, 68, 75, 82
Dallanegra, L. 26, 37 interpretation, joint xiii, 4, 44, 55,
defence mechanisms 6, 24, 26ff, 79ff, 98
48, 51, 53, 63, 76, 92 intersubjectivity passim
see also collusion Jiménez, J. P. 6
depressive position 5 joint session 17, 23, 71
Dicks, H. xv, 18, 24ff, 44, 63, 72 Kernberg, O. F. xv, 9
divorce/separation x, 21, 22, 34, Klein, G. S. 25
66, 80 Klein, M. xii, 4ff, 24, 35, 41, 43,
dyadic membrane 25 64
see also emotional relationships, Lachmann, F. xiii, 10, 25, 90, 95
early Laing, R. D. 28
Eiguer, A. 39, 76 Lemaire, J. G., 92
Emde, R. N. 9, 42 Mangini, E. 3
emotional atmosphere xvii Meltzer, D. 29, 30, 36
emotional links 18, 51 mentalisation 92, 98
emotional relationships, early mirror, analyst as 62, 92
2–8, 18, 25, 43, 90, 100 Mitchell, S. 12, 89
emotions, regulation of passim 17, Monguzzi, F. 76, 91, 92
39, 71, 84, 96, 100 Morgan, M. 32, 36, 45, 58, 64,
Fallone, D. 89 67, 69
Ferro, A. xiii, xvi, 7, 14, 23, 32, narcissistic traits 3, 45, 49ff, 73,
33, 40, 44, 77, 83 92
Ferruta, A. 15 narrative truth 9, 27, 83, 87, 93,
field model 83 96, 101
Filippini, S. 2 negotiation, therapeutic 91, 96
Fisher, J. xiii, xv, 10, 18, 23, 29, Neri, C. 13, 83
30, 31, 35, 44, 47, 49, 58, Norsa, D. x, xiii, 29, 39, 44, 76,
64, 72, 75, 82, 90 82, 90
Fonagy, P. 11, 80, 92 object relations theory ix, xiii, 2ff,
Freud, S. 3ff, 42ff, 62, 81 17ff, 24, 62
Gabbard, G. O. xiii, 37, 39, 95 object, internal 23, 29, 43, 55, 57,
Giannakoulas, A. 25 61, 73, 77, 79, 83, 86, 91
Gigli, F. 44 object, primary 36, 97
Gosling, R. 44 Oedipus complex 6, 19, 21, 56
Grinberg, L. 63 Ogden, T. xiii, xiv, 1, 2, 7, 14, 26,
group analysis 3 36, 77
Hewison, D. xviii Palazzoli, M. S. 62
Hughes, A. D. 95 parasitic relationship 33, 44, 56
 INDEX 119

partner, choice of 25, 75, 87 Teruel, G. 18

phantasy, unconscious 7, 32, 53, transference/transferential field
56, 57, 62, 70, 76, 90, xvii, 6, 14, 27, 44, 47, 56,
91, 93 62, 68, 75ff, 93, 94, 98
idealised 20, 45, 49 negative 29, 51, 56, 71, see
omnipotent 19, 26, 36, 42 also collusion
see also unconscious fit; see also countertransference
collusion triangle, marital 35, 44, 45ff, 64,
Pickering, J. 36, 37 80
Pincus, L. 18 triangle, equilateral/therapeutic
Ponsi, M. 2 xvi, 40, 41ff, 67ff, 80, 84
projection and introjection 3ff, unconscious fit 23ff, 63 see also
18, 54, 83, 90 reciprocity
projective identification xiii, xvi, Velotti, P. 3, 5, 11, 44, 81, 82, 91
14, 20, 24, 26, 29, 43, 56, Vender, S. 7, 40
61, 68, 77, 81, 95 Westen, D. 95
reciprocal 31, 36, 58, 76, 97 Winnicott, D. xii, xiii, xv, 2, 7,
and splitting 4, 24, 84 8, 76
reciprocity/synchronicity xiii, 21, Zaccagnini, C. 11
24, 27, 30, 37, 39, 43, 56, Zavattini, G. C. ix, xii, xiv, xviii,
63, 90, 91, 95, 97 3, 5, 11, 29, 39, 43, 44,
reverie xiii, 5, 8, 14, 25, 27, 83 47, 56, 63, 76, 77, 81, 82,
reciprocal 30, 37 83, 84, 90, 91, 92
Riviere, J. 41 Zucconi, S. 93
Rouchy, J. C. 33
Ruszczynski, S. xiii, 29, 30, 25,
44, 45, 47, 75, 80
Sandler, J. 99
Santona, A. 56, 81, 84
Scharff, D. and J. 44, 75, 76, 90
self-psychology 100
setting, therapeutic xiii, xvii, 9,
14, 17, 18, 24, 33ff, 44,
51, 55, 57, 59, 61ff, 79,
80, 83
external and internal 70ff
Shaddoc, D. 90
Stern, D. 9, 11, 12
Stolorow, R. 89
Sullivan, H. S. 13
superego 6, 29
Tabbia, C. x