Introduction Number 19

Introduction to the issue

“Aspects of the technique in contemporary psychoanalysis with the couple and the family”

Timothy Keogh^[*], Daniela Lucarelli^[**], Irma Morosini^[***]

The development of theory and technique in psychoanalytic work with couples and families has a long history, primarily linked to that of psychoanalysis, but also influenced by relational and social models of psychic functioning. Adding to these developments, about sixty years ago specific clinical and observational studies concerning the phantasmatic and relational functioning of couples and families began to develop around the world. This work focussed on the interpersonal dimension and group features of the family, that is, on the relationship between the intra-psychic and the inter-personal.  Regardless of the theoretical orientation, however, focus on the interactions or relationships between members of the couple or family has been considered the basis for change. In this regard, the aim of the IACFP has been to present and compare different models of couple and family psychoanalysis in order to examine opportunities for integration and cross-fertilisation of ideas and ways of working. It is seen that each model can bring a different perspective to the understanding of the functioning of couples and families, thereby potentially enriching clinical practice and theoretical thinking.  As psychoanalytic theory shapes technique by forming an inseparable binomial equation of psychoanalysis, this approach can enlarge the field of study and practice.

We thus need to consider the repercussions of this exposure to different theoretical orientations. Moreover, we need to examine what changes have taken place over time in terms of the technical choices of psychoanalysts in working with couples and families, particularly with respect to practices such as the choice of setting, the use of transference, the type of interpretative model used or the types of intervention that are privileged.

In contemporary societies and across cultures, psychoanalysts are increasingly seeing individuals, couples and families suffering with uncertainties associated with a sense of not belonging and experiences of disorientation. In this context we are also witnessing changes in family structures and in the nature of couple relationships. As couple and family psychoanalysts, we are therefore challenged to identify new therapeutic tools by researching and examining the new presentations facing us in our contemporary clinical practice.

The articles presented in this issue derive from a diverse range of cultural perspectives and offer a range of theoretical and technical propositions and choices that can help us develop a broader view of our area of clinical interest.

For example, in her article Intervention – Interpretation, Janine Puget invites us to broaden our way of listening to clinical presentations. She considers that it is necessary to expand our theoretical framework and to think in terms of two heterologous logics: one which deals with the internal aspects of the patient and which is the result of the activation of the transference relationships, the other specific to the “link” the couple cocreate, that is to say, that what happens between two subjects is a consequence of the contact with otherness and with the strangeness of the other.

Starting from the observation of significant structural changes in the family and the development of new techniques such as family psychodrama and multi-family therapy, Philippe Robert tackles the topic of Technical Questions in Psychoanalytic Family

Therapy and in doing so he reminds us of the clinical and technical invariants related to the frame. He also re-affirms that what must remain intangible is the role of the unconscious in the configuration of conjugal and family ties.

Damian McCann, in his article A Therapist in Search of the Couple: A Brief Therapeutic Intervention with a Homoparental Adoptive Couple, examines contemporary technique in psychoanalytic couple work by describing a time-limited intervention with a homosexual couple seeking to adopt an infant. He highlights that in such work the goals of the intervention need to be clear and stresses the importance of using one’s countertransference to achieve such identified goals which in the case presented include the impact of adoption on the couple’s relationship, their couple crisis and the impact of sexual and gender orientation on their functioning. He notes that the therapeutic result is related to working with the individual defences of each member of the couple. He also emphasises the need to confront heteronormative views when working with same-sex couples.

Hanni Mann-Shalvi, Timothy Keogh and Caroline Sehon, in their article Contemporary Approaches to Trauma Encapsulation and Dispersion: Holocaust Trauma as an Impediment to Intimacy for Couples, describe the different mechanisms by which severe trauma can be transmitted inter-generationally into a couple relationship. Hanni MannShalvi presents a clinical case that describes these mechanisms and also highlights the importance of holding in the therapy when defensive encapsulation causes feelings to be blocked. Caroline Sehon and Timothy Keogh each then offers a commentary on the case presented.

Marthe Barraco de Pinto and Muriel Orlue bring their experience of working with couples in their article Some Technical Aspects in Couple Psychoanalytic Therapy. Referring to the work of Lemaire, they reaffirm the importance of defining the frame in accordance with the therapist’s internal theoretical frame of reference and experience of personal analysis. Particular attention is paid to the most undifferentiated and most primary levels of communication. The therapist relies on aspects of language and the impact on the other of speech including, in particular, its sometimes-obvious effects on the face of the other. They also discuss other tools that can be used in couples work, including the genogram.

In his article entitled The Multifamily Psychoanalysis Group: Recommendations for its Coordination, Norberto Mascaró Masri stresses the importance of creating an adequate emotional climate for psychoanalytic work and discusses how this generates trust and an openness to the possibility of “developing what is healthy in order to heal what is sick”.  He also reviews the multiple transference aspects of reciprocal interdependencies, clarifies issues to do with the frame and makes recommendations about coordination with a multifamily group.

In his article Psychic Space and Temporality in the “Family Group”, the Convergence of  Biographies in the Context of a Day Hospital, Juan González Rojas and Paloma de Pablos Rodriguez examine the unconscious relevance of the memory link to relationships. They share their experience with multifamily groups in which the exercise of writing narratives can establish a memory link between a group of patients and therapists. In terms of exploring fantasy and psychic representation, they point out the relevance of the place and time of memories in the intersubjective history. They note that access to this “figurability” serves as an envelope which aids recognition, as well as inter and intra-subjective support.

In the article The Terror That Comes From the Future, Gemma Trapanese and Santa Parrello, in presenting a case of conjoint family therapy, emphasise the importance of exploring the fantasy that occupies the field of a family psychoanalytical framework.  They argue that it is the attention paid to the psychic group apparatus which makes it possible to identify pacts and collusive defences.  The transference -countertransference movements are considered essential for the understanding of the transformative processes. Special attention is also given to the trans-generational transmission of mental pain.

In Greco’s article, Growing up Without a Father: Psychoanalytic Work With the Single Mother and Child Dyad, the reader is provided with two robust clinical examples of children growing up in single-parent families where the father is absent. Role responsiveness as a concept, is used to explain how these children carry the mother’s desire that the absence of a father be normalised until their development and curiosity no longer allow this. The author notes that the therapeutic approach described involves firstly recognising the needs of the mother, which is achieved by using countertransference as a means of coming into contact with her inner child. The clinical presentations also illustrate the technique of using children’s drawings as a means of symbolising that which has been emotionally unrepresented.

In his article, Rejection Feels Better than Longing: A Borderline Couple with Traumatic Lesions, Carl Bagnini describes the technical challenges of working with a borderline couple with long-standing problems of intimacy who also have individual difficulties of addiction and hostility and who are part of a family wherein their daughters carry their unmet dependency needs. The difficulty of establishing emotional contact with the couple illustrates the consequences of a non-metabolised transgenerational trauma (revealed in the material of the presented session) that the author considers is common in couples with such serious psychopathology. Also discussed are the associated challenges posed to the therapist in a therapeutic relationship with such a couple where, as in the case of the individual borderline patient, one must limit one’s therapeutic expectations.

In the Book Review, Elizabeth Palacios offers a detailed review of The Linked Self in Psychoanalysis: The Pioneering Work of Enrique Pichon Rivière. It is noted that in this book, the authors, Losso, de Setton and Scharff, have presented the work of PichonRivière in English for the first time.

---

^[*] Training analyst of the Australian Society, member of the Committee on Couples and Family Psychoanalysis of the International Psychoanalytic Association; of the International Association of Psychoanalysis of Couple and Family and of the International Editorial Committee of Psychoanalysis of the couple and family psychoanalysis journal, research fellow of the International Psychoanalytic Association and senior lecturer in the Faculty of Medicine in the University of Sydney. timothykeogh@bigpond.com

^[**] Psychologist, psychoanalyst, full member at the IPA/SPI, IPA recognised expert on children and adolescents, member of IACFP Board (International Association of Couple and Family Psychoanalysis), Editor in Chief of the IACFP Review, chair of the Couple and Family Section of EFPP (European Federation for Psychoanalytic Psychotherapy ), teacher and supervisor at PCF (Corso Postspecialistico di Psicoanalisi della Coppia e della Famiglia) in Rome, founder member of SIPsIA (Società di Psicoterapia Psicoanalitica dell’Infanzia e dell’Adolescenza) in Rome, teacher and supervisor at Istituto Winnicott iW, in Rome, member of the editorial board of “Interazioni” (FrancoAngeli, Milan, Italy), author and co-author of publications on children, adolescents and couple and family psychoanalysis. daniela.lucarelli@gmail.com

^[***] Degree in Psychology (UBA), director of Psychodrama, specialist in Family and Couple Psychoanalysis, full Professor at the University of Buenos Aires and at the Catholic University of Argentina at the undergraduate and graduate levels, full member and founder of the Psychodrama section of the IAGP, full member and founder of the AIPCF, founder member of the Argentine Association of Family and Couple Psychoanalysts, member of the Editorial Committee and the Editorial Office of the Online Magazine “Psychoanalysis & Intersubjectivity”, member of the Board of the AIPCF, member of the Drafting Committee of the AIPCF Review, author of publications in books and specialized reviews, general secretary of AIPCF from 2016 to 2018 and continues. irmamorosini@hotmail.com