Couple psychoanalytic psychotherapy and the analytic field model

Couple psychoanalytic psychotherapy and the analytic field model^[*]

Barbara Bianchini^[**]

Introduction

Drawing on the writings of Bion, later developed by Grotstein and Ogden, we can assume that the purpose of our clinical work is to develop and further the capacity for thinking, which Bion maintained is inseparable from feeling.

From this hypothesis, Ferro and the Pavia school developed the model of the analytic field, whose broad mental scope I believe may also find useful application in our therapeutic work with couples. It is a model that spurs us to promote the development of tools for thinking together and so to achieve a capacity to tolerate and metabolise thoughts, and create new ones forged by the analyst and the couple together in the session.

I aim to show how, in the analytic field model, there is less need to use the concepts of transference and countertransference in the strictly classic sense, where it is assumed there exists a structure in which the two members of the couple and the analyst interact as three separate subjects. From the viewpoint of the field, there is no ‘fact’ of the analysis that cannot be felt as being unconsciously co-created. We can therefore say that the analyst’s emotional experience is not an expression of countertransference, but is the work the analyst herself does while receiving and transforming projective identifications.

I believe that a psychoanalytically orientated therapy with couples is not solely concerned with discovering the unconscious content of their relationship or attempting to resolve its conflicts, in a sort of laboratory of what-has-been. Rather, it is a useful means of furthering a capacity to tolerate, feel and digest uncontainable and disturbing thoughts and feelings produced by the couple relationship, so that they can be thought and therefore be learned from, in a laboratory of what-can-be together.

I shall therefore highlight the creative potential of the analytic field, as this is where both the couple relationship and the analyst participate in an adventure which may give rise to something new that enriches them both. Moreover, it is my opinion that couple psychoanalytic therapy may stimulate new developments in field theory.

The field model and the couple

That which previously belonged to the couple relationship or to the analyst now belongs to the field, as the couple partners and the analyst are constantly communicating in such a mutually pervasive way on an unconscious as well as a conscious level that it becomes impossible to discern with certainty what belongs to one or other of the subjects. In fact, there is no event that takes place in the field which is not co-created by both: the singleness of individual voices diminishes, and a structure is generated whereby emotional turbulence paves the way for and enables transformations and the creation of narratives. The three subjects are no longer considered as individuals who interact with each other, but as a group; they are viewed not in isolation, but as members of that group.

I think an approach of this type is possible and useful, despite the fact that, when both partners are present in a session, it may be difficult to achieve a high level of deconcretisation and relinquishment of the factual. It may sometimes seem that couples who come for psychotherapy have a very childish way of engaging with each other and are seeking parental guidance. Consequently, they do not delve into and explore the disorder and confusion of their relationship, but come asking to be instructed or corrected.  I believe that each communication the patient makes, even the most apparently factual, ought to be viewed as an emotional reality; this may sometimes be difficult to achieve, given that the couple’s propensity to stay in concrete realities reduces the analyst’s receptive capacity, trapping her, too, in preformed realities. Any communication during the session, even when both partners are present, always tells us about something else. It not only indicates the characteristics of the shared internal world of the couple relationship and whether it possesses sufficient tools to feel and to think, but also the facts of the analysis that are co-determined by the couple/patient and the analyst. It therefore reveals an ever evolving and co-constructed expansion of the unconscious.

It is for this reason that the analyst’s listening is required to become increasingly imaginative, and to allow the partners’ discourse to become ‘redreamt’. In this regard, I recall the words of Meltzer (1984): “While I was listening to your dream, I dreamt a dream which in my emotional life would have the following meaning, which I will reveal to you in the hope that it might shed light on the meaning your dream has for you”. I am also mindful of Ferro’s suggestion to listen intentionally to everything said in the session as if it were the telling of a dream. This stance does not eliminate contradictions but activates multiple perspectives, enriching a dialectic outlook, by virtue of the peculiar unsaturated quality of oneiric language based on images and the deconstruction of logical discourse (Civitarese, Ferro, 2020).

In this model, the analyst is no longer the keeper of knowledge used to uncover the nature of the couple’s bond, their shared unconscious themes or their unconscious fit, by which they activate their defence mechanisms. She is called upon, instead, to perform the function of listening, to activate the partners’ ability to recognise their raw sensations and emotions, allowing them to be worked through to the point of expanding the mental and emotional container of the relationship.

I believe, as I have learned from Ferro, that it is fundamental to be with the couple/patient in the here and now while simultaneously maintaining a mental map that helps give meaning to what one is experiencing in the session, even though one might not necessarily need to state it explicitly.

In the couple, each partner performs complementary reciprocal functions in respect of the other. The unit formed by the relationship is a new system endowed with its own particular characteristics which are not a sum of their constituent parts, and in which the intensity of emotions, sensations and differences is magnified.  This unit is the result of what the partners consciously and unconsciously create together: a system of co-created connections that guides and maintains their relationship. It is a question of reciprocal projections and introjections between the partners and their internal couple. «Internal couples are created by individuals and shared internal couples by couples; each bears unique characteristics, some carried forward trans-generationally, all having the potential to develop with us» (Ludlam, 2020, p. 137).

The relationship, considered as a psychic object in itself, does not exist statically, but as a permanent process of destruction, change and the creation of something beautiful and important, in a constant oscillation between instilling hope and containing the confusion and suffering of depressive and persecutory aspects. (Bianchini, Scabbiolo, 2018). Therefore, in the session it can be beneficial to focus greater attention on the themes of change and of becoming, and also on the repetitive forces that may block the therapeutic process.

With a field perspective in mind, the analyst’s office no longer contains only a patient couple who speak and an analyst who listens while trying to maintain a neutral position in order to provide interpretations not conditioned or ‘disturbed’ by excessively personal characteristics or flaws. Nor does it contain only two people linked by object relations associated with their mutual projective identifications, who converse with the analyst through the transference. There is not even only an analyst who interacts solely with the connection between the two partners in the couple, a third element created by them, and who highlights their similarities and differences.

Rather, from the perspective of the field, a couple session gives rise to a complex situation that is constantly moving between creation and destruction. It is made up of entities and characters that are the product of the mental work of the analyst, each partner, their relationship and their respective emotions: a mental group that deconcretises the content and transforms it into an ‘oneiric scene’ which lives in the analyst’s office (Bezoari, Ferro,

1997). The field thus becomes a container for myriad emotional presences or characters in the session, who passionately enter, leave, converse and are transformed, with infinite and unrepeatable potential outcomes.

In addition to being considered from a realistic-historical vertex, such characters can be seen as both shared internal objects and as newly forged creations deriving from the analytic encounter. They can also describe functioning that in other types of language we would call split off or not yet available for thinking, and they vary as witnesses as the atmosphere of the session varies.

The transference becomes visible in the session through an infinite number of possible accounts and characters, expressed in myriad diverse ways. As Ferro says: «It can present in various modes: in repetition, in the external projection of ‘phantasmatisation’, in projective identification, … and therefore recounting no matter what, expressed in the most disparate ways and conveying sensoriality, anguish, an absence of functioning or the presence of dysfunction» (Ferro, 2006a, p.404, author’s translation).

Thus a new grouping is formed in the analyst’s office, composed of the content brought to it by the relationship between the two partners: a grouping that has to do with often intolerable, altogether unstable and continually new combinations of emotions and contrasting passionate bonds, which the analyst considers through the lens of her own characters and stories, in order to co-construct new narratives with the couple. Whereas previously the analyst’s attention focused on the direct observation of the transference and countertransference, it is now directed through the characters, who, as metaphors, constantly signal whatever is moving in the session.

Neither partner can be understood independently of the other and, consequently, the meaning of the couple relationship is not pre-established and should not be deciphered or interpreted, but must be entirely constructed with the couple.  The session starts from the hic et nunc and aspires to creatively bring about meaning by inducing the couple partners to ‘play’ together and to consider possible developments, including the writing of a new three-person narrative (made up of the couple and analyst).

The analytic field model holds, therefore, that the therapeutic factor of the process does not lie so much in the analyst’s truth regarding the couple relationship but, starting from the partners’ accounts, in both an ability to be with and to allow oneself to be traversed by the emotions occurring in the field, and to being open to and accepting of observations from different vertices. In this way, threads of meaning can be woven, expanding the relationship’s capacity to accommodate, without fragmenting, its as yet untransformed proto-content and opening up new possibilities. Ferro maintains that acquiring a thought function is not the product of some interpretative miracle, but of a highly emotional sharing capable of initiating the narrative function that is the true driver of an expansion of the capacity for thinking.

In this way, the patients’ subjectivities are put aside to allow the voice of interaction to emerge, on all possible levels (relating to the history of the relationship and that of each partner, to transferential, counter-transferential, and transgenerational dynamics). To verbal accounts, we must also add a non-verbal, polysemous and gestural, prosodic and expressive component, which gives voice to more primitive levels.

I therefore think that it might be useful if we move beyond a type of couple therapy that is concerned with internal and/or external content, with removed or split off facts or emotions, or with working on otherness/extraneity – all of which, nonetheless, are part of our expertise – to try to include work which aims to develop in the couple relationship tools for feeling and thinking and to expand the mental container. Emotions circulating in the analytic session would therefore no longer be seen as deriving from ‘one-way’ transferential projections or projective identification (Civitarese, 2021). On the contrary, they would be a reflection of the creative and transformative capacity of that collective unconscious (or field).

It is a model much less bound by the need to cure symptoms and repair damage, and more inclined to facilitate the emergence of something new and important, with the aim of achieving a deeper level of understanding and meaning.   

The couple state of mind

Once we have gone beyond reading our work with the couple in a purely individual key, I believe it is important to espouse the assumption of Ruszczynski’s proposition (1993) that the relationship is the patient, from which Mary Morgan derives the concept that she has called the ‘couple state of mind’ (2001).

As Morgan writes, an important factor in the containment of the couple consists of the analyst’s maintaining a particular internal stance, namely the couple state of mind, which does not consist only of keeping both the partners in mind. Rather, it is a question of keeping the relationship in mind, which entails the analyst’s adopting an internal stance that will allow her to be involved subjectively with each partner but, also, simultaneously, to hold herself outside the relationship and observe the couple as they interact: a state of mind that embraces both the couple’s conscious and unconscious relationships. This position also includes the view that the analyst may act as a useful third to their relationship (Britton, 1989), recognising the potential function of the relationship, in and of itself, of acting as a symbolic third alongside the couple. In this state of mind, the analyst and the couple who seek the analyst’s help can concentrate on holding the relationship as patient in their mind. The very concept of a relationship implies enlarging the psychic space, in the sense that we are not only addressing the individual internal psychic space but also one that is ‘imaginary’ and immaterial, where the relationship takes place and the reciprocal internal worlds, with their objects and emotions, meet and intertwine.

I believe that holding this internal position can be of great benefit to the analyst and can be helped by adopting a field perspective: introjecting the analyst’s couple state of mind, the couple may develop a capacity for thinking about their relationship, with the addition of an awareness that they are fundamentally separate and different from each other.

I would like to recall two other aspects highlighted by Ferro (2014), which I consider to be of particular importance: although it is true that there is the utmost symmetry in the development and evolution of the field, it is equally true that the responsibility for maintaining the setting and holding a steady course (the ethical responsibility for safe navigation) lies asymmetrically with the analyst.  The analyst’s position in the field, therefore, oscillates between one of the utmost asymmetry (the responsibility is hers) and one of the utmost symmetry (the functioning of the field is co-determined).

Ferro goes on to say that we must accept that our patients are our best colleagues, a sort of GPS system, as they constantly give us a reading of our current position and of the direction in which we are travelling, providing us with a clear route. In fact, anything said by either partner is a description of the functioning of the field and the characters belong to that same field. Adopting a couple state of mind can help the analyst to follow the emotional movement of the field and to foster her symmetrical engagement.

Development of the aesthetic field

Bion (1962) describes the mother who perceives and metabolises her infant’s distress – and the analyst who attends to the patient’s psychic pain, and he emphasises the emotional tension involved. Meltzer (Meltzer, Harris Williams, 1988) highlights that the impact of the mother’s presence on her baby is an aesthetic one, by virtue of her being an object capable of arousing an intense, contrasting and ambiguous emotional reaction. The encounter between the mother’s beauty and that of her child is aesthetic, in that the resulting contrast is able to generate strong emotional turbulence.

Indeed, Meltzer adds that the infant must be considered by its mother to be an aesthetic object for their loving relationship to be reflected reciprocally and grow in intensity, even though this may generate clashes and/or a possibility of harmony in response to an inherently enigmatic beauty. He says that «…the emotional impact of the beauty of the object is so intense that the child feels it is being inflicted out of cruelty, unless it is absolutely reciprocated: unless the mother gives evidence that the child is as exquisite to her as she is to the child» (Meltzer, 1993, pp.92-93).

If there is an aesthetic bond, the mother, precisely because she lives the experience with her baby, is able to sense his or her deepest needs and anxieties and therefore contain them. The reciprocity of their exchange is essentially creative, with the mother and baby creating and recreating each other (Bianchini, Scabbiolo, 2018).

Meltzer speaks of a “conversation between internal objects” (Harris Williams, 2010). The container for this conversation is not the analyst’s mind, nor that of the patient, but the link between them «… it is the fitting together of the analyst’s attention and attitudes to the cooperativeness of the patient that forms and seals the container, lending it the degree of flexibility and resilience required from moment to moment» (Meltzer, 1986, p.208).  The importance of these experiences lies in the fact that they constitute the basis of an apparatus for thinking, in the sense of a creator of meaning through aesthetic reciprocity, which is not achieved by acquiring information but by acquiring affective qualities, and offers a relationship model that can be introjected.

We can therefore say that the process of containment is aesthetic precisely because of its capacity to intuitively sense, receive, and develop an image, sound, smell or tactile sensation that may confer meaning on the emotional experience in the room, and so enable us to admire it dispassionately (Eco, 2005). During this process, the “alphabetisation” of protoemotions, sensoriality, agitation and contrasting emotions is activated in the field, and new, shared ideas that will gradually make the unthinkable thinkable can be generated.  Thus, the potential is created for the formation of a narrative that «would have the capacity to contain those emotions that, were they free, would be comparable to tsunamis» (Civitarese, Ferro,

2020, p. 3, author’s translation). That which needs to be contained, therefore, is an excess which would otherwise rupture the container. As Civaterese points out, «it is necessary to remove from the emotions that part which exceeds an individual’s capacity to make use of it» (Civitarese, Ferro, 2020, p. 54, author’s translation).

The field model can be considered as strongly aesthetic also in couple psychotherapy. In fact, what the couple relationship conveys always exceeds what the analyst is capable of knowing; it is not possible to attain total and complete knowledge of the analytic object, due both to its non-visible qualities and to each person’s sensorial capacities. Hence an analytic style that is based fundamentally on the possibility of observing and describing, and not on explaining.

For this reason, I believe that the analyst’s work is characterised by a certain degree of nonsaturation, of doubt and curiosity and of a capacity for letting oneself be surprised, so that new ideas may be brought into being in “games” and narratives that would previously have been unthinkable. It involves asking questions (new questions open the way to different perspectives of meaning and can change the reciprocal emotions at play) rather than providing answers. It also means observing and hypothesising, making mostly minimal actions that deconstruct, connect, reposition and illuminate images and sensations, and letting the couple gradually develop their own language and narrative and feel that they are invited and encouraged to share them in the session. It is akin, through play, to helping and allowing the pieces of a jigsaw puzzle to be moved around, as Meltzer says (1984), to complete it in such a way that the pieces correspond exactly to the empty spaces.

Similarly, it can be useful for the analyst to allow the couple to decide the level of intensity they find tolerable in facing the emerging relationship tangle, by choosing the most suitable ‘literary genre’ to ensure the optimum emotional distance without defining univocally and in absolute terms the events and characters in the session, thereby safeguarding its vitality and creative potential so that the container can develop in the narrative (Ferro, 2010).  An approach of this sort helps the partners give meaning to their experience of being part of a couple. It also creates a space where the disturbing elements that every relationship inevitably generates can be received, and it contains the anxiety that the couple carry during the treatment process: anxiety that may be part of the problem they have presented with, anxiety regarding being in a couple, anxiety about something that has become more difficult than they had expected and has taken them by surprise.

The analyst tends to take her cue from what is taking place in the present moment of the session, trying not to be hindered by what she believes might happen (in the future) or by a wish that the present situation were different. She does not necessarily possess a strong theory for decoding content but, rather, through metaphors or rêverie^[1], creating bridges and connections, she performs a sort of continual paraphrasing of the partners’ text, trying to detect and focus on the unexpected. She bases these actions on perceptions and feelings, more or less consciously, and on intuition and connections between verbal and other aspects of the narrative of the session; this all allows the couple’s discourse to be brought to a different level of awareness, removing the concrete and increasing the abstract.

In this model, the concept of interpretation therefore expands to include all the analyst’s apparently conversational unsaturated interventions (Ferro, 2006a).

The analyst should also examine whether her participation maintains a balanced and impartial distance in respect of each member of the couple; it is important to notice if she finds herself colluding with one or other of the partners due to the intensity of the emotions and complexity of the dynamics circulating in the session. In fact, through sharing and containing her own emotions, the analyst also participates in the process of creation and exclusion, acting aesthetically or an-aesthetically (without emotion). She perceives through heightened senses, is drawn towards and led to places she would never have imagined going to, she takes part in the dynamic of the creative process, in its harmony and discord, and in the continual struggle, at once risky and pleasing, between identity and difference. Conversely, in the event of an authoritarian distancing or an arbitrary delivery of a ‘truth’ by the analyst, the couple relationship may be pervaded by anxiety caused by a feeling of intrusion or abandonment, due to an inability to tolerate the content being discussed. The couple realises that some object is preventing development, because the analyst’s mind may be insufficiently receptive or, although receptive, has become too disorganised.

A case example

I first met Anna (names are fictitious) when she requested to come with her husband to speak about and try to resolve some recurring problems they were having, issues described as “macro recurrences”. They were an attractive couple, she an educator, he a successful senior manager.

During our first encounter, it was Giuseppe who spoke the whole time, enthusiastically, about their children: Lucia, a very intelligent four-year-old and Bartolomeo, an eleven-yearold, who suffered from a rare genetic disease, which prevented an adequate supply of glucose to the brain (‘fuel does not get to his brain’) and required a special strict diet.  This diet was not easy to manage and involved considerable effort on the part of patients and their families. Bartolomeo had a very mild form of the disease but they did not yet know how it might evolve.

When Bartolomeo was five years old, it was his father who had noticed his uncoordinated movements and, alarmed, “saved him in the nick of time”.

Giuseppe explained his son’s illness in great detail. It was he who knew all about it and had always spoken to the doctors; his wife was an asymptomatic carrier. It fell to him to manage their son’s life and he complained that Anna did little to help, and especially that she was unable to control the child’s diet or prepare the food he needed. She said she was more fatalistic. For a long time, there was no mention of their daughter!

The couple came from very different family backgrounds. Anna’s parents were no longer alive: her mother had died many years previously and she had recently lost her father after a long illness, during which the couple had had to care for him; Giuseppe’s parents, on the other hand, were fit and active, lived in a nearby town and helped out a great deal with his siblings’ families. This was something that caused them both considerable sadness, but when they had got married, they had moved closer to where Anna lived and she was now resentful of the fact that they had never had any help from her husband’s family. Giuseppe remarked that she dwelled only on the negative and never missed an opportunity to be critical. He felt she was being unfair; he had acted differently, accepting his father-in-law’s constant presence in their lives.

These mutual recriminations led me to reflect on how, through our choice of partner, we try to live some unwritten chapters of our lives, or chapters which, at some deep level, we have not allowed ourselves to live; we hope to construct or reconstruct them in more containing and satisfying alternative scenarios, so that unknown, removed or split off aspects may be emotionally lived. (Bianchini, Dallanegra, Vitalini, 2011). We can hypothesise a «sort of integrating function of the mind that acts as a radar, scanning until it finds that person who can give life and expression to aspects which must urgently be brought to thinkability»

(Ferro, 2010, p. 115, author’s translation). This function can generate ambivalent, hard to tolerate emotions in the couple, which can easily find expression in reciprocal dissatisfaction and resentment.

Anna’s parents were portrayed as having been litigious and adversarial, whereas Giuseppe’s were very active and easy-going: two completely different and difficult to reconcile worlds. In one of our first encounters, they recounted that two years previously, while in the car with the children, they had been involved in a terrible head-on collision when the driver of an oncoming car lost control and swerved into their lane. Giuseppe had broken several vertebrae, and after an operation and three months in hospital, was still frequently in pain and could no longer do any sport; his wife had broken her pelvis and had been bedbound for several months. It was a very difficult time, both because of their physical pain and of trying to care for the children.

From the very first sessions, the couple spoke of fights, tension and clashes, from which they both emerged harmed. Anna described herself as calmer and willing to take things as they came, accusing her husband of being sometimes physically violent and blind to the real state of their son’s health. Giuseppe played down his episodes of rage, and voiced his worry that Anna did not seem to be sufficiently aware of the boy’s real needs. Convinced that it was in Bartolomeo’s best interests, Giuseppe had arranged for him to play on a football team, even though he sometimes had to take him off the field when he began to get so weak he could barely stand up.

As I listened to them, I wondered how long the boy’s sister would have to stay outside the “analytic field”!

Giuseppe considered his point of view to be the only truth and reality of the situation and was very disturbed by the fact that his wife regarded and experienced things differently. He therefore believed he was right and that his wife did not understand because she lacked the intelligence to do so, that it was a matter of a cognitive problem rather than hers being another way of seeing the issue. Their different ways of understanding (for example, during visits to the doctor) became a form of persecution and a source of conflict, in which he tried to put her down, insisting that his view was the right one. They each maintained that they were in the right as parents, that no mediation was possible, that the other’s way of parenting was unacceptable and they were each the better parent.

And I wondered how I could intervene to avoid full-on collisions.

I initially listened to them, hoping to act as a bumper/buffer between their mutual allegations. They spoke of continual acting out, and each seemed to be certain of knowing everything about the other. As I listened, I felt listless and manipulated, I struggled to understand, my movements were uncoordinated, and I thought of how Bartolomeo must have felt.

With great difficulty, I tried to maintain a tolerant, kind and respectful approach before this complex knot of long-established anguish and pain, while realising that I was the only one aware that it could not be confronted head-on. I endeavoured to ‘untangle’ it and let the conflict ‘breathe’ and circulate, and I looked for connections; I tried to provide the conditions for links to be generated with the new characters that appeared on the stage, such as those on the football field. But I struggled to maintain a couple state of mind: each partner experienced and referred only what had happened to him or her and tended to put up defences to keep persecutory anguish at bay. As a consequence, it was not easy for them to shift to another position from which to view how the actions of one affected the other and therefore consider both oneself and the other. I attempted to modify the perspective, so that they could think about their relationship, but I found myself continually oscillating between keeping and losing a couple state of mind.

Giuseppe recounted this dream: “I am in the car, late for my son’s football game; I make a turn and find myself on a familiar road but I do not notice that they have changed the direction of traffic and I find myself face to face with a van, which I crash into. I am extremely angry because this is going to make me even later for my son’s game, and because I have to deal with all the paperwork for the accident. The van drives away but I manage to take a photo of its licence plate, which calms me down as I now have the information to fill in the forms”.

Following this, Anna said that she had had a very tiring week, during which she had to deal with an extremely demanding situation because of a decision that had radically upset the work she was doing.

The recounting of a dream in couple psychoanalytical psychotherapy not only provides a picture of the couple’s shared psychic organisation but also gives us the opportunity to understand the shared mental state that develops in the session, as it is a phenomenon that involves all three participants (Monguzzi, Zavattini, 2023).

The shared mental state of this field was characterised by deep turbulence. The threads of the narrative began to emerge: if, on the one hand, in order to avoid a collision despite the realisation that one was travelling in the wrong direction, there was a need for continuous control, on the other, a deep sense of frustration was becoming evident. And I began to develop hypotheses regarding the way we were interacting together emotionally and how we were functioning unconsciously.

I realised that a rich vein of material was present, which might lead me in an infinite number of directions; I also began to think that the couple shared an internal couple that to me appeared to be intrusive, humiliating and based on coercion, and that neither of them could tolerate ambivalence. In fact, they based themselves on narcissistic relational models that had their foundations in omnipotent projective identification and because of which they each viewed themselves as being occupied intrusively by the other. There was no space within which they were capable of reflecting on their own individual needs, on the needs of the other, and on what was required of them in their role as parents. It appeared that they could not tolerate the fundamental emotional conflict between what is felt from the sensorial experience of external facts and what relates to the partner’s internal world; there seemed to be a lack of mutual trust and a difficulty in ‘playing together’ to find new combinations and possible solutions.

Feeling and understanding the extent to which there were infant elements in this couple that required the attention of the analyst was a transformative step: if they spoke only to each other, hostilities erupted between them that frightened them considerably.

It was not easy for me to realise just how difficult and complicated the life of this couple was. They needed significant defence mechanisms: a little denial, a little magical thinking, a little recklessness and a little pretending that there was nothing wrong. They were denying the complicated situation that their son’s illness had created, and were denying their anger, frustration and difficulty about accepting it. In so doing, they tried, without success, to avoid head-on collisions and to confront their most authentic emotions.

In the field, in fact, there was an absence of the capacity to accept the other person’s pain, and to understand it fully: no one could be trusted and there was always the risk of being unable to stay standing, just as had happened to the boy on the football field. This all derived from their being together, but also from their individual functioning. Together they acted in this manner because they each acted in the same way towards themselves; it was a continual kicking the ball back and forth between what they could not and did not want to see.

I, too, had difficulty maintaining contact with this pain, risking trivialising the situation and not being sufficiently benevolent or tender: I, too, risked a ‘collision’.

At this point, the field was marked by overwhelming fear and worry about the future, where hopelessness prevailed and each of us struggled to tolerate the conflict generated by our being emotionally close.

At the root of the events in a session that can threaten the therapeutic process, be they produced by the couple relationship or acted out by the analyst through, for instance, premature interpretations (explanations, descriptions), there is the human avoidance of pain or of other emotions thought of as intolerable. Such a condition can lead to evacuative phenomena that impede the development of thought and in this case, it would seem it was the ‘cerebral metabolism’ that was severely challenged.

To a certain (i.e. tolerable) extent the field must fall ill with the patient’s illness: as analysts we are unavoidably infected with the couple’s psychic suffering and can only learn how to train ourselves to recover from it, transferring the necessary tools to our patients so they can do the same (Civitarese, 2008; Ferro, Vender, 2010).

To provide wholesome nourishment to the brain, and prevent and control a range of symptoms, it is necessary to adopt a specific dietary regimen, in this case high in fats and low in sugars and carbohydrates. One must eat little and often, restricting the consumption of most foods and giving up all treats.

The couple manifested a situation of muddled and insufficient emotions and hence constantly felt ‘hungry’ and afraid they were unable to perform the functions required of them; they, too, had to learn to measure out the emotional ration that would see them through to the following day.

Throughout the analytic process, which, unfortunately, was interrupted by the Covid-19 pandemic, I tried, through my diet, to help them dissolve emotions they did not dare to feel, so that the couple relationship could receive the ‘metabolic elements’ necessary to feed the normal growth and functioning that had been blocked for the moment in an oscillation of continual mutual recrimination.

I endeavoured to be empathetic and imaginative, proposing alternative possible weaves of the threads of their narratives, using supportive and affirmative language. At the same time, I tried to use unequivocal verbal and non-verbal language to provide the discipline and harmony needed to be able to play together.

In this specific field it was not easy to maintain equilibrium between a protective and reassuring container, which may risk being coercive, and new, energising, but potentially destructive content that was trying to emerge, and not to be afraid of the friction and conflict that would ensue. It was necessary to find a diet and a measured balance between content that was at risk of exploding and a claustrum that constricted, and to build a space where new emotions could be created and shaped, to allow the psychic pain to be transformed (from paranoid-schizoid to depressive suffering).

Session after session, I tried to make immediate and spontaneous contributions, similar to free association, so that the couple could feel embraced and understood, and not forced at all costs to understand.

My interest was not directed at comments of the present based on the persistence of the past, but rather toward considering present events as a product of the current configuration of the field.

I view the task of the analyst as being that of introducing various aspects of potential identities to the arena, acting as a director who can expand the stage of the therapeutic relationship to include even those aspects which are believed to be most irrepresentable. For this reason, I believed that Anna and Giuseppe needed to find a way to sit at table together (in the field of the session) to be able to share and digest not their usual diet, but more varied, flavoursome, rich and nutritious meals, expanding the space and allowing themselves to share ever deeper and more tolerable emotions. I no longer used all the characters that began to come to life in the analytic space as real individuals, as the patients’ internal objects, or as the projective identifications characterising their relationship. I used them as functions that provided an opportunity to narrate the analyst/patient mental functioning and I stimulated the generation of new characters. To this end, I drew on Meltzer’s thinking on inspired interpretation (Meltzer, 1973). I tried to avoid making statements of any explicit meaning and to abandon a pedagogical stance in relation to the infantile personality structures (of the relationship) of each partner, aiming instead, in a spirit of adventure, to assume an attitude of adult camaraderie (with their adult part).

Ferro (2006) compares his method of measuring out interpretation to a chef who creates a dish by adjusting its specific ingredients, tasting and testing as he goes along, rather than following a given recipe. This involves a specific utilisation of the same ingredient – interpretation – in a different measure for each dish – the analytic field – giving back to the analysand whatever the analyst judges to be opportune in that particular case with that particular couple and in that particular session, constantly and continually ‘sampling’ its ‘flavour’. Ferro specifies that while the analyst always keeps in mind the transferential meaning of all communication that occurs during the session (between the partners in the couple and between the couple and the analyst), her interpretations take into account the specific analytic moment and she delivers them in doses according to the couple’s capacity to digest them.

During the course of their treatment, the couple decided to renovate Anna’s family house; I took part in this renovation: together we chose new furniture and paintings to hang on the walls. They moved house and this new creation/home, where they all, including Lucia, found their space, transformed the old mentality, which by that stage had reached the limits of its power of containment and expression and had begun to suffocate the mental development of all concerned.  

Conclusion

The potential for creation will take place in the narrative co-operation that occurs during the analytic session, by dissolving emotions in narration, transforming excessively dense experiences via words and vignettes, in a continual tension between harmony and conflict. Zweig reminds us that creation is a constant struggle between unawareness and awareness, that without these two elements, the artistic act cannot be completed and that the artist is bound by this law of contrasts, in the creative equilibrium. “Within this law he is free” (Zweig, 1939).

The narrative approach gives aesthetic strength to the field model, precisely because of the type of creative freedom it allows each participant. The analyst’s experience of being and becoming in the session should aim to be strongly aesthetic so that she can participate with the couple/patient in constructing increasingly dialogic meaning. Of prime importance is the fact that, in this approach, transference and countertransference, in the classic sense, are no longer central to the process, as the idea of searching for a definitive clarification of content and of the hierarchy of the things the analyst chooses to say takes second place. Rather, the criterion of choice will take account of the characteristics of the couple relationship, the analytic moment, and the amount of truth and intimacy that each partner can tolerate, all in an atmosphere of collaboration. It involves tolerating shortcomings, uncertainty and difference, having the capacity to enter into diverse mental states without necessarily denying or diminishing them, and also accepting unanticipated or contradictory thoughts and feelings, which may differ from our own.

Our interventions start from the assumption that the character of truth is intrinsic to the construction of a narrative rather than to content. The products of the mind, through the continual, unstable and painful tension of different emotions, are what generate new, fertile meanings. The formulation of interpretations, the way they are presented and how exhaustive they need to be, should not be decided by adherence to a strict theory of interpretation, but rather by an increasingly finely honed capacity to receive the responses and the emotional nuances that each member of the couple brings to the session after our interventions (Ferro, 2006b).

This is why Ferro compares a saturated interpretation to traffic lights, where red means stop and green means go, creating no-entry roads and compulsory traffic directions; whereas unsaturated interpretation is likened to a roundabout that illuminates the process and keeps it moving, with a choice of several infinite routes, none unequivocally signposted, providing new possibilities for imaginatively overcoming conflict and misunderstanding (Ferro, personal communication, 2019).

As we are conscious of participating in a process of creation and destruction, I believe that, rather than being preoccupied with how we are working with the couple from a technical point of view, it is more fruitful to strive to be ourselves with that couple, with all we bring of our own training, analyses, supervisions, study and reading, and group and individual reflections.

Learning to work with the field model has resulted in a significant transformation of my sense of identity: I no longer feel myself to be an analyst who treats the couple relationship, but one who participates, in as disciplined a way as possible, in a new creative adventure, in an enriching opportunity for all concerned.

Let us remember that the creativity of the field is also a result of our degree of freedom, our vitality, and of our intuitive thought, a capacity that also relates to our perception of the unconscious truth of the couple relationship (Ogden, 2015).

This approach provides scope for the couple to find new vitality, forge connections on a social level, become creative, and for their relationship to become a place where they reciprocally recognise the other and use their differences and alterity to create thoughts that, individually, they would never have been able to create alone.

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Couple psychoanalytic psychotherapy and the analytic field model
Barbara Bianchini

https://doi.org/10.69093/AIPCF.2024.31.04  

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

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^[*] An earlier version of this paper was published in Italian as “La teoria del campo analitico e la psicoterapia psicoanalitica con la coppia”, Interazioni, 2-2021/54, FrancoAngeli, pp.102-119. Translated by Roma O’Flaherty.

^[**] Barbara Bianchini, Psychologist and psychotherapist, AIPCF member; Tavistock Relationships Association of Psychotherapists and Counsellors (TRAPC) member; Associazione di Psicoterapia psicoanalitica di Gruppo (A.P.G.) member; teacher at Scuola di psicoterapia sede di Milano della Confederazione di organizzazioni italiane per la ricerca analitica sui gruppi (Coirag) barbara@barbarabianchini.it

[1] “In his rêverie the analyst calls up from his unconscious his repertoire of personal experiences, so that some of them may in some way connect with those of the patient” (Ferro, Mazzacane, Varrani, 2015, p. 102, author’s translation)