The ageing couple: the need for changing the links and the unconscious alliances in a time of longer life expectancy

An increased percentage of elderly people has been registered in recent decades in the demographic structures of many Western countries. Currently old age covers a third of life and implies changes, conflicts, and losses that can require a deep elaboration that can prove quite difficult. The doubts and reservations on the use of analysis with older persons, quite common in the past in the psychoanalytical community, seem to be waning, probably also due to the growing numbers of distressed ageing persons. Elderly persons, at times even old persons, come more and more often to see us. This phenomenon is so widespread that it gave rise to the proposal of creating by the European Federation for Psychoanalysis a forum on ageing that aims to include in psychoanalytical training the knowledge necessary for treating elderly and old patients.

If requests for treatment from individual patients have increased, this is even more evident in the case of couples. In fact, the average age of couples who come for help is quite high and it has become frequent to receive requests from patients that in the past we would not have treated such as couples in their 60s and 70s and in some cases even older.

We know that just like it happens for individual psycho-affective development, the psychic life of couples develops through phases and processes, each of them implying crises and transformations, that should be followed by elaboration and a necessary physiological and developmental transformation.

But this does not always happen. In fact, at each stage defensive or alienating unconscious alliances (Kaës, 2009) in the couple link can hamper the necessary transformation processes.

When the passage of time makes it necessary to perform an actual “ageing work”, as suggested by D. Quinodoz (1999, 2008), that includes focusing on one’s overall internal history in order to locate the final part of one’s life in a pathway that has a beginning and an end, the partners should be able to re-negotiate their way of being together and to reconstruct a new image of themselves and of the other. But while they need to experiment and stabilize new ways of interacting, they also need to maintain the continuity of their Selves and to recover the continuity of their couple. This work can be hindered by non-elaborated psychic distress that generated defenses located in the couple’s link. Suffering can be avoided or evacuated and later reemerge through various defense mechanisms, such as conflicts, various kinds of acting out and symptoms, to get sick “through the other”.

In this paper I intend to explore a few modes with which distressed aged couples come to us. At times it can be difficult to work through the transformations necessary to start to reconstruct one’s internal history. At times the features of the intersubjective links (Pichon-Rivière, 1979) and of the unconscious alliances (Kaës, 2007) created by the partners can prevent the necessary transformation processes or, in other cases, the alliances created in the past and stabilized in time for defensive reasons can show, in the later phases of life when new needs emerge, that it is impossible to confirm and renew them. At times it can be necessary to face new internal aspects in each partner that have become intertwined in the link. This task can be hampered by a psychic distress that cannot be elaborated and generates interpersonal defenses that weigh heavily on the individual’s ability to perform personal psychic work because they moved onto another (outside the link, for example in a child) the aspects that the link could not include.

Based on these premises I present three clinical vignettes concerning the treatment of elderly couples that will allow us to focus on some aspects.

I suggest that we observe the clinical situations starting from the following points:

• The object of a couple treatment is the link between the partners, where the term link defines the specific unconscious psychic reality built by the meeting of two subjects. I refer here to the concept introduced by Pichon-Rivière (1979) under the name vinculo, that indicates “a complex structure that includes the subject, the object and their mutual interaction” and specifies that the link creates a behavior pattern that tends to be repeated automatically in the internal world and in the relation with the other.
• Following Kaës (2015), I will consider the existence of a common unconscious, intersubjectively shared and therefore located in the link “outside the subject”.
• Again, following Kaës, I suggest that unconscious alliances form the basis of any link. Kaës (2009) says that to enter the link the subjects of a link must form and seal alliances not only to establish, maintain, and tie their link but most of all to preserve the contents and the stakes for each one of them and for the very link.
• Psychic functioning is seen as centered in multiple Self states (Mitchell, 1991; Bromberg, 1998). According to a non-linear conception of the self, in a state of relative internal consistency there is a constant dialectic between unity and separation of Self states and the different Self states can function without foreclosing communication between them.
• In a couple link some Self states can be activated and kept dissociated from other ones and never be expressed in other relations and aspects of life (Nicolò, 2014, p.65).

With the help of the clinical material from the psychoanalytical treatment of a first couple, I would like to show how their link had been formed using aspects of the other for maintaining a connection with their respective pasts that could not be changed because of strong dissociative defenses and their inability to make a psychic elaboration and integration of very dramatic experiences that threatened the consistency of each partner’s Self.

Giulia and Luca, a couple in their 60s, met in adolescence, married and have two grown-up children who lead a satisfactory life outside Italy. They came to see me because their otherwise “quite solid marriage” was shaken by quarrels that entailed large amounts psychological violence. The quarrels followed a recurring script that left them very sad, upset and helpless to avoid them or to change their emotional reactions. It felt as if the situations were acted out by the unconscious alliance of their link without them being able to do anything to avoid them (Nicolò, 2014, p. 65). We could think that the other parts of their life had not been touched by the aspects located in the couple link in which there was distress and where they could deposit dissociated Self configurations that were separated from other aspects of their selves (Nicolò, 2014, p. 65). Their request for couple analysis could be seen as a search for help for their link where they had located dissociated parts of their Selves^[1]. It emerged that the experiences that linked them were based on extremely dramatic and violent events of their childhood. They had probably seen they were similar in this and together they had found a defensive alliance in their link (Kaës, 2009). They had in fact united their common need to dissociate the traumatized aspects of their psychic reality sharing an original ghost of safety and complementarity.

A symbiotic link had protected them from their most damaged parts charged with aggression where neither could acknowledge that the other was separate or existed autonomously and blocked their possibility to change. The birth of their children in the past and more recently the fact that they had reached a more advanced stage in life had let emerge these new insecure and aggressive aspects in the link that had kept them together until then. Giulia felt not seen and her increasing requests for attention made Luca feel destabilized in his safe position from which he derived an increased need for reassurance of his ability as a man and as a husband that only met negative comments from his wife who used her distress to feel strong. This determined an increase in Luca’s defenses and a tendency to reject in a more and more explicit and aggressive way Giulia’s accusations of insensitivity, contributing to trigger a vicious circle of mutual accusations from which both came out more devastated and disillusioned but even more trapped in the link. They seemed to be lacking that function of deposit of the most undifferentiated and damaged parts of both in a link that for a certain period of time had provided protection. In time and with the changes intervened, the ambiguity^[2] (Bleger, 1967; Amati Sas, 1992) deposited in the link had had to be re-introjected and had become destabilizing. A link with perverse qualities united them now tightly in the effort of containing their present painful experiences related to their non-elaborated and non-representable childhood relations and still constantly threatened their internal stability.

Therapeutic work allowed to change this repetitive psychic functioning that paralyzed their couple relation giving rise to a possibility for symbolizing the traumatic aspects and progressively differentiate themselves in their relationship allowing the emergence of an otherness that it had not been possible to acknowledge.

A second vignette concerns a couple in their 70s, Maria and Franco. They had been married for almost 50 years and came for help due to a great distress caused by Franco’s pathological jealousy that gave rise to emotionally violent verbal aggressions referred to events that had taken place nearly 50 years earlier. When they came to see me both partners were stressed and exhausted by the tension between them. Maria was exasperated and saw the situation as intolerable implying that the problem was only her husband’s pathological jealousy that was her reason for the consultation with the aim of curing it. They met in high school, got together and never separated. After a long engagement and after they both completed their education, they married and Maria immediately stated to her husband that she did not want a “traditional middle-class marriage”, meaning a formally united marriage where betrayals could take place in hiding, but suggested what was called at the time an “open couple”. Franco obliged although he was not convinced, also because he had always considered his wife as more clever and cultured than he was. To better understand this we must remember that the marriage took place right after the events of 1968 in a society and culture in turmoil where politics and habits were changing radically. Their marital life was interspersed with Maria’s initiatives as she tended to court her potential lovers in Franco’s presence, in social situations with friends and colleagues and then went on to have actual affairs. She loved feeling admired and desired. Franco went on hoping that things would change and, at a certain point, started denying the situation but never thought of dissolving the marriage. The reason of the latest jealousy attack derived from his having finally found the journals written by his wife that he had incessantly been looking for. This meant he had found

“evidence” that his wife had continued seeing other men despite her denials. Both partners had contributed to the establishment of a perverse relationship. In the link they enacted a specific version of each one’s Self while all the other versions were silenced. The link built by the two partners represented a third element capable of influencing and changing both (Nicolò, 2016). But despite the appearances we should not think that one was the parasite and the other the victim, but that at a certain level the victim could become the persecutor, as it was happening now. The ideas of 1968 represented the culture and climate of the time when they married and embracing them allowed them to feel they “belonged” in a vast movement where they hoped to find the identification they lacked. Embracing these ideas had become on one side a way for not acknowledging what they lacked and had created their defenses and, on the other, a justification for participating in a perverse relationship. In Maria’s case, the need to defend herself on dependence, the presence of internal parental objects that she hated or despised, made her identify with some of the radical ideas of the period. This confirmed her defensive need for a perverse drift. Franco, on the other hand, had a devalued sense of his Self and was extremely insecure, so he embraced the same ideals because in this ideology he found refuge, a confirmation of his identity, and a family he could idealize. Finding the journals, he had been looking for obsessively let emerge feelings of anger and self-devaluation that had been dissociated until then and now resurfaced with intolerable violence and needed to be transformed and integrated.

The third clinical vignette concerns a couple in their 70s, Lucia and Piero, who came for help because of the problems related to their younger daughter, Sara, 30 years old and living outside Italy, because she had a relationship with a man coming from a disadvantaged environment who depended financially on her and abused her emotionally while she seemed dependent on him and unable to free herself. The parents were afraid that she could become pregnant and, in this way, even more dependent on her partner without being able to choose freely.

The sessions were mostly filled with reports of the symbiotic relationship the mother had with her daughter and with the description of the daily phone calls when Sara complained with her mother of how her partner treated her. Lucia was unable to avoid these phone calls despite Piero’s pressure but in fact he was not really active in this situation. Lucia filled the sessions with her words that left little space to me or to her husband. A rational and balanced man, he controlled his emotions and rarely commented on his wife’s torrent of words. Piero was a successful manager with a very interesting and satisfying job that allowed him frequent travel worldwide with his family. After their marriage Lucia relinquished any idea of a career and followed her husband and looked after their two daughters. From what she said, their life was satisfactory because they had enough money, international relations, nice homes apart from the fact that their youngest daughter developed bulimic symptoms and was quite overweight, in addition to being engaged in the relationship described above that created so much distress.

In the sessions, that were quite monotonous despite their content, at a certain point Lucia remembered an event happened when she was 20 years old and decided to spend a year in the United States as a babysitter in order to perfect her English and to have new experiences. With a certain shame she told us that she was forced to suffer the assaults of the father of the child she looked after to which she was unable to react and felt forced to submit passively. In the end she managed to run away and come back home. She was surprised by the emergence of a memory of events she had completely forgotten.

This allowed us to think together about how this passive dependent part of her, that seemed to show an aspect of her weak identity, had been dissociated thanks to her meeting with Piero, a very active and successful person, who located in her his dependent and needy parts. We could see that their couple was formed so that Lucia dissociated her dangerous passive parts and defended herself through her link with a rational and active man, while Piero located his dependent and threatening parts in her. Their couple link was based on the need to defend themselves from dependent aspects that seemed to have been deposited in their daughter Sara. We can call them transpersonal defenses enacted by the couple to evacuate in the other or through the other, in a space other than one’s mind, the anxiety or mental distress that had not yet been elaborated or could not be elaborated in the couple’s mental space (Nicolò, 2014, p. 65). Piero had recently retired and it seemed that these contents had become threatening again and probably this was the deep reason why they came for help. We could say with Quinodoz (2008) that, although they had been disturbed for a long time by a lacking sense of identity, such patients did not suffer for it as long as their activities kept them busy and prevented them from reflecting on themselves.

Problems and distress emerged when action could a longer mask the lack of “being”. I hope that these clinical vignettes, despite their conciseness, can show the importance of therapeutic work with elderly couples and how an analytical work that keeps account of the links, even in old age can originate transformations in the unconscious alliances forged in the past.

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The ageing couple: the need for changing the links and the unconscious alliances in a time of longer life expectancy
Daniela Lucarelli
https://doi.org/10.69093/AIPCF.2023.28.02

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[1] I refer here to dissociation as a defense that represents the response to a trauma and can be considered as a process that anesthetizes and isolates pain (Schwartz, 1994).

[2] A concept with which Bleger (1967) defined a powerful and deep archaic defense mechanism that has the unconscious aim of avoiding divergences, choices and conflicts making them subtly turn into something ambiguous. A concept recovered and developed by S. Amati Sas (1992).