Nicolò anna maria, trapanese gemma (editors): quale psicoanalisi per la coppia? (what psychoanalysis for couples?) Franco angeli, milano, 2005.

Nicolò Anna Maria, trapanese gemma  (editors): quale psicoanalisi per la coppia? (what psychoanalysis for couples?) Franco angeli, milano, 2005.

Review By Valdimiro Pellicanò

This first volume, along with its “twin” What psychoanalysis for families? is a collection of papers, elaborated and edited, presented to the first international congress held in Naples, Italy, in December 2002 and called What psychoanalysis for couples and families?

The title itself is evocative. We wonder what psychoanalysis can we think of when we think of couples (and families) with the implicit suggestion that we can see psychoanalysis through different models and that these models can contribute to the development of psychoanalytical thinking.

Anna Nicolò and Gemma Trapanese succeeded in neatly collecting the ideas of eminent clinicians and therapists from all over Italy and many parts of the world.

In their introduction, the editors return on the history of work with couples and families within the area of Freudian thinking and of psychoanalysis in general and show that the development of various models on couples and families widened the field of intervention also to pathologies that in the past were not treated analytically due to their seriousness and to the complexity of the clinical picture.

After a comprehensive description of the developments of psychoanalytical thinking on couples and families in Europe and America, the editors explain that, beyond models, “the aim of psychoanalysis for families is to remove the obstacles that prevent families to respond to phase-specific developmental needs and to open spaces for thinking-dreaming during the therapeutic process”.

The first volume, What psychoanalysis for couples?, is divided into six sections and collects papers on issues such as the link in couples and families, models of the mind and of the relation, couple treatment, dreams in the couple setting and the organization of the setting with a couple.

The authors of these papers are many and it is impossible to review each single article, so I will dwell only on some of the issues discussed trying to highlight those that in my opinion represent original contributions. I would like to start by presenting some of the contributors, both well known and emerging clinicians.

Some of the articles have been written by authoritative figures in psychoanalysis of couples and families, such as Berenstein, Eiguer, Losso, Nicolò, Norsa, Pigott, Renik, Scharff, etc with original contributions in various areas of research that have the aim, often explicitly stated, to uncover new areas of the unconscious, or better to establish a new metapsychology keeping into account tradition and at the same time reaching new positions, such as the study of groups, developmental psychology or infant research.

An appreciable novelty of this first volume is the presence of papers produced by groups of clinicians. Of these I like to mention a group coordinated by Anna Nicolò that has been working for years on a scientific and clinical research work and produced contributions such as The work on links as a therapeutic factor in a couple setting (Nicolò, Tavazza, Grassi, Ricciotti) and The dimension of a couple link in individual analysis (Gozzano, Laganopoulos, Lucarelli, Pellicanò, Piperno, Solano).

Other papers on the couple under treatment produced by groups are: On the possibility of genealogical inscription in international adoptions (Sommantico, Boscaino, De Francesco, Madonna, Gagliano, Serio, D’Acquisto, Bucciero, De Luca, Masi), or on dreams: The “double” dream: Working on dreams in the psychoanalytical psychotherapy of couples (Brignone, Mieli, Zani), or on the setting with couples:

Reflections on the experience of co-therapy in psychoanalytical work with couples (Bigozzi, Fragomeno, Parrini, Sacchetti, Trapani).

And as the outcome of work written by a couple (and they could not be missing from a volume discussing work with couples) The psychopathology of an adolescent son caught in a marital and parental troubling context (Carratelli, Giacolini), Narcissistic wound in the couple and adoption (Lanza, Bovet) or The use of dreams in the treatment of sexual problems in a couple (Scharff D, Scharff J).

In the limited space of a review it will not be possible to  discuss the contributions of all the authors and of how the different models and orientations can answer the questions posed by the title of the book nor in turn pose other questions. I apologize with the authors I will not be able to mention.

One of the papers in the first volume that I think is very interesting concerns the link and represents a contribution to widening the psychoanalytical theory of “new areas of the unconscious”.

The first considerations on this issue are left to Claude Pigott, belonging to that group of French psychoanalysts relating to the work of Paul-Claude Recamier.

In his article The necessity of family psychoanalysis, Pigott, starting from Freud, discusses the transference link, in particular group transference as it emerges in families. An expression of this link would be the family novel, in its neurotic and psychotic versions. In the first case it is a temporary defence, that, when abandoned, allows a better relation with reality. The concept of incestuous family belongs instead to a psychotic link, where “the origin is not the resolution in the child of the original mourning that prevents him to distance himself from the early incestuous mother-infant relation” (Pigott, p.34).

In this case we see a pathological link that can be treated only within a psychoanalytical treatment of the family, also because individual analysis cannot “reach the origin of the disorder”, as was proved clinically.

But, is it true that individual treatment cannot succeed in these pathologies, or that if we learn specific techniques deriving from models on couples and families, we can reach new skills in treating our patients, also individually? A kind of treatment that induces the development of new ability and functions in the Ego?

Gozzano, Laganopoulos, Lucarelli, Pellicanò, Piperno and Solano, in their article The dimension of couple links in individual analysis, discuss the possibility of developing new models derived from couple therapy to be applied in the individual setting in serious pathologies.

After discussing the difference between links and object relations, these authors further develop the concept of link between spouses, distinguishing the healthy from the pathological link. They say that the latter is often used as a defence, even in individual analysis, and if used in a well organized mode can block the development of the analyst-patient relation. To interpret this link with the spouse (in his absence) means to act not only on the patient’s internal world and object relations but also on the patient as subject in the relation, on the defences enacted by the link and through the link in order to foster new developments in the transference relation with the analyst. A kind of clinical and theoretical approach that on one side agrees with the one suggested by Renik, when he says the “the analyst’s task is to facilitate the exploration and elaboration of the usual interpretations of the patient’s reality, providing new perspectives” (p. 104), while on the other is very different, when Renik, to solve an impasse with a patients suggests that we can modify the setting and introduce the partner in the sessions (p. 99-100).

From another purview, Thanatopolous too discusses this issue when he says that in especially serious cases a pathological link can trap the analyst in a transference difficult to solve and that the activation of a fatherly function can free the impasse situation.

Nicolò, Tavazza, Grassi, Ricciotti in the article Work on the link as a  therapeutic factor in a couple setting suggest the idea of a couple link as neo-formation, as a new specific element that emerges from the encounter. Developing some concepts suggested by Berenstein and Puget on family links, the authors say that the subject’s inability to recognize the other as an external subject often produces serious pathologies, as the other is exploited, parasitized by means of interpersonal defences. Each one of us activates a version of his self in the link with others that is complementary with the other and functional to the link. In the case of pathological dissociated behaviours, especially when activated in front of the other, couple therapy would then become the elective therapy allowing to operate on the defensive organization specific of that link.

Always on the link Berenstein gives an important contribution with the article The family link.

The family link moves from past to future, from what is inscribed in the infantile past (the hidden meaning, M. Khan would call it) and the event that never had space before (the absent meaning, M. Khan would call it). Through an interesting case history Berenstein says that it is possible with family and couple treatment to foster the establishment of new psychic spaces where to locate the other that would produce a destructuring of existing spaces, of pre-existing links and the structuring of new links, never experienced before.

In the second part of the volume, Eiguer in The modern couple and the pathology of dominance says that couples need myths through which to maintain their dominance. This would be expressed through what Eiguer calls an act of appropriation: a mutual devouring with the important function of feeding the couple’s libidinal area. Dominance for the couple would be functional to the partners’ link, especially in the modern couple, where both lost something and earned something different, due to the evolution of society. However, Eiguer sees the risks threatening modern couples and concerning an excessive cathexis of the external at the expense of the internal. A second risk is represented by the phallic rivalry, fed by the performance of one partner and badly tolerated by the other.

Myth plays an important role in the fight for power within couples, but there are myths coming from the external world and from the culture the couple lives in and transgenerational myths that play a  more structuring role. Myths are phantasms to which subjects add a strong shared belief.

On the other hand Eiguer (1984) said “the couple’s myth plays an essential role because it represents the unconscious of the past, of the family of origin from which one is getting separated with more or less suffering, and of the future through offspring”.

Eiguer’s article continues with an interesting discussion of the phenomenology of power in couples.

In his conclusions, he suggests an idea of the link which is quite different from the one of the Italian authors in this book. In fact he stresses the defensive function of the link: “The couple link is only a compromise formation to solve one for the other a number of unconscious conflicts”. When this link fails, the defences that kept the couple united tend to weaken. Interpersonal defences, however, can be constructive when they are the product of the mutuality of phantasms.

Also Onnis discusses the couple’s myth in an interesting article where he also discusses the epistemological developments of the systemic approach and the influence these can have on couple therapy.

There are many more interesting indications in the search for convergence and divergence of theoretical and clinical approaches suggested in this volume. Can we speak of complementarity of models?

Freud himself presented different models in the development of his thinking and as Roberto Losso (p. 142) states: “although Freud did not develop his technique in multipersonal contexts, he suggested the possibility and the necessity for the development of other techniques that allowed to cope with situations he could not solve”.

In many articles in this volume we talk of new areas of the unconscious, new theoretical models that suggest a different clinical approach to the same phenomena. I think a clinician can take advantage from this because in knowing more than one theoretical model, he can discuss them and use then in the various clinical situations and areas of intervention.

To close I want to quote M. Khan: “Our theories do not make us wiser or more infallible, but they let us see our ignorance in what we do. It is already something positive from which we can take advantage. I do not think that pathologies have changed, but rather that the means to interpret them and cope with them continue to change. And here we find the true function of our theory in our practice” (1974).

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References

Eiguer A. (1984), Le mythe familiale, le mythe social, le mythe de couple. In Dialogue, n° 84, pp. 86-101.

Khan M. (1974). Lo Spazio Privato del Sè. Trad. it., Torino: Boringhieri, 1979.

Pichon Rivière E. (1985). Teoria del vinculo, Buenos Aires: Ediciones

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