INTRODUCTION

Introduction to the issue “Setting, transference, countertransference and interpretation in couple and family psychoanalysis”

Massimiliano Sommantico^[*], Daniela Lucarelli^[**], Almudena Sanahuja^[***]

From the outset, psychoanalytic work with couples and families has differed from the traditional approach based on individual work in several crucial respects : setting, transference, countertransference, and interpretation.

The setting, or frame, transference, countertransference, and interpretation are undoubtedly among the most important technical tools in any psychoanalytic practice, including with couples and families, and are fundamental levers in the therapeutic process.

The presence of two or more patients in the consulting room has made it necessary to review each of these tools from a new perspective. The setting, although confirmed in its function of ensuring stability, is increasingly seen as subject to variations that enhance its function and content, in a dialectical relationship with the process.

Moreover, as intersubjectivity has come to the fore within the therapeutic neo-group, it has become even more significant to emphasize the interweaving of transference and countertransference, and the need for their analysis and interpretation. This can help us to identify movements of repetition in the treatment, as well as new elements that emerge in the course of the sessions.

While much has already been written on these major technical aspects of psychoanalytic work with couples and families, this issue aims to understand the changes that the current malaise in relationships implies for clinical work. At the same time, this issue aims to draw attention to the different theoretical and clinical orientations that characterize couple and family psychoanalysis around the world. In the different currents of couple and family psychoanalysis today, how are the setting, transference, countertransference, and interpretation understood and worked with clinically? Are they treated and understood with preferential reference to metapsychology, the object relationship, intersubjectivity, or the link?

In her article “De-mystifying the countertransference in the couple analytic process” Mary Morgan notes that in couple therapy, countertransference can sometimes seem more complicated because the therapist may experience intense feelings that seem difficult to understand in terms of the couple’s inner world and relationship. In this situation, the therapist needs to refer to couple psychoanalytic concepts. She proposes several ways of looking at countertransference in couple therapy and suggests how a ‘couple state of mind’ provides a frame for working on countertransference with a couple. Looking at the concept of countertransference today, the author identifies three important developments: countertransference as a creation of the patient, the enacted nature of countertransference and working with the countertransference.

In her article, she claims to have demystified countertransference because we need to be aware that ‘we will never fully understand the way in which one unconscious attunes itself to another, nor will we ever be fully aware of the unconscious part of countertransference work’.

Silvia Resnizky, with her article “Acerca de los dispositivos y su diferencia con el encuadre”, in the light of the theories of Foucault, Deleuze and Agamben, proposes a reflection on the concept of the device and highlights its points of contact with contemporary clinical practice. In particular, understanding clinical devices as joint constructions between analyst and patient, which emerge from the analytic bond in the transference, and focusing on the approach of link theory, the author underlines the possibility of including and theorising the presence of the other in the device. In light of the idea of a psyche open to the novelty that arises in the encounter, the author proposes different forms of interpretation and intervention in psychoanalytic work with families and couples, reflecting on the development of the transference and the inclusion of the concept of interference, emphasising the presence of the social and subjective reality of the patient and the analyst in the session.

Christelle Lebon’s article, “En néo-groupe avec le couple: du cadre groupal aux spécificités du transfert”, based on theory anchored in couple psychoanalysis and a clinical vignette, highlights the issues at stake in couple therapy in terms of the frame, the transference-counter-transference dynamics and the interpretation of psychic movements through the analysis of the psychic apparatus of the ‘neo-group’ made up of the couple and the therapist(s). The author focuses on the specificity of the transferential dynamic, in this case that of the intimate in the session, the power of the narcissistic and libidinal seduction movements, the attempts at control and alliance, the indifferentiation and fragility of the psychic envelopes, and their effects in the counter-transference.

Barbara Bianchini, with her article “Couple psychoanalytic psychotherapy and the analytic field model”, aims to highlight the way the analytic field model, as developed by the Pavia school, may  be relevant and fruitful in psychoanalytic psychotherapy with couples. The author shows how, according to this theory, transference and countertransference are used less in the classic, directly explicit sense. In this perspective, the focus is on promoting the development of tools for thinking together, with the aim of transforming proto-emotive and proto-sensorial states into something more comprehensible, and on developing the creation of new narratives that have been co-constructed by the couple and the analyst.

Christopher Clulow’s article “Interpretation viewed through the lens of attachment informed couple psychotherapy” puts forward a critique of the classical view of the ‘talking cure’, according to which the mutative power of psychoanalysis was attributed to the interpretation of transference and the site of transformational change was identified in the patient-analyst relationship and achieved through the medium of language. In the light of attachment theory, the author emphasises the mutational potential of relationships in which both parties are involved in the reciprocal process of creating something new, the prerogative of ‘non-specific’ factors. In particular, the author considers the ‘mood music’ of psychotherapy, suggesting that interpretation can be seen as an act of love, which arises from and is the result of change.

Clelia De Vita, with her article “«So close, so far away». Change of perspective in online sessions with the family”, refers to Winnicott’s concept of ‘foundcreated’, to reflect on a particular moment of transformation which occurred during sessions conducted online with a family whose mode of functioning was psychotic. This moment produced a double paradoxical effect whereby the therapist found himself welcomed by the family ‘in their home’ despite the actual distance resulting from meeting online, and countertransferentially felt the creation of greater intimacy. At the same time, the family also gained greater trust in the therapist.  

Finally, the author emphasises the importance of referring to the internal frame to address and understand the changes produced by online psychotherapy.

Clarisse Vollon’s article “Texture de l’enveloppe psychique de la famille et aménagements du cadre thérapeutique dans la prise en charge de l’adolescent en cabinet libéral : entre interactions et interdépendance”, based on a clinical vignette, considers the interactions between the texture of the psychic envelope of the family group and the importance of its role in the development of the therapeutic frame for the treatment of an adolescent girl. More specifically, the paper shows that the texture of the family psychic envelope gradually evolves during the first interviews with an adolescent and her parents. During these interviews, the first transferential knots emerge, with significant projective movements. They lead to a partial and transitory oscillation in the texture of the family psychic envelope, between disintegration and integration. The emergence of these integrative movements is a necessary first stage in the patient’s adherence to the treatment process, which involves the use of role-playing by the clinician as part of the therapeutic frame, and its safe use by the adolescent in individual sessions. Barbara De Rosa’s review of Patrice Leconte’s film Confidences trop intimes (2004) interprets this work as a kind of comedy of misunderstandings, based on the film’s premise: a slip of the protagonist’s mind leads her to confuse the door of her psychoanalyst with that of a tax expert, who immediately becomes the container for the woman’s very intimate sexual confidences. The author shows us how the lighthearted atmosphere of the beginning gradually slips into an increasingly sombre mood, unsettling the viewer.

The issue closes with Anne Loncan’s book review of André Sirota’s Retour à Jitomir (2023).

As the author of the review writes in her commentary, this book is a treatise on family memory, the conditions under which it is constructed, how it is erased and the hazards of reconstituting it.

Zhitomir or Zhytomyr is a town in what is now Western Ukraine, once part of the Russian Empire. In 1919, the city was fought over by the troops of the Red Army, then included in the new empire, that of the Soviets.

The author’s account brings us face to face with the tragedy of the outcome of wars, with the destruction that wipes out towns, villages and people’s histories, causing traumas that are incredibly difficult to heal. The content of this book – as Loncan writes – is as worthy as any academic consideration of psychotrauma and its generational transmission.

The presentation of this book helps us to reflect on the extent, in our time, of the proliferation of wars and destruction, causing not only the death of countless people, but also the annihilation of a sense of belonging, of links, and the loss of family histories: These situations are so dramatic that when, as therapists, we come into contact with patients who have had such experiences, we become aware of the ‘part of self-defence that it is necessary to construct in the counter-transference in order to be able to provide therapy’.

We hope that this issue will spark readers’ interest and encourage them to reflect on these key elements of psychoanalytic work with couples and families.

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^[*] Psychologist, SPI-IPA psychoanalyst, couple and family psychoanalytic psychotherapist, Associate Professor of Dynamic Psychology at the University of Naples Federico II, founding member of the International Association of Couple and Family Psychoanalysis, editor of the IACFP Journal.  sommanti@unina.it

^[**] Psychologist, psychoanalyst, IPA/SPI member, member of the AIPCF Board, director of the IACFP Journal, professor and supervisor at the PCF (Post-specialization and clinical research course in psychoanalytical psychotherapy of the couple and the family of Rome). daniela.lucarelli@gmail.com

^[***] Professor of clinical psychology and psychopathology, psychology laboratory (EA 3188), family psychotherapist and clinical psychologist. maria.sanahuja@univ-fcomte.fr