The “couple analytic setting” and the psychic development of the couple

Introduction

In this paper I suggest that the analyst’s internal couple analytic setting imbued with a couple state of mind (Morgan, 2001; 2019) can, in itself, have a significant impact on the couple’s own internal “setting”, which has ceased to function or to develop. We might not notice that our internal setting, that is so much a part of our ordinary therapeutic selves, is unconsciously registered in many ways by the couple coming for help and has more significance for them than we might realise. I am referring not only to what we might say to the couple in the form of interpretations but to all the ordinary aspects of the setting and in particular the experience of being in the presence of an analyst with a couple state of mind. This is a factor which can contribute to enabling more psychic space and development within the couple’s relationship.

A couple come for their first consultation. This has been arranged on the phone with him and he says they only want to come for three sessions. I say that is fine. They are an unmarried heterosexual couple in their early 40’s. He is divorced with two young sons. I ask them to start wherever they like, mentioning that I had spoken to him to arrange the appointment and had agreed to the request for 3 sessions. I mentioned this to gather into the “couple analytic frame” anything that has gone on outside it – in this case a fairly straightforward phone call from him. They tell me they cannot decide if, after a year of being together, “on and off” they will live together and maybe marry or if perhaps, they should separate. For her especially, there is the question of whether they could have a child. The problem is they have many impossible arguments about nearly everything. As they talk, he starts to describe their difficulties, but she cannot agree with the way he is putting things, the words he is using, and, quite quickly, things peter out or close down. It starts to become clear to me that, in contrast to him, she does not want to be here (even for three sessions) and quite early on I feel I need to comment on them being in very different places about being here, one of them I felt had an urgency about coming, the other was extremely reluctant and the compromise seems to be the three sessions. They agree with that. In this simple comment I am addressing her negative transference as well as his positive one and also trying to give equal validity to their different feelings about coming, as well as pointing out that between them they have found some kind of way forward. I realise this is the first point in the session anything can be agreed upon for them as a couple.

In the first two meetings they argue about everything and I am given an experience of how impossible this is. They can’t agree on facts and the other’s experience of events is very discordant with their own, it is frustrating and eventually makes me feel as hopeless as I imagine they do. When I say something about this, I experience him as listening carefully to me, taking in my thoughts and thinking about them. Or, I start to wonder, is he taking them in or just agreeing with me? She also listens carefully but argues with everything I say or tells me that what I have just said, she had already said, so why did I need to say it? I cannot find a way of making contact with her and I am aware of the urgency with which he wishes to connect, which I wonder about. I am trying to think about what is happening between them – about the arguing and the different experience I am having with each of them – with him, as if we are fairly much of the same mind with no clear space between, and with her – something excruciating about being in the room and, I am starting to feel, a deep mistrust of me.

They tell me about an argument which ended with her saying to him that she doesn’t want him cooking in her kitchen anymore. He is so hurt he leaves her apartment and returns wounded to his house for several days. He makes some holiday plans for him and his sons that don’t include her. They go into a familiar place in which they feel the relationship must end. I wonder, what does it mean that the kitchen can’t be shared, why does she push him out and why does he feel so utterly rejected? I hear about how she feels he does not take care of her special expensive pans and how he feels wounded as he was trying to make a special meal for her. I start to understand that there is a painful issue between them about sharing psychic space. I interpret to the couple that “in their relationship something happens when they try and get close – one feels the other gets too inside them and the other feels violently ejected”. They hear me – both of them this time and later in the session she tells me about another similar painful event that occurred earlier in their relationship. He had bought her a beautiful necklace for her birthday. He was very excited about it, it was expensive, but he didn’t mind, he wanted it for her and imagined her wearing it always. He took her out to dinner to their favourite restaurant and gave it to her there. People were watching and she feigned joy because she really didn’t like it but couldn’t say. Then for several days she couldn’t tell him. The pressure to join in his enthusiasm started to rock her, she felt confused, perhaps she loved it too, how could she not love something he loved so much? She eventually said to him she was not sure about the necklace. At first, he could not believe what she was saying, then when it sunk in, he was devastated and so was she. He felt mortified that he had got something so wrong, she felt full of guilt and they felt despair about the relationship. In recounting this event I felt they were helping me understand more about their difficulty with psychic space, difference and otherness. I said to them, “I thought they were longing for unity, to join together and be of the same mind, and that when the reality of their difference and separateness broke through it felt devastating for them, it made them feel there was something wrong with them as a couple”.

We meet for the third and potentially the last consultation. She says things feel better between them and he agrees. We discuss them coming for regular sessions. What has happened? I know the couple are not by any means cured but I do believe something significant has happened to do with the beginning of their engagement in a couple analytic process. The “couple’s setting”, as we could call it, is different to the setting created by the analyst, the “couple analytic setting” which enables a different kind of space – a “couple analytic space”. In other words, there is a difference between the setting that the couple normally inhabit and the setting that the couple therapist provides. When the couple first come for help these two settings come up against each other. In my view, the couple analytic setting in itself contributes to psychic change in the couple, not only our interpretations and containing function. But what is it that is so different and how does this affect the couple? Thinking about the importance of the couple analytic setting I want to emphasise three aspects: the importance of giving meaning, perspective and providing continuity.

Meaning

First of all, in the couple analytic setting, what the couple talk about is treated differently — not as social communication but as thoughts and feelings to be understood, however trivial, however disturbing. As Ogden states «Everything the analyst does in the first face-to-face analytic session is intended as an invitation to the patient to consider the meaning of his experience. All that has been most obvious to the patient will no longer be treated as self-evident; rather, the familiar is to be wondered about, to be puzzled over, to be newly created in the analytic setting» (Ogden, 1992, p. 226).

So, for example the way the analyst listens to the material about the kitchen and the special pans is different to how the couple or anyone else might listen to the same exchange. The couple analyst is looking for meaning about the relationship – that something that might be thought trivial – a fight over pans and the kitchen, psychically might feel a fight of between life and death – about being intruded upon, taken over, damaged or humiliated, rejected, even annihilated. Finding meaning, particularly the unconscious meaning of our symptoms, behaviour and experience is central to a psychoanalytic way of thinking and working. And if we can discover meaning with our patients this is part of the process of containment.

The couple I have just described are getting into increasingly despairing states about why they are arguing all the time. They each feel misunderstood, but they can’t understand what is being misunderstood at a deeper level. As I continued the work with this couple, we understood more about how she had felt completed intruded upon by her narcissistic mother. This was a mother who seduced with the offer of intimacy – from early physical care to later sharing of confidences that almost always developed into a disturbing intrusiveness. The current version of this is that the offer of intimacy by being made a special meal by him already created anxiety for her. Having risked letting him in to her internal space (represented by the kitchen), she then found herself feeling assaulted as he messed up her internal space, just as she felt her mother had. For him there was the opposite problem. Arriving in his large family as an afterthought – when his siblings were much older, and his affluent parents had (in their minds) moved on from being parents and resumed their pre-children couple life, he craved intimacy and had a desperate need to insert himself in the minds of his parents. With this depth of meaning we could see that the row about being in the kitchen – his attempt to make a special meal for the two of them and her feeling that he took over and messed up her special pans – might be a battle for psychic survival in relation to either an intrusive object or an abandoning one. The devastating event of the gift of the necklace illustrates how the intrusive object leaves no space for the other, how confusing the presence of the intrusive object is for the other, and, when ejected, how shocking the experience of abandonment is.

Perspective

Even though on the face of it, the couple are coming for help “as a couple” or “with their relationship”, it is worth considering that this might be more the couple analyst’s mindset than the couples. It seems important for the therapist to have in mind, that something which seems so obvious to her, may not be obvious to them. They might not actually conceive of themselves as having a ‘relationship’ in that sense – something between them that they create together consciously and unconsciously and that in health they might nurture. Their state of mind might be more two dimensional – it is more “my relationship with him or her”. The other may be seen as the problem and to blame. If they were ‘not like this, didn’t do this, or did this’ it would be okay. In other words, the other is responsible for one’s happiness and, if failing, is at fault. In this frame of mind, we see that quite often one partner, or each partner, feels brought by the other for treatment and there is the hope that the couple analyst will deal with the problem in him or her. There may also be a wish in either partner to establish their own emotional reality as the “truth” and to enlist the analyst’s support in achieving this. When the couple come for help, they encounter something very different to this – they are both given space, the analyst does not blame, judge, or try to establish who is at fault. Instead she is curious about the meaning of their experiences and about what is created between them.

In this way the analyst provides a different perspective to that of the couple. The capacity to take a “third position” (Britton, 1989) in relation to the couple – that is, being able to be subjectively involved with both individuals, but also, at the same time, being able to stand outside the relationship and observe the couple is crucial (Morgan, 2001, p. 17). The couple analyst, by taking a third position, tries to understand the relationship. Even if both partners agree that one of them is the problem, the analyst doesn’t think about it in this way. The couple analyst by bringing a focus on what they create together relieves one partner of feeling only blame and the other of feeling helpless, since otherwise they are dependent on the one who is at fault to change. Instead there is the beginning of the thought that they are actively creating something together and a glimpse of reflective capacity that is part of a couple state of mind.

If the therapy goes well, the analyst’s couple state of mind eventually becomes introjected by the couple into their relationship. But this takes time, they might need to blame each other and do not feel ready, or safe enough to relinquish a position that functions as part of a secure defence. At the beginning of therapy, the analyst’s different perspective, her couple state of mind, functions in a modified way. It is strongly present in the way she approaches the referral, sets up the initial consultation and establishes the setting. Ordinary aspects, such as described with the couple earlier – gathering into the couple session any initial contact with one of the partners, attending to both partners anxieties in the early encounter, resisting colluding with ideas that one partner is at fault, maintaining curiosity in what they might be creating together – have significance. These aspects of not only what the analyst “does” but also how she “is” enables the couple to cross the threshold into treatment with some hope that they might be helped.

In terms of interpretation the analyst may initially have to use her couple state of mind with a light touch. This is because while it is the analyst’s state of mind, at this stage it will mostly not be the couples. Even if the analyst at this early stage has some understanding of what is often a complex unconscious interplay between the couple, she has to judge how much to say at this point. For some couples a strong couple interpretation at the beginning is absolutely what they need. They can take it and it can have a powerful effect in reconfiguring their perception of each other and the relationship and lead to a real engagement. But other couples will resist such an interpretation, not hear it or understand it or feel that such a perspective, which is about what is happening in the relationship, leaves them feeling misunderstood as individuals at this stage. Nonetheless, even without explicit interpretations about the relationship, the couple are often very affected by the other aspects of the analyst’s couple state of mind.

What I am describing here, could be thought of as the “presence” of the couple and the “presence” of the analyst, their two “settings” that act as “interference” on the other’s as described within the link perspective (Palacios, personal communication). As Berenstein describes «Presence is the quality of the other that impacts powerfully on me as a subject or, if it is my presence, impacts on the other, impresses a stamp, and modifies both me and the other» (2001, pp. 145-146) and later «Interference is what is produced in the space in between as a result of there being two or more subjects whose presence generates something new and unknown. The unknown forces these subjects to do something with it, to inscribe it, and to attempt to produce a becoming based on difference while dealing with the uncertainty about what they may be able to achieve» (2012, pp. 575-576).

This perspective highlights that there is always some kind of precariousness at this stage as there is volatility in this encounter. The analyst has to be mindful of this and aware of the impact of the couple on her, as well as the impact of her couple analytic setting on them. It might be too alienating for the couple if their own couple self – their need to be and see things in a particular way, is not taken in and contained by the therapist. And yet her presence, which is another perspective opening up a way of seeing, a vista, not previously encountered, is also giving them something new and therefore hope. One important aspect of this early encounter might be just the experience of being in the presence of an analyst that sees them as “a couple”. It might be the mirroring of them as “a couple”, that which the couple see reflected back in the analyst’s eyes, that is crucial in the process of being able to see themselves as a couple and the beginning of the development of a couple state of mind (Nicolò, personal communication). Winnicott describes the mirroring of the infant by the mother as an ordinary but fundamental experience for the infant’s sense of being. He asks «What does the baby see when he or she looks at the mother’s face? I am suggesting that, ordinarily, what the baby sees is himself or herself, in other words the mother is looking at the baby and what she looks like is related to what she sees there. All this is too easily taken for granted. I am asking that this which is naturally done well by mothers who are caring for their babies shall not be taken for granted» (Winnicott, 1971, p. 112). Similarly, this mirroring experience for the couple, who may not yet feel a couple, is part of the couple analytic setting that is both ordinary but potentially transforming.

There is something else here too about the triangular setting of couple therapy and about what can be seen. Couples coming for help often talk about their need for a third neutral object to help them see what is happening between them. As well as the analyst functioning in this way, having three in the room can also function to help open up psychic space, often desperately needed by the couple because it has collapsed or never been properly created. The couple can not only experience the analyst as a third relating to them and their relationship but when in the position of observer, they can “see” the partner and analyst (another couple) interacting which can provide a window from which to observe and think about themselves interacting with their partner, or they see their partner from a more outside/third position place. This is one of the unique advantages of the “couple analytic setting” not present in the same way in individual analysis.

Continuity

One of the important aspects of the psychoanalytic setting is its continuity. Not only that it is a different space to the couples setting but that with the analyst’s support it doesn’t get disrupted in the same way.

To return to my couple. After the kitchen row the couple thought, not for the first time, they should split up. They were both very angry and upset without really knowing why and it felt hopeless. It might be that even at the early tentative stage of their therapy having the third session in place helped them. Whether or not that was true, the therapy as a regular bounded and different kind of space from the one they normally inhabited became very important for them. The analyst does not deal with difference, conflict, heightened emotion by enactment (at least not if she is aware of it) and instead conveys that they will continue together with this next week – same time, same place. But without knowing how things are going to unfold, she makes a commitment to the couple to meet with them in an ongoing way to offer a different, enlarged perspective and to uncover the unconscious meaning of their dynamic relating.

If the therapy gets established as a regular, reliable, bounded space, it becomes a different space from that outside it. Being “in” the couple analytic space is different from being “outside” it. As this develops and the couple feel contained by the setting both as an external and internal phenomenon it becomes more possible to bring what is inside the relationship into the therapy, and hopefully more possible to bring insight developed in the therapy into the couples ongoing relationship.

Although the analyst takes care of the continuity of the setting and this is crucial to the work, it is never a perfect process, either internally or externally. As Churcher says «In practice, we all have to cope every day with the fact that the setting we maintain is not ideal. It is constantly being compromised, infringed upon, and modified. Patients may attack it; colleagues undermine it; we ourselves neglect it. Like the house you live in, it only survives because you also care for it and try to repair the damage as you go along» (Churcher, 2005, p. 9).

But the point is that this setting is inside the analyst and part of what she provides for the couple. She knows (or becomes aware of) when the setting is disrupted – when she herself behaves in an unusual way, swayed by her countertransference or other pressures and also when the couple challenge or attack the setting. These failures, disruptions or enactments can provide useful information once processed but unlike in the couple setting, they don’t usually lead to further disruption and acting out. Instead the therapist tries to recover and re-establish the setting. For my couple, all that got stirred up in the kitchen row was impossible to process and led to them once again feeling there was no place to go other than separating. Maybe for them there was the beginning of the idea of a different kind of space to which they could return (the third session) in which something might be processed and understood instead of acted out.

The couple analytic setting and the therapist

Before concluding it is important to note that the couple analytic setting is just as important for the analyst – it changes something for us too. When we fall into the couples setting, for example seeing one as at fault, it helps us recover and revive our curiosity in what they have created together. There can be enactments, for example the analyst can feel pushed into telling the couple what to do, telling them what a couple relationship is, taking sides, reassuring them and making assurances that she cannot realistically make or fulfil and so on. The couple’s ambivalence, nearly always there, even in the consciously “keen” couple or partner, instead of being contained, can result in the analyst trying to persuade the couple to come into therapy. This in turn can make the couple anxious particularly if they are feeling tentative and unsure.

Holding a couple state of mind is not always easy. We cannot avoid difficult and unsettling feelings of judgment, liking one partner more than the other, really disliking a couple, feeling useless, dismissed, attacked, bored or idealised. It is not always easy for the analyst to maintain an evenly balanced view of the couple. The analyst may feel at a loss to understand why these two people are together when one seems quite reasonable and likeable and the other so irrational and unlikeable. She might feel more identified with one partner than the other. This is where a couple state of mind is an anchor to the therapist, helping her analyse these feelings and use them to understand more about the relationship.

The “couple analytic setting” provides a different kind of space to that of the couple’s own setting. I suggest it is especially important in opening up psychic space in three dimensions – meaning (depth), perspective (triangular space, reflective capacity, couple state of mind) and continuity – the establishment of a regular, reliable, bounded space, in which the answers are not yet known but might be discovered if the process is allowed.

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References

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