REVUE N° 6 | ANNÉE 2009 / 2
PANEL
The concept of the link in couple and family psychoanalysis. Introduction.
David Scharff[1]
In the last 60 years, most English speaking psychoanalytic writers interested in the mutual influence of people on each other in couples, families and groups have employed some form of object relations theory. (Bion 1967b; Fairbairn 1952; Kernberg 1976; Scharff and Scharff 1987 & 2006) Meanwhile, there has been a parallel literature, at first from South America, and more lately from Europe, that explores closely related concepts. This began with contributions by Pichon-Riviere in Argentina in the 1950s. Building on ideas of Fairbairn, and others, he described the concept of the link or “vinculo.” This concept extends the concept of internal object relations in a way which I believe we can now see is elided in the English speaking analytic world’s use of the term “object relations.” Pichon-Riviere defined the link as expressing both internal object relations and the external interactions of people or subjects with each other. (Losso 2009; Setton, personal communication)
It is this double use of external and internal object relations that has been implicit in the object relations literature, and that we can now clarify with the help of the literature on the link. In exploring the overlap between the two concepts, I hope that we can extend both literatures, but most especially that we can begin a dialogue between the English-speaking uses of object relations concepts and the Spanish and French preference for discussion of the link. Some authors, such as Nicolo (see her paper in this issue) prefer to use the word bond, a word that is more comfortably used in English, and which does have the advantage of capturing the way the link functions both to connect and also to tie together two or more people, each of whom are subjects and not merely each other’s “objects.” Beyond these alternate emphases, the words bond and link seem essentially synonymous in English.
This double use of the idea “object relating” has, until now, been designated by the terms “internal” and “external” objects. The literature on the link has attempted to explore the complex relationship between the way that external object relations influence internal organization throughout life, and in turn, how internal object relations organize external interaction. I have also done this in many ways, employing close examination of clinical examples to show how, for instance in family or couple therapy, the presence of each person’s primary objects both influences and is influenced by internal object relations, or to be more exact, by the continuing dynamic constellation of internal relations between self and object. Psychoanalytic studies, focusing on the individual, have focused almost exclusively on the influence of internal object relations on the person’s relations with the external world – a one-way effect. Pichon-Riviere’s focus was, from the beginning, a double one focusing on the two-way, mutual influence: of the internal world on external relations and the external world on internal object relations.[2]
In the English language literature, the work “link” stems from the work begun by Klein who described the bond between maternal and paternal, the internal oedipal situation of the parental intercourse (that is of male and female elements) or breast and baby, and the link or failure of a link between thought and feeling. The work link had meant the joining of anything, as in the idea of the interpretive process of linking ideas that belong together. Then Bion’s (1967b) writing took a kind of ownership of the work “link” by describing the linking of thought and mind in his study of thinking, and in his famous paper “Attacks on linking”(Bion 1967a) that applied the kind of links Klein had explored to the growth of thought in the developing mind and to the pathological interference with thought that occurred in people’s attack on their own mental processes. This part of the history of ideas should be kept in mind in our comparative study of the “vinculo.”
Before going on to develop some of the implications of the concept of the link, let me state my conclusion: The fields of study of dynamic internal object relations and of the link largely overlap. However, object relations has emphasized the internal dynamics and its influence on external life, while the study of the link emphasizes that intermediate construction of a shared organization that focuses more on the mutual contribution of interacting individuals to the shared interactional pattern, and the role of that shared pattern to organizing the individuals. This to be a development presaged such concepts as the “joint marital personality” of Dicks (1967) or “the analytic third” of Ogden (1994,) “unconscious basic assumptions” of Bion (1961), and the entire development of intersubjective studies (Stolorow and Atwood 1992, Beebe and Lachmann 2002). Fundamentally these terms represent overarching patterns that are the same territory as the link. The link concept also emphasized the notion of intergenerational transmission, as the link was seen as between the social group, the preceding generations and the individual. As such, it has something to offer in fleshing out object relations studies of the intergenerational transmission of relational patterns, as seen for instance in studies on the transmission of attachment patterns or the transmission of trauma between generations in Faimberg’s (2005) study of “the telescoping of generations.”
On the other hand, the focus in object relations on internal dynamics, the close study of the early mother-infant relationship as a foundation for internal and external development, and the use of transference and countertransference in the clinical setting all represent developments that imply the centrality of early links or bonds. In this way, I believe that as we bring the two literatures into closer approximation, we will find that they complement each other.
The concept of the link
Each person is born into a link and lives in links. Through the link, what is interactive or interpersonal becomes intrapsychic, and what is intrapsychic becomes interpersonal or to use a more recent term, “interpsychic.” (Bolognini, 2010) The concept of the link emphasizes that there is an ongoing bond between subjects that is built by the subjects’ internal world while at the same time it influences each person’s internal world. In each of these cases, one pattern of organization joins with other organizational patterns to produce a new, overarching higher-level pattern that is pattern in itself, and could not be predicted from the components whose interaction produce it. In chaos theory, this is the strange attractor developed from subsidiary organizations in interaction. In analysis, it is the analytic third produced by the interaction of patient and analyst. In marriage it is the joint marital personality. In groups it is the unconscious bond shared by members of the group as basic assumptions that organize them.
It is humbling to see this literature, which Pichon-Riviere developed from his reading of Fairbairn, began half a century ago, and is currently being developed by in Argentina by Losso (2009) and Berenstein (see paper in this issue) among others, and in France by Kaës (2005;2007). Work we know better perhaps, such as Faimberg’s (2005) work on the telescoping of generations, also derives from it. The work of Baranger and Baranger (2009) on the psychoanalytic field is also an important part of current concepts of the link and its role in unconscious transmission, as well as the way that individuals within an interpersonal field are shaped by it.
Here is the concept as I am coming to understand it: The link is the bond between people, motivated by infantile needs for love, nurturance, care, feeding and knowing. It consists of subjects in interaction who also take each other inside through introjection and projective identification, to form the interior world. Individuals are born into and shaped by a field that has two dimensions, which Pinchon-Riviere described as having a vertical axis and a horizontal axis. The vertical axis links each person to previous generations and to the history and culture into which they are born. The horizontal axis links each person to family and wider current social groups, for instance the “village” in which each person lives. These links are formed by infantile need and persist throughout life – the needs for love, care, understanding, containment of frustration and aggression, and sexuality. The link forms a super-ordinate structure, fed by interpersonal interaction. In this way, mutual conscious interaction plays a role, but unconscious interaction plays the more powerful and continual role. The link is expressed in all individual and interactive productions: dreams, symptoms, acts towards others, and bodily experiences. Even those acts or symptoms that seem to be individual contain aspects of relatedness. For instance the dream that seems to be an individual production also expresses both internal object relations and communicates aspects of current relationships. Following Fairbairn, we think of dreams as short versions of internal reality in terms of individual psychology. But they also communicate aspects of the interior world to the people who form current relationships, and in a reciprocal way, they express the influence of those relationships on the dreamer. In this way, as we have written previously, dreams express interpersonal and intersubjective themes, and at the same
time are potential interpersonal communications. (Scharff, D. 1992; Scharff, D. & Scharff, J. 2005a) What the concept of the link adds, is that dreams also express the current influence of those external relationships on the continually developing unconscious organization of the individual, and that such a dream is both a record of that interpersonal influence and is probably a product itself of the process in action of mediating the internalization of the link.
In therapy, dreams communicate to a life partner and about life partners, and they communicate to therapists about the ebb and flow of the therapeutic relationship. In the treatment situation, countertransference is the road to understanding bonds, not only patients’ intrapsychic constellations. But at the same time, since links are always co-constructed, how they reflect the therapeutic relationship must always be considered along with consideration of what a current link says about the patient’s or family’s links in general.
Individual subjective fantasies, dreams, affects and unconscious patterns of interaction all play a role in interpersonal interaction. Overarching patterns (or “attractors” to use the term from chaos theory) are formed by interactive transformations of internal object organizations of each person involved. In turn, these patterns are in constant communication with, and continually modify the internal object relations constellations of each individual within the relational pattern. This is another way of saying that the organization of each person’s interior world is constantly influenced by others. I noted before that for Pichon-Riviere the individual’s psyche was built on the twin pillars of the internal world and its constitution, and the influence of the social. Kaës writes that the three pillars are individual sexuality, language and the social world.i In his formulation, language has the role of mediating between the internal individual world and the influence of the outer interactive world.
Coming from another vertex, Jill Scharff and I (Scharff and Scharff 2005b) have described this situation in a previous paper as the matrix in which each individual unconscious is formed, so that each subject’s individual unconscious is inherently and inextricably interpersonal. What we have said about the unconscious being fundamentally interpersonal also applies to other aspects of individuals, including aspects of conscious functioning. Aspects of the non-repressed unconscious, for instance procedural memory, that are also interpersonally shaped. (Kaës 2007) For instance, it is not uncommon to describe a person as having mannerisms or speech patterns that are like her parent or spouse.
The concept of the link gives us a literature in which this interactive product itself becomes the focus of study. Such links are of many kinds, but they all are formed by the joining of forces from each or all of the individuals so connected and interdependent. They partake of all the forces of each individual, whether we think of these as life and death drives; libido, aggression and knowledge; or desire and avoidance. Each of these has a voice, and in families or groups, various individuals speak at differing times for different aspects of links. This recalls Bion’s Basic Assumptions, those overarching unconscious organizations of groups, Dicks’ “joint marital personality,” or Shared Family Assumptions (Zinner and Shapiro) that express unconscious family organizations. These are the composite organizations of groups that are made up of many participating links that add up to varying overarching organizing patterns. The predominance of any one of these patterns shifts with time and circumstances because all the possible links are present in overt or hidden forms in every group. Bion’s (1961) study of the way that different individuals speak at different times for various basic assumptions is a way of addressing what aspects of links such spokespersons carry. The resonance of the particular link with the internal object relations constellation of the person is what drives the “valency” of each person to speak for a link at a different moment.
At the same time, experience of links provides the material from which each person constitutes internal groups. What is originally interpsychic becomes intrapsychic. (Kaës 2007; Bolognini 2010) This constitutes what Pichon Riviere called the internal group. Perhaps the first and most important of these is the internal family, which includes the internal couple. (Scharff & Scharff 1991)
Kaës (2007) has explored the quality and operation of links through close study of groups, and his work has been liberally applied to family therapy as well in the European literature. Kaës describes the two pillars of the psyche as the individual unconscious and intersubjective function. Life is structured by the elements of individual sexuality, speech and intersubjective linking. Identifications and alliances are transformed and mediated by links. In this process, the individual and the group are in a relationship of constant mutual influence. There are primary groups (the family) and secondary groups (peers, colleagues and institutions.) The mediators of the group are borne by the processes of the speech bearer, the symptom bearer and the dream bearer. The group (beginning with but not limited to the family group, to include the analytic treatment group) has common and shared dream space, in which there is a polyphony of dreaming, that is of overlapping, multiple dream processes and images that express and influence the group and individual components. There are unconscious alliances and resistances that form facilitating pathways and barriers. There is therefore a common area of identity that all members of the group use to realize what is impossible to realize individually.
In this conception, there is, in each person, the subject of the individual’s unconscious and the subject of linking. In the alliances that form, there are offensive alliances and defensive alliances, that is ones that positively express themes and ones that resist themes. (We can see this for instances in adolescents who oscillate between expressing family themes and combating them.) This concept of positive and negative alliances is also expressed by Berenstein’s (2009, this issue) idea of “field interferences” which run counter to the expression of a link, given expression in the idea of the “negative pact. (Green 1999) The positive expression of links is structuring of the unconscious, while the defensive alliances operate against such structure and towards psychic and group splitting and fragmentation. Here it seems to me that the literature on the link overlaps with Bion’s 1967a) exploration of “attacks on linking” in his papers on the destruction of mental processes (Bion 1967b, 1970). In summary, the link is an apparatus for management and transformation of individual psyches that forms and informs them. And it is an apparatus through which individuals form and manage groups of which they are a part.
The capacity of the concept of the link to add specifics about the quality of conscious and unconscious interactions to the study of the object relations of members of a family, group or analytic dyad in whom we are interested is useful in facilitating understanding of the interaction of transgenerational transmission, interpersonal interaction, and interaction between persons and social culture. Most of object relations theory and its application to the clinical situation has focused principally on the internal configuration between components of self and object. Object relations theory considers as a second step how this is unconsciously transmitted through projective identification and taken in through introjective identification to form a cycle of mutual unconscious communication in intimate relationships. This happens from the beginning of life between parent and infant, and continues throughout life, for instance in the formation of intimate bonds, in marriage, between an adult and her children and between intimate friends. We now think of this continuous unconscious transmission as foundational, from its role in shaping and growing the child’s brain and mind, to its continuing role in all emotional communication.
The concept of the link expands this to include the psychoanalytic mechanisms of such transmission. For Pichon-Riviere body, mind and action are inextricably joined, and always carry the potential for transformation between realms. Body, mind and action in the world are rooted together, and so it makes sense that they should share a common vehicle for the transmission of their emotional content. Pichon-Riviere’s concept of the person as a full inhabitant of the social world helps us to avoid considering the individual in isolation, as inevitably a member of her family and social groups. Family and couple therapy follow naturally from this idea, and even individual psychotherapy or analysis should never be conducted as though individuals were isolates.
One of the implications of the link concept is the continual expression of vertical linking in horizontal linking. This is a graphic way of saying that the intergenerational roots of our minds are always part of the expression of bonds to our families, friends and social groups. In turn, while the literal or objective history that could have been recorded from outside personal experience in these “historical bonds” cannot change intrinsically, the meaning each person makes of this does change in the light of current experience. This approach extends Fairbairn’s conception of object relations into an area that in the English-speaking analytic world we have drawn from Winnicott: transitional space and phenomena. (Winnicott 1951) It is here in the transitional or potential space that inside and outside psychological areas join and are mutually transformed, that what is inside one person is taken in by another person, and that primary needs are transformed into object relations constellations. This potential space, the zone of creativity in each individual and through which each individual is created and creates herself, is the area of the link.
When Berenstein (2009, this issue) writes of the interference of the other to the identity of the subject, he is in the territory of the Winnicott’s true and false self in terms of individual development, but in a more interpersonal dimension. That is to say, the tension between the expression of the individual identity and the need to be separate, to establish a separate identity in relation to the other subject in all primary relationships remains a creative tension that is also open to the constant risk of that the person will become alienated from her self. This tension is a necessary force for structuring individuals in link relationships. Like Berenstein, Kaës (2009) thinks that within the intersubjective field, the individual overall psyche and the unconscious are subject to the structuring and potentially alienating force of others, which can have a myriad of influences from felicitous shaping to perverse antagonism. The individual’s inner world, including the unconscious internal object relations, does not belong solely to the intrapsychic realm, but equally to the influence of others. Thus, in a paradoxical way, the unconscious belongs to the individual and yet does not belong to her: It also belongs to the group – at first the family group and later other social groups in which each person lives, loves and works. In this way the individual is both a subject in her own right, and is subjugated by the significant others who variously offer influences of alliance, support, alienation and mutual shaping. Here is the overlap with Winnicott ((1960) for whom the individual has an inner core that is inviolable, the true self. At the same time, each person has a false self that is not a bad thing. The “false self” forms a kind of concentric circle around the true self to protect it but also to mediate with and relate to forces of the outside world. This is the territory of mutual influence that Kaës and Berenstein explore in their writing about the link.
A clinical illustration
The following illustration comes from a single session of a complex family treatment I have previously described. The couple had originally come for sexual dysfunction in which the wife, Velia, disliked sex and the husband, Lars had what he defined as sexual urgency and premature ejaculation. Their 5 ½ year old middle child, Alex, was encopretic and enuretic, and I had diagnosed him as ADD with behavioral and learning difficulties. There were also two other children, Eric, aged 7 ½ and Jeanette, aged 3 1/2. Eric was the sturdiest of the children, but was frequently the target of his mother’s disapproval for failing to be the mature child. Jeanette, early in oedipal development was sweet and spontaneous, but her behavior and play were coquettish and had a sexualized edge.
In an initial family assessment session 2 ½ years before the session described below, the parents had discussed the way their “conjugal difficulty” resulted in anger that the children clearly saw and reacted to. While they were saying this Jeanette and Alex had constructed a long building they said was a firehouse. Driving the fire truck through it, Jeanette knocked the firehouse down. Meanwhile Eric had drawn a picture of a war between enemy space ships and a good “mother ship.” After a long struggle in which evil seemed perhaps stronger, the forces of good ultimately prevailed. Jeanette had made a spaceship with blocks in which she placed a large baby doll “mother” and a small “father”. Lars winced as he saw the huge mother doll smother the father doll.
I have tried to give just enough description of this initial family session to suggest that the children’s play provided a narrative that echoed the parent’s difficulty, as expressed in the sexual symptomatology. The children’s play formed a version of the inner family narrative, of the living link that was being expressed and played out. In the language of the link, we can say that the sexual symptom expressed the bodily difficulty in linking for husband and wife. While it used the failure of a psychosomatic link for this symptomatic expression, it was at the same time emotional and interactive. The sexual symptoms occupied the whole range of expressions of difficulty in linking, giving expression to the alienating, fearful and defensive aspects but also expressing desire and its vicissitudes.
In the therapy that followed, I would discover with the family many transformations of the link played out within the whole family in ways I could just begin to see even in this first family session. Excess aggression in the link was funneled into Eric’s relationship with his mother because of the overflow of her frustration and anger at her husband and her fear Eric would become passive and underachieving like him (and it later turned out, like her own father;) in a more disorganized way, the parents’ frustrations were projected into Alex in several forms, including his unfocused, disruptive play. Somatically, Alex had introjected the psychosomatic disruption in his development of encopresis and enuresis. Both parents had repressed unrealized reservoirs of frustration of their sexual link, and this was being projected into Jeanette because as a young oedipal child, she was receptive developmentally, and because there was something so containing and accepting in her charm that she also had a personality well suited to take this in. The children’s personalities lent themselves to the expression of these links. Aspects of the nature of the parental bond were being therefore reacted to and played with in the children’s individual play and perhaps even more in the interactions of their shared play, where we might say a narrative was being constructed within the family with the holding and containment of the therapist even in this first session. This family was unusually able to work analytically together, and so the therapy made possible the construction of a progressive narrative that slowly addressed their problems in links and in failures of narrative transformation.
For instance, even in this early session, Alex and Jeanette played the excitement and danger of the fire truck in the endangered container, while Eric drew the trouble in aggressive aspects of the family link in terms of intergalactic battle in which the forces of good were on their mettle to defend the mother ship against evil invasion. Eventually Jeanette got the good mother to manage the spaceship, while the father was taken off in a cement mixer. Seeing that image, Lars winced and held his head, but he was smiling too. Eric decided by the end of the session that the good guys had won and the mother ship was safe. There were progressive, potentially healing forces in play in the family from the beginning of my contact with them.
Over the next 2 ½ years, Velia saw a colleague for intensive psychoanalytically oriented individual therapy, mostly four times a week, for her depression and features of borderline personality. Although she was frequently depressed and had rages inside the family and out, she also showed intelligence and many strengths. Lars was discovered to have an adult learning disorder and probably adult ADD, but did not progress well in individual therapy. Alex improved on a psycho-stimulant, but also was unresponsive to individual play therapy.
A year after the initial assessment, I began to see the couple weekly for their sexual difficulty, and also to see the whole family for an hour weekly. At the time of the session I will describe below, I had been seeing the family in this way for about 1½ years.
During couple therapy, which focused on Lars and Velia’s sexual difficulty and provided exercises that slowly helped the couple to move forward, Velia soon found that beneath her the fear of sex was an intense longing, which inevitably was frustrated when she could not achieve orgasm. Lars learned increased patience and forbearance, but the situation improved at a snail’s pace. In most sessions we unearthed more psychodynamic material about their development. In a couple session shortly before the family session I’ll detail below, Velia had remembered for the first time that she had been the victim of direct physical abuse from her father, whom previously she had only remembered as delivering verbal abuse. There had been sibling sexual play sporadically which we had come to understand as occurring in compensation for her father’s verbal abuse and her mother’s helplessness to protect the children.
When Velia remembered the physical abuse, Lars suddenly said that he also remembered physical abuse from his father. Early on, he had told me that his father was arrested for public homosexual behavior when Lars was 17. The parents divorced and, after time in jail, his father had lived in a stable homosexual partnership. But now Lars suddenly remembered that on one occasion as a pre-teen he had asked his father about sex and his father had said, “Here I’ll show you,” and had sodomized him. The recovery of these memories was occurring as the couple made slow steady progress. In terms of establishing narratives about links, we can see that the links which had been buried were now moving out of hiding and being expressed in the next generation, albeit in more subtle and less primitive ways. To cope with them, they shared an unconscious transformation in which a denial of hatred became an inhibition of sexual function, and this became a psychosomatic expression of distance in their sexual bond. There were a great many things that could not be known or acknowledged, so Lars’s pseudo-stupidity, Alex’s inability to learn how to manage bodily functions, and the upper reaches of Eric’s more advanced development were all areas in which problems in links were also expressed.
The session I focus on now, and came deep into the treatment, 2½ years after the initial family assessment, when the children were 10, 7½ and 6. The session occurred after I had been away from practice for two weeks, therefore it had been three weeks since our previous couple and family sessions. This session was videotaped, as were most of the treatment sessions, with the family’s full cooperation, so my description can be unusually detailed.
The session opens with Jeanette building a small containing structure out of blocks with a paper airplane inside and saying, “Here’s his hiding place, Mom.” Eric is playing with two planes that chase each other in a dogfight, and Alex is constructing block buildings. The children continue to play as the parents talk, and Alex and Jeanette go on to play about a boat (actually a toy bathtub) in the sea and a helicopter overhead going away. Jeanette’s doll is waving from the boat/bathtub and calling out, “Bye, bye. See you tomorrow.”
Usually family sessions like these had keyed off the children’s play, but today Velia has a migraine and looks depressed. For the first half of the session, her headache and frustration become a focus of interest for me, and I engage in much more conversation with the couple about the causes of her headache and depression than usual. She says that things have not been going well sexually for the couple in the last two weeks, and Lars agrees. It seems the failures are with his functioning but since the couple doesn’t get more specific in the presence of the children, it is not clear. I pursue the “link” between my absence and their difficulty. While Velia can see the connection, Lars cannot. I interpret to him that he has collapsed in my absence because of the lack of my presence and support. I connect this to his general difficulty “making emotional links,” and to the history that when he asked his father for knowledge, he got something painful instead – the sodomy that has been recently named in the couple session but that I do not specify here in the family session.
At this point in the session, the children’s play reorganizes. Eric takes the lead in playing with a pig hand puppet, that he has loudly grunting and say, “Is there any food around here? I’m hungry.” The other children join in with furry puppets of their own who dramatically complain about their hunger and the lack of enough food to eat. They then close in on me, hand me a purple puppet with big ears, and begin to attack my puppet, playfully but forcefully “honking” its nose. The feeling is intriguingly ambiguous: intimate with the aggression tamed by a kind of loving playfulness. Lars and Velia look on, both smiling. I comment that the children might not be the only ones who want to beat me up, and Velia says she could imagine herself tweaking my nose, and she makes a gesture of doing so. Lars grins, and teasingly asks her why she doesn’t just go over and tweak my nose. Watching the video, I have been able to see myself draw back reflexively, defensively, as if to fend them off by as I say, “No, why don’t you just talk about it?” — as though they weren’t already doing so. A moment later, Jeanette has marched noisily away, her heels clopping on the tile floor, and returned to playfully honk my puppet’s nose again. I ask, “Where have you been?” She answers, “We’ve been honking someone’s nose.” “Why would you do a thing like that?” I ask in playful innocence. In a perfect interpretation, she answers, “Because he’s been mean to us, so we being mean to him.”
As the session went on, the elaboration in play and talk became more specific about the aggression that had been engendered in response to my absence. Each family member expressed in an individual way their own particular combination of longing, disappointment and anger – the children in their play and drawing, Velia directly in words, and Lars in his blocking and not knowing. At the same time, the children made it explicit that they like coming to the sessions, and that their anger for my abandoning them was contained within that overall feeling.
Towards the end of the session, in answer to my direct question about my absence the previous two weeks, Lars said that, “You don’t even notice.” When I confronted him that he was saying that “I had seemed not to notice him,” he corrected his “slip” to clarify that he meant to say that he had seemed not to notice my absence. But Velia playfully slapped him on the leg and chimed in, “Ha, ha, ha. You got caught in a Freudian slip! Nyah, nyah, nyah!” This led to my interpreting the way in which his own not noticing my absence, while experiencing renewed sexual difficulty and falling self-esteem, was actually a transformation of his unconscious experience that my absence meant that I no longer noticed him or the couple’s needs. With a grudging laugh, Lars seemed to take in Velia’s restatement of my interpretation when he had so far been able to successfully fend off mine.
The final sequences of the session were led once again by the children’s play. Eric took a toy ambulance and disrupted play that Jeanette and Alex had organized. Lars, functioning better now in role as father who could set limits told Eric to stop, and Velia, now functioning well as an ordinary mother again, countered Eric’s assertion that he wasn’t doing anything wrong. I asked her what she thought was happening, and she answered, “It’s very clear. The ambulance-slash-doctor was tearing everything apart.” I saw what seemed to me to be a kind of interpretation in the form of her complex pun, and so I said, “I like the part about the ‘ambulanceslash-doctor!”
“Oh, yeah,” she said. Again gesturing a slashing motion, she laughed, “ ‘Slash the doctor!’ ” She had accepted my interpretation that she also felt like getting back at me.
It was time to stop. As the family gathered up their coats to leave, Jeanette whined, “I want to still stay.”
The session marked many of the family’s gains, and it was not long thereafter that the couple achieved orgasmic sex (which was not discussed in any further family meetings) and the children seemed freed enough from their symptomatology that termination was planned.
Discussion of the operation of the link in this session
What I intend to illustrate in this story of a session is the links that are operating in all directions within it. The link between the couple has been disturbed for many years, but is in the process of transformation. Their link contains the complex marks of vertical or historical links to each spouse’s parental generation. Presumably the grandparental generation had disturbed linkages with the generations before them that cannot be specified but whose marks are unmistakable in the traumatogenic traces they have left. These disturbances are factored into the emotional, psychosomatic and interactive aspects of the couple’s current system of links including their sexual, and it is this system that we examine in their couple therapy, emotionally, psychosomatically and interactionally.
At the same time, the couple’s links form the material out of which each child’s unconscious is formed, and to which they react. The multi-directional links within the family are the building blocks of the children’s internal links as they develop, and at the same time, each child (along with each parent) contributes to the family-wide system of linkages. They are in a tension of being formed by, subject to and subjected by the individual unconscious of each parent and by the patterns formed by them as a pair – loving, fighting, struggling. There is a constant tension between each child and the parents and between them as a complex sibling group with each other and with the parents. It all forms a field of almost infinite complexity. Finally, the difficulty with mental and sexual links I did comment on directly is a direct result of these links in the broader sense, and at the same time, influences and contributes to those links.
When the therapist steps into the mix, his mind, his actions, his words form a destabilizing force on the family group’s patterns of interaction and unconscious communication. This takes us again to the territory of Berenstein and Kaës’ “alienation” from the self, for each individual and for the family as a group. But it is this very force of alienation that offers to let the group and each individual reorganize towards growth in the areas in which each has been stuck and frustrated. In this case, the therapist’s absence has removed him as a stabilizing and growth-promoting factor in the expanded family group. The unacknowledged and un-experienced, split-off anger now blocks communication and effective function— more for the parents than the children. The session puts that block – which had been expressed through somatic links of mother’s headache and father’s erectile difficulty — squarely into discussion, and then the children’s play works to restore the link to the discussion that had been running into Lars’ mental brick wall and Velia’s somatic internalization of difficulties in the link. When the emotionally expressive play of the children’s aggression emerges, it reorganizes the family. The aggressive link is confirmed and expressed, and with it, the loving link and the link that supports knowledge and exploration (and growth) is also freed for expression. In the session, I could see the pain of Velia’s migraine ease (the somatic link is transformed) as she reveled the children’s playful aggression, which enabled her to express her own aggression, also with humor, and for Lars and Velia to teasingly join in expressing their anger at me.
The session demonstrates the living out in psychosomatic, emotional and interactional spheres of difficulty in vitalizing links. The therapist taps into difficulties in the bonds and the internal object relations of the family by his persistent destabilizing probing. His presence is an “alienating” link. Then the session shows how joining with the therapist in exploring and expressing these impediments to the link allows the family to use their own links in new creative ways which emerge to repair impingements that also offer to free up and reorganize their internal object relations, and to improve their interactional functioning with each other as well.
If we focus on the quality of the links as they are expressed initially in the session, then cultivated in various ways (verbally, in play, in interplay by and with the family) we can see that the quality of link changes and brings an increment of difference to each member of the family. Velia’s depressed migraine changes to humorous acknowledgement of disappointment and anger; Lars’ know-nothing blocking alters to humorous participation in more active parenting; Eric’s play becomes more explicit and related – and more humorous and creative too; Alex’s somewhat disruptive and isolated play becomes more cooperative and thematic; and Jeanette’s play becomes pointedly focused on me and on expressing the familywide disappointment, anger – and, at the same time, their very real concern for me. This marks an additional increment in the familywide move to more self-sufficiency, more comfort with their own internal objects even in the absence of support from me, and a readiness to continue on the path of group and individual growth, and to higher levels of individual differentiation and of family organization.
The concept of the link offers an extension of object relations theory in all realms of study and treatment, from individual and family, to groups and institutions. It focuses on the intermediate zone that has an overarching organization of its own, which is constructed by the participants and which organizes each of them. We are born into such links, we live in them, we contribute to them, and through them we express to the world of others our inner most issues, wishes and fears.
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[1] MD, Codirector, International Psychotherapy Institute, Chevy Chase, MD, USA
[2] Pichon-Riviere’s writing is not available in English, so what I describe here is taken from reports of Losso, Setton, Nicolo, Kaës, Kirshner and Berenstein, to whom I am grateful.