Real World Clinical Blog: On Couples
by Dr. Danna Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way
Whether you work with couples or you work with individuals, the fact is that you work with couples in some capacity. This is because most of our clients bring in their most intimate relationships, either literally or psychically. To practice clinical social work successfully, it is essential to have a clear sense of the underlying psychological themes that both haunt and strengthen couples.
Do Opposites Attract?
We have all heard the age-old adage that opposites attract. For some it seems true, and for others, of course, it does not. The fact is that there is something to the idea of why people form intimate relationships. Part of the reason that opposites attract is that having a partner who has the capacity for something that we do not offers us containment. For example, half of a couple might be able to apologize, half of a couple might not fly toward anger, half of a couple might be incredibly social. The reason that these characteristics might feel attractive to someone who holds the opposite trait is that it offers the possibility of containing a part of us that we fear or a part of us that feels underdeveloped. The person who can’t apologize, on some level, wishes that they could and envies the person who has the ego strength to survive apologizing. The person who flies toward anger often envies the person who maintains calm and equanimity.
We are drawn to something in someone that we wish we had, that we wish we could develop. Relationship problems start to arise when the couple starts to become entrenched in their roles, relying solely on the strength of one partner and never working toward developing these capacities in the psyche of the other. When working with couples, it is useful to assess the level of exhaustion that accompanies an overreliance on one person’s capacity for something, while the other couple member gets to remain stuck in what is hard for that member. Couples who are able to survive need to work to better distribute the emotional labor. This usually requires a retracing of what originally drew them to each other and seeing if these traits can be more evenly split between both partners.
Projective Identification
Along with seeking containment for the parts of us that feel unwieldy or immaturely developed, we also use our partner’s psyche to regulate parts of our own emotional world. Let’s think about how often we hear about people who hate their mothers-in-law. It is an almost iconic image - the husband who never wants his mother-in-law to visit and stay for more than a day, or the wife who is gritting her teeth as she is listening to her mother-in-law critique how a meal has turned out.
These images are iconic because of something called projective identification. Basically, what happens is that a member of the couple has psychological experiences that feel intolerable. This experience becomes disavowed, but it is kept alive in the psyche of the partner. For example, a daughter feels angry at her mother, knows she needs space from her, and is unconsciously wishing to individuate. Because these feelings are intolerable, the daughter invites her mother for a visit instead of dealing with her uncomfortable and threatening emotions. She actually converts these feelings into the inverse experience of them. This is a defense called reaction formation. But feelings never really disappear unless they are confronted somehow. The intimate partner of the daughter starts expressing discomfort and rage about the visit, and the conflict becomes lodged in the wrong dyad - between the partners rather than between the mother and daughter.
This is a complicated psychological process that underlies a tremendous number of struggles between couples. A member of the couple will take on the unbearable, psychic material of the partner. The partner then becomes enraged at the person taking on these feelings, as if it is an affront to them. A large part of our work, in understanding couples, is to help couples to reclaim and reassign emotions to their original incubator, the mind that is actually struggling with the content. When these feelings are properly reclaimed, metabolized, and managed in the originating psyche, the burden of this process is taken off the couple, and authentic dyadic functioning can resume.
Surrendering Objectivity
The seductive power of seeking objectivity when working with couples is titillating. When sitting with a couple or with an individual, we are invariably drawn to determine who is truly at fault. When violence is present, this is actually quite important to do. But most of the time, struggles between couples are co-created. Each member of the couple has a subjective experience. They turn to us hoping for some objectivity, for someone to see the “truth.” The fact is that in a relationship, there is no actual, fundamental truth. Instead, our constant search, along with the members of the couples, is to search, search, search, for how every single dynamic is co-created. We might hear about how one member of the couple never cleans, never takes care of the kids, never contacts extended family. Although these symptoms seem to reveal clear fault, that level of simplistic understanding is problematically reductive. The question needs to become, “Well, why do you keep cleaning if your partner doesn’t?” We need to help clients recognize how they are equal partners in replenishing repetitive dynamics.
Our search for objectivity ought to be replaced by the knowledge that the mere presence of a fresh outlook might help couple members to re-see what has become un-seeable. Couple members start to experience their patterns of functioning as inevitable. Our presence, the mere fact of it, shifts them away from this perception of inevitability by our offering alternate, empathic perspectives on their struggles.
Repetitive Templates
All couple members come to relationships with past experiences of intimate relationships - with siblings, past partners, parents. These early attachments become imprinted in our minds and form expectancies about how our current and future relationships will play out. Recognizing and articulating these templates that have become imprints, we assist individuals in spotting the ways their psyches anticipate and therefore manifest particular relational outcomes. When clients are stressed and lacking internal resources for a whole host of reasons (stretched finances, struggles with kids, problems at work), they are more likely to rely upon the information they have come to know from their pasts, rather than what is happening in front of them. For each member of a couple to internalize the actual stimuli of the current relationship, a psychological clearing needs to be made.
Clinically, our work is to help individuals and couples to create this exact clearing, so they can engage with the partner in front of them, rather than the partners who are long behind them. Keeping clients engaged in the present often requires a certain honoring, but not succumbing to, the past. This is one of the many ways in which work with clients requires us to remain balanced and unassuming. We are dealing with ghosts, ghost stories, and competing new fictions and non-fictions. Finding a way through all of this requires a total surrender to the complexity of the couple relationship, along with a knowledge that there are also lovingly simple ways out of what appears deceivingly impossible.
Dr. Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. Read more of her clinical perspective and tips on the most burning questions of developing clinicians in her book, Real World Clinical Social Work: Find Your Voice and Find Your Way.