Which ever model one subscribes to, attachment or differentiation, the natural history of marital therapy sessions always includes a large portion of polarizing, push away behaviors. Practically, what this means is that therapy generally alternates between work towards closening behaviors on the one hand, and reconnecting behaviors following polarization on the other hand. It is even possible to conceptualize the therapeutic process itself as a dialectic between these two opposite emotional moments. 

In recent years a groundswell of huge proportions has begun to impact the practice of marital therapy. This lies in the application of attachment theory pioneered by John Bowlby. Mary Ainsworth and Mary Main to the understanding and treatment of couples. Exemplified by the work of Sue Johnson and Les Greenberg, the foundations of this approach is the understanding that marital attachment is largely an adult expression of primary attachment styles learned in early childhood. A central point made by attachment theorists is that psychological differentiation follows after the creation of attachment in the developmental process; hence, it is reasoned that in marriage the same sequencing is important. The argument here is that to grow differentiation in a marital relationship without first growing attachment is to grow differentiation without a solid relational foundation upon which the marital differentiation can rest; that differentiation is only healthy when it is based upon the security of safe home-based attachment. That such differentiation ends up missing emotional depth and emotional connection. This is a very different view from those marital therapists who argue that initial differentiation is the necessary foundation for secure self-other relating. In the differentiation school of thought it is only in getting fully separate from one’s partner that one is then able to fully and richly “see” and “hear” and “experience” ones partner. From the differentiation perspective, it is the experience of psychological apartness that then enables a a taking down of negative projecting onto ones partner that then enables reattachment within the marriage. The thought here is that it is the taking down of projections that creates a renewed sense of safety with one’s partner.  

Relational psychoanalytic psychotherapy is an approach to depth therapy that is grounded in the human relationship between therapist and patient. This is a radical departure from the “rigid frame” of classic psychoanalytic treatment which emphasizes that the treatment situation not vary from session to session and that the therapist’s own personal qualities be highly minimized in the therapeutic process. With the advent of the “relational frame” the treatment of the same patient in varied treatment contexts becomes both understandable and salient. Practically, this enables the effective combining of individual, marital and group therapy modalities not readily possible within the classic model of treatment. The underpinning of these multi-modal approaches is the flexible constancy of the therapy relationship that spans across the different therapeutic contexts. With repect to the marriageofopposites, it especially powerful for each in the marriage to have individual therapist’s who then come together in four-way conjoint sessions for the couples work. This arrangement enables a highly stable form of marital therapy combined with in-depth individual work on the underlying issues fueling the marital conflict.

In escalation, the core-styled are centrally seeking to evoke connection/attachment/rapport where they feel it missing. In the escalating process, however, many additional variables emerge; the conflict itself tends to create rupture which can hugely increase the feeling of lost attachment. The protestive anger, meant to shake the distancing other into contact, typically results in the opposite; massive shutdown, withdrawal and unspoken shaming/blaming.  During this process the core-styled commonly regress into desperation and primitive anger. An unconscious goal that begins to form during these escalations, that is not generally acknowledged, is to induce primitive acting-out behavior on the part of the part of the distancer, so as to prove that they have badness too, thus reducing the terrible feelings of ostracizing shame/badness in the escalated core-styled. 

Most marital therapists work with a vision of increasing marital health related to the taking down of enmeshment, fostering healthy individuation in both partners, thereby clearing the way for empathy, communication, intimacy, play, and mutual acceptance.  This vision of marriage can only happen if both partners are on the “relationship playing field.” If one in the marriage is avoidant, and does not show up for emotional connection, this picture of a positive evolving marriage cannot emerge.  

It is my current belief that the strongest hope for marriages troubled in this fashion rest with the establishment of outside structure that reliably requires both partners to interact/engage the emotional issues and differences in the relationship. Regularity and high frequency are central in the success of outside structure, at least until such time that the structure becomes internalized within both individuals in the marriage.

Couples therapy is probably the single most potent form of outside structure.  Couples groups are another. Religious or spiritual community is sometimes still another. In general, there is a terrible impoverishment of outside community support to support couples in showing up and staying on the playing field.  (to be continued)