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)

Missing personal presence is at the heart of most marital unhappiness. We cannot offer nor participate in true personal intimacy if we are not present with ourselves. Most of us live with an essentially self-rejecting or threatened attitude towards what is deep within us. Underlying depression, low self-worth, anxious/fearful insecurity, post-traumatic-stress-syndrome, interior quiet desperation, and emotional emptiness commonly occupy our emotional cores. Most of us… (cont) 

When marriages are in a troubled way, both partners in the relationship typically function at their worst. That is, each in the marriage is at their worst and responding to the other’s worst. The tendency among couples in this situation is to very harshly judge and devalue the marriage, and to catastrophize any conflicts that do arise as further evidence of the marriage’s essential wrongness/badness. Hence, conflicts that do arise simply as part of normal life, are quickly framed within the context of catastrophe, once again leading both in the marriage to function out of deep threat, emergency, and fight/flight. 

A first order of business in marital healing is to create some beginning confinement of those situations where each in the marriage is at their worst. Secondly, the cultivation of any positive, enjoyable moments/activities is important to fill in the openings created by the containment of the negative, and to provide a hopeful sampling of goodness/attachment that can begin to counter the inclination towards the negative. In order to be enduring, these changes must be accompanied by an unfusing/unenmeshing of the relationship, so that the urge towards reacting is increasingly replaced by two differentiated individuals responding.