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Violence, Alcohol, Seduction—Marital Outliers
Why and When Couples' Issues Stray Beyond Systems Models (Vol. 3; Issue 42)
A decade before psychoanalytic training, I learned a great deal about the psychotherapy of couples and families. Systems theories then reigned supreme. Without exception, the major family theorists like Murray Bowen (1993), Salvador Minuchin (1974), Carl Whittaker (2011), Virginia Satir (1988), and Jay Haley (2016), adhered to variations of systems theory. Haley, interestingly, considered individual psychotherapy unethical. He believes it creates rifts in couples and that all psychotherapy should be encompassed within couple or family work.
My practice, for unplanned reasons, has consisted of half couples therapy and half individual psychotherapy for four decades now. Recent experiences with a domestic violence situation, alcoholism, and a remarkably flirtatious woman-partner caused me to revisit the crucial importance of individual, psychoanalytic psychotherapy. Some persons in romantic relationships require it. They might benefit from concurrent couples therapy but it, alone, proves insufficient.
Before sharing the (usual) fictionalized clinical stories, here is a quick review of family systems theory. It defines the family unit as a unique, complex social system in which members influence each other’s behavior. Because family members enjoy close bonds with one another—whether loving, hateful, or anything in between—the system is best viewed as a whole, single system; each member's behavior impacts others. I remember one entire family in which the youngest child, a 4-year-old, clearly ran the show. Psychoanalytic ideas most relevant to working with families include boundaries, the idea of inter-subjectivity, sadomasochism, and reciprocity. For simplicity’s sake, I only consider the following cis-gender couples to validate my thesis.
The Gonzalezes, married only two years, show a fairly common sado-masochistic, or leader-follower, dynamic. American couples in the 1950s typically showed this pattern. The husband dominates their social affairs, has a wide circle of friends, and is active in the Los Angeles Bar Association. We’ve been meeting for around six months, weekly. Some progress is occurring. They are learning the origins of the system in terms of each of their childhood familial situations. The wife is, gradually, becoming more empowered. Both partners are both non-defensive, readily engaging in our sessions.
Around a month ago, however, the husband verbally abused the wife in the midst of one of their arguments. Further exploration revealed a history of him having frequent “rage outbursts.” Obviously, the underlying systemic pattern of insufficient intimacy and lack of reciprocity invites, in a sense, his outbursts. He is unconsciously exaggerating his dominance. However, the ferocity of his verbal abuse, as we’ve learned, is more intense than previously realized. It has become clear that his problem controlling anger deserves its own, individual categorization. I have gently encouraged him to seek individual help. At first, I resisted the realization, adhering, as noted, to my own family systems theory training. However, couples consist of two individuals in relationship. His individual problem controlling his own rage—clearly related to his father’s history of verbal abuse—needs more attention than the three of us can provide.
The Hanashiros, married 15 years, display another pattern we psychotherapists commonly encounter. The two of them thrive in their individual lives. The husband works as an architect, and his work has gained national attention. The wife, a physician, easily works 60 hours a week. Their children are reared primarily by nannies—a fact eliciting considerable negative counter-transference in me (but that’s an entirely different Oprah). They have little inter-subjective intimacy. (Inter-subjectivity refers to the process of individuals sharing their private, subjective worlds with one another in open and vulnerable ways).
We’ve been meeting around two years, and it’s only in the past six months that the husband’s abuse of alcohol has emerged as a significant, distinct problem. He has succeeded in hiding how much alcohol he ingests, starting as early as noon each day. As it turns out, he’s completely dependent on alcohol. When he “quits,” even for a few days, he goes into withdrawal.
Once again, his alcoholism is simply too severe to be contained within our couples therapy work. Regarding systems theory, it is probably fueled, at least in part, by a yearning for more intimacy. Like often occurs in any of the addiction-compulsive patterns, his relationship with alcohol has become his primary relationship, his preferred form of connection. No interpersonal negotiation is required for him to find tranquility, even only transiently. The couple cannot grow closer, or resolve their systemic problem, until he either reduces or eliminates his alcohol consumption. In his case, a formal alcohol treatment program is needed—particularly because of the clear alcohol dependency (as distinct from alcohol use or abuse).
Finally, the Mustafas, who invite positive counter-transference in me (and, yes, still another completely separate Oprah here), show a pattern rather opposite to the Hanashiros. They are too close. They are so enmeshed that, at times, it’s difficult to tell where one person ends and the other begins. The wife is often flirtatious with me and, we’ve come to learn, with other men at the hospital where she works. The husband complains of her seductiveness, which he himself often observes. My struggle with my transition into my 60s, not to mention my thinning, stark white hair, delayed my capacity to notice her behavior with me. (I mean, who dislikes compliments?)
I’ve been working with them for only six months. We’ve addressed her seductiveness only for the past two. She is unyielding, in denial of an obvious problem. My efforts to interpret it as a way to create space between them—to disrupt the enmeshment—are failing. Miraculously, she grew up in a set of foster homes in which she was repeatedly neglected by both maternal and paternal figures. The miracle is that she’s become a successful “adult.” Ergo, her flirtatiousness seems to be a combination of childhood trauma and an effort to break up the couple’s boundary-blurring (Karbelnig, 2017). I have yet to make the referral, but it’s obvious to me that she, too, will need individual work to learn about, and cease, her seductive behavioral style.
Now, just as a mind-blowing insertion, consider that systems of some types are completely unavoidable. They operate as “internal dramas” within your own minds (Karbelnig, 2020). Donald Meltzer (2018), a Kleinian psychoanalyst, thought those dramas compel us to either choose people in our lives who comport with the plot. Or, we nudge others who hap into our lives into playing parts with which we’re most comfortable.
Obtaining the acceleration velocity necessary to escape orbiting around one system or another is completely impossible—unless you cross over into psychosis. These patterns operate internally, as noted, and encompass our beings in the broader culture. You would not know when to wake up, how to dress, or where to go but for these all-embracing systems. Even if you succeed in exiting one system, you will necessarily become engaged in another one.
In the cases presented here, the angry guy might enter a men’s group with its own system (affected by the leaders as well as the other members); the alcoholic will access the well-established, well-worn detoxification and rehabilitation system which comports well with the horrid medical-industrial complex (Wohl, 1984), and; even the flirtatious woman might run in social circles encouraging it.
These systems are holistic. In other words, they include parts of a whole that are interconnected in such a way that they cannot exist independently of the whole, or cannot be understood without reference to the whole. Your existence as a human, for example, is nested in the earth, solar system, universe, etc., and equally nested in culture and society. However, a part can also be a whole, e.g., an apple becomes an individual fruit once picked but, prior to that, it was part of the greater whole of the apple tree which, in turn, was part of the planet Earth, etc. Like the two Oprahs mentioned so far, this topic also, namely holism and more details on systems, strays way beyond the confines of this issue.
Jay Haley died in 2007, preventing him from offering any response to my rebuffing his (outrageous) idea that all psychological issues require couples therapy. As these three examples demonstrate, sometimes problems within individuals cannot be solved using couples therapy methods. The domestic violence (no less violent because it’s verbal), the alcoholism, and the overt seductiveness examined in these three examples illustrate where and when individual therapy is needed as an adjunct to or, sometimes, as a replacement for, couples therapy.
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Bowen, M. (1993). Family Therapy in Clinical Practice. New York: Jason Aronson.
Haley, J. (2016). Strategies of Psychotherapy. New York: Leopold Classic Library.
Karbelnig, A.M. (2017). The geometry of intimacy: love triangles and couples therapy. Psychoanalytic Psychology, 35(1):70 – 82.
Karbelnig, A. M. (2020). The theater of the unconscious mind. Psychoanalytic Psychology, 37(4), 273–281. https://doi.org/10.1037/pap0000251.
Meltzer, M. (2018). Sexual States of Mind. London: Phoenix/Karnac.
Minuchin, S. (1974). Families and Family Therapy. Cambridge, MA: Harvard University Press.
Satir, V. (1988). The New Peoplemaking. New York: Science and Behavior Books.
Whittaker, C.A. and Napier, A.Y. (2011). The Family Crucible: The Intense Experience of Family Therapy. New York: Harper.
Wohl, S. (1984). The Medical-Industrial Complex. New York: Random House.