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Psychodynamic Therapy for Couples

Current world events have pushed many relationships to the edge, strengthening some, diminishing others. However, help is always available to navigate through difficult dynamics that can come up whether choosing to stay together or to part in a conscious, responsible manner. Below is an excerpt from an essay outlining one psychodynamic counselling approach for those who would like to know more (full script available on request). I am available for 1-2-1 sessions for further insights.

Relationship problems affect almost everyone at some point in life, therefore they are commonly addressed by counselling (Gregory, 2020). Relationship breakdowns and their attendant emotions of sadness, anger and anxiety are linked to many adverse effects on physiological and psychological health, such as depression (Schofield et al, 2012). Relationship distress alone can lead to impaired cognitive, behavioural, and emotional outcomes (American Psychiatric Association [APA], 2013). Therefore, identifying effective counselling methods to improve relationships is of vital importance, as it has the potential to improve societal well-being.

Object Relations Couples Therapy (ORCT) lies within the psychodynamic framework and helps couples to understand and work with the reflections of their past relationships with key internalised figures in their present relationships with their partner. Based on object relations theory, ORCT aims to help partners understand each other’s unique meanings and transferences of feelings for key childhood figures onto one's partner (Klein, 1975). It also gives an appreciation of “transference allergies”, which are severe transference fears that bring about extreme emotional reactions (Nielsen, 2017, p. 689).

Like other psychodynamic therapies, ORCT resolves current malfunctional processes by identifying conflicts from early life and working with their roots. As with other approaches, ORCT helps partners recognise and accept each other’s subjective experiences. It aims to break through maladaptive schemas, towards adopting a non-blaming and caring attitude, and facilitates open communication with an imperfect partner (Macintosh, 2018).

ORCT helps to find a way to accept the intolerable parts of the self, split off and buried deep in the unconscious (Nielsen, 2017), as well as dealing with the unbearable feelings that the revelation of these parts may bring about (Dicks, 1963). Working with projective identification, the defence mechanism that produces unconsciously established rigid negative relationship frameworks (Macintosh, 2018), ORCT transforms relationships, making partners’ motives more straight-forward and feelings more mature (Usher, 2017).

ORCT requires that clients deeply delve into unconscious thought patterns and early life experiences, which can bring up uncomfortable feelings. Countertransference (when a therapist transfers emotions to a person in therapy), is a valuable aid for gaining a deeper understanding of processes at play, however, it can also be an obstacle that therapists must navigate sensitively. ORCT refers to pathological cycles of interaction, usually driven by feelings such as abandonment, shame and jealousy (Nielsen, 2017). Such frustrations can spiral leading to severe relationship discord including infidelity. Defence mechanisms lead people to hide from or minimise emotional distress within negative cycles.

The intensity of couple anguish during these negative cycles from failure of empathic containment by partners when needs have not been met (Nielsen, 2017), is particularly challenging when recovering from infidelity, where trust has been broken. Instead of mutual acceptance of responsibility commonly encouraged within ORCT, Oppenheimer (2007) suggests helping the faithful partner to understand their partner’s negative projections. This can help the involved partner recognize the unconscious internalisation of ideas leading to the maladaptive behaviours. Infidelity is a complex issue that can involve axis II personality disorders, less severe maladapted personality traits, and other factors (Bagarozzi, 2008). Abnormal, maladaptive behaviours witnessed can make more sense when factoring in often unconscious, personal wishes, fears, and defences (Nielsen, 2017).

The therapist can help the couple comprehend their transferences and give them a supportive, clear voice. ORCT can provide a safe environment immersed with empathy for self-discovery and transformative experiences, allowing softening through partners holding compassionate space for one another. (Nielsen, 2017). Therapists observe from a third position (Britton, 1989), to foster insight and avoid projective impasse (Morgan, 1995). Clients are encouraged to adopt acceptive ambivalence of unavoidable issues to re-narrate behaviours, with an emphasis on removing blame and exploring early life experiences to appreciate emotional intensity as schemas from the past (Seigal 2019).

Relationship distress has a powerful negative impact on well-being. Such problems can engender trust issues, damage to self-worth and dysfunctional behaviours, which have serious implications for mental health across societies. By tailoring therapy to clients' needs, therapists can provide a comfortable space in which collaborative therapy can occur, allowing clients to make changes that have a positive impact on themselves and those around them.

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