Academic journal article American Journal of Psychotherapy

Modern Kleinian Couples Therapy with Emphasis on Psychic Retreats and Pathological Organizations

Academic journal article American Journal of Psychotherapy

Modern Kleinian Couples Therapy with Emphasis on Psychic Retreats and Pathological Organizations

Article excerpt

INTRODUCTION

This paper offers a theoretical and technical view of how to understand, contain, and transform a couple's chaotic and destructive ways of relating and non-relating by tending to each party's individual phantasies and internal conflicts while also helping to work through the vicious cycle both parties often become enmeshed in as a mutual method of repeating archaic wishes and fears. This mutual system of destructive, repetitive, and static projective identification is often crystalized into a highly resistive and resilient pathological organization (Rosenfeld, 1987; Shafer, 1994; Steiner, 1990).

When this dysfunctional unconscious bargain breaks down, one or both parties in a couple often withdraw into individual psychic retreats (Shafer, 1997; Steiner, 1993), which leaves each of them embedded in highly resistant emotional impasses. As a result, one party or both may need more individual focus before treatment can resume on the couple as a relational unit. Modern Kleinian Therapy is considered to be a helpful method with such hard to reach couples and an approach to gradually working through the intrapsychic and interpersonal elements involved.

MODERN KLEINIAN THERAPY

Modern Kleinian Therapy (Waska, 2011a; 2011b; 2012a; 2013) is a contemporary hybrid of classical Kleinian psychoanalytic technique and a clinical approach for working with more disturbed or complicated patients in either individual or couples treatment. Modern Kleinian Therapy uses a psychoanalytic focus to understand and work with both internal resis- tances and external roadblocks to psychological integration.

In clinical situations we see many individuals and couples who tend to subsume whatever therapists do or say into their pathological organization (Spillius 1988) with its familiar cast of internal characters. Modern Klein- ian Therapy focuses on the interpretation of this particular transference process by investigating the unconscious phantasy conflicts at play and by highlighting the more direct moment-to-moment transference mobilized by projective identification dynamics (Hinshelwood, 2004; Joseph, 1988, 1989; Segal, 1997). Bion's (1962) ideas regarding the interpersonal aspects of projective identification, the idea of projective identification as the foundation of most transference states (Waska, 2004, 2010a, 2010b, 2010c), and the concept of projective identification as the first line of defense against psychic loss (Waska, 2002; 2010d) difference or separation, all form the theoretical base of this clinical approach.

Therapists strive to move the couple into a new experience of clarity, vulnerability, reflection, independence, change, and choice. We clinically support this psychic change (Feldman, 2004) by attempting to foster and fuel an ongoing level of analytic contact with each party in the couple and with the couple as a whole, creating a potential psychological moment of new, unrestricted, uncensored thinking and presenting the opportunity to approach the self and the other in new more creative ways. As such, analytic contact (Waska, 2007) is defined as the sustained periods of mutual existence between self and object not excessively colored by destructive aggression or destructive defense.

These are moments between couple and analyst, as well as between both partners of the couple, when the elements of love, hate, and knowl- edge and the life and death instincts are in sufficient balance as not to fuel, enhance, or validate the patient's internal conflicts and phantasies in those very realms. These are new moments of contact between self and other, either in the mind of the patient or in the actual interpersonal realm between patient and analyst. These are found fragments of peaceful and pleasurable attachment providing proof and hope that need, change, and difference can be beneficial and worth risking. Internal dynamics sur- rounding giving, taking, and learning as well as the parallel phantasies of being given to, having to relinquish, and being known are all elements that are usually severely out of psychic balance with challenging patients. …

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