The Institution of Marriage: Terminable or Interminable?

By Karasu, Sylvia R. | American Journal of Psychotherapy, January 1, 2007 | Go to article overview

The Institution of Marriage: Terminable or Interminable?


Karasu, Sylvia R., American Journal of Psychotherapy


The institution of marriage has received renewed interest and even appreciation in the context of the controversy regarding same-sex marriage. Paradoxically, though, as marriage has become more valued, it has become, in the minds of some, just another life-style choice. This paper presents an overview of marriage and explores the complexities of the institution from historical, anthropological, legal, and sociological perspectives.

Marriage has many practical implications, including psychological and physical benefits for men and for women, and particularly for children and adolescents, as well as direct benefits to society itself. It is incumbent on clinicians to be sensitive to the many dimensions of this extraordinary institution as it relates to their patients.

INTRODUCTION

No clinician is immune from issues related to marriage, whether he or she treats adults, children, or adolescents; couples or individuals; heterosexual or same-sex patients. A patient's marital status is very much a backdrop for any treatment, and it is often one of the first questions asked in a clinical interview and one of the first adjectives used to describe a patient.

In the United States today, between 85% to 90% of people (Popenoe and Whitehead, 2004; Amato, 2004, p. 5) will eventually marry. Each year there are at least approximately 2.2 million marriages (Munson & Sutton, 2006). For some reason, though, mental health professionals seem to relegate those issues related specifically to the institution of marriage to sociologists, lawyers, anthropologists, or historians. The most recent edition of the two-volume Comprehensive Textbook of Psychiatry, (Sadock & Sadock, 2005) for example, in its more than 4000 pages, has only a few scattered references to marriage in its entire work and nothing specifically on the institution of marriage.

Ironically, the institution of marriage has received renewed attention and even increased status recently in light of the controversy over same-sex marriage. It behooves psychotherapists to understand and appreciate the complexities and many dimensions of this remarkable institution in order to maintain the perspective required to help their patients.

The title chosen for this paper derives from Freud's 1937 paper, Analysis Terminable and Interminable. It is in that paper that Freud speaks of psychoanalysis as one of the three impossible professions, along with education and government (p. 248). It was there that Freud was fairly pessimistic about the efficacy of psychoanalysis: treating one neurosis did not guarantee immunity from another or prevent the return of the initial one. (p. 223). He even said one can be sure beforehand of achieving unsatisfying results (p. 248). He did believe, however that analysis was always right in theory, though not always in practice (p. 229).

Likewise, the institution of marriage, just as Freud said about psychoanalysis, may always be right in theory, though not necessarily in practice. One can be fairly pessimistic about the efficacy of marriage, as well as be sure, in many cases beforehand, of achieving unsatisfying results, particularly when divorce rates in the U.S. hover around 50% and even up to 60%, depending on demographics (Popenoe and Whitehead, 2004; Coontz, 2005, p. 290). Marriage, though, has many practical implications.

PERSPECTIVES ON MARRIAGE

There are three major perspectives from which to study marriage. The first is the psychodynamic approach, which explores a patient's unconscious conflicts and wishes, as well as defense structures about marriage. The other two are the relational and the institutional perspectives (Hawkins, 2002, p. xv).

The relational perspective emphasizes relationship skills, such as communication and problem solving, required to build and maintain marriages. It focuses on the private and interpersonal nature of marriage (Hawkins, 2002, p. xv) and more on its function than its form. …

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