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By McCollum, Eric | Family Therapy Networker, January/February 1998 | Go to article overview

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McCollum, Eric, Family Therapy Networker


Angie lays out the facts dispassionately--a husband whose distance has grown into iciness during the past three years; the demands of raising two young children and maintaining a job; a male coworker whose mentoring has begun to take a flattering, romantic turn; the urging of friends to stay; the urging of friends to go. Finally, she sits back in her chair and asks the predictable question:

"What do you think, Doctor? Should I leave?"

Peter Kramer, author of the best-selling Listening to Prozac , takes this familiar situation as his point of departure in Should You Leave? to ask what advice therapists have for people in Angie's situation, and whether we should give any advice at all.

Should You Leave? grew out of the inevitable push for psychiatrist Kramer to write a self-help book after the success of Listening to Prozac . But Kramer demurred, convinced that people in Angie's position find little help in generic counsel, which typically prescribes the cultural credo of the moment ("Do what feels right!") or shores up more traditional values ("Think of the kids."). According to Kramer, people like Angie need something different--a response specific to their situation. So Should You Leave? is not a book of advice for lay readers, but a book about therapeutic advice-giving and its limitations.

Kramer reviews everything from biological psychiatry to object relations to Ivan Nagy's contextual therapy to illuminate the relationship conundrums clients bring us. Much of what Kramer writes is familiar to family therapists. Bowen systems theory might point us to the triangles and lack of differentiation in Angie's marriage--how her growing infatuation with her coworker is a way to dampen the pull toward fusion with her husband. The object relations take on marriage would suggest that Angie picked her husband because of his proclivity to distance, something she found initially comforting in escaping from her chaotic family of origin. Now Angie longs for the intense emotional involvement her husband can't give her, but that her family did.

In addition to covering familiar family therapy territory, Kramer adds some insights of his own. Some couples, he thinks, choose each other to match a level of stunted affect. Perhaps Angie and her husband, both mildly depressed when they met, created a clinging, "peas-in-a-pod" marriage to protect each other. But when job success lifted Angie's depression and she was ready to move outside of their melancholic togetherness, her husband still clung desperately to their original "deal."

Although Kramer cites feminist psychoanalyst Jean Baker Miller's work on the importance of connection to counterbalance our cultural emphasis on independence, and he talks about the "possession" of some women in marriage, he gives little attention to the issues of money, power and social control. He doesn't consider the possibility that Angie might wish to leave her husband because she's tired of living with an "allowance" and of always having to explain where she's been and where she's going.

Kramer is a talented writer with a novelist's eye for detail and character. His opening description of being awakened in the middle of the night by a neighbor whose wife died only hours before and who now wants a psychiatrist's advice on whether their young children should attend the funeral captures perfectly the odd situations in which we often find ourselves--in therapy and out--when we are asked to make definitive pronouncements on things for which there are no easy answers. Perhaps the best use a therapist might make of Should You Leave? is to give it to anyone wondering whether therapy "isn't just common sense, after all," or to read it to remind ourselves of the complexities lurking behind the seemingly simple question Angie asks--"What do you think, Doctor? …

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