Repairing Intimacy

Couples therapy is greatly enhanced when both the intrapsychic and interpersonal realms can be utilized. Object relations theory allows linkages between the spouses' subjective realities and their relationship in a way that allows the two worlds to be mutually informing. In Repairing Intimacy the theories of the American object relations theorists are applied to couple dynamics. The representational world is used to explain how primitive defense mechanisms and other intrapsychic phenomena contribute to marital conflict. The structure, function, and content of the representational world all contribute to spousal expectations and the couple's capacity for intimacy. Esteem, soothing, and the propensity of splitting strongly affect the ways in which spouses interact. Projective identifications similarly provide explanations of the couple's interaction, internalized conflicts, and relationships with earlier objects. This book explains how object relations concepts can be used in assessment and in planning treatment goals. Treatment can provide stability or help the couple relate to each other with deepened understanding. Object relations dynamics can help therapists assess which treatment objectives and goals are most applicable to the couples they treat. The beginning and middle phases of couples treatment are given special consideration and include issues such as assessing the couple's commitment to each other and the importance of empathic listening. Other treatment topics include analysis of projective identification and the use of countertransference. Planned and unplanned terminations are also explored. In each treatment section case material is provided to explicate the therapist's role. The book also examines common therapy issues from an object relations perspective. These include the consequences and advantages of conjoint, concurrent, and collateral treatment approaches. Consideration is also given to the choice of focusing on the couple when the initial presenting problem is the famil

This book will be especially useful to those working with narcissistically vulnerable couples, where a focus on communication and simple family-of-origin connections is not enough. Repairing Intimacy is an exciting addition to any couples therapist's library. It has already influenced my own couples work., Siegel's description of work with borderline and narcissistic patients makes clear why short-term treatments do not work and why so many couples become treatment failures because therapists cannot handle their own countertransference reactions to the couples' projections. She shows the reader how to engage the couple, provide a holding environment through empathic listening, offer hope, and assess the degree of ego strength to determine how to proceed in treatment., This book advances our field. It gives thoughtful recognition to a group of major proponents of object relations whose work has so far been devoted to individual development and therapy. The lessons of these theorists are applied with clarity and clinical acumen. The book gives an original, creative formulation of treatment as a process aimed at stabilizing, informing,and renewing the couple. Inspired in depth by American object relations, Repairing Intimacy fills a gap in the clinical tradition and brings us important new experience in the art of repairing the wounds that beset marriage.

Judith Siegel, Ph.D., is associate professor at the New York University School of Social Work.