My Approach to Couple Therapy

As with my approach to working with individuals, my approach to working with couples is very client-centered--or, couple-centered.  It always focuses on the unique couple dynamics--unconscious and conscious--the couple has created and that are unique to them.  It is also always centered on empathy creation and working toward lasting change. 

My work with individuals also shares a goal with the couple therapy I do: working toward creating what psychoanalyst and couple therapy expert Mary Morgan calls "a couple state of mind."  We are all essentially relational beings and the type of health I invariably work toward--whether it be in individual or couple work--can be thought of as an actualization of this relational essence, this relational health deep within all of us. 

The more we achieve this "couple state of mind"--within ourselves and with respect to our relationships--the healthier we are.  We might see "a couple state of mind" as being the opposite of narcissism (or "narcissisme à deux"), or at least on the far end of a narcissism-relational spectrum.

As a psychoanalyst, I work in an in-depth way that tries to take seriously what might be happening outside of awareness--and with the understanding that whatever is happening outside of awareness invariably presents challenges and opportunities to at least one of the three individuals involved in the work of couple therapy.

As much as possible, I try to understand the unconscious internal worlds of each individual--and the unconscious elements of the couple's singular and complex relational dynamics.  As a trained psychoanalyst, I have learned how to "listen" for whatever unconscious material may be coming up from each individual in the couple, or is getting activated within myself--and, importantly, how to use what I am "hearing" in the work.

I rely heavily on the intersubjectivity theory of psychoanalyst Jessica Benjamin, particularly her early relational work on "the bonds of love."  Benjamin theorizes another spectrum of relations: one with the poles at hierarchy and equality.  Unfortunately, our default seems to be hierarchy unless we have learned to do the work of maintaining equality in our relationships--and a desire for equality within ourselves (another form of "a couple state of mind").

I also lean quite a bit on the Tavistock Relationships Model and the attachment theory of psychoanalyst Peter Fonagy and others at the Tavistock Clinic.

I use these psychoanalytic theorists to guide me in my understanding of what makes for a healthy relationship, how unhealthy relationships invariably get stuck reproducing themselves, and how best to work with couples towards creating Morgan's "a couple state of mind"--or, a healthier relationship that fosters mentalization, recognition of the full subjectivity of the other, equality, empathy, and growth.

My work attempts to promote relationships that get beyond the invariable repetition of the unhealthy "attachment system" of those who have yet to achieve "a couple state of mind" and who have had to cope with having an insecure attachment style, or being attracted to others with an insecure attachment style.

Psychoanalysis is an inherently two-person modality so there are limits to how psychoanalytic couple therapy can be.  Working in an in-depth and psychoanalytic way with an individual cannot be done in couple therapy, and at least one member of the couple might be dealing with blocks to "a couple state of mind" that might preclude couple therapy helping the couple achieve a healthier relationship. 

If this ends up being the case, I am able to make a referral to one of my colleagues at my instititue, the San Francisco Center for Psychoanalysis, in order for one or both members of the couple to do the individual work required.