Treating Borderline States in Marriage

If one is bold enough to attempt couples' therapy one lesson soon emerges: there are couples, and there are couples. The normal/neurotic couple incorporates communicative-interactive tips and interventions directed towards effective communication, conflict resolution, problem-solving and enhanced intimacy. The personality-disordered marriage, even when managed with strategic skill and therapeutic acumen, too often seems impervious to change. The therapist is frequently left floundering and "at a loss." Charles McCormack navigates the reader around the reefs and through the doldrums that typically wreck or stall therapy with these couples. In doing so he also sheds light on the soft human underbelly of ALL marriages, reflecting, as they do, some degree of early trauma or impingement - now well-met in a partner. McCormack starts with the therapist's capacity to play and takes us on a journey of vigilance and courage to the recognition that, in working with borderline states in marital therapy, it is likely to be the THERAPIST'S resistance to understanding which may forestall - and then foreclose - the therapeutic process. McCormack uses exquisitely drawn vignettes which render the words as well as the "music" of sessions with these couples, transmitting the "feel" AND the "sense" of the sessions. In these couples we hear the echoes of their dreams and see the omnipresence of their nightmares wedded in their coupling. Each individual unabashedly - ruthlessly - uses the other as a self-object. Through resistance and oppositionalism the couple works to use the therapist as a self-object, too. McCormack makes the confusion in working with these couples clear. Using concepts derived from object relations, psychodynamics, self psychology and Ogden's theories of modes of human experience, McCormack sheds light on a unique treatment approach for working with borderline and other personality-disordered marriages. This light dawns gradually and not in a rushing flash of epiphany. What is unknown might not be unknowable; there may be a psycho-logic underlying what seems so "irrational." Therapy begins in the mind of the therapist. Through separate individual interactions within the dyadic context, Mr. McCormack works first to change each partner's relationship with the therapist, and THEN their relationship with one another. Sequential interactions with each member of the couple provide not only "role modeling," but create psychological space in the treatment room, allowing for the development of "thirdness," where the "Other" and "We" can come more fully into being. McCormack offers a myriad of techniques - such as the "deniable interpretation," the challenge to certainty, and teasing out and surfacing inconsistencies in narrative - all of which add to the therapist's armamentarium in this difficult but potentially rewarding process. A world that may seem unintelligible at the beginning of this book, the scorned world of the personality-disordered marriage, ...