On psychoanalytic psychotherapy with aggressive couples

Abstract

The psychoanalytic psychotherapy of aggressive couples presents difficulties linked to the tenacity of their defences and high levels of acting out which inevitably bring the question of analysability to the fore. Whilst it is generally regarded that high levels of acting out are a negative predictor for psychoanalytic couple psychotherapy, it has also been put forward that couples who are “… considered to act-out too much to be treatable, may in fact be treatable, if only we could better understand the nature of their psychic structure and object relating” (Ruszczynski, 2012, p. 134). The author suggests that whilst considering the analysability of such couples we have to specify our therapeutic goal. The main goal is to help the couple create an intersubjective psychic space within which aggression can be transformed. For some aggressive couples this is not possible. Does this mean that these couples are not treatable? The author argues that for certain aggressive couples the therapeutic goal may not be the co-construction of an intersubjective psychic space but the deconstruction of the existing destructive link to acquire the necessary psychic flexibility to disengage and grow towards normal dependence.