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I Nterviewing Husband And Wife together has been for some time a technique used in social work family-service agencies. It is only comparatively recently that psychiatrists and analysts have begun to utilize the conjoint session (husband and wife seen simultaneously by the same therapist) as a regular part of more definitive approaches to the treatment of married persons. Mittelman1 spoke of his occasional use of this method in 1948. Since then there has been an increasing ground swell of reports on the ways in which the conjoint session can be used either at intervals or as the major part of a therapy program.
The conjoint session brings to the forefront most dramatically the technical problems involved in any form of treatment of spouses when one therapist is made privy to information about both marriage partners. It brings great emotional stress to bear on the therapist so that countertransference reactions are more likely to occur in conjoint therapy than in any other form of psychotherapy. The therapist has to avoid the strong pressures on him to be directive when he should not be so; he must avoid being partisan; he must not act as final judge in deciding which partner is telling the “truth” when differing interpretations of the same event are given by each spouse.
To attempt to be an arbiter of the “truth” is a pitfall that can be most destructive. The therapist does best when he holds to his job of helping each spouse change the underlying aspects of his personality that make for distortions of perception or memory. Operationally, the analyst uses the interaction of the couple in the conjoint session as a springboard to help each get clarification of communication, awareness of his feelings and reasoning (insight) for particular affective and behavioral responses.
The conjoint session makes exquisitely dramatic the technical problems that Freud was so wise to avoid when he shunned relatives of adult patients. Unfortunately, we allowed his principles of non-comm