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I want to thank Nathan Horwitz for sharing this wonderful work. I think he has done an exquisite job of delineating the relationship between intrapsychic conflicts and marital conflicts. Considering how often our patients report unhappy relationships, it is surprising how infrequently couple's issues are attended to in the psychoanalytic literature. Perhaps this is due to the assumption that resolution of intrapsychic conflicts will eventually alter relational patterns. Conversely, couple therapy seems to promote behavior changes, the assumption being that altered relational patterns effect change in intrapsychic structures. So, a work like this article is both important in itself and important in the interdisciplinary crosstalk it invites.
Now, I want to comment briefly about the case itself. In learning about Cindy and Bob I was impressed, of course, with how her self-effacement initially meshed so well with his expansiveness, which certainly explained their getting together. But then I wondered what force was unique to the Cindy-Bob dynamic that kept them together long enough to even get to a stage of malignant vindictiveness. After all, Cindy had several serious previous relationships; Bob had two previous relationships. More precisely, what did these partners do for each other to sustain a relationship that the previous partners had not done?
First, each one worked really hard to reinforce the other's predominant idealized image by acceding to neurotic claims. Cindy's self-sacrificing is so flagrant as to remind Bob that he must produce a great novel; 5 years of “ego-stroking” would hardly be justified by a mediocre book. Bob's demands are so outrageous as to remind Cindy that her compliance is critically important to him, she can control his work just by making noise while