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My first question about Marilyn Meyer's dilemma is this. Each partner in the couple is in individual therapy. Is the couple therapy a helpful addition or is it the repository for unprocessed issues from the individual therapy? It would have been helpful to know more about the context that Marilyn was working in.
Both members of the couple have grown up in abusive and neglectful families, and have probably experienced adults denying or dissociating from abusive events. This experience is projected into the worker. In this situation, I get the impression that the worker is not an adult from the past, but the child, not knowing what to do and uncertain whose side she is on.
I wonder if the wife is trying to give up the drugs she has been taking and having to manage her state of mind without the use of drugs. From the description it sounds as if the wife is projecting dependency into her husband. This may create a sadomasochistic dynamic where she moves away from his needs, hurting his feelings, and he retaliates by concretely hurting her. The sadomasochistic dynamic may be addictive to both members of the couple. In this situation it may be unhelpful to label the husband as the