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Carl Bagnini is a founding member of the International Psychotherapy Institute in the US and practices in Port Washington, New York. He is a seasoned clinician of more than forty years' experience with children, adolescents, families, and couples and he draws on a mix of British and American object relations thinking in his work and his writing. Those readers who have had the good fortune to see him present his couple work, or respond to presentations, will recognise the voice that comes through strongly in this book: a voice that carries an enthusiastic and feelingful engagement with the emotional struggles that couples bring to the consulting room and a clinical stance that values access to a flexible and well-articulated countertransference response.
The first half of the book's title (Keeping Couples in Treatment) is slightly misleading, I think. Although Bagnini says that it was in part inspired by a sense that training programmes give “insufficient attention to the challenge of keeping couples in treatment” (p. xvii), it is more inspired by the wish to encourage therapists to work with couples at all and not to lose them to individual therapy (whether done separately or in the same room). It might be better renamed “How to keep working with, and thinking about, difficult couples” as this is much closer to the central theme of the book: the experience of being with different kinds of couples, trying to find a way of working with them that gets to the underlying emotional interactions of object relationships, rather than staying with a problem-solving approach or rushing to close distress down. In this sense, the second half of the title (Working from Surface to Depth) is spot-on and the book is an extended account of the difference between surface and depth, and what it means to move from the one to the other with its attendant challenges, threats, and opportunities for development for both couple and therapist.
The book is structured (deceptively) like a primer