Psychoanalytical Psychotherapy for/with Couples: Theoretical Basis and Clinical Utility1

The objective of the panel was to discuss the characteristics of psychoanalytical psychotherapy for couples and with couples, its theoretical foundation and clinical utility.

One of the first topics to be covered related to the question of the need for therapy for couples or with couples, and to discuss what this type of treatment adds to the contribution of the classical Freudian model. What was proposed in response to this question was that the role of ‘the intersubjective’ will differ according to the type of psychic suffering, and that this dimension has a central importance as regards much of the suffering in a relationship as a couple and must have a place in the design of therapy. This then justifies the idea of a treatment specifically for couples.

This begs the question: what is the intersubjective dimension? It was proposed that all psychic functioning constitutes two faces of the same coin: one face is intrasubjective, in that the fundamental determinants come from the inner world, while the other face is intersubjective, in that the psychic determinants include the other (person) and the intersubjective context in which the subject functions. This intersubjective context and the ‘other’ are fundamental factors in much of the suffering which takes place in the love life and the relationship of the couple. The cases which are suited to treatment as a couple are therefore those where certain factors have a particular importance. These include: the partner; bidirectionality; unconscious interconnections; the interweaving of the phantasies of both partners (interphantasmic weft). In other words, we are dealing with problems in which the psychic determinant of the suffering must be found in an aspect of the functioning of the psyche which is not part of the Freudian psychic apparatus but which lies in the link between the members of the couple (the ‘intersubjective’).

Dr Moraes asked which concepts make up the basic, minimum toolbox of a therapist who works in co