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The institution of marriage in the United States is in a crisis. In the last ten years the divorce rate has more than doubled. One-third of all marriages in the U.S.A. end in divorce. It is estimated that as much as 60% of the middle class who divorce may seek psychotherapy. Marital crises frequently generate immense suffering that goes beyond the boundaries of the nuclear family and often ends in tragedies involving suicide or homicide. In addition, troubled marriages are epidemiological centers of mental disorders which spread from generation to generation.
Do we have effective therapeutic tools for the patients who seek our help? Since Oberndorf in 1938 and Mittelman in 1944 first reported the treatment of husbands and wives, a surge of interest in marriage has emerged among psychiatrists and analysts and has given rise to a copious literature.
Before I discuss the problems of marriage therapy, I should like to discuss briefly a few aspects of the nature of marriage and of the conflicts that disrupt it.
In our American culture the road to marriage goes through falling in love and courtship and is usually followed by the routine of getting a marriage license and a wedding.
For a large number of people a marriage license signifies a license for a stable and satisfactory marriage. But for an appreciable number of couples a marriage license means permission to be abusive with one another or to inflict suffering on each other. These couples form unsatisfactory or neurotic marriages. What is noteworthy is the fact that in both types of marriages, the satisfactory