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A four-person relationship exists from the start when two therapists each treat one of a married pair, and if they never meet, the opportunities for shared phantasies in unconscious collusion between the therapist-spouse couples abound. Previous published work by the Family Discussion Bureau has been much concerned about this hazard which they have attempted to neutralize by constant case conferences and supervision. Reluctance to have ‘foursomes’ in which each can see what the other is up to may be as great on the part of the therapists as on the part of the clients. It is a loaded situation even if the therapists normally trust each other; particularly so if it is not instituted as part of the procedure from the beginning.
In the two cases described in this monograph, joint meetings were decided on in the first case because of the therapists’ need for ‘mutual support’ owing to panicky attempts to split them. Thereafter, joint interviews were alternated with single ones to mutual benefit. Enactment on the Oedipal level indicated a greater degree of development in this couple than in the second pair described who existed miserably by paranoid projection.
It was ominous that the description each gave of the spouse was diametrically opposed to the intake interviewers’ impression of them. Seen separately, such cases are usually therapeutically unrewarding, but it becomes increasingly hard to bring them together as feelings of persecution are often extended to the other therapist and a joint interview is tantamount to being thrown to the wolves. This difficulty is evident in the report. Much unnecessary suffering for all four can often be avoided if husband and wife are seen together at intake interviews.
A great deal can be learnt from such studies in this growing field of interest, particularly where the therapists are as frank about their work and the difficulties encountered as are the authors of this monograph.