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This is a well-written book by Kernberg on a very complicated subject: the potential interlocking dynamics of two people in an intimate relationship. He is fascinated by the challenge of how those in love fit together or clash. In this primarily psychoanalytic offering he takes the time to discuss biology and even ventures into how the couple fits in society. Then he describes the psychology of love relations in patients with various diagnoses. His observations about borderline and severe character disorders are the most complete and show the deepest insights. Unfortunately, he omits a large category of marital pathology, that which reflects the developmental problem that occurs when one or both spouses marry before having completed maturation into adulthood. This group comprises a large percentage of couples heading for divorce. These are the couples who “fall out of love” or find themselves “incompatible” three to five years after marriage.
Kernberg misses much in spouse-to-spouse transference reactions because his sources of data are “the treatment of patients by psychoanalysis and psychoanalytic therapy” and “the long term follow-up study of couples through the window of the psychoanalysis and psychoanalytic psychotherapy of individual patients” (p. x). Other analysts have utilized their analytic orientation for the treatment of couples' pathology “in vivo,” and they have arrived at different conclusions through the window of analytically oriented marital therapy. Love relations, intimacy, entwined neuroses, interlocking reciprocal pathology, and spouse-to-spouse transference reactions have been carefully considered in a study group of the American Psychoanalytic Association since the early 1980's. We have discovered that many couples can benefit from the “in vivo” treatment of their marriage while many individual therapies fail to understand and treat the marital pathology. Not only do analysts tend to have a “blind spot” in diagnosing the double pathology, but