Psychoanalysts View Conjoint Therapy (Apple Valley Symposium): Response to Discussion

To the Editors: This symposium opens many areas for profitable discussion, foremost that of the break-away from the traditional analytic procedure of avoiding encounters with members of the family other than the nuclear patient. Seasoned analysts have long been unbound by ironclad rules in this regard. But many younger analysts, because of their fears of being considered deviant or unorthodox, are reluctant to see other family members.

It must be remembered that the goal of therapy is not that the patient become adjusted to the analyst, but rather that the microcosm of the physician-patient relationship carry over to the macrocosm of the patient's outside world. It happens too often that the therapeutic relationship acts as a device for closing off communications with other pertinent individuals in his life. Let me cite a case:

I had a young man in analysis who presented many problems. His family felt his main difficulty was inability to carry out a consistent school program. In therapy he

brought out many other symptoms, such as fear of death from heart disease, guilt for masturbation and for stealing, and inordinate fear of his father. He had an older sister in analysis with another analyst and a brother in analysis with a third analyst. Since the husband of the older sister and both parents had never been permitted to see the other analysts, they were in complete ignorance of what was going on with the patients.

My patient agreed when I told him there was no communication in his family, and he described the deadly dinners at his home where no pertinent conversation ever took place. I suggested some family meetings. Fortunately, the other analysts offered no objections. These meetings, held at monthly intervals for two-hour sessions, did more to bring about the resolution of the intra-familial conflicts than had been accomplished by years of individual personal analysis.

But this is not conjoint therapy which must not be confused with the occasional interview of a