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Contrary to the popular belief—among the profession, as well as among the laity—that there is a taboo against simultaneous individual psychotherapy of husband and wife by one physician, the author has had rewarding experiences with this type of practice.
This is not to imply that the procedure is without complications. These couples live in a “never-never land” of make-believe, play a kind of “doll's house”, enmeshing themselves in a tangled web of deception, hope and illusion, with realistic defeat and misery. Confusion is a constant in the treatment of these couples as they see-saw and waver in a never-ending indecision of whether or not to stay, either in their marriage or in the treatment that endeavors to understand and facilitate change.
Marital difficulties have proved to be the core and the most important problem of both individuals, and these couples are too complex for counseling or superficial psychotherapy. It has been found that they required intensive individual treatment. Except for an occasional joint interview regarding some immediate trying circumstance, the husband and wife are seen separately. It has been observed in such cases that it is most effective to give an equal number of appointments per week to each member of the marriage. The development of transference becomes a salient link in the treatment of such couples. And through its power the analyst helps one to assume more responsibility towards the other.
The husbands and wives who are the subject of this paper are all in their thirties or forties, have been married ten to twenty years and have two or more children. All attended college; the husbands are business and professional people. Each individual suffered from severe emotional disturbances dating from childhood, yet almost none