For Better, for Worse: Marital and Family Therapy and the Personality Disorders

Long-term relationships necessitate a tolerance for the otherness of others. If that otherness, the essential qualities of another person, is too alien and unfamiliar, a relationship cannot endure, because the individuals cannot empathize or resonate with each other. As couple therapists, we may sometimes wonder how two individuals stay married when all they do is fight and make each other miserable. That may be because what is so apparently alien and different is really unconsciously familiar and becomes amenable to resolution through the marital partner. The partner is needed to help in some way resolve a problem created in an earlier primary relationship. This kind of interaction or interpersonal relationship occurs in healthier relationships but in couples in which one or both partners experience serious personality disorder, the rigidity of defenses and, paucity of responses inhibit their ability to grow together towards some new problem-solving capacity; that is, to create a new couple relationship. They are stuck in trying to revamp the old unconscious relationship.

Object relations theory can be used to understand unconscious problems and mechanisms which may operate in such couples and families, and to intervene in ways which modify, if not solve, the current and underlying problems. Attempting to deal with unacceptable parts of themselves, these couples use defenses such as spliting,