Monday, March 30, 2009

Couples: Otto Kernberg on Mature Love Relationships and Carla Leone on Treating Couples Using a Self and Intersubjective Approach

The Tampa Bay community has had a wealth of thought about Couples lately. On February 14, 2009, The Tampa Bay Psychoanalytic Society hosted Otto Kernberg, MD, who gave a descriptive account of nine features he sees as essential to the capacity for a mature love relationship. He described a mature love relationship as one where each partner has achieved sexual freedom with genital primacy as organizer; the ability to tolerate normal ambivalence (love with aggression); a sustained capacity to have interest in and emotional intimacy with/sexual longing for; and to respect the partner as whole object instead of narcissistically gratifying part object.

The nine phenomena elaborated were: 1. an interest in the life project of another (without incapacitating envy); 2. basic trust (a reciprocal ability to be open and honest, even about one’s own faults); 3. a capacity for authentic forgiveness (versus masochistic submission or denial of aggression); 4. humility and gratitude; 5. a common ego ideal as a joint life project; 6. mature dependency (a willingness to receive help without shame, fear, or guilt and to give help; and a fair distribution of tasks and responsibilities; versus power struggles where blaming about who is right, who is wrong leads to mutual frustration); 7. permanence of sexual passion (to love other with changing body and physical imperfections) requiring resolution of the Oedipal conflict; 8. acceptance of loss, jealousy, and boundary protection (accept that the other can not love us in exactly same way as we love them); and 9. love and mourning (when loss by death or disruption of life project allows for full appreciation of whom lost, leading to acceptance of love for new partner without guilt or insecurity.)

On March 21, 2009, the Tampa Bay Psychoanalytic Society featured Carla Leone, PhD, for a full day workshop on treatment of couples from a Self-Intersubjective point of reference. Leone highlighted four goals applicable to both partners in Couples treatment:

1) Strengthening the Self (of both). These include self-esteem and affect regulation, as well as mentalizing (ala Fonagy and Target). Leone does this by equal (easier said than done) empathic immersion. Each partner must hear that the therapist understands her/him from within her/his own perspective/subjectivity. She uses Fossaghy’s subject centered listening.

2) Explicitly illuminating the self-object needs of each. The therapist offers her/his self as a self object for what is needed at the moment, attuned to the self state of each partner. This can be done using heightened affective moments ‘Can you stay there a little longer?’

3) Illuminating the patterns that prevent each from getting needs met. As implicit relational models on how-to-be-with-an-other are learned, and as defenses are self-protective (once the Self is strengthened, defenses are less useful or less necessary), Leone invites a partner to mentalize (think about the mental life of the other) ‘Do you have a theory about why your partner is being aggressive?’ and illuminates organizing principles and their repetitive dimension. She notes how one partner may participate in or co-create these patterns because ‘that is what they know.’

4) Facilitating new relationship experiences (not just words) between partners, and between each partner and the therapist. Leone coaches and directs, without shaming, each partner to ask or tell the other partner what is needed and how the message might optimally be delivered.

S.E. FL Assoc. Psychoanalytic Psychology (SEFAPP) will also provide “Psychoanalytic Perspectives on Couple TherapySaturday, April 18th, 2009 8:30 AM to 12:30 PM in Hollywood, FL at Memorial Regional Hospital, Auditorium A, B, C & D, 3501 Johnson Street, Hollywood, FL 33021. Presenters: Glenn E. Good, Ph.D. Leonard J. Ferrante, Psy.D., NCSP
questions, please call SEFAPP at 954-597-0820 or via email at

No comments: