Inside out, or outside in: meeting with couples

Abstract

The complex difficulties often faced by couples require a range of models for effective help. Relational intensity is heightened in therapy by the ease with which the therapist can be triangled into the couple's relationship and by the influence of the emotional triggers from their respective internal worlds. This article draws on systemic and psychodynamic models and a transgenerational perspective for gendered stories. Different time frameworks link interpersonal and intrapersonal themes. In this sense, the therapist works ‘inside out’ and ‘outside in’. A framework of behaviours, emotions, feelings, meanings and beliefs is proposed to help link these perspectives. ‘Invisible contracts’ and the sense of there often being an unconscious ‘pact to disappoint’ are described. Clear models are not enough, for it is the intimate encounter between client and therapist that is the bedrock of therapeutic change and growth. There is no short cut to this sense of intimacy in the unique encounter between therapist and each new couple. Brief examples from practice describe how the issues discussed may be addressed in couples work.

Kondisi Orang Dengan Gangguan Jiwa Pasung, Keluarga Dan Masyarakat Lingkungannya Di Kabupaten 50 Kota

“…Keberhasilan perawatan di rumah sakit yakni pemberian obat akan menjadi siasia apabila tidak ditunjang oleh peran serta dukungan keluarga. Penelitian yang dilakukan oleh Jenkins, dkk (2006 h.624) menunjukkan bahwa family caregivers adalah sumber yang sangat potensial untuk menunjang pemulihan PDM (Jenkins, 2006). Nurdiana dkk (2007) dalam penelitiannya menyebutkan bahwa keluarga berperan penting dalam menentukan cara atau asuhan keperawatan yang diperlukan oleh PDM di rumah sehingga akan menurunkan angka kekambuhan.…”

Research on couples: are feminist approaches useful?

“…Ideally, both partners within a coupled relationship should be able to contribute to research so as to allow better understanding of the potential impact of an illness or health issue on the coupled relationship. Literature on couples’ counselling acknowledges that the dynamics of the couple need to be explored simultaneously with the individuals, taking into account both historical and current influences in their relationship (Jenkins 2006). By exploring partnered relationships, knowledge to build on knowledge derived from exploring individual experience can be gained.…”

Systemic work with clients with a diagnosis of Borderline Personality Disorder

“…Over the years I have learned to trust and to draw more openly upon whatever comes to me as I sit with clients and work in different ways with what is of use at the moment. I integrate theories and frames to work with inner and outer systems (Jenkins, 2006;McNamee, 2004;Pocock, 2006) as I move my lens in and out, working psychodynamically and systemically with individuals, couples and families as seems appropriate to what is needed. I think, communicate and act in the multiple languages I have learned, and work in a way that may appear to be chaotic, but is experienced by me as an ordered and clear approach.…”