Figure 9.1 First Geneogram of the Yardley Couple
Marital therapy is often treated as a discipline separate and distinct from family therapy. For example, leading textbooks in the field of family therapy separate 'marital' from 'family' therapy in their titlesNote 1. The position of marital therapy as a separate discipline, requiring its own strategies and techniques, acknowledges real differences. The heterosexual bond upon which marriage is based differs from other bonds in important respects. Sexuality is the first of these distinguishing features. The physical relationship between a man and woman joined through their lovemaking adds a new dimension to emotional attachment and cohabitation. A second feature is the peculiarity of the marital choice. Marital relationships are newly-formed; spouses do not grow up together nor do the partners accept each other from birth, as occurs in almost every other family relationship. Two comparative strangers choose to share their lives together. Transgenerational influences in the family collision affect this marital bonding. Finally the marital bond differs from other bonds through its future potential. The marital partnership can be and often is a prelude to parenthood and the production of children. This procreative function creates unique problems as new families develop.
For the above reasons alone, the marital relationship is subject to immense stress. It is all too common in Western societies to isolate this stress within the marital subsystem. Even when requiring treatment, the marital couple are regarded in isolation, without consideration of the
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extra-marital sources of the stress. In his attempts to solve the marital puzzle, PaulNote 2 offers a model with a transgenerational perspective to marital therapy. He incorporates marital therapy within the framework of the extended family, analysing the marital quandary to determine whether there are unsolved problems which relate more properly to pre-existing relationships.
In the following clinical case study I have attempted to illustrate the type of marital therapy which can be done through the use of the transgenerational perspective. This brief case provides a model in which only the marital couple attend the therapy sessions, but their extended family members become involved in the therapy.
Mrs Susan Yardley was referred for individual treatment to a general psychiatric clinic by her general practitioner. She was a 21-year-old married Canadian secretary, with a history of depression for several years which had recently worsened. She and her husband were referred after the psychiatrist treating her in the outpatient clinic found a link between her major problems and symptoms and her relationship with her husband. She had refused medications; her referral was an alternative to admitting her to hospital for voluntary electroshock therapy.
The referral was a verbal one initially. I spoke with my colleague and examined the case notes before my first interview.
Mrs Yardley was accompanied by her husband at her first interview. She had been depressed for three years, with increasing intensity since a visit by her mother and sister, Linda, four months previously. She had suicidal thoughts but had not attempted suicide. Her depression began in Toronto where she attended Art School. Her relationship with a boyfriend ended when she became pregnant. She had an abortion and then visited England hoping to enrol in an Art School but was turned down. She met her husband at a pop concert in England six months after arriving in the country.
He was a guitarist in a band. They lived together for a while and married eighteen months later. She felt that her relationship with her husband was deteriorating as had many of her previous relationships.
Her family background was recorded as unremarkable except that her father died when she was eight years old. She was the middle daughter of three sisters. She felt that her younger sister received attention that was rightfully hers. Mrs Yardley argued frequently with her mother. She
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felt her mother had a wicked streak. After their rows she would leave home. After her elder sister left home there was a relatively happy period in her life at home.
Mrs Yardley had been treated briefly for depression in Toronto when she was sixteen. At the end of this first interview, the psychiatrist diagnosed a neurotic depression and prescribed tricyclic antidepressants.
In the following interview, the psychiatrist listened to the husband's view of the problem. He seemed an inoffensive man, concerned for his wife's welfare. He added little to her history and his background was unremarkable. He was an only child with no psychiatric or family problems. She complained that medications hadn't helped.
After missing one further appointment the couple attended four weeks later. Mr Yardley felt his wife was much improved. He rambled on until his wife interrupted and asked to see the psychiatrist alone. She admitted to a great marital unhappiness. She couldn't bear his touch, couldn't communicate her feelings to him. She felt they had little in common. If she was critical of him he responded by looking and acting hurt so that her guilt increased. Their sexual relationship had been a good one until they were married. She had made the decision to marry him after returning to Canada on a visit. She had missed him desperately. She now regretted returning. She felt that nothing was shared and that they were leading two independent lives. The psychiatrist asked her husband back into the office and shared this information with him.
The next session four weeks later she attended alone. She and her husband had had a dreadful row. She was depressed and tearful. She stopped her medicines because they were ineffective. Her eldest sister had visited but the visit increased her misery. The psychiatrist prescribed phenelzine and agreed to see her in two weeks.
She returned alone and told him the medication had been useless. She felt worse and her relationship with her husband was poor. The psychiatrist offered her the choice of marital therapy or admission to hospital and she chose the former.
My discussion with her psychiatrist added his conviction that the relationship between the husband and wife was a crucial precipitant. Although the couple had been living together before their marriage, their sexual and emotional relationship had deteriorated immediately after their marriage.
I found myself with more questions than answers. Was this a case in which marital therapy would help? My thoughts skipped about. Do
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these two love each other? From all the present information they remained together despite their unhappiness and the bond was strengthened during a separation. Their family backgrounds must incorporate essential and important national differences as well as family cultural ones. The transgenerational influences must clash in ways not yet apparent in this 'hybrid'marriage. I drew my version of their family tree (see Figure 9.1). Her father's death was the most important of the life events which required exploration. I wondered if her husband replaced her father in several important unconscious attributes. What was her reaction to his death? What happened to her family afterwards?
She was the middle of three girls and her husband was an only child. Perhaps this was the root of his communication problem with her. She expected that he would know how to communicate with peers the way she had learned to communicate with her sisters. Neither of them had experience of other sex siblings, however. His parents would have moulded him to a greater extent as an only child. I wondered why he was an only child. I felt that his extended family might be more necessary as a resource than hers. I wondered why he married her. He knew about her past background. Did he tend to pick women who needed him for his own compulsive reasons?
Videotape recording was used in this session. The couple were told that the tape would be available for them to watch. It would also provide me with a record of their interactions for later study and for teaching purposes if they agreed. I wanted a tape which would show the geneogram
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technique. The couple agreed to the use of the equipment and subject to its review they agreed to its use as a teaching aid.
They sat opposite me and Mrs Yardley began a long, tedious monologue about her depressive symptoms. Nevertheless, she was more animated than her husband, who sat silent and looked brooding and miserable. I asked about his feelings but he defended himself. He argued that he did his best to cheer his wife up when she was in her moods, but she seemed to get worse when he did it. I felt they were both too wrapped up in their own feelings and thoughts. I explained that I'd like to learn a bit more about their family background.
I began with Mrs Yardley and drew the resulting geneogram on the blackboard (see Figure 9.2). We quickly entered into an exploration of circumstances leading up to and including her father's death. She felt that her father had favoured her eldest sister, Linda. Susan had loved him or his character. She felt warm and loving towards her father and denied experiencing angry feelings towards him. Idealisation of her dead father? He developed cancer of the stomach when she was six years old and died slowly at home after refusing an operation. Her mother reacted badly to the death. She withdrew from her children, becoming bad tempered, irritable and depressed until she received private psychiatric
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care when Susan was sixteen. Susan was receiving psychiatric help herself at this time. The death of her father had not been worked through by her mother or herself. I felt that Roger was a replacement for him. I was fairly certain that family therapy was the correct approach for this couple. My reasons for this certainty were unclear.
I asked if Roger resembled her father in appearance or character. After some hesitation she compared their fastidiousness and artistic abilities. She also felt that his face resembled that of her father. I explained that people fall in love with partners who may represent the image of a person whom they loved in the past. The frustration which occurs in the resulting relationship owes much to the discrepancy between expectations and the reality of the other person's nature. I'm leading up to an explanation of the way she replaced her father with her husband. We discussed the details of her father's death more fully and I found out that she was the only member of the nuclear family who had not attended the funeral. She had avoided it and had stayed home with her maternal aunt, but she could remember why. The first signs of morbid grief? She could recall little of her reaction to her father's death but as I continued probing she began to cry. Her husband looked uneasy and moved to comfort her. He told an amusing story but she became angry at him and her tears dried up as they began arguing. I wondered if this was their usual pattern of disturbed interaction. But how did marriage precipitate the depression in her? I interrupted to explain the way in which an unmourned loss can remain dormant and reappear to haunt a person for years after the event. I pointed out that her tears had flowed while discussing her father. I introduced the idea that she might need to discover more about her father. I wanted to explore painful feelings originating with his illness and death. I connected this task with the fact that I felt she had placed some aspects of her father in Roger without being consciously aware of it. I wondered if marrying him had put her in the position of repossessing her father only to paradoxically await a new loss. Had this reawakened her grief at her father's death? I explained that she must discover what her buried feelings towards her father were and work them through rather than using Roger as a replacement for those feelings. Roger was NOT her father, came from a different family background and culture than her father and reacted to her differently than her father. I then suggested three tasks to her. Since she idealised her father, I asked her to write to her mother and ask about the negative aspects of his character and personality. I hoped this task would allow her to obtain a more realistic view of her father while establishing an adult relationship with her mother. Her second task was to list the
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similarities and differences between her husband and her father. Finally, I asked that she write separately to each of her sisters and ask them about their memories of her father and his death. She seemed to be the only child in the family who had been adversely affected. I wondered whether this was due to her sibling position. Her mother was the second child of a mother whose own mother had remarried after her first husband's death. Identification with mother? Loss of a father would have been a very sensitive issue. Had her mother's psychiatric work involved this issue?
The session was drawing to a close. Roger had been fairly uninvolved personally, acting as an observer. He felt that his wife prevented him from successfully dealing with her feelings of loss, depression or anger. I asked him why he had married Susan. He knew she had been depressed intermittently in the past and had accepted her despite this. He admitted that he had always had a tendency to put himself in situations with people who were basically unhappy and needed to be loved. I asked him to consider seriously from whom in his family background this particular tendency might originate. I told them both that their marital therapy was linked to their own respective past experiences rather than the present problem in their relationship. I asked if they were willing to work with me in this way and they both agreed. I admitted to Roger that I had neglected him and his side of the issues and that our next appointment in one month's time would be devoted to him and his family.
After they departed I studied the geneogram. Roger was included as an appendage to Susan's family. Neither of Susan's sisters had married yet. Her mother came from a home in which her own father had died. Her mother had also lost her husband. This fortuitous transgenerational pattern suggested a focus for the current quandary, derived from Susan's family system. Childhood bereavement was a focal issue. It had occurred in her mother's childhood as well as her own. Susan needed to learn to deal with loss in a less disabling way. I hoped to get her to achieve this by balancing her positive memories of her father with her repressed negative ones while encouraging the sharing of her feelings with her sisters and mother. Marrying Roger had set up a situation in which she awaited his death. It was as if a time bomb was set to go off. His attempts to cheer her up actually increased her agony. Roger would achieve more if he allowed her to suffer. A spiralling negative interaction was set up between them. After their display of a developing argument
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in the session, I felt it would be pointless to set them a task related solely to their arguments. The content was trivial, not unlike those of most married couples in their beginning. The background context was significant.
I felt that the Yardleys were satisfied with my approach to their problems. I was confident that they would return for their next appointment and that they would work on the tasks I had set for them. I was convinced that they were strongly bonded together; the work required was related to transgenerational influences. Future problems in therapy would depend on the material which came from Roger's side of the family. I guessed that his family might be more secretive and that his inability to penetrate this secrecy was related to his sibling position as an only child. His repetitive choice of unhappy women who needed him indicated some replacement aspects to his choice of partner.
The session was again videotaped. We began by reviewing the tasks which had been set during the previous session. Susan had written to her mother and sisters. She received a reply from her mother which had been informative and revealing. She learned that her mother had needed help in dealing with the aftermath of her father's death. At the time they had both attended psychiatrists; her mother had continued with the treatment. The mother's psychiatrist had involved her in an exploration of her feelings towards her husband, and the treatment had helped her overcome her grief. Her mother admitted that there had been several negative features to Susan's father which created difficulties in the home. He was a very stubborn man; he had been too stubborn to seek medical treatment when the first symptom of his illness occurred. Later, her parents had dreadful rows while considering the operation recommended by his surgeon. Her mother wondered why Susan was raking over the past in this way. She hinted that she had been thinking of visiting England in the near future. Susan reported that she had been more relaxed at home but she was still intermittently unhappy. She was often very angry with Roger since the last session. I felt that her anger reverberated to her angry feelings over the loss of her father. She had found it difficult to list her father's unpleasant traits. She found it difficult to thing about him without getting depressed. She admitted that it served to confirm that her depression was directly related to her father. This understanding gave her hope for the future. The letters she had written to her sisters had not yet been answered. I felt that she had done some useful work and was pleased with her mother's response. Susan no
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longer felt that Roger was responsible for her unhappiness. I asked that she continue her correspondence with her mother about her father's death. I suggested that Susan trace her mother's reaction back to her own upbringing. I pointed out that her father's brother had died tragically in a car accident, her mother's mother had remarried after the death of her first husband. Death and loss were particularly sensitive issues in her mother's family background. Some of Susan's reaction to her father's death was certainly determined by moulded reaction patterns to loss derived from that heritage. I noted that her loss of her father might be translated within her into a fear or dread of the loss of her own husband. Finally I added that her mother's middle name and sibling position in her family or origin were similar to Susan's in her own family of origin. Susan and her mother had more in common than she realised. I released the information gleaned from the geneogram in a blunderbuss fashion. I hoped she would be receptive to it. I was conscious that Roger was anxiously waiting and I felt that I must keep my promise to explore his background with him.
Roger had been sitting patiently while I was speaking with his wife. I turned to him and asked for his impression of our last session - how he had felt and what he had remembered and understood. He had given the session a great deal of consideration and thought. He learned a great deal about his own response to Susan. He had been particularly intrigued by the idea that he picked people to befriend who were unhappy and in need of love. Susan agreed that he tended to date girls who were sad and depressed. I suggested that if she sorted her problems out, their relationship would have to change or it would probably disintegrate. Roger needed to understand the need for himself actively to change his reactions. If she didn't need what he gave to her any more because she had become a more integrated persons, then he would be unnecessary. I asked if he had discovered the source of his tendency to pick unhappy women. He could find no one in his family who had been so unhappy that he had cheered them up and helped them in the way we had discussed.
At this juncture in the session I turned to the blackboard and began to construct his family tree (see Figure 9.3). He admitted that he had questioned his parents many times about their past and their backgrounds but neither of them had been very forthcoming. His parents had consistently refused to bring out any information related to sexuality or childbirth. Painful matters that may have occurred in the past were brushed aside. I pointed out that secrecy was a way of putting boundaries between the generations. Those on both sides of the boundary were
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responsible for maintaining it. He felt that his parents were basically happy although his mother often argued with his father. He described his mother as being very temperamental and thoughtless with her tongue, while his father was honest and caring. His descriptions of his parents didn't fit his description of his wife's character; I led him into a discussion of his extended family. We examined his grandparents in great detail, especially his maternal grandparents. His mother's father had abandoned his grandmother shortly after his mother was born. His grandfather then went to live with another woman. Roger had no idea whether his grandparents were divorced. He had tried his hardest to find out details about his grandfather when he was younger, but when he asked his grandmother she would become upset and tearful. I began to
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wonder if there was a parallel between the relationship with his grandmother and his relationship with his wife. Roger believed that his grandmother had never stopped loving her husband despite his desertion of the family. She still cried over him and felt bitter to the present day. His grandmother criticised his mother because of her arguments with his father. She would point out how lucky his mother was to have such a good husband. Here Roger passionately said 'She's a lonely old lady, my grandmother, and she had nothing but a hard time all her life. It's a shame!' I felt that the link between Roger's grandmother and his wife was definite. I asked Roger if he had had much contact with his grandmother during his childhood. He recalled that as a child he visited his grandmother and great-grandmother nearly every day. His parents lived nearby and there was a great deal of contact between family members. Even when he grew older he would visit two or three times a week. He went to have a laugh with them; they would cheer him up when he was down and he would do the same for them. I now saw the origin of the pattern with Susan. I explained to Roger that I knew his grandmother was a crucial influence in his life and that his grandfather had been a crucial, if absent, influence on her life. I detailed my growing certainty about the parallel between his relationship with his grandmother and his relationship with Susan. I thought that these parallels needed to be further explored. Both Susan and Roger denied strongly that Susan was anything like his grandmother. I wondered why they protested so strongly. I suggested that his relationship with Susan was at least partly based on one established with is grandmother, but he felt there was no connection. Was I wrong or was the resistance due to taking his defences on directly? I decided to outflank him. I asked Roger why he had been unable to find out more about his maternal grandfather and the circumstances surrounding his disappearance. He admitted that he had asked his uncles, his grandmother and his mother, but they had kept the veil of secrecy firmly drawn. He had not been able to pierce it. I felt that he had established a useful task for himself. I pointed out that he didn't know how to ask his family about these matters so that they would give him the answers. I challenged him to return to the members of his family of origin to discover the cause of this secrecy. I asked if perhaps he didn't feel adult enough to discuss these matters with them? Cross the generational boundaries and become an adult was the message. His reluctance and inability to pursue the matter was a major factor in his lack of information. Why had this particular task assumed such import? The answer glimmered on the threshold of my thoughts but eluded me.
After this confrontation with Roger I spent further time establishing
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other facts about the extended family background on both sides of Roger's family. He had always wanted a grandfather and had envied his school friends because they had one. His paternal grandfather had died when his father was young and his paternal grandmother had died when he was a child. The reactions to these losses were explored and seemed to have been appropriately mourned by the family members. I finished the geneogram by adding Susan to the Yardley family as an appendage. In order to add some conviction to the need for Roger to undertake and complete his task with his grandmother, I played back the section of the videotape which had captured his intense feelings about his grandmother. He watched a scene during which I had speculated about the effects of his grandmother's death upon him. He was able to detect that his outward appearance was incongruous with his inner feelings at the time.
The session ended with Roger promising to contact his relatives. Both Susan and Roger were pleased with the work that had been done so far. The session ended with assurances that they would continue their work.
The session was a highly successful one. Not only was Roger engaged in to the therapeutic process, he became a wholehearted and eager participant. He departed eager to pursue the task which he had suggested. I realised afterwards what I had glimpsed in the session. For Roger to complete his task with his grandmother he would have to refrain from cheering her up and cause her some pain during the process of finding out about his grandfather. I was worried the the task might alienate him from his grandmother. But I was reassured that there was no evidence in family patterns of this type of reaction. His capacity to tolerate his grandmother's unhappiness would increase. By forming a relationship based on empathy and tolerance he would establish a new model for his relationship with his wife, breaking the negative feedback in their relationship. If he no longer needed to entertain and comfort his grandmother he could talk more openly about the distressing and unhappy feelings which his wife possessed.
Susan had actively pursued her tasks. As a result of her work she seemed somewhat brighter than in the previous session. I felt especially encouraged upon hearing that her mother might visit her. The visit would provide a personal encounter which would be superior to the effect of communications by letter. I was certain that Susan would continue her work on her tasks.
I was confident that the therapeutic outcome would be a beneficial
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one for both marital partners and their families. I believed that their mutual understanding would increase and that their bond would be strengthened. There were areas of family life which remained untouched. The Yardleys had no children so that the collision of family culture might in future by activated by the occurrence of children. The familial pattern of absent male figures was a mutual one and seemed compatible but socio-cultural backgrounds might cause conflict in child-rearing practices. But very little marital work would remain if the Yardleys were able to accomplish the work which we had mutually set out.
Mr and Mrs Yardley returned for their appointment in a relaxed and cheerful mood. Mrs Yardley was beaming. The session was videotaped once again. Susan had received an unexpected visit from her mother. The visit was preceded by one day's advanced notice. A confirmation of the strength of the effect that her letters had in opening new communication channels. Her mother discussed her letters on the way home from the airport. She noticed the change in her daughter's attitude from her letters. Her mother was both curious and pleased that Susan was at last asking about those difficult years in their lives. Her mother shared many personal feelings and thoughts with Susan during the short visit. Susan learned that she had always been her father's favourite daughter. He was a strict, unbending man however, dealing out punishment in the family when necessary. When his illness developed he became very depressed and considered ending his life if the pain became too severe. Susan related with great feeling that she and her mother had cried together for the first time in her adult life. This was a significant alteration in their relationship. Susan went on to describe her father's faults in greater detail. She admitted to angry feelings about some of the punishments he had imposed. But she realised that the anger towards her father was related to his desertion of her when he died. An acknowledgement that she accepted some of the facts I had taught her about the mourning process. She incorporated this information and it had changed her emotional reactions.
Susan felt that her relationship with Roger was much improved. Recently when she felt unhappy, he allowed her space to be alone, he did not interfere unless she asked him for comfort. His changed reactions coupled with the work she had done on her father's death and the alteration of her relationship with her mother had considerably eased her depressive symptoms.
Roger entered the office with a new air of assurance. He explained
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that he had left the second session determined to find out more about the secrets in his family. During the following week, he arranged to see his parents, his grandmother and his uncles. He visited and questioned them about many different areas of their past. He forced himself to ask questions at first, but found that he was much less frightened by the last of his family interviews. He was able to find out a great deal about his past and the family background. He learned that his maternal grandfather was a bigamist and might still be alive. He examined his grandfather's life minutely with his grandmother. Although she was reduced to tears, he persisted, and when he had finished he felt emotionally closer to his grandmother than he had ever been. He constructed his own geneogram during his visits to his family. He proudly showed it to me during the session (see Figure 9.4).
Their sexual relations had greatly improved; their daily interpersonal interactions were less sticky, warmer and more realistic. They both felt that their reactions with each other had improved to the point that they were better than before their marriage. If their reports were true there was little work left for us to do.
I questioned them about their plans for the future. Roger was considering a move to a new job in Scotland or Canada. They had recently discussed the possibility of having children although no definite plans had been made. Roger felt that the work we had done had benefited him considerably. He admitted that he had never before taken time to look at himself and his family. He valued the opportunity to let his true self show through the facade with which he had previously protected himself. I agreed to their request for several months' respite in order to let their new relationships settle. They would return in four months for a follow-up appointment.
I was delighted with their achievements. Roger had done more family work than Susan; he had been ready and willing to attempt tasks which followed his natural inclinations (he had tried more than once to do the tasks on his own). Roger was now able to cope with Susan's unhappiness. The only remaining difficulty could be his ability to cope with his children, an issue which was too premature to contemplate.
Susan had done a great deal of work aided by her mother's helpful response. I was not as certain about the changes in her. My uncertainty stemmed from my experience with others suffering from morbid grief. Longer periods of time were required to recover. However, the morbid process had been converted to a normal reaction. Her mother was available as a family resource so that she could continue the necessary grief work in her family. I believed that they would both return without further need for therapy sessions. My analysis of the family quandary was more coherent at this point. Roger felt responsible for his wife's happiness. He had to cheer her out of the depression which began shortly after their marriage. This need to help others was present in all of his previous female relationships and was rooted in his childhood relationship with his grandmother. He also gained the expectation that after marriage, husbands either die or leave home before they can become grandfathers. Susan's depression was a delayed morbid reaction to her father's death when she was eight years
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old. Marriage symbolised to her the end of a relationship, not its beginning. The more her husband attempted to cheer her up the greater was her feeling of loss stimulated by his presence and imagined proximate loss. Roger's change of relationship with his grandmother produced an empathic tolerance for distress which he could apply in his marital relationship. The change in the marital relationship was aided by Susan's work with her feelings about her dead father. The replacement aspects of Roger were returned to their source, the unmourned loss of her father. The work they had done was sufficient to resolve their quandary.
Mr and Mrs Yardley appeared for their follow-up appointment on time and in good spirits. They both felt embarrassed about taking my time. They had experienced no difficulties since our last appointment. They had learned quite a lot about each other and about their relationship. They were especially pleased with being able to look into their family backgrounds and the way in which their families influenced their marital relationship. Susan still had patches of sad feelings, especially when reminded of her father, but she recognised and coped with them. I felt that Susan had been working through her father's loss and would continue this work in a healthy manner.
Roger mentioned that they were finalising their move to Scotland and that they would be leaving in a few months. I asked them to keep in touch, perhaps by postcard once a year. Two years following the start of their treatment they were continuing happily without further need of help. Their first child was expected soon. I was satisfied that the work had produced a lasting change in their relationship.
The preceding case illustrated the use of transgenerational analysis and consequent therapeutic practice in a marital case study. Both husband and wife received major benefit by conceptualising their quandary as involving their families of origin. Conclusion of unfinished work with their family members improved their relationship. But not all cases involving this approach will resolve in such an agreeable manner. The following vignette describes a treatment during which transgenerational approach with a marital couple failed.
Mr and Mrs Derdle were referred following a three year history of depression in Mrs Derdle, unrelieved by medications. Her husband's threat to begin divorce proceedings led to their referral for marital therapy. Three marital sessions were followed by one individual session
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each with Mr and Mrs Derdle respectively. During the first session Mr Derdle admitted that he had lost his job. He was so involved in looking for a new job that he was too preoccupied to work on his relationship with his wife. I took a short history and constructed a geneogram which revealed a sibling position mismatch, and a major family collision difficulties. He was the youngest of three sons from a European lower class immigrant background, while she was the youngest of two daughters from a well-to-do English family. Neither of them wished to take on a task until the work situation was sorted out.
At their next two appointments I carefully explained the transgenerational influences which seemed to bear on their marital conflicts. They discussed the extra-marital affairs they had during their marriage. Despite obtaining a job Mr Derdle was reluctant to undertake any task at home or with a member of his family of origin. In their last marital appointment Mrs Derdle felt that she was the one who needed help, not her husband. She wanted to be seen on her own. By this time the issue of divorce had disappeared. After a great deal of argument I agreed to see her alone if the session were audiotaped, and her husband was allowed the same option. I felt that they remained unengaged in the therapy. There were controlling the sessions with no investment in work aimed at changing themselves. I made my feelings about their lack of involvement clear. Their individual sessions were long vituperative catalogues of their partner's faults, interspersed with romantic descriptions of their various affairs. Neither partner understood their behaviour, yet they were curiously satisfied with the present state of affairs. I wondered if divorce had ever been more than an idle threat. No further sessions occurred after I asked them to listen to each other's taped individual session at
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home. They did as I asked, but prior to their next appointment I received a tear stained letter from Mrs Derdle cancelling our appointment and requesting no further contact. She took me to task for my 'ludicrous' theories and castigated me for my calculated attempts to break up her marriage. She had talked to her husband's parents and found them a much greater help than my attempts to separate them. On follow-up of her case notes three years later Mrs Derdle continued to be seen by a psychiatrist. She had made several further attempts to engage in marital therapy but they proved as unsuccessful as her individual visits to psychiatrists. She and her husband remained together despite her complaints about their relationship.
1. R. Skynner, One Flesh, Separate Persons: Principles of Family and Marital Psychotherapy (Constable, London, 1976); I. Glick, and D. Kessler, Marital and Family Therapy (Grune and Stratton, New York, 1974).
2. N. and B. Paul, A Marital Puzzle (Norton, New York, 1975).
