Editors’ Summary. The author discusses how a combined systems and object relations approach can provide valuable insights into many marital interactions. Since intrapsychic and interpersonal systems are isomorphically related, interventions at one level can often effect changes in others. Systems theory is useful in conceptualizing short-term therapy aimed primarily at symptom relief and for those individuals who are not generally responsive to insight; object relations theory is more pertinent for conceptualizing interpretive interventions. Interpreting distortions of the spouses in terms of their original family situations, as well as in vivo confrontations with their original families, can help to detoxify dysfunctional marital relationships.

Marriage can, in one sense, be seen as a developmental tendency to seek continued bonding in order to reenact past intimate traumas in the context of the present, where toxic introjects can be exorcised and a newer capable ego can fight and do battle. A committed intimacy reactivates the denied, repressed aspects of the ego and presents an opportunity for working these through. Tremendous energy is detonated in the process. Individuals may use a variety of intrapsychic mechanisms to regulate the degree of tension they can tolerate. Just as the amount of tension that can be tolerated is based on the degree of structural maturity of the individual-that is, the differentiation and integration of ego structures-a social system can likewise only tolerate tensions based on its degree of differentiation and integration. Since the system is more than the summation of its parts, a systems therapist observes how the system as a whole deals with tensions created by changes in membership, boundaries, communication patterns, roles, power, and alliances.

The structural integrity of units and the processes between these units can be portrayed along a continuum from healthy integrated complexity to an enmeshed chaotic system in either the internal or external worlds. Historically, the major theoretical problem has been the locus of pathology and the level of intervention. Is the locus of pathology within the individual, as in the medical model, or is it within the social system as a whole? Pragmatically, this would lead to tile issue of where the intervention should then be aimed-at the individual or the system. The point of view presented in this chapter is that psychopathology is best represented as a continuous process of interacting units from intrapsychic to social realms isomorphically linked to one another. Personalities are a result of social systems and social systems come about through a process of interacting personalities. Each system must eventually adapt to the other-, therefore, an intervention at one level can effect changes at another. It is suggested that a continuous model allows for interventions at either the intrapsychic or social level, depending on the most accessible level of intervention.

IMPLICATIONS OF SYSTEMS THEORIES
IN MARITAL THERAPY

Some people work very well with insights. They are not only able to change their view of themselves and the world around them-becoming more objective-but are able to use these insights in organizing their internal structures so that structural change and personal growth are evident. For others, insight is not as effective. However, changing the external structure in which they are embedded can have a powerful effect, resulting in symptom relief. Behavioral systems techniques-such as using paradoxical tasks or reframing a destructive process as benign in order to de-escalate tensions-can be used to change the structure of a system without invoking conscious awareness or cognitive insights. Symptom relief can often be achieved in a short time-within 10 to 15 sessions.

In systems thinking, pathology provides a homeostatic function. A person’s pathology may be seen as a role function necessary for systems operations. If the system changes in a way that no longer requires that role, the role changes to accommodate the system. Thus, the symptom vanishes. Systemically, the therapist asks, “Why does it make sense for this person to have this symptom at this time, and what is its function? How can this symptom be substituted with something that is less costly and still maintain the operations of the system?”

The symptom is an attempt to regulate the degree of tension in an interpersonal system. A symptom can be used to escalate or de-escalate tensions. Examples are: 1) triangulating someone into a system, such as extended family, friends. lovers, or children; 2) a “sick” or “bad” child becoming the focus of attention, diverting the issue from marital tensions; 3) a “sick” or “bad” spouse becoming the symptom bearer, or spouses taking turns flip-flopping in their roles of provider and symptom bearer; and 4) distancing by excessive working, obsessional diversions, and exclusiveness.

These symptomatic sets can be used to create distance and diffusion in order to cool down the relationship. These same symptomatic sets can also be used to escalate the tensions. Although a third party can act as a support and a stabilizing influence in a marriage, the presentation of an interfering parent or lover can create an immediate threat to the same system. A “sick” or “bad” person may defocus the marital problems, but may eventually tax the emotional resources of the system itself. Obsessional working and diversions may be used to create a tolerable distance for one spouse but eventually present an issue to the pursuing spouse who is feeling rejected. It is assumed that the one who is in the pursuing role falls in love with someone who is enacting a distancing role, precisely since it is safe to pursue an individual knowing that he or she will create a needed distance. The pursuing spouse is secretly longing to conquer the rejecting parent, while the distancing spouse constantly is reassured in his or her ability to escape the impinging, absorbing mother. These roles may flip-flop back and forth, both spouses colluding to regulate the degree of tolerable intimacy for the system as a whole. However, a sudden shift in roles often releases a great deal of tension which can bring a couple into therapy or dissolve the relationship.
In viewing the pathology of the system as a whole, one must look at both the structure and how the system operates in dealing with the flow of tensions. The system’s structure may vary in its: 1) degree of permeability or rigidity of the boundaries; 2) differentiation versus enmeshment, i.e., how clear are the boundaries between the family of procreation and original family systems, the sibling subsystems, and the marital subsystem; 3) degree of stability, i.e., the degree of commitment and identification of members with each other; and 4) alignments or alliances, i.e., who sides with whom and over what issues? The system’s operations may vary in terms of the rapidity and rigidity of its patterns of doing tasks. A family system may be observed in its patterns of operations in the initial session by the therapist posing the question, “What seems to be the problem?” The family typically presents a symptom bearer as the problem. One can observe how roles are assigned and enacted, what issues are acknowledged, how problems are handled, how communications operate, how bids for power are negotiated, and where the alliances exist. Rather than getting caught up in the content of issues, which often varies and becomes extremely confusing, the family therapist looks first to the pattern of how issues are brought up and handled.

Communications, particularly metacommunications, act to maintain the structure of a system. Don Jackson (8) noted that individuals are constantly commenting on their definition of a relationship implicitly or explicitly. Poorly differentiated families have rigid rules about what can and cannot be discussed. When an unacceptable issue is brought up--one that is believed to be a threat to the stability of the system or its operations-the statement is handled by a stereotypic pattern or set of rules. These metacommunications, which are never overtly spoken, are implicit in the operations of the system, and consist of intricate patterns of rules in which all content is subjugated. One such metacommunication in the poorly differentiated family system is: “No one say anything definite, lest we acknowledge something with which we feel we cannot cope.”

Conflicting messages and double binds resultantly confuse and mystify. Family members may nonverbally communicate tensions to other members of an alliance, but if this is challenged overtly, it is disowned, disqualified, or mystified (9). Sluzki et al. (11) classified types of disqualifications: 1) evasion--change of subject, 2) sleight-of-hand- whereby the response to an issue is so confusing that it is lost, and 3) status disqualifiers-whereby an issue is discounted because the other is in a position of superior knowledge. Additionally, nonverbal disqualifiers can be employed, such as facial expressions and silence. Naturally, these avoidances are unsuccessful in warding off tensions and eventually succeed in producing symptoms that make sense when viewed in the context of the system. An individually focused model would emphasize the individual’s internal chaos and poor reality-testing, since the confusion has been internalized. However, systemically the person’s internal structures fit the external realities. Within the system, it is futile to make sense, when making sense leads to disqualification, invalidation, and rejection.

The family therapist must join with the system before interpretations can be made. Premature interpretations may not be absorbed constructively, since they would become diffused, as would any other content. The process of joining with the family introduces a healthier ego to the system and results in greater tolerance by the system as a whole. The therapist begins to build up selected members of the system and reinforces boundaries between generations, thereby strengthening alliances such as the marital subsystem. As the system becomes better organized, it can deal with content with greater clarity.

Once the system is offered viable ways to reduce tensions, costly operations that produced symptoms can begin to change. At times, prescriptions for a process can be offered as a means of bargaining with the system, in exchanging one symptom for a less costly one. That is, rather than seeking to change the entire structure of the system, a change in the operations can occur when a modification is all that is asked by the therapist. In a paradoxical assignment, the symptom could be described and then prescribed as a task. The individual may even be asked to pretend to have the symptom, and to have the individuals involved in the symptom react in their stereotypic fashion (10). This serves to provide the system with a way to continue problem-solving or relieving tensions without the threat of radical structural change. When a person is asked to pretend to have the symptom, that person gains power without having to bid for power by being weak and having an uncontrollable symptom. The symptom is now something that he or she can choose to do; therefore, that person is deemed a healthy and creative problem-solver. Additionally, once a symptom is given permission to occur, it is put more in the control of the healthier conscious ego with its discretions and adaptations. This is often reinforced by benign reframing of the symptom, not as a disease, but as an attempt by the individual to solve a problem “through the instinctive but inefficient wisdom of his or her unconscious.” An effective paradox and reframing is at best an excellent psychoanalytic interpretation, since the unconscious often works paradoxically.

IMPLICATIONS OF OBJECT RELATIONS THEORY
FOR MARITAL THERAPY

Object relations theory views the human being as a social animal, not propelled by drives, but attracted to needed love objects (4). These theories allow for a much greater understanding of interpersonal relationships based on early primitive attachments and frustrations. The locus of pathology in object relations theory is clearly housed in the internal world of bad objects. Guntrip states,

The psychoneuroses are, basically, defenses against internal bad object situations which would otherwise set up depressive or schizoidal states, though these situations are usually reactivated by a bad external situation (7).

These internal bad objects act gyroscopically to seek out others who fulfill our wishes and fears (12). Individuals seek to fulfill these expectations by seeking those who provide sufficient reality justifications for their transferences and projective identifications (5). Therefore, the reactivations of these bad objects are inevitable. The question is whether or not this is pathological or an attempt to exorcise these toxic introjects through regression and reactivation with the more capable adult ego. Conflicted attachment to external objects attempts to at least save the self from a total regression.

Guntrip states that the depressive is still in the world of objects, raging internally against the rejecting and frustrating internal bad objects. The depressive is afraid that hate will destroy the needed object. The schizoid fears that not only hate, but also love will devour and destroy. The schizoidal core of personality is constantly oscillating between the fear of being engulfed and devoured by the object and losing the object-that is, a conflict between the object-less world of nothingness and psychic death, the death of being absorbed into the object. This results from a relationship with a mother who is narcissistic ally impinging and rejecting. The emotional frustration proves too much for the primitive ego. The pristine ego splits into the central ego which copes with external reality, and the internal ego which is left with the world of introjected objects. The internal ego is further divided into the libidinal and anti-libidinal egos, which internally struggle between having needs and wishing fulfillment, and negating needs and refusing fulfillment. These internal dynamics get played out in the marital relationship as one spouse secretly hopes that the other will act to reject and deny needs according to internal anti-libidinal wishes. Finally, the split-off and regressed ego goes into cold storage, and this regressed ego--which Winnicott (13) refers to as the “true self”--awaits a new love object or idealized parent to whom it can attach and grow.

All this draws off enormous energy from the central ego’s ability to invest in the external world. In the infant’s frustration at trying to master the external world, the child seeks to internally represent the frustrating needed object, as if to innoculate him/herself with small dosages of the bad mother. However, the introject is too toxic and becomes a “fifth column” or “internal saboteur” (7). The introject becomes further split into the libidinally exciting, the libidinally rejecting, and finally the idealized object. This idealized object is projected back onto the external, needed object. The external object phenomenologically can be pursued with less anxiety. Security feelings can then arise within a situation where the infant has no choice. This idealization is at an enormous cost, for it maintains the internal split of the immature aspects of the bad objects that are later projected onto one’s spouse or child. The idealizations are best maintained outside the realm of intimacy. The idealized love object aids biologically in the mating desires implicit in marriage, but quickly turns to bitter disappointment with reality and projective identification (3).

Guntrip describes the schizoid’s dilemma of not being able to be “in” a relationship when the external object becomes noxious, but not being able to be “out” of it for fear of losing the needed and valued object. This “in-and-out program” may be reflected in the changing of spouses, jobs, and lovers-anything that promises an alternative to commitment. Fantasies and infatuations with others outside of a relationship are another way of preserving a sense of freedom from absorption into a devouring object. The schizoidal fear of being smothered, possessed, or absorbed leads to a greater fear of a positive loving relationship than of a negatively hostile one. Anger, disappointment, or disinterest presents a rationale for distancing out of a relationship and into safety. Splitting of the needed object generally attempts to stabilize the internal world as well as the social world. To be “in” with the spouse may mean being “out” with one’s parents or children. This represents a structural balance that is used in classic analytic situations, marital therapy, and family of origin techniques.

Analytically, through transference onto the analyst, a person’s idealizations, disappointments, and fears can be interpreted and replaced onto the original objects. The marital therapist, embodying the observing ego, nurtures the relationship with benign interpretations and replaces the projective identifications and transferences onto the family of origin and original love objects. Family of origin techniques may involve in vivo confrontations of the original family system (6), or coaching individuals in detriangulating and individuating from their original family ego mass (1, 2). Whereas parents may be able to stay together by being “out” with a child, later that same child may be able to be “in” with his/her spouse only by being “out” with his/her respective parents. An emotional cutoff, however, represents a pseudosolution, as does overt rage, appeasement, or idealization of the original family. A realistic ambivalence towards one’s parents, with an existential awareness of who they are and the limitations of what they can and cannot do, represents a higher degree of self-differentiation.

Framo has found that a warring couple will join forces to support each other in an heroic effort to get their entire original families into sessions with them (6). People are surprisingly protective of the systems from which they originate despite their complaints. Framo maintains that dealing with the real external parental figures tends to loosen the grip of the internal representations of these bad objects which have been transferred and projected onto the spouse. Framo particularly stresses the need to acknowledge the love that may have turned to hate through disappointment. The existential awareness of what can no longer be gotten from a person’s parents and accepting them for who they are, helps an individual to go on and to invest in his or her spouse.

I suspect, however, that the key factor is working through the idealization of the family of origin-idealization present in even the most embittered individuals. Somehow, within the context of therapy sessions, individuals can more objectively observe the original family’s operations. They have a greater sense of the frustrations and hurts that came about and that give meaning to their oversensitivities and fears within the context of their marriage. The costly idealizations of their family of origin mean displacing the bad object onto a spouse or child. By replacing appropriate anger and ambivalence onto the original frustrating love object, the intensity of the transferences and projective identifications onto the spouse becomes significantly diminished. Systemically, this represents a move toward greater differentiation of boundaries from the original family and a redirection of tensions. The early defensive idealization of the primary love objects fosters the further splitting and later projection of the bad destructive object. Failing in love and attraction can be a hoped-for, idealized rejoining, but loyalty is still embedded in the original system. Thus the expendable spouse becomes the target of the need to exorcise the bad object. The integrity of the marital system necessitates an objective, rational replacement of appropriate anger onto the original family. With the de-escalation of tensions, the marriage can be turned into a therapeutic system whereby the individuals can provide an atmosphere of healthy regressions and working-through of early hurts and needs.

I often explain the necessity to regress in marriage, drawing on the individual’s early recollections of how his/her parents were intolerant of his/her regressive behaviors and needs. Marriage is a natural institution where individuals can regress. In other institutions, repression is often demanded to intolerable degrees. Instructing individuals to regress to a degree, within the context of their marriage, can help control the regression. In other words, I describe and prescribe the presenting symptomatology, but de-escalate it through a benign reframing and interpretation. They are asked to differentiate to what extent their feelings come from the past and how much of their feeling has something to do with the spouse. The degree of affect often puts the situation into perspective. Once the transference and projections become apparent to either one or both of the spouses, an empathic atmosphere can be created. Typically, one spouse had overreacted to the other one’s overreaction, indicative of cyclical countertransferences and regressions. Each may reinforce the other's anti-libidinal impulses to reject and deny their needs. Regression with an understanding spouse allows for the maturing of the regressed ego and at the same time provides for a detoxification of the bad objects-an opportunity for the damaged self-esteem to be nurtured and grow. Marriage provides a natural hotbed of intense transferences and projective identifications. The role of the therapist becomes that of an interpreter and a regulator of tensions. The therapist is both the observing ego and good parent, reframing and teaching. In individual therapy, the therapist may be used as a stepping-stone out of the marriage-that is, he/she is included temporarily in the system to further increase the splitting. He/she becomes the idealized good object, and the spouse the wholly bad one. The family therapist is equipped to coach the individual to include the spouse in the treatment. Although it is maintained that the spouse is not the cause of the problem, the therapist convinces the individual that, by including the spouse in the treatment, this viable unit can be a more therapeutic system--one that can provide not only symptom relief, but also mutual personal growth.

SUMMARY

Marriage can be viewed within the contexts of both object relations theory and systems theory. Object relations theory provides the understanding of the transferences and projective identifications that become intensified in a marital situation. The marital partner is sought out to fit the internal representations of past processes and original bad objects. Marital tensions arise out of the spouses’ intensified cyclical countertransferences onto one another. Systems theory views the locus of pathology as not within the individual and the internal objects, but between the spouses. Individuals can only exist within systems, and they will compromise their maturity by producing symptoms in order to stay within the original family. They will reenact these symptoms within the new family of procreation.

The combined view of systems and object relations theories allows for a wide range of intervention possibilities. The use of insights, paradoxical techniques and the establishment of a climate of objectivity and warmth with benign reframing are suggested, to be used within the context of the marriage. Confronting the realities of one's past, the cost of idealization of one’s original family in maintaining internal bad objects, and projection onto the spouse are considered to be the primary foci of the interpretations. The overall therapeutic goal is to change the marital system from a destructive reinforcement of the internal bad objects, to an opportunity to regress and exorcise toxic aspects of the self.

REFERENCES

1. Bowen, M. On the differentiation of self. In: Framo, J. (Ed.), A Dialogue Between Family Researchers and Family Therapists. New York: Springer, 1972.

2. Bowen, M. (Ed.) Toward the differentiation of self in one’s family of origin. In: Family Therapy in Clinical Practice. New York: Jason Aronson, 1974.

3. Dicks, H.V. Marital Tensions. Clinical Studies Toward a Psychological Theory of Interaction. New York: Basic Books, 1967.

4. Fairbairn, W. R. D. An Object Relations Theory of Personality. New York: Basic Books, 1952.

5. Framo, J. L. Symptoms from a family transactional viewpoint. In: Sager, C.J. and Kaplan, H.S. (Eds.), Progress in Group and Family Therapy. New York: Brunner/Mazel, 1972.

6. Framo, J.L. Family of origin as a therapeutic resource for adults in marital and family therapy: You can and should go home again. Family Process, 15: 2, 193-209, 1976.

7. Guntrip, H. Schizoid Phenomena, Object Relations and the Self. New York: International Universities Press, 1969.

8. Jackson, D.D. Family interaction, family homeostasis and some implications for conjoint family psychotherapy. In: Masserman, J. (Ed.), Individual and Familial Dynamics. New York: Grime & Stratton, 1959.

9. Laing, R.D. Mystification, Confusion and Conflict. In: Boszormenyi-Nagy. I. and Framo, J.L. (Eds.), Intensive Family Therapy. New York: Harper & Row, 1965.

10. Madanes, C. Marital therapy when a symptom is presented by a spouse. International Journal of Family Therapy, 2: 120-136, 1980.

11. Sluzki, C.E., Beavin, J., Tanopolsky, A., and Veron, E. Transactional disqualification. Research on the double bind. Archives of General Psychiatry, 16: 494-504, 1967.

12. Stierlin, H. The function of inner objects. International Journal of Psycho-Analysis, 51: 321-329, 1970.

13. Winnicott, D.W. (Ed.) Metapsychological and clinical aspects of regression within the psychoanalytical set up. In: Collected Papers. London: Tavistock; New York: Basic Books, 1955.