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Ehrlich, F.M. (2000). Dialogue, Couple Therapy, and the Unconscious. Contemp. Psychoanal., 36(3):483-503.

(2000). Contemporary Psychoanalysis, 36(3):483-503

Dialogue, Couple Therapy, and the Unconscious

Frederick M. Ehrlich, M.D.

Psychoanalytic Couple Therapy Extends the reach of psychoanalysis. In analysis, the analysand takes his or her enlarged self-understanding back into the outside world. Interactions there are modified by changes that have taken place in the analysis. The data base in the consulting room is the analysand's report. Even a verbatim quote is vulnerable to the flaws of memory and is selected for reasons that may be conscious or unconscious. In couple therapy, an important segment of the outside world is observed directly by the therapist. The importance of such observation is an extension of the current emphasis on the interactional quality of psychoanalysis or, as Gerson (1996) asserts, “What we are is determined by whom we are with, not in internal dialogue but in actual ‘external' relationships” (p. 64).

The goals of analysis cannot be achieved with a third party present. It is a method carefully structured to focus the conscious mind on exploring what is unconscious. The realities of the patient's life are relevant to this exploration. No matter how conscientiously analyst and analysand try to be objective in their understanding, however, they are both partisan and on the same side. In work with couples and families one must deal directly with part of the world outside the patient's own descriptions. Psychoanalytically informed couple therapy looks at unconscious forces that alter and distort the explicit communications of the participants.

In daily life, words and actions are affected by forces that are not conscious to the participants. Over time, as people get to know each other, they learn how to work through or around enough of these issues that life can go on. Couples who come to our offices are generally stymied by areas of conflict and misunderstanding that have not yielded to the ordinary modes of conflict resolution. Discussions become repetitive and circular, with no progress toward solutions or peace or acceptance.

Conversation in daily life is evanescent and unrecorded.

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