Ca, P, Mg y relación Ca:P

In the clinical situation with couples, I am aware of needing to create a relationship with both people which can recognise the different humanities they express in the room. My inclination on hearing a woman's complaint about her man's inability to give, to be emotionally available, to take for granted and not recognise the emotional labour she provides, would be to arouse an empathy in me. The structural arrangements of heterosexuality, as I and others have written about, so often set the development of masculinity and femininity in ways which mean that women can often feel unnurtured within an intimate relationship. So a woman's complaint, voiced in the consulting room about being undervalued, or her husband failing to take the emotional initiative are familiar themes with which I have considerable sympathy.

However, invariably, in the clinical setting, after the women feels that her pain has been acknowledged and her desires legitimated, perhaps due to my efforts to connect with the men, perhaps because the hurt of women turned bitter is so painful and distasteful, perhaps as a way to infantilise the men - and this I throw out as a question because I am not entirely sure what I think is going on here - 1 have discovered that I am repeatedly drawn to the man's point of view and feel an enormous surge o f love for the man - who at another level and in another setting I might consider a bit of an nincompoop, or even pathetic.

Now why is this? Why are loving feelings aroused in me? What do I mean by loving feelings? Is it that if I experience a cross gender empathy or identification the

compelling nature of heterosexuality means that I don't simply like the man but sexualised parameters hone my feelings in a specific direction?

For us to consider this I need to share more with you about the man's response to being criticised or denigrated by his partner. My 'love', as it were, arises when the man, having taken on board the complaint - one he has doubtless had hurled at him several times before but somehow hasn't been able to absorb or understand until the couples treatment - makes the move from a mea culpa stance "Oh I'm just a clumsy bloke who can't get it right" or a flinging it back on the woman -"you want too much" to an attempt to meet what is asked from him. At that moment, the man moves to recognising an area of underdevelopment, contacts his desire to meet what he rationally believes is a legitimate request on the part of his lover and haltingly exposes his vulnerability and inexperience as he attempts to give emotionally, not through diamonds and flowers but by hanging in with his lover, trying to be with her in whatever emotional space she is in rather than manage her feelings or concealing his feelings from her. Let's say that as a threesome we have enunciated the uselessness to the woman of the pragmatic interventions the man is wont to give and he, taking on board that there is a different way to relate, attempts to do so, but in the first instance he is a bit awkward. He goes from shushing her pain to listening, albeit robotically rather than reflectively.

Now at the point in the treatment, just when it seems to me something is shifting in the process between the couple and the woman has managed to start up a dialogue that begins to address her dissatisfactions, her focus can turn to her partner's clumsiness rather than a relief that her agenda is now between them. This is the time that I can feel, in the countertransference, an extraordinary impatience with the woman and great feelings of love for the man.

Well we might ask, is this purely idiosyncratic. Is it simply that I, identifying with the woman and aware of my own ghastly impatience, enter as Racker (1968) would have called it a concordant Countertransference? Is it that what turns me on in a man is the revealing of vulnerability? Yes I am sure both of those are true. I do dislike my own

impatience and I do appreciate when a man is open and vulnerable. But what else is going on here?

I wonder whether the contempt the woman may feel for the man's inadequacies, which in the clinical setting I feel tender towards, is worth understanding. I wonder whether my love in the countertransference protects and defends the treatment against the toxicity o f the woman' contempt and denigration o f the man. I wonder whether, if I allowed her contempt to instigate my own, - which must surely be stimulated somewhere - the infantilisation or hate that might enter the treatment situation would be so overwhelming that it would contaminate the possibility of working through any of the problems between the couple. In other words, I am wondering whether in order to work with the couple as a lone psychotherapist, I need to keep a modicum of love circulating in the room. And as a female psychotherapist, I need to hold in some way, the possibility o f loving feelings for the man, while the woman in the couple is unable to do so.

We shall take up a piece of this point - the holding of feelings for the couple in another issue - but before we go onto that, we need to recognise that I have left hanging a strand about my love as a defense for myself against the contempt that I might feel for the man. I can only highlight what I mean by, in the first instance, putting this in the negative.

I have considerably less difficulty in the clinical situation with acknowledging to myself, within the countertransference, the negative feelings, the downright critical feelings, the dislike I can experience at times for the women in the couples. These negative feelings, although extremely uncomfortable are familiar enough to me as the transmission of misogyny, the wish to separate myself form another woman's negativity at the moment when we are struggling to move the situation forward, the ambivalences in my relationship with my mother where hate was not an unknown feature of the relationship and so on. I have a facility with handling such feelings. They may not please me but they don't alarm me and they co-exist with sets o f powerfully loving

feelings for members of my sex and empathy for the struggles we face, the situations we survive in and so on.

However with men, my experiences are more limited, more stereotyped as a response and more bifurcated. I am not so able to handle feelings o f dislike or contempt when they arise in me in the clinical situation towards men. I feel distinctly uneasy and try to understand in my head, the phenomenon with the tools I have at hand, interpreting the projective identification, the split off self contempt and so on. In other words, I find it too dangerous to actually hold the dislike inside o f me undigested or unthought through for a prolonged period of time - i.e. over several weeks. I have to do something with it. Is it possible that what I do with it, is turn it into love?

My second point is at a tangent to this point. It relates to the therapists' holding of feelings for the couple and within the room, that the couple are unable to hold for or between themselves, namely love.

For many couples in therapy, bitterness and anger, conceal the hurt and deep disappointment that has brought their relationship to a critical juncture. They squabble, accuse, withdraw, insult, demean, moralise to such an extent within the therapy as part of the process of sorting through, that it is as though the love that may have once brought them together has been vacated. With some couples it seems obvious that the adhesion of the two people is a reflection of their fidelity and devotion to bad internal object relations. The anger, resentment and bitterness in the relationship is the cement that confirms for both parties the impossibility of a connection not built or adhered to by conflict.

But it is the former of these two couples that is most relevant. I want to address the countertransferential feelings of love engendered in me when I am with a couple who are fighting. I don't mean by this literally fighting in the moment, but in that phase of the therapy where the discontent and hurt are most manifest, rather than even a glimpse of the feelings of positive attachment. In thinking about how frequently warm, tender, friendly feelings occur for me, I have wondered whether what I experience in the countertransference, since this is so seemingly at odds with what is in the ambience in

the room between the couple, is in essence apposite. It is apposite precisely because it is the split off affect of the couple - their positive and hopeful feelings for one another which need to be held by someone but have to be temporarily suspended and put in a bubble while they work through their rages, misunderstandings, dissatisfactions and so on. Both parties are so determined not to give in on what they feel to be justifiable struggles for recognition from one another for differing sets o f grievances, that they have to cover their compassionate feelings for one another or steel themselves against them. Because they actually do have strong positive and loving feelings, they entrust them unconsciously to me. They export them over to me who is both within and without the couple where they can be held until such time as they can be re­ encountered.

I think that in this process, they, while feeling helpless, hopeless, angry, weary, ensure through the projective identification - my forbearance o f their painful feelings by unconsciously passing on the love - that they can survive such painful feelings and struggles. They create the conditions in which I am stoked up and fortified by enough love to allow the three of us to work on and through the tremendous distress that is in the room.

I, consequently, am not frightened by their distress or made anxious about the potential for destruction in their relationship, because I have been lent their good feelings for one another. When they have resolved or clarified a piece o f the conflict between them, they reconnect with a piece of their love. This reclaimed and reshaped love, because it now takes on a different character than it had when it was created between them in the first instance, re-balances the feelings in the consulting room. The warm and tender layer inside of me that reassured me that we could proceed without too much danger, is now diffused. It re-inserts itself into the relationship via the individuals in the couple and there are many interesting technical issues that accompany this reinsertion.

I wouldn't go so far as to say that my countertransferential feelings o f love were a diagnostic, although perhaps that could be argued. But we might think about whether the absence or presence of such feelings when with a couple in difficulty is significant

or barometric. Certainly when I am with a couple who are exhibiting hate and I too feel pessimistic, I don't make the assumption that they have unconscious love for one another. Of course that is possible, of course they may be too fearful o f trusting love, too fearful o f maintaining intimacy if created and more familiar with the contours of dissatisfaction and emotional betrayal. In such instances I am inclined to look at how attachments and their internal object worlds has compelled them towards the compromise of destructive relationships.

There is a third area that coalesces around love in the countertransference when working with couples. And this bears somewhat on the previous discussion but possibly undercuts my argument. This is the knotty matter of erotic transferences, or as I shall demonstrate, the curious lack of erotic transferences that I experience when working with couples.

Tansey (1994) writes of the phobic dread which surrounds the recognition of and the discussion of erotic countertransference. In a series of engaging papers Tansey (1994), Messier Davies (1994) and Hirsch (1994), take up problematic occurrences of erotic transferences and the ways in which they have used these to further the psychoanalytic enterprise. While there is much to sympathise with in their approaches there does seem to be a void or absence o f erotic or eroticised countertransferences in work with couples.

If we take what I consider to be the overly broad definition o f erotic as posited by Wrye and Welles (1994) then of course I would subsumed my loving feelings into this category. But if we focus on the erotic within the countertransference, I find the situation strikingly devoid of explicitly erotic feelings.

Many o f the couples I've seen in couple therapy have had as a point of concern, the diminishing o f sexual desire and sexual activity within their relationship and by implication these feelings might be absent in a couples therapy. I have had patients whose sexuality is the means by which they attempt to establish a connection, who may actively seek to flirt or turn me on in a session. This rather obvious interaction isn't what I would call the kind of wildcat countertransference that seeps into one, is compelling.

and disruptive in the ways that Vincent (1995) has so beautiful elucidated. These manoeuvres on the part of patients are more akin to what the Sandlers (1976) have termed role responsiveness. They aren't confusing when thought about and they aren't disturbing or especially illuminating about the erotic. What puzzles me about couples work is where does the erotic go to? Or perhaps we should say, where does it come from?

As we have seen, in an interpersonal object relational view of human development and interaction, the sexual, the erotic, is not simply a given. To be sure it is vital, important and in intimate relationships an often very crucial medium o f expression both for contact and for the negotiation of conflicts, struggles around merger, around mutuality, recognition, separation and so on.

But neither from observing the manifest or latent material between couples or the emotional ambience with the three o f us, or the transference countertransference can I locate anything but the disappearance of the erotic. How does it goes so far underground? Does it vapourise? Why isn't it palpable in some sentient form in the room? If there is a negation, this is surely interesting.

Perhaps an interesting point of departure is how being a lone psychotherapist working with a couple means that one is potentially the recipient of at least three different countertransferential scenarios - his, hers and theirs in the case of a heterosexual couple or hers and hers/ his his and theirs with gay couples. The volume and density of countertransferential material and the capacity to sort through the differing strands are intriguing and remain a relatively unexplored area of the way gendered body and gendered mind plays out in psychoanalytic work with a couple.