Keeping Couples in Treatment: Working from Surface to Depth is written for the beginning or seasoned therapist who wants to learn a powerful and effective in-depth approach for keeping couples in treatment. The book focuses on the problems that present themselves when the therapist lacking in-depth knowledge of couple treatment loses empathy and curiosity, resulting in a feeling that couple therapy presents an overwhelming task. Therapists who embark on couple work need practice theory for making meaningful contact with the couple’s internal conflicts. In the surface to depth approach the treatment field consists of two spouses, their unconscious relationship, and the therapist. Therapists may micro-manage couple emotions because they cannot conceive ways to deal with couple anxieties because their own anxieties run so high. This book illustrates the therapist’s use of self and the theory behind this powerful treatment approach that can help therapists more effectively manage treatment anxieties. For the beginning couple therapist, this book offers an object relations rationale for treatment and an expansion of the technical shifts from individual therapy to couples. The book guides the inexperienced therapist through the couple’s pain, rage, and attacks on the frame when in deeply distressing situations. For the experienced therapist the book emphasizes the couple as an unconscious and conscious system best treated using an in-depth understanding of intrapsychic-interpsychic communications. Couple situations demonstrate a treatment that experienced therapists will find liberating. Throughout the book the therapist’s countertransference and use of self as a therapeutic instrument is examined. Divorce, infidelity, dreams, and disorders of the self are detailed in the case materials. The cases represent a variety of problems difficult to treat at any level of therapist experience. The book studies the therapist’s personal feelings and countertransference throughout treatment that enables the reader to hone his or her capacity to deal with difficult couples.
About the Author
Carl Bagnini, LCSW, BCD is a faculty member of the Adelphi University Gordon Derner post-graduate programs in clinical supervision and couple and marital therapy, and the New York Institute for Psychotherapy Training. His clinical practice is in Port Washington, New York.
Table of Contents
Chapter 1: Introduction
Chapter 2: A Walk in the WoodsFrom Surface to Depth
Chapter 3: Object Relations Couple Therapy
Chapter 4: Types of Marriages Encountered in Couple Treatment
Chapter 5: Couple Assessment and Treatment of Narcissistic Anxieties and Defenses
Chapter 6: Infidelity and IntimacyWorking with the Extramarital Affair
Chapter 7: Accessing the Internal World of Couples through Their Dreams
Chapter 8: The Persecution of Divorce
Chapter 9: Containment, Projective Process and the Couple: The Therapist’s Dream
Chapter 10: The Couple Therapist’s Growth Experience
Chapter 11: Are We There Yet? The Journey and Destination of Keeping Couples in
About the Author
What People are Saying About This
This is a warm-hearted book from a seasoned psychotherapist. In it Carl Bagnini assembles the knowledge and experience he has developed and accrued from a lifetime of psychoanalytically informed clinical practice. He offers novice and experienced therapists alike a window on the unconscious dynamics of couple relationships, and a means of making sense of the affective turmoil that motivate couples to seek help. Modest and humane, this book invites us to reflect on the totality of the encounter between couple and therapist in working with complex relationship problems.
This is an excellent, closely observed, and humane exposition of the troubled couple relationship from an object relations psychoanalytic perspective. Keeping Couples in Treatment is of enormous value in a world in which the psychoanalytic understanding of the complexity of the couple relationships has still a long way to go. The book is suffused with clinical examples and one feels the privilege of being invited right into the author's consulting room, and his thinking within the session, to see him at work. He does not shy away from the complexity of couple dynamics, the sometimes disturbing impact on the therapist, and makes a stand for giving the psychoanalytic process time in a world where brief interventions that stay on the surface dominate, though are gradually being shown to be less effective. His capacity to move from surface to depth stems from a wealth of clinical experience and theoretical understanding that will guide practitioners at whatever level of experience and his book may be one they want to symbolically hold on to while weathering the storms of couple psychotherapy.
Keeping Couples in Treatment:A Surface to Depth Approach offers an astute and sophisticated application of object relations concepts to couples. Bagnini’s approach is carefully articulated in ways that reveal the nuances and depth of a highly experienced, insightful master therapist. The book is finely balanced with presentation of theory illustrated by abundant case material that explicates the exact role and reasoning of a therapist who has successfully treated a wide range of couples in extreme distress.As a result, both the emerging as well as advanced couple therapists will find ample material to stimulate and expand their understanding of couple therapy.