Marital Tensions: Clinical Studies Towards a Psychological Theory of Interaction

379 Pages·1993·10.909 MB·English

by  H.V. Dicks

MARESFIELD

LIBRARY

H E N RY V.

D I C KS

marital tensions

clinical studies towards a
psychological theory of
interaction
Foreword by Fred M . Sander
KARNAC
MARITAL TENSIONS

M A R I T AL TENSIONS

Clinical Studies

towards a

Psychological Theory of Interaction

Henry V. Dicks
M.A., M.D., F.R.C.P., F.B.PS.S.
Honorary Consultant, The Tavistock Clinic
Foreword by
Fred M. Sander
MARESFIELD LIBRARY
London
K A R N AC BOOKS
First published in 1967 by
Routledge & Kegan Paul Limited
This edition reprinted in 1993
with their permission by
H. Karnac (Books) Ltd,
118 Finchley Road,
London NW3 5HT
Copyright © Henry V. Dicks 1967
All rights reserved. No part of this book may be reproduced,
in any form, by any process or technique,
without the prior written permission of the publisher.
A CIP catalogue record for this book is available from the British Library.
ISBN 978-1-85575-064-7
Printed in Great Britain by BPCC Wheatons Ltd, Exeter
CONTENTS
Foreword to this Edition Xlll
Preface xvn
I. INTRODUCTION 1
Motives and pressures for the priority in studying
marital interaction; need for help in family stress
and breakdown; improving security of children;
theoretical bases for the approach to marriage
therapy in newer psychoanalytic and sociological
thought: Fairbairn v. Freud; the concepts of role
and culture pattern; a definition of marriage in
socio-psychological terms, which also defines the
aspects of stress requiring study; the marriage as
the unit of study, and the consequent adaptations
in method
PART ONE

THE CONCEPTS

II. THE SOCIAL SETTING 13
Social patterns and variations for safeguarding
matrimony and chastity; the norm for English
marriage, threatened by social and technological
change; the features of traditional family
structure; the modern urban family contrasted; the
constriction of human relations into a small
nuclear group; the emancipation and changing
v
C O N T E N TS
status of women; culture distance and mate

choice; the equivocal role of parental wishes;

effects of housing and earnings; summary

III. THE INDIVIDUAL SETTING 28
The effect of the social setting on personal

development and 'fitness for marriage*

A. The fate of dependence: heteronomy and
autonomy as influencing marital role playing
B. Identity and object-choice; cultural sex r61es,
v. biological sex functions
C. The concept of genitality
D. The child is father to the man; phases of ego
development in object-relations terms;
healthy and unhealthy ego defences
E . A general view of marital pathology based on
this concept of ego-development
IV. THE DEVELOPMENT OF THE STUDY 45
A. The starting point; converging concepts and
practical involvement of the author; the first
*marital* case and its lessons; early
hypotheses developed in the light of further
cases
B. The setting up of a pilot study: findings

resulting in elaboration of hypotheses on

further case material

V. THE FURTHER EVOLUTION OF CONCEPTS I 68
A. The collusive marriage and ego boundaries;
the importance of conflicts between conscious
expectations and deeper needs; ego splits in
action
B. The significance of idealization in containing
ambivalence; the role of scapegoating and
projective identification; clinical illustrations
vi
CONTENTS
C. Shared internal worlds: the threat of the
repressed; the breakdown of mutual
idealization; contrasts of healthy and
collusive marriages
VL THE FURTHER EVOLUTION OF CONCEPTS II
CONFLICT IN THE DYAD
A case of chronic conflict, reported and
discussed
(a) husband's object relations; (b) wife's object
relations; (c) the collusive system in the dyad
VII. PRESENT CONCEPTS
Evaluation of conflict in the dyad; re­
internalization as the clue to better relations;
review of other Hypotheses; the Eisenstein
symposium; Ackerman; Jay Haley; Winch on
mate selection; concords and criticisms on the
complementarity hypothesis; folic & deux in its
relation to our topic; the double-bind and 'driving
the other crazy'; conclusion and summary
abstract of my current conceptual framework,
relating back to the first chapter's 3-level analysis
PART TWO
THE PRACTICE
VIII. SYMPTOMATOLOGY I
The kind of cases we see, and the kinds we do
not see; principles of ordering various types by:
1. Distribution of impact; one or both partners
are carrying the stress, which may be psycho­
somatic or psychological in expression
2. Dominance/submission conflicts as presenting
issue
vii
CONTENTS
(a) dominance and role; (b) submission and
role; shared martyrdom
3. Disturbances of sex functions as presenting
issue and their variety; sado-masochism,
overt and masked
(a) primary sexual failure: variants of non­
consummation; (b) secondary sexual failure:
regression to hysterical mechanisms
IX. SYMPTOMATOLOGY II:
GROUNDS FOR DIVORCE 164
Acting-out v. containment
1. Sexual acting-out
(a) adultery: benign (collusive) variants and
dyad; destructive or malignant variants; the
role of the third party; (b) other aspects of
acting-out
2. Cruelty; conditions under which the issue

comes to the surface

3. Desertion, benign and malignant variants;

constructive desertion

4. General comments
5. Containment and its hazards; dead marriages
X. INVESTIGATION AND DIAGNOSIS 187
1. Principles of handling referrals
2. The aims of investigation: the ascertainment
of the meaning of marital conflict in terms of
the concepts
3. What data do we seek?
(a) intrapersonal; (b) the dyadic culture­
pattern; (c) the unconscious dyadic
transaction
4. How do we collect data? Our bias
(a) interviewing; principles; transference;
viii
CONTENTS
(b) the joint interview; its evolution as a
diagnostic tool; criteria for its use; handling;
(c) supportive psycho-diagnostic methods;
cognitive and projective tests; early models of
(i) the Self-Object Perception Test for
unconscious object-relations; (ii) the Marital
Role Involvement Questionnaire for role
distribution and role congruence
5. How do we collate data into diagnosis?
(a) exclusion methods—what and when do
we exclude? (b) positive diagnosis;
judgements on certain phenomena;
(c) construction of summary picture—a
schedule of crucial variables on which
prognosis and treatment are assessed
6. Towards a classification—a major task
towards which the foregoing is a step; other
workers' attempts; my own provisional
classification
7. Classification and the concept of crisis; is
there a mid-life crisis?
XI. TREATMENT 227
1. Introductory — link with Probation work;

summary of methods used by us

2. Aims of marital therapy-values as distinct

from individual therapy

3. Separate therapy for each partner
(a) the foursome; (b) by one person —
disadvantages
4. Joint therapy
(a) foursomes; brief; longer; some indices of
change; indications for its use; (b) triadic
(one therapist) joint therapy — arguments for
it (i) in long cases; discussion of long
therapy; (ii) shorter therapy — the
indeterminate attitude
ix