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4 0000 00165827 I

Clinical
Handbook
of Couple
Th erapy

Eolrpo ny
ALAN S. GURMAN

fr
THE GUILTORD PRESS
New York London

Transgenerational Cou ple Therapy
Launa RosRTo-Fonun
Transgenerational (TG) therapies were pioneered
in the 1950s. fu agroup ofmethods, one could say
at their development has reached only its early
adulthood, having experienced a consolidation o{
workin e 199G (Robeno, 1991, 1992; Robeno-
Forman, 1998, 2002). This chapter reviews major
cunent TG theories, relevant research and appli.
cations, and current techniques in view of what
TG therapies offer for couple treaenent.r Couple
therapists of every penuasion use at least some
TG rools, althou$r ese tools often are not fop
mally recognd as "transgenerational." In fact,
Carl Whimker (1982) once refend to the cenral
tenets of TG theory as "univenals." For example,
one prestigious training irutitute's most recent
training brochure offen a "coaching group" (de-
frned later in his chapter) for examining the ther-
apist's position rr his or her own family of origin.
As a second example, a suwey reveals that in e
flagship marital and funily erapy joumal Farnill
Process, between its inception in 192 and March
2007, rhe terms "transgenerational," "intergen-
erational," and "multigenerational" were cited in
388 articles. In yet another example, most thera-
pisn and health care profesionals routinely assess
and refer to family-oforigin isues when treating
i96
partners, if only to create a genogram, or to uke a
medical or sexual history. Until the late 1970s, is
was not standard practice. However, although TG
ideas permeate most marital therapy, TG rherapies
ae often not explicitly acknowledged as khool
ofthought.
Tiznsgenerational family process is, as I dis'
cuss later, a series of unfolding relational dynam-
ics that evolve over the coune of 20-40 yean or
more, such as in e concept "adult child of an
alcoholic" (ACoA). This term encapnulates a self-
definition, idenrity, set of roles and implicit family
mandates, and behavioral repertoires at develop
over the course of a child's life up to age 18 and
beyond. Similuly, the concept of the "memorial
candle" (Vadi, 1990) describes the strong mutual
bond between the patent survivor ofgenocide and
a chosen child. A small but growing number of
qualitative research papen look at the connection
b'eween family-of-origin problems (e.g., alcohol'
ism) and later relationship issues in couples, yet
this research is not commonly pulled together
under the umbrella of "TG." This chapter aims
to address that deficit, pulling togeer, compar-
ing, and combining different TG perspectives on
couple erapy to demonstrate several points:
7. Transgenerational Couple Therapy
1. TG theory and TG therapy provide a powerful,
.. nonhierarchical approach to ftaming and voic-
:, ing problems, and undenunding and working
wirh couples in disnes.
2. ..TG therapy moves beyond immediate symp-
.'tom reduction to increase marital resilience
and prevent future symptoms thnough the fa'
cilitation and developmentof intimacy, mutual
. problem solving, and satisfaction in couples.
3. Expansion ofprevious work identifres common
bridging concepts among several historical TG
schools, working toward a unitary, powerful
TG model.
4. TG can inform a new generation of heal pro'
fesionals, who penonally may not have srud'
ied with the departed founders ofTG models or
ei earlier proponents, about central tenets
and practices that cn inform their research,
theory and practice with couples.
BACGROUI{D
The major schools of TG thmry and therapy
over the past five decades include natural systems
( Bowen) theory symbolic-experiential (Whitakeil
theory contexrual (relational ethics, Boszormenyi-
Nagy) theory and some aspecs ofbbject relations
theory (Robeto, 1992; ftharff& Bagrini, 2@2;
Schaff&. Schaff, 1987; Slipp, 1984; Wachtel &
Wachtel, 1985). Alough object relations marital
and fami[y erapy (MFT[in iaiiiiulu has been will y, the *insition involved in mihg'one
more in vogue since the 1980s, all ofthese mod'
els are widely used by MFB to explain problems
and urform teatment of couples. Cunent object
relations theory has become more qptemic, striv-
ing to addres relational problems; even though ia
interview sryle focuses on affective, inaapsychic
experience. Cenain kinds of obect relatiors in.
terventions, such as holding, interpreting, elicit'
ing unconscious material, fotering integra.tion
of painful memories, and wo&ing through in
the present, have all been modifed for use with
couples in conjoint therapy. Because object rela-
tions theory includes family.of.origin material to
undentand marital behavior, sorne of its tenets
are included in this discusion (also see Scharff &
Scharff, Chapter 6, this volume). Although none
of ese major eories has been explicitly named
tnnsgenerational, ey can be gouped together
as theories that draw on intergenerational (long-
term, slow to change) family processes to explain
couples' problems.
r97
TG rnodels have been extended to examine
specifrc spousal, family, and larger systems prob-
lems: personal authority in marriage and family
(Williamson, 1981, 1982a, 1982b); family-of-origin
consula (Framo, 1976); sexual dysfunction (Hof
& Berman, 1989; Scharff, 1989; Schnarch, 1997);
unconscious marital contracts (Sager, 1976); une-
solved los [iwak-Hirsch & Bu-On, 2006; Paul,
1967); genderipower conflicts (Goodrich, 1991;
Walten, Carter, Papp, & Silverstein, 1988); do'
mestic violence work (Jory 1998); late'life econ-
ciliation (Hargave, 1994; Hargrave & Anderson,
192); and multicultural maniages (McGoldck,
198* McGoldrick, Peace, &. Giordano, 1982).
A number of auon have sought specifically to
apply feminist ttreory to TG couple therapy (Cart-
er & McGoldrick, 1989; Knudson Manin, 1994;
Roberto, 192; Valten et al., 1988). Thei ideas
have informed and enriched all of e meods
presented in this chapter' .
The TG erapies formulated in the last half
of the 20th century reflected their dme, in that
they stemmed from individual models of human
development, normality, and dysfunction The
work of early theorisn aimed to observe, describe,
and rutructure the context of invidual prob-
lems by looking "one level up" at the strucore of
e family of origin sunounding, supporting, and
maintaining the views, values, cultural, religious,
and personal identity, options, mandates, and sub'
jective interpretations of people in therapy. .As we
level upn meant that many TG techniques were
formd to allow a client in individual psychother'
apy to reflect on family-of-origin contexts without
e entire farnily berng in the room--+r even e
spouse, Over e last 50 yean, TG techniques
have evolved to include family memben in the
psychotherapy proces.
I shae the hopefulnes of Johnson and
Lebow (Z@0), who stated in eir decade review
ofcouple therapy at "we are, perhaps, beginning
ro build a generic base for couple intervention
that is less constrained by differences in language"
(p. 33). Howeve over the last 50 yean, each of
these four theories has been disseminated in dil
ferent postgraduate training institutes, different
publications, and even different profesional or'
ganizations and conferences. For example, during
Munay Bowen's years at Georgetown Univenity,
his family sptems naining proglam held its own
confeences and symposia, and published its own
archives. Although Bowen sewed as a President of
198 I. MODELS OF COUPLE THERAPY 7. Transgenerational Couple Therapy 199

the American Family Therapy Academy (AFTA),
neither he nor Cal Whitaker (the founder of
sgnbolic-experiential therapy) presented at
AFIlts prestigious annual conference or other
family therapy conferences (lvan Boszormenyi-
Nagy alone did so). Thus, rhe history of these
four methods developed within separate groups of
writen and institutes at the expense ofdeveloping
common vocabulaies. Furthermore, each of e
four models is also based on the work of a highly
charismatic male founder and his trainees: Narural
systems theory is based heavily on Munay Bowent
work; symbolic-experiential theory on that of
Carl Whitaker; contextual therap on the work
of lvan Boszormenyi,Nagy; and object relations
erapy on the work of D. tiL tlinnicott. Even
though TG work is now iq its fourth professional
"generation" (assuming tlur a younger generation
of trained profesionals moves toward the lead.
ing center of a xierrce every 20 years), literature
bringing together common concepts and compat-
ible interventions arnong the four models is still
quite sparse.
NatunlSysfems lDeory
Natural qstems mry (Bowen) developed out of
research observadoru of the interactions in fami-
lies with a rhizophrenic member. While at the
National Institutes ofHealth frorn 1954 to 1959,
Bowen sought to descrih dysfunctional cycles of
behavior between e parena and e psychotic
patient (Bowen, 1972/1985b). At that time, he
was looking for a elational buis for the striking
lack of personal boundaries and autonomy of pa.
!ien6 with psychodc disorden. He was especially
interested in the posible role of family-of.origin
enmeshment (and a elated problem of "cutoff')
in the evenoal emergence of schizoptrenia over
generations of a family's life. Bowen subscribed
to the diathesis-*uess model of psychosis, which
holds that illnesses do not necessarily emerge un-
less a person is suessed and cannot mobilize self-
observation and rlf.regulation skills.
Early clinical reseachers looked only at con-
nections berween inpatients and eir mothen.
Later, Bowen began to look at e role of rhe fa-
the and th. q*lity of parental marriage as well.
Bowen's team observed that in parent-<hild re.
lationships situations with very highly involved-
low interpersonal boundaries ("enmeshment"
or "fusion"), emotional tensions increase to the
point that a'triangle" (inclusion of a third per-
son) evolves. The team began to look for evidence
of fusion and triangulation in families whenever a
psychiatric patient experienced frequent relapses.
Bowen also predicted that if cenain pattems of
rion are present in a maniage or famil then
modifring these pattems in family erapy will
lead to improvement in psychotic symptoms and
improved individual resilience ("differentiation").
After l97, Bowen developed and ex-
perimented with methods to difluse family en-
meshment, to incease individual differences
and self.focus, and to promote give and take in
family.of-origin relationships (a direction later
continued by !illiamson [1981] in his theory of
"personal authorty"). Bowen became increasingly
interested in the connection between .rsion and
differentiation, and, in one famous appearance,
even reported audaciously at a national medical
conference on his own personal experiences in-
cresing differentiarion with his family of origin
(Anonymous, 1972). This fint reponed use ofself
in e history of marital and family drerapy had a
powerfirl effect on both Bowen, who hlieved that
experiential leaming is potent for profesional,
as well as psychotherapeutig growth, and on the
audience, whose members srw a new modality
for training in front of their eyes. Ttrough this
penonal family-of-origin work, Bowen redefined
differentiation-which had been viewed as an
intemal developmenal phenomenon-as a func-
tion of family tolerance for individual differences
and*lf.exprrsion. He posited tlut urce set dup
ing rearing, differentiation of slf is very difficult to
incease later n life. This concept has tremendous
implications for therapiss working with isues of
parmer selection and maftrity in couple erapy.
A training institute rvas opend at George-
town Univenity in Washington, D.C. Bowen
began to use assignrnenc and family-of-origin vis-
its as training tools with his own pychiauy resi-
dents as a way to teach his model and to address
profesional gowth (BowerL 1974). He obsewed
that trainees who completed Familyof-origin as-
signments remed to possess more clinical effec-
tiveness than those trainees who did not. By 1 9? I ,
he concludd that work focrsed on creating one-
on-one, well-delineated rclationshin with onet
parcnts essentially raised one's own level of differ-
entiation, ncreasing a drerapisCs ability to func-
tion in marriage, parenting, and practice of thera.
py. Tiinees were encouraged to present their own
families oforigin in classes and conferences, and ro
enter psychotherapy with their spouses to look at
how stagnant, unresolved family dilemmas colored
their maniages and views of themselves. Alough
graduate naining institutes are no longer encour-
aged to allow dual relationships in training, family
of origin presentations and experiential leaming
ae srill highly utilized in advanced erapy ex-
temships and supervision.
Like his contemporaries, Bowen used the
genogfirm, an old medical tool for chaning fam-
ily history-but with a twist. He and his tain-
ees mapped symptom-bearers in relation to their
extended families, then looked for intense rela-
tionships and niangles that might be helping to
maintain clients'distres. Studenc such as Fogarty
(1978) and Guerin (1976) applied the concept of
triangles to problems of individual despair (emp-
tiness), disconnection, and eriotional distancing,
and began to examine specifically the effect of
distancing on maniage. The technique of"coach-
ing" was developed to allow adult individuals and
couples to disengage from family rriangles, control
distress ("reactivrd'), and create one-on-one re-
lationships with parents and key family memben.
Bowen also saw marital counseling as a way to
prevent enmeshment problems from emerging be-
tween parents and ei children.
Eventually, the natural systems group at
Georgetown created a "think tank" to generalize
ese frndings on the nature of enmeshment and
triangulation in larger systems. Studena applied
the concepts of poor differentiation, sion, and
"undiffeenrlated egb masi tririgles, and "projec- an inteiactional, systemic model. The"symbolic-
tion' (of unresolved isues) to less impaired fami-
ufamilies,"
lies, workplace social groups, and the
training ofclinicians. This expansion has included
consultation in many rypes of wo*places. For ex-
ample, Friedman (1985), an ordained rabbi, cre-
ated a training model for clergy to apply to churchl
synagogue rehtions. Throughout the 1980s and
190s, groups for clergy were run under his direc-
tion to examine the minister's/rabbi's relationship
with congregational members and boards. The
natunl systens model works seamlesly widr geno-
gram studf because it focuses on recunive, repeti-
tive, chronic cycling of symptoms between mari-
tal garmers, parents, grandparents, and drilden.
After Bowent death, one ofhis principal snrdents,
Michael Ken, took ove direction of their insti-
tute. The infuence ofrhis rnodel offarnily rnc-
tioning has also helped to shape e curriculum at
a number of irnponant training institutes, includ-
ing programs such as the Multiculoral'liaining
Institute at Rutgen University in New Jeney.
Sy mbol ic-Experienti a I The ra py
Carl Whitaker also began working in the 1940s
with adults hospitalized with psychotic symptoms.
Tiained as a psychoanab'tic child psychiatrist, a
contemporary of Murray Bowen, Lyman \ynne,
Gregory Bateson, Ivan Boszormenyi-Nagy, Virgin-
ia Satir, and Nathan Ackerman, he also worked
in public and Veterans Adminisuation hospitals.
Consistent with the predominant androcentric
model in the 1940s, his emphasis was initially on
parenal (especially matemal) dysfrrnction as a
contributor to relapse. However, he also consulted
at e Oak Ridge atomic reseach facility during
World War II, where he courueled scientists and
war veterans showing severe stress reactions to the
clusied project. This experience gave Whitaker
d sense ofhow personal disintegation can be a re-
action to intoleable breakdowru of societal order,
and everyday ethics and norms-what Whitaker
( 1982, p. 36) latercalled "being driven [as opposed
to beingl crazy." He later emphasized that one goal
of therapy is to allow individuals to believe more in
themselves and their potential, and to extemalize
the forces that lead us to view ourselves as differ-
ent and marginalized. Extemalization has become
a centrl feature ofsome rurative therapies.
As a faculty member in the Department of
Psychiatry at Emory Univenity in the 1950s,
Whitaker continud to shift from a psychoana-
lytic, intemal conlict model of mental illness to
experiential school of TG therapy thus echoes
the same bridging ideas linking individual symp-
toms to larger family dysfunction as does natural
systems theory. Unlike later methods, which are
more problem-, present-, and solution-focused,
TG models were created to provide a relational
view oflifetime vulnerability and to explain why
emorional breakdown occurs in one family mem-
ber rather than othen. Because he was a child
psychiarist (Neill &. Kniskem, 1982; Whitaker
& Rrn, 1989), V/hitaker continued to feel at
nonverbal affective experiences are an imponant
avenue to self-awaenes and ruilience. This view
distinguished hlrn om peen, such as Bowen, who
were viewing the same dp;rnctional pattems in
coubled families but emphasized intewention on
the verbal and cognitive level to treat them (Ro-
beno, 1991, 1992).
In addition, worting with wlnerable clients
such as drilden, wonied parents, and trauma.
related cases at the Oak Ridge faciliry Whitaker
 I, MODELS OF COUPLE THERAPY
came to believe that couple and family therapy re-
quire a high level ofemotional safery and erapist
transparency. Whitaker refened to this as "use of
self': the abiliry to respond penonally to the needs
and concems of clients in therapy. In symbolic-
experiential therapy, the role of e therapist is
unique: He or she shows multilateral caring raer
an neutrality (Roberto, 1992). It is a proximal,
emotionally focused, personal therapy rather than
an abstract, coaching, educational therapy. fu we
will see; this view of the therapist's role overlaps
e view held by Boszormenyi-Nagy in contextual
th.opy.
Finall in a "ird period" of work at Emory
University, Whitaker began using a cotherapist
and including the family of origin in therapy
sessiqns.Like Bowen, he also began to make his
residtxay training $oups more systemic, having
eq'do .family-olorigin presentations in class.
The$
ideas were picked up by orher systemic
therdiiies and elaborated into observing and re-
flectih ieams, including family-of-origin consults
in cople therapy (Framo, 1976) and in-sesion
conqltation with multiple therapists. The Emory
faculry forined a process group and generated the
Sea Island'.Conference of 1955-e fint family
proces conference.
Afur Vhitaker went to the Univenity
of Wisconsio Psychiarry &partment, unril the
mid-1980s, he and colleague David Keith rrained
residents using live and videotaped interviews
of,extended fbmilies to teach marital and farrily,
therapy. Symbolic-experiential rechniques remain
heavily rooted in this collegial context of peer su-
pervision, penonal family-of-origin work, and use
of self in therapy. To the other TG models of thep
apy it added hean, warmth, and therapist-<lient
connectiiry.
ContqtualThenpy
Beginning aound l95, Ivan Boszormenyi.Nagy
and colleagues focused on e concept that un.
resolved relationship problems over the course of
several generations create, or "feed forward,n into
later emotional symptoms. He viewed families as
possesing an implicit, invisible network of felt
loyalties berween parents and children, and be.
lieved thar these bonds of attachment and loyalry
constitute a separate dimeruion of relationship
an "ethicaf'dimension. By adding the concept of
"relational ethics" (Boszormenyi-Nagy &. l(rasner,
198; Boszormenyi-Nagy, Grunebaum, & Ulrich,
1991), contexoal theory adds a layer offamily ex-
perience to therapy that is not addressed by oer
TG models (Robeno, 1992).
In 1957, Boszormenyi.Nagy fornded and
directed the Depanment of Family Psychiatry
at Eastem Pennsylvania Psychiatric Instirute in
Philadelphia. Like the workplaces of his peers, it
contained both research progams and a clinical
service, until state funding ended in 1980. His
early family observation was, like that of his con-
temporaries, based on intensive care of inpatients
with schizoptuenia and their families (Boszorme,
nyiNagy, 1962, 1965, 1972; Boszormenyi-Nagy
& Spark, l9i3). The lstitute sponsored several
of the earliest hmily erapy conferences in the
1960s, and Bovormenyi-Nagy was a founder of
AFIA, formed in 1977.
Contextual theory draws on e ideas of Eu-
ropean object relatiors writen such as Fairbaim
( 1952) and existentialist, experience-based theo-
rists such as Buber. These ideas were broughr to
e United States by Sullivan (1953), Fromm.
Reichmann (1950), Searles (190), and others in
the Chesmut Lodge group. One of e dominant
interests for therapisa at at rime wrs !rstrrror- that the parent shapes the childt experience-in a
tJriruss---+specially how a therapist's trustwonhi-
ness affects a client's ability to tolerate and man-
age psychotic symptoms. In the late 1950s and
l90s, Boszormenyi.Nagy made his theoretical
shift to systems thinling and began to apply it
in his medical sening. Ar that same time, cyber-
netic theory .war also'.berng devebped. It was dif- .
frcult to stimulate dialogue and attention to the
idea of relational ethics-lololry binls, mtitlarwat,
ntsrit, mst, and mltualiry-with cybemetic theory
in vogue (BouormenyiNagy &. Ulrich, 1981).
Contexoal theory focuses orr implicit emotional
communication and'typa of bonding berween
people, so it has a poor "d'wi purely behav-
ioral, problern-focused drinhing. Rather, contex-
tual theory explains how the qualiry of long-term
family relationships affeca inrimate behavior tlut
people bring to maniage and to parenting two. to
ree generations later.
Abj*t Rdattunslhany
In the history of maritl and family theory, the
influence of psychoana['tic theory is enormous.
This was especially the case in the work of Nor.
man Paul (196D andJarnes Framo (197, 1981),
whose techniques are reviewed here. Virginia Satir
(1983), a TG erapist, was trained in analic
7. Tnnsgenentional Couple Therapy
theory as were Jaclaon, \ynne, Bowen, Whi-
taker, Boszormenyi-Nagy, Minuchin, Palazzoli,
and Stierlin-many of the originaton of cunent
marinl and family techniques (Jackson & Lederer,
1968; Minuchin, Montalvo, Guemey, Rosman, & maniage behavior in sons and daughten. A review
Schumer, 197; Satir, 1983; Stierlin, 1981; Palu-
zoli, 1974; Wynne, 1965). In e United States,
psychoanalytic theory existed mainly as Freudian
theory through the 1950s. In Europe, however, an-
alytic theory was modified between the late 1950s
and the 1970s to become a theory ofhow self is
created ftom intimate relationships. Object rela-
tions theory was a revolutionary departure ftom
Freudt wish-deferue theory of e mind.
Object relations theory is based on a Euo-
pean view of self-in-relatior-how a young indi-
vidual adapts to the encircling environment ofthe
parent(s). Through adaptation to the loved other,
the young personb deeply held wishes, beliefs, and
emotional resporises arise in the context of family
responses and initiations (Roberto, 1992). Some
object relations theorists devoted thei life's work
tohowfamilysystems shape e individualt experi-
ence of self, That body of work uses e linea view
unilateal fashion (Bowlby, l99, l9?l; haiberg &
fr"ihrg, 1980; Mahler, Pine, & Bergrnan, 1975).
Initially, the theory focused mostly on individual
behavior and self-concept (Fairbain, 1951 Klein,
1957; Wiruricon, 1965). Fairbaim focused on how
intemal views ofthe "ideal object [other]" evolved
frgm inte-ractipn between baby-ard_mother, ?nd -
how painful and disappointing events arc taken
in ("introjected") and en represed or buried to
preserve this ideal. Klein extended the idea of re-
presion to propose that repressed experiences stay
buried to avoid emotional pain but emerge as prc-
jetrions onto'iinponant caetakin. da, in an -
early application to couple work (1963), looLed
at how projection colors marriage. He poaited at
alfuuCh a tusting marriage gives us e oppor-
$nity to revisit and come to tenns wi Finful,
rrpresiorr
repressed experiences, ftequently the
projection cycle is repeatd instead.
Object relations eory has been applied
in many settings in Europe, e Americas, Aus-
tralia, and Canada, and has suftsed most MFT
mries in rse now. Ideas abou the place of the
unconscious or unintegrated experierce, ego, or
self-denition, and intemal experiences, such as
introjectior projection, and amibution, are pan
of the bedock in our understanding ofpsychologi-
cal development.
20t
WHAT WE HAVE IEAR]{ED FROM RESTIRCI|
A number of associations have been identified be.
rween family-of-origin relationships and counship/
of the liteatue shows that the family of origin has
been shown to pass on a number of marital pat-
tems. Pefened values (Vanlear, i992), panems
of coping with stress in maniage and with childen
fluni, 1992), adjustment in and readiness for ma-
riage (Campbell, Masten, &Johnson, 1998; Haws
& Mallinckrodt, 1998), and age at marriage and/or
pregnancy (Manlove, 1997; Thomton, l99l) are
rransgenerarionally linked. Illnes and resilience
pattems (Abrams, 1999; Jankowski, Leitenberg,
Henning, & Coffe 1999; Wallerstein, 199),
ability to hold a "double vision" ofmarriage and to
resolve confict (Wallentein, 199), and intimacy
(Prest, Benson, & Protinsk 1998) are also trns-
generationally linked.
' These intergenerational pattems provide the
blueprints and pattems of connection that will
evolve later in every couple. Yet, when couples are
interviewed to clarifr e stnrcture of thei ma-
riage and pattems of interaction, therapists often
do not explore how e couple may be replaylng
lessons leamed in rhei families of origin. I discus
this iszue as it applies to e most cunent empirical
models of marital dysfunction.
Research on Cwpls in Disess
oni"n (1SSA; Gottman'& Goa*-, Cipii:
5, this volume) identified seven complex pattem$
of marital intemction that distinguish between
satisfied and unsatisfed couples: greater reciproc-,.
ity of negative affect; lower ratios of positive to;'
rregative behaviors; hiBt levels ofcriticisrq defFll
siveness, contept, rrd stonewalhng (rhe'forr
honemen'); and ncgative and lasting amibtrtions
about the parmer. The reseachen also identi-
fred a fuquent paaem rhat they called the "wife
demandlusband withdawn cycle, They con-
cluded that positive affect and persuasion work
better to presewe subility in marriage: Positive
affect buffen conflicts, prevenn negative attribu-
tions (attributing hd motives for *re partnert
behavior), and Eotects agairut pathologizing one
anoer.
These ndings are extremely germane o TG
eory. For e>raople, the Gottrnan team lened
the function of sable marriages to a bank accomt
in which each parmels posirive conribudons
202 I. MODELS OF COUPLE THERAPY 7. Transgenerational Couple Therapy 203

compensare for negative feelings during conflicts.
This frnding parallels a central tenet of conrexrual
therapy, which holds drat the level ofmrst built up
over time colon and influences people's ability to
negotiate and reconcile. The initial fund of msr in
a maniage also panly reflecr each spouse's history
in previous love relatiurship, as well as needs and
abilities each has brought ort of his or her family
of origin. But Gottman's research to date in look-
ing at his couples' transactions does nor include
concepts from TG rheory.
Two-generational research sodies help to
explain the facton that lead to and maintain the
skewed interactions of unhappy couples. Good-
row and Lim (1997) descihd a pattem of high
eactivity and defensivenes in an engaged couple
and the relevant behravior pattems transmitted
from their respective parents. Lanon and Thayne
(1998) showed that nion and niangulation in
subjects' families ae relatod to negative opin-
ions and feelings about mariage. In Nelson and
llamplert (2OOO rrt of 9 couples in coun-
seling, in which one or bo parmen reponed
childhood abuse (physical or sexual), the parmer
who reported abtse mctiored especially poorl
and the tauma affected the other parmer as well.
The authors concluded ut "a penon may experi-
ence secondary Fuma isses resulting from iden-
tication with the treuma vicim" (p. 180). One
wonders to what extent the negative attributes
discussed by Gonman's tanr could reflect such
mediating family-of-origin problems aid. their se.
rious marital consequences.
Interestingly, Gotmran and Levenson ( 1999a,
1999b) stated drat in their nmples, couple inter-
action is remarkably durable over a 4-yea period.
These pattems probably *become pan of e fab-
ric of a couple's life and M
resistant to change"
(Lebow, 1D9, p. 169). Coryles also present with
the same issues after a ,fyear period
in
samples. Therefore, the viabitiry of a maniage
must depend not so ruch on whether isues are
resolved, or whar isugs are resolved, but on hou
patners mgage each oe. Degree o engagement
about marital isues is cncial. We can speculare
that when transactions bemeen spouses are so re-
markably stable over rime, ren it is probable that
we are viewing patems thatare "trait" rarher than
"situarional" behavion (i.e-, ey reflect funda-
mental underlying perceptims and charactenstics
at each spouse brings to thLe rnarriage).
I conclude that families oforigin pass on pre-
fened values; styles of intiuwe relating, meanings
and beliefs abour difference tolerance ad acceo-
tance, faimess, and muruality; and oer inrrinsic
aspecs of family life. Their children then go into
maniage with expectations, needs, and deams
colored by these formative experiences. Maniages
either develop characteristics of safery mutual re-
gard, and hope or are compromised by the past. lt
seems imperative, given these findings, tlut couple
erapy provide powerful ways to identifr and to
change the modes of attachment by which parmers
relate to one another. These emotional processes,
so deeply ingrained and colored by one's birth fam-
ily, are beautifully addressed and described by rhe
TG model. In fact, it is the TG modelt Diice d
rcstst4trce.
THT HEILTHY PART]IERSHIP
Formulated as ey were in European American
societies, most TG theories hold that healy
marriage begins with a love bond in which rhe
parmers have chosen ea other. It is cenain that
the deep psychological bond of love allows the
couple to form an emotional boundary around
the twosome that is preeminent and diffeent
from other connections-more intense, focused,
and intimate. Although a love bond tums the
partners'focus toward one another, the boundary
aound them must be somewhat permeable for a
healthy pannenhip. The loyalty berween partners
in a maniage of choice is typically sronger rhan
the toyalry to family-of-origin o'orher relation-
ships.
Falling in love as a basis for marriage is a 20-
century European and American concept. Howev.
e the love bond may be of increasing imponance
in.maniage historically. As women and girls are
allowed grearer acces to education and paid work,
e economic factors sustaining marriage become
their les crucial, and marital commitmenr becomes in-
creasingly more choice-based. Yer it is important
to understand the TG forces of culture and reli-
gion that have shaped marital stnrcrlr----even the
concept of maniage as a twosome-rather than
committing the "beta bias" (Hare.Musrin, 198i)
of assuming at all maniages ae alike regardless
of ethniciry. And in many communities and coun-
tries (e.g., in observant Islamic and Onhodox Jew.
ish families), marriage (or ar least e meeting of
prospective mates) is ananged by a msted elder.
Ethniciry, religion, and class ae so fi:ndamenral
and crucial in defining the concept of a "marital
dyad" at I discuss them in a separate section of
.L:- ^L^--^-
urD LrrdPLc(.
Enpathy and Mutuality
There is a flow of empathy or understanding in a
healthy maniage-a shaed framework in which
each panner's behaviors and ntentions are for the
murual good of the couple. It is difficult for part-
ners to build empay unles each member has an
imaginative sense of e other's experience. Em-
pathy partly comes from dialogues in which each
parmer confides the personal meanings he or she
derives from the maniage, personal beliefs, and re-
sponses to past events that have been signicant
and formative. Empathy is aiso to some extent a
developmental ability that requires an intemal
sense of well-being and the wish to be consider-
ate and generous with othen. In dysfunctional
families of origin, painful or traumatic events and
disasters can destroy anympaic connection and
tum members aside into self-absorption, haned, or
mismrst (Boszormenyi.Nagy's "desmrctive entitle-
menr").
Thee is no term for the shared emotional
"flow" that occun in satised couples. This flow is
referred to as "give and take" in contextual eory
(Bovormenyi-Nagy & Krasner, 1986), as a sense
of "we"-nes (Whiaker & Keith, 1981, p. 192) in
symbolic--experieltial theory and as reciprocity
in behavioral theory. I prefer the term "mutual-
iry," which implies that ere is a back.and.fonh
affective quality: "One exrends oneself out to e
other and is also receptive. ... There is openness
to influence, eotionatavailability. ;'...There is'
both receptivity and active initiative toward the
oer" (Jordan, 1991, p. 82). This interconnect-
edness sustains a couple during times of confict,
because parmen rely on eir frurdamental attach-
ment. Thrst evolves from the reciprocity: If one
the paftner en responds
i:il:il:*.r*er'
Mutualiry and marital 4d pro 4n iawlve
agreeing to clear rules. Rules ae unique to each
couple and ailow parmen !o carry out their re-
sponsibilities and commitments as a ream. In
healthy couples, the agreements and requests are
not oriented so much toward "doing'as towad
"supporting"; tradrng car repair for housecleaning
is nor mutuality. It is the sense of bilateral agree.
ment belund e responsibilities at constitutes
mutuality. rhen empathy and consideration are
flowing back and fonh, each parmer has a feeling
of being understood- Attachment theory considen
this quality to be cenual in producing emotional
security in couples (Silverstein, Buxbaum Bus,
Tuttle, Knudson-Martin, &. Huenergadt, 2006).
There is a dimension of imagination in
healthy couples: Partners can share fantasies,
hopes, and expectations together. In secure mar-
riages, emotional energies are freed up to antici.
pate the fi.rture-connectedness that transcends
today and adds depth that may not be apparent to
the casual obsever. Paftners have murual curisity
about each other. lt is a good sign when couples
come together to marital erapy because one or
both panners want to increase marital satisfaction.
When a spouse refi$es to participate in the emo-
tional work oftherapy despite an available and ca-
ing therapist, e ensuing distance will likely harm
the marriage. The death of hope and imagination
is a primary sign of eventual marital dissolution.
Differentiation, Comm itment,
and Maihloie
uDifferentiation"
is the abiliry to experience dif-
ference, the selfas separate alough in relation to
everyone else. Many definitiorrs have been offered
to conceptualize differentiation and what compris-
es "enough" or "good" differentiation Bowen was
foremost among writen rrying to dene and ex-
plain differentiation, not only psycJrologicall but
also biologically and sociologically ( 196/1985a).
Well-functioning couples are able to ctrange
their dynamics over time as shifrs in family and
social network produce "reality snesses of life"
(Bowen, 1966/1985a, p. 171)..The panners' fa-
miliar ways of interrelating haie to adapt to e
inevitable triangles that fonn rough oer com-
mitmen6, such as children, friends, famil and
work (Vhitaker &. Keith, 1981). Relationships
uoutside"
and connections the dyad are accepted
and encouraged between.healthy spouses. When
each parmer has a differentiated sense ofself (self-
identity), he or she can be resilient in the face of
change. \lithout self-awareness, partners revert to
emotionally volatile, reactive modes of respond-
ing, and cannot tolerate stres well. Bowen specu-
lated tlut "the highest level ofdiffeenriarion rhar
is posible for a family is the highest level that any
family member can attain andmaintain against the
emorional opposition of the hmily unit in which
ffie livel' (Bowen, 1966/1985a, p. 175). Bowen
believed that the capacity for differentiation be-
comes gradually more and more "setn over gen-
erations, with a dorvnwad drift into what Bowen
termed "undifferentiated ego trrass,' or family fu-
sion. Cenainly this is seen in families with a multi.
genearional hisrory of violence, incest, addiction,
or neglect.
204 I. MODELS OF COUPLE THERAPY
Differentiation includes the ability to discem
one's Lntemal emotions and thoughcs, ro identifu
them as separate from othen'emotions, and to
mainrain one's own observations and judgment-
one's own "voice.' Differentiation includes per.
sonal goals and direction, self-knowledge, self-
guidance, and self.soothing. It allows personal
probl'em solving and self-cone*ion. Since the
1980s, when science began to study female, as
well as rale, development, our view of differen-
tiation has been modified to acknowledge that
self- knowledge always occun in the context ofsig-
nifrcant, long.term, intimate relationships-"self-
in-relation" rather than "self' (Boszormenyi-Nagy
&. Ulrich, i981; Fishbane, 1999; Knudson-Manin,
1994). Differenriarion is a prerequisite to a healthy
maniage bcause when one can be emotionally
sellsufficient, then "dependency on each other is
voluntary""(framo, 1981, p. 139). Neither parmer
feelsur.dened from consrandy having to be in the
"helpef role, a siruarion that Bowen referred to as
"losing'self," popularly known as codependency.
TG models view differentiation as a comer-
stone of peogle's ability to enter into long-term
commitments and live together. We have only to
look at maniages in which one or both spouses
-trivial
have poor differentiation to see how even
and unimponant disagreements.lead to defensive-
ness,recrimination and blaming, self-centeredness;
and discrediting the parmer.
Individual differentiation probably infl uences
how we selecorr parinen. Although rnany other
models of couple therapy do not examine isues of
marital choice, TG models provide a Famework
to undentand variations in commitment, marital
readines, and choosing one's panner. The reason
for this is that TG models do not view young trur-
rieds as individuals, but as members of rwo families
who have been launched (to a lesser or greater de-
gree), and are expected to form their own relation-
ships.
lntimacy and Healthy Athchnent
Attachment is e metaphor used to explain e
supponive propefties of commitred relationships
(Johnson & Lebow, 2000). However, auachment
has to develop hand in hand with individual self-
awareness. Maturna (personal communication,
March, 198), a reseach biologist, remarked rhat
from the point of view of environmental biology,
love is "the intention ro coexist." Attachment and
adaptation evolve in the conrext of mo different
people who have decided to shae their lives. Re-
search and clinical study in the areas of emotional,
traumatic, and developmental disorders have also
shown that there is a neurobiological element in
the abiliry to auach to loved ones (Siegel, 200).
The abiliry to regulate and integrate emotion, ro
engage, and to respond are neurological activiries.
Secure (consistent, empathic) attachment and at.
tunement to others require a healy mind that has
not been craumatized. Abuse, neglect, and disaster
survivors have difficulty wi secure attachment.
Maniage requires a significant amount of "ac-
commodation" (Jory Andenon, & Greer, 1997),
or tolerance. Individual diffeences demand that
partnen accept each other's limits, in spite of
whatever expectations each carried into the rela.
tionship. Accommodation is part of the "relational
ethics" of caring and faimess. It involves following
tirough on requests and expresed needs instead of
questioning or criticizing each other's vulnerabili.
ties. Accommodation does not occur unles pan-
ners ae able to show faimes; in families where
pathological hurt has occurred, faimess can be
erased or distorted. For example, in the situation
of the retrobing shte (Boszormenyi-Nagy & Kras-
ner, 198{), people whose families have harmed or
'wonged em tend to feel entitled or that they are
"owed" compensatibn in thei own families later. If
there is. not d reasonable amount of accommoda-
tion in e maniage, neither parmer feels cared
for or safe. 'i
-l Marital intimacy also."requies akeen sense
of self.identity and self.differentiation. . . . In con.
trast to distancing, the feelings iruidz a person and
betueen people are critically imponant in devel-
oping closeness" (Fogarty, 1978, p. 70). To a large
. extent, people's.capacity for intimate relating also
includes willingnes ro exainine their own inter-
nalized beliefs about love, fulllment, caring, and
mutuality (Jory et al., 1997; Schnarch, 1997). Ir
is this self-examination that clarifies ei values
and expectations regarding closeness, reciprociry
sexual intimac and numrance, so that they can
evaluate maniage and identifr desired changes.
Self.examination is the direcr experience of
the inner self, subjectiviry, and "going deep" into
one's core assumptions and expectations of the so-
cial world. It is not posible to share this kind of
spiritual and emotional zubjectivity wth a spouse,
unles one is fust willing to explore and reflect on
penonal experiences. When rrutined, intemal-
ized beliefs and memories of love relationships
draw heavily on family-of-origin experiences.
7, Transgenerational Couple Therapy
Schnarch (1997) points out that intimacy is thus
a "two-pronged" process of both examining rhe
self and expresing one's self to the panner. Pan-
nen who ae capable of self-validation rather than
approval seeking are beter able to contribute to
their marriage. This view of intimacy reflects the
natural systems concept that chronic anxiety (e.g.,
approval seeking) is a relational obstacle.
Defining "Good " Communicaon
The prevailing view of couple communication
that "good" communication provides active listen-
ing, openness, and empathy toward onets parmer's
views. However, in this "open" proces, e con-
nection beveen parmers is not necessarily "good."
There are many forms of"open" but troubled com-
munication as well: spilling of anxiety (venting),
expressions of self-doubt, unesolved issues, and
projections carried from other relationships. In
contrast, "good" communication is dialogue with
personal accountability and is relevant to the pan-
ne who is listening. Concems expresed must be
resolvable, the stress level has to be controlled,
emotions must be contained to some degree, and
the spouse must have room to respond; A good
dialogue occun between two people who ae re-
flecting on an issue from different vantage points
in which each has some understanding and emo-
tional equilibrium.
.T. is view, called 'telf-validated" (Schnarch,
- l99TI,communication,. creates' gender,specific.
tasks for couples in therapy. Women are socialized
to move toward the parme trying to clarifr their
feelings through connection with oers (Jor.
dan, Kaplan, Miller, Stiver, & Sune 1991). fu
Knudson-Manin and Mahoney (1999) point out,
.
women may feel presure to "seek elatiorship and
connection," sometimes compromising or 2p.
pressing parts of tliemselves that appear different'
(p. 331). Men, presured by gender expectations
tlut they should "protect their independence"
(p. 311), hide para of themselves tlut would fos-
ter connection. In couple therapy, therapists tend
to follow this gender bias and call on the ftmale
partner to open the dialogue. It is asumed thar
is will help the male panner leam ro disclose
himself. Gendepstereotypical behavior-women
punuing while men detach-leads to e bumout
(hers) and disengagemenr (his) tlrat ends maniag.
es (Johrson & Lebow, 2000). Ideally, good com.
munication involves investment of eadr partner!
mre, not hidden, self (Scheel et al., 2000). The
205
woman does not aim to be the "sole keeper" of
the connection and can formulate thoughts at
are different, and the man is willing to risk emo.
tional contact and can express thoughts that con-
IHE DYSFUICTI(}I{AL PARII{ERSHIP
As I have mentioned elsewhere (Roberto, 1992),
"smrcrural" (connectivity vs. distance, hierarchy
s vs. equalit conflict vs. cooperation) symptoms
reflect problems in a couple's emotional "process."
Strucrural symptoui are tmrisactions that can be
marked on a genogram. They may look like bound-
ary problems, in which rhe marital dyad is distant,
"locked" (fused o enmeshed) togeer in depen-
dency and/or frghting about it, or pseudomumal (a
socialrelationship with no attachment). The mar-
riage may be too open to intrusions ftom othen, or
so closed that a qpouse is punished for any outside
connection. The parmen may have triangled in a
third party. Or there may be extreme complemen-
tarity (codependent-addict or caretaker-patient
maniages); exfteme symmetry (rwo parmers with '
similar symptoms); and "tilts," where ere is an
imbalance of power or equity (e.g., the "dollhouse"
or "one-up-one-down" marriage).
In contrast to stnrctural symptoms, e un-
derlying process problems do not show on any
geno$am. "Proces problems" include unworkable ..
rypes of bonding nt produce stres and enotional. ''
pain. There may be unrealistic or desmctive ex- I
pectations, such as contempt, disrespect and ridi- ,
cule, narcissiim, or exploitiveness. One or both I
paftners may have problems wirh idealization and
perfectionism. Or there may be indifference, sex-*..
ism, or prejudibe. Proces probleris easily escape;r'
discussion in marital therapy, because they are im- '.
plicit in thought, difficult to verbalize, and painful ''
to admit.
Delegation and Negatiye Attibuons
"Delegation" is e nansmision of unesolved
family stress onto a child, which is inremalized ',
(Boszormenyi-Nagy &. Krasner, i986; Stierlin, ,
Levi, & Savard, 1973). The child experiences "ob-
ligation," leaming that his or her personal wishes
are less significant than family needs. As the off-
spring tries to carry out e expectations delegated
to him or her, choices become nanower, and the
obligations become a heavy burden. The sense of
206 I. MODELS OF COUPLE THERAPY
burden is usuallv not in conscious awareness and
is instead expresed in the maniage. Paul (196i)
commented on how "losses and associated sense
of deprivation lead to deposit of such affects as
sorrow ... guilt ... bittemess, despair, and regret"
(p. 189).
There can be "displaced exploitation," such
as expecting the spouse to share the sense of ob-
ligation also-especially with family of origin.
These are rhe situarions in rvhich a husband dines
rvith a parent several tinres a week and expects his
wif'e to participate. Or a rvit'e expecc to nke in
an inesponsible sibling to lile with the couple in.
definitel.v. When Jelesated child lacks empathy
for him- or herself, by extension he or she lacks
consitleation for the spouse.
Pro.jection has been ivell discussed in rhe ob-
ject relation-s lireratue-in fact, it is part of rhe
oldest literatue on couple problems (e.g., Jackson
& Lederer, 1968). $'namicallv, the bond l'ith
a parent is icleali:eJ in childh.,oJ, an,1 painful
events are oilen distoned bv chrldren to maintain
that ideali:ation. As a voung person splits ott nega-
tive or problematic characteristics of the parents
or elder siblings, these perceptions are suppressed
to maintain the loving connection (Fairbaim,
1952,). Clinicians ae tmiliar rvith the problem
of an adult child of abusive parents, who refuses
o admit that rhe parenrs rvee busive rnd in-
steird overreacts when the spouse raises hs or her
voice or makes rhe slightest dissatislied conmenr.
When the spouse hen protests, rhe negative reac-
tion seems to validate those projections (Robeno,
1992). This is ,rne ol the central problems of abu-
sive relatiunships: The r.itrlent., lusive parturr.
.llticu i:
n ht hrm- ,rr herself u a. ,rnce hame,l, hils
t eliclrng lhlr rhe,'thcr a.lrE:. F(c:r.t:c lhc p:rrrnr.
iiid not -.h.rv canng. There cn ls() hc "mutuai
.utriL,urr,n" (Dicks, 196i), in rihich cacir spouse
pcrccivc,i tire ,rthcl s simila r,t hurtiLil Feri()ns in
rl're past.
Wh'r le c,rnnot .lccept in rrursclvcs, rve .ic-
uv-nJ then
JerFise it in ,tur r(nihcnt ,rrhcr.
lu rhe pirenrrrtnon ot "l,rLrtectile i.funncl)trr-.r1. '
lhc slouse is i tetteJ ic[ol)c()rislr) rrs ltr'Lnq ccr-
t1in .rtntrilies r)r reci,
'ns ith
u irhrch l e uur-.e1i es
srruggie i.ur trii n.'r r.imrr, For crentpic, -r '.r'rfc
ini' teel ,:itici r,nrJ her hu-.it:in.{ -. Jerrrtr,tn ,r
irt. rnrrk. r'ienrng ilLnt ,1-i tL\) j(tit-,rr-lcntel:
firc t
me time. ,,he pu:he. irer.e ii -rnJ cven'r)ne lrounLl
irer rorrari her ,,u n ltral: t..r uccc:. It i: nt r li.rr.i
:L,r lntlcr:ilni h.,u hc-.. i.'ng-.t,rnirng, .ii.:,,lrr.e.i
irrc(ftr n- - rnc r. e. .rrl ih. .iccn rnJ r:rr:.rr'.'
rrtlCilllrcrlr I r l:1tn.llc. i...'u.c -iil. . n. r
conscious or deliberate act, it is to some degree
inevitable.
Through understanding the d-vnamics of sup-
pression and projection, we can recognize Gott-
man's discoi'ery in the narrrage lab of negative
anributions as an example of projective behav-
ior. As he and his colleagues noted, this problem
spells the end of marital viabilit-v. There can be no
trust in a maniage ii there is not hope that it will
comfort and give support, and attributions are self-
fulfrlling prophecies thar do not allow healing ro
take place.
Fusion and Distancing Patterns
Fusion
Natural srstems therapists cored the term "fusion"
to describe the "glue" rhat makes some couples too
attached. ln fused marriages, one partner tends ro
geater passivity under stress than the other,
-shtrrv
and appears Jependent on the other while seem-
ing to give in or adapt. Bowen\ (196i1985a,
1972/1985b) group believed that the overly adap-
tive partner loses a sense oicompetence, while the
unileradaptive partner seems to gain it, Over time,
the panners merge into a tightly locked unit, with
lirtle overt conflicr. Bolven\ rheory holds that the
"comperent" spouse is protecred tiom stress in this
rva\'-at the expense of the "incompetent" spouse
(Robeo, 1991). One o both partners linally iorm
emotional s-vmptoms-usually the overly adap-
tive sprruse (Btwen, 196/1985a; 19i2l1985b;
Ken, 1961, 198r). The "competent" spouse, who
is grining tunction,rl "-.elf' tiom rhe other, may be
com-.leteir uniiwiire ()i thc .g55u., on tl-te "in-
c(rnlFetent'' souse. Ti-re onilict that Jrives them
ittr,, drcr;rp.v cottcs ilhetl nerther .pouse rvtll tur-
th.r ccommo.lite rhe rrther rn the fusion, or when
thc cne rvho firnerll qave up self cannot tunction
ren rveil iinvm()re .
in he natLr:rl r\:stenls vie\v .f tuston, the
''l.rcking" [ogetlrer
r-rf Ftners is seen as a esponse
ar) cilr0nic .t\lct\ i\r ''ullresr)i\,ed emorronal
'.rhmcnt' r ' I lr.runan. u.ri tlunrLt ,'f ' ri,trn
rB.rlen. L9?4). Fmiir mernlers re Jraun intrr
rntcl1:c :in! .inrrcli -ir.iJen !rr-rlilons u ih each
ther The rnxetr ievel rn rire milt' resultr in
, irrck ,i fi-.crr,. ,,n :elf nd otertbcr,rsng ,.n others.
''Frtmiir pr,.rjecrirrn pn.,cess.'' ,r relate.l concept. Je-
.ciL.cs htru l.rtlcular chrlJrcn become enrneshed
:l) ., lnl|lg.c r rrir -h. .lrenL.. th.n nrl -o Jcvei,'F
r"irfierentiatc') .r rocus on,eif. in an rnteresting
, empiricaL itulir |,f trLSLon lrnLi tirrnrlr projection. al-
7. Transgenerational Couple Therapy
coholics who were children ofalcoholics and their
nondrinking spouses showed similar scores on a
codependencv measure. They also reponed simi-
lar levels of dvsfunction in their families of origin.
Participants endorsed items on a f'amily systems
questionnaire indicating low individuation, high
anxiety; low ansgeneational intimac-v, and lou'
spousal intimacv (Pres et al., i998).
U nconscious M arital Contracts
Object relations theorv maintains that when an
adult has not addressed important developmental
needs betbre leaving home, they are played out in
mate selection. This has been called an "unc,n-
scious marital contact" (Sager, 1976). In those
areas in rvhich we feel inadequate, we project that
need and are then attracted to others who appear
correspondingly stonger. For example, a woman
who believes that she is not competent to make
decisions mav seek out a spouse who seems m,-lre
decisive.
course, she then experiences frustra-
tion when he is decisive because in realitv
can make workable decrsions and only assunred
tha his rvere pret'erable. A man who sees himself
as abandoned and vulnerable mal choose a part-
ner u'ho appears self-conlident enough to protect
him. Atraction is extremelv powelul between
incomplete or suppressed pans of ourselves and
the image we ibrm of another who appears more
comple[e. lt is very difficult to tbrm a dispassion.
ate perspecrive on this unconscious'agenda until
well into a marriage, rvhen the spouse show human
iiailry anJ fhils to tulfill the rvishes and desperarelv
JesrreJ missrg qualities.
Transitii,ns ,rnJ Lr[e chailenges hrmg a iecl-
ing ernptinesstnJ ct ntusion. The tensirn thrr
'.f
accompanles cmptrness challenges our senie ,)t
competence, an,l aduLts turn to their manizrge
anticrpating )uf'ptt. Mut Fe('nlc r\FeLi r. ln
each other cretes nticipation nd Jeman,is, .1ts-
appointment, hurt :rnd anger. The e\Fectatlons.
which airvirvs come hom past experience rrutsiJe
ar- lhc InarilJg(. -tre.: rh. rc].tlt'n:htF (F, i:lrtr'.
1973). Ech pilrtncr must L.e ble to oLeate .lis-
appointments nd un,iestanJ his or he ouu Jit-
satrsfacrion. ln ihe process,'irne shoulJ not erpect
anv more non husband ,rr rvif-e than he uoul.l cs- p.
pect om an\' lnn \)r womirn out,.iie rhc tanilr'
rF \Ji. fhc.c.t.rrtlilrg rsnrlrk.'ir r:rrnit'hc rn-
snctiue sense oi rntinlac\' s t,)getheneis.
i
one extreme rm erf uncrrtscitlus cJntr:1ct ls
rhe self-iuitillinr prrrphecr'. in rlhtch a partner ts .o
greatlv iistres:cJ l\' tears rrr n\lcties in rhe lltL-
207
riage that he or she actuallv makes them come to
pass. For example, a man whose mother left him in
childhood mav be so riddled $,ith iear that his $'ife
u-ill leave him, or be unfaithful, that he pushes her
arvay with his doubts and suspicions. Pathological
jealousy, pathological guilt, and destructive enti-
tlement (Bos;ormenvi-Nagy &. Krasne, 1986) are
examples of self-fulfilling propheo'.
Marital Violence as Fuson
lvlaital r,iolence is prol.ab,lv the premier svmptom
of marital fusion. GoLdner ( 1998) commented par-
ricularlv on thc "compelline. automatic projection
that has come to possess the [abusivelv
process
connectedl couple" (p. 277, mv brackets). In bat-
ggl -spouse svndrome, batterers retain a sense of
contol and personal meaning. Because the bat-
terer irirhtcns hit ,,r hcr iFuuse into agreement.
the victimizeil spouse progressivelv Loses any sense
of self.rpart frorn tq,ing to contain n.l lo,rk ,ut
fbr the next episode ofviolence. Both partners are
she reluctant even to seek help without the othe-a
ci)mple:( situation thlr forces therapisn into inter-
vierving them together, Jespite the danger in the
home. The victimized partner, rvho spends energy
adapting to the demands of the riolent, poorlv
contolle,l partner, ceases ro be self-protective
,rvcr trlr. InsteJ. he ,'r .hc heeomes lrotective
of the banerer.
Exploring tarnilv histtries of abusir,e spouses
has clarilied some confusing irspeets of violence-
lbr example, whv there rs TG transmission. The
ct,ncept,li "Jestuctivc enitlement," discusseJ
l.rrur ilt lhi. -italc;, .{cs.rtl'c. :hc crflrrititc he-
havn,r ,,i abrisers ,rs a teaction to milv-t,f-.rrigin
,il.uc: ii,ne's parent \rls ll()t .tccountable tor hurt-
Lng rlrc r:rnrth. ritcn *iry {n'ui ')nc i'e rct..unL-
.rhie to tne': srtr-ss 1lw1 Denial nd ninimi:a-
'i, n. :r'., f('.\ rth :he . i, Icnt tntilt ,i,'rl:rn.
"r(,1
rc rJ. -,'
lrk .,i ,..''rurr:rl'tlirr ln ,'n(. ,,wn mtr-
rrge Lrrr. llrtJfi,,lt l. irc lurcst iorm,,ftusi,,n.
T,r Lrnpack rtnt ,ti he-.e unJerh'tng issues
rn rirc mritrl fusL,rn, 'c,treui iec..nstructitut .if
cch in.livi.luai's per:r rnul h1ruiv is ltecessarl
preenf,lc firr rhe m,,rrllv crucral Jiscussion ofper-
:t'nal res!.onsrliiitr' ,rnJ .rqenci" iColJne. i99r\,
Jii). lon. usinq rntllnitte iusice theor!. also
)llt ht to eirf ,, r,tleuce, I'ncrc inust ne in
f (tlnt-i L
exmrnation,ri rnrcrnali:ed timtl! expenences.
.tne nl.lt..r,linra.r;,l1tcr'.'(r'ltr-n :n\r'hcs'c\P].,r-
lng \nericnce5 ivith lrtU\\'ermcnt, li-(empos'
erment nJ the atLr:c. ,,i ...11's rn rh rnrlv ,-tt
,,rtgrn'' lJul .\iricl:rrtl. l:199. p l jr'l).
208 I, MODELS OF COUPLE THIRAPY
Triangles
Fusion is expressed not only in "locking together"
but also in the eactive contlict and backing awav
that ensues. ln manv couples, periods of depen-
dency explode into anger and pushing apart. The
marriage is unstable and shifts back and fonh be-
tlveen two poles of coming together and backing
away. Couples react to these exemes b.v pulling
in a third person, who moderates the closeness and
distance bv being available to one or both partners.
This person becomes a "boundary keepeq" rvho
stabilizes the shifiing maniage (Bvng-Hall, l98tl,
p. 355), much as a goalie guards a goalpost and
keeps the ball in plav The partners then contin-
rheir back-an.l-fonh shifting. approaching and
ues
then backing away, but without extremes. Com-
mon triangles include flairs, job entanglements,
or ibrming a famill or child "coniilante." Hol-
ever, 'nce the trienglc has become persistent, , 'ns
or both spouss begin to have lo.valty binds, and it
is ,iifficult to tbcus attention on rhe marriage. ln
many couples, emotional triangles rnay afrect the
very future of the elationship. Extramari{al allairs
re a Jramatic example.
Children are otien the most common third
parties in a cross-generatlon tnangle'called a "cct
aliion." The cLruple becomes chrld.focused o
creates a "three-u'av marriage" (Palaz:oli, 1974).
The couple maintains stability lbr Jecades of chil,l
rearing, with one i)r both pafincrs rel,ving rrn a son
or daughter forlupport. When the son or Jaughter
becomes more separate from the parent(s). otten
aiier inJir,idual therapr', thesc maniages Jestabt-
li:e (e.g., see Braverntan's 193l That chrlJ's
'tudv).
'nrerse.i rn.lnn,lence. \'rn llter ln lite, arr lte{
a signilicant ios ti-,r rhe parentl-i;. The su'bseqLrent
emotlonal Jlsrance is not halnceJ bv -.tong
lnarllaqe e.
The other nost comm()n thti c,trtl ts ,tn rn-
L1w, usuailr a mr)the-in-la\\'. L)ne .,r ht-.th i i:hc
spouses remlins highiv interconnecre.l $ith thc
morhrr. uho mJlntarns .ln .lcil\'( l3n rn rhc a'\tl'
ple's relatitrn-.hip. occupies ttme. t.ls [) Liecislr)11
making, anJ turnislies support. Ho\rever, the,rriet
-rbout he harm caused bv thi. cross-generational
trranglc c,'nthttl. V'c.rcm e,rnrcrn dl','Lrt Iilc frl-
macv r)i the married pair irnJ he rnis,,':r'nis i.lert
rh;i imir tntcrjcicnJcnir ,. r r' iie:n. Th.
concept \)f !ross-qeneratt,lnrl irianglcs ,t. J!lunc-
ri,rnai culurailr LinkeJ r \\'esem in.iivi.ltLiisi
is
.rciercs (Faiicor, l99S). ln e.rilecill.t cultue,, .rr rsk to piar ,rut tl',rs revollrng sLate oi "l'ho gets
)uch .ls ,\5ian. East lnJian. \leJitcnnean. .rnJ
Larino societies, the weight of the parent-child
bond is equal to that oi the marital bond and may
acnrallv be more endurLng and important. Em'
parhv and eceptiveness between a parent and a
chiLd are expected, and differentiation from the
lamily of orrgin is not expected or tolerated.
Entitlement and Revolving Slates
Anl discussion of attributions, projection, and
mutuai projection leads rnto discussion of "entitle'
ment," which is the expectation that because one
has sacrificcd tb others, one deserved acknorvledg-
rnent and consideatitn back (Boszormen.vi-Nagy
S;. Spark. L97J; Bos;ormenyi-Nagy . Ulrich,
l giJ 1 ). "Destructive entitlement" is the belief that
one is berng ,lenie.l ilcknowledgment or consid.
eration. Helthv i-eelings of entitlement begin in
tomarive rears, rvhen a .voung person is given the
cae and attention that is part oi normal iamilv de-
i'elopment. ln d1'sfunctional f'amilies, unmet needs
tbr care and acknowledgment are canied tbrward
rnto adult love relationships and maniage as negii-
tive felings of entitlement. In a painful and unfair
"rerolving slare," the positron of "giver" is passed
on ro the spouse. N'leanrvhile, the partner who feels
destuctive entitiement teels justified in making
demands anJ expecting care from his or her mate,
becruse it should be his or her tum to benelit.
PeopLe caught in a revolving slate of une'
quited carinq rvith their famil.v of origin, plav out
this unresolved problerir with spouse. I belive
rhat manv repeeting marital pattems seen on
qenogram rre the result oi the revolving slate phe-
nomenon. For example, the neglected son ofa busr
frrthe nar e\f,sct th.It his spouse rvill let his ou'n
lrt.e rer.rire rronrl hin1. On the maital genoqram,
\\'e see ir "Jocted line" ,rf Jistancing betrveen the
"cntrled" man nd his tather, :rnd the same "dot-
red [ne' l.enveen rhe nvo husbands norv. Whita.
ker, lokrng bor,rt pr,hLems of the revolvtng slirte,
c()lnmented rhat marriages are "reall,v just t\vo
:cpcgoats sent Jut bv nvo iamrlies to repro,luce
crch ,.rrhe. ... The hattle is rvhich rrne it rvrll be"
i68). Destuc-
tcitc,l in ;'r..erll S Knrskern. 19EJ, p.
n e entrtiement ln mrrrtage is mos clearlv seen tn
c,rtlepenient malrlages, Somehon'. one Lrrtners
LrecJs nJ fercslti()n\ e valued as mte impor'
i.rrr. nJ tn(.'tlrEr;'.trn(r'- ncels lnJ fcr.cFtl, nr
,ue ,rlerioukeJ hv b,rtir ,ri them. If the situatou is
nt rcctrtle,i. he chri.lren in that househoiJ re
:il.l r|ho i-llvcs.' ln m.rrrtal ther;rpt', pointing ou
7. Transgenerational Couple Therapy
this risk can be a powerful motilator tbr a code-
pendent spouse in setting limits and leaming not
to make so manv sacrifices.
f ,,^g
^;^+^ -^,-^
ut5Lat tLtr\ ^^/ru vuLUtl
ar
Chronic tusionlcan produce a ilistanr marriage.
For example, in the distancer-pursuer pattern' one
partner tries to speak tbr, approach, oi dras'out
the othe'-s concems, and usuall,v miseads them.
An overexpressive spouse pursues an underexpres'
;ive spouse. In rum, rhe unJcrexpresstve partner
acts without expressing his or her thoughts or ieel-
ings, leaving the "mind-reader" to fbllou'along
completelv mystilied and usuallv approaching
again for some explanation. The more nonexpres-
sive one partner is, the hatler the other lrne works,
and the couple becomes trapped in this pattem,
with one as the "rock" and the ,rther as the "emo-
tional rvreck."
Signilicant tension underlies the distancer-
pursue pattem. The tension is elated to each
partner\ Jeepl.v held beliefs about how to gain
securitv and love, desire for r.alidation fiom the
other, t'eas of the dangers of conflict, an,l expecta-
tions about who must do the work in a relation-
ship. These beliefs and tensions ae intemali:ed
from previt-rus relationships, including experiences
with the tamily of origin. Distancers want to see
themselves as self-suflcient, and carn an iJeali:ed
an,1 depersonali:ed vier'- of marriage that tenJs to
break doin uhder stress. Prsuers see themselves
as dependent, and helieve rhat their hrrpe for a vi-
hle marrige cr)mes tr()m carrving both patners'
,lissatistactions sc, thev crrn untlaterallv 'patch up"
reas oi contlic. lt is ls. possible to hr-e ,un-
metrrcal Jistirncer-ptrrsiler fi;tttem in rvhich eci'r
spouse dances to\rall the other, then rvev, like
rhe characters Scalett O'Haa n.l Rhet Butler
in rhe 'ook t ione u rrh l \I in,l.
The exteme oi Jistancing is cuoti. Ceninl
fcatures of cutotf include mintmi:atron r)r Jenlal
f trachment, s ii rhe relaionship never existed,
acting c.rrnpleteiv seit-.utircient, rn.1 even phvst-
crill running rvav. Th. cutot{ ls n()t :ublectiveLr-
seen as a problem, lut as a justrtie,l teeiine that 'l
h:rve to get awav honr this." At the receiving en.i,
the partner rr ho is cutting ,rff >eems tr) ha\-e great
-reit-ietenrnrrtliln, :trength. .rni t1,..e iell-cstee:1l
than the partne,- lho i-, Ief lehinJ. lir rtaLitr'. L
retlects seree Jecrts in the alihrl to toleritte tius-
trlrti,)n. to preser|e iroc in the trce r, arLsis, .]11!i
trt mlntain connection unJer :tre-.s.
209
Religion, Culture, and Class
Feminist-informed theories of cultue and the fam-
il.v have provided pou,erhrl larger.svstem explana-
tions for marital dystunction. Feminist theon fo-
cuses on the ways that male-centered culture rules
how husbands and wives difierentlv approach
marital conflict, problem solving, intimao. man-
aging stress, self-empol'erment, sexualitv, finan-
cial and emotional power distibution, and even
delining what constitutes a problem or a marital
cnsis. Each TG moJel in irs .-rriginal fonn. htril
in the 195tls and 1960s, neglected to examine bi-
ases of male-centered culture (beta bias). "Beta
bias" hee would be the assumption that gender
Jiffeences are unimportant, thus placing them
outside the scope of discussion (Hare-Mustin,
198?). Syrnbolic-experiential theorv does point
out the impoftance of rddressing eender inequi-
ties in martal therap.r', either by moving couples
tou,arJ egalitarranism. rr acknrrvledgrg justice
issues for women, such as the need for autonomv
rn family Life. Yet there has been linle tbcus on
gender inequities in maniage. For example, femi-
nist theorists rvould argue that entitlement is gen- .
dered-that in maniage, the needs of the husband'
tend to be value,l as more rvorthv than the wife's
needs. Slipp (1994) has pointeJ out thar because
male children are pushed arvav fiom nurturance in
their socialization, thev carrv a certain amount of
destuctrve entrtlement into maniage. If, in this
-transitional
societ-, fathen were to pick up nurtur':'
,' i
'Jt
ance functions ior their sons, there would not be a'
Jeficit tor thei sons rr caq tnto marrtage. ln rhe'
past JecJe, temrntsr theorl' ltr,, r,,.rr.J,nur. u.f'
iarger-,.r'stem prirhlems. unair':ing s,rcrai and t,lrtt-
raL m,rvements tht colo thc cxpcctaluns of lncn:
n,l w,rmen ln marrlitge. The rmplication ttlr mari+
tal therapv is ht rhe theraprsr must take r posi-
il\'n rl'L)ut th. iarg.r.r\tcn) Lhdf lEluscs I,, ign,rr(
venJer inequin', ,,r else the therupist will b in the
posrtron of L.eta bias. .{s GoiJner (1995) put i,;
"Given rht rve te bom lnto a svnbolic nd ma-:
terial rvorlJ that is irir gcnJercJ ... -r 1,rix-
.rble to ',r,esate its ettect-..,n mtnJ anJ cukure.
... $'e cnnot ;ee ihrough {enrler to tire pers()n
'inside,' since qenJer and ;eif hr'e co'elriveti,
rhr.rughtrut the .levekrpmental process" tp. {i.
Even ii crruf lc 1s not -1$itre ,\I 1rr aalrrl]ilinlng
rbout inequitics in ll.reii iiilriiirgi .rr irnihcs ;
origur. rhe culturil,; competent marital tl-reraprsi
nu-.t ,tJJess the Lmpact ,.ri cult,.rral teetrt|Fe-' rrn
the couple's tunctonitlg.
 2r0 I. MODELS OF COUPLE THERAPY
Therapists musr carefr:lly look at what is
normative for a familyt cultural group when
evaluating srrucilral or process symptoms. lvlari-
tal problems can reflect and even be mediated or
have their meaning changed by cultural issues.
Culture affecc how a family denes its members,
and where the boundaries exist within a family or
a multiculnrral maniage (lv{cGoldrick, 1989). For
example, not every nuclear family is defined as
penons who live in the home. In a Roman Catho-
lic famil parents, godparents, and the spouses of
sons and daughten are all seen as pan of the nu-
clear family. In an African American household,
neighbors and church fellows may be part of the
spousal support system. In a religiously observant
farnily, if a relative is a ministe he or she may be
of the nuclear family during
[ffir;,l..ber
In Easr Indian, Asian, and Southeast Asian
families, the inlans ae cenral to a couple's loval-
ties. Tiadirional Chinese and Japanese families are
similar in their emphuis on filial loyalry, and fam-
ily stmcture derives from Buddhist and Confucian
ideals emphasizing paniarchy and the extended
family (Tmura &. Lau, 1999). ln these families,
the emphased relationship is berween mother
and''child (especially a son), not husband and
wife. In extreme conBast, Gucasian Eurocentric
Chistian families (e.g., Brtish families) expect
the married pair to h split off ftom other family
memben when it comes to personal problems and
- coniems; parents and.in-laws are peripheral (T-
mura & Lau, 1999). The smcture of a family and
e boundary (if ere is one) around the couple
are defined by at least three to four genemrioni of
family tradition and ethnicity.
Generarional an{ gender hierchies are
culrurally lrrked. The idea I ust expressed-rhar
couples should move roward egalitarianism to the
extent at their relational symptoms reflect gen-
der inequities-is a Westem concept. The indi-
vidualist societies of e West locate the couole
as a unit of leadenhip in the family-, ,o ,y*rn.t
rical inteactions are considered ideal (Falicoq
1989). The "united fronC' of two parents making
decisions abour children stems from the view of
couple as a unir of leadership. In extended.family
societies, leadenhip is venical across generarions,
wi lifelong authoriry given to elders. For ex.
ample, Mexican American couples defer to the
parents rhroughout maried life, urtil e parents
are gone; hence, there is no srage of "personal au-
thority" in one! o',vn manied home (Williamson,
1981, 1982a, 1982b). Because ofcenturies of male-
dominated economics and lan', authority extends
through fathen to husbands to brothes to sons.
Emotional process is also cultured. For ex.
ample, the concepts of entitlement (what is owed
to us our spouse and family), destrucrive en-
b.v
titlement, and attendant problems such as the
revolving slate, cannot be used in the same way
across cultures. For example, the current genera-
tion of Korean American young adults has risen to
educational and financial advantages through the
personal sacrifice and hard work of eir parents.
They carry a tremendous sense of obligation to
respond by choosing work and maniage that will
please their parents. In Japanese families, individu-
al happiness is considered less imponant, and hap-
piness is consideed to be linked to achieving the
well.being of the whole group; excessive demands
by any one member wold disrurb h, or harmony
(Tarnura & Lau, 1999).
Conflict and communication are culturally
linked. In extended.family societies, where large-
group harmony must be preserved due to proxim-
ity and involvemenr, indiecr and implicit com-
munication is prefened. Rae than being able to
assen oneself and make "I"-focused statements in
the Bowenian mode, rhe couple relies on careful
listening to read wishes underlying each other's
much more compacr comments. Or, an ally is tem-
porarily triangled in to represenr the interests of
one spouse; for example, a wife may conde in a
sister-in.law, who tells her mother, who tells her
.- son (e husband) of dre r+iftb concerns. - -
Political movemenrs create legacies that are
expressed in maniage. Young couples now are the
third generation after the American Depression,
and it is no accident that many of rhem ae diven
by the job market and frnancial ambition_. Some
. middle-aged aduls whose parenc were rergees
during \orld War II have seen rheir parents sue
for intemational repacrtion. This historic set of
events will creare for some people a shift in social
identiry from "second. or third-generation Ameri.
can" to a more long-term, healing, self-respectful
view of family history. \le can also expecr ro see
changes in the social class and privilege experi-
enced by families of reparation, who, once impov-
erished refugees, are able to attain financial privi-
lege two generations later.
ASSESSIilEI{T 0t CoUPLES
Procedures for TG assessment of couples are not
rvell anicuiated. Several well.researched tests of
7. Transgenerational Couple Therapy
family functionng are available at use a circum-
plex model to assesses families regarding distribu-
tion of power, intimacy and cohesion, autonomy
and other important factors. These tools have
been underutilized, refecring e predominant
thinking that the frame for couple work can be
completely consmrcted within the manied dyad,
instead of being viewed as an extension of larger-
family problems. Thus, despite the wealth of infor-
mation about family impact on later adult func-
tioning, couple therapy is too often cordoned off
as a modaliry separate from family therapy. ln con-
trast, TG therapisa "puncuate" the problems ex-
perienced wiin a couple by looking ar rheir place
in the three.generation grid of their two families
during assessment.
It is also important for the therapist to un-
derstand what effects flow ouward from changes
within a couple, to their families of origin. The
two families, connected as they are to each spouse
in dyads and triangles, will be changed if the cou-
ple changes. In fact, this is one ofthe tenets ofna-
ural systems erapy. The two families will prob-
ably experience these shifts as uncomfonable and
unfamilia and will have their own responses. For
example, families with low differenriation tend ro
"pull" harder when boundaies ae moved, and the
pressure to move boundaries back will challenge
the couple. These responses need to be predictd,
planned for, and consideed in couple work (Ro-
beno. 1992).
but not dose
F|GURE7.l, Relationshiplnesonagenogram.FromMcColdick,shellenberge,andGerson(1999,p.10)
Copyright 1999 bv .L \. Nonon & Co., lnc. Reprinted by permission.
2LI
Genognms
Assessment usually takes place in the first one to
three meetings with both spouses presenr. Part-
ners are not divided up for individual intewiews,
unless thee are issues ofsafety and well-being to
be assessed (e.g., parmer violence). The major
tool for identifring problem pattems is the family
genogam. Genograms have been adapted in vari-
ous ways for clinical use. $namic markings have
been well developed (Guerin & Pendagast, 19?6),
so that dyad and TG pattems can be easily shown
(see Figure 7.1).
These markings are used ro make certain
couple interventions, such as pointing out re.
peated problem pattems in bonding; generations
of symptoms, such as alcoholism and codepen.
dency; or complementarity of behaviors. Initiall
however, genograms guide rhe clinician to address
problem-maintaining isues in either or borh fami.
lies of origin, and to plan realistically regarding
long-term family change. The time.line genogram
(Friedman, Rohrbaugh, &. Krakauer, 1988) plots
imponant family-of-origin events clearly in eir
time frames.
Genograms have also been adapted for clini-
cians treating specific types of couple problems,
such as sexual dysfunction, family illnes paaems,
spiritual and religious histories, medical and ge-
netic disorders at could affect planning ofchil-
dren, and even providing self-study for medical
2r2 I, MODELS OF COUPLE THTRAPY
students and ther spouses. Assessment includes
looking at hisrorical patrems of u:ork, religion,
and even political affiliation. For example, a hus-
band whose f'amilv has alwa.vs been religious, with
himself being the exception, u'ill probably mean
that there is tension between the husband and
his spouse, and his family of origin, and this ten-
sion probablv contributes to the couple's present-
ing problem. It is common to 6nd people whose
parents, gtandparents, uncles or aunts, and even
in-laws have all been physicians, businessmen, or
milirary officen.
Whereas in o*rer schools of couple therap
genogram information is used to look mainly at
family structure, the TG therapist is looking for
multigenerational pattems (e.g., Wachtel, 1982).
Sometimes pattems of relationship repeat them-
selvs ver generations without varying:spousal
abuse,'poor health, depresion or anxiery', under-
achieiement, abandonmenr and neglect, drug ad-
diction. These pattems feed forward nto maniage
problems, such as distancing, fusion, chonic mis-
trust, ommunication problems, or triangling in
rhird parries.
Finally, the clinician looks for critical inci-
dents (e.g., natural disasters), lived uauma or vio-
lence ("common shock." e.g., war; Weinganen,
2004), and immigration/resettlemenr and other
social upheavals that have created or challenged
family coping and resilience.
The clinician uses a couple's first one or two
sessions to identr$ key 6gures in each family,.of,..
origin, formative evenm in each family! past, and
the history of the marriage. Dynamic markings are
made to indicate proximity and disrance rvith kev
f'amily members and within the dyad, presence of
fusion or cutoff rhat may be affecting the boundan
'
around the marrige, and any repefitive parrens
found in more than one generation. For example,
rhe .vounger panner in a couple may shou'a pat-
tem of alrvavs defening decisions to her spouse,
and in he parenrs' maniage, her mother may also
,lefer decisions to he father.
The couple is asked for rhcir ou'n narrative
abour the problem, and horv each spouse perceives
its origin, meaning, and sequence. This rech-
nique is not Jifferenr frtm other svstemic, eien
ahistoncal therapies. However, TG rhenpists in.
cerview and observe couples rvith a "rvide.angLe
lens" (Roberto, 1992) ro inquire and rrack thee-
generational pattems of culture, marital and fam-
ilv structure. and beliefs about maniage. The TG
therapisr ri'ho asks a wiie her rheon- of whv and
hoiv she chose her parmer is not looking to explain
why they met, but rather for a theory that explains
the needs, wishes, and drives present in that wife
for many years before she couned her panner.
Spouses are asked to describe whether and
how kev familv members have eacted to their
problem to clarifr whether triangles exist and
need to be addressed. For example, in the classic
"mother-in.law" triangle, the husband acts disrant
from his rvife, who tums to her mother for advice,
following which the husband distances more. Of
course, assessment is not the same process as ther.
ap and not all triangles are targeted for change.
Howeve creating a "macro" view of key panici-
pants in a couplet problems helps ensure at a
clinician creates workable goals of change by
understanding the forces around the couple's re.
lationship. During. therapy, paticipanrs are alao
more aware of potential extended.family reactions
to marital changes.
Clinicians using genograms for couple assess-
ment must be culturally competent regarding nor.
mative family structures. The dynamic markings
for genograms as they cunently exist are culture-
blind and can imply that some relationships are
pathological, when in a particular cultural group
they are normative. For example, in Islamic fami-
lies, the moer, mother.in-law, and other female
relatives are an important support to the wife. In
a hierarchical famil religion and culture are gov.
emed by men. Class also inrersects with what TG
therapists consider' "norrqal" family dynamks. In--.=.
poor families, young women bear children young
fathers are not able to provide resources, and ela-
tives may become central to their lives as help-
ers, such u child care providers. Poor families are
more likely to experience- chronic srress, fragme-
'tation,
unemployment, illness and addiction, vio-
lence, obstacles to education, difficulty planning
childen, and broad lack of access to health cae.
Unless the geno$am contains information about
class, cultural, religious, and historical differences
at intersect with couple dynamics, the clinician
runs he risk of pathologi:ing couples insread of
understanding their needs and the TG meaning of
their symptoms.
Assessng Rel ationa I Qu a I ity :
The Clinical lntewiew
Each partner is inten'iewed regarding his or her
subjective experience of the presenting problem,
as uell as the habitual wais rhe parmers interact
7. Transgenerational Couple Therapy
around it. TG therapies do not bypass central
complaints. Rathe they use identified problems
to expand the freld of inquiry into e "macro"
context of the couple's long-term connection with
each other and with the past (Robeno, 199i ). The
object is to begin framing the family-of-origin con-
text immediately, so that one can retum to this
frame repeatedly while addresing the couple's
problem.
TG erapies utilize classical circular inter-
viewingto identifr unique differences in each
partner's views. The binocula picture prized by
systemic erapists emerges easily in initial as-
sessment. Each spouse attaches personal mean-
ings to events in the maniage, and these personal
meanings must be brought into the dialogue. For
example, a man may personally feel that he has
deliberately tried to depend more on his lover to
show his trust, whereas his lover believes that his
increased dependence is only a temporary reaction
to stress. Tlr indvul meanngs auu,lvd m tlw cou- tone gives important clinical information: The
ple's expuences mewedu thc dynanic cueaf couple
t^eruyy nhigltight prtner's emotiomlneeds anl
each
the fanib irheriwue fuhh1t tlwn. When the dif-
ferences cause confusion or conflict, e couple is
helped to frame them in ways that are protective
of the marriage.
Timing of symptoms is very imponant to TG
therapies. Once each parmer's view of the prob-
lems is elicited, the clinician works to consmrcr a
hypothesis that accounts for their.emergence at the
gesent.time. Most marital dysftrnction.involves'
repeated impasses, not isolated or short-term stres-
son. The clinician must have a theory about when
and why those impases reached ninaway propor-
tioru. Many long-term emotional pattens com-
, , bine with life stressors to "blow upn a marriage:
uruealistic expecra[ions, feelings ol entirlemenr
or frustated wishes, low supportiveness or empa-
th lack ofself-eipression and warmth, legacies of
abuse, and maltrearment or losses at color part-
ners' abiliry to extend trust or be trusrwonhy.
It is important to address the disribution of
power-power to name problems, power to make
decisions and to problem-solve, power to make re-
quests or claims on one's spouse. Cunently, there
are no dynamic markings to depict power relation.
ships on a genogram, nor have we a precise lan.
guage to describe power. Assessing the distribution
of power in a marriage is as imporrant as assessing
ia affective and functional qualiry. Although some
clients mainain tlLat they do not mind an unequal
balance of poweq too often ey avoid e issue,
213
because power affects privilege and resources in a
relatonship. For example, it may be easier for a
woman to claim she has lost sexual desire because
she is depressed than ro admit she is dissatised
with her mate. Money and sex are good illustra-
tions of how a couple manages power: Are the
decisions democratic, unilateral, obtained unde
pressure, hidden, or avoided completely?
To be "emotionally intelligenC' (Schwanz &.
Johnson, 2000), beginning interviews must also
include assessrnent of affect. Affective facton in-
clude the degree of securiry and mlst in e mari-
tal bond; presence of negative attributions and/
or disrespect (two of Gottman and colleagues'
"Four Horsemen of e Apocalypse"), signifrcant
reactiviry that might stem from frrsion, dissatisfac.
tion, and the desire for change (panicularly when
shown by the more accommodating partner); and
emotions that might be biologically significant
(related to mood and physical health). Affective
words "My parmer asked me to come" mean one
thing when said with concem, and another ing
entirely when said in a manner that is flat and dis-
engaged.
Only recently have marriage erapists un-
dentood the importance of a positive affective
bond to the survival of a maniage. Each school of
TG therapy tends to emphasize cenain domains of
information from the clinical intervieq wirh ob-
ject relations and ymbolic-+xperiential therapists
more focused o ssessment of affeet: fu Wachtet.;
''
has noted, "Such a focus enables the therapist to,
leam more about what the client values than he
could disclose consciously" ( 1982, p. 340). Marital
therapies need to explore and describe differenr.
qpes of affective.bonding more clearly. For ex.j.
ample, there are vast differences among e kinds'.
of intensity found in a couple sed together by ( I ) i
anxiety and dependency, (2) addictive behavior,
and (3) a traumatic bond through mutual aban.
donment o survival of loss. More work is neces-
sary on a rypology of attachment.
At the end of the assessment phase, rhe clini-
cian should have a clear genogam, a descnption
of the presenting problem ftom each partner's po.
sition in the maniage, a theory explaining e dif-
ferences in their ideas and resporses to e prob.
lem, information regarding long-term connibuting
factors in the families oforigin, and an idea abour
what the parmers wish to change. These ideas ae
fed back to the couple in the goal-sening phase of
therapy. The therapist must do the following:
214 I. MODELS OF COUPLE THERAPY
o Aticulate mutual r,alues and goals underlving
the pannen' r'iervs of commitment, including
an undentanding of culrural underpinnings of
those r,alues.
r Articulate anv differences or conflicts between
spouses' closely held beliefs and family legacies.
Describe the position of each spouse in his or
her family of origin regarding imponant family
issues and experiences.
. Predict horv these positions will shift if the part.
ners solve their problem.
. Ally with each spouse in a way that creates a
basis.of trusr for doing couples work and initiat.
lng cnange.
SETIII{G TRIITiIEI{T GOALS
TG couple work seela to achieve greater relation-
ship competence, enhance self.knowledge and
self-esteem, increase partners' confidence at
they can solve rheir own problems, and help the
dyad support imporranr individual and murual de-
velopmental tasks (Robeno, 1992). The TG e-
apist recommends a relational thenpy even when
the problem appears individually based. Even
though the general public is bener informed about
the value of spouse.assisted counseling for severe
emotional disorden (e.g., mood and thought dis-
orders), coming to therapy together can be daunt-
ing. And, often rhe serious concems seem to be
one!.own burden. A common example of this is
sexual dysli.rnction: Many clienrs assume thar they
will explore and resolve physical and emotional
symptoms about sexuality individually with a
therapist, en take home what they have leamed.
In reality, both parmers have to communicae
about their sexual needs. lhitaker refened to two
decision poinrs in planning MFT: the "battle for
structure" and the "battle for initiative" (Napier &
Whitaker, 19i8). The term "banle for structure"
is a somewhar adversarial way to describe how the
therapist and clienm agree to include the relation-
ship as the unit of change arher than one of the
partners alone.
There are two npes ofgoals. I have made the
distinction previously between mediating goals
and ultimate goals in systemic work (Robeno,
1991, p. 454). ln intermediare-length therapr',
unlike briet, symptom-tbcused rherap.l', 6li.rtt
and c[ent couple can take the rime to evolve an
ongoing, deep personal bond. In this therapeu-
tic riangle, "mediaring goals" of therapv include
( 1 ) expanding the presentrng problem into a TC
frame, (2) activating and holding "positive anxi.
ety" about change (Whitaker & Ryan, 1989), (3)
encouraging a multlateral perspectve of prob-
lems, (4) creating a boundary around the partners
and their relationship work, and (5) creating a
shared meaning about the origin and nature of the
problem. By agreeing to ongoing work, a couple
in TG thenpy also creates time to investigate
and undersmnd formative family-of-origin experi-
ences. This mediaring goal that may at rst seem
inelevant to the cunent problem becomes clearer.
For example, a man with a chronically alcoholic
parent is unable consistently to set limits on his
involvement in his spouset drinking. He may be
asked to explore whether he believes that recovery
is possible without his help, considering the fact
that his own parent never sought help.
Like od'rer rypes of couple therapies, TG
therapies hold that ultimate goals of change are
created by couple and erapist together. These
can vary widely: greater autonomy; decrease in
ligha and tension; greater intimacy, including
sexual intimacy, support of career, work, and per-
sonal development; greater self-esteem and effec-
tiveness; commitment; empathy and nurturance;
and a decision whether or not to have children. Ir
has been noted that ultimate goals are sometimes
difficult to aniculate clearly (Whitaker & Kei,
1981): A couple may know only that they "arent
getting along," "aren't close anymore," or "don't
have sex." Discusion of crucial family experiences
and legacies help parmers to make sense of the
painful isues playing out berween them.
Problem-focused couple erapy addresses
one problem or d prioriti:ed list ofclearly delinear.
ed problems. However, this means anoer course
of erapv in the future, if there are other problems
(tlatzlawick, 1984). TG marital erapy aims to go
beyond symptoms to increase a couple's relation-
ship competence. The therapy must strengthen
frustworthiness, consideration, understanding and
speaking up for personal beliefs and needs, toler.
ance for differences, muoal respect, nufturance,
and idenrification. I call this goal "restoration."
In the TG therapy model, because the course
of therapy is intermediate-term, sessions are often
held les often-npically everv 2 weeks-so that
paftners can rrtegrate a larger perspective. con-
ract amily.of.origin members and hold visits, and
have time to focus on self. Therapv may extend
from l-12 months in length; therefore, rvhereas
brief therapl may conclude after 3-10 sessions,
TG therapies mav ake from 10 to 14 sessions.
Howeve, unlike mosr couple therapies rhar ad-
7. Transgenerational Couple Therapy
joum during holidays, TG therapies are more like-
ly to hold thmil-v-of-origin consults (see comments
later in this chapter) over 2 to 3 consecutive days
while family membes are in town. Such meetings
are usually 7 o 2)l hours in length to allow for a
meanngful dialogue about past events and impor-
tant, unresolved family issues.
ROTE OF T}|E THERAPIST
The Therapeutic Alliance
A strong, compassionate, "patial" (in contextual
therapy terms) alliance is pivotal in this type ofcou-
ple work. Putiality replues rcutralq. A TC focus
opens up the therapy conversation to emotionally
laden ssues in a way that requires a high degree of
trusr in the therapist. Spouses discussing stories of
abandonment, illness, conflict and berayal, abuse,
los, and stressful family loyalties are looking at a
dimension of experience that feels far more wl-
nerable than that in problem- or solution-based
talk. The therapist is a participant from irside e
therapeutic triad, helping to create and protect a
safe environment to expand symptoms into their
deeper relational context. If neutrality means that
no member, after a session, can tell whose side the
therapist is on, then partality means at, after a
session, each member knows that the therapist is
on his or her side- Systemic neucraliry, e position
of therapists holding circular interviews, does not
. build the panial, concemed alliance oecessary.
The streng of paniality provides "anese-
sia fo the operation," as Whitake called it. It is
only when the therapist can offer an affective con-
nection that spouses in therapy feel empowered
to work on their affective connection. Finallv,
asNapier commented (1983), it is a mark of our
commitment to a caring and humane sociery that
therapists offer kndness and compassion rather
than rhe distanr "expert" stance, to the clients
who entrust to them their love relationships.
Use of Self: Therapeutic Tnnsparency
Pan of exercising partialiry means that the TG
therapisr has to be actively engaged and person-
ally responsive, which calls for a cenarn amounr
of tnnsparency (Roberto, 1992). In the early
symbolic-experiential literaure, "use of self ' meant
"rransparency." The clinician shares fragmena of
experience, penonal reflections, and teaching sto-
ries (Robeno, 1991) to deepen, expand, or enter
into a dialogue in a wav rhar is intimae but also
215
instructive. As Framo wrote, it is important "that
the erapist convey in some form that he has ex-
perienced pain and loss, shame, guilt, and disap-
pointment, as well as the exhilaration and jols of
living. ... lt is just as unwise to support the fantasy
of the therapist's life as ideal as it is ro overburden
clients with one's own problems" ( 1981, p. 147 ).
Use ofselfconnotes the possibiliry ofchange
for therapy couples, because the therapist is com-
municating thoughts and actions regarding events
n and out of the therapy session that may differ
from those of the spouses. The therapist's com-
ments include a high degree ofdsclosure, but they
ae selected deliberately and thoughtfully. Isues
shared with a couple must be resolved issues to be
useful, so it is best not to share information that
is anxiety-provoking oi confusing to the therapist.
Ideall they are well-digexed thoughts that while
minoring or paralleling a couplek dilemmas hold a
view that leads to a solution. The therapist's self-
disclosure does not have to be a lived experience,
but can be a metaphor, an idea, an echo of the
clients' thoughts, a reflection, a wish, or an imag-
native vision.
A RH.AT|0!SI||P tlr STAGTS
TG rherapies unfold in sages as a couple's ftame-
work moves fiom the particular (evena at home)
to the larger system (their families of origin), and
fr_om the hsre and now (recurring conflicts) to the
longer term (beliefs about maniage, themselves,
and their union). The structure moves from high
to low, the therapist moves from a cenual postion
toward the periphery interventions move from di-
ective to nondireqtive, and use of self increases
(Roberto,'1991). This is not as true of Bowen
erap but even in natural systms therapv, as
clients go home to visit their families and work
on diffusing triangles, the ensuing debriefings and
insights probably change a therapist! role toward
less directiveness.
In early-stage work, the "battles for structue
and initiative" take place as the therapist recom-
mends couple sessions and creates a stting in
which parmen focus on their relationship. Dur-
ing this time, panners are encouraged to begin
sellstudy of their maniage, genogmms are made,
family histories are taken, and the maniage is ex-
amined from each panner's standpoint. The mid-
phase ofcouple work aims to reorganize parmers'
undentanding ofkey problems in a newlv expand-
ed. relational, context. Use of self communicaes
216 I. MODELS OF COUPLE THERAPY
that the clinician understands the complexiry of
intimare relating, the difficulty of accepting and
changing oneself, and the ilux berween intimacy
and autonomy. Each partner becomes more clearlv
defined: self in relarion to rhe orher.
Late-stage couple work calls for less therapist
coaching. At this point, rhe partners can obsewe
themselves responding to one another wirhout the
erapistt help. They are usually reporting progress
Ln .aeas of intimacy, disclosure, self-knowledge,
and mutuality, and can identifi' and discuss flash-
points u they push themselves and each other
toward change. Parmers create innovative ways
of supporting their own and the other's needs ad
requests-often in ways that the erapisr could
not have predicted. They are a flexible system
that generates its own solutions, and the clinician
serves more as a sounding board.
PR()CSS AlID TECHIIICAT ASPECTS
Creaffng a Tnnsgenenonal Fnme
Eatlier,:l explained genogramming as an assessmenr
tool. It is albo a.reaching tool in early therapy (Ro-
beno, 1992; Wachtel, 1982). When shared with
the cople, it is-a technique of change, because
it adds to pnnen' sense of "where they are each
coming fiom.r The mutual self.disclosure and will-
ingnes to exirose vital and often unprocesed in-
formation alse has a healing quality. Creating the
genogramftiidolates erapi.rt and Clients to think
about extendd family issues, and contributes to
forming cohnetiordfugeen events in the ma-
riage and the legacies that came before.
Genograms enable family members ro devel-
op a metaperspective together about their history.
Gaining perspective helps t calm interuiry and
may help to diffixe a crisis atmosphere in couple
work when ere are "hoC'conflicts, such as af-
fairs, religious differences, parenring problems, or
extreme complementariry. Where there is a power
imbalance in the relarionship, genogramming
"levels the playing field," so that both parmen
must look at both srrengths and challenges in their
past lives. Finally, mapping the hmily of origin can
increase a feeling ofconfidence that symptoms are
not random but are irutead responses to ongoing
family issues. Therefore, it is one core technique.
Tncking Problem Cycles
If oneaslcs rvhere a TC clinician's focus is dunns a
therapy session. the answer rvould be rhe sam. u
7, Transgenerational Couple Therapy 217
that for other clinicians. Dysfunctional, reacrive,
seling. It reflects e orientation that " .... When Siblings are sometimes reluctant to attend
"stuck," conflicoal, disengaged, or
ineffecrive
... adults are able to go back to deal directly wirh a consult. V/hen this occurs, it is most probably
responses and the cycles around those responses
their parents and brothers and sisters about the because the client in marital therapy has formed
are always the target of couple work. The thera-
previously avoided issues that have existed be- an ambivalent relationship wi that sibling, or
pist watches to see which spouse names the prob-
tween them, an opponunity exists for reconstnc. because that sibling is even more distresed by the
lems and which one defers, elicits their individual
tive changes to come about in eir marital rela. family than rhe client. It is imponant to expend all
theories about underlying tension and differences,
rionship" (1981, p. 114). k is importanr ro note means to bring about sibling participation. Later,
and observes how they handle the differences. For
that consults are rarely requested by e couple. the bond fomed by is visit may become a power-
example, if their s'ymptom is distance and cold-
They are a tool initiated by e therapist in mid- ful means of support for the client, one that may
ness, the therapist notes what happens when one
phase couple work. have been absent since childhood, and create an
spouse ties to attract attention, and whether one
Family.of-origin consults ca usually occur alliance that meets needs e client once expected
or both spouses rry to engage each other, and how
only once or rwice during couple therapy because in the maniage.
this is done. Their strucual characterlstics- of distance and cost. They can be scheduled in At the coruult, the client is asked to describe
distance, fusion, disengagement or cutoff, conflict
2-hour segments on Z consecutive days, although for the family the problems that brought him or
or pseudomutualiry-are noted.
they have also been organized fo entire extended her to couple counseling. Because this is a mid-
a week (!hitaker, personal com.
families for up to phase technique, the client usually explains his or
fncki n g Antecede nE : Tni I i ng munication, October, 1979). Meetings are not her subjective difficultie coping with streses in
strudtued with therapeutic task, but are orlanized their marriage. The mily is encouraged to discus
A TG therapist tracks presenting problems with
around makng intergenerational connections vis- what they know of their childt difficulties and to
an eye toward antecedent events in the couplet
ible, explicit, and available for discusion. ask questions, so that the focus is frrmly placed on
life and the parmen' own lives with their fami-
Couples in therapy expenence extreme anxi- their child. Every consult is unique in its emotion-
lies of origin. It is like watching a "uailing cursor"
ety about bringing parents in, and the idea should ality, pace of dirusion, degree of openness and
on a computer mouse, looking to see where it has
be "seeded" for at least a month prior to the meet. disclosure, panicipation, and historical perspective
come from and where it is going. I call this'trail-
ihg. There are usually many reservations that need (Framo, 1981). Some families need 2 days just to
ing." Tiailing antecedents uses a time frame of up
to be worked through regarding whether the par- acknowledge that their son or daughter might be
to two, or even ttfee, generations.
ents (and siblings, if posible) should attend. In having relatioruhip problems and at family isues
Tiailing inquiries do not replace discusion
itself, experiencing this anxiety and smrggling to might be involved. Othen begin with a request for
of altemative ways partners can approach rela-
come to terms with it directly challenges a client's help from a parent that opens the way immediately
tionship problems. Rather, a trailing quesrion ac-
illusion that the spouse is causing all ofhis or her for a deep and sincere discusion. The meeting can
knowledges another dimension ofa clientt experi-
disuess. One family of origin is brought in at a be audiotaped or videotaped, and there should be
ence. Tiailing keeps parmers located on their TG
time. Whereas some TG therapists do not include an a$eement ttut all family rnembers who wish to
rnap. The experience 9f trail-rg babk from com-
the ryouse (Framq-197, 1981), othen.blieve may receive a coy, includi.Iu.absent members.. ,
plaints to antecedents makes people feel that they
that observing can $eatly aid clariry and under- Although couples do not explicitly connect j'
are "gening to the root of things." The spouse gets
standing in the maniage (Roberto, 1992). When ihanges in their families of origin to progress n i
a sense that there is an entire family and its mm-
anending, the spouse is invited to sit in withour their maniage, consults add depth to their un-
bers'histories behind a loved one's behavor, and it
participating, because unresolved family issues are derstanding of the rclational problems they have ft.
makes more sense. Sparring decreases, and context
easily displaced onto. a son- or daughter-in-law. brought into rhei commiunent. There is tes oth- Fi
and mutual understanding increas. For example,
Family conzults are ananged by dre parmer er-focus, more self-observation and investment in I'
a woman who hean in session that her parmer
who is preparing for the visit. The inviation can change, and greate self-respect after a consult is ',
was criticized by his family for leaving school may
be 6amed as: an invitation to parents to help move held. This is tnre even though the consult itself 7:
understand more clearly that his low suppoft for
therapy forward by giving the family's viewpoint or may be painful or complicated. Seemingly little .l;
her recent promorion does not reflect lack of car-
to help clarify imponant family issues while ther movement creates a very different view ofself, and {:
ing, but an unresolved conflict abour being seen as
son or daughter is in therapy. Family memben are of self-in-relationship.
equally worthy.
told at they will not be made into clients by the
therapist; rather, they are ]rere to give the era-
&thanci ng hnonal Authority
Fa m i Iy - of -Origi n Consu lts pist imponant history. TG therapists agree on the
crucial importance of respecting the generational "Penonal auoriq/ in the family system (Wil- r:
There are few tools so clarifring to a couple ther.
boundary and do not demote parens in the eyes of liamson, 1981, 1982a, i982b) is defined as the
apist as a family-of-origin consult. When a mari.
rheirgrown children. While awaiting the visit, the ability to discem and use one's own opinions and '
tal parmer sits in ro wimess a meeting between judgment, to choose whether or not to express
husband or wife in therapy is asked to reflect on
the spouse and the spousei paren* anflor sib-
personal concems and issues in the marriage that oneself, to hold a metapenpective on relation-
lings, at clarity is even moe powerful. Framo
may be connected to previous experiences wi ships, to take resporsibility for one's actions and
produced a body of*ork (1976, 1981) on his ex-
the family. These key experiences become pan of beliefs, to choose whether and when to be close to
periences in meeting families of couples in coun-
the material for rhe inten'iews. someone, and to neat elders as peers. Williamson!
218 I, MODELS OF COUPLE THERAPY
rvork on personal authorirl'hinges on rhe idea that
many marital impasses reflect intergenerational
intimidation and failue to develop an aduk rela-
tionship with self (1981). This rheory holds that,
bv midiife, there is a normative life.cvcle ransi-
tion that involves ending e hierarchv with one's
parents and moving toward an adult-adult con-
nectlon.
An unrecognized power issue, the investment
of lifetime authority in parents, produces a tilt in
the familv's distribution of power that limits the
personal sense of choice. The term "intimidation"
refers to the reluctance we feel about challenging
parents, family history, and rhe values with which
we wee reaed (Roberto, 1992). \illiamson sug-
gests that in middle adulthood, the generational
hierarchy of the fim half of our lives has to be
terminated, leaving in its place an egalitarian,
mutual, give-and-take elationship. Oerwse,
that hierarchy creates pressures via old legacies
(unesolved issues) and delegations (unlived and
transfened expectarions; see Stielin, 1981; Stier-
lin et al., 1971). It is an enormous challenge to
"leave home" in the sense ofseeing and relating to
parents as peers instead of authoriw frgures (Wil-
liamson, 1981).
A husband in his early 6(b developed a psychotic depres-
sion wi zuicidal thoughts; left h wife, children, and
grandchildren; and begn living with a young woman he
met in a shop, several yem after his om father disinher
ited him and died, following which his mother eftued to
oppose the will and give him i share bf rhe'inhritance.
Couples commonly come for courueling in
response to one o both spouseJ exploitation of
their maniage to conform to stagnanr family re-
lationships (e.g., expecting a parme! to help care
for a {iail parent bur refusing to give care oneself).
llilliamson's belief is that couples must give up
their expectation of geaing approval, and thei
irnage of the parents as dispensers of approval.
The technique for creating and enhancing
personal authoriry is a coaching technique, in
which the client beguu ro seek more information
about rhe parenr as an aging indvidual and ro
moum the end of the parent's protection (or the
wish tbr it). The client examines his or her lifelong
perceptions of the parenr, exploring rhese images
and how thev aose (Williamson, 1982a). Meet-
ings focus on the reladonship rvith each parent
and the changes that need to occur ro move the
relationships forward into the here and now The
client rvorks to express him. or henelf clearly and
to ask important famili questions. There s usu-
allv a least one visir home, in which the clienr
talks one.on-one rvith each parent, then with both
parents about their earl.v lfe and experiences with
love relationships. The object is for rhe client to
see the parents as real people.
When the client is no longer relucrant to dis-
cuss parent{hild issues, a family.of-origin consulr
is held to propose changes and to discuss them. As
with any other family consult, the partner ideally
should attend; he or she will have the opportunity
to view signifrcant issues that he or she previously
has only heard about secondhand. It may be the
first time that a woman's depression, or a man's
distancing, is completely visible in the conrexr
in which it originally formed. Ir may be the focal
point at which a clent finally lets go of blaming
the mate for marital problems. As Paul (1967)
pointed our, facing loss has profound potential to
unlock personal resources for solving problems in
maniage and personal life.
CURATilE FACTORS
Historically, couple and family therapy has never
been comfonable with emotions. The models that
dominated their early development (structural
and strategic) were aimed primarily at changing
behavior pattems and, through reframing, e cog-
nirions that maintained them. Increasingly, due to
adv_ances in neurobiology and attachment theory,
emotionaliry is being viewed as the underpin-
ning of adaptive behavior and a positive organiz-
ing force in human functioning (Damasio, 1994;
Johnson &. Greenberg, 1994). TG therapies, with
the exception of Bowen techniques, acknowledge
and urilize the emotions thar arise thrgh bond-
ing, and use them as motivators for change.
tfhen clients listen to
their own subjective
responses in a dialogue with each othe reflec-
tions, emotions, beliefs, and recolleced behavior
are integrated (Schwarz &Johnson,2000). If emo-
tions cany constructive messages, as research indi-
cates, adding them ro therapeuric dialogue helps
each panner "get the message." Anger can be seen
as a demand for change; sadness, as loss; pleasure,
as the hope and oy of connection. Convenarion
that includes personal responses helps to evoke
in clients the respect and acceptance *rar couple
therapisrs Jesire-it increases intimacy.
There ae gender differences in expression
of affect at need to be considered. Women mav
tend to value expression of emotion because it is
7. Transgenerational Couple fherapy
normally suppressed. When rvomen in families are
marginalized fom the executive unit, they are ex-
pecred to accept the decisions of others and not
show "negativity." Therefore, in trust relation-
ships, women seek openly to admit the opinions
and concems that they are expected to suppress
dailv. From this point of view, it is imponant to
encourage this avenue to intimacy for women and
to teach men to respect and value eir wives' wish
to engage rhem in honest conversation.
In addition to integrating affect into therapy,
TG therapies consider contextual and experiential
learning as curative. The encounter between part-
ners and the clinician, who participates, as well as
conducts, the sessions, increases their awarenes
of altemative ways to solve problems. Therapist
ansparency has unique qualities that model dis-
closure and self-acceptance raer an justifca-
tion and defensiveness. The processes ofgenognm
work, and family-of-origin visits and consults,
crete metaperspectives on recuning problems.
Like rhe "connect the dots" puzzle in which the
solution is a single iine leading orr*idr the group
of dots, a TG perspecdve allows couples to rework
their marital connection in ways that are "oumide"
their previous cycling repertoires.
N egave Then peutic Reacti o n s
Freud (1937/1964) first coined the term "negative
therapeutic reaction" (p. 243), refening to interxe
negative emotions that spike after discusing ma-
tdid ih a rherapist.'Couples frequentli exiidri-=
ence negative effects during and after meetings
that focus on painful subjects. In my experience,
the stress of couple work exceeds the sress of fam-
ily therapy, in which cliens can perceive respon-
sibility for change as shared among parents and'
children. For some clients there is great anxiery
related to verbalizing intentions or reactions that
have never been voiced in their maniage, espe-
cially in Westem societies, where maniage is a
voluntary contract and our rates of separation and
divorce are high. Other clients find the intensity
of the process overwhelmng-for example, an
overaccomodating spouse who "smoothes overn
con{icts, or a rigid, walled-off spouse who is un-
accustomed to integrating emotional information.
What appean matter-of.fact or easily voiced to a
clinician mav be exuemelv difficult tbr clients to
acknowledge.
Some couples feel shamed by the disclosure
of marital problems. For example, in a European
American Protestant couple, discussing sexual
2r9
problems is experienced as too intimate and as
evidence ofpenonal nadequac-v. A Jewish couple
rhat prides itself on famil.v accomplishments may
feel shame after discussing job problems o destruc-
tive behavio such as spousal abuse or addiction.
A japanese pair may feel they have "lost tace" after
voicing complaints about each other or eir ex-
tended family. Cultural competence requires that
the clincian understand his or he role in relation
to families that are culturally different. Aaend-
ing to partiality includes asking couples for their
consent to discuss specific issues, and for feedback
about their willingness to disclose each subject.
Court-mandated marital therapv is compli-
cated by the fact at the therapist is a representa-
tive of social control. The therapist in this situa-
tion must wok hard to hold the boundary beween
legitimate community concems (e.g., personal or
public safety) and legitimate couple concems.
These couples benefrt ftom raruparency, which
enables the therapist to express the wish to help
partners sengthen the relationship and protect
themselves and each other of further intervention
from legal or community agencies. Mainraining a
TG Famervork for couple work does not preclude
use ofsafety conrracts, setting the terms and limits
of outpatient erapy (e.g., procedures for emer-
gency calls), creating a safe home thnough setting
of rules, and other basic security needs. These
techniques add to the client's view that the thera-
pist cares about his or her welfare.
Applicability of Tn nsgenentional Methods
Whitaker commented that, when interviewing
a coupie whose cultural legacy is different from
onet own, it is best to use a cotherapist with the
same heritage as the couple. The decline in use
of coerapy and Fearment teams outside training
institutes is related to insurance industry restric-
tions on therapy benefits. In the 1990s, standards
ofpractice moved toward every clinician establish-
ing and exercising a personal knowledge base, to
the degree possible, for undersunding and attend-
ing to cultural differences. To date, this awareness
has nor extended to religious differences. Couple
and family work has tended to split off religious
discusion to the clergy or self-identified pastoral
counselos, and this schism can be seen clearly in
the histories of the rwo major Nonh American
family associations (e Ameican Association for
Marital and Family Therapy and AFIA). In the
6eld as a whole, spirituality has been relegated to
the margiru u a erapeutic resouce and as a cul-

220 , MODELS OF COUPLE THERAPY
rural identity issue. The TG clinician needs care-
rlly to ascenain rvhether a couple has cultural or
spiritual needs that are more effectively sen'ed by
a clinician who has the same cultural heritage or
religious communi4'.
It is commonly thought that relational, dy-
namic therapies require intellectual or academic
achievement and self-observation or insight. In
fact. some of the TG theories. as well as foster
care and community menml health agencies and
therapeutic schools, were created from hospital-
based work in large metropolitan areas comprising
a specmrm ofcultures, social classes, and religions.
For example, symbolic-experiential theory was
developed at Emory Univenity in Atlanta, Geor-
gia, and Univesiry of Wisconsin in Madison. The
clinics atUniversity of \ilisconsin, located in the
capftl ierve families at include rural Lutheran
families of Swedish derenr, farming families,
urbaa families, survivalist and cultist families liv-
ing iir irnote rural areas, Gech families that his-
torically migrated to its industrial cities for jobs,
health care profesionals, poor families, and clients
with cluonicschizophr-enia and addiction.
TG erapies hav a unique capaciry to ad'
dress gender-based problerns common in Westem
maniage. For men, the oppomrnity ro explbre e
relationship with their parents is precious. It is ex-
traordinarily moving to see a man who has been
withdrawn and unresponsive begin to examine
his relationship with his parents and realize that
rn:pushing away his wife,,he hu pushed away
the most imponant and intimate relationship of
his adult life. For women, whose focus may be on
connection to the exclusion of their intemal ex-
perience, family-of ongin work creates a venue to
reexamine thei own needs and wishes.
There are complexities with therapy for cou-
ples from Middle Eastem, lndian and Pakistani,
and Asian and Southeast Asian families. Cultural
groups at ascribe power to parents and previ-
ous generations are sensitive to any intervention
that may appear to lay blame on family elders.
The maniage may actually be at the behesr of the
parents. In some societies, as mentioned earlie
couples are not viewed as a unit of rwo at all, on
an,; rung of the familv hierarchy. Power here is not
really defined by generarions of fami\', bur rarher
from outside, as a reflection ofreligious traditions
that venerate authorit-v and duty, as well as soci.
etal mores. There ae profound implications in
ese differences for couples' awareness and com.
mitment to their connection as dyads. They must
be reated in erap.v as a segment of their familv
and their religious communiry or therapy may fail.
Interactionally based and ahistorical therapies are
Iikely to ask clients to "put the maniage frrst," or
to "make a boundary around the maniage." We
believe that, if properly applied, TC therapy is
unrqaell relevant for these families, because one!
place in onei family is respected contextually.
CASE ITLUSTRATI(}II
Karen and Keith, two previously divorced pro-
fessionals in their 40s, requested couple therapy
3 years into their counship. Alough they con-
sidered themselves a committed couple and spent
much time together and with their respective
families (visits with parents and children), they
did not live together. Both stated in the initial
interview that they were noubled by a number of
relationship problems. Keith, a musician and band
leader, felt that he did not get as much ofKaren's
attention as he would like when he was off work
during e day, and there was constant bickering,
in which Karen insistently took his words and acts
as personal insults and malicious slights. He could
not seem to please her. Kaen, the diector of a
nonprofit agency, wonied that Keith refused all so-
cial invitations, showed little warmth rc her chil-
dren, and exhibired a lack ofsocial experience and
refinement that she atnibuted to his blue,collar
background. The result of these tensions rvas a
panem obeing overly careful (pseudomutuality)
when approaching each other, marked by a lack of
spontaneity and rapidly decreasing sex, combined
with anger in Karen and depression in Keith.
Both had become disuessed enough that they
t'eared they would never be able to live together
without re relationship deteriorating. In facr,
Karen had received an exciting job offer ftom a
larger nonprofrt in the nearby capital, and won-
deed ifshe should take it.
Both panners also said at ey had been
miserable in their ftrst marriages, and that their
spouses had left them. Because of the ctronicity of
their relationship problems and the severitv of rhe
cunent discord, the frrst four sesions were devoted
to exploring familv-of-origin and relationship his-
tory up to the present day'. A session was devoted
to gathering family.of-odgin and previous marital
historv from each parner, wi the other present
to observe. In genograms created for each spouse,
they were asked ro think abour and droose the
dynamic markings that described each significant
relatioruhio.
7. Transgenerational Couple Therapy 221
Keith saw hirnself as the "differenr," more
tory professo was more uneasy-although they
atistic member of his hardworking New England had always gotten along, they seemed to exchange
family', the product of a closely bonded couple that
onl-v good news on the phone now and she felt a
manied out ofhigh school and had high expecta- conrsing lack ofdesire to be more disclosive.
rions for him and his brothers. The youngest child, In Karen's lirst maniage, she u'as shatteed o
Keith described his fathe as a no-nonsense rades- discover at her husband had conducted a secret
manforwhomwealthwasthemosrimportantgoal affair after falling in love with someone he met
for his sons, and his morher as concemed mainly at work. Although she had ried to stay after the
for his fathe's happiness and her sons' achieve- discovery o save the maniage, he later told her
ments. His father had died suddenlv ofheart fail-
that he felt the relationship had been a mistake
ure;Keithhadnothadtimetosaygoodbyetohim. and that his lover "needed him more than she
He spoke to his mother only wice a year-before ever had." To her added honor, their son Kevin
the Jewish High Holy Days and around her binh-
had elected to live with his faer after the couple
day-and described his relationships with both
nally divorced, and she felt he sided wi father
pui.nt ,. distantly polite. Keith had two older and stepmother whenever she confronted him
Borh
brothers living close to their morher's home. about his choice, which was often.
were professionals: a high*takes lawyer in a fast. lt was difficult for Karen and Keith to give
cracklitigation pracrice, and a physician. He did their histories in front of each oer, and at one
nor feel respecred by either ofthem. point Keith asked if they could give history sepa'
His frst marriage was to rhe high school rately. He seemed to want more response from the
sweetheart with whom he grew up with and who, female therapist, and said that his concem was
he assumed, would give him the affection and "looking bad" in front of Karen and her fam[1',
acceprance he craved. Keith gradually felt alien- whom he angrily dubbed "The Perfects." Because
ated, b.c"use she had more career advancement there did not seem to be dangerous (e.g., abuse-
and made more money than he, and did not seem related) history he was asked to work with Karen
to show appreciarion. This relationship was de- in the room. The couple was given the framework'
scribed as riginally quite close, but evenrually that hearing each oert challenges and needs
disrant-conflicmal. His ex-wife had asked fo a wouldhelpthemtounderstandeachotherinadif-
divorce in their 30s, seemingly as soon as rheirferent way. They were also encouraged to consider
daughter Krista graduated ftom high school. His that although, after 3 years, it.might seem that
ex-wife confirmed all of his feelings that he was they knew each other inside and out, each was at-
unyglue.d when she sued for, a4d got, most of therJ .i$rting motives to the other th1.yei9 probably
.uritul u5trl .ir home, .u. their pets. e inccu.ate and ionterprouctive. liiigued and':
"nd
saw Krista as disrespecrful and superfrcial, feeling challenged, they began to work together.
thar she had looked down on him as a breadwin- The frfth session was used to assess the part.:'
ner and was too materialistic, and he usually felt ners'goals for their work. They asked for (1) help
depressed when he and Karen saw her on holidays. to 6nd some way of relating to each other instead'r
Keithlivedinasmall,undecotted,uncomfortable bf'disconnecting with disinterest and boredom;'
aparrmenr fumished with his business equipment, (2) help in discusing Karen's job offer; and
(3.f
h. did not socialize. help n constructing a social life as a couple.with'
^.td
Karen, in contrast, described her childhood their families, children, and friends. The therapist
as magical. She and her younger brother had been noted that the process of four sessions devoted to
goodfriends,andtheirpopulaiparents---oldeac- family-of-origin and marital history had already
ademic people-had kept the house full of visiting opened a window into both spouses' pain, disap-
colleagues, ftiends, andneighbon. All the adults pointments, and underlying needs and wishes fo
e rwo children. She believed themselves and their family life.
seemed to dote on
thatshehadneveriacedadvenity.Shehadexpect- Mediating goals of TG therapy call for ex'
ed to and had done well at college and "fell inro" pandingthe focus oftherapy ro its largerfamily'of-
her nonprot ob rough her father! connec- origincontextratherthanpathologizingthecouple
rions, rviihout hating to stress over a job relationship. Therefbre, in the six through 10th
search.
Shedescribedherrelatronshipwithherparentsas sessions (the "midphase"), the couple was asked
"quite close" and spoke ro em often. They were to consider what legacies (unresolved iarnily-of'
a Lt perplexed by her choice of Keith x a partner. origin patterns) they had canied with ther into
Her irnenr relarionship rvith her broher. a his-
their first marriages and into this courtship. Karen
222 I. MODELS OF COUPLE THERAPY
began to focus on the familiar, gratih'ing, arten.
tion that her parents had gamered for themselves
and their children, and admitted hat it had left
he intolerant of disagreements, disconnected
when not catered ro, and easily hustrated. llith
active input provided by Keith and the therapist,
she recognzed her paaem ofplaying out her sense
of leamed entitlement wth both Keith and Kevin,
and their reactions of hun and withdrawal. The
therapist worked with Karcn to examine specifi-
cally how her patem of responding during con-
flicts was to privilege her onn feelings, to assume
that e oer was inadequare, and to make de-
mands that hlittled and disempowered her loved
ones.
Keith became aware that he avoided taking
risks and held on to people and things that made
him feel successful andsecue, because he had not
felt secure as a young person. Underlying comperi-
tiveness and resentment of the successes of oth-
ers, which had emerged eryecially with women,
caused hin to withhold love and to pull back ftom
supporting Karen and lGisa. This meant that the
affection he sought sas withheld as the women
pulled back from him in rum, which made them
appear uncaring even as he blamed them for the
problem. He was asked to lmk at how he under.
mined Kaen when they fought, hitting "below
the belt" wi spite.rl and rejecting yet indirect
emarks that he told himself were simply giving his
opinion.
In the llth through 15th sesions, Karen
and Keith were given asiignments t reconneci
with parents and siblings in a way that reflected
their growing undentanding of their roles in their
families/rnaniage. hdng this proces, each part-
ner was asked to (1) accompany the other ro an
upcoing fami\'mction as an "anchor" in the
present, (2) schdule couple time alone during the
visits and stay together at night in a separate hotel,
(3) debrief with each other privately when they
experienced disrcss, rther dran expecting the
othe to 6t in and avoid family issues.
Kaen was given the following rasks: (1)
ro focus on how Keith or Kevin were perceiving
and feeling incidents at home, rarher an on her
own feelings; (2) to reFae her parenm' legacy
as handicapping (nther un preparing her) for
adult intimacy; and (l) rc begin speaking with
her parenc and brothe about personal problems
and ask about furnily problems trat had nor been
discussed. Kuen garticularly decided ro tell her
parents about the pain she expeienced when her
lirst mamage ended. She dmrtted to hem that
she felt she had contributed to the breakup by see-
ing herself and the past as perfect. She asked her
parents to see her as a real person and to acknowl-
edge thar she had been raised in a somewhat sell
congratulatory, selt.righteous manner. Her parents
responded bv opening up the life experiences that
had drven each of them to seek constant approval
and entenainment, while neglecting personal time
with their childen. She and Kei made a trip to
visit her brother and his wife and children, where
Karen spoke with him about their childhood years
and gathered her brother's memories of imponant
family events that had previously been ignored
and whitewashed. For example, he disclosed thar
their father had been briefly manied some years
before marrying their mother, and that he had left
his young ex.wife and their baby because he did
not find her supponive enough.
Keith was assigned to (1) tell Karen clearly
and flrmly what he expected and needed ftom her
as his mate; (2) share his views with his mother
and brothers regarding his talent, commitment,
and'succes in music; (3 ) spend several visits alone
with Krista, in which he allowed her to choose
their activity and introduce him to her ftiends.
He began calling his family and shared with his
moer how he had intemalized a sense at he
must eam well, and thar being a musician was self-
indulgent and unimportant. He admitted at this
had made him angry at his brothers and ex-wife,
even though he was working in e profession he
; believed he had chosen, He and (en attended a
' nephew's gradation wirh hii broihers, and spent'
time talking about his father's reserve and difficul-
. ry getting his affection.
As both partners faced and challenged the
sources of their perceprions and family legacies,
they saw each othe iit a more hoiJeful, more re.
spectful, less suspect lighr. They expresed feeling
closer, more loving and sexual, and began to con-
sider living together in Karenl home. Karen spoke
with her son, admirting her own problems and
apologizing for personalizing his boyhood choice.
She told him how much she loved and respected
him, and he in tum began to call and to visit more
often.
Toward the end of e founh monrh of
couple work, Keirhs daughrer became engaged.
His ex-wife contacted him abour a lavish wed,
ding shower that she and her family were plan-
ning and for which they would pay. Keith had to
face the fact that he could not contribure much
money. W'irh Karen\ loving support, he was able
to think through realisricallv and with dignity
7. Transgenerational Couple Therapy 223
how he wished to conibute, and decided instead (Eds.), Handbook offcmill therapl (pp. I 59-186). New
on a satisfying personal gift that he checked out York, Brunner/llazel.
Bowen, )vf. ( 1974). Toward the differentiation of self in
with his grateful daughter. He now felt dignilied,
one's or"n family of origin. In F. Andres &. J. Lorio
respect-worthy and content, able to handle Kaen
(Eds.), Geogetun Family Slrnposia (Vot. 1). l0lash-
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