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The first edition of The Narcissistic/Borderline Couple abstracted
concepts mainly from classical psychoanalysis, self-psychology (Kohut),
and object relations (Klein, Winnicott, Fairbairn, Bion, Kernberg). At
that time, clinicians, particularly classically trained psychoanalysts,
looked somewhat askance at diagnosing and treating relational disorders.
Many thought of self-psychology and object-relational approaches as an
"odd-couple" relationship. But they can indeed work together, as evidenced
by the increasing number of clinicians who have begun to apply an
object-relational approach to the treatment of marital conflict. Even
those who for many years “avoided” couple therapy on the basis that it
went against their classical orientation are now actively working within
this modality.
In the first edition of this book, a number of psychoanalysts and
psychoanalytically trained researchers who understand both fields were
acknowledged as making major contributions to marital therapy. These
include Dicks 1967; Lachkar 1984, 198b, 1986, 1998; Lansky 1981, 1987;
Rutan 1985; Scarf 1987; Scharff & Scharff 1987; Schwartzman 1984; Sharpe
1981; Slipp 1984; Solomon 1985, 1986; Strean 1980, 1985; and Willi 1982.
Since then, an increasing number of researchers who understand both fields
have been directing their attention to marital conflict. These include
Carlson & Sperry 1998; Kernberg 1995; Lachkar 1998; Levene 2000; McCormack
2000; and Rothstein 1992.
This edition further emphasizes the contribution of object relations in
the treatment of couple therapy - especially in helping couples face
internal deficits, conflicts, distortions, and projections. Melanie
Klein's (1957) formulations have proved invaluable in couple therapy -
including her introjective/projective process, a priceless construct in
helping us understand the tangled web couples weave—how one partner
projects a negative feeling onto the other, and how the other then tends
to identify or over-identify with that which is being projected. In
applying this process to couple therapy, I have renamed it “dual
projective identification,” a term that seems more suited to the
co-dependent nature of the relationship. In conjoint treatment, we see how
certain dynamic mechanisms of the narcissist (grandiosity, entitlement,
guilt, withdrawal) can arouse states of unworthiness and non-existence in
the borderline (shame, blame, envy, abandonment, and persecutory
anxieties).
While the first edition referenced the work of D. W. Fairbairn, it may not
have sufficiently stressed his importance. Extending beyond Klein,
Fairbairn, more than anyone, helps us understand why couples stay in
painful conflictual relationships. His concept of splitting of the ego
into multitudinous internal objects deepens our understanding of why
couples remain forever loyal to their painful internal objects (rejecting,
insatiable, unavailable). My training in classical ballet led to the
conceptualization of “the dance of the couple” to help understand the
choreography—the ongoing, circular repetitive behaviors and interactions -
that takes place within the narcissistic/borderline relationship. This
“psychological dance” stirs up highly charged conflict that meets the
primitive needs of the individuals involved. Each partner “needs” the
other to play out his or her personal relational drama. Within these
beleaguered love bonds, the narcissistic/borderline couple is redefined in
this volume as two developmentally arrested people who coerce each other
into certain roles as each brings into their current reality archaic
experiences embedded in age-old sentiments. Together they play out a drama
characterized by painful, never-ending patterns of behavior. They form a
parasitic bond that leads not to growth and development but to destructive
and repetitive patterns of behavior. It is not really important how they
find each other; more important is what makes them stay together. Two
narcissists or two borderlines do not “do the dance,” but when paired
these oppositional types appear to maintain a bond. It is almost as if
they have some extraordinary built-in sonar system or sniffing device to
find one another, like a bloodhound after a rabbit.
Why are narcissistic/borderline couples more prevalent today? Perhaps
the reason many clinicians are encountering more of this kind of
pathologic pairing is because of an increasing percentage of single-parent
families, higher divorce rates, increase of working mothers, parental
unavailability to children, the near extinction of extended families, and,
in general, greater social isolation.
The ten years that have elapsed since the first edition of this book
have brought the opportunity to present material on couple therapy to
mental health professionals and colleagues throughout the nation and
Europe. Having evolved and gained new knowledge and insights not only from
colleagues and clinicians but also from my students and patients, I have
come to recognize the ever-changing states of narcissistic and borderline
vulnerabilities. These disorders are not clear entities; rather,
narcissistic/borderline states, traits, and characteristics tend to
vacillate. In addition, narcissistic vulnerabilities can be recognized in
other disorders. As the first edition stressed, the confusion between
narcissistic and borderline states, traits, and characteristics is further
acknowledged when we consider the type of narcissist or borderline we are
talking about. A Freudian narcissist? A Kohutian narcissist? A Kernbergian
narcissist? A borderline narcissist, an obsessive-compulsive narcissist,
an antisocial narcissist, a histrionic narcissist, a depressive
narcissist, or a malignant narcissist?
Although many couples may not fit into the paradigm of the
narcissistic/borderline configuration, the treatment techniques and
approaches outlined in this book are useful for almost all aspects of
conjoint therapy. This edition ventures beyond narcissistic and borderline
vulnerabilities to explore a variety of other dyadic configurations—such
as what happens when a histrionic personality hooks up with an
obsessive-compulsive, a dependent with a schizoid, or a passive-aggressive
with a perfectionistic / caretaking type personality. Not only are there
narcissistic borderlines, narcissistic obsessive-compulsives, narcissistic
passive - aggressives, but there are many faces and phases of narcissism.
Although they may all show the same pattern, they form different modes of
dyadic attachments.
Since the appearance of The Narcissistic/Borderline Couple, a
remarkable number of therapists have extended beyond
narcissistic/borderline relations. Within these thematic motifs, we now
have narcissistic vulnerabilities in couples (Levene 1998), the
narcissistic couple (Kalogjera, et al. 1998), masochistic–narcissistic and
polarized traits in couples (Glickauf-Hughes 1994), the passive–aggressive
couple (Slavik, Carlson, Sperry 1998), the dependent/narcissistic couple
(Nurse 1998), narcissistic disorders and dependent/narcissistic couples
(Nurse 1998;Carlson & Sperry, 1998), the psychotic couple (Maniacci 1998).
Others have gone beyond this malaise to address a garden variety of
maladaptive strains. Carlson and Sperry in The Disordered Couple (1998)
include the psychotic couple and the eating-disordered couple. Although
many theorists have made contributions bridging classical theory and
marital conflict, few of these authors have distinguished between
narcissistic and borderline vulnerabilities within a particular dyadic
relationship.
Although psychoanalysts have made significant contributions to the
field of marital therapy, a review of the literature that has appeared
during the last decade reveals that the most inspiring material, oddly
enough, has come from non-conjoint therapists. Behaviorists are too
directive and ask too many questions. The object relationists are too
confrontive and too focused on the internal world. The self-psychologists
are "too empathic" and focus too heavily on the external (self objects).
The difference between the psychoanalytic/psychodynamic model of
therapy and the cognitive approach is that the former holds the
relationship to be the number one priority while the latter holds the
individual to be the number one priority. My approach begins with
regarding “the relationship” as the patient, gradually weaning the couple
away from the relationship to that of self-development. Initially the
relationship stirs up many unresolved developmental issues. This new
approach holds that even when the therapist is confronted with the
"impossible couple," or when one partner throws up his hands at the
"impossible partner," a new window of opportunity appears to explore
virginal territory (the unconscious or repressed conflicts the "impossible
partner" arouses).
Among the new material included in this edition is an examination of
the role of psychohistory in couple therapy, a growing analytical focal
point. My interest in this burgeoning field began in the 1980s with a
study of the Israeli-Arab conflict, which at that time held striking
similarities to the marital discord between narcissistic and borderline
personalities that I had observed in my fledgling clinical practice. This
confluence of psychoanalysis and psychohistory led to my doctoral
dissertation, “The Arab-Israeli Conflict: A Psychoanalytic Study” (Lachkar
1983), a marriage of psychoanalysis and psychohistory. Tragically, the
situation in the Middle East has now escalated far beyond
narcissistic/borderline parameters.
As my practice grew, I noticed a growing number of couples that could
be classified as narcissistic/borderline, which led to the publication of
the first edition of this book and elicited further questions. What is it
that perpetuates conflict and makes individuals and groups sacrifice their
own lives and resort to self-destructive behavior? Finding these answers
requires us to analyze cultural patterns handed down from generation to
generation, embedded in the very identity of the group and expressed
through myths, ideology, religion, and childrearing practices - i.e., the
psychohistory of the group.
This edition also includes a focus on the inherent complexities of
cross-cultural relationships. Since we now live in a multicultural society
and our consultation rooms are beginning to resemble a mini United
Nations, new material has been included on the cross-cultural
narcissist/borderline relationship. An increasing number of clinicians are
beginning to pay heed to cross-cultural differences. It is difficult
enough to treat individuals from similar cultures, let alone those from
varying cultural backgrounds, traditions, and religions. Understanding
group dynamics from a global perspective helps make the conflict within
cross-cultural relationships more glaringly apparent. Here we consider
narcissistic and borderline vulnerabilities within the matrix of cultural
and societal traditions. How much is cross-cultural and how much is
pathology in cross-cultural couple therapy? Where do culture and pathology
meet?
This edition introduces another new concept - the “V-spot” or
“vulnerable spot” (Lachkar, 2003). The reference is to the partners’ most
sensitive area of vulnerability, known in the psychoanalytic literature
known as the archaic injury - a product of early trauma that each partner
relentlessly holds onto. This material delves into how each partner taps
into the other’s deep reservoir of early painful experiences, repeating
again and again the same traumatic injury. It will emphasize how the
therapist must continuously remind the partners of what stirs up the
V-spot and give them techniques to avoid the repeated opening up of old
wounds and painful archaic injuries.
Chapter I expand the domain of narcissistic and borderline
personality disorders to encompass the variety of shapes and forms these
two personality types can take. In addition to discussing different types
of narcissists, it introduces two new models of narcissism - "the artist
narcissist" and the "cultural narcissist." Heinz Kohut's pioneer work in
self psychology, along with that of other authors, broadened our
understanding of the narcissist. The borderline syndrome is discussed
mainly from an object-relations perspective, with particular emphasis
given to the theories of Bion, Klein, Fairbairn, Winnicott, Kernberg and
Grotstein. This chapter describes the narcissist and borderline
personalities and elaborates on their interlocking mechanisms of defense -
a most vicious link that holds narcissistic/borderline partners together
as it impacts perception, reality testing, and the ability to learn from
experience.
Chapter II outlines the theoretical constructs, drawing mainly
from self psychology and object relations. The integration of these
theories into conjoint treatment has its primary focus on maternal bonding
and attachment, mirroring, containment, and the unique way in which these
theories seek truth (internal vs. external reality). Although many have
suggested that self psychology and object relations make strange
bedfellows, this "odd couple" relationship yields a perfect merger in the
treatment of the narcissistic/borderline relationship.
Chapter III details the dance, the drama, the bond of the
narcissistic/borderline couple. The metaphor of the dance describes the
vacillating choreography of interactions and behaviors that are circular,
on going, never-ending and destructive. The dilemma of the
narcissistic/borderline relationship is further outlined to understand how
couples in these beleaguered relationships on the one hand desire an
intimate love bond and on the other are weighed down by a compelling force
to sabotage and destroy all that is good. Chapter III explores the reasons
that couples stay in painful conflictual relations - not because they are
crazy, but because each partner stirs up some un-developmental issue in
the other that desperately needs to be worked through.
The focus of Chapter IV is on "Marital Theatrics" and
psychodynamics, acknowledging the qualitative differences within
narcissistic/borderline disorders and exploring the interlocking systems
of guilt/shame, envy/jealousy, and omnipotence/dependency. At the core of
the dynamic flow between the narcissistic/borderline partners is a duel
between omnipotence and vulnerability. This chapter introduces the concept
of the "V-spot,” the area of greatest vulnerability in each partner,
which, when aroused, unwittingly elicits similar early trauma in the other
partner and impedes the ability to think and learn from experience.
Chapter V addresses dynamic positions and transference
formations, including the various countertransference issues evoked in the
therapist. My concept of the "couple transference" is elaborated as a
device for treating couples. As in the original edition, the focus is not
on teaching the partners to perform self-object functions for one another
but rather teaching them to rely on the therapist for this function.
Chapter VI relates ideas from group psychology and psychohistory
to the understanding of group fantasies and shared couple myths as a
preparation for the study of cross-cultural relationships in Chapter VII.
Understanding group behaviors provides a backdrop for understanding the
regressive/primitive nature in couples. Just as groups share collective
myths, so do couples share “couple myths.” Chapter VI examines
psychodynamics such as shame, guilt, and saving face, and gives how
examples of the part each plays in narcissistic/borderline relationships.
Chapter VII is a completely new chapter devoted to the treatment
of cross-cultural couples. It emphasizes how the entire spectrum of
psychoanalytic theory takes on a different face when treating couples from
various cultural and traditional backgrounds. It questions how much is
cultural and how much is pathology in these relationships and where the
boundaries between cross-cultural lines meet. Psychodynamics as
experienced qualitatively from various cultures are also given
consideration as a major factor in the treatment of couples from varying
ethic backgrounds and origins.
Chapter VIII presents the model of treatment. A six-point
treatment procedure is suggested within the paradigm of three specific
developmental phases, along with therapeutic function treatment points for
the therapist.
In Chapter IX, new clinical case and illustrative material has
been added to demonstrate some of the points made in this revised and
expanded edition.
We conclude with definitions.
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