Individual sessions as part of couple therapy? How concepts from self psychology can help us decide

ABSTRACT

The question of whether to see partners individually as part of couple therapy has been hotly debated in couple therapy circles for decades, but has rarely been addressed in the psychoanalytic couple therapy literature, especially the self psychology literature. In an effort to fill that gap, this paper briefly reviews the reasons many couple therapists have traditionally avoided such sessions, encourages a reevaluation of those concerns, and suggests ways to minimize or reduce the risks. It argues strongly that in some cases, individual sessions can be an attuned, empathic response to the needs of one or both partners and the most effective way to help improve the relationship between them. Rather than hard-and-fast rules, the paper advocates that couple therapists use their empathic understanding of each partner’s history and inner world, the couple’s dynamics, and their own needs and motivations, to make attuned, empathically responsive decisions based on each partner and couple’s particular needs at a particular time. Clinical vignettes are used throughout the paper to illustrate key points.

KEYWORDS:

• Combined individual and couple therapy
• couple therapy
• individual sessions in couple therapy
• psychoanalytic couple therapy
• self psychology

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ In her discussion of a previous version of this paper, Benioff warmly noted that while she understood my reasons for offering individual sessions in some cases, she herself had never done so and, in fact, would “never even think of it!”.

² For example, in one case in which a wife requested an individual session with the couple therapist to help her move beyond her husband’s affair, the paper suggests that the request reflected “an unconscious attack by her on the couple relationship itself and, as such, could be seen as an anti-therapeutic manoeuvre” (McCann, 2022, p. 308). The request is seen as potentially the wife’s effort to exclude her husband in the same way that she had felt excluded from his relationship with the other woman, and as an unconscious effort by both partners (since the husband supported his wife’s request) to avoid or sabotage the couple treatment by positioning the other as the primary problem. Alternative possibilities, such as the wife having a valid and healthy wish to be able to express herself more freely, an understandable idea that her husband might benefit from individual therapy, or expressing what she saw as the best ways to save her marriage, among others, were not mentioned. The same was true in another case in which the therapist considered offering individual sessions to help the partners process early pain that the therapist saw as interfering in their adult connection—McCann suggests that the therapist “may be acting out in the transference by attempting to repair a crucial aspect of mothering that was missing for both partners during their childhoods” (McCann, 2022, p. 311), without considering any more positive possibilities.

³ I had previously interpreted the forward edge of the patient's aggressive behavior, as a way to stand up for herself, protest hurtful behavior and experience the vitalizing and energizing effects of anger and righteous indignation.

Additional information

Notes on contributors

Carla Leone

Carla Leone, PhD. is the Director of the certificate program in Integrative Psychoanalytic Couple Therapy co-sponsored by the Chicago Psychoanalytic Institute and the Institute for Clinical Social Work. She is on the faculty of both institutions and directs a group private practice in a Chicago suburb, where she sees individuals, couples and families, provides supervision and runs study groups. Dr. Leone recently served a three year term as Secretary of the International Association of Psychoanalytic Self Psychology (IAPSP), currently co-chairs its Membership Committee, and is co-founder and former chair of its Couple Therapy Interest Group. She is the author of several published papers on the application of self psychology to the treatment of couples and families, and one paper on the “unseen spouse” of patients in individual treatment, and has presented nationally and internationally on these topics.