Complex and Creative: Thinking about the process of couple interpretation

19 March 2021

Tavistock and Portman student, Suzie Quartermaine, shares her experience of the first 'Psychodynamic Psychotherapy with Couples' (D59C) Alumni Event, which took place in March 2021.

Couples Alumni Event Image

Last week I joined fellow students and staff for the first Alumni Event for the Psychodynamic Psychotherapy with Couples course. We were here to think about interpretation within couple work, and there was a sense of curiosity as to how we would begin to tackle such a vast and complex topic. Our speakers were Mary Morgan and Joanna Rosenthall, two of the leading thinkers and clinicians in the field of couple psychotherapy.

Mary started with her paper, Complex & Creative – The Process of Couple Interpretation. Having myself turned to Mary’s writing on too many occasions to count when feeling at sea with my training, I was excited to hear how she would bring her clear and straightforward analysis to this difficult topic. What followed was a thoughtful meditation on the nature of interpretation, not as a final statement but as a communication to the couple of the limits of the therapist's understanding – perhaps reflecting the way in which two partners in a couple relationship will also have limits to their understanding of each other, which can often cause conflict. In this way, Mary reminded us of the importance of relationship building in the process of interpretation, and that our curiosity is our greatest asset in coming to know the couple and helping them become interested in their relationship themselves. As she spoke, I felt empowered by the concept of an interpretation as neither correct nor incorrect, but a means by which the unconscious could be made conscious, a way of introducing a new thought when thinking may have become stuck. Mary spoke about the complexity and creativity in couple work, an inevitable consequence of the range of different interrelated relationships and unconscious dynamics at play. These elements are enacted before the therapist during a session and she brought all of these ideas to life with material from her recent clinical work. The stimulating clinical examples were a reminder of how complex, demanding and alive sessions with couples can be.

Joanna responded to Mary with her own paper, Working Towards a Couple Interpretation, in which she further explored the idea of interpretation as a process which happens gradually. She shared her own feelings of intimidation associated with the topic and described Mary’s paper as a ‘gift’ in which a complex area had been broken down into much more manageable pieces. She stressed that interpretation operated, not as a silver bullet or magical thing the therapist says, but cumulatively. She highlighted how important it is for the therapist to keep a lively attunement to each partner and the interaction between them as it emerged. I felt both reassured and encouraged by these ideas. Joanna reminded us that interpretations were often imperfect and clumsy but were part of an explorative mutual process with the couple. She picked out Mary’s phrase ‘leaning towards an understanding’ in which the true nature of interpretation could be understood as a feeling around in the dark. Joanna finished with clinical material which was powerful and moving and felt very much alive. She described closely tracking the countertransference and it was possible to see just how crucial a part this plays in informing and creating an interpretation that might reach the couple. She gave the group an experience of getting lost with this couple – the moment by moment interaction with both partners – and demonstrated how her emotional and thinking response informed her interpretations as they felt their way gradually to a fuller understanding. 

After the presentations, we broke into small discussion groups to share our thoughts and associations on what we had heard. It was clear that we’d been enlivened by the talks. The theme of exposure and voyeurism emerged, and we thought about how, as couple therapists, we are often being both invited into a relationship whilst simultaneously being defended against fiercely. We wondered what effect this had on the way we might interpret and how one approaches sensitive areas, such as sex, when the potential of shame and exposure feels so threatening. How do we manage an appropriate distance and how do we balance this with the desire not to turn a blind eye to areas the couple cannot face? We thought about the ways in which interpretation can facilitate a couple’s ability to gradually internalise the work, but also how hard that can be. 

We then reconvened as a larger group and continued to grapple with the complexity of the issues that had emerged from both the papers and the smaller group discussions. We discussed the role of interpretation as a shared endeavour between therapist and couple and how this can feel at once playful or impossible depending on the position you find yourself in with the couple and your countertransference. We thought together about the pressure that a couple can exert during treatment and the importance of being able to allow things to emerge over time. The issue of how interpretation, and couples work generally, had been impacted by the move to online delivery was clearly very much on everyone’s mind. One attendee suggested that perhaps Zoom was speeding up the transference and the countertransference within sessions and we wondered about this together as a group. Some felt that their couples felt safer joining from their homes while others felt the lack of a physical frame led to a loss of containment. I wondered if there was a sense that everything was faster but not as deep, if there were some areas that simply couldn’t be brought to virtual work. The discussion was animated and, as we explored these areas, the group members shared how enlivened and enriched they felt by the day’s work. Numerous attendees expressed how much the morning had lessened their anxiety about interpretation and reinforced how important it was to trust the process, even as we feel overwhelmed by the feeling of not knowing. As we wrapped up proceedings there was a hopeful sense in the group that this might be the first of many such events to come.

Learn with our Couples Unit

If you're interested in working therapeutically with couples, the Tavistock and Portman Couples Unit offers a rich variety of education and training opportunities to support you on your journey. 

Whether you're looking to expand your current skillset, deepen your understanding of psychodynamic theory, or embark upon a new chapter, we have a course for you.

BPC accredited course:

  • Psychodynamic psychotherapy with couples (D59C) – This part-time, two-year course enables you to be registered with The British Psychoanalytic Council (BPC) and practice as a psychodynamic psychotherapist with couples, in the NHS or as an independent practitioner.

Short CPD Courses:

  • Understanding Couples – This workshop will provide an introduction to the ideas and concepts which help us to understand couple relationships – exploring unconscious processes, the 'couple' state of mind, and the potential impact of this work on the clinician.
  • Working with Couples – This course will develop your potential for working with couples, examining unconscious interactions, underlying difficulties and interventions, and acknowledging the couple's relationship and their individual needs.
  • Working with Couples who Adopt: The Impact of Adoption on the Parental Couple – This course explores the complex psychodynamics involved in the adoption process, considering the theory and practice of working through traumatic losses, and identifying interventions that can ease unconscious pressures and prevent adoption breakdown.
  • Working Therapeutically with Couples Contending with the Effects of Long-Term Illness – This workshop will outline approaches to understanding the meaning of illness, how it can be seen as a shared phenomenon, and how its associated narratives and challenges are positioned within the history and dynamics of the couple or family.

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