The Narcissistic Borderline Couple: New Approaches to Marital Therapy 2nd Edition

249 Pages·2003·1.61 MB·English

by  Joan Lachkar

The Narcissistic/Borderline Couple
The Narcissistic/Borderline
Couple
New Approaches to Marital
Therapy
Second Edition
by
Joan Lachkar, Ph.D.
BRUNNER-ROUTLEDGE
New York and Hove
Published in 2004 by
Brunner-Routledge
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New York, NY 10001
www.brunner-routledge.com
Published in Great Britain by
Brunner-Routledge
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BN3 2FA
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Copyright © 2004 by Taylor & Francis Books, Inc.
Brunner-Routledge is an imprint of the Taylor & Francis Group.
This edition published in the Taylor & Francis e-Library, 2005.
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All rights reserved. No part of this book may be reprinted or reproduced or utilized in
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Library of Congress Cataloging-in-Publication Data Lachkar, Joan.
The narcissistic/borderline couple: a psychoanalytic perspective on marital treatment/ by
Joan Lachkar.—2nd ed.
p.; cm.
Includes bibliographical references and index.
ISBN 0-415-93471-0 (Print Edition) (hardcover: alk. paper)
1. Marital psychotherapy. 2. Borderline personality disorder. 3. Narcissism.
4. Psychoanalysis. 5. Couples—Psychology.
[DNLM: 1. Marital Therapy—methods. 2. Borderline Personality Disorder.
3. Narcissism. 4. Object Attachment. 5. Self Psychology.
WM 430.5.M3 L137n 2003] I. Title.
RC488.5.L348 2003
616.89 ′156—dc21
2003009288
ISBN 0-203-50125-X Master e-book ISBN
ISBN 0-203-57546-6 (Adobe eReader Format)
Contents
Acknowledgments v
Introduction vii
Chapter 1 The Narcissist and the Borderline: Clinical 1
Description
Chapter 2 Theoretical Implications 14
Chapter 3 The Couple: The Dance, the Drama, and the Bond 32
Chapter 4 Marital Theatrics: The Psychodynamics of the 52
Narcissistic/Borderline Couple
Chapter 5 Dynamic Positions and Transference Formation 78
Chapter 6 Group Psychology and the Narcissistic/Borderline 107
Couple
Chapter 7 Cross-Cultural Couples 124
Chapter 8 Model of Treatment: Treatment Techniques and 143
Procedures
Chapter 9 Final Cases 176
Curtain Call: A Final Note 210
Definitions 212
References 221
Index 228
Acknowledgments
I am particularly grateful to all my colleagues and friends in the field of
psychoanalysis, as well as to my teachers and codancers in the artistic
world of classical ballet. The latter contributed much to my efforts to
understand the psychic pain and conflict that occurs in the mental lives of
the conflicting couples demonstrated in this book. What better way to learn
about narcissism than to have looked at myself in a mirror every day since
the age of seven! I feel compelled to acknowledge the special contribution
of Carmelita Maracci, Stanley Holden, and Margaret Hills, noted ballet
masters of classical dance, with whom I have had the good fortune to study
dance for more than 20 years. It was through ballet that I learned the
importance of artistic expression, and the blending of technique and
discipline. Be it at the barre or within the constraints of the consultation
room, one must adapt to “the dance”: Both ballet and the practice of
psychoanalytic psychotherapy involve the subtle blending of scientific
principles with art (offering one’s unique interpretation while remaining
steadfast to analytic principles).
The study of narcissism and borderline pathology would not have been
possible without the mentorship and influences of the following master
blenders to whom I owe much gratitude. They include Drs. Wilfred Bion,
James Grotstein, Otto Kernberg, Nancy Kobrin, Albert Mason, Harvey
Martz, Hindy Nobler, Marvin Osman, Florence Bienenfeld, Irene
Harwood, Orli Peter, Roberta Rinaldi, Judy Warmbrand, James Weiss,
Peter Berton, Peter Lowenberg, and the late Drs. Samuel Eisenstein and
Alexander Rogawsky. Also, my ex-husband Robert Kahn, M.D., whom I
met when I was 18, taught me more about psychoanalysis than any
supervisor. I am also grateful to Lloyd deMause, Jerry Piven, Jerry Atlas,
Howard Stain, and all the others at the Journal of Psychohistory who gave
me permission to delve into the political arena, blending political and
marital conflict as a new dimension in the study of cross-cultural couples.
I am indebted to my editors and the staff at Taylor and Francis—
particularly George P.Zimmar, executive editor, Luciana Cassano, senior
editorial assistant, Mick Spillane, senior production editor, and Shannon
Vargo, assistant editor—for their patience and assistance in the rewriting
vi
of this book. In addition, I am grateful for the editorial efforts of Joanne
Freeman, her patience in enduring an endless plethora of revisions, and her
invaluable insights and good ear. I’m also indebted to my research
assistants Nicole Lachkar, Rafi Raffee, Scott Raphael, and Alexander
Sokhis.
I offer special gratitude to my family, friends, and colleagues, to my
patients, who paid me to learn from them, and to my dear children—
Sharon, Pamela, and Nicole—to whom this book is dedicated.
Introduction
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, 1985, 1986, 1989); Lansky (1981,
1987); Scarf (1987); Scharff and 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 and Sperry (1998); Kernberg (1995); Lachkar
(1998); McCormack (2000); and Rothstein (1998).
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
overidentify 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 codependent nature of the relationship. In conjoint
treatment, we see how certain dynamic mechanisms of the narcissist
(grandiosity, entitlement, guilt, withdrawal) can arouse states of
viii
unworthiness and nonexistence 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, increased numbers of working mothers, parental
unavailability to children, the near extinction of extended families, and, in
general, greater social isolation.
The 10 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 United States
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
ix
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, 1997), the narcissistic couple (Kalogjera
et al., 1998), the passive-aggressive couple (Slavik, 1998), the dependent/
narcissistic couple (Nurse, 1998), narcissistic disorders and dependent/
narcissistic couples (Carlson & Sperry, 1998; Nurse, 1998), and 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), included 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 1 priority while the latter holds the individual to be the
number 1 priority My approach begins with regarding “the relationship”
as the patient, gradually weaning the couple away from the relationship to
self-development. Initially the relationship stirs up many unresolved
developmental issues. This new approach holds that even when the