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THE CONCURRENT ANALYSIS OF

MARRIED COUPLES
BY BELA MITIELMANN, M.D. (NEW YORK)

This paper is a study of complementary neurotic reactions as

revealed during continuous treatment of a husband and wife
by the same analyst.
A thirty-two-year-old woman sought analysis because of obses-
sive thoughts, of three years duration, of cutting her child's
throat. She felt worthless because she had experienced clitoral
but never vaginal orgasm. It became clear after about six
months of analysis that during ten years of marriage the wife
was always disappointed in her husband's sexual performance
but out of considerateness never said anything to him about it.
His ejaculations occurrred within about thirty seconds after
intromission. Seven years previously the patient had seen a
child run over by a streetcar and had become so emotional
that people thought her child had been killed. During six
months of anxiety and depression that followed, the patient
wanted no sexual intercourse. The husband agreed out of
considerateness, and then assumed that he was much more
potent than his wife.
Being told of his sexual difficulty, the husband consented to
treatment after a period of reluctance. A capable architect, six
years his wife's senior, he was periodically moody, feeling that
he had failed his family by not earning more, and at such
times his sexual potency diminished. The wife, meanwhile,
had been relieved of her obsessive thoughts, had partly acknowl-
edged her disappointment in her husband, and had become
somewhat more self-assertive. She now insistently raised the
question whether she would be capable of vaginal orgasm if
her husband were adequately potent. The analyst agreed to

From the New York Hospital and the Department of Psychiatry, Cornell
University Medical CoIlege, New York.
18~
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CONCURRENT ANALYSIS OF MARRIED COUPLES 183

suspend her treatment until the husband's potency became

adequate, and this was accomplished in six months. The
wife, however, still experienced no vaginal orgasm, felt at
times repelled by her husband, and had obsessive fantasies of
taking men's infected penes into her mouth. She resumed
treatment with great reluctance and discomfort, despite evi-
dence from her husband's improved functioning that her own
analysis could be successful.
Her analysis came to a standstill about eight months after
resumption. She began each hour by relating in an affected
voice incidents and dreams she had prepared for the hour.
When the analyst commented about her lack of spontaneity,
she first felt hurt at being 'criticized', then agreed, and finally
admitted she was afraid of the breaking up of her marriage.
A divorce would prove her final worthlessness, having failed
in her occupational ambitions, and in her relationship with
her parents and with her child, now six years old. She was
told that her implacable ideals and dependent needs inter-
fered with the investigation of her sexual frigidity as well as
of her disappointment in her husband, of whom she demanded
compensation for all the disappointments of her life.
The husband talked shyly and wept occasionally, but was
unable to give vent to his emotions or to associate freely. In
discussing his defensive attitude he too expressed catastrophic
fear that the marriage might terminate.
After a year and a half of analysis, the husband began openly
to voice objections to interpretations not to his liking. He
also began to experience and at times to voice anger towards
his wife when she declined to have sexual relations, or if she
was unreasonably critical of him.
The analyst believed the husband was justified in com-
plaining that the wife, although in a gentle way, was always
critical and never gave him credit for anything; furthermore,
he felt that in her reluctant complaints about her husband's
shortcomings she so colored the stories as to make him appear
in the wrong. A trivial but characteristic incident made this
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BELA MITIELMANN

clear. In early summer, they rented a bungalow. Each week

end, the husband dragged two heavy suitcases to and from the
train. The wife reluctantly told the analyst that the husband
objected to carrying the suitcases-showing thereby his pas-
sivity, lack of responsibility and of manliness. The husband
independently told the analyst that the suitcases could be sent
by express except for his wife's objection. In reply to a casual
question in her next interview, the wife stated that she was
sure the express company would not accept the suitcases, or
that if they did they would not be delivered on time. The
analyst remarked that there would be no harm in trying it
once. Two weeks later, the husband related laughingly that
the express company had accepted the suitcases and regularly
delivered them in time. The wife mentioned nothing about
this but, in reply to a casual question by the analyst, confirmed
the story.
The analyst then began consistently to point out to the wife
that she always had to be right in any difference of opinion
with her husband, and that she disparaged him in order to
feel superior to him. This feeling of being right and
superior, the analyst suggested, was one of the ways in which
she escaped feelings of utter worthlessness. He made these
constructions by selecting relevant material from the patient's
spontaneous productions, or he used them as the basis of
approach to the patient's defenses when the trend of her asso-
ciations was obscure or she was detached. Occasionally he
asked questions to clarify some incident she related but did not
quote her husband's version.
The patient at first reacted with self-condemnation, then
she attacked the analyst for destroying the last vestiges of her
self-esteem. However, the analysis started to progress. She
was made aware that although her feeling of being superior
saved some shreds of her self-esteem, the effects were pernicious.
It made her feel guilty because of her severe conscience, and
deprived her of the affectionate and manly husband she needed
to compensate for the kind of parents she had always missed.
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CONCURRENT ANALYSIS OF MARRIED COUPLES 185

It increased her sexual rejection of him and led her to fear

abandonment and retaliatory genital injury. Her attitude con-
stantly undermined his feelings of competence and masculinity,
damaged his sexual potency, and thus she deprived herself of
what she most wanted. The resolution of these attitudes made
the patient's infantile experiences more accessible to analytic
investigation, and she reported two dreams.
A man is pursuing two young boys, captures them and
holds them as prisoners. One of them sits crouched in terror.
He looks effeminate. The older one is stronger; he throws a
knife at the man and kills him.

Her parents had quarreled from her earliest childhood. Her

mother, she learned, often refused intercourse with the father.
They were divorced when the patient was eleven years old.
Her further associations led her to the recollection that her
father used to tell the story of Bluebeard to the patient's sister,
who would crouch in terror listening while the patient angrily
asked him to stop. For the first time she spoke of having been
'left out in the cold' as a child. Her sister, two years younger,
was pretty and everybody's favorite. Her brother, four years
her senior, was sickly and received a lot of care. The patient
herself was a 'miserable' child, with teeth missing, whom every-
body teased.
In the second dream, the patient is sitting at a table with
her mother and her sister. The patient is afraid that people
will see how her sister is behaving. She notices a pair of
bloody and soiled drawers on the chair. She angrily reproaches
her mother for having worn and soiled them.

The sister has a compulsion neurosis which the patient tries

to conceal from everyone. This dream revived the memory
from childhood of humiliating and frequent enemas, openly
discussed before visitors. Both dreams tell the story of parental
rejection and hostility, sibling rivalry, fear of destruction,
wanting to be a male, blaming the mother for being a worth-
less, soiled, injured female and for failing to be an adequate
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186 BELA MITTELMANN

woman. She now spoke in the analysis with adequate affect

about such topics and responded to the interpretation with
further material and relief of distress. Her need to be right
and to surpass her husband had to be elucidated recurrently
when revived in new situations of stress or when new problems
were approached in the analysis.
In the course of these developments the patient stated she
had obsessional thoughts about the analyst during the analytic
hours. She visualized taking his infected genital into her
mouth, whenever he made a comment that she considered
derogatory to her. It had been clear from the beginning of
the analysis that she wanted the analyst to be a figure of
omnipotence who would compensate her for all suffering,
establish her worth-whileness and need to be loved, and would
relieve her of all problems and satisfy all her wants. His inter-
pretations implied to her exposure of her deficiencies and of
her guilt and thus shattered her expectations; furthermore,
when the analyst through his interpretations questioned her
extreme ideals and goals of perfectionism she felt he threat-
ened everything by which she had tried to gain self-valuation
and affection. Her reaction to these threats and frustrations
was anxiety, resentment and guilt which re-evoked infantile
feelings of rejection by her parents, of injured self-love and of
worthlessness. She reacted with a renewal of striving for per-
fection, and of having to be right, which had first appeared in
her school years. These strivings included rivalry with her
mother, her siblings, and penis envy. In her helplessness,
however, she could not tear herself away from the analyst nor
could she openly express those strivings; instead, as illustrated
by the obsessional fantasy, she debased him, debased herself,
but tried to obtain some satisfaction of her needs. The need
to be right was one of the forces that made the patient oppose
indirectly every interpretation offered during the most difficult
period of the analysis. This opposition was further intensified
by the idea that accepting the analyst's interpretations meant
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CONCURRENT ANALYSIS OF MARRIED COUPLES 187

that she was wrong and her husband was right. These attitudes
were unrecognizable in the transference because of the
patient's self-effacement, detachment and guilt. Simultaneous
treatment of the husband enabled the analyst to recognize the
needs in both relationships.
The husband's bitterness could now be brought into the open
in his analysis, as well as the fact that he regarded successful
treatment of his sexual difficulties, defeatism, and self-
effacement impossible as long as his wife's behavior remained
unchanged. His infantile and adolescent experiences became
more accessible to analytic investigation, and he reported a
dream.
He is in front of some building in which a man had died
and he feels he ought to know who the man was and what
his affairs had been.
The associations led to the death of both parents. The
patient's only memory of his father, who died when the patient
was six, was a vague picture of him, dead, before the funeral.
In his childhood and adolescence he felt that his life would
have been happier if his father had lived. He was the young-
est of five siblings. When he was twelve, his older brother
attempted anal intercourse with him without penetration.
The patient, feeling guilty, refused the second time. The
mother worked hard to provide for the children, and the
patient felt both pleased and guilty that she did not remarry
being 'loyal to the father's memory'. He never dared to assert
himself with his domineering mother and siblings until he
decided to marry. They all opposed his marriage and called
him ungrateful and disloyal. When his mother died not long
ago, he experienced little grief. Thus the dream referred to
the patient's harsh fate of losing a protective and strong father,
of being exposed helplessly to the domination of his mother
and his siblings, to his hostility and his cedipal conflict, his
submissiveness, his unconscious passive (anal) homosexuality,
and his guilt.
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188 BELA MITTELMANN

TYPES AND DYNAMICS OF NEUROTIC INTERRELATIONS

Oberndorf (2) analyzed nine married couples and found the
procedure feasible and advantageous. He states that in narcis-
sistic individuals the idea of the possession of another person
persists instead of giving way to the mutual participation
inherent in adult love. Wishes of this kind stem from the
longing for a parent-child relationship which is revived in the
masturbatory fantasies of adolescence continued into mar-
riage. The narcissistic individual's need for acceptance is
acutely exaggerated because of the limitation of his own capac-
ity to give affection. While acceptance by the partner would
seem to validate the esteem which the neurotic member has
placed on himself, it essentially affords reassurance against
his inferiorities, both physical and emotional. Expectations
of the miraculous in marriage are doomed to partial disillusion-
ment. Oberndorf concludes that intermarriage difficulties are
caused by emotional immaturity, incest wishes and taboos,
and identifications with parents of the opposite sex-all inher-
ent in the unresolved cedipus complex.
In most prolonged neuroses, complementary reaction pat-
terns develop between individuals in intimate relationships.
In a previous paper (I), the author distinguished the follow-
ing neurotic patterns: 1, one of the partners is dominant and
aggressive, the other, submissive, passive, and masochistic; 2,
one of the partners is emotionally detached, the other craves
affection; 3, there is a continuous rivalry between the partners
for aggressive dominance; 4, one of the partners is helpless,
craving dependency and consideration from an omnipotent
mate; the mate tries to live up to this expectation but periodi-
cally wants to assume the role of the dependent. partner.
In all of [Link] complementary patterns, bot.h partners may
obtain a measure of satisfaction and safety. Mutual identifica-
tion between the partners can play a significant supportive
role in the following ways: (a) both mates find security, satis-
faction, and increased self-esteem through a mutual over-
idealistic approach to life; (b) in their helpless dependence
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CONCURRENT ANALYSIS OF MARRIED COUPLES 189

each considers the other a haven of refuge and by helping him

helps himself. The feeling of safety for the dependent partner
from the 'omnipotent' supporting mate is obvious. The sup-
porting partner allays his own unconscious fear of helplessness,
isolation, and abandonment by helping the dependent mate.
The feeling of helplessness may, however, be renewed through
identification with the helpless partner; also resentment is
engendered when one partner does not live up to expectations
and thus makes the other's deficiencies again evident; further-
more, the one assumes as his own those deficiencies that the
mate manifests, and thus feels guilty and inadequate.
Fears of frustration, condemnation, abandonment, and
attack arise from the one partner's own impulses of hostility,
or submissive dependency needs, as well as from the partner's
behavior. The reactions are likely to be most intense when
the intrapsychic distortion and reality coincide; thus patients
consider a partner's hostile overreaction as a proof of the
catastrophic dangers of self-assertiveness.
The following types of relationships have been observed
between the sexual attitudes of the two partners. First, both
value coitus highly, and have relatively good potency in spite
of otherwise serious problems. The genital relations then
acquire considerable compensatory value for other difficulties
and may become one of the important ties maintaining the
relationship. Second, both partners have strong anxieties and
guilt about sex, accompanied by impaired potency, feelings
of inadequacy, and repressed infantile sexual strivings. If
one or both of the partners blame the other for the difficulty,
the feelings of frustration, hostility and guilt become intensi-
fied. Blaming the partner appears fully justified because of
the other's actual difficulties. Third, both partners have
strong masturbatory, oral, anal, or sadomasochistic impulses.
Although these activities are followed by some guilt and feel-
ing of inadequacy, the reactions are not intense, because
through identification, they relieve each other's guilt. If,
however, the reaction-formation against the partial impulse is
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BELA MITTELMANN

strong in one of the partners but absent in the other, or if the

permissible partial impulses are different in the two partners,
the difficulty can be serious.
The habitual attitudes of a spouse may contain clearly the
reaction to a parent toward whom they were originally
directed, or the attitudes may represent generalizations from
infantile experience, for example, 'I was rejected by my mother
and am being rejected by everybody; 1 have no hope in life'.
The attitude may represent a longing that was frustrated or
secretly gratified, or reactions against now repressed strivings
either in the form of moral repudiation or defense; thus, the
demand for gratification of frustrated longings for dependence
may have persisted throughout the patient's life. Although
without insight into its nature, extent, and unconscious moti-
vations, it may dominate the patient's marital behavior.
Similarly, sibling rivalry may lead to sustained aggressive
competition or to passive homosexual trends.
The dominant symptoms and trends which develop out of
the wide potential possibilities are determined in part by the
mate's difficulties. The choice of a mate takes place on the
basis of a limited knowledge of his or her functioning, and
subsequent developments depend upon reactions of both
mates to one another. Thus, it seems likely that the wife
previously discussed would have developed a more adequate
vaginal response if the husband had been potent. This, in
turn, would have altered the development of her oral trends.
Husbands and wives may conform to infantile and pubertal
images of parents and siblings that they transfer to each other.
If a mate's behavior be the opposite, the complexity of the
problem is illustrated by the couple described. The wife
was superficially entirely different from her husband's domi-
neering mother and siblings, but she was like them in her
continuous criticism of him, and evoked comparable reac-
tions in him; however, because of the subtlety of her behavior
and his own self-effacing submissiveness, his bitterness and
resentment were repressed. His defense was a false self-esteem
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CONCURRENT ANALYSIS OF MARRIED COUPLES 191

maintained by their mutual ego ideals, by his illusion of

exceptional potency, and lastly by his feeling that, with utmost
considerateness, he was looking after her needs.
Current attitudes of dependence, hostility, sexual needs,
anxiety, guilt and infantile experiences are interrelated in
complex complementary reactions. Rejection by the mate leads
to anger, then to anxiety and guilt; this revives infantile help-
lessness and dependence, with fear of genital activity and
reinforcement of infantile striving; this in turn reinforces
current anxiety and guilt, and leads to anticipation of rejection.

TRANSFERENCE REACTIONS
Similarities and differences in the mates' behavior toward the
analyst are equally instructive. Similarities were illustrated
by the couple discussed. They both spoke quietly, could rarely
associate freely, and lapsed into silence, unless the analyst made
a comment, early in the hour. By contrast, one spouse may be
taciturn and self-effacing, and the other friendly and talkative.
Both partners may show boundless faith in, or superiority to-
ward, the analyst or may manifest contrasting attitudes. Such
observations enable the analyst to understand the mates' mutual
reactions and to judge the reality of the problems they present
to each other.
The following attitudes may arise in one or both married
partners who are being treated by the same analyst: (a) con-
cern as to whether the analyst agrees with one patient's over-
evaluation of the mate or whether he considers him or her
as deficient; (b) the fear and accusation that the analyst is
siding with the other partner; (c) the wish-fulfilment fantasy
that the analyst will change the other mate by magic and thus
save the patient the necessity of coming to grips with his own
conflicts.
The following reactions may arise out of discussion of marital
problems: (a) blaming the analyst for the assertiveness of the
previously submissive mate, which may be combined with the
complaint that the analyst deprived the complaining partner
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BELA MITTELMANN

of any defense against such attacks; (b) fear of divorce arising

in connection with the liberation of repressed submissive or
aggressive impulses; (c) complaints about the destruction of
overidealized values attached to the marriage. The husband
and wife previously discussed stated that if their 'ideals' of
unlimited loyalty, considerateness and perfect harmony were
questioned the marriage would lose all its value.
An important aspect of the concurrent analysis of married
couples may be one patient's feeling that by changing the
mate, the analyst alters a reality which presents insurmountable
difficulties. The correction of these difficulties relieves the
patient's helplessness, increases his confidence in the therapist,
removes some of his most important rationalizations, and forces
him to face inner and external problems.

TECHNICAL CONSIDERATIONS
The type of material presented by the patient and the com-
ments made by the therapist do not differ essentially whether
one or both of the mates is being analyzed. The advantage
of the analyzing of both is that the analyst gains a more com-
plete picture of the realities and of the complementary reac-
tions of the two individuals. Information may be obtained
from one that the other does not reveal or underplays to such
an extent that the analyst might fail to recognize some crucial
trends. Without the interpretation of these trends, the success
of some analyses would be seriously limited; moreover, by
gauging the relative risks involved in the changing reactions
of one or the other, the analyst can increase or lessen the
emphasis in his interpretations. The therapist can utilize
knowledge gained from one by shifting his focus and selecting
for comment relevant material from the other's associations.
He may also ask casual questions about incidents of which
he had been given a different version, or which had not been
mentioned. Rarely, he may actually quote the mate or state
what his opinions were about certain incidents. This last
procedure requires careful judgment.
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CONCURRENT ANALYSIS OF MARRIED COUPLES 193

Occasionally it may be necessary to increase, by interpre-

tation, a patient's rebellion against the mate's behavior.
Although the mate may at first react with increased aggression
or anxiety and guilt, without such rebellion he would never
be forced to recognize his difficulties. On the other hand,
when one of the mates is temporarily under severe external
or internal pressure, a reassuring word from the therapist
mitigates anxiety.
To Oberndorf's (2) statement that in the analysis of married
couples the analyst has to maintain scrupulous impartiality
toward both, the comment may be added that when one
presses the therapist for a stand as to who is 'right' he may
state that both parties have problems, and that his role is to
help each one without taking sides. He may state that on
certain points the grievances of one or the other are justified,
e.g. if the mate cannot stand contradiction, pointing out, how-
ever, that the patient reacts to this justifiable grievance in ac-
cordance with his own problems. He may usefully add to this an
explanation of the complementary nature of the difficulties,
for example, how the patient's submissiveness fosters the
partner's domineering behavior. If both patients color inci-
dents in their own favor and the realities and dynamics of the
situation are perplexing, the analyst should state that he does
not understand the problem. Through the reactions of one
or both the mates, the picture soon becomes clarified to the
point where the analyst can interpret again.
As a rule both patients accept the confidential nature of the
information they give to the therapist and are not afraid that
he will divulge it to the mate, nor is it usual to ask for infor-
mation about the mate, even when there are jealousies about
possible infidelities. Both mates are best advised not to dis-
cuss their analyses with each other in order to avoid compli-
cations. Nevertheless, such discussions occur occasionally.
If one of the mates asks questions about the meaning of the
other's behavior it is best to state that the two analyses should
not be 'mixed'.
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BELA MITIELMANN

Increased tensions may arise when they 'quote' the analyst to

each other during periods of stress, although the tensions
aroused may lead to insight into pertinent problems. Diffi-
culties may arise if one of the mates has a negative therapeutic
reaction, or terminates the treatment.
Concurrent analysis of married couples by the same analyst
is practicable in the majority of cases. It may be inadvisable if
one of the partners has paranoid traits or is very dependent
and also if it is likely that the marriage will break up. In
doubtful instances the trial period of analysis enables the
therapist to decide whether one of them should be transferred
to another analyst. In all instances included in this report, one
of the mates started treatment at least one month before the
other, the second coming for interviews after it was evident
that he too had significant problems. By this time the first
patient is sufficiently established in the transference to cope
adequately with conflicting feelings arising out of the visit
of the mate. The mate's anxious eagerness to turn to some-
body for help or to vindicate himself makes him accessible to
therapy.

CASE MATERIAL AND THERAPEUTIC RESULTS

The material discussed in this paper was based on the treatment
of twelve couples. In four instances, husband and wife had
daily analytic interviews over prolonged periods of time. Of
these, two husbands have terminated their analyses, one
because he improved adequately after two years of treatment.
His wife is continuing her analysis. The other man stopped
his treatment after deciding to divorce his wife, and has since
remarried. In this instance, an exceptional procedure was
followed. In the eighteenth month of the wife's analysis and
the sixth month of the husband's, the analytic sessions of both
were filled with recriminations against the mate, both of them
coloring the stories entirely in their own favor, and making
all interpretation ineffective. The therapist finally had two
sessions with husband and wife together in which they related
their contradictory stories. These two sessions were very
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CONCURRENT ANALYSIS OF MARRIED COUPLES 195

revealing of facts and complementary reactions with the result

that the husband decided to divorce his wife. In so doing he
liberated himself from neurotic goals that he had unhappily
pursued through ten years of marriage to vindicate himself,
retain his dependence and still to win a victory over his wife.
The wife agreed to her husband's decision, and continued her
analysis.
All of the analyses in this group have advanced far enough
to be considered successful as regards disappearance of clinical
symptoms, as having effected favorable changes of character,
and elucidation of dynamics. In eight instances one of the
mates came for analytic interviews, whereas the other received
a minimum of two but not more than twenty treatments at
intervals of one week to several months. Of these, in six
instances there was sufficient change in the mate's reactions to
make the relationship satisfactory for the patient. Three of
these patients have terminated their analyses successfully.
With individuals who need or accept only infrequent inter-
views, it seems best to start with the comment that their atti-
tudes will strongly influence the effectiveness of the mate's
treatment. Utilizing knowledge gained, for example, from a
wife in analysis, well-placed questions may elicit the husband's
symptoms. This may accelerate the whole therapeutic process,
or make therapy possible for an otherwise resistant individual
who needs it.
The effectiveness of limited treatment of married couples
even with serious psychopathology is illustrated by the example
of a sixty-two-year-old man who was successfully analyzed for
hypertension and anxiety hysteria. The wife was sufficiently
paranoid to confide to the therapist that her husband 'has
millions of women'. She was not cured of her paranoia, but
the therapist's comments in the course of six interviews, to the
effect that she would ruin her family unless she behaved dif-
ferently, stopped her from watching and questioning her hus-
band, neglecting her appearance, nagging and trying to TUn
her children's lives.
The effects of a mate's uncooperativeness, which occurred
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196 BELA MITTELMANN

in two of the eight couples, depend on the analysand's poten-

tial self-reliance. In one case, phobic symptoms and anxiety
attacks of a forty-year-old dependent housewife recurred, after
a year's improvement, from her husband's unresolved neurotic
character. He always had to have his way; otherwise he became
taciturn or made polite but biting remarks. He was reluctant
to come for treatment, and spent the interviews vindicating
himself. Amid distortions of the therapist's comments, he
repeatedly decided to stop the treatment. In the tenth inter-
view, the analyst told him that if he refused treatment from
him or some other psychotherapist, the wife's further treat-
ment would be futile. That evening the husband told his
wife that the analyst intended to stop her treatment. She had
a serious attack of anxiety continuing through the next day and
did not return for treatment. It is at times difficult to judge
how emphatic the therapist should be with an uncooperative
mate. With less emphasis both to the wife and to the hus-
band, the effect of the failure might have been less over-
whelming in this instance. The reaction of this dependent
woman may be contrasted with another whose husband, it
became evident after two interviews, had characterological
difficulties as severe as his wife's, but was unwilling to undergo
treatment. His wife, always self-assertive, decided to institute
divorce proceedings. Following separation, her tension less-
ened and the treatment progressed smoothly. Relative eco-
nomic independence favored this patient's ability to cope with
an uncooperative husband.

SUMMARY AND CONCLUSIONS

Treatment of married couples by the same analyst makes more
concrete both the realities and the neurotic interactions
between the mates. Current reactions of dependency, guilt,
hostility, anxiety, and superiority are revealed in a clearer
light, and at times one of the mates gives information about
crucial trends in the other mate. These trends may be so
underplayed by the other mate that they would not otherwise
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CONCURRENT ANALYSIS OF MARRIED COUPLES 197

be adequately recognized by the analyst, although their investi-

gation is imperative for the success of the treatment. Light is
thrown on the problem of why certain symptoms and trends
develop out of the many infantile and pubertal possibilities,
and to what extent the mates actually correspond to the
infantile prototypes of parents and siblings. Transference reac-
tions include concern about whether the analyst favors the
other, whether he values the mate as highly or as poorly as the
patient, fear of divorce or separation, and the defense of unat-
tainable marital ideals. Increased tension may develop if the
mates (mis)quote the analyst to each other during new situa-
tions of stress, or if one of the mates has a negative therapeutic
reaction or stops treatment. Simultaneous treatment of mar-
ried couples was successful in eleven of twelve instances, includ-
ing two which ended in divorces satisfactory to both parties.
In four of the twelve couples, both mates were analyzed, in
eight, one mate was analyzed, the other received briefer
psychotherapy.
REFERENCES
I. MIITELMANN, BELA: Complementary Neurotic Reactions in Intimate Rela-
tionships. This QUARTERLY, XIII, 1944. p. 479.
2. OBERNDORF, C. P.: Psychoanalysis of Married Couples. Psa, Rev .• XXV, 1938,

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