Conceptualising Relational Normality in Psychoanalytically-Informed Couple Psychotherapy

A review of the psychotherapy literature highlighted an absence of publications exploring the conceptualisation of relational normality in adult couple relationships. This research set out to address this gap in theoretical and clinical reflection. The central aim was to contribute to an enriched understanding of the manner in which explicit theory-derived concepts and implicit notions of relational normality are applied in couple psychotherapy.
A qualitative design was adopted. Twenty-seven psychoanalytically-trained couple psychotherapists participated in one of the four focus groups used for data collection. Thematic Analysis led to the identification of three main themes namely: Political, Indigenous to psychoanalysis and Non-native paradigms.
The ‘Political’ theme refers to the discernment of who carries the responsibility to define relational normality. It captures the weighting couple psychotherapists give to their role and expertise, patients’ views and experience as well as socio-cultural imperatives. Additionally, it highlights how their discernment is complicated by a degree of ambivalence. The second theme, ‘Indigenous’ denotes how psychoanalytic thinking is brought to bear in evaluating the quality of dynamic processes within and between partners, their psychic capacities and the genesis of difficulty. Participants concurrently maintained the view that sub-optimal states are normal. The third theme ‘Non-native paradigms’ refers to ideas sourced from outside the psychoanalytic tradition highlighting the contribution made by statistical and medico-legal models of normality.
The main strength of this research lies in having recruited a sizable number of highly experienced couple psychotherapists. Limitations relate to the poor representation in terms of gender and ethnicity. This study recommends further research on factors influencing the consideration of the three identified themes. The research outcomes can also inform future training of professionals.
This study identifies how couple psychotherapists seek to move away from their initial, potentially biased appraisal of normality towards a sophisticated reflexive position. Holding rigidly to normative theory and personal belief is considered ineffectual. Conceptualising normality is not simply about discerning facts but involves the attainment of a sense of dynamic equilibrium between the multiple perspectives couple therapists contemplate.