Is Two One Too Many?

Marianne has asked to bring her partner in today. It’s a request I usually discourage, believing it can cloud the relationship between myself and my patient, sometimes leaving the patient feeling unheard, ignored or even rejected. But Marianne has persisted. She has a specific issue she wants my help with. She wants Beth to know and believe that she’s working on her reluctance to be a mother.
 
So Beth comes to the session. Within ten minutes I remember yet another reason for not seeing a patient’s partner. It is always best to see the world and the people that inhabit that world through the patient’s eyes. Marianne loves Beth. She sees her as intelligent, intense, and caring. I see her as bombastic, dogmatic, controlling and distancing. Marianne’s fear of being a mother stems from her own abusive background and her fear that she could not love a child as she would wish. I have more concern about Beth’s capacity to mother than Marianne’s, but that’s not the question on the table. 
Before too long, through clenched teeth, Beth says accusingly to Marianne, “It’s just your way of being controlling, just your way of trying to withhold from me. You don’t love me enough! You never have!”
 
Marianne is crying. “You know I love you! You haven’t heard what Linda said. I’m trying really, really hard to work through all the pain of my background, to feel good about myself, to feel like I am loveable so that I can love a child, our child. I am trying! I am!”
I know exactly what I want to say. I know exactly what I would say if I were sitting alone with Marianne and she was relaying this scene to me. I’d say, “I wonder if you’re still trying to win with your mother, if you’ve again gotten yourself involved with someone like your mother, someone who always makes everything your fault.” But I’m not sitting alone with Marianne. I don’t like this position at all.
 
And then it crosses my mind to wonder why I feel so much more constrained by the couple than I would with Marianne alone.  Am I feeling intimidated? By whom? By Beth? By my ideas of what’s expected in couple’s therapy? Or is it more complicated? Have I returned to being the child in this threesome where I want to support my beleaguered mother and feel intimidated by my angry father? All of the above? Regardless, it’s time for me to return to my role as therapist.
 

“Don’t you think you’re being rather hard on Marianne?” I ask Beth.
 
“You would say that,” she replies contemptuously. “You’re her therapist.”
 
“Yes, I am,” I say determinedly. “I wonder, are these the kinds of discussions you have at home, because it doesn’t sound as though you’re really listening to Marianne, Beth. It sounds as though you’re browbeating her and insisting that she give you what you want.”
 
Beth sighs with exasperation and rolls her eyes.
 
Marianne looks at me, her eyes wide open through her tears. “Is that really what you see as happening here?” she asks. “You see her as beating up on me and demanding what she wants for herself?”
 
“Yes, it is,” I say gently.
 
I can see Marianne struggling. She feels my support. She sees me as offering a view of the world that’s very different from her own experience. But she’s not sure she can take it in. To take it in would mean moving beyond her abusive relationship with her mother, and perhaps even beyond her abusive relationship with Beth.
 
Our work continues.