Author: Lachkar, Joan
Publisher: London: Taylor And Francis, 1992
Reviewed By: Marilyn Newman Metzl, Fall 2004, pp. 49-50
In this original edition of her wonderfully insightful book, Dr. Joan Lachkar presents both a groundbreaking overview of psychoanalytic theory and an overview of the drama that occurs when two pathologies meet and marry. (A second edition of this book titled, The Narcissistic/Borderline Couple: New Approaches to Marital Therapy, 2nd Edition, published by Brunner-Routledge in 2003, utilizing and expanding the concepts outlined in this original book, was not available for review at this time.) According to Lachkar, it takes two to tango, and two to sustain a long-term relationship that involves abuse. To witness the lives and loves of the couples presented in this book is to be transported back to The War of the Roses or the memorable game of “get the guest” in Edward Albee’s play Who’s Afraid of Virginia Wolfe?
Defining the narcissistic/borderline couple as “individuals who, when they are together, form a shared couple myth that gives rise to many collective fantasies,” Lachkar proceeds to describe the intricacies of each pathology and to demonstrate how different practice paradigms are needed for successful treatment: the narcissist responds most profoundly to the mirroring aspect of self-psychology, while the borderline requires the containment of object relations theory. Lachkar demonstrates how both theoretical constructs can be intertwined during the course of treatment to provide effective marital therapy.
“It is recommended that the technique of mirroring, empathy and introspection can be blended with an object relations approach to help these narcissistic individuals deal more directly with their internal deficits and areas that contribute to the maladaptive nature of their relationships. When couples can face their internal deficits, they feel more secure and contained. For borderlines suffering from abandonment anxiety and preoccupied with the lack of maternal bonding and attachment experiences, self psychology is not enough (p. 5).”
Lachkar makes several points of interest, focusing on the difference between narcissistic rage and borderline rage observing that the difference between narcissistic rage and borderline rage is profound. The narcissistic responds to being misunderstood, ignored or hurt especially when the injury is to one’s sense of entitlement. This can be illustrated by “I dare you to put me down in front of all my friends;” or “Here I have tried so hard and you never appreciated all these things I have done. I am leaving.” Borderline rage is a sensory response to the threat to one’s very existence, a fear of not existing as opposed to narcissistic rage, which is in response to a threat to one’s special sense of existence. Borderline rage is the attempt to destroy that which is envied in order to hold on to the good internal objects, while narcissistic rage is an emotional outburst to a threatened self, an outcome of guilt, from an indulging self. Excellent suggestions are provided for dealing with what the author considers to be an impossible couple. In her treatment model the more primitive and destructive the couple, the more structure is needed for containment.
Lachkar has developed a systematic approach to treatment in order to deal with the enmeshed, chaotic relationship of the narcissistic/borderline couple. She relies heavily on Bion, and has developed a multi-stage treatment procedure. Stage I develops a state of oneness, Stage II develops a state of two-ness and Stage III develops the emergence of separateness. In the author’s theoretical formulation, the sequences illuminate movement from a stage where self and others are indistinguishable with boundaries blurred and fused, to a state of more clarity, and finally to an awareness of separateness. In Lachkar’s model, the therapist must see the couple together before transitioning into individual therapy so that a safe bond can be established. She cautions against moving into individual work too quickly, and stresses the importance of timing to determine when the couple is ready. Too early a separation of the “couple” can precipitate a “rapprochement crisis,” which may cause them to withdraw from treatment. Lachkar provides case examples that each partner of the dyad must be assured of entitlement to his or her own subjective experience. She cautions that each member of the dyad experiences anxiety differently, with the narcissist reacting to a loss of “specialness” and the borderline fragmenting when faced with things that abandon. An interesting point that Lachkar suggests is that this therapeutic alliance with the patient should initially focus upon the narcissist since the narcissist’s tendency to flee would pose a serious threat to successful treatment.
“Getting rid of something by turning to “passion” or mania paradoxically diminishes the passion and creates further disappointment and narcissistic injury to the self. The narcissist’s need for self objects, the formation of positive ties, and the need to turn to a variety of external sources can help explain what the person’s real self-object needs are. The formation of healthy object ties provides for both the narcissist and the borderline a vital function and is not to be confused with fusion or immersion. Often such individuals who are partners in couples turn to the wrong self-objects, keeping the partners in a circle, reinforcing their delusions, boredom, confusion, anxiety, dullness, and emptiness. While I suggest that both internal and external object function are vital, it needs to be emphasized that both need to be explored in light of these two specific disorders (p. 117).”
Lachkar describes each of the pathologies in clearly defined terms utilizing theoretical constructs from Kohut, Grotstein, Klein, Bion and others. She makes it clear that these personality disorders are not necessarily discrete and that each individual may show a tendency towards a behavior while exhibiting certain vulnerability. In her attempt to describe the bonds and binds that attract such individuals together, she simplifies the descriptors and describes the basic characteristics of each partner as components of events that perpetuate the circular, never-ending quality of the conflict. According to Lachkar, the borderline is the one who searches for those with whom to bond. When the promise of that bond is threatened, the borderline responds with blame and attack as primary defenses. At the slightest hint of abandonment, the borderline is seized with a desire to get even and to “teach” the other a lesson. Conversely, the narcissist tends to withdraw, becomes easily injured and fears becoming ordinary. The narcissist is constantly searching for others to confirm feelings of entitlement and is constantly seeking approval. Lachkar points out throughout the book that even though these behaviors cause much pain, they are not purposefully enacted but are a replay or a reenactment of early primitive infantile longings. These findings draw upon Freud’s concept of transference, with the past being brought into the present and the attachment to early interactive experiences resulting in later personality development. According to the author, these personalities function in the constant hope that these infantile longings, yearnings and wishes that are being expressed will somehow result in a happy ending and they replay it repeatedly hoping that the ending will be different. Lachkar paraphrases Bion when she observes that unfortunately, couples who rely heavily upon magical thinking and repetitive behaviors never learn from experience because conflict is not resolved through repetition.
Lachkar illuminates experiences that occur in our personal and professional worlds, when we are in the presence of a couple who “gives us a pain in our stomach”.
“Suddenly my head begins to spin. I feel dizzy and confused. My head keeps going round and round. In front of me sits a married couple; they go on and on in circles, going nowhere. A feeling of despair overwhelms me as I think to myself, “This couple needs to be in therapy.” I then realize I am the therapist (Lachkar, 1985).”
The author explores the nuances of the parasitic bond, and describes the difficulty of entering into and changing the circular pattern of behavior. Suggestions for treatment and cautions about possible obstacles to change are carefully delineated. The abusive dyad impacts friends, family, and children involving all who come in contact with it into a kind of “Stockholm Syndrome,” i.e., bonding rooted in trauma.
As we watch the case studies unfold, and watch the abuser laser in on the psychological vulnerabilities of the victim, it feels as if one were watching the lion prey upon the weakling of the antelope herd in the African Veldt. This bond between the abuser and the abused is the glue that holds the relationship together, and the bond is strong, dynamic and co-dependent. According to Lachkar, two narcissists or two borderlines would not be able to maintain intimacy over time. It is the folie a deux quality of the two specific pathologies that “make love last.”
This book is original, sensitive and eminently useful. Dr. Lachkar gives credit to her classical dance teacher of 12 years, Carmelita Marcacci, from whom she first learned the importance of artistic expression, the blending of technique and feelings, and the effect that one human being can have on another. Lachkar’s classical training in psychoanalysis has combined with her classical training in dance to yield a wonderful creation.