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The new chapters, case illustrations, and updated treatment sequences are invaluable to both beginning and experienced clinicians. Read more Read less. Kindle Cloud Reader Read instantly in your browser. Customers who bought this item also bought.

The Narcissistic / Borderline Couple: New Approaches to Marital Therapy

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The Narcissistic/Borderline Couple (Book Review)

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Emotional Connections & Borderline & Narcissistic Personality Disorder

Joan Lachkar continues to break new ground in the application of psychoanalytic theory to couples therapy in this second edition of her innovative text. New Approaches to Marital Therapy , 2nd Edition, published by Brunner-Routledge in , 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.

Lachkar demonstrates how both theoretical constructs can be intertwined during the course of treatment to provide effective marital therapy. 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.

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. 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. She relies heavily on Bion, and has developed a multi-stage treatment procedure.

4 editions of this work

She cautions against moving into individual work too quickly, and stresses the importance of timing to determine when the couple is ready. Lachkar provides case examples that each partner of the dyad must be assured of entitlement to his or her own subjective experience. 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. 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.