ABSTRACT
This chapter presents the essential features of a psychoanalytic approach to the assessment of a couple and proposes a model for assessing manifestations of prolonged grief and their impact on couple functioning. This model, informed by object relations theory and link theory, pays attention to the level of psychic functioning of the couple and their associated defensive strategies. The role of interpretation in assessment is also discussed. Attention is drawn to the importance of the analytic setting and stance, as well as the overall psychoanalytic frame, in establishing a therapeutic alliance with the distressed couple. It is proposed that these elements, along with the maintenance of a “couple state of mind”, facilitate an understanding of the unconscious elements of the couple dynamic through the use of the therapist’s countertransference responses to the couple’s interactions and affect. A clinical vignette is presented to illustrate the response of a couple following the death of their child and the psychodynamic formulation.
