ABSTRACT
This chapter is devoted to working with primitive collusive defensive systems that
typically characterize relationships in which one or both partners is diagnosed
as having a borderline or narcissistic personality disorder. Frequently, individuals
form intimate relationships with and marry partners who function at similar levels
of personality organization/disorganization. Therefore, one should not be surprised
to fi nd that sometimes both partners who present for therapy have diagnosable per-
sonality disorders. Given the short-term, problem-focused model of intervention
presented in this volume, structural changes in personality organization are not to
be expected. The major goals of treatment with this population are as follows:
1. Improved dyadic functioning in the areas of couple communication, problem
solving, confl ict negotiation, empathy, and role taking
2. Modifi cation of dysfunctional contractual arrangements that are damaging the
partners’ selves and stifl ing to the relationship’s positive development
3. The strengthening of those contractual agreements that encourage individual
growth and enhanced relationship functioning
These goals are not substantially different from those one strives to achieve with
most couples that enter marital or relationship therapies. However, with this pop-
ulation, attaining these desired outcomes is always a challenge, and one should
not be discouraged by gains that are only modest.
