Ethical Perspectives on ‘Fit’ and Fidelity in Clinical Practice

Two Couples 2001 Diana Ong (b.1940/Chinese-American) Computer graphics

The Bruce Wine Memorial Fund and ICP+P present: The play, Dinner with Friends, by Donald Margulies, is a cautionary tale about the vagaries of compatibility and commitment in long-term relationships—platonic, professional, romantic, and familial. The play will be presented as a parable about complex questions in clinical practice that have neither easy nor proscribed answers:

“What unconscious personal biases and values inform therapist ethical decision making?”

“Am I a ‘good enough’ therapist—for this patient, at this time?

“Are my co-therapist and I an effective therapeutic team?”

“Is being a psychotherapist (still) a vocational choice I want to commit to?”

This interactive program will give participants an opportunity to explore these and related questions, as they might be relevant to their clinical practice.

At the conclusion of this program, participants will be able to:

  1. Recognize ethical issues related to effective working relationships—between therapist and client, colleague-to-colleague, and self to the profession.
  2. Identify personal values and biases that inform ethical decision making in clinical practice.
  3. Apply a collaborative decision making process to the resolution of ethical dilemmas.

This conference is appropriate for clinicians at all levels of experience.


About our Presenters:

The Red Well Theater Group of Washington, D.C. contributes to the professional development of psychotherapists through continuing education presentations that combine a dramatic reading of a stage play with clinically informed commentary and a moderated audience discussion. The mission is to illuminate and explore themes related to ethical clinical practice and therapist wellbeing, in and beyond the consulting room. Members of the Red Well Theater Group share a love of theater and a commitment to dynamic therapy training and practice, approaching each discipline as a healing art.

Robert Schulte, MSW is a clinical social worker and psychotherapist in practice in Old Town Alexandria, VA. He is a graduate of the ICP+P Psychotherapy Training Program. Bob is also a faculty member of the Washington School of Psychiatry National Group Psychotherapy Institute.

What is the Bruce Wine Memorial Conference?

Bruce Wine was a founding member of ICP+P. The Bruce Wine Memorial Fund was created in 2008 with a mission to sponsor conferences that bring creative and innovative theoretical and clinical perspectives to ICP+P and to the larger mental health community. The Fund’s central mission is focused on fulfilling Bruce’s wish to bring cutting edge thought to theory building and clinical practice.


Conference Fees

Free for ICP+P Members and Fellows                                 $90 for Non-members                                    $35 for Unaffiliated Students

For more information, to request reasonable accommodations, email administrator@icpeast.org.

Continuing education credit:  3 CE credits available for full attendance. The Institute of Contemporary Psychotherapy and Psychoanalysis (ICP+P) is approved by the American Psychological Association to sponsor continuing education for psychologists. ICP+P maintains responsibility for this program and its content. ICP+P is approved by the Maryland Board of Social Work Examiners to offer Category I continuing education credit. Because ICP+P has approval from the Maryland Board, CE credit hours awarded by ICP+P may also be claimed by social workers licensed in Virginia and the District of Columbia. These continuing education credits meet the ANCC approval standards for nurses and the approved standards for marriage and family therapists. Attendees from the above professional groups will earn 3 CE credits for attending the conference. Full attendance is required to receive the designated CE credit. ICP+P is accredited by MedChi, the Maryland State Medical Society to provide continuing medical education for physicians. ICP+P designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Red Well Theater Group of Washington, D.C. and the planners have informed us that they do not have a conflict of interest and have disclosed that they have no relevant financial relationship with any commercial interests pertaining to this educational activity. Additionally, the presenters have been instructed to disclose any limitations of data and unlabeled or investigational uses of products during this presentation. This presentation will not contain any references to off­label (non­FDA approved) use of products or devices.

CE Credit is granted to participants with documented attendance at individual workshops and completed evaluation forms for those sessions. Credit will not be granted to registrants who are more than 15 minutes late or depart more than 15 minutes early from a session. Please arrive at least 10 minutes before the scheduled start time of 9:00 am to allow time to check in.

Please contact Jen Bissell, ICP+P’s Associate Director of Conferences, with any questions, jenbissellLICSW@gmail.com.


AGPA 2017 Special Institute

Special Institute, Monday, March 6, 2017, New York City

By Bob Schulte, MSW

Red Well Theater Group members and guest artists participating in the APGA Special Institute include Kavita Avula, Connor Dale, John Dluhy, Mary Dluhy, Barbara Keezell, Liz Marsh, Yavar Moghimi, Bob Schulte, Rosemary Segalla, Tom Teasley, and Rob Williams.

People Flying Peter Sickles

People Flying
Peter Sickles

Our daylong ethics-focused program, Wounded Healers and Suffering Strangers: Navigating Ethical Dilemmas Together, features two dramatic play readings, each illuminating a variety of ethical delimmas relevant to dynamic group psychotherapy. We will also examine a collaborative process by which ethical dilemmas, understood as situations whereby multiple ethical imperatives are in conflict, might be resolved by therapists and group members working together.

Play Selections

The morning session features The Great God Pan, by Amy Herzog. The Great God Pan is “an unsettling yet deeply compassionate account of what is lost and won when long hidden truths are revealed. Jamie Perrin has a seemingly idyllic life in Brooklyn, NY—a beautiful girlfriend, a budding journalism career, and parents who live connorjust far enough away” (Herzog, 2014). But then his childhood friend Frank Lawrence visits to reveal a history of childhood sexual abuse perpetrated by his own father. He suggests that Jamie may also have been a victim during a week when Jamie’s parents sent him to stay with the family of his childhood friend. All this comes at a delicate juncture as Jamie and his pregnant girlfriend Paige are in conflict over the prospect of becoming parents.

rosemaryThe Great God Pan explores the impact of complex trauma on attachment relationships, the destabilizing effects of family secrets, and the healing power of truth seeking within a group context. Themes relevant to group psychotherapy include the risk of vicarious trauma, the impact of unconscious enactments on group functioning, and the ethical obligation of the therapist to maintain a safe therapeutic environment.

The afternoon session features Dinner with Friends, by Donald Margulies (2002). The play opens in the fashionable Connecticut home of Karen and Gabe who are giving a dinner for their married best friends Beth and Tom, which Beth attends alone. By dessert the truth emerges from the devastated Beth that Tom has left her for another woman. We approach the play as a parable about ethical dilemmas faced by professional colleagues with one another, most notably those issues related to fidelity and trust within the group co-therapist duo. Dynamics within professional “marriages” inform a group’s formation, survival and capacity to thrive.

Theater & Group Therapy

The central place of dramatic action and values-based ethics in group psychotherapy and theater is well cast50established. In his classic text Poetics, the Greek philosopher Aristotle championed a moral purpose for creating theater. J. L. Moreno’s development of psychodrama in the 20th century reflected his own values-based mission to restore theater to its original civilizing purpose of promoting mutual recognition and communal wellbeing.

Contemporary dynamic group therapists nonjudgmentally recognize the inevitability and utility of unconscious enactments in the process of achieving group therapeutic aims. Therapy groups rely on the emergence into the here-and-now of unconscious enactments. These ‘little dramas’ reveal the contextual and relational compexity of the human condition and the “scripted” suffering that the group members have yet to resolve and “rewrite”. Action, reflection and meaning making are common core endeavors to both theater and group therapy.

Ethical Principles

dsc00561We are all wounded healers. No one escapes childhood to become an effective group psychotherapist without blindspots and vulnerabilities. Ethical failures by primary caregivers are very often implicated in the very decision to become a psychotherapist (Rice, 2011). This Institute will be an opportunity for practioners of all levels to discover something new or to revisit what they may already know—about themselves and their group work—with colleagues who are also on the path of practicing at the highest standard of proffessional care.

We will review basic ethical principles of beneficence, non-maleficence, respect for autonomy, fidelity, and justice and core ethical virtues of the moral practitioner including compassion, discernment, trustworthiness, integrity, and conscientiousness. We will outline a process of resolution that emphasizes the dynamic interplay of information gathering, empathy, transparency, and collaborative decision-making in the here-and-now (Brabender, 2006). Our program illuminates these concepts through the dramatic play readings, each accompanied by a clinically informed commentary and an audience discussion.

Continuous ethical thinking by the group therapist is central in maintaining a safe, therapeutic group 100_8050environment. The dependable modeling of ethical behavior by the therapist has enduring therapeutic impact on a group’s members. Ethical dilemmas are co-constructed from many influences, within and beyond the therapy group. Engaging members in the process of resolution is key.

Registration Continues

The Special Institute is open to training and practicing group psychotherapists. To register go to the Annual Meeting section at: AGPA.org.

References

Brabender, V. (2006). The Ethical group psychotherapist. International Journal of Group Psychotherapy, 56 (4), 395-414.

Halliwell, S. (1998). Aristotle’s Poetics. London: Gerald Duckworth & Co.

Herzog, A. (2014). The Great god pan. New York: Dramatists Play Service.

Margulies, D. (2002). Dinner with friends. New York: Dramatists Play Service.

Rice, C. (2011). The Psychotherapist as “wounded healer”: A Modern expression of an ancient tradition. In On Becoming a psychotherapist. Edited by Klein, R., Bernard, H., and Schermer, V. Oxford: Oxford University Press. p. 165-189.

Schulte, R. (2016). Red Well Theater Special Institute Preview. AGPA Group Circle Newsletter. Portions of this article are included or paraphrased in this blog post.


One Affair, Many Divorces: The Cascading Impact of Infidelity

DWF_pcfineOne Affair, Many Divorces:
The Cascading Impact of Infidelity
The Red Well Theater Group presented a dramatic reading of Dinner With Friends, by Donald Margulies, at the spring meeting of PCFINE (Psychodynamic Couple and Family Institute of New England) in Boston on May 14, 2016. Dinner With Friends, winner of the 2002 Pulitzer Prize for Drama, was presented by special arrangement with Dramatists Play Service of New York.

crowdThe acting ensemble showcased an all-Boston cast, including PCFINE members Barbara Keezell, MSW, Ron Goldman, EdD, Justin Newmark, PhD, and Belinda Friedrich, MSW and our musical colleagues from Boston Musa Duo, Zoya Shereshkova and and Yulia Musayelyan. The discussant was Eleanor Counselman EdD, CGP, LFAGPA. RWTG founding director Robert Schulte, MSW directed the play. RWTG member Rob Williams, MSW served as the narrator consultant to the program.

dinnerMany thanks to the PCFINE Program Committee for their guidance and support, including Susan, Rivka, Wendy, Brenda, Debora, Mark and KC, and extra thanks to Co-chair Susan Phillips, who was instrumental in selecting the play and coordinating the committee’s work.

ABOUT THE PLAY

In their fashionable Connecticut home, international food critics Karen and Gabe are giving a dinner for their married best friends Beth and Tom. Beth, however, attends alone. By dessert time it spills out from the devastated Beth that Tom has left her for another woman. Gabe and Karen are heartbroken, having expected “to grow old and fat together, the four of us”.

musiciansWhen a committed couple is impacted by infidelity numerous questions emerge, in search of deeper truths. “Why? Are you in love with him/her? Are you leaving me? What do we tell our children? Our friends?” This program featured a theatrical case study of two married couples coping with the shock of betrayal and its cascading impact on their entwined relationships.

The needs for secure attachment and exploratory excitement are difficult at times to reconcile within committed intimate relationships. It’s instructive to look at how each couple in this play works out their own unique balance between these, sometimes competing dimensions of married life. A companion idea is around the concept of fit. As therapists, we know there are good fits and bad fits. How does this factor predestine a couple’s future? In this play, both couples are challenged to reconsider their mate choices, without a guarantee of how that reappraisal might ultimately impact their lives.

eleanorA clinical commentary relevant to couple therapy and an audience discussion followed the play reading. The text of the discussion (as delivered by  Eleanor Counselman EdD, CGP, LFAGPA) is presented below.

CLINICAL COMMENTARY

The late Stephen Mitchell wrote: “The central dynamic struggle throughout life is between the powerful need to establish, maintain and protect intimate bonds with others and various efforts to escape the pain and dangers of those bonds–the sense of vulnerability, the threat of disappointment, engulfment, exploitation and loss.” (“Relational Concepts in Psychoanalysis: An Integration,” p. 29).

Or, as the character Tom says more graphically, “How do you keep love alive when you’re shoveling shit all day?” (p. 91)

Two Couples  2001  Diana Ong

Two Couples 2001 Diana Ong

There are many ways to think about this play and the relationships portrayed. In a way it is like a couples treatment that shows the two sides of dilemma that Mitchell cites. You could even think about the two couples as two sides of one couple relationship: the tension between the comfort but tedium of the familiar and excitement and longing for the new.

The opening scene is like a first couples therapy session. We get a snapshot of the relationships and of the presenting problem. We are engaged by Beth’s distress that her husband is leaving her for another woman. We see Tom through her eyes – a cheating scumbag who has left his wife and two children – the cherubs – for a stewardess. Beth paints him as a man with some kind of midlife crisis, seeking sex from her in a movie theater.

Karen and Gabe’s relationship is not presented as a problem. We are introduced to them as a couple of foodies who playfully describe their recent trip to Italy. But is something a little posed about them? Is there something a little forced about their repartee? Are they trying to look and sound better than they really feel inside? Or are they representative of an intimate and secure relationship?

Later, in Scene 3, we get Tom’s side of things. It turns out that he has been lonely for years and that the physical longing he has had is not merely sexual but for basic affection, for the human touch, that he now has with Nancy, (who he clarifies is a travel agent, not a stewardess.)

So already we are in that familiar couple therapist position of being presented with two perspectives, two stories, about the same relationship.

After our Act I “intake” in Act II we get some history in the scene on Martha’s Vineyard where we learn how Beth and Tom met. Karen and Gabe, already married, have invited Gabe’s good friend Tom to visit, as well as Karen’s friend Beth. We learn that Tom and Beth had met before, at Karen and Gabe’s wedding, and Gabe recalls her as “the woman dancing all by herself on the dance floor doing that weird Kabuki shit.” Is Beth authentic or is this some artistic persona she has? And does her lack of conventionality appeal to the somewhat burned out lawyer, Tom?

When Tom tries to ask her about her art – “what kind of stuff do you do? Expressionistic, neo-psychotic…?” Beth responds rather hostilely: “Who are you to me anyway?” Tom: “You’re right, I’m a nobody.” Is this a harbinger of things to come? Certainly not the best predictor of a loving relationship,.

In the same scene Karen and Gabe talk about being married:

Karen: ”The social pressure that comes with being single is gone.” “What was nebulous and noncommittal is now right out there, in sharp focus: We’re married. We’re a married couple.”

Gabe: “It’s strangely comforting: There’s no way out now, you’ve gone and done it; may as well relax and enjoy yourself.”

This stirs Tom and Beth to talk about how tired they are of being single. Is this what made them get married? After Karen and Beth go out on the deck to watch the sunset Gabe asks Tom what he thinks of Beth. Tom says she is nice, intense, “Better yet, what does she think of me?” When Gabe says he thinks Beth likes Tom, Tom says “Then I like her.” In fact, we see a few other things in this snapshot of their history that don’t bode well. Tom’s sarcastic remarks about Beth’s art, and Beth’s negative comments about how Tom was treating the girlfriend he brought to Karen and Gabe’s wedding.

We don’t know what their courtship – if any – was like but we are seeing a powerful pull to join their friends Karen and Gabe in this seemingly attractive place of being married. In an intake, a couples therapist might ask Tom what drew him to Beth. It would not be very reassuring if all he could say was that Beth liked him.

Now let’s think about Gabe and Karen and their relationship. We initially see the Karen/Gabe relationship as driven by Karen. She is more the warrior woman who makes her husband go fix the kids’ tape and who is so angry on her friend Beth’s behalf that she can’t stand to be in the same room with Tom. Her anger, her outrage – we are very familiar with these reactions to infidelity and a marriage breaking up –eventually soften to a much more vulnerable Karen at the end of the play

In Gabe initially we see a basically good guy who isn’t the most insightful or reflective. But he doesn’t get rattled by Karen’s ferocity, and he tries to be a good friend to Tom in the third scene when Tom comes over to their house. Is he the steady anchor in the relationship with warrior Karen?

Scene 2 shows us a different version of the Beth/Tom marriage, as so often occurs in a couple therapy. After Beth admits that she told Karen and Gabe about their separation, Tom asks ”Did you tell them what you did to me, how you killed my self-confidence?…How I tried to get you to listen to me – for years – but you wouldn’t? Did you tell them that? …I cried out for help, so many times…” This is despair of a man who has felt lonely and shut out for a long time.

The next scene at Karen and Gabe’s is painful. Tom is aware that Karen and Gabe have heard Beth’s side and he fears judgment, which he gets in spades from Karen. He tells Karen she can hug him, “I’m not contagious.” He is speaking to a fear many couples experience when good friends split up; “could this happen to us?” Gabe, ever rational, tries to reason with Tom and offers solutions, “have you tried counseling?” this is just the “heat of the moment – and Tom pleads with Gabe just to listen. “If you were really my friend, you’d just listen.” “I hope you never know the loneliness I’ve known.”

The final scenes of the play occur six months after the opening scene. We see change in all the relationships. Beth and Tom have split. Beth and Karen have lunch and when Beth complains about Tom, Karen can ally with her around Tom’s bad behavior. But then the subject turns to Beth and how she has mostly disappeared from Karen’s life. To Karen’s surprise (and maybe disappointment?), it turns out that she has adjusted quite well and is not in need of Karen’s sympathy. This changes the dance between the two of them. Beth has not only quit her art, admitting “I was never very good” and she has reconnected with David. Here we get wind of an interesting backstory – that she had some kind of relationship with David ten years earlier – and now his marriage has also fallen apart.

Karen still can’t quite comprehend all this and is somewhat patronizing, saying that “it is great that you’re getting your feet wet” and Beth insists it is a lot more than just that. She is clearly having a lot of fun, and Karen doesn’t know what to do. “Boy, that was fast…Tom is barely out the door…you didn’t want to be alone for a while?” Beth says she was alone all twelve years of her marriage so why should she want to be alone any longer? She insists she is in love with David.

Karen says stiffly “I wish you well” and insists she is only thinking of what is best for Beth. Beth pushes back hard, confronting Karen with “I think you love it when I’m a mess…The minute I show any signs of being on an equal footing with you, forget it; you can’t deal with it, you have to knock me over…”

Karen is truly shocked by this confrontation and says that Beth is her chosen family, alluding to having worked hard to get away from her own family. But in a shift that indicates that these two friends will continue some relationship although not as close as before, Beth asks “How are the boys? And you and Gabe?” and Karen replies “We’re good. We’re fine.”

The scene between Tom and Gabe is more painful, and the gap seems wider and more permanent. Tom is so over the top excited about his new life – sex every morning, the weight loss, all the exhilaration of new love. “She saved my life.” But Gabe’s reaction is “You sound like a fucking moonie to me.” Tom found his former life deadening, but Gabe defends it as “the price you pay for having a family.”

Tom insists that he just wants Gabe to be happy for him and then adds “You’re not immune to all this, you know. Even you and Karen.” (Remember how he insisted in the first act that he was not contagious.) Gabe insists that marriages go through rough patches but you just ride them out. Tom derides that and says he is just trying to prevent him from the same painful experience he had. But Gabe comes back with “You don’t get it. I cling to Karen. Imagining a life without her doesn’t excite me; it just makes me anxious.”

Gabe’s hurt moves into sadness as he says “we were supposed to get old and fat together…I thought we were in this together. You know? For life.” As they part, Tom says he’ll call Gabe. Gabe’s response is “Bye.”

So we have seen the dissolution of Beth and Tom’s marriage, the end of the couple to couple relationship, what I would call the reorganizing of Karen and Beth’s friendship, and now most likely the end of Tom and Gabe’s friendship. What about Karen and Gabe?

In the final scene Gabe and Karen are having an intimate talk in bed. Karen shares her dream of being in bed with the other couple, also them, who are bickering and criticizing. Perhaps this dream reflects the inevitable tension in a long intimate relationship – the love and the bickering.

Gabe, who has been pretty articulate about his feelings about Tom, has trouble talking about the dream but finally says that it is “what happens when practical matters…begin to outweigh…abandon.” Karen is clearly touched and asks Gabe if he ever misses her. When he says with great feeling that he does, she ends the play with “How do we not get lost?”

In conclusion, some of the things we might want to think about as couples therapists: how would you help Gabe and Karen not get lost (to use Karen’s word)? What about Tom and Beth? What would you make of their new relationships? Are they better off out of their marriage or are they in a flight into health/honeymoon stage? And can or should a long term marriage sustain “abandon?”


AGPA 2016 “Dinner with Friends”

Two Couples 2001 Diana Ong (b.1940/Chinese-American) Computer graphics Two Couples by Diana Ong

The Red Well Theater Group presented Dinner with Friends, by Donald Margulies, as an Open Session at the 2016 AGPA Annual Meeting on February 25 in New York City. The new cast features RWTG members John Dluhy, Mary Dluhy, Liz Marsh and Yavar Moghimi. The Open Session Chair is Bob Schulte. The play is being directed by Rob Williams. The play (winner of the 2000 Pulitzer Prize for  Drama) and was was presented by special arrangement with Dramatists Play Service of New York. The Discussants were Molly W. Donovan and Barry J. Wepman. The text of their discussion (as delivered) is presented below.

BARRY

This discussion is a group effort. Reading the play together in various combinations, with each of us taking different roles, we have come to see it from a variety of angles. Many of the insights we have gained about the play have come from this process of sitting together, and talking about all of our experiences with the material.. The talk you are about to hear is the direct result of a couples collaboration bet

ween the Molly and me. Developing this talk together felt like playing improvisational jazz. The ideas came as we talked, read scenes to each other, and brainstormed. It is often unclear who wrote what or where the ideas originated. Cool Jazz.

 

MOLLY

Poem – Special Problems in Vocabulary
BY TONY HOAGLAND

There is no single particular noun
for the way a friendship,
stretched over time, grows thin,
then one day snaps with a popping sound.

No verb for accidentally
breaking a thing
while trying to get it open
 —a marriage, for example.

No particular phrase for
losing a book
in the middle of reading it,
and therefore never learning the end.

There is no expression, in English, at least,
for avoiding the sight
of your own body in the mirror,
for disliking the touch
of the afternoon sun,
for walking into the flatlands and dust
that stretch out before you
after your adventures are done.

No adjective for gradually speaking less and less,
because you have stopped being able
to say the one thing that would
break your life loose from its grip.

Certainly no name that one can imagine
for the aspen tree outside the kitchen window,
in spade-shaped leaves
spinning on their stems,
working themselves into
a pale-green, vegetable blur.

No word for waking up one morning
and looking around,
because the mysterious spirit
that drives all things
seems to have returned,
and is on your side again.

In the play we’ve just experienced, the two couples, as close as they are to each other, seem to have different views of what their relationships are about.

We witness the collision of the wishes of each couple for their lives. There are several couples here, not simply the two married ones. The betrayal of the friendship bond, as Gabe sees it, is an uncoupling of the two men. The women also lose their closeness, though this break seems less complete. How do friendships snap? And, when they do, do they make a popping sound?

Beth and Tom find other partners who seem to help them re-discover parts of themselves they had lost in their relationship together. Gabe and Karen then must turn to themselves, with their awareness of missing pieces of each other, as they have perhaps, in Gabe’s words, “let practical matters outweigh abandon”.

BARRY

Seminar by Diana Ong

Seminar by Diana Ong

Almost from the outset of this play we’re challenged to think about the limits and boundaries of relationships, our assumptions of the other, how well we know the people we think we know, and how much we can know of another or ourselves. These questions reverberate as the story unfolds, and, as the layers of history become revealed, the assumptions we’ve made about the characters continue to be revised in the light of new information.

Relationships are, in part, about stories: The stories we tell about ourselves, and the stories we tell ourselves about the other. Gabe & Karen have their story about their counterpart couple, Tom & Beth. Tom and Beth they tell themselves, are just like them: loving each other and taking some pleasure in the regularity and predictability of settled life. This story helps Gabe & Karen enjoy their life, just as it is, without noticing that there may be something lacking. G&K have constructed an image of Tom & Beth’s relationship that bolsters their own choices and subjectivities. This requires, as it always does, careful unconscious editing and selective inattention. Their story is set.

The story of the play itself begins simply–a dinner, a gastronomic travelogue, a typical evening,–one of countless like it–among close friends. It’s a familiar tapestry to the hosts, and presumably familiar in some form to the audience, as well.

Suddenly, the confirming mirror shatters as Beth breaks down just before dessert (a lemon almond cake, made with polenta instead of flour. The first couple is shaken by this news, and each goes into what I imagine to be an old adaptive coping style: Karen gets outraged and moralistic, and Gabe gets baffled and goes into a laconic withdrawal.

MOLLY

Donald Margulies is a playwright who is clever about shifting our sympathies over the course of the play – just as happens with the characters themselves. In the first scene, we see Gabe and Karen as a couple sharing a passion for food, wine, travel -. In this scene, their intensity is about the food – the most erotic moment of this opening scene comes in their description of an old woman in Italy crushing tomatoes with her knobby hands in preparing pomodoro. When Beth, sobbing, tells her story, Gabe and Karen are, of course, sympathetic and upset for her. The following scene with Tom and Beth adds a layer of complexity, and we, the audience, see that our feelings and alliances may become more fluid.

In Act II, when we go back to the beginning of the foursome, we see foreshadowings. Beth and Tom step into an embodied idealization on Martha’s Vineyard and right into their roles as a mirror of Gabe and Karen’s couple. They begin by sparring and in retrospect one can see the seeds of trouble. Tom wants what Gabe has – even in college, Tom was stealing Gabe’s girlfriends. Beth states that she’s ready for a change. After she and Tom commiserate about the wearisomeness of the single life, Tom asks Gabe -what does she think of me? Gabe says – she likes you. Tom says – then I like her. And so it begins.

Tom and Beth stay in these roles – at least on the visible surface – for many years, apparently trying to make it work, despite what we later discover was a very early disruption in their marriage.

We might begin to think – what led them to stay in this relationship? Was the friendship a determining factor? What does make unhappy couples stay together? We’ve all seen this, personally and professionally, and there are many variables.

Gabe and Karen come to find that they know nothing about Tom and Beth’s early troubles – or their later ones – there was a lot they didn’t know, and, as it turns out, a lot they have stayed unaware of in their own relationship.

No one truly knows what goes on in a marriage, sometimes least of all the people in it.

BARRY

Nothing remains simple in these characters for us, or for them in their relationships. As we do in our own lives, they each view themselves and their actions with a particular subjectivity: we make up our own stories. If we insist that our relationship partners conform to our stories about them little or no communication is possible.

The friendships of the like-sexed pairs pose interesting material for us to use to think about these ideas. While both sets of relationships seem to have been damaged, the scene between the women seems to move into just a bit more mutuality than does the scene with the men, where no understanding of the other’s subjectivity seems to have been achieved. There’s the impresion that the women might have some hope for continuity. There is none for the men.

Gabe & Tom each insists that the other remains a character in the stories they tell themselves about the other. Each feels mortally hurt by the other’s rejection of his story. Between them there is no understanding or tolerance of the legitimacy of each other’s experience. In the end we feel that the long friendship has snapped. You can practically hear the pop.

Beth & Karen’s interaction, on the other hand feels like it was more relational. The two talk more about the structure of their relationship–and what mutual needs sustained it .

MOLLY

Gabe and Karen, each in their own ways, cannot accept the changes in their friends as they differentiate from them, leaving the roles Gabe and Karen have wanted them in. Gabe feels betrayed – as if the entire friendship had been a sham. In the story of Icarus, most people forget that before he crashed, Icarus had flown. Gabe, and maybe even Tom, seems to forget or to discredit the good times they had had. Perhaps Tom and Beth’s crashed marriage could be seen as a success, helping them grow into a place where they are now more able to have full relationships.

They could be seen as thriving, each presenting themselves as happy for the first time in years. And, in the end, Gabe and Karen must look to themselves and their own relationship to see what they have now that their carefully constructed extended family has broken. Karen asks – How do we not get lost? We are left to imagine where they go from here – all four of them. If you were to write the story of the next five years or so for these couples – the romantic pairs and the friendships – what would it be for each of them? What do you anticipate given what you know now?

BARRY

So, what might this play have to teach us about psychotherapy, group therapy and co-therapy? For one thing, the play is about relationships–what fosters them and what is incompatible. As therapists (and co-therapists) none of us is immune to getting stuck in our own stories about the other, to thinking that what works for us in our lives would work best for them, to overidentifying, and losing the otherness of the other’s subjectivity in the velcro of our own internal issues. There are limits to what we can know about the other, even in the multi-mirrored setting of the therapy group. We are made aware that the next piece of information we learn might change how we perceive the other, and there may always be a next piece of information. We always have to be open to revising our story about others and about our part in relationships. We must always be on the lookout for the unexamined, and remember that openness to the unexpected is what enlivens.

MOLLY

As the playwright demonstrates, there are many layers to stories, and, just as he pulls us along opening up other parts, we need to, as therapists, stay curious about what other layers there may be to the stories we are hearing. Assuming we know, or knowing too much, can, as Winnicott said, can stifle the patient’s (or the group’s) creativity.

BARRY

Poem – Special Problems in Vocabulary
BY TONY HOAGLAND

There is no single particular noun
for the way a friendship,
stretched over time, grows thin,
then one day snaps with a popping sound.

No verb for accidentally
breaking a thing
while trying to get it open
 —a marriage, for example.

No particular phrase for
losing a book
in the middle of reading it,
and therefore never learning the end.

There is no expression, in English, at least,
for avoiding the sight
of your own body in the mirror,
for disliking the touch
of the afternoon sun,
for walking into the flatlands and dust
that stretch out before you
after your adventures are done.

No adjective for gradually speaking less and less,
because you have stopped being able
to say the one thing that would
break your life loose from its grip.

Certainly no name that one can imagine
for the aspen tree outside the kitchen window,
in spade-shaped leaves
spinning on their stems,
working themselves into
a pale-green, vegetable blur.

No word for waking up one morning
and looking around,
because the mysterious spirit
that drives all things
seems to have returned,
and is on your side again.