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Marital therapy from a psychiatric perspective: an overview

Published Online:https://doi.org/10.1176/ajp.132.6.583

The authors describe various methods of marital therapy in use today. Although absence of a unifying conceptual scheme in the past has hampered developments in this field, the increasing acknowledgment by psychiatrists of the important effect of the environmental system on thoughts, feelings, and behavior has facilitated a therapeutic approach stressing not only a person's intrapsychic conflicts but current environmental, family, and spouse-related phenomena. The authors discuss three dimensions of marital psychodynamics--power, intimacy, and marital boundary setting--and relate them to the marital life cycle and to four classifications of the marital relationship: 1) rules for defining power, 2) parental stage, 3) level of intimacy, and 4) personality style and psychiatric terminology. The paper includes a brief discussion of therapy techniques, sex counseling, the use of cotherapists, the future of marriage, and alternative lifestyles.

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