Article Review: 'Couples and Mental Illness'
Written by listed counsellor/psychotherapist: Kimberley Howard BSc (Hons) MBACP - Hope Counselling & Psychotherapy
31st May, 20140 Comments
Through my work as a counsellor I hold knowledge of DSM -1V-TR (2000) terminology, however I view humans as individuals not conditions - rejecting pathologising mental health as an illness (Bayne 2008:61-69). Crowes' article on mental illness in couples complimented my outlook, hence my interest in the paper.
Crowes' focus on how the stigma of mental illness affects a couple, and increases the likelihood of depression upon the other partner insightful. I am more mindful of the need to respect both partners autonomy in clinical practice. Enhancing my empathy towards both partners, not just the one affected by the mental illness, as both are equally affected - heightening my awareness on safeguarding both partners, and the requirement of supervision assistance.
The statement that a systemic approach on enhancing communication between the couple, and systemic therapy being as effective as antidepressant medication, maintaining improvements for two years, was insightful and supportive of my practice. Despite Crowe speaking of systemic theories, using the family systems and dynamics as examples, there was insufficient theoretical backing. Also Crowe looks at a range of mental health disorders, however most were skimmed over, especially alcoholism and eating disorders.
Crowe mentioned lowering affect to help the partner suffering from a mental health disorder, however this would create more of a power imbalance in the relationship, compromising autonomy. It would have been more interesting to look at what attracted the partner to the relationship and the payoff for staying.
Crowes' awareness of the need for research into the implications for couples suffering mental illness is encouraging, however more detail could have been included, especially surrounding Systemic theoretical evidence and referencing. As in Lachkar’s (2004:33-53) paper The couple: The dance, the drama and the bond, where Lachkar uses theoretical explanations to get underneath behaviours - the unconscious projections, projective identifications etc. These make his argument more compelling, providing evidence for more research to be undertaken.
However there is a connection between Crowes' article and Lachkar’s, where both state the importance of the couple’s relationship. How a relationship can be supportive and helpful for the person who is suffering from mental illness, or how it can inhibit the other partner.
Overall despite Crowe asking for more research but failing to provide it, the paper raised awareness on the need for support groups, the effectiveness of systemic therapy in couple counselling, and aided mindfulness on the effects of both parties in the relationship - facilitating the need for empathy, improved communication and supervision assistance, when working with a couple where one suffers with a mental health disorder.
American psychiatric association. (2000) DSM-1V-TR. 4TH edn. Arlington, VA: American Psychiatric Press Inc.
Bayne, R. (2008) The Counsellors handbook. 3rd edn. Great Britain: Nelson Thornes.
Crowe, M. (2004) Couples and Mental Illness [online] Sexual and relationship therapy. Available: <http://www.ebscohost.com> [27th October 2012].
Lachkar, J. (2004) ‘The couple: The dance, the drama and the bond’. The narcissistic/ borderline couple. 2nd edn. New York: Brunner Routledge 33-54.
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