Archive for October, 2005

Personal incompatibility may of course take many different forms, from the superficial “nothing much in common” to the deepest levels of personality differences. On the more superficial levels it is often found that the partners gradually drift further apart because they each become more and more involved in individual interests and fail to preserve or cultivate any worthwhile interests in common. This is one kind of inattention to the marriage, which will be dealt with later.

Another kind of personal incompatibility may be due to different levels of intelligence or education, especially when either partner is emotionally immature to the extent of being unable to avoid jealousy of the more advanced one. This is generally more common in our culture when the wife is much more intellectually advanced than the husband, and even though she loves him deeply and avoids anything that could be construed as “rubbing it in,” he finds it difficult to avoid feelings of inferiority, however able and successful he may be in his own field. This is important in pre-marital counseling, mainly for its recognition and for the awareness of the need for development of emotional maturity and psychic security so that acceptance is easier. With careful help this kind of difficulty can often be overcome by the partners.

There may also be gross differences between the partners regarding the principles and methods of child management, which may contribute much to marital disorder. The attitudes of many people to such things are derived more than they may realize from what they absorbed in their own upbringing, and to that extent they are not quite fully open to “sweet reason.” Ideally such questions should be faced before marriage, and at least before the arrival of the first child, so that they can present a “united front” to the children. But this is often not done, and arguments, backed by “righteous indignation” grow more and more intense.

The fact that children may suffer far more from the constant parental conflicts than from the kind of management either parent would employ does not seem to penetrate the emotionally disturbed minds of the parents until the emotional tensions are “unbottled” fully in good counseling. In some cases the conflict regarding child management is not what it seems, but rather a deep emotional conflict between the partners which fixes itself on any available battleground. As they unburden their feelings fully this will often become clear, and until it does, to the partners as well as the counselor, the fights will go on.

Another form of personal incompatibility may be found in the various kinds of “mixed marriage,” between Christian and non-Christian, between Roman Catholic and Anglican, Episcopal, or Protestant, and even at times between two closely related Protestant denominations. People’s denominational and religious attitudes are largely accidents of birth, and they are imbedded so deeply as to be often out of the range of reason. Here again the trouble is not so much the difference, although this has difficulties in it especially with training of children. The trouble is mainly on the level of emotional immaturity, which brings intolerance and attempts at domination or the imposition of religious attitude on the partner. Such differences need competent counseling if they are to be faced in the light of reality and resolved to the extent of mutual acceptance. The same principles apply, sometimes to an even greater extent, in the case of marked racial and cultural differences, especially when there are also color differences.

Deeper (though not necessarily more intense) than any of these “acquired” differences which may make for personal incompatibility are inborn “temperamental” differences of personality type, which may have much to do with marital disorder, especially when, as often, they are not understood and accepted. Here, for example, are Tom and Betty, married for four years, with two children. They have apparently been in increasing conflict almost from the beginning of their marriage. Now that they look back on it, the conflicts were there during their engagement, but they thought that it would be easy to work them out after their marriage.

There are masses of complaints on both sides, but they seem to be reducible to fairly definite differences. Tom’s main complaint about Betty is that she is so utterly careless and irresponsible that he is continually worried that he will be reduced to bankruptcy in his finances and humiliation with his friends. Betty on the other hand takes the view that there’s no such problem at all except in Tom’s imagination, and that he makes so much of a fuss about every decision that she is driven to desperation. When she wants to invite her friends to their home Tom does his best to dissuade her; or if they do come he behaves in a most ungracious manner, or retires into his den, which she feels is insulting.

As the stories unfold it soon becomes clear that Betty is what Jung called an extrovert type of personality, completely natural and spontaneous, friendly to everyone, and impulsive in almost everything she does. Tom has to admit that even with her impulsiveness she has so far proved that her judgment or “intuition” is sound, and that his deep apprehensiveness is not based on any previous failure on her part. But he finds her intolerant of his need to take time to think out all the different aspects of any proposition or decision, and also of his rooted suspicion of the motives of people whom she “just knows” are good and reliable.

Tom is an accountant, who is building up a first class professional reputation for his reliability and conscientiousness, and he has his office imbued with these great principles. He is not a good mixer, but he has the respect of his associates and clients, and feels content and competent in his work. In other words he is an introvert type of personality in Jung’s classification. He had always been shy of girls as he grew up, but Betty’s spontaneous friendliness and charm overcame his shyness to the point that he proposed to her, and she was attracted by his conscientious and steady nature; he was so different from many of the boys who had tried to sweep her off her feet. They got on very well together until they found themselves in the intimate relationship of marriage, and then each began to find the attitudes of the other difficult to accept. It is possible that with some encouragement Tom might develop more sociability, and Betty might tone down some of her impulsiveness, but these qualities of extroversion and introversion are deeply imbedded in Betty’s and Tom’s personalities and are not open to radical change. But with better understanding each can learn to accept the other, and to be more responsive to the better aspects of each other’s personalities.

Other types of personality which may bear on marriage are the “schizoid” or suspicious type, the obsessional or very particular, the “mercurial” or “cyclothyme,” and the “hysteric” or over-dramatic. Tom had some obsessional and schizoid elements in his personality. The way to better marital harmony is through acceptance of each other’s personality types. It seems obvious that in any consideration of incompatibility we must face the fact that it is a matter of degree, depending on what amount and intensity of difference people can tolerate. The word “compatible” comes from two Latin words and means “able to suffer with,” or “endure together.” There are obviously limits as to what can be endured together in marriage, but there are some considerations about incompatibility that are most relevant to marriage counseling.

The first is that people do not necessarily have to remain as they are. Sick marriages, like sick persons, can often be healed if given some help. It seems clear that any help is more likely to succeed when the underlying factors in the incompatibility are discovered and dealt with, and the plausible rationalizations are honestly faced. Many examples of “incompatibility” are more fittingly regarded as intolerance and these can only be dealt with when this is faced and accepted. Others as we have seen are not of the same kind as they appear, and “sexual incompatibility” may be a manifestation of personal incompatibility, in which case it needs to be dealt with from the personal rather than the sexual point of view.

Secondly the whole question needs to be seen in relation to the fact that if any two partners were completely “compatible” their marriage would become intolerably dull. Within the limits of what can be endured together, incompatibility provides a source of mutual interest, and a challenge to continued mutual exploration rather than an excuse for writing it off as hopeless. The good counselor may help the partners to learn to accept each other’s different feelings and attitudes, even the hostile ones; and each other’s conduct within the law. At the same time one of them may learn to keep on contributing what he can to the relationship, even when the other one seems to be doing very little about it.

Incompatibility is commonly suggested by the partners and by their relatives as “the cause” of marital disorder, and this is made more plausible by the fact that when people find themselves in conflict their differences become intensified and much more distressing. Some attention will first be given to various kinds of incompatibility that are found in marital disorders, and then to the whole question of incompatibility in general.

Sexual incompatibility seems to be very common in marriage, and many couples accept it, though not at all happily, without allowing it to bring their marriage into any great danger. In some marriages it appears to be the primary cause of deepening marital conflict-when, for example, the partners from the beginning find themselves unable to carry out the sexual relationship to any degree of satisfaction and come to feel disillusioned and frustrated, or when their whole attitudes to sex are found to be so different as to seem irreconcilable. In such cases an apparently good personal relationship may become greatly and progressively strained, especially when the two partners have had high expectations about the sexual relationship, and regarded it as the main basis of their partnership.

But in many cases what appears to be sexual incompatibility is really of deeper origin, either in the inter-personal relational area, or even in the intra-personal field already considered. In the relational area sexual incompatibility may be a manifestation of a deeper personal incompatibility. For example Harry and Helen have reached the point of almost despairing of their marriage, because Helen has been unable to meet anything like all of Harry’s persistent demands, even though she has tried all she knows to satisfy him. The situation has now become much worse because she has found evidence of an affair between Harry and one of the girls at the office. They have decided, with the help of some well-meaning friends, that this must be a matter of sexual incompatibility, and that there is little hope of making their marriage work. But they came for counseling, and the counselor was able to look with them behind the apparent point of conflict.

As the picture unfolded it appeared that Harry was the only child of a very insecure marriage. His father had an eye for many attractive women, and took little responsibility in their home. His mother reacted to her husband’s neglect by over-coddling and overindulging her son, so that Harry grew up as a “spoiled child” who got everything he wanted. He then fell on his feet in a good job, and was clever-and unscrupulous -enough to get practically everything he wanted there too. Then he met Helen and carried her off her feet, and he got the only girl he ever wanted without any trouble. It was almost inevitable that he should go on to assume that he should get all he wanted in the sexual relationship whenever he wanted it, and that he should resent any “frustration” from his wife when his mother had always given in to him.

Helen, on the other hand, had had a rather sheltered upbringing, by good but reserved parents, with whom she had never felt free to discuss any of the “facts of life.” She had no brothers and no other close “boy friends,” and when Harry came along she plunged eagerly into marriage with little or no intellectual or emotional preparation for it. Her difficulties only drove her more deeply into her shell, which made Harry more insistent and aggressive than ever, until finally, like his father before him, he found some “comfort” outside his marriage.

Here is gross incompatibility, but it is not primarily sexual. It is a deep personal incompatibility (Harry being domineering and Helen lacking in confidence), which is using the sexual relationship as a battleground. This is no hair-splitting distinction, because the healing of such a situation has nothing to do with hormones and everything to do with psychology: with the basic assumptions about life and about people that were behind the attitudes of Harry and Helen to each other. These things are much more amenable to change than hormones. Until Harry can “come to earth” about his demands through seeing himself more clearly it will be very difficult for Helen to cope with the situation, for after all love is not fittingly given at pistol point. When Helen too gains better insight into her own attitudes the way will be open for growth to more mature responsiveness. As they each come to better understanding of the other personality they will find themselves more ready to accept and adjust to their differences, but this will need time and patience, and persistence through many apparent setbacks.

In the intra-personal field an apparent sexual incompatibility may be due to the fact that one of the partners has a sexual abnormality with which no normal marriage partner could be compatible. The frankly homosexual man or woman could only be sexually “compatible” with another of the same sex, and there are many impotent men and frigid women whose difficulties lie deep in their own personalities and need to be dealt with there. Some apparently impotent men and frigid women are basically adequate, but are reacting to a disordered personal relationship with their partners, for example, the nervous man who feels that his masculinity is at stake, and is quite potent with a prostitute but quite impotent with his wife, because of her expressed expectations of him.

A further example of sexual incompatibility is found when one of the partners is the victim of grossly abnormal sexual urges or various forms of sexual deviation. These conditions are generally outside the competence of the marriage counselor, and such people are most appropriately referred for any suitable help they are willing to accept.

These are factors which primarily concern the relationship between the partners rather than the specific fitness of either of them for marriage. Those who come into close contact with marital disorders find many examples of people who are individually well developed in every way, and able to get on well with all kinds of people, but yet find themselves in deep and destructive conflict with each other.

This has become more common in these days, partly because we expect much more from marriage in happiness and fulfilment than our grandparents seemingly did, and partly because of what is termed “the emancipation of women,” because of which they are no longer compelled to put up with tyranny and cruelty through dependence on their husbands. Modern marriage demands much more from the partners than ever before, and there are consequently many more risks of breakdown.

Disturbances in the quality of the marital relationship need therefore be considered in relation to the “role perceptions,” the “role expectations,” and the consequent “role frustrations” of the partners and of modern society. This social and cultural aspect will be dealt with in the next section, on environmental factors in marital disorder.

Irreligion as an intra-personal factor may be distinguished from difference of religious denomination and other forms of religious incompatibility, which are more fittingly considered with the inter-personal factors. Irreligion is difficult to define in simple terms, and it may not necessarily correspond to outward or conventional indications. It may be thought of as a lack of an adequate sense of purpose, and consequently of values; gross self-centeredness and selfishness.

In this sense it will obviously make for great strain and difficulty in marriage, which requires some genuine concern for the welfare of others, some willingness to accept and forgive in realistic awareness of one’s own fallibility. Professor John MacMurray once observed that “the field of religion is that of human relationships,” and the Founder of Christianity laid down one predominant criterion by which the quality of our religion can be tested, “By this shall all men know that ye are my disciples, that ye love one another” (St. John 13:35).

It is not the province of the marriage counselor as such to preach religion to those who come for help. But he may be able to contribute much to such a situation, first through the quality of his own empathy and acceptance of both partners; second, by respecting their own religious attitudes even when they are markedly different from his, and looking with them at the implications of their attitudes with regard to the marriage relationships; and third, through referral to someone who may be able to give constructive help in any religious difficulties which may be recognized. No marriage counselor has any right to use his position to seek to impose any of his own beliefs or attitudes on anyone else. He may “let his light shine” out of himself, but that is quite a different matter from trying to make it shine into any other person.

We have considered four sets of intra-personal factors which can contribute to marital disorder, ignorance (or misinformation), immaturity, illness and irreligion. Although they are primarily intra-personal they cannot help bringing a degree of strain on the relationship. But they generally need to be dealt with mostly on the individual level, sometimes with the help of an appropriate person. As we have seen they are often best helped by a wise referral unless the marriage counselor has some special competence in the field of individual therapy concerned.

At the same time the marriage counselor may well have an important role in helping the other partner to live with the disturbed situation while any individual help is being obtained, and possibly when the intra-personal disorder persists in spite of any attempts to help. He may also be able to help two disturbed people to live more peacefully together and to work out some flexible “live and let live” arrangement.

With steady and patient and non-retaliatory handling, and with acceptance of the deluded person, it is often possible to carry on, and sometimes the delusions seem to become less intense over the years, although with periods of greater pressure at times. But it always demands great restraint and devotion, and a firmness that carries on one’s own life calmly in spite of the attempts to upset it. Marriage counselors can sometimes help the partner greatly in this.

It seems clear then that when any form of physical or mental illness becomes a threat to the preservation of a good marital relationship the counselor’s task is in two directions. It is first to recognize that an illness exists by having some idea of the main indications of illness, and of the various kinds of illness, so that he may recommend appropriate medical help. His second task is to help the sufferer if possible, and even more the partner, to live with the situation if he is willing to do so.

It is certainly not necessary for the counselor who is not a medical practitioner to recognize the exact nature of any illness, nor can he set out to treat any illness. Diagnosis and treatment lie within the field of medicine and it is important for marriage counselors to have close contact with medical consultants of the appropriate kinds, family doctors, physicians, psychiatrists, gynecologists and pediatricians.

Conversely marriage counselors can be of great help to doctors because many of the disturbed people who go to doctors for help are found to be suffering from strains and conflicts in marriage which have a material effect on their illness and on the efficacy of any medical treatment. Many people who come to marriage counselors are actually referred to them by doctors.

In the matter of referral to psychiatrists it is wise for a marriage counselor who believes a client needs psychiatric help to refer him first to the client’s own family doctor if he has one, and to suggest a list of family doctors from which he can choose if he has no regular doctor. It is then quite appropriate for the family doctor to make a suitable referral. This practice has two important advantages. It is less upsetting to the client to be told that the counselor believes him to be in need of “medical” help than “psychiatric” help. A suggestion that he needs psychiatric help will not always be well accepted from a “layman,” and may be regarded as an “accusation” that he is “mental.” He will take such referral much better from a medical man. Second, it is often valuable for the psychiatrist to have a family doctor cooperating with him, and possibly available to tide over an emergency when the psychiatrist may not be available. This is best secured by the referral being carried out by the family doctor.

The most difficult “psychotic” marital problem is probably that of what is called “paranoid schizophrenia,” a chronic disorder characterized by fixed delusions, which are woven into the person’s total attitudes and are completely resistant to any kind of argument or persuasion. They may sound completely plausible at the beginning, and often cause very great embarrassment, inconvenience and distress to many people, and particularly to the marriage partner.

A common delusion affecting the marriage relationship is that the partner is being unfaithful and carrying on a constant “affair” with someone else. The attempts by the partner to reassure such a person are completely ineffective, and often add to the emotional tension. All kinds of reasonable actions are adduced as “proof,” and bitter aggressive recriminations may be made, even for hours on end during the night, the person not allowing the “victim” any opportunity to sleep, even following him into another room to carry on the accusation.

As time goes on the character of the delusions may become more obviously false, for example the idea that neighbors are injuring the person with electric waves, or “thought waves,” or the conviction that a group of “super scientists” can “see” everything the person sees and can speak and act through him, or that the person is God’s anointed agent to rule the world. There is no limit to the range of these delusions, but their main characteristic is their fixity and lack of change except very slowly over the years.

No successful treatment for the relief of these delusions is at present known, and unless they are of a kind or intensity that would bring a risk of danger to the person or to others it is not often necessary to put the sufferer in hospital. The marital partner therefore finds that it is either necessary to develop some way of accepting and tolerating the fantastic ideas, or else, if the situation becomes impossible to the partner or the children, to break up the marriage.

In most cases the partner finds ways of coping with the situation with help for most of the time, and when there are bouts of greater intensity the person may be given some hospital care to tide him over the difficult period. Deluded people are often easier in their minds in the “protected” environment of a mental hospital than they are at home.

In many cases the partner will be able to get some help from the doctor about ways of handling the situation, but sometimes the marriage counselor may be asked about it. In general it is best to accept the feelings and ideas of the deluded person without argument, and say, in effect, “if that is so what do you want to do about it?” This does not mean agreeing with the delusions, or disagreeing with them. When bitter accusations are made it may be best again to say “You think I’m doing so and so?” with no attempt to defend, explain, or argue. It may be necessary to say “We will just have to agree to differ on that.” It is not at all necessary to defend oneself against all accusations, or even most accusations. It is better to allow one’s life to be its own justification and to allow others to think unjustly if they have made up their minds.

The third group of mental disorders which may render people unfit for the responsibilities and obligations of marriage and parenthood includes what are called the psychotic illnesses, or in more popular terms the insanities. The occurrence of a psychotic illness does not necessarily bring about a hopeless marital situation, any more than a severe physical illness will do. Treatment of many people with such illnesses is much more successful in these days, and many of them are very responsive to the devoted care of an understanding partner and relatives.

The psychotic may generally be distinguished from the neurotic, although there is no sharp line of demarcation, by the fact that he lacks insight into reality as well as into his own inner attitudes, while the neurotic, with defective insight into himself, generally has reasonable insight into the realities of life. Because of his lack of insight into reality the psychotic shows more irrational attitudes, and is much less “accessible” to counseling and psychotherapy than the neurotic.
The commonest types of psychotic illness are the “affective disorders” which mainly but not entirely involve feelings, and the various forms of schizophrenia, in which feeling, thinking and behavior are generally all involved in the disorder.

The affective psychoses are more common in the second half of life, and are of two general types, which in some cases alternate with one another in the same person. First are the depressive illnesses often termed “melancholia,” characterized by progressive inconsolable sadness and by deadness of feeling and utter pessimism. There may be strong delusions of guilt and failure, and about bodily functions. The other type includes the elated-feeling people, with bouts of tireless energy and enthusiasm and increasing restlessness, in which everyone is expected to share.

The melancholic people may bring some strains on marriage, but with reasonable understanding, which avoids attempts to argue them out of their depressions and delusions, they are generally manageable except for certain agitated types that need some restraint. There is often some danger of suicide, and such people are usually hospitalized and given special treatment, which is reasonably successful in many cases.

People suffering from mania may need urgent restraint in some cases, and particularly some protective measures against overenthusiastic spending of money, which may rapidly reduce a family to financial straits. They are usually responsive to treatment in hospital, and may remain well for some time until a further attack of mania or a gradual drift into a period of melancholia.

Schizophrenia in its various forms is commonest in the first half of life, although one form, the paranoid or delusional, often occurs in older people, either as a gradual development from the earlier form or as an apparently fresh illness. The most common early indications of schizophrenia are indifference, incongruity of emotions, such as giggling in the face of tragedy, irresponsibility and lack of initiative, dreaminess, and emotional withdrawal. There may be bizarre associations of ideas, delusions and hallucinations, and in one form fixed symbolic posturing. In early stages a young person may become involved in an impulsive marriage, and with the strains and responsibilities of marriage, and particularly those of pregnancy and childbirth, may suffer a serious breakdown in health and sanity.

Another type of mental abnormality which can be very destructive to the marriage relationship is what is called the psychopathic personality. This term covers a number of different kinds of disorder seen primarily in the field of behavior. While the neurotic feels a significant part of the trouble within himself, however much upset his trouble may bring about for other people, the psychopath usually shows little signs of disturbed inner feelings, and practically the whole disturbance is felt by other people.

In many ways the behavior and relationships of the psychopath are comparable with those of the grossly immature, and this is in harmony with certain physical characteristics of the psychopath. The tracings generally found in electroencephalograms of psychopathic persons are often similar to those found in children, and the conformation of the capillary loops in the nail bed of their fingers is also frequently like that found in children.

“These people” wrote David Stafford-Clark (”Psychiatry Today” Penguin Books, 1952) “are impulsive, feckless, unwilling to accept the results of experience and unable to profit by them, sometimes prodigal of effort but utterly lacking in persistence, plausible but insincere, demanding but indifferent to appeals, dependable only in their constant unreliability, faithful only to infidelity, rootless, unstable, rebellious, and unhappy. A survey of their lives will reveal an endless succession of jobs, few of which have been held for more than six months, many of which have been abandoned after a few days; very little love but often a great number of adventures, very little happiness despite a ruthless and determined pursuit of immediate gratification.”

It is easy to see how unfit such people are for the responsibilities and obligations of marriage and parenthood, and there is no doubt that they are responsible for a great deal of misery, bewilderment and despair in their marriages. It is extraordinary how much they are trusted in spite of many failures, and how often their plausibility and even charm (when it suits them) get them (temporarily) out of trouble. But their lack of apparent insight, their unwillingness to undergo any kind of psychotherapy, and the futility of most efforts to help them to better social responsibility, make the outlook generally far from promising. In most cases of any severity the marriage either breaks up or else the other partner makes the best of an intensely difficult situation with whatever safeguards can be established. In some cases it is found after a period of strain and conflict, and possibly great financial loss, that the person has made a bigamous marriage without giving any hint of the existence of a previous wife and family.

The most important consideration relating to the psychopathic personality as it affects marriage is the discovery of the disorder before marriage, which would generally be during pre-marital counseling. It is possible that very much unhappi-ness in marriage would be prevented if more people understood something of the indications of this abnormality and of the difficulty of changing the character of such people. This might involve considerable knowledge of the past activities of prospective marital partners, and this is much more difficult in these days when so many people choose their partners from outside their own neighborhood, and therefore may know much less about their backgrounds. The choice of a life partner is surely important enough to warrant a fairly full knowledge, rather than a series of unsupported “assurances,” or a very short acquaintance of a fairly superficial kind.

How can they be recognized? A simple description has been offered by Albert Ellis, M.A., Ph.D. in his book “How to Live with a Neurotic” (Crown Publishers, Inc., New York, N. Y.). “Psychologists usually label as ‘neurotic’ only those individuals who are so inappropriate in their feelings and so ineffective and disruptive in their behavior that they sooner or later get into rather serious difficulties of their own making.” The inappropriateness of feeling may be shown in undue anxiety, irrational fears (such as claustrophobia), crippling indecision even about straightforward matters, extreme touchiness and hostility over trivial things, seeing “insults” in perfectly natural attitudes, and suspicion of even the most genuine motives. In other cases there may be obsessional feelings, compulsive striving for perfection and rigid demands on others for perfection, blaming them bitterly when they fail to meet expectations. There may also be extreme or morbid guilt feelings.

These inappropriate feelings generally extend beyond the domestic relationships to every other relationship. There are frequent conflicts in the person’s job, in which everyone else is wrong and he is the “injured party.” This expression of inappropriateness in a wider field may help to differentiate neurotic illness from the emotional immaturity already considered, but there is no clear point of division between the two.

The neurotic is constantly “ridden” rather than in control of his life, he is compulsive, self-centered and demanding, even demanding love and friendship at the same time he is doing everything possible to alienate those who would help him. When it suits him he can turn on the charm, but this is superficial and short lived, and turns quickly to hostility when his desires are not fulfilled. He may have the capacity to succeed but stands all the time in his own light, making the most plausible excuses, and many obviously stupid ones, for his failures.

The important feature about all of these inappropriate feelings and attitudes and the ineffective and disruptive behavior is that they are not open to “reason” or to the direct awareness or control of the neurotic or of anyone else. They can only be tackled by helping the person to work backward from them so as to discover the false concepts and assumptions about life and about people, including himself, which are behind the symptoms; for example that other people “must” fulfil any person’s arbitrary expectations, or that love is something that can be obtained or preserved at “pistol point.” There are many such false assumptions about life and they are extremely varied, and well protected by very strong psychic defenses. That is one reason why psychotherapy is such a skilled, patient and complex art.

It is easy to see how such intense and falsely based feelings can be so destructive to the marriage relationship, and how all attempts at “sweet reason,” criticism, advice and admonition will be doomed to failure. Unless the neurotic is willing to face the “blood, toil, tears and sweat” of possibly prolonged psychotherapy (which means accepting his need for help), the trouble tends to recur. An interesting and important aspect of neurosis in marriage is that people often make their choice of a mate in a manner greatly influenced by their neurotic needs. For example an insecure boy who has a neurotic need to get girls to “fall” for him might come to marry a girl with a sense of inferiority who needs a “masterful” boy. When the neuroses of the two partners “neutralize” each other the marriage might well be very satisfactory to both of them. When the relationship is or becomes satisfactory it may be quite harmful to the marriage to set out to treat the neurosis of one of them, because the whole balance of the marriage may be completely upset. It is often better in such cases to “let sleeping dogs lie.”

Illness, physical and mental, may sometimes be found as a decisive intra-personal causative factor in marital disorder. The heavy burden of severe or repeated physical illness, possibly including hospitalization and surgical operations, may overwhelm married couples who have not the physical, emotional and possibly the financial stability necessary to cope with it. When it happens early in a marriage it might be particularly difficult for them to negotiate. In some cases the help of social workers and of good neighbors and relatives will have a decisive effect on the preservation of the marriage.

A less obvious kind of physical illness fairly common in these days, and often a source of strain to a marriage is exhaustion from overwork, particularly in the case of young mothers with demanding children and insufficient help. They often become deeply disillusioned by the never-ending daily grind, so different from their rosy dreams about marriage and parenthood. They are too tired to be of much inspiration to their husbands when they come home tired after a trying day to an untidy house, a late meal, crabby children and a miserable wife. Tempers tend to be much more easily provoked, and the two partners may easily find themselves drawing further and further apart. There may also be financial worries to add to the trouble.

These situations need counseling to allow each of the partners the opportunity of unburdening disturbed and hostile feelings and apprehensions and worries. Sometimes this is enough to enable them to take hold again, with the help of relatives and friends. Sometimes they need help towards more efficient household management and better use of available financial resources. In such troubles as these marriage counselors need to have an awareness of the social welfare resources that may be available and appropriate to the situation.

The most common mental illness met with in the background of marital disorders is what is called psychoneurosis, or neurosis for short. The marriage counselor does not set out to treat neurotic illness, but he must be able to recognize some of the indications of such disorders, so that he is less likely to waste time and effort in trying to reason people out of them, or to make them worse by misunderstanding. He is then more confidently able to refer them if necessary for medical treatment.