Faculty Bibliography

Review of book: Couple Therapy for Infertility. By Ronny Diamond, David Kezur, Mimi Meyers, Constance N. Scharf, and Margot Weinshel. Guilford Press, New York, 1999, 237 pp. Reviewd by Linda Perlin Alperstein.

Discusses the structural base for pretend therapy, in which untrusting families (e.g., those seen for child abuse) seem to go through the motions of treatment while baffled therapists struggle with resistance. A case study, involving parents and a 6-yr-old physically abused girl, illustrates the impossible contract, therapy without trust, and cooperation without agreement.

Discusses the physical and psychological trials of infertility testing and treatment. The course of psychotherapy is described with a husband (aged 42 yrs) and wife (aged 39 yrs) in which problems of infertility were compounded by the couple's own dynamics. Discussion focuses on dynamics in the family of origin, the wife's loss of the fetus through an ectopic pregnancy, her subsequent pregnancy with twins through in-vitro fertilization, and the loss of one of the fetuses.

A typology for troubled families was developed based on the configuration of family members and the position of the identified patient within the family structure. This typology was investigated by surveying the demographic and clinical characteristics of 110 families of patients treated in a day hospital. Four types or "constellations" were found in the sample population. The families in the four Constellations differed significantly from one another in the gender, age, and diagnoses of the identified patient and the income level of the families. The Constellations thus appeared to constitute distinct clinical entities in the population studied. The reasons for the differences among Constellations are discussed in terms of the stress families experience during developmental crises involving structural change.