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Book Reviews   |    
Working With Relationship Triangles: The One-Two-Three of Psychotherapy
Reviewed by Nancy Glimm, M.S.W.
Psychiatric Services 1998; doi:
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by Philip J. Guerin, Jr., Thomas F. Fogarty, Leo F. Fay, Judith Gilbert Kautto. ; New York City, Guilford Press, 1996, 251 pages, $27.95

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This invaluable new addition to the treatment literature will be appreciated by the student, the novice or experienced psychotherapist, and the educator. In Working With Relationship Triangles, the well-regarded team of Guerin, Fogarty, Fay, and Kautto have set out to advance clinical knowledge of the relationship triangle.

Although triangles are frequently referred to in the family therapy and psychodynamic literature, the authors believe they are less than fully conceptualized and translated into workable treatment approaches. They make their readers aware of the omnipresence of relationship triangles, and they hope the psychotherapy community will become more comfortable with thinking about them in individual, dyadic, and family treatment. They also hope to provide new ideas to sharpen conceptualization and intervention skills.

The authors first review the evolution of the concept of the relationship triangle. The basic instability of the dyad produces the relationship triangle; the authors explain how emotional reactivity is the key to seeing the emergence of triangles from unstable dyads. They discuss Bowen's work as it enlarges on Freud's view of the oedipal triangle-dilemma as well as the evolution of their own work.

The book swiftly moves into the clinical context. We are reminded that although triangles are everywhere, we tend to think in linear and dyadic ways—especially harried clinicians in busy clinics attempting to provide service in a time-sensitive manner. The authors believe their treatment methods are applicable to short-term care, and they provide varied clinical examples. All the while they emphasize patients' complexity and the influences that individuals in relationships have on each other.

Three types of primary triangles are introduced: those seen in individual therapy, child- or adolescent-centered triangles, and marital triangles. The authors explain that clinical work should be focused on the process in the relationships between the individuals in any triangle. The problems emerge as those in treatment try to rework their relationship triangles.

The therapist is much more a coach, and interpretation is usually not employed. The emphasis is on helping those in treatment to see their individual lives, dyadic personal relationships, and relationship triangles in such a way as to become self-focused, rather than being directed by underlying emotional forces. Self-focus is the ability to see a relationship problem as a result not only of the other person's limitation but of one's own.

The authors go on to clearly and thoroughly describe the structure, process, and function of relationship triangles. The structure will determine the movement, or lack thereof, within the triangle and the reactive process. Function or dysfunction will follow for the individual. The interaction between structure, process, and function is described.

The second half of the book is devoted to treatment. Coaching and direct interventions are applied to individual, marital, child and adolescent, and family treatment. These treatment chapters reveal the authors' clinical expertise as well as their compassion and creativity.

The authors provide a richly conceptualized treatment that is patient centered and process oriented, with self-focused awareness as the goal. As a clinician, one feels renewed optimism for providing care after reading this book.

Ms. Glimm is a psychiatric social worker with the child and adolescent team at the Bronx Mental Health Center of the Health Insurance Plan of New York.

Ms. Glimm is a psychiatric social worker with the child and adolescent team at the Bronx Mental Health Center of the Health Insurance Plan of New York.

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