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Book Reviews   |    
Couples on the Fault Line: New Directions for Therapists
Reviewed by Judith Brandzel, M.A., M.S.W.
Psychiatric Services 2001; doi: 10.1176/appi.ps.52.8.1109
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edited by Peggy Papp; New York, Guilford Press, 2000, 344 pages, $35

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It is exciting to read a book that tries to bring new ideas to the world of couples therapy. In Couples on the Fault Line, Peggy Papp has collected a series of well-written papers that focus on the way the external stressors of modern life affect the inner world of marital relationships. Each chapter demonstrates how important it is for the therapist to be attuned to these issues in order to fully uncover and deal with the multileveled strains and pressures that couples experience in today's world.

Some chapters stand out as highlighting particularly timely and poignant issues. "The Three-Career Family," by Lawrence Levner, covers the problems faced by two-career families, in which raising children and running a household count as the third career. In "The New Triangle: Couples and Technology," Evan Imber-Black addresses the impact of technology, such as the Internet, cyber-relationships, and time spent in isolation with the computer, away from the family. Another interesting chapter, "Clocks, Calendars, and Couples," by Peter Fraenkel and Skye Wilson, focuses on the role of time and how its scarcity can affect a marriage.

In "Infertility and Late-Life Pregnancies," Constance N. Scharf and Margot Weinshel explore the complicated dynamics that surround the new reproductive technologies and the complex issues that infertility can stimulate. The authors contend that unless the therapist is able to separate infertility issues from the couple's own unique problems, the marital functioning can be viewed erroneously as pathological. This chapter contains an excellent summary of what all therapists should know if they want to treat such couples successfully.

The final chapter, "Reflections on Golden Pond," by Ruth Mohr, focuses on the latter stages of life. The author sees the therapist's main task as helping the couple to "stay connected while letting go." This process presents a unique challenge to the couple, the family, and the entire therapeutic system.

Other chapters in the book are well done and cover such topics as gender differences in depression, issues of domestic violence, therapy with African-American couples, and working with gay and lesbian couples. One of the most useful of these chapters highlights key concerns in working with cross-cultural marriages. The author suggests a useful paradigm for tapping into the unconscious cultural pressures faced by the couple and by the therapist.

Couples on the Fault Line offers such a wide range of topics that almost any therapist interested in current trends in couples therapy will find relevant information in it. Most of the authors not only skillfully outline the problem at hand but also offer pragmatic therapeutic strategies based on their observations and experiences.

Ms. Brandzel is a psychiatric social worker in private practice and is a psychotherapy supervisor in the residency training program in the department of psychiatry at the University of Rochester.

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