Other couples may do the work intensely for a brief period then find they have had enough. Joe and Lisa, for example, had a rather dramatic success which satisfied them in itself. Lisa had a longstanding physical problem, a severe recurring pain in the upper abdomen. Psychiatrists had declared it to be of nervous origin but discussion of the stresses of her childhood had given her insight without cure. Surgeons had explored the area and found no clues. When this couple came to me I pointed out various ways in which the pain was of use within the dynamics of their relationship. They were intensely devoted to each other but just as intensely jealous. Lisa's pain ensured that their social life was kept to a minimum (each hated seeing the other talking or dancing with others), and that Joe was in a perpetual flutter of attention around her. But making this clear would not in itself have been enough.

A few sessions of breathing work, both in therapy and between themselves, established that Lisa's abdomen never moved with her breathing, which was always high in the chest. This was unusually easy to correct. Sometimes deep fear prevents the person from breathing into the abdomen, but whatever fear Lisa had was put aside in the desperation to get rid of her pain.

When she breathed down, with Joe's assistance (he would rest his hand on her abdomen and encourage her to make it move up as she breathed in, down when she breathed out), the pain quickly vanished. At the same time Lisa became possessed with a startling friskiness: she felt the urge to kick and bang and yell and roll around. This reminded her, she said, of the temper tantrums she used to have as a small child, which she had had to suppress in order to be a good girl and please her parents. Since her parents had not been harsh with her, she found that re-living the tantrums brought out as much pleasure as rage.

After a very few sessions her abdomen was moving freely, she felt increased energy, including sexual, and the pain was a thing of the past.

Such a quick and radical cure was bound to create too rapid a shift in the dynamic of the couple. It is rather like installing a new part in a car motor: various worn-out components are put under new stress and may break. A marriage, though not a machine, is a system in which sudden change necessitates adjustment. Within a few months Joe had fallen into a depression. But it only took a single session of couples therapy to sort this out: Joe was quite simply angry at Lisa for all the years of having had to constrain his activities because of her pain. I have the impression that they would have worked this out eventually without my help. Joe expressed his anger at Lisa, aided in focusing it by a session he had done on exploring emotions through the eyes. She understood his resentment. It, and the old jealousy, quickly faded away in the light of increased pleasure in each other.

Joe and Lisa do not do couples work any more. But they have the techniques should the need arise.

Another couple, William and Helen, went through all the explorations given in this book. Their work was systematic and not dramatic apart from a few flare-ups. Both were "fight-oriented" (see chapter 4), quick to anger and resentful of the control implied in following instructions. But the work deepened their trust in each other. The techniques they had learned turned out to be most useful at the birth of their child. Helen took no medication. She wanted to live the birth fully which, since the baby was for a while a posterior presentation (the head down, but facing backwards), meant a period of great pain in which she felt both fear and anger. She dealt with this by standing in a half crouch, her hands on her knees, and yelling as the pain came, while looking directly into William's eyes. The importance of eye contact in moments of possible panic is well known to experienced midwives. William's role in the birth was to be emotionally present while the midwife supervised the physical procedures. His previous emotional work with Helen enabled him to receive the force of her anger without becoming too upset and to accept his own natural fear in the situation. Later he helped in the actual birth by applying necessary pressure to Helen's lower back as she breathed out with the contractions which brought a healthy baby into the world.

Sometimes couples work is done in an attempt to save a marriage which is falling apart. Alan and Dorothy came to see me in a phase when they were hopeful, after repeated separations and affairs with others, that they could after all make a go of it. This seemed doubtful. But I taught them the basic methods of couples work. Dorothy, a rather fierce person with a hard muscle tonus and penetrating eyes, learned to soften a little with Alan's help, and in the breathing explorations began to show him a previously hidden "little girl" side of herself, expressing loneliness and crying openly. Alan, a rather passive man, eager to please and over-polite, made contact with a great deal of rage. His eyes had been used to pleading with Dorothy not to leave him. Now they flushed with rage as he beat down on the mattress, twisted a towel, and was able to tell Dorothy how much he resented her.

But none of this saved the marriage. Dorothy was crying with sadness at having to leave Alan. Alan was raging at having lost Dorothy. They realized that they had to separate for good. At least they made a clean job of it, without rancor. I think the couples work helped make this possible. Now, years later and with other, better-suited partners, they remain friendly with each other.

The explorations in this book will not save failing marriages because they lead the couple closer to the emotional truth and make deception more difficult.

However, couples work can help resolve sexual problems by placing them in a wider emotional context. Too often, people have followed instruction manuals or narrow therapeutic approaches and worked on such problems mechanically, considering them only in terms of genital dysfunction. This in effect splits the genitals from the rest of the body and the person. In an attempt to cure himself of premature ejaculation, Clive had done various physical exercises, involving stop/ start masturbation and squeezing the penis to check excitation. His wife Linda had cooperated in much of this work which made her even more tense in a situation that already annoyed her. She said she was fed up with the technicalities of sex.

It took some time for them to feel comfortable working with each other. For one thing Linda felt unexpectedly insecure about her own breathing and movement being closely observed: Clive's problem had ensured that most of the attention (critical from Linda, self-critical from himself) had been on him. In fact both had a similar breathing pattern, with rigidly inflated chests, and were extremely tight through the pelvis. Both loosened up through kicking and pounding on the mat. But, as so often in couples work, the key factor was the nature of the contact it encouraged between them. They gradually became much more comfortable than they ever had been with each other's bodies. After exchanging a few critical home truths about each other's appearance, weight, and smoking and drinking habits, they found they liked each other better. Their lovemaking became more relaxed.

But a crucial fact emerged. Clive had been brought up with an over-idealistic view of women and was quite afraid of hurting or crushing Linda who was considerably smaller than he. In consequence, while making love he was so gentlemanly as to support himself entirely away from Linda's body: the only area of physical contact during intercourse, then, was the genitals.

When they began to feel more at ease embracing each other fully, genital penetration became merely the most intense part, the center, of a more general contact and fusion. Clive's genital anxiety was de-emphasized and he became more able to prolong intercourse—not from a sense of his duty to satisfy Linda, but from sheer enjoyment.

Not all cases of premature ejaculation are resolved so easily; some people may need counseling. In Clive's case I was able to give him some extra help by putting him in touch with a part of his feelings which had been hidden, a layer of vindictive rage against Linda (and all women) which was camouflaged behind his fear of hurting her.

At the very least, couples work can lead to a much more open general contact between partners so that specific problems can be discussed and worked on more easily, either by the couple themselves or in counseling if necessary.

Couples work, because it insists on equal attention being paid to both partners, may also restore perspective in a relationship which has become dominated by one partner. Sometimes one has become the informal therapist in the relationship, often because this partner is in fact a psychologist, a doctor, teacher or nurse. The other partner then becomes the "disturbed" one, the patient. But as I point out in this book, almost all couples with a good relationship are fairly evenly balanced in terms of emotional capacity and knowledge. What is more, the "therapist" partner often has a suffering "patient" buried inside (like the proverbial thin man inside the fat man); and the "patient" can turn out to be an observant and capable "therapist."

In the explorations proposed in this book, you take turns being "explorer" and "guide." These are not equivalent roles to those of patient and therapist, of course, but they do exercise some of the capacities of each.