Marriage and Its Discontents

This is a book about the dynamics of marriage, both as an institution and as represented in society. It is filled with rich clinical vignettes and robust theory to deepen our understanding of the nuances and variations of marriage and the ways clinicians can help the couple to salvage their relationship or part graciously when it fal

With contributions from Anne Adelman, Salman Akhtar, Shawn Blue, Ann Eichen, Arpana G. Inman, Sameer Khan, Olga Santa Maria, Andrew Smolar, and Pratyusha Tummala-Narra. The realm of marriage is affect-laden and challenging on many psychosocial fronts. What is the relationship between love, sex, and marriage? Is marriage a developmental landmark? Why do marriages fail? Is monogamy “natural”? What about bigamy and polygamy? There are many, many questions that arise about marriage and Marriage and Its Discontents seeks answers. The chapters cover topics that range from the normative to deeply worrisome, from customary to highly unusual, from rapture to rupture, from sacred to profane. The book opens with a wide-ranging Prologue by Ann Eichen. It is followed by the first part, “Variations,” which includes chapters on same-sex marriage and interracial and intercultural marriages. The second part, “Vexations,” has chapters on marriages that are designated as “perverse” or “dead.” The third and final part of the book, “Violations,” addresses the topics of marital infidelity and divorce. Closing the book is the Epilogue by Andrew Smolar, bringing his keen psychoanalytic attention to the matters of marital discord. The insight and knowledge imparted by these fascinating chapters enhances the readers’ empathy and affective attunement to the blend of conflict and bliss found in many marriages. It is essential reading for all practising clinicians and those looking for greater insight into the impact of marriage on individuals’ lives.

Acknowledgments 

About the editors and contributors 

Introduction 

Prologue

CHAPTER 1
What is marriage?
Ann Eichen

Part I: Variations

CHAPTER 2
Same sex marriage
Sameer Khan

CHAPTER 3
Interracial and intercultural marriage 
Pratyusha Tummala-Narra and Arpana G. Inman

Part II: Vexations

CHAPTER 4
Perverse marriage
Olga Santa Maria

CHAPTER 5
Dead marriage
Anne Adelman

Part III: Violations

CHAPTER 6
Infidelity 
Salman Akhtar

CHAPTER 7
Divorce 
Salman Akhtar and Shawn Blue

Epilogue

CHAPTER 8
Can a faltering marriage be saved? 
Andrew Smolar

References 

Index

Salman Akhtar MD, is Professor of Psychiatry at Jefferson Medical College and a Training and Supervising Analyst at the Psychoanalytic Center of Philadelphia.  He has served on the editorial boards of the International Journal of Psychoanalysis, the Journal of the American Psychoanalytic Association, and the Psychoanalytic Quarterly. His more than 400 publications include 105 books, of which the following 22 are solo-authored: Broken Structures (1992), Quest for Answers (1995), Inner Torment (1999), Immigration and Identity (1999), New Clinical Realms (2003), Objects of Our Desire (2005), Regarding Others (2007), Turning Points in Dynamic Psychotherapy (2009), The Damaged Core (2009), Comprehensive Dictionary of Psychoanalysis (2009), Immigration and Acculturation (2011), Matters of Life and Death (2011), The Book of Emotions (2012), Psychoanalytic Listening (2013), Good Stuff (2013), Sources of Suffering (2014), No Holds Barred (2016), A Web of Sorrow (2017), Mind, Culture, and Global Unrest (2018), Silent Virtues (2019), Tales of Transformation (2021), and In Leaps and Bounds (2022).

Dr Akhtar has delivered many prestigious invited lectures including a Plenary Address at the 2nd International Congress of the International Society for the Study of Personality Disorders in Oslo, Norway (1991), an Invited Plenary Paper at the 2nd International Margaret S. Mahler Symposium in Cologne, Germany (1993), an Invited Plenary Paper at the Rencontre Franco-Americaine de Psychanalyse meeting in Paris, France (1994), a Keynote Address at the 43^rd IPA Congress in Rio de Janiero, Brazil (2005), the Plenary Address at the 150^th Freud Birthday Celebration sponsored by the Dutch Psychoanalytic Society and the Embassy of Austria in Leiden, Holland (2006), the Inaugural Address at the first IPA-Asia Congress in Beijing, China (2010), and the Plenary Address at the Fall Meetings of the American Psychoanalytic Association in 2017.

Dr Akhtar is the recipient of numerous awards including the American Psychoanalytic Association’s Edith Sabshin Award (2000), Columbia University’s Robert Liebert Award for Distinguished Contributions to Applied Psychoanalysis (2004), the American Psychiatric Association’s Kun Po Soo Award (2004) and Irma Bland Award for being the Outstanding Teacher of Psychiatric Residents in the country (2005). He received the highly prestigious Sigourney Award (2012) for distinguished contributions to psychoanalysis. In 2103, he gave the Commencement Address at graduation ceremonies of the Smith College School of Social Work in Northampton, MA.

Dr Akhtar’s books have been translated in many languages, including German, Italian, Korean, Romanian, Serbian, Spanish, and Turkish.  A true Renaissance man, Dr Akhtar has served as the Film Review Editor for the International Journal of Psychoanalysis, and is currently serving as the Book Review Editor for the International Journal of Applied Psychoanalytic Studies. He has published 11 collections of poetry and serves as a Scholar-in-Residence at the Inter-Act Theatre Company in Philadelphia.

Ann Eichen, Ph.D., is a licensed psychologist and psychoanalyst. She received her Ph.D. in clinical psychology from the Derner Institute of Advanced Psychological Studies, and she completed her postdoctoral work at Johns Hopkins Hospital. Dr. Eichen is on the faculty at the Psychoanalytic Center of Philadelphia. Her interests include female psychological development and the nature and function of love relationships on development throughout the lifespan. She has a private practice in Wynnewood, PA, where she provides individual, couples, and group psychotherapy. She has also served as a divorce mediator in Montgomery County. Recently, she has discovered a passion for painting and is studying art with local teachers.

Andrew I. Smolar, M.D. is training and supervising analyst at the Psychoanalytic Center of Philadelphia and clinical associate professor of psychiatry at Temple University School of Medicine, also in Philadelphia, PA. He has been in the private practice of adolescent and adult psychiatry in Wynnewood, PA since 1998. He specializes in psychoanalysis, combining psychoanalytic psychotherapy and medication treatments, couples therapy, and group therapy. He has led groups in his practice, as well as groups for residents of psychiatry and Albert Einstein Medical Center (Philadelphia) Hospice staff. He has supervised residents and psychology interns, psychiatrists, and psychoanalysts in training; he also served as consulting psychiatrist to several local colleges, including his alma mater Haverford College from 2000–2011.

Dr. Smolar served as president of the Psychoanalytic Center of Philadelphia from 2015–2017; he has also served there as chairman of the Education Committee, Training and Supervising Analyst Committee, cochair of the Supervision Study Group for Supervising Analysts, and is codirector of the Developmental Pathway for recent graduates. Dr. Smolar has contributed to the academic literature by writing on the following subjects: analytic work with an immigrant analysand, group therapy in various clinical settings, gift-giving in group and individual settings, combining analytic treatment with group therapy techniques, and most recently, psychotherapy during this era of political turmoil and contributions of group fragmentation toward national discord. He is coinvestigator of research of American citizens suffering from conspiracy thinking. His article in press for the American Journal of Psychoanalysis addresses group identifications during individual development and techniques for including them during psychoanalytic clinical work. He has also published op-eds on mental health subjects in the Philadelphia Inquirer and in the Pittsburgh Tribune Review, where he is a regular contributor.

• Edited by Salman Akhtar
• Edited by Ann Eichen
• Edited by Andrew Smolar

"Covering a wide terrain and myriad configurations of the marital relationship, this well put together book takes us on a rare sojourn of academic illumination, clinical wisdom, and near-sensual excitement. More importantly, the essays contained here provide us with a deeply humane and astutely empathic understanding of love, ambivalence, dependence, and sustained loyalty. A remarkable achievement indeed!"

— April Fallon, PhD, Clinical Professor of Psychiatry, Drexel University College of Medicine, Philadelphia

'This book addresses the ancient topic of marriage in an innovative, fresh, and original manner. It covers a wide range of marital configurations ranging from traditional, intercultural, interracial, same-sex, perverse, and dead marriages, as well as infidelity and divorce. The conceptual journey is deeply incisive, looking straight in the eyes at the myriad pleasurable and painful phenomena associated with marriage. The result is a true rarity: a serious professional book that is hard to put down!'

— Hanni Mann-Shalvi, PhD Training Psychoanalyst, Israeli Psychoanalytic Society, Tel Aviv, author of 'From Ultrasound to Army'

'Covering a wide terrain and myriad configurations of the marital relationship, this well put together book takes us on a rare sojourn of academic illumination, clinical wisdom, and near-sensual excitement. More importantly, the essays contained here provide us with a deeply humane and astutely empathic understanding of love, ambivalence, dependence, and sustained loyalty. A remarkable achievement indeed!'

— April Fallon, PhD, Clinical Professor of Psychiatry, Drexel University College of Medicine, Philadelphia, co-author of 'The Impact of Parenthood on the Therapeutic Relationship'

'The external skin that supports, or fails to support, partners in navigating the often troubled waters of couple relationships can often be neglected by therapists as they focus on internal dynamics. The editors of this American collection help redress the balance, assembling eight copiously researched and well-illustrated, psychoanalytically informed chapters interrogating the variety and vulnerabilities of relationships that take on the mantle of contemporary marriage. This expansive book will challenge therapists of all persuasions to review their assumptions about what causes couples distress and how best to help.'

— Christopher Clulow, PhD, Senior Fellow, Tavistock Institute of Medical Psychology, London, author of 'Sex, Attachment and Couple Psychotherapy'

'There is abundant wisdom and idea-rich scholarship, features that make it a stimulating and enormously worthwhile read.'

— Robert C. Abrams, Journal of the American Psychoanalytic Association, December 15, 2025