The seeds of creativity have the potential to germinate and flourish within the rich, ambiguous and unsettling tapestry of the core dialectical tensions related to the central organizing dialectic, life and death, generated in the patient-analyst relating. The author introduces the concept of the "dialectical edge" and describes it as the pivotal point in the dialectical struggle within these core dialectical dilemmas. This is a fluid, emotionally evocative threshold, where there is maximum potential for change, as well as for homeostatic stagnation. Drawing on Winnicott, the author illustrates how the presence of an edge within these dialectical dilemmas has the potential to open up into a creative, reflective space. He suggests that this, however, will depend on the therapist's capacity to contain/hold at this edge the arousing and intense affects--such as anxiety, dread, excitement and passion--that are inevitably generated at these pivotal relational moments. This will determine whether the patient will move forwards into the light of a creative, reflective, dialectical space, or backwards into collapsed, non-reflective darkness, where fluid oscillation is transformed into rigid ossification. The author uses a clinical example to illustrate these dialectical phenomena, with a special focus on two clinically relevant dialectics, i.e. "ritual versus spontaneity" and "closeness versus separateness".

Enactments in psychoanalytic theory and practice have been well described as a dynamic that is co-created between analyst and patient. This article explores this concept in analytic couple therapy, focusing particularly on how it is played out in the context of the three-person dynamics of the couple–therapist system. The author considers that only couple interactions that involve mutually coercive projective identification can be truly described as enactments. By invoking dialectical theory and the notion of the dialectical edge, the author attempts to provide an understanding of the psychic mechanisms involved in the transformational moments relating to enactments that occur at times of heightened tension and ambiguity.

Using a research‐informed version of how analysts think and work, this paper renders more explicit and transparent how analytic concepts can inform working with couples. It describes how each partner's subjectively held belief systems interlock and escalate, which is referred to as ‘colliding subjectivities.’ The paper illustrates the potential for this situation of heightened tension to facilitate change.

An attempt is made to move from the previously described notion of homeostasis and the symptomatic distance regulator, to a more coherently systemic one, based on the work of Maturana and Dell. Maturana's concept ofstructure-determinism is used to explain how individuals who have consensually shared fears of being either too close or too distant in relationships to others become structurally coupled in such a way that a highly resonant system emerges that regulates itself in a way that is coherent with the structure-determined beliefs of the individual family members. These belief systems are seen as vital ingredients in understanding the process of structural coupling.

Four major paradigms of family therapy are contrasted: affective‐experiential, structural, strategic and Milan. The differences are defined according to the way in which therapists think and behave in relation to their premises about change, and they are discussed under the following headings: historical roots and understanding of symptom formation; therapists' stance and techniques used in change; focus, goals and locus of change; and time perspective in change. Some suggestions are made with regard to training family therapists based on the differences that emerge when contrasting these models of family therapy.