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Couples
Counseling
General
Introduction
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COUPLES COUNSELING: GENERAL
CONSIDERATIONS
People seek couples
counseling for as wide a spectrum of issues as there are a variety of
relationships. Certainly there are
common dynamics that many couples share but counseling
sessions need to be adapted
to each couple's unique circumstances, life styles and
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according to the
types and intensity of their concerns. The article below is
primarily intended as a general orientation to counseling for
those considering couples work for the first time. You may
read the remaining material below as if it is one continuous
article or you can click on the items in the box to the right to
be directed to various aspects of the couples counseling process.
Please bear in mind that examples of couples' issues are not
about any specific clients*.
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Click below for sub-topics in this article
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When Couples Finally Seek Counseling:
Typical Scenarios
A few rare couples come
for counseling just to improve an already satisfying
relationship. But much more often, couples come at the 11th
hour 59th minute--when problems have brought them right to the
edge of breaking up. Some report only that one or two big
issues drag them down-raising the kids, her/his mother, money,
time together, sex, etc.; but just as many say they don't
have any big problems-but squabbling over every little
thing is beginning to poison their enjoyment of each other.
Frequently, one partner has been dissatisfied for sometime
and pushed for joint counseling years ago while the other either
didn't even recognize a problem or assumed things would blow
over. Not uncommonly, the latter partner reluctantly agrees
to come as a last resort to save the relationship-- but with
little or no belief that counseling can help. Again, there
are as many different scenarios as there are couples. In
the case of those hesitant to come, it may be worthwhile to note
that over the last few decades quite a body of scientific data,
both quantitative and qualitative, has been assembled about
success and failure in relationships. No doubt some of
those researchers were as informed by the twists and turns of
their own relationship experience as scientific methodology.
In any case, much of that data resonates with theoretical
and practical traditions which came long before. (There is
overwhelming evidence indicating that therapy in general is very
effective.)
Common "Revolving Door"
Problem Patterns
Different styles of
conflict have been studied by researchers of successful
marriages. Occasionally, both partners fight long and loud.
Others may hardly utter a peep of an overt conflict (even
while growing more distant by the day). A beginning, helpful
insight is to see how these common dynamics repeat in frustrating
loops: For example, one person gets angry when their
partner withdraws. That withdrawal is often a familiar,
though ineffective, default strategy to avoid an uncomfortable
conflict. However, the withdrawal typically frustrates the
attempts to connect by the first person who then reacts with her
or his default strategy-anger. That engenders more
withdrawal …and so it goes! Other obvious loops are
angry rebuttals responded to with angry rebuttals; withdrawal and
avoidance responded to with resentment and distancing. Of
course, once a couple goes around these loops a few times, it
doesn't take much to set off the pattern: a raised eyebrow
and or a quiet pause can trigger an “emotional
allergy” in the other and then the dynamics may cascade
into a negative spiral. Just as individuals have blind
spots, so couples also don't seem to see themselves clearly
enough to stop these painful revolving door patterns.
A Key Element Driving Common Problem
Patterns
Couples most often go
awry, irrespective of their style (frequent fighting or very
little) or their specifics issues (bills, not enough time
together, in-laws, children, etc.), when one doesn't fully
acknowledge the value of what's vitally important to the
other. To illustrate this, let's examine a few
scenarios in obvious, broad strokes. (Please note that I
always change the details of stories about clients for
confidentiality though many of the themes are very common.)
A man came in for therapy and stated that he wanted to quit
gambling. He said that he's tired of wasting time in
front of slot machines and feeling foolish about $1,000 he's
racked up on a credit card. But within a few sentences, he
told about how his wife responded when he told her he was going
to quit gambling. In sharp tones, she said “you
better quit gambling”. At first, he calmly
repeated that he recognized how stupid his gambling was; but she
became even angrier with accusations about how his gambling was
threatening their retirement. Then, he lost his cool and
came back with antagonism and rebuttals; and she came back with
more anger. Within minutes, he was yelling that they had a
sizable 401(k) and that he worked hard for his money and had a
right to spend some. He stormed off to the bar to gamble.
Amazingly, even as he told the story, he failed to notice
that he'd lost track of his focus on quitting
gambling--even in the counseling sessionpresumably
dedicated entirely to his goal, almost his entire energy stayed
on the insensitivity of his wife (who, remember has exactly the
same goal as he does!) Before analyzing what this angry argument
is really about, let's investigate a similar scenario.

A
woman sought
counseling saying she really wanted to get back into
exercising--knowing how much better she'd feel. Indeed,
she met her partner in her early 20's at a running event.
As the years went by, her work demanded longer hours.
Having had a parent who died of congestive heart failure,
her partner started to get on this woman's case for high
cholesterol and weight gain. After just a few comments, she
told me how she had some ice cream the night before and
“kind of hid” the container out of sight in the back
of the freezer. But her partner found it and angrily
confronted her about breaking her commitment to cut back.
After three angry exchanges, she was yelling that she'd
eat what she wanted--and she did! In both examples, these
clients lost sight of their stated goals very quickly in a
conflict with their partners (who actually had exactly the same
goals!)
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Neither of these
couples are really arguing over, let alone discussing, gambling
or healthy eating except at the most superficial level.
Sure, those words are in the narratives, but the real
discussion is better understood in light of the “prime
psychological force”--the desire (frequently the intense
need) to be seen and acknowledged in accordance with our
preferred identity. Right below the surface discussion,
the exchange amounts to: “I'm not getting your
validation [about what I've put up with over your gambling]
and that hurts; so I'm clobbering you with anger and telling
you what you're going to do”; the other responds with a
variation on “Oh no, I'm hurting even more than you
because of your unwillingness to give me validation [for
quitting]; so I'm angrily telling you where to get
off”. Later in a couples counseling session one of
these spouses might claim, e.g., that it isn't the lack of
validation that was so upsetting but the actual gambling losses;
however, usually, as in the example above, just a little probing
brings out the spouse's hurt feelings for being disrespected
or lied to in the past discussions about the gambling or left
alone at home with sole responsibility for the kids for many
evenings. In any case, it's the lack of feeling the
other is attuned to “my” hurts that quickly drives
these conflicts into downward spirals.

Both
partners want the other's validation, respect, and support.
Intellectually, they may be clear they don't really
need a supportive response, but, at the level of their
psychological identity, their hearts are nothing less than
sharks blindly striking out in anger (or recoiling in withdrawal)
to get what they want. I'm using dramatic images like
“prime force” and “sharks” for good
reason--getting validation or being “seen” by others
isn't optional. As elaborated in another article on
this site, it is actually necessary for fundamental
human development--even for developing some physical
movements. When very sensitive, painful issues hang in the
balance, it is obvious that when it comes to couples'
arguments, logic is out the window-whether both partners are
lawyers or have PhDs in Physics. When these partners
didn't get the acknowledgment they thought they deserved,
they reflexively responded along the spectrum of angry
emotions but it could just as easily have been a subtle
withdrawal with or without fantasies of being with another
person. Rather than leave this at the level of intellectual
understanding, I suggest examining how the alienating responses
couples make to each other are driven by the pain of not getting
the acknowledgment they wanted from the other. Frequently,
the issues never get discussed except in the
“surface structure” of a couples language. The
essence of the “dialogues” could better be understood
as something like this. Partner 1: “I have
important, legitimate HURTS and that's what is important
here”; Partner 2: “Yours? What about MY
HURTS?”; Partner 1: “Yes, my HURTS! You never
recognize my HURTS”; Partner 2: “I can't
believe you, It's always your hurts, when is it ever
going to be MY HURTS?” I believe you'll find
these same patterns play out in relationship dynamics from
Shakespeare to situation comedies.
The First Session: Don't
Worry, There Are No Needles
Is there anything that
helps couples break these crazy repetitive loops which left
unchecked too often lead to painful breakups? People
usually come to the first session with some trepidation.
After all, the counselor is just a stranger and they are
about to share some of their most intimate experiences and
painful feelings, about which they have dwindling hope of
resolving. The first order of business is to gather
information with ordinary questions put to both partners:
what brought them to counseling? what do they want to change? any
precipitating incidents? the history of the relationship?
children? and some general background information related to
work, financial health, etc.. Actually, most of the time
there isn't even a need to ask many questions-the critical
information just pours out.

Some counselors put
more emphasis than others on inquiring into each individual's
family of origin. I pay special attention to each
couples' specific way of “doing” conflicts as
well as how they try to solve their problems.
Couples Counseling Intervention
Strategies:
Behavior change, Communication skills,
Differentiation
Couples counseling
therapy research has evaluated many techniques to help couples
change. Much of that research isn't very surprising and
definitely not inspiring just as information. It really has
to be experienced. But, for those considering counseling it
is sometimes comforting to be familiar with the landscape of
“change strategies”. These generally range from
straightforward “behavioral” commitments like
planning more time together to subtler communication methods all
the way to more demanding personal growth issues--requiring
healthy “differentiation”, a developmental process of
learning boundaries that allow each member to deepen and express
their own uniqueness while maintaining loving connection.
Again, as you read these, keep in mind that to be useful
they often need to be led by a skilled therapist for the very
reason that couples are as blind to their dynamics as individuals
are to their faults.

--Simple Behavior Changes: There
are a number of researchers and writers who emphasize behavioral
changes-- make a list of ten small things that would please
you in the relationship, exchange the list for your partner's
list; now, each person commits to doing two of them.
“Solution Focused” therapists may ask a couple
what worked in the past…and then urge them to do more of
that. If you think that sounds too simple, in my experience
you're absolutely right!
It is worth noting that
while more sophisticated methods go far beyond
“behavioral” suggestions, they don't exclude
them. For example, though positing that childhood wounds
are at the heart of healing relationships, Harville Hendrix still
teaches couples to make specific dates and commitments for joint
activities or times to talk. Frequently hailed as the most
“scientific” of couples theorists, Dr. John Gottman
recommends that couples pattern their relationships after
“successful” couples who say 5 positive comments for
every negative one.
In
fact, so called
simple behavior changes have “ecological”
ramifications-that is, they involve changes in feeling, attitude,
meaning, etc.. They may necessitate a deeper attunement to
one's partners feelings and needs. Gottman recommends
that men generally need to make sure they do their share of the
housework, but he frames that with an elaborate and quite
reasonable explanation to those men about how that is important
to their partner's feeling of being respected in the
relationship. So, while behavior changes sometimes seem
like contrived, mechanical actions, if they work, it's
usually related to the underlying meaning to a partner and/or a
change in the spirit they're done in. In my experience,
they often won't be attempted unless the communication about
them is sensitive.
--Communication: Another more
substantial level of interventions touching on more emotionally
intimate issues includes all sorts of communication
“skills”. Any number of methods coach basic
skills like speaking in “I messages” (“I'm
losing interest in making appointments when you cancel as often
as you do.”) as opposed to blaming “you”
messages (“You are a complete flake.”) which
inevitably triggers defensiveness. Several of the
supposedly most scientific approaches recommend taking a
“softening” approach when bringing up complaints to
your partner, “structuring” your conflicts into
prescribed steps, learning to pause before a critical threshold
of hurt feelings is crossed, or asking formal permission in an
agreed upon format first before bringing up a complaint.
Again, if you're wondering if “science” was
really needed for these brilliant conclusions, you aren't
alone. But the fact is, that even sophisticated couples may
benefit from having a few techniques to fall back on when they
discussing issues with the highest degree of difficulty for
them.

There are more
systematic training of couples' communications. Dr.
Ellen Bader of Stanford created one of the most complex models of
the stages couples go through in their relationships.
Nonetheless, she teaches couples very ordinary tools such
as learning to “inquire” into each others'
experience without reflexively responding with rebuttals, counter
examples, anger, withdrawal, etc.. In a book on healing
after affairs, Janis Spring describes several variations on
this theme. “Peer counseling” methods have long
prescribed this same technique to non-professionals--though it
can make all the difference when used by a skilled couples
counselor as just one aspect of a broader therapeutic approach.

Subtler yet is the capacity
to communicate different emotions at critical junctures during
conflicts. For example, expressing sadness or
disappointment over a lack of time together rather than blaming
the other for not being available. The latter usually
elicits a defensive response. Expressing sadness over the
lack of time together doesn't deny the other's
culpability, but rather articulates the basic problem with a
different emotional coloring that partner may or may not
empathize with-but is much less likely to react to.
It is, of course,
ridiculous to think that a couple will read an outline like this
and feel hopeful. Reading multiple books on relationships
may be helpful but certainly does NOT necessarily translate into
real time skills for couples to work their way out of gridlock.
While the methods outlined above are useful, the actual
landscape of couples problems is very convoluted and may take a
very skilled therapist to navigate. Individual members
of a couple are often accomplished communicators and problems
solvers-except in the context of their primary
relationship. When couples come to counseling
initially, their ability to agree on anything is often
lacking and their interest in pleasing each other is at a low
point. Persistent couples' conflicts are usually
driven by deeper, “psychodynamic” patterns:
When old wounds (we all have them) are triggered, our
hearts hurt so intensely our minds are blinded--by our hurt
feelings, despair or emptiness; without a skilled third
person's perspective, we simply can't see how our
repetitive attempts to escape that pain actually traps us.
There is another general intervention strategy-promoting
differentiation-that is at still another level of
complexity.
--Differentiation: How is it
possible that relationships once fueled by love, respect, and
consideration come to such painful impasses? Let's
first consider what each individual brings to the partnership--a
fundamental sense of self, formed and reformed in continuous
interaction with the world. There is enormous, quantitative
and qualitative, research, that shows how children only grow a
healthy sense of self when they are “mirrored” by
their caregivers. When mom gives her attention and marks
out the child's emerging abilities, humor, persistence, etc.,
the child can own those qualities (“autonomously
incorporates” those qualities). Self esteem is, then,
a kind of catch-22: We can only learn to validate our self
if we get external validation.
But this process
doesn't stop in childhood. Confident adults demonstrate
a healthy sense of autonomy but still yearn for intimacy--but too
much togetherness threatens our sense of autonomy. It's
as if a good feeling of independence or autonomy wants to be
expressed-but to whom? Too much “autonomy”
leads to feelings of separateness and/or loneliness and that
inevitably hungers for release into something bigger; ultimately
an intimate connection with another. This basic dynamic
isn't limited to romantic relationships. Consider that
the seemingly most intelligent, creative adults often reveal
themselves as incredibly fragile in the face of criticism of
their work, art, cooking, parenting style, etc.. Check this
out in your own experience: observe how often your partner,
boss, friends, or co-workers react, at least mildly, to the
smallest criticism or just a slightly disapproving raised eyebrow
or tone of voice. That is because psychologically we
are open systems requiring “mirroring” energy from
other humans in and creative energy out.
Perhaps, most obvious when
couples first get together, they want to “let in” the
other person's feelings and thoughts as well as share
life's experiences. We want to taste that
other's essence. But when we open that door of
intimacy, ALL aspects of that person come in too-their emotions,
opinions, and preferences about our friends, the way we dress,
the food we eat, spirituality, our bodies, family, how we brush
our teeth and what size we cut the garlic! And some of
those emotions and opinions are negative, sometimes extremely
judgmental.
That presents all sorts
of dilemmas: how much to stay open and how much to filter
out. We may argue, rebut, get angry at, or withdraw from
the other as unconscious ways of navigating the disconnected
differences we're discovering. One common strategy is
to avoid the other's negative judgment or reaction by giving
up one's own preferences. When done on occasion, that
may be wisdom or mature generosity. But in our less
developed psychological stages and states, we don't
just repress; we actually lose tract of what our own preferences
are. It's a kind of self-abandonment. That's
not unselfish, but a lack of a self-inevitably unsatisfying to
both partners and frequently accompanied by depression for the
self abandoning partner. People often describe this in the
course of a divorce. Tired of their own feelings of
resentment and convinced of their partner's selfishness, they
finally divorce while eager and challenged to discover their own
unique tastes in movies, food, etc.. Note, however, that as
developmentally appropriate and satisfying as that may be in the
short term, it doesn't necessarily lead to learning the
skills for responding when differences come up in the next
relationship with a partner who may be just learning to do the
same.
So what are those
“differentiating” skills? And how do we learn them?
This is much too complex to reduce to a few aphorisms.
Dr. David Schnarch devotes 400 pages to the theme in
Passionate Marriage, a book for couples struggling to regain a
vibrant sex life. He summarizes the dilemma:
“Giving up your individuality to be together is as
defeating in the long run as giving up your relationship to
maintain your individuality.” He makes multiple attempts to
provide directives such as learn to “self soothe” and
“stop taking your partner's reaction
personally”.
Though the topic
resists simple caveats, I will offer a few examples in two broad
categories of differentiation skills: 1) learning dialogues
that break the reflex of participating in old
“scripts” with your partner and 2) learning to
identify, feel, and contain losses in the relationship without
projecting them onto your partner. Let's revisit a
familiar dynamic: A man announces to his wife that he is going to
start an exercise program. She responds with a jibe in a
frustrating tone, “And you expect me to believe
that?!”. He could “take it personally” by
reacting defensively, “Oh no, I stopped expecting anything
supportive from you long ago!” Notice that response
has a structure. It begins with “I” and follows with
a statement that is much more literally about him than her.
A better, learnable
alternative also has a structure--one that focuses on the
other's feelings: “Ok, ok, you sound
pretty frustrated with me. Do you want to tell me
more?”. Notice that this response starts with
“you” instead of “I”. At least
this
interrupts this couples' dialogue
“habit” for one sentence. Sure, the second
partner might stay on the attack but she might slow down, take
stock, and say, “Yes, I am very frustrated with all
the times I've heard how you're going to get back in
shape…look it's only that I know you'll feel so
much better about yourself and, of course, I do want you to try.
I just don't know if I can be the one to keep rooting
you on”. Now, that couple is much less likely to go
around in escalating circles of attack and hurt feelings.
Certainly, it's not as easy as these few examples give
the impression. But the fact is these alternate responses
have a learnable structures. Like learning music, with
practice the new skills quickly evolve from feeling awkward and
contrived to natural and harmonious.
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