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 Portland Couples Counseling

Bernard McDowell, LCSW

Psychotherapist & Licensed Clinical Social Worker

811 NW 20th Avenue, Suite 104, Portland, Oregon 97209
503-234-9904
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COUPLES COUNSELING:  GENERAL CONSIDERATIONS

     People seek marriage counseling for a wide a spectrum of issues.  Frequently, they cite the need to "improve communication".  Some argue too much while others live parallel lives.  The list of other variations goes on and on. 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 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 note examples given here aren't about any specific clients*. 



 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, in-laws, 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 session presumably 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!)       

    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 dates 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.  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.



 
     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, rather it articulates the problem in a different emotional coloring consistent with your loss without giving energy to a partner who is not likely to empathize with your blame.  
                                                                                                                 

  
  



    It is, of course, ridiculous to think that a couple will read an outline like this and feel resolved. 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 hold that door of intimacy open, ALL aspects of that person come in -- 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!



   




     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.  That's called 'negative affect reciprocity' by the most scientific researcher in the field.  It's a marker to predict divorce up to 93% of the time.  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.

    

    
     This same example may serve to illustrate the second broad category of differentiation skills.  When this man told of his plans for an exercise program, at the very least he wanted to share about his life if not get some support.  Suppose the dialogue doesn't result in either of his needs being met.  What if his partner just flatly and honestly states that she isn't willing to talk with him about this issue any more.  That's a loss --defined as an unfulfilled need.  He could try to squeeze it out of her by repeating himself, making demands, expressing irritation, attacking her on other issues, withdrawing from her in general, etc..  These are all ways our primitive sense of self frequently acts out in an attempt to get our needs fulfilled.  However, he could also face the loss by being willing to feel the pain of it and claiming his responsibility for his choices.  There is no law of nature that he has to cop an attitude to his partner.  It's not her job to be all things to him!  Schnarch says, “Stop trying to make your partner listen, accept, and validate you. Listen to yourself”.  But that doesn't imply only a shift in mental perspective.  Some losses are much bigger than the one in this example.  Some require grieving.  Some require grieving and exploring other ways to get those needs met outside the relationship.  (You may wish to read another article on this site about containing losses in relationships when all your best communication skills have failed.) 


 Conclusion
     This article offered a brief introduction to issues concerning couples counseling.  It was primarily intended for people considering couples counseling for the first time.  Frankly, I have found most books on couples to be rather “clunky” relative to the infinite complexity of relationships and the human psyche.  Analytical concepts can't capture the contours of a rich relationship.  When a couple comes in on the verge of separation, they may feel like they're having their cells torn apart.  All the concepts above fail to do justice to the intensity of the pain of being “stuck” in a once flourishing relationship or the wonder of reclaiming love and respect.  In reality, couples counseling requires a fluid and unique approach to each couple that comes.  I personally find working with couples to be challenging, delightful, difficult, and ultimately a creative joy.