Couples Therapy
When Couples Therapy is Indicated
Couples therapy is indicated when one or both individuals feel a loss of joy, passion, and fulfillment; when communication is faulty or non-existent, there is conflict and/or withdrawal, and when intimacy or sexual problems arise. Additionally, when there is the presence of infidelity, addiction, or if the relationship is significantly stressed by life transitions or financial strife, it is time to seek therapy.
Couples therapy requires that both individuals can meet one another with mindful and sensory awareness at what is called the contact boundary between them. If one or both are entangled with historical and internal issues, individual treatment may be needed first or collaterally to couples therapy. When a couple comes to see me, I make this assessment and provide recommendations.
During couples therapy, when an historical and internal issue does come forth, I help to illuminate these for each individual and discuss how the past may be impacting their current relationship. Often this observation can help the process move forward. Couples therapy is not designed, however, to “dig deep” into intrapsychic and developmental problems. When indicated, couples treatment can serve for some as a safe stepping stone to individual psychotherapy.
After learning about each person’s concerns and goals for therapy and listening to how they interact and communicate, I have one independent session with each to get a sense of their background as well as their relationship and attachment history.
Common Resistances to Couples Therapy
Resistances to Couples therapy overlap a great deal with resistances to individual psychotherapy. A more complete discussion of those can be found in my website article “Resistance to Beginning Therapy.” I will focus on a few resistances that are specific to Couples Therapy.
1) The fear that the process will get bogged down into a circular and nonproductive “He said, She said”cycle.
While it is important for the therapist to understand the needs of each person and the quality of their communication, a skilled therapist will not let this counterproductive activity persist. Instead, I will help both to see the unmet emotional needs that are driving the conflict or withdrawal. I will also help both to understand their, often differing, attachment styles and the protective importance of each of these styles. If one or both individuals attachment style is unhealthy, this will be illuminated and worked with within the scope of couples therapy.
Bickering will be replaced by enhanced listening to each other’s experience and this will motivate both to communicate with greater empathy. When we feel emotionally understood by our partner there is greater incentive to work together more constructively and bring awareness and flexibility to the “System.”
A relationship is not two isolated minds; it is a System where each individual’s verbal and nonverbal behavior is co-creating the the relationship from moment to moment. Try sitting and talking to your partner and then one or both of you lean forward with your elbows on your knees. The system has now reorganized itself significantly whether it carries the meaning of greater earnestness and concern or one that is more invasive and combative. The metaphor I use to capture the systemic nature of any relationship is that of a “seesaw,” where one person’s movements inevitably affects the other.
When couples enter treatment, the partners on the seesaw are often polarized in several or many arenas of their relationship. The system is out of whack and frozen. My effort in couples therapy is that both partners move closer to the fulcrum of the seesaw so their relating functions with more balance, fluidity and health.
2) The fear that the therapist will take sides.
An experienced and skilled therapist will have had their own intensive personal therapy. If not, they will be vulnerable to contaminating issues, i.e., gender bias, favoring or discriminating against one person as a result of the therapist’s unresolved issues with a parent or a sibling (who one of the individuals in treatment might resemble), or any unresolved life experience. In the couples therapy I conduct, there are no “good guys or bad guys.” My singular agenda is to successfully meet the therapeutic goals of the couple I am working with. If each person’s goals are at odds or cross purposes with each other, this will come forward and an assessment will be made.
3) One or more partners are afraid of a perilous outcome once they focus on relational problems in therapy.
This resistance is very understandable. However, denial or procrastination in seeking treatment can unfortunately accelerate the very scenario one or both individuals are trying to avoid.
The biggest obstacle to effective and successful couples therapy is when it is initiated too late. Unhappiness and negative feelings if unaddressed will be stored and anger, whether expressed or not, will turn to hardened resentment. Eventually the two individuals are at risk for falling out of love. Couples too often contact me when their relationship is on life support.
Sequential Processing
I have developed a method in working with couples that I refer to as Sequential Processing. This method is designed for couples to meet needs and wants and to repair collisions or disjunctions (misunderstandings) without destructive anger or withdrawal.
Sequential Processing is initiated when the words or behavior of the other leave us with a negative feeling. This process addresses not only the content of the exchange but the form or behavior as well. The form or behavior (sarcastic tone, eye role, grimace) is, in many instances, more toxic and globally shaming and/or guilt inducing than the content at hand.
Sequential Processing addresses not only the current collision or disjunction but also resolves old injustices and emotional pain that have been stored. The introduction of this protocol will also prevent the accumulation of injustices and injury moving forward, i.e., “keeping the slate clean.”
Sequential Processing attends to any concurrent stressors (i.e., when one individual is dealing with an oppressive and micro-managing boss) that will impact the system, and if not attended to properly will lead to either anger displacement or withdrawal.
Finally, Sequential Processing addresses pre-existing vulnerabilities (i.e., when one person had a condescending and verbally abusive parent and is being triggered by their partners similar behavior). In particular, the illumination of pre-existing vulnerabilities can bring new awareness to the partner that will, in turn, increase their understanding and compassion. The understanding and compassion when both are utilizing Sequential Processing will lead to sensitivity, consideration, and the avoidance of trampling on each other’s vulnerabilities going forward.
After teaching my couples this process, I provide them with the protocol to use on their own. Having this resource empowers both individuals with an actionable intervention tool to use after months or years of frustration and helpless.or