Therapy for Couples: The Relationship is the Focus

Polly has been restless since her youngest daughter left for college. She has had trouble sleeping and finds she has less patience with her husband Ken. Brandon and Yvonne received news last week that their fifth attempt at in vitro fertilization has failed. Mick lost his job last summer as an industry analyst and has difficulty coping with the loss. He can hardly sleep and lost all his usual energy. His wife Kay sees him getting more and more depressed and is worried. After a horrendous fight during a car ride Frank and Maxi feel discouraged and hopeless about their relationship.

Despite the varying circumstances, these hypothetical couples have much in common. One or both partners have to face an issue that is troubling the couple’s life. In those situations, it is increasingly common that couples decide to seek conjoint therapy instead of individually working with a therapist. They hope that couples therapy will increase their chances of solving their problems. Research supports their hope. Couples therapy by a psychologist trained in this modality is effective. It is usually an intensive, but short-term experience, and supportive of the couple’s own strengths and values. Working together in therapy requires courage, openness and active participation.

Couples therapy is not just advisable as a last resort before a couple might be headed toward divorce. Often a couple can revitalize a stagnant and unfulfilling relationship through intensive work with a couples therapist. In joint therapy they can become intimately involved with each other again. They can learn to listen, to understand, and acquire the necessary skills to manage their anger and their money better. As their relationship improves the partners will discover how to argue successfully toward the resolution of a conflict, how to accept the other’s limitations, to forgive an affair without minimizing it, improve their sexual relationship, and many other aspects of a long-term marriage.

Relational problems are only one of many reasons that bring couples into therapy. Many personal issues, traditionally defined as individual dysfunctions or mental disorders, can be successfully addressed jointly with a therapist. Among them are depression, anxiety, addiction, eating disorders, phobias, sexual problems or life events such as illness, career shifts, sudden losses, or the need to take care of aging parents. Conjoint therapy can be the treatment of choice for all kinds of partnerships, including gay and lesbian couples or two adult siblings living together. The focus of attention in therapy is always the relationship, not the partners as individuals. The experienced couples psychologist will be able to enhance each couple’s unique features and strengths and will avoid a “one size fits all” approach. As the quality of the partnership improves, the well-being of each partner is also enhanced. Psychotropic drugs are not encouraged in couples therapy, because they perpetuate the myth that life’s challenges can be solved with chemicals.

The therapist’s task in couples therapy is to explore the dynamic forces that shape the couple’s relationship. As a rule, both partners are seen together. Individual sessions are discouraged because they tend to exclude the other partner and restrain open communication. During the sessions, the therapist observes how the couple interacts with each other and explores the roles of the partners. The therapist may guide the partners in their conversation and help them discover how one partner’s way of talking will lead to an angry response in the other.

As therapy proceeds, the partners may need to look into the implicit understanding they formed at the beginning of their relationship or marriage. A man may secretly have hoped to find a mother in his partner or a woman may have assumed that her partner will always remain the strong protector that she missed since her beloved brother’s death. The honest examination of the hidden contracts at the origin of a long-term partnership often proves to be the turning point of therapy and the beginning of a realistic and more satisfying relationship.

Many couples get stuck in conflicts that derive from differences in the cultures of their families of origin. The partners’ family cultures may have to do with a specific understanding of gender roles, the socioeconomic status of the families, religious traditions, or simply certain family styles that the other partner finds difficult to accept. A wife who grew up in a blue collar family with both parents working may find it hard to adjust to her new role as a mother who can afford to stay at home raising the couple’s children, but feeling economically dependent on her husband. Or one partner’s family background encourages emotional closeness, physical affection and open airing of opinions and hurt feelings, whereas the other is familiar with polite distance, privacy and keeping one’s feelings inside. Couples therapy allows men and women to learn from their different experiences and increases their mutual understanding.

While it is often necessary to take a historical perspective, the present should never completely move out of focus in therapy sessions. What is the current life stage of the couple? Are the partners in a moment of emotional crisis and, therefore, perhaps ready for a shift in their relationship that is more radical than usually possible? Do they have small children or did the children just leave the home? What recent losses did the couple experience?

Do all couples face the same issues? Yes and no. Clearly, money management, sex, parenting, relationship to in-laws, work and leisure time, household chores and religious affiliation, are topics that most couples have in common. Yet, couples and their relational dynamics also differ profoundly, not the least according to their ethnic background. The traditions, rituals, norms, foods, and values of a particular ethnic heritage have a powerful impact because the partners in committed relationships share their daily and intimate lives with each other. Keeping the focus on relationships enables couples therapists not to lose sight of the uniqueness of each couple.

What if a couple has decided to separate and file for divorce? Couples therapy can assist in making the process much less emotionally destructive. The spouses remain in charge of their own lives. Couples often seek out a psychologist trained in mediation who can help them settle issues in a more cost-effective manner in therapy rather than through a legal battle. If children are involved, the spouses will a chance to negotiate their new relationship as divorced co-parents who need to cooperate for the benefit of their children.

Couples therapy can be very beneficial for people who want to solve pressing problems together with their partners and are at the same time committed to strengthen their union. To find a qualified psychologist, look for someone with at least two years of postgraduate training in couples therapy and a license in marriage and family therapy.

[Reprinted with permission from the Princeton Packet, Princeton.]

couples, relationships