A Marriage Therapist's Blog
Thoughts on Marriage Counseling
Archive for the ‘About Marriage Therapy’ Category
When a couple first comes to see me, I always ask if they have done any previous marriage therapy. If they have, it is important for me to hear about what parts of the counseling helped them and what parts did not. Frequently, these couples share feelings of discouragement and defeat that stemmed from too much of the previous counselor’s focus being on problems, and in particular, difficulties from childhood.
I then explain that I take a different approach known as Solution-Focused Brief Marriage Therapy (with emphasis on the brief part!). “Solution-focused” means that we spend less time talking about problems and more time talking about solutions, strengths, fresh perspectives, successes (large and small!), and exceptions to the “problems.” We work together to identify existing internal and external resources and to employ them toward tangible solutions. We talk about what is working instead of what is not working. And instead of delving into the past, we focus on the present as well as the positive future that you prefer to have as a couple.
The brief part means that unlike longer, more in-depth approaches, I typically see a couple approximately eight times. So if you (like many other couples) are resisting marriage therapy because you are afraid of months and months of appointments and thousands of dollars in fees, this wouldn’t happen. Within a brief timeframe, it is possible to set positive goals, identify existing resources, proactively take steps toward your goals and find renewed hope and strength in your marriage.
I never saw an episode of Jon & Kate Plus 8; since I work evenings there are a lot of shows that I don’t get to see. However, I knew something was up when I saw Jon and Kate on the covers of the People magazines in my waiting room week after week. As I understand, it was a reality show about a couple who had twins and sextuplets, but that the couple went into crisis due at least in part to infidelity, and is now separated and possibly divorcing. The skeptic in me wonders if the whole thing was preplanned and orchestrated to boost the show’s ratings (if so, the plan was very successful).
What really caught my eye, though, was that Jon appeared on Good Morning America recently and discussed counseling. He said that Kate refused to go to marriage counseling with him. That’s interesting enough, because usually it’s the husband who refuses to go to counseling with his wife. However, here’s what really, really got my attention: on the show, Jon said, “I have a $22,000 therapy bill. I mean, I tried to have marriage counseling. I did it myself. She refused to go.”
Yes, he did say a $22,000 therapy bill.
Let’s do the math. Assuming therapy costs around $100 per session, that’s 220 therapy sessions - or four years if he went once a week. That’s unlikely! If he went to a really, really expensive therapist, he might have paid $200 per hour, but that’s still 110 sessions, or two years at one session per week. Also unlikely.
So count me as skeptical about the $22,000 therapy bill.
I’m pretty sure I’ve written about this before, but that’s OK because (1) it’s interesting and (2) it might influence someone in a good way. According to a study to be published in the September issue of the Journal of Health and Social Behavior, people who had been divorced or widowed had more illness than married people. The singles suffered 20 percent more chronic health conditions, such as heart disease, diabetes or cancer. The study was done on 9000 adults between the ages of 51 and 61.
To be sure, this study does not prove that divorce causes people to be sicker. It does show that there is a correlation between the two, though. The cause could be something else, for example, maybe people who don’t take very good care of themselves physically don’t take very care of their relationships either.
If I can draw that analogy out a little further: when you’re seriously sick, you should see a doctor. When you relationships is seriously in trouble, you should see a marriage therapist.
- Cinco de Mayo 2009
- Photo © 2009 Jay Slupesky
At this point we were about halfway through the 50-minute session, meaning that it was time to delve into the issues and events that brought Cliff and Claire to my office. When I asked the question, they nervously looked at each other as if neither of them wanted to be the first one to answer. Finally Claire spoke up and said, “We’ve been arguing a lot more than usual and the intensity of the arguments has ratcheted way up. Lately whenever it gets bad we are calling each other names and threatening to leave each other. We never did that before.”
I asked if they were arguing about the same issue over and over. Claire replied, “Well, we had been arguing about about bills a lot. I mean I’m sure you think we must make a lot of money, since Cliff’s a doctor and I’m a lawyer. But since we moved to California our income has gone way down. Plus we have always spent way too much money and we have never saved any. Now we have over $20,000 in credit card debt. I think each of us blames the other for spending too much money…you know, we both like nice things. But anyway, the last big blowout argument happened when I was looking at the cell phone bill and I noticed that Cliff had been calling one particular number almost every day and talking for a long time…like 45 minutes or so. This really got my attention because Cliff has never liked talking on the phone and I’m lucky if he calls me at all during the day!”
Claire went on to say that she asked Cliff whose phone number it was, hoping for a reasonable explanation but fearing something much worse. He said that it was cousin’s phone number and that he had been trying to help out this cousin, who has been going through hard times because he lost his job and the health care coverage for his family. Claire said, “I actually believed this story for a while, but the more I thought about it, I didn’t believe it, because he hardly ever talked about this cousin before. So I told Cliff I was skeptical and that I was going to call the number, picking up the phone as I spoke. Cliff stopped me and said, OK, you’re right, it’s not my cousin. Well, he finally admitted that it’s a woman, a former patient of his, and that they had become friends. He admitted that they met for lunch once a week in addition to talking on the phone. He claims that nothing physical happened between them, but I don’t know if I believe this or not. He said he is sorry, but I just think he’s sorry that he got caught.” Cliff was looking out the window as his wife spoke, watching the squirrels run up and down the trees behind my office, trying to remain calm in what must have been an embarassing moment for him.
I didn’t say anything, hoping that Cliff would speak without being prompted. After a minute, he did. “Yes, I have become close friends with Maria, a former patient of mine. We do talk on the phone and text each often, and yes, we have met for lunch. I have felt guilty for sneaking around behind Claire’s back, but really, I’ve been so lonely lately, I just needed someone to talk to. With Maria I can talk for an hour and it seems like only a few minutes have gone by. Unfortunately, Claire and I don’t talk much, there is a way too much silence when we are together, and I feel like I can’t tell her a lot of things that are going on in my life without her getting upset.”
By this time I was thinking that both Claire and Cliff had told me a lot of things that are going to require exploration in future sessions. Time was running down towards the end of this session, though. and I asked a few follow-up questions. I told them that I wanted to see each of them individually one time. They agreed, and we set an appointment for Claire for the following week, and one for Cliff the week after that.
They paid me my fee by check, then we shook hands and they left. I took a few minutes to make some notes of my impressions of the session and reminders to myself of things that we need to cover later. I put the notes in their case file.
- ACE Train Rolling
- Photo © 2009 Jay Slupesky
Cliff and Claire’s first session with me was scheduled for Wednesday at 6:00 PM. They arrived at my office a few minutes early, sitting down in the waiting room, having braved a driving rainstorm that had begun about an hour before. Both of them wondered what to expect from the session since neither had been in counseling before.
At 6:00 PM I went to the waiting room, introduced myself, and invited Claire and Cliff into my office, pointing out the couch my clients sit on, and welcoming them to my practice. They handed me the paperwork that I had emailed them after they scheduled the appointment. They had filled out the background information forms and had read and signed the Informed Consent document which covers some of the parameters of the counseling process.
I asked them if they had read and understood the Informed Consent document, knowing that some people sign forms without reading them, and wanting to be sure that they understood important things like my cancellation policy; they said they had read the document and agreed to it. Next I took a few minutes to look over the background information forms they had filled out, noticing that Claire was on a medication to help her sleep and that she had suffered from an eating disorder as a teenager. Cliff reported that he had somewhat of a problem with alcohol, occasionally drinking too much in social situations.
Having the formalities out of the way, I began getting to know my new clients. Claire told me that she is a partner at large law firm, specializing in consumer law, and had recently won a lawsuit against a car repair company. Cliff said that he is a physician in private practice. Cliff and Claire were both born and raised in Brooklyn, New York, and had moved to the San Francisco area about five years ago, wanting to get away from the winter cold of New York, and hoping to advance their careers faster in California.
I asked them how they met. Claire answered with a smile, saying that when they were in undergraduate school at NYU they were in the same American Literature class, and each thought that the other was “cute,” but for a few weeks they didn’t talk to one other, each being too shy to approach the other. But when it came time to form groups for a presentation, the two of them made sure to get into the same group, and the ice was broken. Now having reason to be together, their friendship blossomed rapidly, and very soon they were dating.
Next I asked what attracted them to one another, knowing that this question usually lightens the mood in the counseling office, at least temporarily, since each person will be speaking positively about the other. Cliff and Claire both said that the other person was physically attractive, and Cliff added that he loved (and still loves) Claire’s eyes. Claire grinned at the compliment and countered that she has always loved how Cliff can make her laugh.
As I always do in the first session, I asked them about the history of their marriage. Did they consider it to be generally happy? Mostly unhappy? Or has it been up and down? Claire said that in her opinion the first five years of marriage were very happy. After that, a slow decline set in as increasing job responsibilities meant more time spent at work and less time with each other. She had travelled frequently during the early part of her career, and many times they were apart for five days of the week and saw each other only on weekends. Since they were spending so little time together, they began to drift apart emotionally and physically.
Cliff agreed with most of what Claire had said regarding their history together and added that he blamed her work habits for a lot of their difficulties. He said that a 12-hour work day was routine for Claire, and that he resented it because he knew that as a partner in her law firm she was not required to work long hours. He said he sometimes wonders if Claire worked so much because she prefers not to be at home with him.
- Sailboat Racing, S.F. Bay
- Photo © 2009 Jay Slupesky
My clients’ confidentiality is of the utmost importance. Hence this story is not about a real couple, but the problems that bring the couple to marriage therapy are drawn from various people with whom I have worked. I have blended the issues from a broad range of my actual cases into the lives of one fictional couple, Claire and Cliff.
When Claire and her husband Cliff came to me for marriage counseling, they were on the verge of separation, living unhappy lives, no longer enjoying being together, even feeling contempt for one another as they cycled from one fight and short-lived make-up to the next, gradually losing hope that their relationship would ever improve. Like so many couples, they had waited too long to begin marriage therapy, not seeking professional help when troubles began to invade their lives after the birth of their child, hoping instead that things would get better on their own, convincing themselves they didn’t have the time, money, or energy to see a marriage counselor. I have heard this many times and I always wonder why a happy marriage isn’t at the top of a couple’s priority list and thus more deserving of their time, money, and effort than just about everything else.
Neither Claire nor Cliff had been in counseling prior to meeting with me, other than a few sessions of pre-marital counseling with their pastor, a requirement for getting married in their church. They had seen depictions of therapy on TV and in the movies, assuming them to be accurate depictions of the process, not realizing that screenwriters often sacrifice reality for the sake of plot development, dramatic value, and, occasionally, humor.
Once Claire decided that she wanted to attend marriage counseling, she brought it up with her husband. Cliff, like some men, was unenthusiastic about the idea, saying that he was uncomfortable with the thought of airing their “baggage” to a third party. Clair countered that an unbiased third party was precisely what was needed in their situation because they were unable to discuss their more contentious issues in a civil and healthy manner.
Not long after that first discussion about counseling, Cliff and Claire had a particularly nasty argument, raising their voices to one another, calling each other names, which they had done only once before, and the prospect of separation was brought up for the first time. They wondered out loud whether things could ever get better between them, despairing at the thought of spending the rest of their lives just tolerating each other, losing just about any hope for improvement. At that moment Claire again suggesting marriage counseling, and Cliff agreed, not really wanting to leave his wife and child, panicking at the thought of being alone.
Claire called me the next morning and scheduled their first appointment, giving me some background on their situation and asking the usual questions about cost and duration. Fortunately I was able to schedule the appointment for later that same week.
Once Claire and Cliff knew they were about to embark on the counseling process, tensions lessened to some degree and a glimmer of hope returned. They were able to go the next few days without any arguments.
- Oak Trees - Pleasanton
- Photo © 2009 Jay Slupesky
Sometimes when I am listening to a man and a woman talk about a difficult issue, a problem that has become divisive and has impacted their happiness as a couple and may even be threatening their relationship, I try to use my intuition and my experience to figure out what is “really” going on, in other words, what is being felt but not being said.
I have come to believe that in a couple’s relationship the bottom-line question that lurks unseen, unspoken, and frequently exists outside of conscious awareness is this: how much do I matter to my spouse?
I have chosen the plainest way I can think of to state the question, but it can be said and thought of in other ways, some of which might make the sentiment a little clearer, so consider the following variations. Are we still a happy couple and are we going to remain so? Am I the most important person in your life? Is there anything I don’t know that I should be worried about? These are the questions that can cause so much pain to someone who is no longer sure what the spouse’s answer would be.
The issues that a couple argues about and that frequently land them in my office are frequently not the “real” issues. My job is is see beneath what is spoken and figure out what is really going on.
- Fishermen, St. John’s, Newfoundland
Wile’s “Collaborative Couple Therapy” does a great job of explaining the cycles that all couples go through. There are three phases in any relationship:
- Collaborative phase, in which the partners are speaking what is on their minds. They are making “I statements” which are not blaming and which express deep feelings. For example, a wife says to her husband, “I get lonely when you work late.”
- Withdrawn phase, in which partners are not speaking what is on their minds. To continue the above example, even though the wife is unhappy with her husband working late, she doesn’t say so. She may say nothing, but she probably feels resentful.
- Adversarial phase, in which partners are blaming each other. In this phase, the wife might fire off a name-calling/blaming statement such as, “You are a workaholic and it’s destroying our marriage.”
Obviously, the collaborative phase is the best place to be. In this phase, spouses are allies and work things out together. When the husband hears that his wife his lonely, he is touched and may feel some guilt. He’s then in the mood to talk about it and to work together (collaboratively) towards a solution. Contrast this with the husband who is greeted with the “workaholic” accusation: he will be in no mood to respond positively. He may fire off his own salvo or he may just withdraw. Neither of those options does anything to improve the situation.
It can be a challenge to learn how to avoid blaming and to make the kind of statements necessary to stay in the collaborative phase. That’s a major goal of marriage therapy.
- Young Boy, Qaqortoq, Greenland
People who call me to talk about beginning marriage therapy usually want to know how long they will be in counseling. Since I’ve had couples who came to only one session - and couples who came for more than a year - it’s hard for me to predict how long a particular couple will be in therapy.
The most variation I see is with couples who begin therapy as a result of a crisis. For example, the couple has been through an argument that got hot and heavy and lasted all weekend. With these types of couples, we usually have made a lot of progress after four or five therapy sessions. The crisis is behind them and they are starting to feel better about one another. At this point they are in the honeymoon period of marriage therapy.
Sometimes couples end therapy at this point. They think they don’t need counseling any longer since the crisis has passed. I try to tell them about the honeymoon phenomenon and that while yes, we have dealt with the crisis, we have not yet addressed the underlying issues in the marriage that led up to the crisis. Usually they listen politely but end therapy anyhow. I can’t stop them, of course, but I fear that at some point in the future they are going to be facing another crisis and not have the skills to deal with it.
The wise couples stay in counseling and do the real work required to repair the flaws in their relationship.
- Bird on Berkeley Pier
Just kidding about that title. I’ve heard The Secret the Credit Card Companies Don’t Want You to Know commercial on the radio too many times. However, I do want to write about something that may come as a surprise to you.
Some couples begin counseling with the belief that they should feel warm & fuzzy about each other at the end of every counseling session. When that doesn’t happen they think that I must not be doing my job very well. I’ve even had couples drop out of counseling after a difficult session.
The fact is that some couples are conflict-avoidant, meaning that they don’t talk about things that might lead to an argument. Those subjects that they don’t talk about at home are things that we need to talk about in my office. That means that at the end of the session they may feel worse about each other than they did at the beginning of the session. They won’t be feeling warm & fuzzy about one another when they leave my office! But in the long run their marriage is going to be stronger because they have made progress on a key issue.
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East Bay Couples
Counseling
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- Walnut Creek, CA Off I-680 at South Main St.