A Marriage Therapist's Blog
Thoughts on Marriage Counseling
Archive for the ‘About Marriage Therapy’ Category
Once in a while I have a couple in marriage counseling who are so used to arguing with each other that they think they can just continue to fight while they are in my office. They’ll come in for their first session and while one of them is telling me his/her point of view, the other will interrupt to try and tell me the other side. Pretty soon they are no longer talking to me, but instead are arguing with one another, as if I weren’t even there. They must think that this is healthy, a good idea, and that I won’t mind.
Wrong.
I intervene pretty quickly and tell them that if they want to argue with one another, they can save a lot of money by doing it for free at home rather than paying me to listen to it. That usually gets their attention. Sometimes I have to repeat this process a few times before it really “sticks” with them, but eventually most couples learn that I’m not going to allow them to play the blame game while they are in my office. We then start working on healthy communication right away.
I’ve had a few couples who simply could not stop blaming one another during marriage counseling sessions, no matter how many times I intervened. When this happens, I stop seeing them together and start seeing them separately in individual sessions. We work on communication individually and get that down before we start meeting together again.
And no, I don’t give couples foam bats to hit each other with!
Recently during a marriage therapy session, a young couple was telling me about the issues that had been causing them to be in intense conflict. It was a typical session for me until the couple mentioned a particular problem with an extended family member. Unfortunately for me as their therapist, that particular issue was very similar to a problem that had caused some strife several years ago in my own marriage. At that point in the therapy session I had to summon the self-discipline to stay in the moment with my clients and to block out thoughts and emotions regarding what had happened to me a few years back.
If you and your spouse have ever been to marriage therapy, you know what it’s like. As the clients, you sit on the therapist’s office couch and talk about your roles as husband and wife, your communication problems, and your areas of disagreement. Usually you and your spouse are doing most of the talking. The therapist occasionally interjects observations and asks some probing questions in order to help you better understand yourselves and the issues that are afflicting your marriage. Some therapists may also at times engage in “psychoeducation,” in which they take on more of a teaching role rather than the usual listening and observing roles. No matter what the details of your therapy sessions are, you presumably view your therapist as a professional, an expert in the field of relationships and psychotherapy, perhaps even someone who will impart some wisdom to you and your spouse.
Maybe you have wondered if your therapist has ever been in your place, that is, if your therapist and his or her spouse have ever been the clients of another marriage therapist, talking about their own problems with some other expert counselor. Can you imagine your therapist as a client? It may be difficult. (Try to visualize Freud lying on another analyst’s couch while having his own dreams analyzed!)
The next time you’re in a therapy session, you might ask your therapist if he or she has ever been in therapy. This question may well catch your therapist off guard, and he or she may even get a bit uncomfortable or defensive and ask you why you would want to know that information. Of course, you have a very good answer to that question: you want to know if your marriage therapist knows what it’s like to be in pain, to be a damaged relationship, and to be seeking help from a third party. This may well be more information than your therapist is willing to reveal to a client. (I’m sure that Freud wouldn’t have shared that information!)
Regardless of whether or not your therapist fesses up, the question remains: can someone be a good marriage therapist without ever having been in marriage therapy as a client? Yes or no? I’m going to take the “no” position. Why? Because in therapy, the most important factor for success is the quality of the relationship, the rapport, between the clients and their therapist. The clients have to believe that their therapist “gets” them, that he knows exactly how they feel. If clients don’t feel heard and understood, the therapy won’t be very effective. And it’s so much easier for therapists to understand how spouses in therapy feel if those same therapists have themselves been therapy.
Some powerful people agree with me that counselors should be in counseling. In California, marriage and family therapists who are in training internships are strongly encouraged to seek their own therapy. They are even rewarded for doing so by the licensing board in a unique and powerful way: every hour, up to a maximum of 100 hours, that an intern spends in his or her own therapy is counted as three hours of experience toward the 3000 hours of total experience required during the internship. That’s a strong motivation for an intern therapist, and it speaks to how strongly the licensing board believes that therapists in training should be in therapy themselves. I took full advantage of this when I was an intern.
Here’s another way to look at it: therapists should fully understand their own minds, their own emotions, defenses, and beliefs, before helping someone else to do the same thing. Furthermore, marriage therapists should understand their relationships, both past and present, including the ups, downs, strengths, and weaknesses, so that they can better help their clients to mend their own relationships.
Therapists also need to be able to deal with the feelings that they experience while listening to their clients speak. This phenomenon of the therapeutic process engendering feelings in the therapist is called “countertransference,” and it is an unavoidable aspect of therapy. It’s important, therefore, that therapists are well-prepared to handle these feelings, and this preparation is enhanced when therapists have already been through their own therapy.
A marriage therapist works with many couples and over the years will hear innumerable different relationship crisis stories. Sooner or later, probably sooner, and probably when it’s least expected, all therapists find themselves listening to a client describing a situation that parallels the worst relationship event in the therapist’s life. What will happen at that point? If the therapist has not worked through that crisis in his or her own personal therapy, the result may be a welling up of emotion – grief or anger, for example - and result in the therapist becoming much less effective as a helper, not only in that session, but in future sessions with the same clients when the therapist is again reminded of the painful events of the past.
Remember my clients and their extended family problem that was so similar to my own issue? Fortunately, I was able to handle that situation well. I didn’t get emotional, and I remained focused on my clients. How was I able to do that? Because I’d already worked through that issue in my own personal therapy.
So the next time you’re looking for a marriage therapist, I suggest you look for one who has experienced marriage therapy from both sides of the room: from the client’s couch as well as from the therapist’s chair.
You know about preventative maintainence for your car, right? You take it in for factory service every 15,000 miles or so, and you have your oil changed every 3000 miles. Right? You do, right? Good. Your car be happy and will take you wherever you want to go for a long, long time.
What about preventative maintenance for your marriage? How about doing it before you get married? That’s what we call premarital counseling, and it’s becoming more and more popular. In fact, many churches require a couple to attend premarital counseling before they can be married in the church.
How does premarital counseling work? Typically, we meet for 6 sessions. We spend a lot of time talking about communication styles. We also look at expectations, goals, and shared dreams. It’s usually a lot of fun.
Of course, it’s possible that some glaring issue could arise during premarital counseling - something that the couple hadn’t realized was a problem. That sounds bad - but isn’t it better to find out about it before you tie the knot? Yes it is. On the other hand, you may learn in premarital counseling that the two of you are made for each other!
I see that HBO has a new five-part series about a psychotherapist. It will be on every weeknight next week (Monday, January 28 through Friday, February 1). The series is called In Treatment and it’s produced by Mark Wahlberg. Each episode is only 30 minutes long and each one has the therapist working with a different client. Apparently the Thursday night episode is a marriage therapy session, but the other episodes are all individual therapy.
As much as I enjoyed The Sopranos (except for the final episode), I never felt the therapy scenes with Tony and Dr. Melfi were very realistic. She was so cold and aloof, so Freudian. I suppose there still are a few therapists like that, but I don’t think there are too many of them.
The short-lived HBO series Tell Me You Love Me did a much better job of showing how therapy really is, in my opinion. And the fact that it was marriage therapy kept me really interested throughout the brief lifespan of the show. I liked the focus on the three couples; their relationships and problems felt authentic to me. The sex scenes were gratuitous, though.
I’ll be tuned in to HBO next week to see how well In Treatment does in presenting therapy.
I figure that I lot of people must be curious about what a marriage therapy session is like. The marriage therapy scenes in television and movies never seem very authentic to me, with the possible exception of the HBO series Tell Me You Love Me. So I decided to write a script of a sample therapy session for you to read. Please know that this is not the transcript of an actual therapy session. This is a fictional session; it is the product of my imagination. I would never violate a client’s privacy!
This is a first session, so I have not met with the couple before. My goals in the first session are: (1) to build an alliance between myself and the clients by showing that they can trust me and that I understand their feelings, and (2) to begin to understand what issues are facing the couple and causing them to be in conflict.
So here we go…
Therapist: Welcome.
Husband: Thanks.
Therapist: So tell me a little about yourselves. How long have you guys been together?
Wife: Together for eleven years, and we’ve been married almost eight years.
Husband: Our anniversary is next month.
Therapist: I see. Did you live together before you got married?
Wife: Yes, for a while…a little over a year, I guess.
Husband: And we had another roommate too! It was an interesting situation.
Therapist: Wow! That must have been tricky at times!
Both: (laughter)
Therapist: Do you guys have kids?
Wife: Yeah. Two.
Therapist: Tell me a little about them.
Wife: We have a boy who is six. He just started kindergarten. And we have a daughter who is almost four.
Husband: I’ll say right off the bat that my wife is a great mom.
Therapist: That must mean a lot to you. You appreciate that about her a lot.
Husband: That’s true. She’s really good with the kids. I don’t have nearly the patience with them that she does.
Wife: It’s easy. They’re good kids. We’re really lucky.
Therapist: And is this the first marriage for both you?
Husband: Yes, for me it is. For both of us, actually.
Wife: Yeah.
Therapist: OK. Well, what brings you into my office? How can I help?
Wife: (to husband) Do you want to go first?
Husband: (to wife) No, you go ahead.
Wife: OK. Well, starting about six months ago I guess, I just started to feel distant from him, like something had changed. I didn’t know why. I knew I loved him as much as I ever did. I thought we were a happy family. But we just weren’t connected, you know? I worried about it all the time. And I would ask him what was wrong. Please tell me what is wrong. But he always said that he was fine, don’t worry about it.
Therapist: I can understand why you would be worried. You feared that something bad had happened to your relationship, something you didn’t even know about.
Wife: Exactly. And then after a while I started to wonder if there was someone else. He swore there wasn’t, but I didn’t know if I believed him. So one day I checked his emails. He had forgotten to sign out before he left for a doctor appointment. And then I saw all the emails from this woman that he works with. Someone who I had met at the office Christmas party, and I thought she seemed nice. I had no clue that she was talking to my husband behind my back. They were emailing each other, like, five times a day. And I read all the emails that he had sent to her, talking about how he wasn’t happy with me but felt like he had to stay because of the kids. (starts to cry)
Therapist: That must have felt like such a betrayal. And I can see that while you’re sitting here now, thinking about that day, it still hurts.
Wife: (still crying) I was furious. I had always trusted him. So now I find out that he’s got something going on with another woman. And then I realized, to add insult to injury, he’d been lying about it, denying it when I asked him. I felt like such a fool.
OK. That ends part 1. More to come in our next episode.
Recently a potential client couple told me that they were Christians, and that their faith was very important to them. They said that to understand them well, I would have to be conversant with their Christianity. They wanted me to know this about them before they began marriage therapy. I assumed that they were going to ask me if I were a Christian as well, and that if I were to answer “no” then they would look for another marriage therapist.
They never did ask me, but I went ahead and told me that I was a practicing Catholic. I also mentioned that Emotionally Focused Therapy, which is the mode of marital therapy that I favor, is well-known in Christian circles and is taught at Fuller Theological Seminary and Indiana Wesleyan University.
The clients were fine with that and began marriage therapy with me.
It probably wouldn’t surprise you to know that husbands and wives who come to marriage therapy don’t always agree about what their problems are. And sometimes one spouse (typically the husband) thinks that everything is fine, while the wife thinks there are big problems in the relationship. In this scenario, if I were to ask the husband what brings the couple in to marriage counseling, he might say something like, “the only problem is that she thinks there’s a problem.”
He’s right, to a certain extent. If either spouse thinks something is a problem, then, in my opinion, it’s a problem for both of them. So if the wife thinks there is a problem in the relationship, she is automatically correct! It can’t be disputed.
However, I think the husband would probably be wrong that there are no other problems. A man who says something like that is likely to be one who distances himself from his wife - and that’s a problem right there. We would need to look at why he distances himself. Does he feel attacked, or does he feel hopeless that he will never be able to please his wife, or is it something else? That’s something we would delve into in marriage therapy.
One problem that we marriage therapists face is working with men who don’t seem to be in touch with their emotions. Another way of describing these men is “inexpressive.” In my experience, younger men (say age 35 and under) are more likely to be inexpressive than older men.
A big part of emotionally-focused couple therapy is to get to the root (or primary) emotions which underlie the partners’ pain, and have the man and woman express these emotions to one another, perhaps for the first time. This can be a bit of a challenge with an inexpressive male.
Here’s a fictional (but typical) example. Let’s say the woman has just finished talking about how lonely and abandoned she feels when her husband works late almost every night instead of coming home and being with her and helping her with their children.
Me: “John, what’s it like for you to hear Mary talk about how lonely she feels, and how much she misses you, when you work so late every night?”
John: “Well, my boss is putting a lot of pressure on me lately…” (defends himself and doesn’t answer the question)
Me: “I understand that your boss is unreasonable, but what is going on inside you when you hear Mary describe how she feels?”
John: “I know it’s a problem, and I think it’s going to get better in a few months.” (still not answering the question)
Me: “John, I am asking how you feel, not what you think.”
John: “Oh. Well, I guess it’s kind of sad.”
Me: “OK. Tell me more about feeling sad.”
Emotionally focused couple therapy is very effective with inexpressive men! It can have a powerful effect on their wives to hear them express a deep emotion, possible for the first time in years. And for the men, it can be very therapeutic to have a counselor who understands and validates their emotions.
This week I’m in Pasadena, studying Emotionally Focused Couple Therapy (EFT). The workshop is being taught by two of the best-known researchers in the field.
Emotionally Focused Couple Therapy is quite different from many other marital therapies. There is no educational aspect to it: no lessons in communication skills or conflict management. Also, there is no behavioral aspect to it (such as trying to do more nice things for your spouse).
The three stages of EFT are:
- De-escalate the conflict cycle.
- Changing interactional positions (such as softening blame and getting the withdrawn partner to re-engage).
- Consolidate and Integrate.
EFT has done very well in effectiveness testing with real couples.
If you feel your marriage needs help, what should you do? You have several options from which to choose. Here are some of the alternatives.
You could read a book about marriage and relationships. If you search for marriage counselling on Amazon.com you will find dozens of books on the topic. A lot of these books probably have some good ideas in them (and some bad ideas as well). But once you have solved the problem of getting your spouse to read the book too, you are faced with the “one size fits all” problem: the author of the book does not know the specific and unique problems that are facing your marriage today.
You could attend a seminar or weekend retreat. These options, of course, suffer from the same “one size fits all” problem as does reading a book. How do you know if your specific issue will even be mentioned at the seminar? And what are the credentials of the persons who will lead the seminar?
You could sign up for a web-based program. Some of the advertisements for these programs say they are an alternative to marriage counseling, but in fact they are marriage counseling done remotely by internet or telephone. Why choose marriage counseling by phone when you can choose marriage counseling in person?
You could meet with a priest/pastor/rabbi, who is probably a wonderful person, and is eminently qualified to give you spiritual advice, but who has no training in marriage counselling, and who is not a licensed counselor.
And finally, you could choose marriage counseling. A marriage counselor has specific training in working with relationship problems. The counselor will get to know both of you and will hear your issues in detail. He or she will give you ideas, point out problems, and give you assignments that are specific to you. And remember that marriage counseling has been proven to be effective in drawing couples closer together. I offer marriage counseling in my San Ramon, Livermore, and Walnut Creek offices. Nearby cities include Pleasanton, Danville, Dublin, Concord, Pleasant Hill, Clayton, Antioch, Brentwood, Sunol, Mountain House, and Tracy. Call me at 925-351-8447 to schedule a session.
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Two Convenient Locations
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