Couple & Marital Psychotherapy / Counseling
Couple Therapy Issues: Rebuilding Trust | Recovering from Infidelity | Sex Issues
Emotional Regulation | Parenting Issues | Co-Parenting
Dealing with Money and Finances | In-Law Issues | Domestic Violence Family of Origin Issues | Sexual, Physical, or Emotional Abuse Divorce & Separation | Insecurity and Intimacy Issues
While the above list is not exhaustive, I've found that the majority of issues couples face relate to those issues listed above. In most cases with couples, we can find the heart of the conflict early in the process. Most couples do not have 5, 10, or 15 issues they fight or disagree about, but instead have a central argument that comes up all of the time across many issues. Essentially, there is one argument behind every argument which we try to identify and resolve so that all of the smaller issues can be dealt with accordingly.
Couple/Marital Therapy vs. Discernment Counseling
Doing the work of couple / marital therapy is an important and unique undertaking that not all therapists are trained to do. As a Licensed Marriage & Family Therapist, I have specialized and focused training working with couples. Family and couple therapy is at the core of my education, training, and experience. Further, as a Certified Restoration Therapist, I have trained with one of the Marriage & Family Therapy field's leading couple/marital therapists, Terry D. Hargrave, Ph.D., which has given me additional insight and practice at the specialized work of couple therapy. Many people have heard of Sue Johnson's Emotionally Focused Therapy (EFT) for couple/marital therapy, and the Restoration Therapy approach shares some similarities. Those familiar with EFT will be right at home with Restoration Therapy.
The outcome of good couple therapy, it is hoped, is that two people will be able to arrive quickly at a more stable, connected, loving, and intimate relationship. My approach to couple / marital therapy is fairly structured and follows a usual course of treatment, unless there is a crisis or trauma, such as an affair or infidelity, physical separation, illness, traumatic event, death in the family, etc. If one of these events has taken place, we will be most likely to instead engage in discernment counseling rather than couple/marital therapy.
Discernment counseling is generally a better fit for couples where there has been a breach of trust, usually caused by infidelity or some other crisis or trauma, or where significant pain is affecting a person's life such as in the event of the death of a loved one. For these couples, discernment counseling is highly beneficial as it helps to stabilize the relationship. Sometimes this process can go quickly, taking just a few sessions, or it may stretch out over many months as both partners vie for power and stability in the relationship. How long the discernment process takes is dependent upon the commitment of both partners toward the relationship and how willing both partners are to balance power, love, and give-and-take in the relationship to rebuild trust, which is the necessary foundation for doing the deeper work of couple therapy. After all, it makes little sense to wade into the waters of couple therapy if all parties do not agree on the common goal of restoring and repairing the relationship.
When you meet with me for the first time in couple therapy, we will take a good look at the commitment both you and your partner feel toward the relationship and we will iron out whether to move forward with discernment work or traditional couple/marital therapy work. In either case, therapy will be tailored to you and what is going on right now in your relationship. I will sometimes see partners together or individually to help them figure out what decisions they need to make to gain stability in the areas of love, power, and give-and-take in the relationship. If stability is achieved through this process, then we may be set up for success in moving forward with the traditional couple/marital therapy process.
The Four Phases of Couple / Marital Therapy
1) Understanding the Problem and Identifying the Pain Cycle
In the beginning of therapy, we'll spend some time getting to know one another and seeing if we feel comfortable working together. If so, we'll move into discussing each partner's family of origin and personal background, so that I can understand each of you in the context from which you come. Then, we'll move into talking more specifically about the things that brought you to therapy.
In this first phase of therapy, you'll come to see that it is not that you are having 5, 10, 15, or 20 different fights as a couple, but that you're having the same disagreement, argument, or fight 5, 10, 15, or 20 different times. Coming to understand that your relationship conflict/withdrawal plays out in a consistent and predictable fashion brings a sense of understanding and hopefulness because the problem is now more tangible and seemingly easier to resolve. In essence, you'll learn that there is one consistent argument that is behind every argument. This is called the pain cycle. I will give you one simple tool to help you identify, learn, and become an expert on your own pain cycle so you can work to interrupt the cycle when it occurs in your relationship. I find that the simpler we can make things in therapy, the easier it is for you to be successful.
I will help keep you feeling comfortable and secure in the therapeutic process by the way I structure our sessions, keep us on track, and show concern and care for the times when you get stuck and don't know what to do, become angry, lose hope, or want to quit and give up. These are rough times and they always happen at some point in the therapy. My job is to help you consider new options during the worst of times.
2) Identifying the Truth and Mapping the Peace Cycle
In the second part of therapy, our focus will be on identifying the more peaceful and connecting behaviors you can practice as individuals and as a couple to bring stability, peace, and intimacy to your relationship. Identifying what behaviors will bring about these changed and better feelings toward yourself and your partner is the first step, which is followed by "truth work." In doing truth work, we will essentially be working on helping you identify truths about your worthiness, lovability, and belongingness, as well as security, safety, and capability in the context of your environment, circumstances, and relationships. This truth work is done through imagery, role-play, and verbal exercises and comes from much of what is known to assist the process of learning in the brain. The key to transformation in your sense of self and in your relationship comes from focusing simultaneously on insight about past issues that brings new understanding and the practice of specific skills designed to bring about behavior change.
3) Moving to Transition
This part of the therapy involves taking the new knowledge and skills you and your partner have gained about yourselves and applying it to your relationship by discussing old issues using the new understanding and new behaviors that we have identified and begun to practice. This tends to take the most time of the overall process of therapy because in order to make a change that lasts, it must become an automatic reflex in the brain.
How does something become a reflexive or automatic action? Practice, practice, practice. Research tells us that about 90 repetitions of a new behavior leads to the new behavior "sticking" to the point that it becomes mostly automatic, or semi-automatic. For you to more automatically do the new behaviors necessary to have a more stable and peaceful relationship, you will need to practice.
90 repetitions sounds like a lot of practice, and indeed it is. However, between regular homework assignments and in-session work, my patients get most of this practice under their belts before they terminate therapy.
4) Creating Intimacy
As patients work toward practicing these new skills to battle against old thoughts, emotions, and behaviors, there is an enormous opportunity for the couple to achieve a level of intimacy and peace with one another that many have never known before. Individuals, as they move toward completing the therapeutic process, must be reminded of the importance of continual practice of the new behaviors so that the brain learns them to the point of automation.
It is helpful to take this opportunity to have couples practice specific behaviors that allow for a more intimate and connected style of relating. Many of these behaviors are things neither partner has tried or practiced much, such as increased physical touch, emotional expressiveness, and moves toward sexual intimacy and open expression of desire. I have a number of suggestions ready to help partners move closer with one another when they reach this point in therapy.