Marriage & Couples Therapy

There are many therapeutic models for helping couples having trouble in their relationships.

The model I have found most successful is a communications model. This approach begins with the assumption that problems in relationships begin when the couple stops communicating well. Poor communications can take the form of distorted messages or simply the lack of any message at all.

I like to compare it with the Rorschach inkblot that is sometimes used in psychological testing. The inkblot is deliberately ambiguous and this ambiguity allows the person being tested to project their own fears and imaginings onto the blot. The couple has a relationship field of information consisting of daily micro-encounters with each other. They include the words they speak, their gestures, their body language, their comings and goings, and even things as seemingly as trivial as where they sit in the family room to watch television. If this field is ambiguous, that is if there is little communicated meaning, one or both members of the dyad are free to project their own meaning onto it. If these projections are not reality tested, they are assumed to be true and over time build up a critical mass. Since us humans typically fill up information voids with “monsters,” the result can be ever increasing resentment and hostility.

The communication model assumes that poor communication is self reinforcing within the relationship. If one member, for example, starts to become resentful about her partner working long hours and not spending much time with the family, she may assume that he does not want to spend time with the family. In reality, he may be trying to make extra money for the family’s economic security or may simply be acting out an old work ethic he inherited from his family of origin. Her assumption causes her to be more distant, feeling that she is no longer loved. He picks up on her coolness and assumes that she is less invested in the relationship and begins, based on this assumption, to stay away more and more. Thus the cycle, which I refer to as a toxic dance, is set in motion and neither member knows how to call attention to it.

I encourage couples to start to notice the toxic dance and understand how it got started and how it built up its momentum. Thus, we will frequently go back to a time when communication was better and do a history to understand how it deteriorated. Frequently, it is some stressful event that the couple did not handle well: the birth of a child, an economic setback, the death of an extended family member or the chronic illness of a child. These events cause stress fractures in the relationship and frequently begin a cycle of non-communication, resentment, and distancing.

We may also visit the couple’s own family of origin to look at communication patterns each brought into the relationship. Did either come from a family that was conflict avoidant, or had trouble talking honestly about feelings, or used shouting or even violence to settle conflicts? Did one member come from a family that favored strictness and routine in raising their children while the other came from a family that preferred a more casual and lenient approach? Was sexuality a taboo or difficult topic in one family and not in the other? Did one family emphasize frugality in spending and the other more spontaneity and a “live for the moment” approach? Did one favor a hard work ethic and the other allow for playful spontaneity? These differences inevitably are brought into the marriage and create conflict. Frequently, the couples I see have been unable to communicate with each other about them so have been unable to reach a middle ground, have given up, withdrawn, and harbor a lot of resentment.

Under the communication model, infidelity is seen as a symptom of an underlying disease. Just as a physician would not treat a patient’s dangerous fever without looking for the underlying cause, so I would not help the couple work past the infidelity without looking for the underlying cause of the affair. Frequently, it is an increasing lack of intimacy caused by growing resentment driven by poor communication. (This is not to excuse the infidelity but to give a reason for it, and I will not conduct marriage therapy with a couple while an affair is continuing). In my experience, most couples are able to come to an understanding of what caused the affair and their relationship actually becomes stronger.

The therapy will thus emphasize honest and direct communication. In session I will insist that both listen carefully to the other without interrupting, whether or not each agrees or disagrees with what is being said. I will look for ambiguous exchanges between the two and ask for clarity. I will note non-verbal communication in the session and inquire what it means. I will note asymmetries in communication such as one member talking much more than the other, and attempt to readjust the balance. I will constantly reality test what is said if I think there are hidden meanings, innuendos, sub-plots, or subtle put downs, I will demand clarity. The session becomes a practice for the couple. The goal is for the couple to learn honest and direct communication and thus immunize themselves from future problems. The goal is described in the old saying, “Give me a fish, I eat for a day. Teach me to fish and I eat for a lifetime.”

In the vast majority of cases I have found that this approach brings relief to the couple in a reasonably short amount of time. However, certain characteristics of one or both members of the couple may impede progress and cause me to recommend individual therapy before the MT can proceed. In these cases I will suspend marriage therapy and refer one or both partners to a provider I believe can help them.

Substance abuse. When one or both members are chemically dependent, progress in marriage therapy is impossible until the substance abuse is treated. This is true because for the person dependent on alcohol or drugs, the focus is on the substance and not on fixing the relationship and the whole relationship is conditioned by the addiction..

Narcissism. A person is narcissistic if he or she must erect and maintain a grandiose persona that needs constant affirmation. This persona, which is a defense against feelings of worthlessness, cannot abide criticism, no matter how gently or constructively offered. Improved communication often cannot penetrate this need for constant stroking as it operates on a subconscious level and the narcissist has little insight about its function as a defense mechanism.

Passive Dependence. A person adopting a stance of extreme passivity and dependence creates huge problems in the relationship. This person is not able to adequately assert and verbalize their needs as they are always deferring to their partner. Thus, an asymmetrical dominant/dependent relationship is maintained. Individual therapy is often needed in this case, both to uncover the origin of the dependency and to work on assertiveness.

Perfectionism/Control Issues. If one partner demands perfection of the other and insists on rigid control of their behavior, communications training alone often cannot help. Frequently control issues manifest as excessive neatness, an ongoing effort to make their partner over into what they view as a better person, or unreasonable jealousy. Often, this characteristic comes from early trauma. Individual therapy is required to uncover the origins for the need for unreasonable control and to practice letting go of it in ordinary life situations.

Borderline Features A borderline client has little sense of a self and desperately clings onto their partner in what I call a Velcro relationship. There is little room left for the partner to be an individual. Small disappointments and short absences are treated as disasters. Feelings about the other switch rapidly and tend to be absolute, that is, the other is vilified or idolized. Individual therapy is required to retrain the borderline person to tolerate reasonable separateness and to modulate their “roller coaster” feelings about the other.

submitted by: Jerry Lawler, PhD