Tuesday, December 18, 2007

Insider Thoughts on Couple's Therapy...An issue-oriented post.

Friends and family often ask me for advice about problems they're experiencing. This is essentially free therapy for them under the presumption that I have can share my issues with them for some reciprocal advice--but I rarely get that. Do I mind? No, not really. If it ever gets excessive, I just plead ignorance and reflect how difficult it must be to go through such an ordeal. Reflection, if you're unfamiliar with psychotherapist lingo, refers to a sort of re-stating of what a client says in order to confirm that we understand what's being said. I actually find that when my colleagues and I use reflection, we're actually stuck and have no clue what to say next. When done right, the client usually just responds positively: "Yes, exactly! And to make matters worse...." This usually helps the conversation along, while allowing the client to feel that we truly get what they're saying and that they're being heard. This may sound like we're just fleecing clients in need, however, to effectively reflect in a convincing way, we actually do need to understand where a client is coming from. So, no, we're not fleecing anyone. You can save that draft of hate email for another post.

I have a special fondness for couples therapy. In my second year of grad school, I chose the child/family/couples track of clinical training, with no real experience in this area at all. My program has two specialty tracks: Child/Family and Aging. Then there's this third track, the adult track, which refers to working with everyone that's left over. I'm in the adult track. I figured that if I was trained in both of the other tracks, I would be covering my bases with respect to the specific needs of kids, families, couples, and older adults. What else would "just adults" be dealing with? So, when my co-therapist and I first laid eyes on our inaugural couples case, we were so eager--brimming with therapeutic hope and a brand spanking new reserve of innovative interventions. We had no clue what we were in for. The couple we saw were dealing with things that are rarely discussed in training texts. Transvestite prostitutes anyone? (Actually, we had three separate cases that dealt with TPs, as we started calling them!) Oh sure, we'll take care of that no problem. Let's just talk that one out...

Well, we helped some couples achieve some happiness and other relationships dissolved before our eyes. I finished that year with a better understanding of the true goal of couples therapy. It's not about saving the relationship at all costs. It's not about just translating different communication styles. It's also not about working miracles or doing the fighting for couples in a "safe space". Couples Therapy is truly learning about who the heck you're in the foxhole with and figuring out what you want out of the relationship. If this means you want to do everything you can to salvage this thing you've got, fine. Try it out. Do what the therapist asks you to do. But if you come in with the hope that the therapist is going to change your partner and that you're doing just fine, you might want to re-evaluate your expectations. Also, if you think just going to therapy is the panacea you both need, that the therapist will simply mend the relationship with her magic wand, you're in for a surprise. Therapy is work. The hardest reality to accept, and to convey to clients, is that sometimes we feel that both parties would be better off not in the relationship. The final goal in sessions is up to the couple, so if you want to give it the old college try, of course we'll work with you. However, it usually becomes clear during the course therapy if the relationship is heading toward hopelessness. Our supervisors often reassure new therapists that it's okay that couples break up if that's really what seems best--it never seems okay for the couple, of course. I've noticed that many couples are well aware of the reality of the future of the relationship before stepping foot in the door and are just coming to therapy to say they did everything they could. More often than not, one member of the relationship feels this way more than the other--I find this scenario particularly heart breaking. In the end, I think that couples therapy helps people become really honest with themselves.

If you're not quite ready to jump into couples work,this is a wonderful book that's based on the training manuals for couples therapists, only it's geared toward the general public. The authors are the among the premier relationship psychologists and this book is based on over 20 years of their research with thousands of couples.

No comments: