Resolution, Not Conflict

The guide to problem-solving.

Individual Therapy for Married People: A Huge Mistake

If not criminal, is it at least a very mistaken, albeit common, practice to treat individuals without assessing the family context of the therapy client's life? Read More

Affair? Abuse?

Sure, I can see that an affair or abuse are a reason not to bring your spouse to the first session. But there are plenty of people out there who are just trying to sort out their feelings about their spouse in a safe place. Requiring them to come to therapy with that spouse ruins that experience from the get-go. There are some things in a marriage that deserve privacy. Individual psychotherapy is one of them. Would you recommend that anyone undergoing a post-marital psychoanalysis stop? Or how about that spouse who is uncertain about staying in the marriage or leaving, but does not want to wreck it right out of the chute by involving her or his spouse?

I agree that ....

I agree that many folks "are just trying to sort out their feelings about their spouse in a safe place."
The reality however is that often their negative feelings about their spouse, while totally justified, are about issues or habits of their spouse that good couples counseling can change.

If there are no children involved, I feel much more lax about people choosing to do individual therapy and then just move on. Once there have been children added into the mix though, I feel that the therapist owes it to the kids to first make the marriage the best it possibly could become.

So in general, I prefer to enable the uncertain spouse to decide whether to keep or leave the marriage on the basis of how the marriage is once it has been upgraded rather than how it was at its worst.

At the same time, I trust individuals who say that they really would prefer to come in alone for an individual session in spite of my usual policy. I find that this preference is relatively rare in the population I work with, and at the same time always merits hearing. Your comment alerted me that I might need to make this point more clear, which I have done. Thank you for bringing this ambiguity to my attention so I could fix it.

One example of the point you made, that sometimes a spouse does need the privacy of individual therapy to discuss a marital issue, was a woman who just didn't find her husband's body type sexually attractive. She appropriately wanted to discuss this issue in private rather than to hurt her husband's feelings. An excellent decision. We talked the issue through, and she was able to make a decision that left her feeling comfortable.

Great answer!

That's a great and helpful response.

At some point, could you maybe blog on that last problem, of the woman who didn't find her husband's body type sexually attractive anymore? There has been some great new research on that subject.

See: http://www.psychologytoday.com/blog/fulfillment-any-age/201310/avoid-the...

"Nevertheless, whether real or perceived, changes in a partner’s attractiveness emerged as a strong predictor of current sexual satisfaction. Amazingly, although we tend to think of relationship satisfaction as strongly related to sexual satisfaction, once the woman’s attraction ratings were entered into the equation, relationship satisfaction no longer played a role."

Thanks for this blogpost idea...

I'll think about that topic. It could fit well in a post I've been working on. The subject is "Can all conflicts about sex be resolved?"

Thanks for your good suggestion ... and I'm very glad that you found my response helpful.

drh

Answer? No!

Can all conflicts about sex be resolved? The answer is yes...but not always in the way that both parties will be happy.

I look forward to your blogpost on this, but the answer to me here in the trenches is obviously no. Then the question is whether the unresolved conflict will be fatal to the couple continuing as a couple, whether the parties can successfully renegotiate sex in the marriage (say, by opening up the marriage, a DADT policy about masturbation and pornography or online sex, or by one person agreeing to have less than than they might otherwise want to fit with the partner's diminished desire or incapacity), or whether sex/romance is so strongly motivated in the marriage as to have the marriage end when it stops working for one of the partners. (I use motivation in the Dr. Steven Reiss sense of the 16 main motivational forces, in the same company as honor, order, saving, family, status, physical activity, tranquility, etc.)

http://www.psychologytoday.com/articles/200101/secrets-happiness

Write on!

data

I enjoyed your article, and I agree with your premise. A therapist has to obtain some baseline confirmation of the accuracy of data being provided by each spouse if the therapist is to give helpful marital advice. Observing each spouse "in action" is essential in my view. But, that data only will be helpful in resolving marital conflict if both partners will recognize the accuracy of the therapist's determinations after proper observation/due diligence.

It seems to me that "agreeing on some facts or shared understandings" is the key here. Therapy cannot address problems when one or both spouses are unwilling to admit that they are contributing to the problems and the spouses cannot agree on what is happening. Unfortunately, I think that many spouses in troubled marriages have the same type of factual agreement as the Palestinians and the Israelis. In my view, good will or sufficient mental health on the part of both spouses is essential to bridging fact gaps so that therapy can proceed.

I think that one duty of a joint therapist, though, is not to work/advise towards "saving the marriage" at all costs. In my view, therapy cannot be honest unless a therapist is willing to concede the possibility that specific marriages should not be "saved" based on the cost to one or both spouses. Stated another way, I believe that a therapist who sees his/her duty as towards the couple and not the spouses short changes one or both of his/her clients.

I look forward to your article on sex conflicts.

basic mental health of clients...

This last session I had a couple in which the wife was locked in a fixed and angry belief system that all her problems are her husband's fault. Until she is freed of this paranoid delusional system, I can strengthen the husband so that he ceases to be an enabler of her anger explosions by standing there and letting her berate him for long stretches of time. I also can help him to evaluate his options. I MUST TALK WITH HIM ABOUT HELPING THE CHILDREN TO UNDERSTAND WHAT IS GOING ON SO THEY DO NOT BELIEVE THE PROBLEMS ARE THEIR FAULT. But there is no point in doing "couples therapy."

Fortunately in most cases both spouses are functioning in more or less normal emotional zones, with more mild levels of depression, anxiety and anger. In general however, emotional functioning has to be fixed first (I mostly do this with visualization and/or energy therapy techniques) in order for the sessions to be productive in terms of guiding win-win conflict resolution and teaching the couple skill improvements that will enhance their future relationship.

Secret lives not revealed in couples meetings

G.G. Marquez says that all people have public lives, private lives, and secret lives. The revelation of the client's secret life is essential to good psychotherapy, but that client is not going to reveal if his or her spouse in the room. Therefore, the idea that the the therapist can get a honest baseline about the way the couple functions from a single meeting or meetings with both spouses should be called into question. Only therapists willing to keep the secrets of the individual spouses in couples therapy will get a true window into the crucial secret lives of the individuals in that couple.

Accessing the secret life of both spouses is essential

Accessing the secret life of both spouses is essential. That is why a couples therapist needs to meet from time to time in individual sessions with each spouse. In family systems terminology, the therapist needs to meet with various sub-systems as well as to work with the whole couple or family system.

I often spend at least some time talking alone with each spouse as part of my initial intake. I also schedule sessions for individual work if I have any hint that there is a major secret life, if either spouses requests it, or if individual issues seem to need attention in addition to the couples work.

Your final sentence also merits repeating for emphasis:

"Only therapists willing to keep the secrets of the individual spouses in couples therapy will get a true window into the crucial secret lives of the individuals in that couple."

For this reason it is imperative that couples therapists a) do the individual treatment with their couples therapist, not with a different therapist and b) that the couples therapist explains the confidentiality rules, i.e., any thing said in an individual therapy session is protected by confidentiality. That is, the therapist will not communicate to the other spouse anything that one spouse has shared in the privacy of individual work with the therapist. The client can share this information with his/her spouse, but the therapist cannot.

most couples therapist have a no secrets policy

Most couples therapists out there have a "no secrets" policy. If a member of the couple wants to keep a secret with the therapist, the therapist insists that it be shared or the therapy is terminated.

Some rare therapists are willing to keep secrets. I am impressed that you are in this group. Otherwise, how can the parties feel safe to reveal the truth to you, so you can know really what is going on?

Thank you for your support

Maybe it's all in what word we use. If we call it "secrets" the therapist is likely to feel icky and if it's "confidential information" we feel more comfortable... In any case, I do appreciate your support for my somewhat outlier position amongst psychologists.

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Susan Heitler, Ph.D., is the author of many books, including From Conflict to Resolution and The Power of Two. She is a graduate of Harvard University and New York University.

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