I just discovered your blog, Dr. Stosny, and boy did you nail it!

The wrong kind of therapy definitely can make many relationships worse -- for exactly the reasons you point out.

For example,when people who are dealing with partners who have untreated ADHD ask me about couples therapy options, I tell them they're taking their lives (and relationships) in their hands if they pursue "standard" couples therapy. Things can go downhill go fast if neurocognitive deficits (and undiagnosed psychiatric illness) aren't factored in.

I especially found this part of your column to be spot on:

"So now the problem isn't Gary's sense of inadequacy or his addiction to blame or his yelling or his abusiveness; it's Estelle's judgmental tone of voice. With this crucial shift in perspective introduced by the therapist, Estelle rehearsed her new approach. Gary responded positively to her efforts, while the therapist was there to contain his emotional reactivity. At home, of course, it was another matter."

Too many couples therapists also confuse association with causation. For example, they blame the "nagging" spouse while trying to "support" the spouse who can't be budged from the sofa.

And I completely agree on this point:

"One popular marriage therapist and author has written that women in abusive marriages have to learn to set boundaries. "She needs to learn skills to make her message - 'I will not tolerate this behavior any longer' - heard. [The] hurt person [must] learn how to set boundaries that actually mean something." This is the therapeutic equivalent of a judge dismissing your law suit against vandals because you failed to put up a "Do not vandalize" sign. You have to wonder if this therapist puts post-its on valued objects in her office that clearly state, "Do not steal!""

LOL!! Exactly. They say that "good fences make good neighbors." But what if you erect a perfectly strong fence, and your neighbor runs it down with a Humvee -- or more benignly, in a fit of distraction or hyperfocus, forgets that the fence is there when they decide they want to build a new garage. Is that the fence-builder's fault? Some therapists will imply so when it comes to couples therapy.

Some people just can't believe that the wrong therapy might make things worse, but it's absolutely true. Thanks for explaining, in part, why.

Gina Pera, author
Is It You, Me, or Adult A.D.D.?
Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder

A lot of people say that the first step in change for an abusive man is that he fully admit to all his abusive behaviors. But if the root cause of the abusive behavior is his inability to regulate feelings of guilt, shame, and inadequacy, it would seem that the 'admit you are an abuser' approach is doomed to fail.

I understand your point of view. If either or both of the partners don't have the ability to either recognize their behavior, or control their impulses, the usual style of counseling probably won't be effective.

Counseling that focuses on increasing the self esteem of both parties individually prior to working together with them as a couple might be an alternative, if both are willing. (big if!!)

From my experience abuse occurs due to a lack of self esteem and a feeling of inferiority.

I have worked with abusers and found them to be quite sophisticated in their ability to blame others to take the spotlight off themselves. The direct approach of trying to discuss daily challenges rarely works. They are too caught up in the blame game.

Many times the abuser has so much shame with regard to his/her own behavior, as well as past events, that getting to underlying issues is extremely difficult. The rage that underlies abuse, due to the shame and inferiority, can be frightening.

For male clients, I have found that men's groups have been an effective tool. Usually when complaining about the actions of the partner at home, the group member is surprised to get called out by the other men in the group on his own part in the conflict. This seems to create some level of awareness. The group also serves as a safe place for men to vent regarding their frustrations, an important need often ignored.

I used to spend 2 hours after each therapy appointment calming my now ex-wife down to the point where seh could interact with our then 9 year old son on something other than a "senseless rage" basis. She loved therapy when I was not there, since it gave her a forum to talk and she did not have to agree to anything. She did not like it when I participated. That is where all the problems arose -- my pesky participation.

Nevertheless, it WAS a useful exercise. I went back to my marriage counsellor after marriage counselling had been over for 9 months --- to get grounded on my already made (and filed) decision to divorce. It was very useful to talk to someone who had independent knowledge of my ex wife. And, it was useful to understand that marriage counselling was useless since you were undergoing the process with only one side willing to address behavioral issues.

So, maybe you can look at this type of counselling as a "two step" instead of a twelve step" process.

I would NEVER go to marriage counseling again nor would I reccomment it to anyone. It by far spiraled my marriage into a deeper tailspin than it was already in doing more damage than ever. Now divorced.

I'm wondering about the benefits of boundaries... despite the value of Steven's example of how bringing up the subject of boundaries in counselling with an abused/abusing couple does NOT help. [Good to read about, good awareness to have, considering I advised a friend ending an abusive marriage about using boundaries... now I see why it wasn't very helpful!]

Are boundaries still important to learn to use? [and if, like me, you lacked good emotional life skills from early in life?]

Can using newly-learned boundary skills keep you safer from entering into abusive relationship?

Is using boundaries too much of a shortcut to be effective in learning to develop intimacy as an adult?

I read the story about Lifestreams Solutions Counseling Center(Arizona) about Matt Manka And Debbie Manka. Matt was the Psychologist who married his patient Debbie and it destroyed their family and kids etc. There is a reason psychologists arent supposed to marry or date their clients. They have ultimate mental/emotional leverage over the patient. Mr. Manka should have considered the well being of her children and family before forcing his gold-digging agenda onto that family(who i undrstand are millionares). Its a disgrace,the whole story. Manka was even counseling the couple for marriage problems before moving in on the wife. Is she deaf,dumb and blind or what? Any comments out there?

Steven, I very much agree with what you say here:

"So now the problem isn't Gary's sense of inadequacy or his addiction to blame or his yelling or his abusiveness; it's Estelle's judgmental tone of voice. With this crucial shift in perspective introduced by the therapist, Estelle rehearsed her new approach. Gary responded positively to her efforts, while the therapist was there to contain his emotional reactivity. At home, of course, it was another matter.

In a less reactive relationship, the therapist's advice wouldn't be so bad. If Gary could regulate his emotions and sense of entitlement, he might have appreciated Estelle's efforts to consider him in the way she phrased her requests; perhaps he would have become more empathic in response. But in the day-to-day reality of their walking-on-eggshells relationship, Gary felt guilty when Estelle made greater efforts to appease him. Without self-regulation skill, he blamed his guilt on her -- she wasn't doing it right, her "I-statements" had an underlying accusatory tone, she was trying to make him look bad, etc."

My wife would also feel guilty (I suspect shame is a better word) in such a scenario, I suspect. My solution was to drop pressuring her to go to marriage counseling and to focus on myself and my own communication skills. I have learned a few important things over the past year. I truly CAN interact with my wife in such a way that her own tendency to blame me for her negative feelings isn't getting triggered on a daily basis. I have also learned to validate her feelings, to the point where she now (almost) trusts me enough to communicate these feelings to me (in the past she would simply retreat into stormy silences for days). I also feel a great deal of compassion for what appears to be a massive amount of shame that she experiences.

This is not to say that I think her emotions are my fault. I simply recognized that, if my goal was to reduce the chaos in our marriage, then I could change the one thing I had any control over: myself.

I suspect you agree with this, since you speak a lot about the value of cultivating compassion as a means to increase the odds that your partner will reciprocate positively. I just wanted to emphasize that I do think there is value in focusing on our OWN behavior when we are unhappy with our partner's behavior, as long as that focus is not self-judging, and, agreed, as long as that focus is not in the context of marriage counseling. Finally, I agree that developing such skills requires a parallel focus on cultivating empathy and compassion, without which the communication techniques will sound artificial and we'll be walking on eggshells.

Finally, the truth!

We are divorced but things got so bad that we had to go to family therapy, which did, in fact, make things worse in ways described by Dr. Stosny. The therapist did appear to side with my abusive ex-husband against both me and our son. It was disastrous. She urged him to "take control" -- one of the worst things she could have done.

She told me I should just simply listen to him when he screamed and ranted at me over the phone and say, "I hear you." My own therapist told me just to say, "I'll talk to you when you calm down" and then say goodbye. That is more appropriate. Also, the family therapist told me that when my ex called up screaming at anyone who would answer, I should immediately grab the phone and go and talk to him behind closed doors so our son didn't know about it. If our son was able to answer the phone, my ex would scream at him. This was supposedly my fault. I was supposed to prevent it.

Finally, the therapist stopped the therapy because it wasn't doing anybody any good. Ya think?

Finally, the truth!

We are divorced but things got so bad that we had to go to family therapy, which did, in fact, make things worse in ways described by Dr. Stosny. The therapist did appear to side with my abusive ex-husband against both me and our son. It was disastrous. She urged him to "take control" -- one of the worst things she could have done.

She told me I should just simply listen to him when he screamed and ranted at me over the phone and say, "I hear you." My own therapist told me just to say, "I'll talk to you when you calm down" and then say goodbye. That is more appropriate. Also, the family therapist told me that when my ex called up screaming at anyone who would answer, I should immediately grab the phone and go and talk to him behind closed doors so our son didn't know about it. If our son was able to answer the phone, my ex would scream at him. This was supposedly my fault. I was supposed to prevent it.

Finally, the therapist stopped the therapy because it wasn't doing anybody any good. Ya think?