A recent Sunday edition of the New York Times featured an attention-grabbing article entitled, "Does Couples Therapy Work?" It was the buzz in my therapy office this week. Check out KPCC's in-depth exploration of the topic with host, Patt Morrison. Both stories highlight the challenges of couples therapy for both the couple and the therapist.
While I spend most of the hours in my week working with individuals, I do enjoy the challenge of working with a few couples. Well, "enjoy" might not tell the whole story! In a way I do enjoy the work. As these news pieces point out, therapists in couples therapy need to be—and get to be—more active and involved than they do in individual therapy. I enjoy that. But I also am challenged by it, even intimidated by it. With couples more than individuals, I have to screw up my courage to get involved in what is often-times an emotionally messy dance.
Now, I am more active and involved when doing individual therapy than the stereotypical passive, supportive, head-nodding therapist. As psychoanalyst Robert Caper put it, a good therapist has to be willing to get into the fray in order to understand what the fray is about. But in individual therapy, it is much easier to keep one foot in and one foot out of the fray. In couples therapy, I think you have to be willing to jump in with both feet sometimes. As a couples therapist, I believe that I can't just stay on the sidelines; I've got to "get in there." Especially when working with highly volatile couples where blaming, projecting, and attacking can really get destructive, I've got to get involved sooner. I must be willing to become part-referee, part-coach, part-fire fighter, part-tough-love-speaker. I think every couples therapy is something of an Intervention with a capital I.
As the experts rightly point out, a lot of couples therapy is not particularly effective—in part because therapists stay too passive and are afraid of speaking up for fear that they will alienate one or both members of the couple. In addition, couples therapy is often at a great disadvantage because the couple has waited too long to get help. By the time they get help, their heels are stubbornly dug in; too much damage has been done. Also, couples therapy is often at a great disadvantage because each member of the couple overtly or covertly is there in order to get help for the other one. Therapy can't be of much help unless the each person is willing to work on him or herself.
So how can couples therapy have a better chance of success?
For me, there are three basic guidelines that can go a long way.
1. Couples therapy can only work if there is one condition present from early on: both members of the couple must be primarily motivated by love and a desire to do better. If one or both members of the couple is mostly interested in using the other as a trash can into which they can dump all of their troubles, then there isn't a basis of a good relationship to build on. Each member of the couple must become dedicated to working constructively in each session—and to do their best to contain their destructive impulses.
2. The primary task of the therapist is to help each member of the couple understand his or her own, unique contribution to the problems in the relationship. Just like it takes two to tango, each member of the couple plays his or her part in the relationship's troubles. While the therapist cannot take one person's side over the other, she must have the courage to point out the troubles in each person so that they can change for the better. As one of my mentors says, the therapist must be neutral like Switzerland—not on anybody's side but on everybody's side.
3. The primary task of the couple is to take a good hard look at themselves. It is so common for each member of a couple in conflict to put the blame onto their partner while defending themselves as a model citizen in the relationship. Defensiveness and projection of blame are deadly to couples therapy. In order to succeed, each member must be open to looking in the mirror and dedicated to making changes in themselves.
Undoubtedly, different therapists will have different views about how to enhance the effectiveness of couples therapy. For me, these basic guidelines pave the way for members of the couple to become better listeners, to improve their communication, to decrease destructive ways of interacting, and to learn more positive ways of supporting and loving one another. Couples need a therapist who has the courage to get involved and help sort things out. It is hard work—but can be good work—for every one involved.
Copyright 2012 Jennifer Kunst, Ph.D.
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