This post is in response to Couples Therapy: The Four Questions by Susan Heitler
(c) hjalmeida www.fotosearch.com
Source: (c) hjalmeida www.fotosearch.com

Couples therapy is not like aspirin; that is, not all therapy is equal.  What are some of the principles that guide the work of effective marriage counselors and couple therapists? 

If you are wanting to choose a therapist—or wondering if one you currently are working with really can do the job—check out these criteria.  If you are a therapist yourself, how consistently are you covering these bases?

The impetus to write this post came from reading an excellent new book on couples therapy: psychologist Ellen Wachtel’s book, The Heart of Couple Therapy: Knowing What to Do and How to Do It.  The book delighted me.

(c) Ellen Wachtel
Source: (c) Ellen Wachtel

I myself have written on the topic of couples therapy skills, produced a video and an audio, encouraged creation of an online interactive marriage skills learning site, and teach workshops around the globe to therapists who are learning or upgrading their couple therapy skills. 

It therefore pleased me very much to see how similar Dr. Wachtel’s and my ideas are. 

At the same time, The Heart of Couple Therapy re-clarified for me a number of guidelines that all therapists, including me, need to remind ourselves of from time to time to do our very best at helping couples to emerge from their relationship difficulties.  

Here’s my list of 15 principles that I regard as especially vital signs that a marriage counselor will be effective.  

After each of my principles, I share quotes from Dr. Wachtel’s book that express similar perspectives.

Do you as a therapist, or does your therapist:

1. Focus on the positives as well as the negatives?

“Choosing what to attend to …is fundamental to good work with couples. …therapists are often trained to notice deficiencies…”  Equally and maybe more important for therapists is to learn to “see what is going right as readily as to see what is causing problems.”  The Heart of Couple Therapy, page 5

2. Expect to facilitate at least one specific growth arena in every session?

Each session should give you relief from negative feelings, a new insight about why you have been doing what you do or feeling what you feel, an upgraded skill, and/or a win-win solution to a troubling concern.

“Couples need to feel that …they are fairly consistently making progress toward resolving the issues between them. “  The Heart of Couple Therapy, page 7.

3. Teach skills, and build the new skills into habits by practicing them within the session?

The job of a therapist is to cause “understanding to translate into change in how a person acts in the world…not only to facilitate new understandings … but … to point the way to new behaviors that follow from these insights. The Heart of Couple Therapy, page 7.

4. Have a clear map of treatment—of the treatment goals and of how to guide a couple to these destinations?

“The most important job of all is to keep the session on course.”  That is, rather than get “swept along by the powerful force of the couple’s emotions…” effective therapists keep a tight rein, “taking charge of a session.”  An effective therapist also “keeps the discussion moving forward in a useful direction” enables clients to feel safe and the sessions to feel productive.

5. Calm excessive emotional intensity?

“Even before there is a perceived need to calm things down” the effective couple therapist, most of the time, “protects the couple from feeling that the session is … little more than the mutual accusations that all too closely resemble what happens at home.”  The Heart of Couple Therapy, page 8. 

“The therapist controls the emotional intensity of the sessions.” (page 33)

6. Keep a tight rein on how the spouses talk with each other so that talking stays respectful, listening occurs consistently, and the dialogue stays collaborative?

“Each person needs to feel that his or her point of view has been heard and understood.” (page 32)

7. Keep the tone of all your interactions with clients warm and positive?

“Each person…needs to feel liked by the therapist.” (page 32)

8. Teach couples to problem-solve?

The therapist's job is “helping the couple to find their own solutions.” (page 33)

Therapists need to teach spouses to “find their own solutions,” not do the solution-finding for them.  Offer solution ideas only if the couple has hit a dead end.

9. Teach spouses to forego the temptation to tell their spouse what they want them to do differently?

A couple first needs to discuss an issue enough to understand the concerns of both partners.  Then each of the partners needs to ask themselves, “What can I do differently to contribute to a plan of action that will solve this dilemma?”

Neither partner gets to criticize or tell the other what to do. Each is responsible for asking, “What can I do that will be responsive to my partner’s concerns?”

10. Ask questions that help the partners to discover and thereby understand more clearly and compassionately the earlier-in-life experiences that have fed into their current difficulties?

“… the couple therapist helps them understand the role of family history, individual sensitivities, and different coping styles…”  (page 33).

11. Replace finger-pointing, blaming and fault-finding with understanding in terms of circular causation?

The couple therapist helps the couple to clarify “the repetitive vicious cycles that have developed.” (page 33). 

For instance, she listens for what’s wrong with what he says, pushing away the information he is trying to give her.  He then feels frustrated, and begins to raise his voice in a subconscious attempt to get her to hear better.  She becomes agitated, and starts accusing him of shouting, at which point he feels criticized and does shout.

12. Teach couples to use collaborative dialogue sentence-starter phrases like “I feel _____" and “My concern is ____”?

Effective therapists “focus on what each person is longing for rather than on his or her complaints. … Wishes, longings and sadness…are much easier to hear than criticism.” (page 34)

13. Look back to learn what has been good in the relationship as well as to learn from the mistakes?

The therapist reminds the couple of “what had drawn them to each other and made them want to stay together.” (page 37)

14. Start each session by asking each spouse what they would like to address that hour…and end by assessing what they accomplished toward that goal?

“The first step in keeping the sessions focused is to ask the couple what they want to focus on overall, and again [at the outset of] each session….” (page 44)

15. Facilitate awareness of progress to build and sustain hope and optimism?

“Therapists give feedback about how they (the couple) are changing and becoming.” (page 83 and page 237)

Progress keeps us all learning and loving.

WHAT IF you yourself as a therapist, or a couples therapist you have been seeing, have some yes answers plus too many no's?

All is not lost.  To the contrary, read The Heart of Couple Therapy to learn and grow.  In fact, if you are part of a couple, whether or not you are either in therapy or a therapist, you are likely to find reading this book enlightening.

When I first began writing about therapy, one of my clients said she loved reading the cases in my books and also watching my audio and videos about therapy.  "I find," she said, "that reading about or watching someone else's therapy is almost as helpful as going to my own therapy sessions." 

The Heart of Couple Therapy is chock full of glimpses into others' therapy experiences.  Open the book to any page, read, watch, and learn!

---------------------------

(c) Susan Heitler, PhD
Source: (c) Susan Heitler, PhD

Denver clinical psychologist Susan Heitler, PhD offers multiple resources for couples who want to upgrade their marriage.  She is author of two books that offer marriage-counseling via bibliotherapy: The Power of Two and The Power of Two Workbook, available at Amazon and from booksellers everywhere. She is also co-founder of a

(c) Ellen Wachtel
Source: (c) Ellen Wachtel

fun interactive website that teaches the skills for marriage success, PowerOfTwoMarriage.com.

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