As a practicing psychologist, in the course of doing individual therapy, I sometimes determine that a person's difficulties are largely due to a troubled marriage (or problems within another committed relationship).
In most cases, when I suggest that the "patient" should be the relationship rather than the individual, I have no trouble shifting the focus from one member of the couple to the couple itself. Indeed, the person currently in therapy simply has to suggest the idea to his or her partner and cooperation usually follows.
When cooperation is not forthcoming, I encourage my clients to use the "mirror metaphor." Thus, the partner is told (by the person already in therapy) that people are often too close to their own issues to see things with clarity and focus; as if they were looking in a mirror with their nose pressed right up to the glass. To see with greater clarity, one must step back a certain distance lest the image remains out of focus.
Hence, a therapist presumably has sufficient distance from the relationship to see with the necessary clarity and focus which problems need to be addressed.
In spite of the mirror metaphor, on some occasions I am met with a less than willing partner and in some cases, one who is openly hostile to the idea of counseling or therapy. In these situations, I usually try the following strategy to enlist the cooperation and involvement of the reluctant partner.
I obtain the necessary releases and authorization, and appeal to the resistant partner in a nonthreatening way that is unlikely to evoke defensiveness. This is done by contacting the person (usually on the phone since "live" discussions usually work better than email or other forms of asynchronous communications) and explain that I'd very much appreciate his or her assistance.
Thus, the conversation often sounds something like this (of course, I'd use people's actual names during the discussion but for the sake of illustration I'm using the generic his/her, etc. here):
"Hi, this is Clifford Lazarus. I believe you know I've been meeting with your partner to help him/her with some difficulties. I was hoping that you'd agree to meet with us to enable me to help your partner even more. After all, you know him/her better than I ever can and you have a vantage point on the situation that I never will. So, who better than you to help me help your partner since you're uniquely qualified to provide me with extremely useful information?"
If this approach is met with refusal I'll usually ask the hesitant partner if he/she has any questions about the counseling (e.g., my approach, training, qualifications, expertise, experience, etc.) that, when graciously answered, might garner greater cooperation. If this is still met with a negative response, I might consider using some other metaphors to provide further understanding in the hope of gaining agreement and cooperation.
One especially useful metaphor is to liken the psychic distress of the partner in therapy to a physical illness that requires a blood transfusion for successful treatment. Hence, the question is posed whether or not the reluctant partner would "step up" and provide the remedy of his or her actual blood if meant saving his/her partner from serious physical pain. In light of this metaphor, if the resistant partner still refuses, I might be tempted to say that the selfish refusal to enter into a collaborative therapy process seems to reflect a profound problem in the relationship and it's no wonder the person in therapy has sought counseling. What's more, I might mention that while my hope is to help my client to the utmost of my ability, without the willing participation of the resistant partner I fear the outcome will be suboptimal and might even lead to discussions of separation and divorce. Hence, I finish the conversation by mentioning that the invitation will remain on the table and I sincerely hope the reluctant person will reconsider and join in the therapy process.
I realize that some people might find this approach objectionable because of its ostensibly bullying or apparently guilt-manipulation tactic. Nevertheless, I feel that in most cases the stakes are high enough so that the ends justify the means. Moreover, it is my experience that many therapists are so anxious about confrontation that they ought to be learning assertiveness skills rather than counseling others. Even more disturbing is the fact that a lot of therapists are so afraid of ethics complaints (or even litigation) that they practice defensively thus straight jacketing their therapeutic effectiveness.
Ultimately, if the resistant partner proves to be completely unyielding, at least the process of individual therapy will have gathered additional grist for the mill.
Remember: Think well, act well, feel well, be well!
Copyright by Clifford N. Lazarus, Ph.D.