How I do Couples Work

Flexibility

When people ask me how I work with couples I usually start by saying that my first principle is flexibility of approach. In 40 years of doing and teaching psychotherapy I’ve studied and taught a great variety of clinical methodologies, and many different theoretical points of view and techniques find expression in my client sessions in response to the needs of the moment. I’m comfortable with a wide range of issues, from sexuality to spirituality, communication problems to severe emotional disturbance, parenting issues to substance abuse and infidelity.

After hearing about the goals that each member of the couple bring to the first session, and getting to know a bit about the strengths of the relationship as well as its difficulties, I’ve almost always been able to tell a couple at the end of the first session how I would basically recommend we proceed. How the work unfolds over time will depend on what emerges as it becomes safe for each member of the couple to express more about what they’ve been thinking, feeling and doing – my therapeutic approach will then respond to what seems most helpful.

Gottman Couple Therapy

For the past several years I almost always begin in a treatment frame based upon the work of John and Julie Gottman. I usually suggest that clients purchase two copies of “The Seven Principles for Making Marriage Work” (New York: Three Rivers Press, 1999) after our first session and use it as a workbook while we proceed through the therapy. To support and deepen the Gottman techniques I frequently bring in material about DBT Emotional Regulation and Interpersonal Effectiveness Skills. I almost always spend some time in the first session pointing out the inevitability of the way that a couple’s problems have evolved and circled around on themselves – it really couldn’t be otherwise than that they have the difficulties they do. This is a point of view that comes from family systems, object relations family therapy, behavioral and transpersonal models.

It’s because the Gottman approach provides the initial framework of therapy, and because I utilize most of his techniques somewhere in the therapy, that I am referring to my work as Gottman Couples Therapy. To avoid possible confusion in using this name, I need to let you at this point that I am not yet a “Certified Gottman Therapist”, though I am now in the pipeline to become one. I have been using Gottman techniques for twelve years, completed the five-day Advanced Study course in 2006, and have taught the techniques to my psychotherapy interns on a regular basis for the past seven years. I recently completed the 4 day Live Workshop that begins the Certification Practicum, and am now in the consultation and video review process required to become a “Certified Gottman Therapist”.

So let me expand further upon what I find helpful about the work of the Gottmans and other clinicians. I hope these ideas will be helpful to you whether or not you decide to seek professional assistance.

Research-based Treatment

Gottman’s approach to working with was grounded in extensive research about goes on in a relationship. Based on the analysis of thousands of hours of videotaped conversations between couples about their difficulties, Gottman is able to predict with 91% accuracy whether a particular couple will stay together or divorce. The ability to make as nearly an accurate prediction based on a few minutes of tape has made him famous in books like Malcom Gladwell’s “Blink”. (What Gottman is mostly listening for in such a short analysis is the presence of “contempt” – that corrosive attack on a person’s character delivered in a sarcastic and scornful tone, perhaps accompanied by a rolling of the eyes. When the circular interactions between members of a couple have escalated to the point where contempt is present, the couple is probably headed toward divorce unless decisive intervention is made.)

The Seven Principles

Gottman’s analysis of research about treatment effectiveness in other styles of couples work is also striking – approaches to marital therapy that emphasize listening and empathy skills have less than a 20% success rate over time. Accordingly, he has put together more comprehensive approach involving a number of key factors in maintaining good relationships. By intervening in seven areas of the “sound marital house” the Gottman approach appears much more promising. The seven areas of intervention include:

1. Enhancing your love maps—creating connection through what you know about your partner and his or her daily life.

2. Nurture fondness and admiration – turning attention towards the positive in the ways you think about your partner and your relationship.

3. Turning to each other – creating positive sentiment override by making and responding to bids for connection, and supporting each other through difficulties outside the relationship with the stress reducing conversation.

4. Let your partner influence you — getting past cultural and gender conditioning that make people reluctant to accept new ideas.

5. Resolving solvable conflicts, through techniques for softening startups for difficult conversations, making repair attempts when communications go off track, soothing yourself and the your partner when emotional flooding prevents skillful communicating.

6. Overcoming gridlock in “perpetual problems” by understanding the historical basis of each partner’s deeply held values that are discovered in arguments, and supporting the most crucial parts of these “dreams within conflict”.

7. Creating shared rituals that express and support the values and aspirations of each member of the couple.

The Four Horsemen

Gottman’s research shows that a variety of communication styles can work successfully for couples if the styles are shared. He knows that a marriage is in trouble, however, when he hears the presence of what he calls the Four Horsemen of the Apocalypse: Criticism, Defensiveness, Contempt and Stonewalling (an icy refusal to respond to what the partner is saying). Family systems therapists would highlight something not emphasized by Gottman, which is the circular and spiraling interaction among these Horsemen. Criticism inspires defensiveness, which in turn causes more criticism. As this hardens into contempt, it causes stonewalling, leading to more contempt, and more stonewalling as the relationship (in Gottman’s phrase) “tumbles down the marital rapids”.

Beyond Blaming

Gottman’s approach to overcoming gridlock echoes the view of Object Relations Family Therapists such as Samuel Slipp and David and Jill Scharff that the differences between people which bring forth the Horsemen or create other problematic patterns in relationships come mostly out of the inevitable differences between the families in which each member of the couple were raised. Family relationship patterns are carried within each member of the couple and recreated in both unique and familiar ways in the new relationship.

When members of a client couple get it that these new patterns, and the suffering that is caused by them, are beyond the conscious control of either partner, it becomes easier to stop blaming each other. Usually it becomes clear in the first session or two that the problems the couples have are the inevitable result of growing up in their respective childhood families and then getting together — there is no way that they could not have these problems! Once this happens we can start to work on replacing the Horsemen with kinder patterns of communication and problem solving.

Creating a Safe Environment for Change

Moving beyond blame and defensiveness is essential to the creation of a therapeutic environment in which members of a couple can safely experiment with new ways of relating to each other. It is the task of the therapist to support this safety by moderating conflict in the early stages of therapy, and in focusing attention on the positive intentions of each member of the couple.

One of my favorite stories on this theme comes from the 18th century Hasidic masters, in which a married couple has come for counseling with a Rabbi in his home. The wife complains bitterly about the way that her husband has let her down, and at the end of her tirade the Rabbi says, “You’re right!” Then it’s the husband’s turn, and he is equally blaming about how his wife has not given him what he needs. Once again, the Rabbi listens carefully and then says, “You’re right!” At this point, the Rabbi’s own wife comes into the parlor, having overheard all this from the kitchen. She points out to the Rabbi that the couple has vehemently and directly disagreed with one another, and that he has told each of them that they are right. She tells him, “They can’t both be right!” The Rabbi looks at her and says, “You know, dear, you’re right!”

It is the therapist’s job to support what is right about each person’s point of view at a time when it is too difficult for the partner to see this. Gradually, the therapist helps members of the couple to see the positives more clearly and express them in a more effective way. Gottman says that a relationship needs a 5 to 1 ratio of positive communications over negative ones in order to thrive. (To learn more about how to change what you see on your own, follow this link to more about validation.)

Pursuer/Distancer Patterns

Based on what they bring out of their childhood families in to the new relationship they create together, couples usually have one of more of a few basic patterns. Some of these are symmetrical in structure, as in a back and forth escalating exchange of insults that build towards physical violence or separation. Others appear more complementary in structure, with one member of the couple ending up again and again in a familiar role. Most couples have something of a pursuer/distancer relationship, in which whoever has more desire for emotional closeness or sexual intimacy comes in pursuit of the other partner, who typically moves a bit away to create a more comfortable distance. As the pursuer experiences the distancer pulling away, the pursuer tries harder for contact, which inspires the distancer to move away again. By now each is reacting to the other in a circular pattern, which as it escalates may turn into a critical pursuit and defensive distancing process that “tumbles down the marital rapids”.

It is usually helpful for couples to see that they are caught in a circular pattern that has taken over, beyond the desire of either partner, and that this again is the inevitable result of childhood family patterns. Along with the other tasks of therapy to be mentioned below, it is the job of the therapist to help the couple find a way to be less caught by their patterns.

With couples caught in a pursuer/distancer dynamic I encourage the pursuer to diversify his or her social contacts and devise other ways to meet the emotional needs that lead to pursuit. I encourage the distancer to expand his or her tolerance for intimacy and time spent with the partner. This is an individuation and differentiation process of the kind described by David Schnarch in Passionate Marriage: Love, Sex and Intimacy in Emotionally Committed Relationships (New York: Henry Holt and Company, 1997). His work is particularly useful in working on sexual problems in couples work. He suggests that the key to developing greater intimacy is to develop the capacity to “maintain your sense of self when you are emotionally and physically close to others,” to find the balance between “holding onto yourself and holding onto your partner.”

Escalating Conflict and Physical Violence

With couples who escalate toward more dramatic (and possibly dangerous) fights it is useful to negotiate time out agreements in which either partner can call a halt to the argument for a designated period (say an hour or so) while the partners calm down. If you have this pattern of escalation, see if you can negotiate a time out agreement yourself. You may find, however, that is necessary to have a 3rd person as witness to the agreement (such as a friend or therapist), and it may be necessary to learn additional skills in staying calm and non-inflammatory communication. If there is any physical violence occurring between you and your partner, please seek professional help immediately! This is a dangerous situation that is unlikely to change without skilled assistance.

More about Gottman

Without attempting to summarize the entire Seven Principles book, I want to mention a few concepts I frequently emphasize with couples. I also want to suggest that working through the book from start to finish — with its diagnostic tests, exercises to do individually and together, and techniques to learn and apply in daily interactions — will be helpful to any couple.

Emotional Flooding

One profound discovery Gottman and his associates found in their research (which included hooking couples up to blood pressure and heart-rate monitors during arguments) is that partners stonewall as a protection against feeling emotionally “flooded”. Physiologically speaking, flooding means that the heart rate and blood pressure go through the roof. The emotional experience is feeling shell-shocked and unable to think of an appropriate response. Gottman says, “In 85% of marriages, the stonewaller is the husband… The reason lies in our evolutionary heritage.” As I joke with couples, this is basically a “hunter/gatherer thing”, related to different roles in primitive culture, but its physiological legacy makes a serious contribution to the spiral of contempt and stonewalling. It needs to addressed in order for couples to find more harmonious relating.

Gottman’s approach to dealing with this emotional dysregulation in one member of the couple is similar to what Dialectical Behavior Therapy provides to individual clients (see What is DBT?): it offers techniques for focusing attention on positive parts of the relationship and enhancing them (“Nurturing Fondness and Admiration” in Chapter 4); gives guidelines for communications (the “Stress-Reducing Conversation” in Chapter 5, “Softening Your Startup” and “Learn to Make and Receive Repair Attempts” in Chapter 8); and it offers suggestions for regulating emotion and tolerating distress (“Sooth Yourself and Each Other” in Chapter 8). I often find myself supplementing these techniques with related DBT Skills (see Skills for a Life Worth Living).

Perpetual Problems

Gottman offers a protocol for distinguishing “solvable problems” from what he calls “perpetual problems”, which are differences of opinion or temperament likely to remain fundamentally in place throughout the marriage. About these, he quotes Dan Wile in his book After the Honeymoon: “When choosing a long-term partner… you will inevitably be choosing a particular set of unsolvable problems that you’ll be grappling with for the next ten, twenty or fifty years.” Getting married to someone else would have involved perhaps a different set of unsolvable problems, but would have involved problems nonetheless. Gottman comments, “Marriages are successful to the degree that the problems you choose are ones you can cope with.”

Solvable problems are the easier ones that can be dealt with by effective communication and compromise. Perpetual problems require a deeper investigation of the dreams and desires of each partner, and a process of differentiating the non-negotiable core areas of the conflict from the areas of greater flexibility where temporary compromises can be found that honor the fundamental dreams of each partner.

In the Wake of an Affair

This has become such a common issue in my practice, I’ve written a separate page for it. Click here to see it.

Divorce Counseling

Sometimes this common ground cannot be found, and it becomes the therapist’s task to help a couple separate in the most harmonious, least painful manner possible. Counseling can also be helpful in the process of separation and divorce to maximize what each member of the couple learns from the relationship and takes into the next ones.

When children are involved, I usually advocate more strongly than otherwise for a couple to find a way to work things out, because of the research data available from Judy Wallerstein and others about the high price paid by children in the divorce process. If divorce is necessary, however, counseling during the process can reduce the damage to everyone involved.

Blended Families

I have considerable experience both personally and professionally in dealing with the special dynamics of families where remarriages have brought stepparents and other children into the picture. In my experience “wicked stepparents” are made, not born. Out of loyalty towards their biological parents children often give stepparents a pretty hard time, which makes it more challenging for the stepparents to behave in a tolerant and loving way. One common problem is that a natural parent may prematurely invite the stepparent into a disciplinary role with his or her children, before the right to discipline has been won through more nurturing, less stressful interactions.

Other Families

Although I have emphasized couples work in this website, I also have considerable experience in working with families and their children. I have taught a number of parenting skills classes, and as addressed in the pages on Helping Someone with BPD, I specialize in helping families deal with children who are struggling with severe emotional problems.