Couples Therapy
Objectives
~ Identify common mistakes in couples therapy
~ Explore things counselors need to consider when working with couples
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~ Provide a confidential dialogue, which normalizes feelings
~ Enable each person to be heard and to hear themselves
~ Set boundaries so each person feels safe and empowered to express his or her point of view in a way the other can hear and understand, even though he or she may not agree
~ Teach active listening, using I statements and objective terms from the beginning
~ Reflect the relationship's difficulties and the potential for change
~ Inform couples that it is not a matter of one person being right or wrong, since both partners make sense from their perspective. They will be learning how to better understand each other and improve communication to restore harmony and intimacy
~ Identify times in the past that have been good and what was different
~ Help each partner begin to understand how he or she is contributing to the conflicts and can contribute to solutions
~ Move from the “blame game” to looking at what happens to them as a process.
~ Look for exceptions
~ Help both partners see the relationship in a more objective manner
~ Identify repetitive, negative interaction cycles as a pattern
~ Sex/Intimacy
~ ResentmentsExplosions
~ Change the view of the relationship via functional perspective taking
~ How is this behavior helpful to him/her/you?
~ Help each partner begin to understand how he or she is contributing to the conflicts and can contribute to solutions
~ Understand the source of reactive emotions that drive the pattern
~ How does this situation trigger past hurts?
~ How does this situation trigger feelings of failure, rejection, loss of control or isolation?
~ Empower the partners to take control and make vital decisions
~ What are workable solutions to this problem?
~ Facilitate a shift in partners' interaction
~ Which solution will you choose?
~ What is each person’s responsibility?
~ Create new and positively bonding emotional events and establish intimacy
~ Meet the couple where they are— What can they currently comfortably do?
~ What do they hope they will eventually be able to do?
~ Teach the 5 love languages (touch, gifts, words, acts, quality time)
~ Have each partner make a list of what those things are for them
~ Foster a secure attachment between partners
~ Responsiveness
~ Consistency
~ Compassion/empathy
~ Caring
~ Mindfulness paraphrasing activity
~ Decrease emotional avoidance
~ When you are feeling [upset] what will you do?
~ Mindfulness
~ Radical acceptance
~ Distress tolerance
~ Problem solving
~ When you are upset with your partner, what will you do?
~ Promote strengths
~ What are your strengths as a couple?
~ What are your strengths as individuals and how can you synergize?
~ What positive things did your partner do last week?
~ 9 minutes of connection (3 morning, 3 after work, 3 before bed)
Assessment Areas
~ Communication
~ Conflict Resolution
~ Appreciate Individual Differences
~ Financial Management
~ Leisure Activities
~ Sexuality and Affection
~ Family and Friends
~ Relationship Roles
~ Children and Parenting
~ Spiritual and Cultural Beliefs and Values
Assessment
~ Each person’s goals for treatment
~ What changes are you hoping will come out of therapy
~ Phenomenological truth for each person
~ Temperament
~ E/I
~ S/N
~ T/F
~ J/P
Conflict Resolution
~ Set a time and place for discussion
~ Define the problem (specific and objective)
~ List the ways you each contribute to the problem
~ Identify past unsuccessful attempts at resolution
~ Brainstorm 10 possible solutions
~ Discuss and evaluate each solution
~ Agree on a solution to try
~ Describe how you each will work toward that solution
~ Set another time to discuss your progress
~ Reward each other’s efforts
Fair Fighting
~ Know when you need a time out
~ Do not enagage when enraged
~ Identify wat you were thinking and feeling and why it became so difficult to discuss it
~ Explore how those feelings are related to
~ Assumptions based on the past
~ Fears of rejection, failure, loss of control, isolation, the unknown
~ Resume the conversation
Fair Fighting
~ Stay seated (or go for a walk together)
~ The talker presents his/her point of view about one issue using objective words and “I” statements.
~ I get anxious whenever you are late, because I remember when that happened before and you were having an affair and I get scared that it is happening again and I am afraid of losing you.
~ No name calling.
~ No blaming.
~ The listener listens to understand and paraphrases.
~ When I am late, you feel vulnerable and you get afraid that I might be planning to leave.
~ The talker verifies the accuracy of the paraphrase or clarifies
~ The listener continues to listen to understand and paraphrase
~ When the talker feels fully heard and understood, the roles switch.
~ After both parties are fully heard, then solutions are discussed.
Activity– Learning to Listen
~ The couple faces each other. The sender is asked to offer a one-sentence “guess” as to why he or she thinks the partner decided to come to this appointment.
~ “I think you came to this session so I can learn how to be nice to you.”
~ Regardless of whether it is true, the receiver mirrors it
~ “So you think I came so you’ll learn how to be nice to me?”
~ The sender keeps adding more reasons
~ “I think you are also here because you want to save our marriage.”
~ This, too, is mirrored by the partner.
~ After the sender completes all guesses and each are mirrored, the receiver is then asked to add to or correct what was said.
~ “It is true I’m here to save our marriage, but it’s not a matter of being nice to me. It is more a matter of learning how to talk to each other.”
Seeking Forgiveness
~ Try to understand/empathize with the pain you have caused.
~ Take responsibility for your actions and make restitution if necessary.
~ Assure your partner you will not do it again or will work toward a resolution.
~ Apologize and ask for forgiveness.
~ Forgive yourself.
Granting Forgiveness
~ Acknowledge your pain and anger.
~ Be specific about your needs for the future.
~ Give up your right to “get even,” but insist on working toward a resolution in the future.
~ Let go of blame, resentment, and negativity toward your partner.
~ Communicate your forgiveness to your partner.
~ Work toward reconciliation (when safe).
Improving Intimacy
~ Intimacy triggers oxytocin and dopamine
~ Ask the couple to face one another.
~ The sender is asked to state one thing he or she likes about the receiver
~ I really love what a hard worker you are
~ The receiver paraphrases this appreciation.
~ So you appreciate how hard I work
~ The sender deepens the appreciation by using the phrase
~ “This is so special to me because…”
~ The receiver again mirrors the comment.
~ The process is repeated with the receiver offering appreciation.
Common Mistakes
~ Letting one partner dominate sessions
~ Remind partners that you are not a referee they need to be speaking to each other, using I statements and practicing paraphrasing
~ Interrupt as necessary to redirect the conversation (see fair fighting)
~ Failing to elicit information from both partners
~ Have each person write down and share in session with each other
~ Their perception of progress
~ Anything important that transpired
~ Experience with the homework
~ Their concerns about the direction or interventions for treatment
Common Mistakes
~ Failing to have couples arrive at a workable definition of important concepts such as intimacy
~ White board definition
~ Describe what intimacy looks like (on television)
~ Moving too fast
~ Sometimes the pain is too ingrained to start with intimacy exercises
~ Start with what the couple thinks they both can handle
~ Imposing YOUR vision of a happy relationship
~ CNM/Poly
~ Pornography
~ Sleeping together
~ Sex (asexuality)
Summary
~ Working with couples is very different than individual therapy 1+1=3
~ Key challenges
~ Helping each person understand the other’s perception of what the problem and resolution are
~ Understanding what the problem means to them and how it might be triggering stuff from the past or serving to protect them in the present
~ Helping them increase motivation and efficacy
~ Ensuring bother partners hear each other and themselves
~ Rebuilding the intimacy bridge with a foundation of trust