Couple Therapy - An Information Guide

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cOUPLE THERAPY

an

Informa

tion

Guide

Dave Denberg, MSW, CSW


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cOUPLE THERAPY AnInformation

Guide

Dave Denberg, MSW, CSW

A Pan American Health Organization /

World Health Organization Collaborating Centre


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Couple Therapy: An Information Guide

ISBN 0-88868-332-4

Product code: PM007

Printed in CanadaCopyright 1999 Centre for Addiction and Mental Health

No part of this work may be reproduced or transmitted in any form orby any means electronic or mechanical, including photocopying andrecording, or by any information storage and retrieval system withoutwritten permission from the publisher except for a brief quotation(not to exceed 200 words) in a review or professional work.

For information on other Centre for Addiction and Mental Healthresource materials or to place an order, please contact:

Marketing and Sales ServicesCentre for Addiction and Mental Health33 Russell StreetToronto, Ontario M5S 2S1

Tel: 1 800 661-1111 or 416 595-6059 in TorontoE-mail: [email protected]

Web site: www.camh.net

Disponible en franais sous le titreThrapie de couple : Guide dinformation 2185E / 03-05 PM007


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Couple Therapy

ACKNOWLEDGMENT

I would like to thank the couples who were treated at the Clarke Institute

of Psychiatry, now a division of the Centre for Addiction and MentalHealth, for their questions, suggestions and comments on the original edi-

tion of this guide. Also my thanks are extended to the many Centre staff

who were instrumental in producing the publication.

I would like to thank Pamela Blake, MSW, and Barbara Edwards-Evans,

MSW, my co-authors on the first edition of this guide, and Pamela particu-

larly for her contribution to the current edition.


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8 Couple Therapy

Stress in life is inevitable. The number of stressful situations, their length

and severity and a partners individual capacity to cope, are all factors that

will affect a relationship. It is normal for couples to experience difficulties

during periods of change until they can find their own ways of adapting to

the situation. A couple may be less able to adapt if they face significantstresses in several areas of their lives at the same time. A major physical or

emotional illness in the family can have great impact. Financial difficulties

and loss of employment are other common stresses facing couples. In such

times, family support (or lack of it) and the involvement of friends will

play an important role in improving or worsening the situation.

Improving a relationship

There is no universal, ideal model against which a relationship can be

evaluated. A good relationship is one that works for both partners and

effectively supports them in achieving their goals. If this is not working at

some point, it does not necessarily mean that the couple requires therapy.

All relationships tend to encounter problems during stressful periods and

at different stages, and many couples are able to resolve their difficulties

without professional help. Some couples find that they are able to do so

at one stage but not at another. Others may find that they are continually

unhappy with their relationship. Sometimes one partner feels frustrated

and misunderstood while his or her mate is totally unaware of the

situation.

If the couple are unable to resolve issues in a manner that is acceptable to

both partners, professional help should be considered. Many couples only

consider therapy as a last resort. It may however, be helpful at any time,

and sometimes seeking therapy soon after things get stuck prevents a

buildup of frustration and disappointment.


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12 Couple Therapy

What will the therapist do?

The therapist is a professionally trained, objective third party who will lis-

ten to both partners as they express their thoughts and feelings and help

them identify and clarify problem areas.

Most therapists start with an assessment. In an assessment, the therapist

asks about the problems and how both people see them, the history of the

relationship, and the individual histories of the partners. This enables the

therapist to develop a deeper understanding. Most therapists will discuss

their impression of the situation with the couple at the conclusion of the

assessment. The couple then can decide whether to accept the therapists

recommendations about whether or not to enter therapy and what kind of

therapy to pursue.

Once the couple enters therapy, the therapists interpretation of issues may

offer the couple a new perspective, which permits a change in feelings and

behaviour. The therapist may act as a mediator, attempting to clear up

misunderstandings in communication. This is often difficult for people to

do themselves because they are emotionally caught up in the situation.

The therapist may also help the partners consider alternative ways of han-

dling problematic situations.


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14 Couple Therapy

Is this just a phase were going through

or do we really need help?

At one time or another all couples go through difficult changes and stages

and experience stress. How much stress each person can, and is willing to,tolerate at any particular time varies. If you feel your stress level is intoler-

able or that you have reached an impasse, you should seek help.

Some people ignore problems and hope they will go away. Other people

find they are unable to solve their difficulties despite repeated attempts to

do so. If problems in your relationship persist, or if you cant solve them

in a way that is acceptable to both of you, do not wait to go for help. Prob-

lems are easier to resolve before they become larger and when there are still

positive feelings in the relationship.

Were intelligent people.

Why cant we sort out our own problems?

Feelings are in a different realm from logic and cannot always be re-

solved on an intellectual level. Sometimes an objective third party is

needed to mediate conflict, or to help clarify what the issue means to

each of the partners.

Were fighting a lot and cant agreeon anything.

People who fight often feel as though they are going around in circles. Un-

resolved issues that continue to bother a person can begin to colour every-

thing, and to obscure the original causes of feelings of anger or outrage.

There may be aspects of the original problem that were fully or partly


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22 Couple Therapy

Weve had a bad experience with a couple

therapist. How do we know if another one would

be any good?

There are a number of possible reasons for a bad therapeutic experience.

The timing may not have been right for you or your partner to tackle your

problems. Alternatively, you, your partner or both of you may not have

been comfortable with the therapist or his or her approach. It is useful to

be as clear as possible about what the problem was with your former ther-

apist and to discuss this with a new therapist at the outset. It is well worth

thinking about this carefully and discussing it with your partner, if possi-

ble, before seeking a new therapist.


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24 Couple Therapy

in whole or in part by the provincial or medical health insurance plans,

employee assistance programs or private insurance programs. While some

social service agencies have a sliding fee scale based on financial circum-

stances, professionals in private practice set their own fees. Costs should be

discussed at the outset.

Is therapy always during business hours?

Not always. Some agencies and therapists schedule appointments outside

normal business hours.


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26 Couple Therapy

Who will have custody of the children?

How will family react?

What will happen with our friends?

How will I/we manage financially?

How will we divide our possessions? What will it mean to be a single parent, to live on my own?

How do I deal with my feelings of anger, loneliness, failure?

Will the therapist continue to see

me if my partner and I separate?

If you separate it may be helpful for either or both of you to engage in

individual therapy. Some therapists, after having seen a couple together,

will not see either of them individually, but instead will refer them to

other professionals for individual therapy. However, under certain cir-

cumstances, therapists may continue to see one or both partners on an

individual basis.

What is mediation counselling?

This is a specific kind of counselling for couples who have decided to sep-

arate and require help in resolving issues such as custody of children, vis-

itation rights, division of property and assets. The aim of mediation

counselling is to avoid painful confrontation and to resolve conflictsfairly, without bitter legal struggles. Mediation counselling may be avail-

able through the Family Court system. Some family agencies and private

practitioners also offer this specialized service. Mediation counselling aids

in solving problems and making decisions. Couple therapy will address

these issues, but it will also help the couple look more deeply at the mean-

ings and feelings underneath the conflicts.


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38 Couple Therapy

SUGGESTED READINGS

Books for the public

Coleman, Paul. (1994). Getting to the Heart of the Matter: How to Resolve

Ongoing Conflict in Your Marriage Once and For All. Holbrook,

Massachusetts: Bob Adams Inc.

Wile, Daniel B. (1988).After the Honeymoon: How Conflict Can

Improve Your Relationship. New York: John Wiley & Sons.

Books and articles for professionals

Carter, Betty & McGoldrick, Monica (Eds.). (1988). The Changing

Family Life Cycle: A Framework For Family Therapy. New York:

Gardner Press. 2nd edition.

Guttmann, H. (1982). Transference and countertransference in

conjoint couple therapy: Therapeutic and theoretical implications.

Canadian Journal of Psychiatry, 27.2, 92-97.

Jacobson, N. S., Gurman, A. S. (Eds.). (1995). Clinical Handbook of

Couple Therapy, Second Edition. New York-London: Guilford Press.

Karpel, Mark A. (1994). Evaluating Couples: A Handbook for Practitioners.

New York: W. W. Norton.

Siegel, Judith. (1992). Repairing Intimacy: An Object Relations Approach

to Couple Therapy. Northvale, New Jersey: Jason Aronson.


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cOUPLE THERAPY

an

Info

rmation

Guid

e

A Pan American Health Organization /

World Health Organization Collaborating Centre

For information on other Centre for Addiction andMental Health resource materials or to place an order,please contact:

Marketing and Sales ServicesCentre for Addiction and Mental Health33 Russell StreetToronto, ON M5S 2S1Canada

Tel.: 1 800 661-1111 or 416 595-6059 in TorontoE-mail: [email protected]

Web site: www.camh.net

ISBN 0-88868-332-4

Documents

Couple Therapy - An Information Guide