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Describing my Work with Couples

Recently, a client in couple’s therapy, who was obviously struggling with our work, asked me about the purpose of therapy and how it works. I thought it was a good question, and, surprisingly, one that I had been asked directly only a handful of times in my many years of working with couples. With his wife also in the therapy session, the three of us discussed his questions, but it was a brief conversation and left me wanting to give a more complete response. That led me to begin thinking more about how I would describe what actually happens in couples therapy and how I would capture that in writing. Below is my attempt to do so.

I think of this as a draft that will continue to be re-written and updated through time. Having articulated these ideas, having put them on paper, lets me step back and consider them from a little distance.
It gives me the opportunity to edit and refine them as I think about my work, as my work changes through time, and as I continue to learn from clients about what is helpful and unhelpful to them. I welcome your feedback and questions, too.

What is the Purpose of Couple’s Therapy?

Although the purpose of couple’s therapy changes according the specifics of the clients’ situation and their goals, in general it is to help couples improve their marriage or relationship; to help them live together in ways that are more satisfying and meaningful, or just easier than what’s currently happening in their relationship. 


The exact nature of what a couple would find more satisfying, meaningful, or easier, depends on the couple, so I can’t say, except in general terms, what “improvement” looks like. But I do have as one of my primary goals, helping the couple describe what “improvement” looks like for them, so that we have a reasonably clear understanding of what we’re working toward. This also lets us check in along the way to see if we’re making the progress they desire.

How does Couples Therapy Work?

Therapy works or happens in a variety of ways depending, again, on the interests and abilities of the couple. In a very basic sense, couples therapy happens by talking and listening; by exploring, thinking, and feeling; and by the partners making changes in behavior, in ways of thinking, and in emotional responses. More specifically, the following processes or goals are components of nearly all the work I do with couples.

Understanding Concerns or Problems

I work with couples to try to develop a clear understanding of the concerns or problems they have about their marriage or relationship. For most couples, some of these concerns are shared by both parties, while some are seen as a problem by one person but not the other.

Through conversation we explore how these problems “show up” or what they “look like,” and try to understand their effects on the couple, as individuals and on their relationship. I try to get beyond the common labels we often use to describe problems in our relationships, to get a detailed understanding of how the couple actually experiences these problems or concerns and the impact they have on their lives.

Understanding Preferences

We work together to identify the couple's “preferences” for their relationship. How do they want their relationship or marriage to “be”? What do they want it to “look like”?

For example: How do they want to show or give affection? How do they want to make decisions or plan for the future? How do they want to divide up housework? Who should earn income, one or both? What principles do they want to guide their raising of children? How do they want to manage their finances? What are their preferences for religious or spiritual practices? How about friendships, in-laws, vacations, play, sex?

There are many aspects of a marriage or intimate relationship, and some matter a great deal to a given couple, while others matter little. My goal is to understand what is preferred by a particular couple, what their hopes and dreams and deepest desires are, and why those matter to them.

Listening and Acknowledging

Because problems, concerns and preferences can be difficult to talk about and can elicit strong emotions, it can be a real challenge just to listen to one’s partner talk about such things. And yet, it’s very difficult for couples to improve their relationship if they don’t feel “heard” and if they don’t believe their partner really “gets” or understands them.

So my work with couples often involves helping them develop their ability to listen to one another with interest, compassion, and empathy: to try to put themselves in one another’s “shoes,” and let themselves be affected (“moved” or “touched”) by the other’s concerns, fears, hopes and dreams.

Often such intentional listening leads one or both partners to want to acknowledge or “own up” to the effect they’ve had on the other. Such acknowledgment can be a powerful step toward creating a different atmosphere or spirit in the relationship, one that can open the door to more effective ways of being together as a couple. So we might spend time figuring out how one or both partners can provide meaningful acknowledgment to the other.

Developing Strategies

In light of the couple’s preferences and concerns, we work together to develop strategies to help their relationship become more like the relationship they want. This might involve a discussion to identify times when the relationship has “worked” better, to develop an understanding of how that was possible. It might involve identifying the skills that could be used to bring about more of those “preferred” qualities. And it might involve “borrowing” strategies and abilities that have worked in other areas of the couple’s life, and put them to work in the marriage or relationship (e.g. strategies from work or friendships, or from involvement in sports, the arts, clubs, or other organizations). 

The strategies usually have practical implications that the couple can put into practice outside the therapy setting, so they can add to their repertoire of ways to build their relationship.

Clients Working Outside of Therapy

The research is pretty clear that the biggest factor in therapeutic change is the effort made by clients outside the therapy session. So at the beginning of each session I try to check with couples to see what kinds of changes they’re making: what kinds of skills they’re developing, what new ideas or strategies they’ve come up with on their own, how they’re currently thinking about their relationship, and what’s working and not working for them. The developments and insights that come from clients’ efforts “on their own” then influence how we proceed in therapy.

Agreeing to End our Work or Take a Break

Ideally couples reach a point in their therapy work where they are pleased with their progress and are experiencing the kind of marriage or relationship they want. At that point they may decide they want to focus on other areas of the relationship in therapy, or they may decide to slow the frequency of therapy into more of a “check-in” or “maintenance” mode (meeting every few weeks), or they may decide that we’ve completed our work together.


In the decision to end therapy, I want to be guided by my clients’ thinking about what’s best for them. If they decide to end, then I hope I get to hear from them about what they’re “taking with them” from the therapy experience (e.g. the insights, skills, helpful perceptions, “stories,” goals, self-understandings, and strategies they plan to utilize in their marriage), so that I can learn from them about how I can improve my work as a therapist.

3 comments:

  1. Three questions: 1) In my experience, people tend to slide back into habits of mind, particularly when things are running a bit more smoothly. Do you see the effect of therapy, of the motivation of one or both partners, wane in time? Or do most people value the new-found (by hard work) peace and harmony, and therefore maintain the new habits? 2) What about when you work with only one of the people, when one partner is desperate enough or savvy enough or simply flexible enough to give the necessary time and effort and money for therapy, but the other isn't? 3) Do you work with gay couples, and if so, do the same principles apply? Are there other concerns specific to same-sex couples?

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  2. Hi Lauren,
    My response to question 1: In narrative terms, the problem story is usually well entrenched in people's ways of thinking, acting, etc., and it doesn't cease to exist just because we've named alternative and preferred stories and started to live out those stories. So I'd see "waning" as reflecting the challenge of keeping the preferred story present and available, and having it become more prominent in people's lives. I try to focus on how we can strengthen and enrich those preferred stories, which often means that we talk about how the old problem story gets in the way and what to do about it. That being said, I've been impressed through the years at the power of the preferred story to alter the course of a relationship so significantly that the old patterns fade considerably into the background.

    Response to question 2: I'm hearing this question as about one partner being in therapy, and the potential effects on the "couple" they are a part of. First, if I'm seeing someone alone and most of our conversation is about their marriage or partner, then I'm probably going to try to get the partner in, too. But if the partner doesn't, can't, or won't attend, then we're left to discuss and try to strengthen the one partner's preferred stories for themself and their relationship. Sometimes this results in an improved relationship, and sometimes not.

    Response to question 3: I've worked with only a few couples who identified themselves as gay or lesbian, so I don't want to claim any special knowledge here. Here's my perspective: In many respects, the narrative approach, with its focus on identifying and developing preferred stories, follows the same lines of exploration, deconstruction, and story development, regardless of the sexual identities (or the gender, racial, ethnic, socioeconomic or religious identities or backgrounds) of the clients. Yet, in one area of narrative work in particular, identifying the effects of dominant "discourses" on people's lives (discourses from a particular culture, family, community, etc.), the therapy discussion is likely to be quite different across these various identities. In this regard we know that same-sex couples are subjected to many discourses that can undermine their relationships and preferred stories, that heterosexual couples don't have to face. That is, gay and lesbian couples, as a group, have certainly experienced far more prejudice, discrimination, antagonism and suspicion than heterosexual couples, as a group. And we'd expect that such negative treatment has an effect on identity and relationships, and on the identification and living out of preferred stories.
    Thanks for the questions!
    Kurt

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  3. Hi,
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