Marital Therapy: Concepts and Skills for Effective Practice

 

The above entitled book is by Joe H. Brown and Carolyn S. Brown (Brooks/Cole: Pacific Grove, CA, 2002).  All the following quotes are from their book.

 

Even though you may not plan on being a marital therapist, the information in this book is helpful to you for both your personal life and for clients that you will be helping that have been, still are, or hope to be married.

 

Until we come up with a better substitute, marriage is the option the vast majority of us will spend a great part of our life involved in or thinking about.  Marriage is both the most overrated and potentially one of the most wonderful relationships that a human being engages in during their life.  However, as we all know, marriages frequently fall apart.  It is very rare for a marriage to fall apart due to financial problems---although this is often used as the cause when it really is a symptom of deeper problems.  Sometime people blame the in-laws; however, this also is a symptom of more profound complications in the marriage.   Marriages are most likely to fall apart due to ineffective communication between the spouses---which is usually the reason any relationship falls apart.  Naturally some people should have their marriages fall apart because they shouldn’t have gotten married in the first place.  However, that is far less common than some would have you think.  Most persons get married because they saw in one another a variety of things that were attractive.  Values held, physical appearance, sensuality, spiritual inclinations, earning potential, educational level---lots of things attract one to another.  Sometime, some how that attraction begins to fade in the vast majority of relationships.  When it does, the vast majority of couples can restore their attraction through developing more effective communication skills.

 

When you read the following statement by the authors, think about how these things did or did not apply to your parents.  Think about whether they apply to you right now if you are married/were married or if you think they will apply when you do get married.  You might also ask if the statement is valid for all cultures?  I for one know it is not valid for the Philippino culture.  How might you alter this statement to better reflect how you would like to live your life?

 

“The marital relationship evolves as the needs and resources of individual members change over the cycle of family life.  The first major task of the couple is for both spouses to function as a separate branch of the family system.  Spouses must establish different relationships with families of origins; their roles as sons and daughters must become secondary to those of husband and wife.  The birth of a child, or the decision not to have a child, requires spouses to reorganize to deal with new tasks.  These new tasks may trigger underlying conflicts and challenge early resolutions.  Couples who have been able to resolve conflict and have achieved a sense of intimacy without extreme cost to autonomy will be more likely to handle the challenges of midlife marriage and later life following retirement” (pp. vii-viii). 

 

“Marriage requires two individuals in a couple unit to renegotiate personal issues that they had previously defined individually, or that were defined by their parents.  That is, they now have to negotiate when to eat, sleep, have sex, fight; how to celebrate holidays; where and how to live, work, spend vacations, and so on.  Couples must renegotiate their relationships with parents, siblings, friends, and other relatives in view of the new marriage; this, to some degree, will affect all personal relationships.  Carter and McGoldrick (1989) state, ‘This places no small stress on the family to open itself to an outsider who is now an official member of its inner circle.  Frequently, no new member has been added for many years.  The challenge of this change can affect a family’s style profoundly; the tendency of members to polarize and see villains and victims under the stress of these changes can be very strong.’

 

“Every spouse enters marriage with a set of unspoken expectations, based largely on past experiences.  Through their families of origin, they have observed how their parents related to each other, and this is often the model on which their expectations are built---expectations for how spouses relate to each other, how they express affection, how they handle conflict, how they spend free time, how they handle money, and so on.  Expectations are further determined by gender and ethnic differences, and spouses often enter marriage with a set of assumptions of how the mate will behave based on these differences.  If the therapist is to work effectively with couples, he  or she must have an understanding of how the couple system functions (what the boundaries or rules are), what messages each spouse has brought from his or her family of origin, and what messages they bring to marriage related to their gender and ethnic backgrounds” (p. 4).

 

“Gottman (1999) refer s to a situation in which a couple differs on how emotions should be expressed as a meta-emotion mismatch, and indicates that a mismatch is typically related to gender stereotypes.  Women are more likely to want intimacy and believe that expressing feelings will lead to intimacy, while men are more likely to think expressing feelings is a waste of time, wanting to quickly solve the problem instead.  Such a mismatch leads to emotional withdrawal and precludes the positive affect that is necessary in an effective relationship.  In order to assess a couple’s expression of emotions, Gottman asks them to think about how they have responded to various emotions.  Here are some sample questions:

 

  1. When you were growing up, how did members of your family express anger?
  2. What kinds of things made you sad?  How did you deal with sadness?
  3. How did your parents show love to you when you were growing up?  How did you show love to them?
  4. How did you express happiness when growing up?  How did you know when other people were happy?

 

“Even if partners recognize and discuss the differences in their philosophies of expressing emotion it does not necessarily follow that either partner will change his or her way of dealing with feelings.  It will, however, help them develop a better understanding of why they respond as they do, and make minor changes that, in some cases, promote a more positive relationship” (pp. 7-8).

 

“Haley (1976) offers several suggestions to therapists for getting couples to follow their tasks or directives:

  1. Discuss all the things the couple has done to try to solve the problem. 
  2. Ask spouses to discuss the negative consequences if their problem is not handled now.
  3. Assign a task that is reasonable and easily accomplished.
  4. Assign a task to fit the ability and performance level of each spouse.
  5. Use your authority to get the couple to follow the directive/task.
  6. Give clear instructions” (pp. 38-39).

 

Solution-Focused Marital Therapy Model

 

  1. Focusing on the past is unnecessary.
  2. The focus is on solutions-not problems.
  3. The couple knows what needs to be done to solve the problem.
  4. It is more effective to build on strengths than on weaknesses.
  5. Clients who come asking for change do not resist change.
  6. A rapid resolution of problems is possible.
  7. Small changes lead to bigger changes.
  8. Understanding follows behavior change.
  9. Therapy is action focused---not feeling focused.  (pp. 64-66).

 

Taking the above nine points, describe a specific marital problem that you would want to work on with a solution-focused approach.  Then role play that problem with a friend or classmate.  Write up your rote play.

 

Focus on what works

 

“No matter how severe a couple’s problems may be when they enter therapy, they most likely have experienced some times that are peaceful, smooth, and even enjoyable.  When a person is in crisis, however, he or she is not likely to recall those times and may consider them oddities or unusually occurrences” (p. 67).

 

If the client says that their spouse NEVER does something, ask if there is ever an exception to this “never” situation.  You do this because:

 

  1. Exceptions shrink problems.
  2. Exceptions show that people can change.
  3. Exceptions supply solutions.
  4. The focus on exceptions empowers people. 

 

“In order for exceptions to exert positive change, a couple must know how to identify them.  Some questions that may be helpful in this regard include the following:

 

  1. What is different about times when your relationship is positive or free of conflict?
  2. Think about earlier years in your marriage when your relationship was satisfying.  What was going on them?
  3. How do your conflicts end?  (By determining what happens just before the partners call a truce, they can then make choices to cut fights short by meeting the needs of the partner.)
  4. If you cannot think of any exceptions, when is the problem less intense, less frequent, or shorter in duration?
  5. What is different about the times when the problem situation occurs, but something good comes out of it?
  6. What is different about the times the problem situation occurs, but you were not bothered by it?”  (pp. 67-68).

 

“The following points are helpful in identifying strengths:

 

  1. Emphasize positive statements that spouses report about each other.
  2. Encourage couples to describe their courtship.
  3. Ask each spouse to identify strengths and competencies I the other.
  4. Emphasize activities the couple enjoys.
  5. Attribute positive motives to negative behavior.  For example, ‘Your jealousy shows how much you care about him,’ or ‘Your anger may show you want more attention from him.’  (It should be noted, however, that it is important NOT to attribute positive motives to destructive behavior, such as emotional or physical abuse.)
  6. Emphasize positive interactions” (p. 117).

 

Common Conflicted Interactions

 

“Markman, Stanley, and Blumberg (1994) list four patterns of conflictual interactions that often lead to marital distress:

 

  1. Escalation.  Escalation occurs when arguments become out of control.  It is likely to occur when spouses try to ‘one-up’ each other through personal attacks and verbal abuse.  The spouse who is attacked attempts to defend himself or herself by attacking the other.
  2. Invalidation.  Invalidation occurs when one spouse puts down thoughts, feelings, and behaviors of the other spouse.  Such a pattern often reduces self-esteem and self-respect, leaving the other spouse feeling discounted.  Invalidation often leads to spouses withholding thoughts and feelings to protect themselves against put-downs.
  3. Withdrawal and Avoidance.  Withdrawal and avoidance occur when one spouse is unwilling to participate in an interaction.  A spouse may withdraw from a conversation by not talking, rolling his or her eyes, or by withdrawing more obviously by leaving the room.  Avoidance occurs when a spouse attempts to avoid a conversation. 
  4. Negative Interpretations.  Negative interpretations occur when a spouse believes that the beliefs and intentions of the other spouse are more negative than warranted.  This often occurs when there has been a history of negative interactions, and spouses begin to question each other’s motives.

 

“In each of these conflictual patterns, spouses feel unheard.  This often leads to disappointment, bitterness, and mistrust, thus blocking intimacy, which in turn leads to further conflict. Couples who are unable to resolve conflict often ‘fall out of love.’  One or both partners begin to distance themselves from the other and often seek the affections of a third party.  The result is often alternating cycles of intense arguing or distance that bring couples to treatment” (pp. 128-9).

 

Role play each of the four interactions noted above.

 

Marital Conflict Styles

 

“John Gottman (1994) in his book Why Marriages Succeed or Fail reports that based on twenty years of research with 2,179 couples, similar marital styles for dealing---or not dealing---with conflict predicts a healthy marriage.  Gottman found three styles of a healthy stable marriage:

 

  1. Conflict Avoider.  This is perhaps the most unexpectedly stable style of marriage.  These couples conspire to avoid discussion that will end in gridlock.  They, in effect, agree to disagree.  This style of marriage is characterized by two strong individuals with traditional beliefs.  Each spouse often takes the lead in a particular domain of the marriage.  Rather than try to resolve conflict, they focus on what is positive in the marriage.  They have strong support systems---religious, social, community, and recreational---outside the marriage.  The cost, however, for avoiding conflict is loss of intimacy.  When conflict does arise, both feel unskilled in resolving the problem.  This often leads to avoidance, isolation, loneliness, and a general uneasiness about the relationship.
  2. Volatile Marriage.  For some couples, volcanic arguments are just a small part of a loving marriage.  The energy and passion that they put into fighting often fuels their positive interactions more.  In these marriages, the couple expresses more anger, but at the same time, they balance it by sharing more affection.  These couples have no difficulty making up and moving on to resolve their differences.  The cost to the volatile couple is endless bickering and potential for violence when there is too much negativity.
  3. Validating Marriage.  Couples negotiate problems to their mutual satisfaction.  Each spouse hears the opinions of the other.  Even in the midst of disagreement, each still considers the other spouse’s opinions important.  With these types of couples, you often hear the use of ‘I see,’ or ‘I understand.’  This, however, does not mean that the spouses understand each other.  Instead, it means ‘I have a different view but I want to hear your view.’  The mutual respect shown by each tends to limit the number of disagreements.  These couples value ‘we’-ness, and unlike the conflict-avoiding couple, do not have a need to individual privacy.  Validating couples are often good friends who value communication, honesty, affection, and shared time.  In some cases individual pursuits may be sacrificed for friendship and togetherness.

 

“Successful marriages generally evolve into one of these styles.  In truly stable marriages both spouses use the same style, and only in unstable styles are there mismatches.  The mismatches may explain why it is that some people get divorced who have a lot of everything else going for them.

 

“There must be a balance between positive (mutual pleasure, humor, and support) and negative (criticism, anger, and disgust) interactions for the marriage to maintain a satisfactory relationship.  According to Gottman, satisfied couples maintain a five to one ratio of positive to negative interactions, regardless of their style for handling conflict.  Some conflict is necessary to keep the couple engaged. 

 

“Couples who are unable to resolve the way they manage conflict and who experience an absence of positive interactions often face a downward spiral of escalating conflict that often leads to separation or divorce.  Gottman (1994) has identified four behaviors that are characteristic of these marriages.

  1. Criticism.  Criticism occurs when spouses attack each other’s character, rather than a specific behavior.
  2. Contempt.  Contempt differs from criticism because it is designed to emotionally abuse the partner.
  3. Defensiveness.  Defensiveness occurs when both partners blame each other and fail to take ownership of the problem.
  4. Stonewalling.  Stonewalling often occurs when one or both spouses remove themselves from the conversation, either emotionally or physically.” (pp. 130-132).

 

Although shoving all couples into one of the above three categories is rather simplistic and should be avoided, you should be aware of the three categories as many people do fall into one or the other or are dealing with mismatches.  By having a couple see that this is what is going on in their marriage can be very helpful.