COUPLES COUNSELING FOR ONE- A NEW 21ST CENTURY MODALITY?

Early in March Elizabeth Bernstein reported in the Wall Street Journal on a study that followed 300 long-term heterosexual couples for five years.   All couples received relationship skills training- a.k.a., behaviorally based, here-and-now couples counseling-  but some received it ‘solo’ – in other words, only one partner, usually the woman, got counseling.  Both groups experienced improvement in their relationship.  Those couples where only one partner attended sessions did just as well as those where both were present, but what was most telling is that the happiest couples were the ones where women got the training without their male mates.   The lead researcher noted that women learned relationship skills more easily and were better at teaching their partners.

I’ve been thinking about this article for the past few days because it opens up a whole new modality of therapy: solo couples counseling.  Anyone who does relationship counseling knows that heterosexual males are not big consumers of therapy in general and in particular go to marriage counseling kicking and screaming only at the behest of their girlfriends or wives.  To make matters worse, the majority of therapists are women.  And, not to lean on stereotypes TOO much, but – many guys just aren’t wired for much of an interior, introspective life.  It’s not just that they ‘aren’t in touch with their feelings,’ it’s more like they less frequently look inward to examine their own thoughts, feelings, and behavior patterns.

I don’t think that’s a bad thing, but it is a disadvantage in today’s world of companionate marriage, where men are expected to ‘work on’ relationships and not just ‘do’ them.  And it’s really hard to sustain a long-term relationship when partner satisfaction is based on intimacy and togetherness, instead of financial dependency and child-rearing.  Most people can use help, and the CBT-based approaches that emphasize improved communication, negotiation skills, and methods to enhance intimacy are really helpful.   Really, if you think of this kind of counseling as ‘coaching,’ it’s a pragmatic choice to get some help as soon as your relationship gets a little bit shaky.  But that’s not what people do.  The reason relationship counseling is so difficult and fails so often is:  1) couples wait too long to come – an average of seven years after the problems emerge! And 2) possibly related to 1), men hate it.

And it’s also true that women tend to be more skilled at close interpersonal relationships- it’s our raison d’etre.  So if the husband hates therapy, and his wife is good at it-  why not let her learn and teach him in the privacy of their home, where he feels less threatened?

It does sound good on paper but I can foresee a few problems.  First, some couples are just too far gone for this to work – their hostility towards each other precludes anyone learning from their partner.  Second, the partner that doesn’t come – which usually will be the guy – has to at least be committed to changing the relationship, and he has to be willing to be taught.

And it also would help A LOT for him to come to one or two sessions, not for ‘interventions’ by the therapist but simply to give the counselor information, his perspective, and insight into the dynamics between the two partners.

One other thing is tricky:  the partner that attends therapy has to understand that ‘solo’ couples counseling is different from individual therapy.  In individual therapy, the client usually has a warm fuzzy relationship with her shrink.  If the client talks about her marriage, she may complain about her husband, but the goal of treatment is probably not to ‘fix’ the relationship, but rather give the client a safe place to talk about her life and gain self-understanding.  In fact, I’ve gotten into trouble sometimes in individual therapy when I get the notion that I need to help a client by expressing what I think might be her husband’s point of view. I’ve broken the contract.  I am supposed to be HER advocate, and hers alone, and it feels to her like I just took her husband’s ‘side.’

But in ‘solo’ couples counseling the therapeutic contract is different.  For it to work, right from the beginning, there would need to be an understanding that I as the therapist would NOT bond primarily with the partner attending sessions.  I think that might be difficult for me and for many therapists, not to mention the client.

But it’s worth trying.  If you really want to save relationships, intervention should come when problems are starting, not when things are so bad that partners feel like each others’ enemy.   And if both partners want change but only one is willing to come to therapy – well, let’s tailor our treatment for that.  Let’s learn to do solo couples counseling.

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