Couples counseling and marriage counseling are terms used to describe conjoint therapy. Couples therapy generally describes a couple in a relationship and marriage counseling describes individuals who are in a legally committed relationship. Reasons for seeking couples therapy are varied, but common themes include premarital counseling; recurring personal issues experienced in previous relationships; a persistent argument with no resolution; unhappiness about sex; life transitions; arguments involving money/time/parenting/recreation; repairing an issue before it worsens; and physical/mental health issues impacting the relationship.
Like family therapy, couples therapy is complex. It is valuable to acknowledge that couples do many things together to solve problems and are resourceful in their pursuit. The benefits from outside support in couples therapy include information gained in therapy and time to discuss issues. These combined with personal study can go far to create lasting change, which is why I encourage self-study outside of therapy sessions.
Books I often recommend include:
The Seven Principals for Making Marriage Work
Getting The Love You Want
Passionate Marriage
Waking The Tiger
I have more than one therapeutic approach in couples counseling. Gottman Method Relationship Therapy is a resource I use that revolves around a detailed assessment of the couple’s perspectives about their relationship. I take time to observe the couple in problem-solving conversations and as they share historical information about themselves in order to understand the ways they discuss and interact with one another around issues. Systemic family therapy (SFT) explores interactional patterns and interventions that have contributed to maintaining problems, not solving them, as well as the impacts from outside influences or people as contributing factors to ongoing conflict.
Ongoing assessment is essential to help couples identify the things that contribute to conflict. Individual family-of-origin beliefs, and how those cultural beliefs are impacting the couple, can be invaluable in understanding the reasons for feeling reactive with one another. Identifying life dreams that undergird conflict can bring about increased empathy and lead to a desire to help one another. Negative and repeating patterns of behavior, unmet needs, affairs, useful or destructive styles of communication, attachment styles, emotional themes, and understanding the role of childhood injuries in relationships are all examples of issues couples deal with in the life of their relationship.
In therapy, curiosity about each other and receptivity to new solutions can bring about effective new interactional patterns.
When substance abuse plays a role in a relationship breakdown, attention is first focused on helping the partner to stop using alcohol or drugs. If a partner continues to misuse substances while in couples counseling, attention is given to the addictive pattern until the partner has determined the right path to getting help. My role is to support the couple and, if desired, provide alcohol and drug treatment resources to the partner struggling with addiction.
I advocate continuing individual mental health counseling during the time a partner is in treatment so that both are working on a recovery process to prepare for subsequent couples work. Avoiding blame, building empathy through deep listening and reflecting, and learning ways to manage distress all combine to bring about loving and compassionate feelings toward one another, and reduce isolation and despair. This leads to celebrating alcohol and drug addiction recovery gains and improved mental health made in treatment and counseling.
The long term nature of mental health problems often necessitates additional support for a couple. Attention is given to the cycle and nature of the moods and mental processes that contribute to the difficulties experienced in their relationship. An assessment of each individual is helpful to rule out a diagnosis that would benefit from adjunct therapeutic support such as with Naturopathy, psychiatry or formal mental health treatment.