Sunday, August 28, 2011

Couples Therapy 3

In Couples Therapy the therapist helps identify recurring negative patterns in conflict.  Bianca Jenks described a number of these in her books.
One she called the 'ambush'.  This was when a partner picked a time to discuss something important and insisted that if the other really cared they would discuss it then.  Typical times for 'ambush' were when one person came into the room, when one was leaving or when one was tired.  Children learn to recognise that daddy or mommy 'gives in' when they are tired or hungry or don't have time.  In the 'dirty play' of 'ambush' one partner 'wins' but at the cost of 'resentment' and by 'dirty tricks'.  To this end both identify these typical 'ambush' times and agree to 'respect' each other in this regard.
For example, no major questions or discussion starters in the hour of meeting or departure or before bed.  Others have agreed that potential dispute topics are not to be discussed at the dinner table.  Each couple has it's own unique circumstances but the 'ambush' can be identified by each and like 'nuclear disarmament' each agrees not to 'do that again.
When adolescents are most difficult the first and simplest solution is to first establish 'house rules'.  Group homes specializing in violent and difficult kids post these rules with great success. They're used in asylums and even hotel rooms have succinct lists of 'acceptable behaviour'.
It's another great strategy for a couple to make a list together of what are 'unnaceptable behaviours'.   This is not an attempt to rewrite the law books but rather to establish the '10 commandments' for the home or 10 commandments for communication.
Time out - is a strategy used in any sport. Each team can call a time out. The number of time outs is limitted however since often in couples one person, often the offender, doesn't wish to have a discussion about the 'offensive behaviour'.  To this end it was suggested that when a person call a 'time out' which is like a 'cease fire', they also agree to a time to have a 15 to 30 minute further discussion about the subject when heads are cooler or the subject can be addressed at a mutually aggreeable time. This is usually within 24 hours.  To this end, who takes out the garbage this month becomes what time will we discuss who takes out the garbage this month.  However it doesn't become  'lets not talk about it'.  or "I don't want to talk about it'.  The subject is addressed but not at this time which might well represent an 'ambush'.
"Tit for tat" describes the central mechanism of business "change".  Transactional Analysis was one of the most powerful descriptors and process for helping relationships change. For transaction to occur it was simply understood that most people want to know  "What's in it for me?"  If I want you to stop calling me names then I exchange my making fun of your invalid mother in law with the children's water pistol. Any number of situations call for 'tit for tat'. This came up because quite commonly in relationships one person wants the other to 'change' but doesn't see that in relationship change requires both.  So if I am giving up golfing this weekend what are you willing to give up in your schedule to make my giving up golfing worthwhile to me.  Not uncommonly people will each ask the other to make a change for "the family" , the "children' , "ask not what the country will do for you but what you will do for the country', without noting that couples are usually a democracy and no individual necessarily made the other 'king' or 'queen' and neither has the 'moral high ground' genetically.  In raising children, mother don't know how to father and fathers don't know how to mother. It's true for so many other aspects of a relationships but arrogance by one or the other is common.  It comes out with statements like 'for this relationship to work you have to die, suck a rock, get rid of your friends, stick your head in the toilet, whatever. " However, no one appointed this person as 'objective' so really all anyone in a relationship can say is an 'I" statement which doesn't come out as a divine pronouncement but rather "I don't want you to call me names or threaten me anymore. Otherwise I can't be around you because I find you too dangerous to associate with. I am frightened when you call me names."
Not surprisingly when aberrant adolescent behaviour was adressed with cash rewards the dangerous little offenders rapidly did things that they'd never done before but other children did as 'normal'.  This raised the issue of which behaviours are agreed as 'community' 'norms' versus which behaviours are 'special'.  I don't want to have to pay my partner to flush the toilet and vice versa she/he shouldn't have to pay me not to pee on her/his side of the bed.  Yet this is the level that couples disputes descend to in the 'adolescent development' phase of relationships.
Today there are even catch phrases like 'emotional abuse' that have no real meaning and no agreement in any dictionary known to the world but can be used for all occasions whenever one person wishes to be one down and play the victim. Playing the victim is what is commonly done if there is hope for an audience (children, girlfriends, boyfriends, judges, socialworkers, judges, the dog or cat or goldfish) rather than acknowledging that couples are 'volunteer' arrangements even if at times they seem like a stint in the military or incarceration in a penal facility or asylum. My dog 'emotionally abuses" me but my cat 'emotionally abuses' me even more.
Some couples theorists have likened the development of the relationship to that of an individual roughly using Erik Ericksonian concepts for each phase of relationship development.  Baby relationships are all googoo, gaga with lots of physicality and focus on orifices and such.  Then come the terrible twos with whether to have the toilet seat up or down. Then the adolescent phase with it's 'I need my own space'. and "I can't be me with you" ad nausum.
Mature relationships aren't without their own unique issues and major trauma for a couple can fling them back into earlier stages of development just as fully grown adults will start sucking their thumbs when they see that multi billionaire bankers have squandered their total stock portfolio on cocaine and hookers causing them at 75 years of age to have to return to working when they had thought they could be at the bedside of their dying spouse instead.  No one is immune from regression. Even Jesus said, "My God why hast thou forsaken me."
Couples relationships grow stronger and deeper through facing crisis and working them through no different from military platoons that suddenly function efficiently after they have seen fire and each member has found they can rely on their fellow or shot the silly officer who thought it particularly good if the unit ran across a mine field so she could get a promotion.
Name calling is a particularly onerous behaviour.
Defensiveness is a further distraction. It's up there with the false accusations that 'shelter dogs' demonstrate. You go to pet them and they cower back like you're about to hit them. It has nothing to do with you but is a carrying over from that dog's childhood, their former owner or their institutionalized experience.  Commonly, especially today, where there is a lot of baggage as couples bring not only their family of origin with them but their failed relationships including all the abuse they took and all the dirt they slung.
Couples commonly are working through old relationships in the new relationship in addition to addressing the well worn old issues of picking one's same sex parent psychologically.  Smart couples therapists ask interesting questions like 'do you remember your parents ever doing such a thing" (eg. killing small animals in front of you).  Was this something you noticed other women didn't like about you (eg sleeping with their brothers, mother, sisters, fathers). Did other men complain that you wouldn't have sex with them after you'd been going out for decades and expecting them to pay for everything or is 85 yo John here the first bloke to ask about your virginity?
The "Rebound" relationship is not just where a person is 'opposite' the last one but where a person can be described as 'alike' or 'different' from the previous person. Probably the previous person was 90% okay for a link but the 10 % not okay caused the 'graft' to fail. That's what's seen with immunity issues and couples early break ups are more like 'transplant' reactions than they might care to realize.  The trouble with the 'rebound' is that a person who really would do well with a 'strawberry blond' picks a 'sandy blond' then rejects blonds for redheads only.  I know the example is simplistic but it's more understandble than trying to explain why "middle children' have been compared to "O" blood.
It was recognised early that some people do well in relationships and some don't which doesn't mean that some should be and some shouldn't be in relationship. It just may mean that poodles are easier to house train than pitbulls, regardless of gender.
Defensiveness is it's own 'accusation'.  I remember a head nurse pointing out to me how a mother was afraid to let any one hold her baby but herself. She said "There's one sick child in the making'.  The mother was paranoid though she held a great job and was married to a very fine man.  She was 'projecting' her own emotions onto others.  This kind of 'psychosis' is really common in relationsips especially when relationships go further than theyve ever been before. It's kind of like Star Trek, where we go where no one has gone before and find out that in our own idea about the unknown we've watched alot of Steven King and expect Carrie, Invasion of the Body Snatchers and Night of the Zombie.  It's not going to be William Hurt transforming into the light and energy in love if one or the other is basically 'afraid' and hasn't addressed their deep insecurities.
Controlling is a means whereby out of control people try to stay in control. It's why mutiny is common at sea when the least competent person won't address their fear but suddenly think they should be the captain.  It's why military have had to impose strict hierarchy because when there are external threats people normally become hysterical and psychotic.  The family drama is often likened to a pressure cooker or a blender, or any number of other kitchen utensil.
The therapist doesn't 'judge'. The last thing the therapist should do is  decide "I don't think these people should be togehter."  That is incredible arrogance but unfortunately it is extremely common.  "You know I don't think Mexico should be beside the United States. It would be better if France wasn't situated beside Germany. " Obviously the smart French would leave Europe along with the smart Germans and move to Indonesia.  It's not surprising that migration is notorious for being merely a 'geographic' solution that fails to address the fact that 'when you move, you take yourself with you'.  People are attracted by complementarity. Good men don't pick bad women or vice versa. The blind man finds the deaf woman and that's what makes them compatible.  The weaknesses not necessarily the strengths  are the glue of physics and human relationships.
A couples therapist in this regard, if trained is like a diplomat.  Obviously mainly relationships on first look would be improved with a neutron bomb but the couple's therapist like the trauma surgeon looks to see what can be saved and that to use the obstetrical analogy doesn't include first killing the mother so she doesn't have children any more.
A couple's therapist is there to assist the couple in finding new ways of reclaiming the spark and flame that brought the couple together. To this end it is a common 'structural and strategic' couples therapy recommendation to tell the couple to plan a 'date night'.  Indeed the planning of the date night might well include the therapist (lonely therapists don't go on date nights either) though not uncommonly the therapist is there to discuss why the date night was a disaster in the session following the first date night before the reasons for the date night failure are addressed and the second more likely to succeed date night is established.
Young couples with young family commonly are just 'tired' and 'overworked'. It takes a 'village' to raise a child.  When the debate about 'daycare' funding was going on and day cares were funded, it's long forgotten that the alternative resolution shafted by those who wanted day cares and women working was that mother's should be paid a full time salary , roughly $40,000 (one of the figures) for being at home with their children if they so wanted. The state was challenged to put it's money where its mouth was regarding mother hood and women's rights but instead introduced a further medium for state control and propaganda.  Women got the "choice' to work out of the home.
So many of the young couples with young children are simply exhausted and want to break up and can't get along because both are worked inordinate hours to pay for day care and high costs of children (minimum estimate, a child costs $10,000 to raise in Canada a year at least - consider people routinely spend thousands on their designer pets ) . When the context of the relationship is 'understood' and this often takes each person having a chance to tell how they spend their day to each other and the therapist, it's often the therapists task to help the couple find help for them raising the kids, supporting them getting parents to baby sit or friends with children to form a cooperative baby sitting endeavour so they can get a night off for a 'date'.  or just some sleep.
There's nothing wrong with the couple in these situations and many like them. It's society as a whole that sucks.  Often a couple comes in blaming each other and themselves and the principle first job of the therapist is to celebrate that they're actually making an effort at being more than superficial shallow narcisisstic hedonists like so many of todays 'players'.  Good time charlies abound. Few have the depth and character of the men and women who were revered for generations. Today's Hollywood would have us believe a 20 year old porn star is equivalent to Moses, Lincoln, JFK, Lester Pearson, Gandhi, or Diefenbaker.
I think Mrs. Bush is amazing.  Like Sarah Pailin she is pilloried yet both are mothers, daughters and have been great citizens like Hillary Clinton is too.  Queen Elizabeth is one of my all time favourite ladies but we hear little about these greats because there's more dirt in the stories of the muck ups.  What examples are we putting forward for young people.  I would love to read a parenting book by Bush and Queen Elizabeth. I still love Mrs. Roosevelt's writings on relationships.
I've asked couples who were their 'examples'.  It's often taken for granted that couples are together for 'idealistic' reasons. Often they just want to get laid.  Men and women will join the military for shoes or uniforms only to become great heroes. The lowest level of committment can lead to the strongest relationship. The question is what are your "ideals'. What examples would you like to follow.  I think this is a basic question. What do you want from your relationship now and forward.  Yet rarely have couples been asked this question before they have come to see me. Indeed they have often had counsellors who want them to re fight and re fight their disagreements but never look first at what they 'agree on'.  Often couples today don't have examples of successful relationships they can learn from. Yet if they do it's good to talk about this and it's good to identify what it is they want so the therapist can help them to achieve this idea of 'the couple'.
One of the basic 'homework' of couples therapy is to ask each to make a list of 10 things they like about the other without showing the other the list. This is usually a way of seeing who lacks boundaries too. As one person will weedle the other or sneak a peek or any of these things giving further grist for the therapy mill. However asking them what's wrong with the other is a common mistake and marriage breaker used by junior uneducated inexperienced therapists.  I can always tell you what's wrong with my partner when things are going wrong. I can tell you what's wrong with my dog when things aren't going my way.  The question that I need to be asked is 'what's right with the relationship'.  I might not see it now so I have to be asked what was right with it in the beginning.
Further I sometimes have to be 'accused' of 'buying the car' in the first place and acknowledge that I was stupid about buying this car and likely will make a similiar stupid mistake and someone who buys my car will probably think it's an amazing car that will run for 200,000 miles when they just add a pint of oil.  People commonly try to distance themselves from things they've broken including relationships.  The things broken down. It doesn't take a genius to tell you why you don't want it broken down. Couples come into therapists when the relationship is struggling. It's important to get a really clear idea why they were attracted to each other in the first place. It's usually not obvious to any therapist even the most experienced, educated and knowledgeable.
I personally don't even know why my parents were together and they were together for over 50 years and I can't doubt their relationship was a good enough one or I'd have to doubt my very existence.
Hence when people said "I should never have married" and they have kids, I commonly say, "how should we kill the kids?" since your relationship was a mistake they're probably become  mutants and their wrongedness will likely show up to the horror of the universe some time in the future.  Generally this gets a couple to realize they must have had something to produce their children even if as a therapist you might think the children are as ugly as the parents.  What it does do however is to get to the root of what was attractive about each other.  Commonly too what is attractive about a person will later be the thing that is no longer attractive about the person and this needs to be identified.  When that's 'shown' it's often an 'aha' moment and people have insight into their relationships seeing that it's not just his or her 'fault'.
Often couples therapy is done by couples who have been together longer.  If a couple is seeing a couple they can actually look at each other and ask each other if they didn't have a 'similiar' disagreement and then tell the couple how they resolved their 'similiar' disagreement.  Self disclosure is a normal part of couples therapy. The taboo against 'self disclosure'  was developed originally as part of the Freudian experimental model in which the 'analyst' was establishing a kind of sensory deprivation experience with the person 'free associating' and the therapist responding to the patients "projections', the therapist being wholly unknown and hence a blank screen, or tabula rosa.  It's application outside of that realm has been as flawed as therapists who 'teach' like the cognitive therapist today who tells individuals and couples how to think and feel in the most pedantic and parental way without any thought about how offensive and belittling this might be.  Judicious and selective and moderate are words to remember considering all therapy.  
But couples therapists, as a couple,  have the opportunity to 'model' and not uncommonly couples who are long related or themselves in long term relationships with others have had extreme advantage over couple therapists who are individuals themselves, utter failures at relationships or don't even get into relationships coming from broken homes and believe couples should be lined up against the wall judging from their shoddy workmanship.

Couples are wise to ask a therapist , 1) What is your longest sexual relationship.  2) Are you presently in a relationship 3) Do you believe in relationships 4) Did your parents separate or divorce?  4) How many successful couples therapy have you done where the couples remained together?  5) How many unsuccessfull cases have you had?  6) Or simply, even, How many cases have you treated and what is the average number of sessions you have seen couples for?
Normally therapists would say that's none of your business. It was also considered nobody's business to ask a surgeon how many cases of a procedure he had done and how people lived. It's now routine for surgeons to offer this kind of information on request and many surgeons advertise 'their rates' of success.
The "Love Lab" is one of the leading couples therapy models today and they are happy to advertise their 'statistics'.  Jay Haley, a leading marriage therapist was happy to say he was married.
Dr. Paul O who was married to Max what seemed like their entire lives were extremely funny sharing stories of their relationship in therapy helping others to laugh at the challenges that face couples.
The point is there are many examples of self disclosure in the field of couple therapy.  It was seriously frowned upon in psychoanalysis, though people are often happy to overlook that Freud saw people in his home and that patients often smelt his wife's cooking.  Couples therapy hasn't established the 'rigidity' of 'orthodoxy' but there are guidelines.  Individual therapists doing couples therapy would be wise to not talk about their 'present' relationship or discuss the negatives in their 'relationship' since it's so easy to 'dissociate' under these conditions and it's not particularly helpful for the couple to watch a therapist breakdown sobbing remembering their one relationship with a house plant or to hear their best sexual experience was masturbation.
Unfortunately common sense is usually  uncommon.


tbrumm said...

Marie Claire magazine is looking for women who are in couples therapy with their boyfriends (no kids, not engaged, not living in NYC) and are interested in being part of a story about the rise in couples therapy among unmarried couples. Please let me know if you know anyone who might be interested.


haykind said...

My woman friend loves Marie Claire so I do hope you find people for your article. The churches have been doing a lot of great work with 'marriage enhancement' workshops. I thinks there's a real place for couples with long standing relationships and training helping couples along the journey. I think the Gottman Institute is doing some fine work in laying the ground work for the kinds of things that work better. I regrettably didn't have the kind of knowledge I have today when I was married and believe that if my partner and I had better training before marriage we wouldn't have crashed that 'vehicle' of relationship or burnt down that 'house of relationship or stumbled so badly on the journey of life that we needed helicopter rescue on the side of the precipous. Good for Marie Claire!