can individual therapy harm a marriage
When Monica declined this invitation, Rob bolted from the house and was found the next day wandering around aimlessly in a nearby woods. Most couples end up with mainly couples treatment, plus occasional individual therapy sessions on an as-needed basis. Indeed, Rob had never been able to cope with her diagnosis, or with his own job loss six months afterwards. She focused on Paul's ambivalence about the Christian faith, his avoidance of personal topics of communication, and his tendency to criticize her when she expressed her worries and fears. Thank you for your good work. The fifth plank concerns the importance of education for marriage and early intervention to prevent serious marital problems. He too was committed to his marriage, and he needed his wife immensely. And the health care system should support this kind of treatment as an essential part of health care, instead of regarding marital therapy as an "uncovered benefit.". There has been some great new research on that subject. Marquez says that all people have public lives, private lives, and secret lives. That's very appropriate, in my thinking, for cases where the abuser has a serious anger problem and would endanger the spouse if he was upset by something that was said in a couples therapy session. My heart goes out to you. ", Marsha: "Are you saying I should get a divorce? There is no inherent contradiction between emphasizing the moral nature of marital commitment and promoting the value of personal satisfaction and autonomy within the marital relationship. Observing each spouse "in action" is essential in my view. In family systems terminology, the therapist needs to meet with various sub-systems as well as to work with the whole couple or family system. Yes, most people can benefit from the right kind of therapy at the right time in their lives. Most marital therapists, when giving professional presentations, use the term "couples therapy" or "couples counseling." Interestingly, marriage counseling as a professional activity developed independently of "family therapy," which grew out of psychiatry's experiments with family treatment for mental health disorders. Rather than lower the bar for marital commitment by abandoning the term "marriage," why not expand the definition of marriage to include gay and lesbian couples who wish to make a permanent, moral commitment to each other? There is nothing neutral about asking a newly married, depressed woman "Are you happy in your marriage?" First, the couple saw a counselor who was not well-trained in marital therapy. They found my name on the internet. The sixth plank asserts that therapists should help spouses hold each other accountable for treating their spouse in a fair and caring way in the marriage. When he gets turfed off to another therapist to do his "individual" work, he balks, thereby confirming to his wife and her therapist that he is unwilling to work on his own "issues" and thereby do his part to save the marriage. Marsha was even more stunned than she had been by the therapist. Only therapists willing to keep the secrets of the individual spouses in couples therapy will get a true window into the crucial secret lives of the individuals in that couple. I was trained in the 1970s to dismiss clients' spontaneous moral language ("I don't know if a divorce would be fair to the children") by telling them that if parents take care of themselves, the children will do fine. and urging her to trust her frightened and confused feelings. National political leaders make no apologies for having benefited from marriage (and family) therapy. My own work has offered a communitarian critique of the individualist ethic of psychotherapy in the United States. This kind of appalling therapist behavior occurs every day in clinical practice. At the time I had no idea what we were dealing with... and neither did the counselor. Here are the reasons you may need marriage therapy. Why are so many people drawn to conspiracy theories in times of crisis? By the time we met again the next week to launch the couple treatment, Bert had already determined that he would never again speak angrily to his wife. exit any situation he might not be able to handle calmly, Secret lives not revealed in couples meetings, Accessing the secret life of both spouses is essential, most couples therapist have a no secrets policy. She sought out recommendations to find the best psychotherapist available in her city. At the same time, certain problems may not be able to be addressed unless both partners participate. And equally fortunately, she and Rob found a good marital therapist who saw them through their crisis and onward to a recovered and ultimately healthier marriage. Two aspects of Marsha and Paul's case stand out. No self-respecting therapist would urge a suicidal patient to "trust your feelings about how worthless you life is," but many well-regarded therapists play cheerleader for a divorce even when the couple has not yet made a serious effort to understand their problems and restore the health of their marriage. I also schedule sessions for individual work if I have any hint that there is a major secret life, if either spouses requests it, or if individual issues seem to need attention in addition to the couples work. Even if we use the term "committed couple" or "committed relationship," we beg the question of how deep and permanent the commitment. Most couples therapists out there have a "no secrets" policy. Power of Two Marriage, which teaches skills for marriage success. To assess the couple, I first worked with them together in an initial intake session. In general, treatment effects of warfarin therapy for individual patients can be divided into four quadrants: 1) benefit without harm; 2) harm without benefit; 3) neither benefit or harm; and 4) both benefit and harm simultaneously (Table 1). Sometimes, however, it's some other issue that would have been unhelpful for the spouse to hear. G.G. Sexual Problems Are Often Solvable Without Therapy, Four Characteristics of Effective Conversations. That is, the therapist will not communicate to the other spouse anything that one spouse has shared in the privacy of individual work with the therapist. Like most psychotherapists, she viewed only the individual as her client. Requiring them to come to therapy with that spouse ruins that experience from the get-go. Many spouses who have had once or twice physical violence but overall are reasonably emotionally stable however seem to benefit from getting into couples work asap. First and foremost, be sure to find out from your wife and/or the counselor what they feel they need to protect her from in your behavior. I do not believe all individual therapy is harmful for a marriage. No doubt the therapist also viewed herself as "neutral" on the issue of marital commitment. Marsha sought help at the university student counseling center where she and Paul were graduate students. Couples Therapy: 15 Essentials That the Best Therapists Do, 3 Sides of an Affair: Infidelity in Dramas and in Real Life, 4 Steps to Solving Your Core Relationship Problem. During the 1950s and early 1960s, "conjoint" marriage counseling became more widespread as therapists began to appreciate the power of working on relationship patterns directly in the session. Amazingly, although we tend to think of relationship satisfaction as strongly related to sexual satisfaction, once the woman’s attraction ratings were entered into the equation, relationship satisfaction no longer played a role. Find a marriage counselor experienced in affair recovery. In any case, I do appreciate your support for my somewhat outlier position amongst psychologists. Research and professional literature on marital therapy burgeoned during the 1970s during the era of skyrocketing divorce rates. Even happily married couples can hit obstacles along the way. To his credit, while Bert's first impulse was to seek an immediate divorce, after calming down enough to think over the situation, he relented and requested instead that they seek marital counseling. Some studies have suggested that when a therapist treats a married client in individual therapy, the odds go up that the marriage will end up in divorce. At the same time, you have a family to preserve. Particularly in the presence of minor children, the decision to divorce would be akin to amputating a limb: to be avoided if at all possible by sustained, alternative treatments, but pursued if necessary to save the person's life. Interestingly, couple and family therapy is quite commonly practised by therapists with little or no specific training. Another option is to find a trusted third party who can help you and your wife discuss what is happening. Or how about that spouse who is uncertain about staying in the marriage or leaving, but does not want to wreck it right out of the chute by involving her or his spouse? For a therapist to get a broad enough database to diagnose and treat effectively, it's my view that the individual therapy client's spouse is best off being part of the treatment and intervention processes. My spouse ended up re-traumatized and has easily manipulated the counselor who has ended up angry at me - though we've spoken only once in a clinical setting. They stem from a pervasive bias among many individually-oriented therapists against sustaining marital commitment in the face of a now-toxic relationship. The priest urged her to wait to see if her depression was causing the marital problem or if the marital problem was causing the depression--a prudent bit of advice. Marriage therapy or individual therapy or both: 5 tips to knowing which will be most helpful to you. Susan Heitler, Ph.D., is the author of many books, including From Conflict to Resolution and The Power of Two. But the dark secret in the mental health world is that therapy can cause harm. After the Infidelity: Can Counseling Help? Nothing could be further from the truth. I have no doubt that the profession of marriage and family therapy (now credentialed in 37 states an independent mental health profession) would take a different name if it were being created in the late 1990s. When things get difficult, couples can either do the best they can to reconnect on their own and try to work through their issues themselves, or they can seek the guidance of a trained and experienced marriage counselor . Therapists with a narrow treatment approach will generally fail to be of any assistance to people who suffer from such conditions. A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. Thank you for bringing this ambiguity to my attention so I could fix it. ", I'll think about that topic. Although he claimed during his hospitalization that he wanted a divorce, his therapist had the good sense to urge him to not make any major decisions until he was feeling better. If the spouse still won't join us, I offer to phone the spouse myself, which often proves effective. But sadly, as per the aphorism “if all you have is a hammer, then everything looks like a nail”, some therapists reject any possibility they might be providing totally inappropriate treatment. She resisted, pointing out that this was a long term marriage with young children, and that she was hoping that the real Rob would re-emerge from his mid-life crisis. And then I would move the conversation back to the safer ground of self-interest. I say it's my policy. Their teenagers, it turned out, had been reacting to their mother's tendency to get overly controlling with them. She suspected that the affair with her friend would be short-lived (which it was). Paul, who was frustrated and angry about how distant and fretful Marsha had become, was a reluctant participantin the counseling. She had no responsibilities beyond promoting this individual's immediate needs and agenda, no obligations to other stakeholders in the client's life. There was little recognition of spouse abuse and the ways in which a stable but destructive marriage can undermine spouses' emotional health and create domestic hell for children. My daughter and her boyfriend were a "couple" during their summer after high school, but the relationship did not survive their going to different colleges. The marriage is often doomed at this point, an iatrogenic effect of poor marital therapy. Therapy provides potent tools of communication and dialogue. Changes in one person can have an impact on the whole relationship and help improve things all around. An individual therapist can very subtly lead you to divorce, or help you be firmer in your resolve to divorce, even if you've only been pondering it as a choice. A decision about divorce became just like any other lifestyle decision such as changing jobs; the therapist's job is not to influence the outcome of the decision but to help people sort out their needs and priorities. Fortunately, Monica had the strength to fire the therapist. For some time therapists have expressed concern that individual therapy with a married individual may inadvertently harm the spouse and/or the marriage. The second plank affirms that personal health and psychological well-being are indeed central dimensions of marriage and important goals of therapy. This was first seen in Michele Weiner-Davis' early 1990s work on solution-oriented therapy for highly distressed couples. If a member of the couple wants to keep a secret with the therapist, the therapist insists that it be shared or the therapy is terminated. This does not mean that every therapist that practices individual therapy in troubled marriages will make bad decisions. In the term coined by Barbara Dafoe Whitehead in her book The Divorce Culture, therapists followed the popular culture in embracing the "expressive divorce" as an enlightened way to start a new life when the old marriage was in disrepair. In her individual session, Anna announced her decision that she would gradually end contact with her affair partner in order to focus on improving her marriage relationship. A Communitarian Approach to Marital Therapy. This is reflected in a number of professional areas, but starts with the therapist's competence to practise. No, I am not referring to bad marriage therapy that often sounds like a screaming match behind closed doors, though that also does its share of damage. Individual therapy is often very helpful. The main techniques of this kind of therapy are twofold: a) walk clients through a cost-benefit analysis with regards staying married--what is in it for me to stay or leave? If those questions yield what appears to be an irrational commitment in the face of marital pathology, as the therapist believed to be true for Monica, then the therapist falls back on pathologizing the reasons for this commitment. By including in the diagnostic and treatment process the full person rather than just the area of specialty of the treating physicians, the new doctor indirectly healed the lung and heart problems as a by-product of the cancer treatment. Rob was continuing in individual outpatient psychotherapy, while living alone in an apartment. What If Everything You Believed About Love Was Wrong? He may be reached at Department of Family Social Science, University of Minnesota, 290 McNeal Hall, St. Paul, MN 55108. www.drbilldoherty.org, The words Smart Marriages® and Smart Marriage® and the couple puzzle logo are registered trademarks of CMFCE, LLC Poor Communication Consumers also should be aware that many therapists who primarily work with individuals are not competent in marital therapy and thus are likely to give up prematurely on the marital therapy and the marriage itself. I recently have been treating a couple in which one spouse—let's call her Anna—had been in individual therapy treatment for several years. I recommended a trusted counselor. When a couple attempts to improve their marriage by hiring two individual therapists, (one for his individual therapy and one for hers), the risk of divorce is even higher. I do offer individual therapy to all married clients, but as part of an overall family system treatment program. Multiple research studies have demonstrated that individual therapy for a spouse in a distressed marriage may make a couple’s conflict worse, … The revelation of the client's secret life is essential to good psychotherapy, but that client is not going to reveal if his or her spouse in the room. In my view, therapy cannot be honest unless a therapist is willing to concede the possibility that specific marriages should not be "saved" based on the cost to one or both spouses. To prevent sibling rivalry, I aim for symmetry of individual time. Unfortunately, I think that many spouses in troubled marriages have the same type of factual agreement as the Palestinians and the Israelis. But on the value of preserving marital commitment if possible, the field was mostly "neutral"--which means embracing a contractual, individualist model of commitment. The list of presentations at national conferences of marriage and family therapists contains multiple references to "couples" and scant references to "marriage." Forget about infidelity or lying to your spouse about your finances: there are other, less-talked behaviors that are just as destructive to a marriage ― and you and your partner are probably guilty of some of them. Marital therapists who were trained in these new techniques viewed themselves as performing a form of mental health treatment that not only helped marriages but also the individual well-being of the spouses. Individual therapy can be very helpful as long as the therapist does not turn his or her client against the spouse without hearing their side of it. She appropriately wanted to discuss this issue in private rather than to hurt her husband's feelings. _____________________________________________________________ William J. Doherty is a Professor of Family Social Science and Director of the Marriage and Family Therapy Program at the University of Minnesota. My spouse is also fearful of the kitchen for some reason... which when other behaviors are examined lead me to believe that my spouse is dealing with PTSD and possibility some other challenges. On the other hand, however, the psychiatrist knew that his client had been having an emotional affair, and condoned it, in part because Anna's descriptions of her angry husband had created an image of a hopelessly unsympathetic spouse that had seemed to justify Anna's turning elsewhere for comfort. The critique is that "marriage" marginalizes cohabiting couples and especially gay and lesbian couples. Sure, I can see that an affair or abuse are a reason not to bring your spouse to the first session. The individual tended to get lost in the marriage. The early marriage counselors were mostly gynecologists, educators, and clergy. Sobered by feminist critics and enamored with the 1970s cult of individual fulfillment, marital therapists largely rejected the "marriage saver" image. They also had determined that they would work together as a team to mend their full family. An Alternative Theory of Generalized Anxiety Disorder. A marriage therapist ― even one who’s worked in the field for years ― can’t know a couple’s full story by the first therapy session. Although commitment is the linchpin of marriage, justice and caring are essential moral elements as well. If you do go into individual therapy, admit to having problems (and your spouse doesn’t admit any), you risk having your spouse become a co-therapist, and the relationship problems still don’t get addressed. All hope is NOT lost however. When Bert, Anna's husband, eventually discovered Anna's affair—which by then had become sexual as well as emotional—he, needless to say, was furious. These are just some starting ideas, not specific advice. I was told by the counselor that we could not do couples therapy because he had been physically abusive on a few occasions. My critique focuses on the practice of therapists, many of whom lack good skills in helping couples, who philosophically view marriage as a venue for personal fulfillment stripped of ethical obligation and divorce as a strictly private, self-interested choice with no important stakeholders other than the individual adult client. 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