Individual problems in marriage counseling
In relationships, sometimes the way a couple relates is the problem, and the therapist's job is to help the couple modify their interactional styles (i.e.: teaching them how to "communicate better").
Sometimes, however, improving communication is not enough.
They may have a long history of "no fighting," yet both remain discontent, unsettled, or sad. For many, this is a developmental challenge, and requires them to look more deeply into the conflict, to find the dreams that reside there
I hope in this post to demonstrate two things: one is that working with couples is a challenging undertaking. It becomes an impossibly aimless one without a good assessment. The assessment results I've listed here are routine for myself and my team. We know what each of these marital elements are and we have specific interventions to turn them from a "problem" into a "strength."
Two, I want to outline one couple's clinical issues and how helpful it is to both the couple and the therapist, to have a roadmap to assist them in solving them.
Some wounds go deep. They have a history that began a long time ago, even before the couple met and got together. An individual may have partially resolved the issue, through individual counseling, addiction treatment, or their own hard work.
But painful memories leave scars.
In this post, I'll be talking about one couples that had to do work on themselves, as well as their marriage, in order to have a happier relationship.
Lorraine and Jack: Childhood abuse and repeating major depressive episodes
The couple came in after chronic fighting between husband Jack, and his son led to his wife request for a separation.
The Assessment Results:
Lovemaps: Needs Improvement given conflict avoidance
Fondness and Admiration System: Needs Improvement
Turning Toward Instead of Away: Needs Improvement, missed Bids because of high anxiety
Positive/Negative Sentiment: Negative Sentiment Override.
Managing Conflict: Low skill level.
Three of the Four Horsemen of the Apocalypse present:
Conflict Style: Avoidant Couple
Making Life Dreams Come True: Gridlocked issues - Parenting, Managing Mental Illnesses
Creating Shared Meaning: Disengaged. Needs Improvement.
Co-morbidity: Minor elevated depression scores (Jack); PTSD (Lorraine)
Treatment Focus includes processing feelings and encouraging Lorraine to seek treatment for PTSD.
Sexual Styles: Partner One (Lorraine)- Trancer (? Trauma induced?) Partner Two (Jack) Partner Engager
No sex in 16 years. Very little physical affection.
Estimated Number of Sessions: 22-26 or 1 intensive and 6-10 sessions
Clinical guide to treatment
The sound relationship house analysis
Lovemaps: Needs Improvement
Fondness & Admiration: Needs improvement
Turning Toward: High anxiety causes missed bids. Needs Improvement
Positive Perspective: Negative Sentiment Override.
Managing Conflict: Low Skill Level. Three of four Horsemen present
Making Life Dreams Come True: Gridlocked Issues include Parenting, Managing Mental Illness
Creating Shared Meaning: Disengaged. Needs Improvement.
Co-morbidities: Minor Depression (Jack) Developmental Trauma-PTSD (Lorraine)
Lorraine: Trancer? Trauma inducted?
Jack: Partner Engager.
No sex in 16 years. Very little affection.
Estimated number of sessions: 22-26.
While Lorraine was functioning much better in her everyday life than was often the case with her husband, Jack, her childhood history was painful and left her a bit numb most of the time.
Her father was an abusive alcoholic. Lorraine regularly witnessed frightening abuse aimed at her mother, and lived in terror most of the time, as a child. She worked hard in school, despite her home life, and was able to complete college and get a good job as a nurse. She first met Jack while finishing graduate school in Nursing Administration.
What she most loved about Jack was his gentle nature, but also his warmth and affection. These were characteristics she had never known in a man. As Jack was later able to express:
"Lorraine never trusted me. She loves me, I know she does, but she never fully trusted me. And there was nothing I could do to prove that I was trustworthy. Believe me, I tried."
While the couple presented Jack's crippling depression as "the problem," the layers beneath the surface told a different tale. Jack's depression was impacted by his wife's with untreated PTSD (Post Traumatic Stress Disorder). Both had individual problems in marriage counseling, and these individual problems could not be ignored.
Lorraine's PTSD impacted not only Jack's depression, but also the couple's sex life, which Jack described as "always cool, but eventually turned cold and then non-existent."
Jack's family was more functional than Lorraine's. He was raised in a warm, loving family, but despite this, his mother suffered from depression that ranged from mild to moderate. He remembers her as often "sad," and sometimes "overly emotional."
"When she was depressed, she would get very agitated and irritable, and the slightest thing would have her lock her door and cry. I know it was the depression now, but back then, when I was a kid, I thought I caused it."
In Jack's excellent individual psychotherapy, the depressive episodes were the focus on treatment. But his marital relationship was never fully explored, despite the fact that depression in one spouse causes a nine-fold increase in divorce.
His therapist had referred him for anti-depressives medication believing "he had a family history of depression," and otherwise did brief treatment. Jack learned strategies for better managing his depressive symptomatology, which helped.
When he presented for couples therapy treatment, reported being upset at his marital troubles, but not currently depressed
Couple's presenting problem
Jack and Lorraine had always thought of themselves as being in a "good marriage." They never fought, and lived a comfortable life. True, they had lost a sense of closeness and sexual intimacy with each other, but they rationalized that "sex at our age isn't a big deal." Lorraine is 58, and Jack just turned 60.
The couple would probably not have come in, had it not been for their son, Jared. Jared, now 32, had moved home after a hostile divorce that left him close to bankruptcy. Jared was also depressed, borderline alcoholic, and was resentful of his life circumstances, and his financial dependency on his parents.
His attitude became increasingly belligerent and his behavior became harder to live with. As his drinking increased, and his behavior worsened, his worried parents began to argue about how to best handle it.
In the past, as already mentioned, this couple remained distant from each other and seldom fought. Neither felt entitled to the unhappiness they experienced in the marriage. They treated each other like wounded soldiers who had to be treated gently.
When they interacted, it was not hostile, but hardly engaged. They described themselves as having an "efficient," but not passionate marriage, and were proud of their friendship.
Their son's circumstances changed all of that. Jared came back to his parents' house one night, after a night of drinking, and made a lot of noise.
Neither parent was asleep. Despite Jared being well into adulthood, they worried about him the same way they had when he was still a teenager.
Jack wanted his son to "face up to the problems" he had and "deal with them." Jack would go down to meet Jared when he got home and the two would "go at it."
While the men fought downstairs, Lorraine sat in bed, frozen with fear. While she hadn't identified it at the time, the raised voices brought her back to childhood, when she felt helpless to intervene in the violence directed at her mother.
Her own individual problems in marriage counseling impacted her capacity to communicate effectively, and this would take more than teaching communication "skills" to fix.
While Jack and Jared never came to blows, her body reacted as if they had. She was flooded, her heart pounded, and she wanted to run away. She felt sick inside.
While Lorraine didn't know what caused her feelings, she knew it needed to stop. She thought "it" was the anger and the hostility between Jack and Jared, but it was also the flooding she experienced in her body. She was overwhelmed--and she blamed it all on Jack.
To Lorraine, Jack was the one who "started it." "If he just left Jared alone, things would be okay," she told herself. It was impossible for her to hear Jack's side of the story, through her fear, and bodily reactions.
Her anger was intense toward her husband, greater than it had been at any previous point in her marriage. It was as if the fights between her husband and son opened up a floodgate of anger toward her husband that was decades old.
Unbeknownst to both of them, Lorraine was attempting to heal old childhood wounds, but she was ill-equipped to do so. Lorraine had learned in her childhood that fighting was dangerous, and led to violence, so she had scrupulously avoided it in her marriage
But now, in the battle between her husband and son, she was the protector. She stood up to Jack. Symbolically, she was unconsciously defending her mother when she "protected" her only son.
As a child, it was too terrifying (and dangerous) to have been able to actually protect her mother from her father. Jack was not like her father. He was a stand-in that she could safely take on.
She had promised herself that her household would not be full of the turmoil she lived with as a child. Now, however, she and Jack were now embroiled in a bitter fight that saw no resolution.
The history of the conflict
While the couple had a different philosophy about parenting throughout their marriage, they had successfully avoided fighting about it, by each drawing clear lines of responsibility for managing the household and the family.
If Jack tried to institute discipline, Lorraine stepped in to "handle it." Jack acquiesced most times, but never felt right about it. Instead of putting in place what Jack considered "logical consequences" for Jared's childhood misbehavior, Lorraine preferred to have "a quiet talk," with him, and review what Jared had done wrong, and extract a promise of better behavior.
Now, from Jack's point of view, things were different. Jared was an adult, and Jack would no longer tolerate behavior that Jack felt "violated his right to a peaceful and quiet home." If Jared couldn't respect the rules, he could "find somewhere else to live."
This dynamic between father and son became symbolic to Jack of every failed attempt he had made to institute discipline, and be a good father.
This time, Jack would not back down. He would be an active and responsible father. Jared would either live by Jack's rules, or Jared could leave.
The demon dance
When the couple fought about Jared, the battles were brief and intense but left a long trail of bitter resentment. Neither had any history of learning how to fight effectively. Lorraine was sharply critical of "the way Jack handled things," and she sniped at him.
Jack was astounded and hurt at his wife's attacks. Despite the earlier agreements made by the couple before Jared moved in, Lorraine seemed completely unwilling to enforce any of them.
And there was more.
While Lorraine was very patient during Jack's depressive episodes, she now blamed him for these symptoms. She talked as if his behavior was intended to hurt her. Her years of resentments flowed out during these fleeting fights.
Jack was stunned. He felt like a fool. Here he had believed all of this time that his wife was understanding and supportive of his painful periods of depression, but to Jack, this was now an act. Lorraine would never again be a safe person.She was a phony, a fake...and dangerous emotionally.
When the fights began he would initially be angry, but then withdraw and stonewall. His bitterness toward his wife grew daily. And as it did, his anger toward his son intensified. It was a repetitive demon dance.
Negative sentiment override
As their disagreement about how to handle their adult son became entrenched, their fights broadened to become about everything that was ever wrong with their marriage. They fell into Negative Sentiment Override and repainted their relationship history with a dark brush. The good in their relationship faded, and the problems came to the fore.
While normally they would try to "ignore" perpetual problems, this one could not be ignored. Jared became even less respectful and more demanding, as the fights and tensions between them grew.
Long-standing issues between couples, that don't ever get resolved aren't "the problem."
In fact, of all the things couples fight about, 69% fall into the category of
"perpetual problems," that don't go away. This is true of happy and unhappy couples equally.
Perpetual problems often arise from differences in personality or lifestyle preferences. Differences in parenting styles are a common perpetual problem. Both happily married couples and miserable couples have perpetual problems that account for 69% of what they fight about.
If the problem isn't "the problem," then what is?
Gridlocked issues between couples feel like "life or death" struggles. They bring out the worst in people when not handled well. Neither can give up their positions, and these positions become polarized and entrenched.
The way a couple fights about a perpetual issue will either lead to greater understanding or greater alienation and gridlock. If the issue isn't likely to change (and it isn't), the goal is to talk about it in a way that respects each person's position.
As respect and safety grows, the couple is able to explore with each other the underlying beliefs, values, or meanings that the position holds for each of them. Gottman calls it "The Dream within the Conflict," and a formal process is used to help couples resolve these issues.
When gridlocked issues become personal, defending one's position can turn into an attack on your partner's perspective or personality. Often motivations are framed as negative intentions. Instead of being viewed as a "couple's problem," the gridlocked issues becomes a "your problem..." a personality defect that each partner is blamed for.
In this conflict, Jack framed Lorraine's position as a continuation of a parenting style that had "ruined" Jared, by never holding him "accountable." She "sided" with Jared against him, according to Jack's version of reality, and "undermined" him as Father at every turn.
Jack's behavior, from Lorraine's perspective, "antagonized an already tense situation." Jack was being "selfish" and "rigid" for insisting that Jared either comply with the rules or leave. For Lorraine, Jack was being "a bully...kicking Jared when he was down."
And this couple, who "never fought," and "got along so well" despite their life challenges, were now on the verge of divorce. Their relationship history was being re-written as each fight progressed. All the "bad" between them was coming to the fore, and all the "good" was disappearing.
They each had "a chip on their shoulder," seeing "the glass as half empty." This is common in couples that have fallen into what Gottman calls "Negative Sentiment Override." This is a roach motel for lovers: They check in, but they don't check out.
Fighting was problematic because any sort of difference between them made both of them very anxious. Previously, they could manage this anxiety by smoothing over or ignoring the issue, or pretending it didn't exist. Now, they could not.
Each of them became more polarized. Neither could listen, understand, nor respect the other's point of view. The "existential heart of the matter" was never uncovered for either of them, and a stalemate developed.
During the last fight that Jack and Jared had, Jack told his son to "move out." Lorraine said she thought Jack should be the one to leave.
Facing separation, they sought help.
The couples therapy issues
For Jack and Lorraine, the issues that brought them into therapy were long-standing and had dramatically impacted their relationship. While they each believed that the problem was "the fighting," in reality it was the avoidance of conflict over the years that had created such fragility between them, including distance and loneliness.
While they would never become a couple who actively enjoyed a good fight, they had no real skills to process conflict at all. Avoidance and distance were their only strategy, and it didn't serve them well
In couples therapy, the fight around Jared allowed the couples to learn effective ways to process disagreements.
These included six skills:
- Using Gentle Start-Up
- Practicing Physiological Self-Soothing
- Repairing and De-Escalating
- Listening to Partner’s Underlying Feelings
- Accepting Influence
Lorraine was insightful. As she spoke about her fears, she recognized that her fear of Jack's aggression was not grounded in reality. Jack was and had always been, a gentle soul. Her fears were linked to her trauma around her family-of-origin.
She also became aware that while "a quiet talk" had been useful in parenting a 10-year-old, it would hardly work the same for a 32-year-old that was actively abusing alcohol. Her "dream" was "rational cooperation," and any signs of fighting threatened that dream. But she had to agree with Jack, that "rational cooperation" required two willing parties, and Jared was hardly "willing."
For Jack, his historical sense of powerlessness in parenting his son was woven into his feelings about having depression. It was painful to him and left him feeling like a failure. He felt weak, and was unwilling to "rock the boat."
While he recognized Jared's precarious situation, he expected his son to talk it out, not "act it out" in a destructive and self-destructive way. Confronting Jared's drunkenness, was Jack's way of now actively parenting his adult son, perhaps for the first time.
While his long history of depression caused him often to forsake this responsibility and allow his wife to "run things her way," Jack was not depressed now.
He was feeling strong. He wanted to be a role-model to Jared, even if it meant getting tough. He wanted his son to "be a man," and for Jack, this meant facing into his problems, and actively working to solve them.
He, too, initially saw fighting with his wife as the initial problem, and Jared as a bigger problem. However, as he was able to identify his dreams, and vocalize his goals of becoming a better father, he began to feel closer to his wife. He learned that asserting himself could be productive, and bring them closer together.
His attitude about fighting changed, as he realized that processing a fight well was the "solution," not the problem.
For couples like Jack and Lorraine, the work of couples therapy involves allowing them to understand the anxiety that gets generated in conflict as a growthful, positive sign.
Historically, feeling anxious was interpreted by each as a sign that meant "something was wrong," and they would withdraw in reaction to anxiety. Now, they learned that managing anxiety was a task of adult development, and they learned to "move closer," for intimacy, rather than "moving away" for safety.
Their ability to develop the six skills of fighting allowed them to talk in a deeper, more meaningful way than they had been able to do previously. Lorraine spoke in more depth about how terrifying her early life had been, whereas before, she would gloss over it.
Jack was able to understand just how terrifying raised voices were to her, and vowed to stop them in his interactions with his son. He also began to see Jared as depressed, instead of disrespectful and rebellious. He talked to his son about getting help for a mental illness he, too, knew intimately.
Jack was able to talk about what it had been like for him to be depressed on and off over the years, and the powerlessness he felt. This was a subject filled with such shame, one that he had avoided. As they talked, both of them began framing the depression as the challenge, not Jack, the man.
As Jack began to talk candidly about his depression, this allowed Lorraine to speak of her sadness and loneliness when Jack was depressed, and her upset about his sexual withdrawal from her.
Intimacy, while not always easy to achieve, was the key to revitalizing this couple. As they got closer and felt more intimate, they were able to come to an agreement about how to handle their son. But more importantly, they developed valuable skills that allowed them to process disagreements as they arose.
As they were able to vocalize disagreements as they happened, their relationship became more vibrant and alive.
Not surprisingly, couples therapy evolved into sex therapy as the couple turned to issues of sexuality, and ways to revitalize their intimate sexual partnership.
Most problems between couples are a blend of skill building and processing past issues with present-day life. Even complicated, seemingly "impossible" issues can be helped with a science-based approach.
Have you been living with a perpetual problem that is painful?
Do you feel distant from one another, rather than intimate and alive?
Do your troubles need to heal? Do you want to repair your relationships?
Do you want a richer intimate life.
Give us a call.
* To protect my clients' privacy, the names and details of this couples are fictitious. However, the interactional styles and issues they present are very real and common in couples therapy.
Originally published April 4, 2014.