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.
Although they may have a long history of “no fighting,” both remain discontented, unsettled, or sad. For many, this is a developmental challenge that requires them to look more deeply into the conflict to find their dreams.
I hope this post demonstrates two things: working with couples is challenging, and without a good assessment, it becomes impossibly aimless. The assessment results I’ve listed here are routine for my team and me. We know each of these marital elements, 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.
Individual problems
Some wounds go deep. They have a history that began long 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 couple that had to do work on themselves, as well as their marriage, to have a happier relationship.
Lorraine and Jack: Childhood abuse and repeating major depressive episodes
Presenting problem:
The couple came in after chronic fighting between husband, Jack, and his son led to his wife’s 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:
- criticism (wife; husband -> son)
- defensiveness (both)
- stonewalling (both)
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.
Comorbidities: Minor Depression (Jack), Developmental Trauma-PTSD (Lorraine)
Sexual Styles: Lorraine: Trancer? Trauma inducted? Jack: Partner Engager. No sex in 16 years. Very little affection.Estimated number of sessions: 22-26.
Lorraine’s* History
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 and 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 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 history
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 of treatment. However, his marital relationship was never fully explored, even though depression in one spouse causes a nine-fold increase in divorce.
His therapist had referred him for anti-depressive 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, he reported being upset at his marital troubles but not currently depressed.
Couple’s presenting problem
Jack and Lorraine had always considered themselves 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 resentful of his life circumstances and his financial dependency on his parents.
His attitude became increasingly belligerent, and his behavior became more challenging. As his drinking increased and his behavior worsened, his worried parents began to argue about how to handle it best.
As mentioned, this couple remained distant from each other in the past and seldom fought. Neither felt entitled to the unhappiness they experienced in their marriage. They treated each other like wounded soldiers who needed 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 parent’s 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 like they had when he was still a teenager.
Jack wanted his son to “face up to his problems “ 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 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 like 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 they needed to stop. She thought “it” was the anger and 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. She couldn’t hear Jack’s story through her fear and bodily reactions.
Her anger toward her husband was intense, greater than at any previous point in her marriage. It was as if the fights between her husband and son had opened a floodgate of anger toward her husband, who was decades old.
Unbeknownst to both of them, Lorraine attempted to heal old childhood wounds but 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, she was the protector in the battle between her husband and son. 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 actually to 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. However, she and Jack were embroiled in a bitter fight that saw no resolution.
The history of the conflict
While the couple had different parenting philosophies throughout their marriage, they successfully avoided fighting about it by each clearly defining their 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, review what Jared had done wrong, and extract a promise of better behavior.
Current struggles
Now, from Jack’s point of view, things were different. Jared was an adult, and Jack would no longer tolerate behavior that he 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 “how Jack handled things” and sniped at him.
Jack was astounded and hurt by his wife’s attacks. Despite the earlier agreements made by the couple before Jared moved in, Lorraine seemed utterly 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 resentment 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 they usually try to “ignore” perpetual problems, this one cannot be ignored. Jared became even less respectful and more demanding as their fights and tensions grew.
Perpetual conflicts
Long-standing issues between couples that never 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 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?
Gridlock
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.
How a couple fights about a perpetual issue will 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 discuss it in a way that respects each person’s position.
As respect and safety grow, the couple can 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 one’s partner’s perspective or personality. Motivations are often framed as hostile intentions. Instead of being viewed as a “couple’s problem,” the gridlocked issues become “your problem,” a personality defect for which each partner is blamed.
Jack framed Lorraine’s position in this conflict as a continuation of a parenting style that had “ruined” Jared by never holding him “accountable.” According to Jack’s version of reality, she “sided” with Jared against him and “undermined” him as Father at every turn.
From Lorraine’s perspective, Jack’s behavior “antagonized an already tense situation.” Jack was “selfish” and “rigid” by insisting that Jared either comply with the rules or leave. For Lorraine, Jack was “a bully…kicking Jared when he was down.“
This couple, who “never fought” and “got along so well” despite their life challenges, was now on the verge of divorce. As each fight progressed, their relationship history was being rewritten. All the “bad” between them came to the fore, and all the “good” disappeared.
They each had “a chip on their shoulder,” seeing “the glass as half empty.” This is common in couples who fall into what Gottman calls “Negative Sentiment Override.” It is like a roach motel for lovers: They check in but don’t check out.
Fighting was problematic because any 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 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 fundamental skills to process conflict. 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:
1. Using Gentle Start-Up,
2. Practicing Physiological Self-Soothing,
3. Repairing and De-Escalating,
4. Listening to Partner’s Underlying Feelings,
5. Accepting Influence and
6. Compromising.
The dream
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 helped parent a 10-year-old, it would hardly work the same for a 32-year-old who 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.”
Until now.
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 his problems and actively working to solve them.
He also saw fighting with his wife as the initial problem and Jared as a bigger problem. However, as he could 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.
Case Summary
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 fighting skills allowed them to talk more profoundly and meaningfully than they had previously. Lorraine spoke in more depth about how terrifying her early life had been, whereas before, she would gloss over it.
Jack could 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 subject was filled with such shame that he had avoided it. 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.
While intimacy is not always easy to achieve, it was the key to revitalizing this couple. As they became closer and more intimate, they could agree on how to handle their son. 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.
Summary
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?
We can help!
* To protect my clients’ privacy, the names and details of these couples are fictitious. However, the interactional styles and issues they present are very real and common in couples therapy.
Originally published April 4, 2014.