Couple & Family Therapy
Do you want to improve your marriage or other family relationships?
Is your family struggling to adjust to a difficult life transition, such as divorce, remarriage, serious illness or death in the family?
Are you concerned about the behavior of a child or adolescent?
If so, you might want to consider couple or family therapy.
Q - My partner and I are interested in couple therapy, but I would like to come in alone for the first session. Is this a good idea?
A - Sometimes this is appropriate. However, it's not generally recommended, because it can make it more difficult for the therapist to engage the other partner. This is especially true if the other partner is reluctant or if there is a high degree of conflict between the partners.
Q - Do you see gay/lesbian/unmarried couples?
A - Of course. A couple is two people who are in a committed relationship with each other.
Q - Do you see divorcing couples?
A - I sometimes see divorcing couples with the purpose of helping them to understand what went wrong in their relationship, or helping them and their children adjust to the breakup. I do not do custody evaluations or provide reports to the court. If this is needed, a mental health professional specializing in doing these types of evaluations should be consulted.
Q - I've seen an individual therapist in the past. Is couple therapy similar?
A - Yes and no. In couple therapy, the focus is the relationship between partners. Only individual issues that are relevant to the couple's struggles will be dealt with in any depth
Q - Are partners always seen together?
A - It depends on the circumstances, but, most of the time, partners will be seen together. However, I will generally see each partner individually during the evaluation process.
Q - What is the evaluation process like?
A - Unless the couple is in crisis, I will generally begin with an evaluation, which takes several sessions, depending on the complexity of the situation. These sessions are more structured than later sessions, in which the couple will have more responsibility for setting the agenda. Expect to discuss desired changes in the relationship, problem areas as both partners see it, attempted solutions, relationship strengths, significant events in the development of the relationship, your family of origin, previous experiences with therapy, medical and mental health history. Previous significant relationships, sexual development, school/work history, and use of drugs and alcohol will also be touched upon. At the end of the assessment phase, we should have clear agreement about which issues will be given priority and some ideas about how to begin working on them.
Q - Is there research that supports the effectiveness of couple therapy?
A - Yes. As in medicine, the field of psychotherapy has placed more emphasis on research in recent years. Research clearly supports the effectiveness of couple therapy for improving relationships and for treating some issues that are usually thought of as individual problems (for example, depression or anxiety). Obviously, as with any therapy, the results are unpredictable. Therapy of any kind is most likely to be successful for those who are committed to making changes, are as open and honest as they can possibly be, and are willing to discuss painful issues.
Q - Which theoretical approaches do you use?
A - Like most experienced therapists, I have developed an eclectic blend of approaches that I individualize, depending on the needs of the couple. I draw primarily from family systems theories, psychoanalytic theories, and attachment theory. In English, that means that I focus primarily on the current interactions between partners (especially those repetitive, problematic interactions that seem to have taken on a life of their own), with some attention given to family of origin issues that help to keep current, painful interactions in place. I also assume that both partners will need to make some changes in order for the relationship to improve, and I work with the couple to identify what those are.
Q - Can you suggest readings that will help us understand more about how relationships function?
A - The work of Maggie Scarf is a good place to begin. She is a professional journalist who researched family therapy by attending a postgraduate institute that trains therapists who want to specialize in working with couples and families. I received my family therapy training at the same institute, so her work is very representative of some of the theories I draw upon. She has written many books. The most relevant is Intimate Partners: Patterns in Love and Marriage. Another of her books, Intimate Worlds: Life Inside the Family, takes a somewhat broader view of the family, and Secrets, Lies, Betrayals: The Mind/Body Connection, deals specifically with the impact of childhood trauma (physical and sexual abuse) on the family life of adults.
Augustus Napier and Carl Whitaker are noted family therapists who wrote a book titled The Family Crucible: The Intense Experience of Family Therapy. It is essentially an extended case study that reads like a screenplay. It is fascinating reading.
I also recommend The Genogram Journey: Reconnecting with Your Family by noted family therapist Monica McGoldrick. It is a book for the general reader that describes a process for constructing a family diagram that can help identify important family patterns. She also wrote Genograms in Family Assessment with Randy Gerson for a professional audience. However, it is written in very clear language and can be very helpful to the nonprofessional reader as well. In it, she constructs genorgrams of many famous people in order to illustrate important concepts.
Finally, Hold Me Tight: Your Guide to the Most Successful Approach to Building Loving Relationships by Sue Johnson is based on an approach called Emotionally Focused Therapy (EFT) that has been extensively researched and shown to be quite effective in resolving relationship conflict and increasing empathy between committed partners.