WAYS OF RELATING TO THE COUPLE, PART 2

This is the second of a two-part discussion of the tasks required of a couple therapist and how a collaborative couple therapist accomplishes them. In the previous writeup, I talked about three factors: the management of the session, who talks to whom, and the role of the therapist. Here I want to talk about the skills the therapist seeks to develop in the couple and the information s/he tries to impart to them.

Develop Skills

Almost all couple therapy approaches include a psychoeducational element involving some form of information-giving and/or skills development.Common skills we seek to develop in couple include:

1. Communication.
2. Problem-solving.
3. Getting close: making and accepting bids for emotional connection (John Gottman’s language) or functioning as reciprocal secure bases, safe havens, and sources of comfort, reassurance, responsivity, and cherishing (Sue Johnson’s language).
4. Establishing personal agency: asserting oneself—expressing wishes, needs, feelings, and aspirations while taking into account those of the partner.
5. Creating a meta-level, an observing couple ego, or a couple platform from which partners can talk together about what is going on in the relationship.

The principal skill collaborative couple therapists seek to teach—and the one out of which all the other skills emerge—is intimate conversation: figuring out and expressing what each partner needs to say in a manner that generates a collaborative exchange rather than triggers a fight or precipitates a withdrawal. The ability to have intimate conversations—that is, to communicate skillfully (#1)—creates:

• The optimal conditions for arriving at whatever agreements, compromises, solutions, or accommodations might be possible when dealing with conflict (#2),
• Connection (#3),
• Personal agency (#4),
• A shared vantage point above the fray (#5) from which partners can jointly monitor their relationship, make mid-course corrections (John Gottman’s repair efforts), hold recovery conversations, and turn problems into opportunities for intimacy.

Depending on their particular approach, therapists teach the desired skills in:

• Formal ways—providing rules, instructions, steps to follow, and practice exercises.
• Informal ways—modeling these skills, reinforcing any manifestations of the otherwise missing skills (celebrating “exceptions” in the language of Narrative and Solution-Focused therapy), and asking questions that slow the action, generate thoughtfulness, and set the groundwork for the development of these skills.

Therapists with a Collaborative Couple Therapy approach tend to use informal methods for developing the needed skills, and particularly those of modeling: speaking as if they were one of the partners talking to the other.

Provide Information

As couple therapists, we want to tell couples things we think they need to know. Depending on the theory and language of our approach—and, for example, whether we use psychodynamic, cognitive-behavioral, or psychoeducational language—we:

1. Make interpretations, provide insight: uncover unrecognized or unconscious meanings, make connections, and trace problems to earlier relationships or earlier in this relationship.
2. Re-examine faulty ideas, unrealistic expectations, negative self-talk, black-and-white thinking, pathogenic or pathology-saturated beliefs, and blame-oriented thinking. We reframe negative attributions, engage in cognitive restructuring, and/or externalize the problem.
3. Inform couples about:
4. Relationships in general. Tell them about the honeymoon and post-honeymoon phases, secure and insecure attachment, pursuit and distance, and so on. Tell them what Gottman & Levinson found distinguishes satisfying from unsatisfying relationships or engage in neuroeducation, teaching partners what is driving their reactivity (Mona Fishbane and Stan Tatkin).
5. Their relationship. Describe the pattern they’re stuck in. Show how what troubles them about the other is connected to what attracted them in the first place. Draw a compassionate picture of their struggle.

Each couple therapist has particular information that she or he wishes to impart to partners—the rules for good communication, for example, or the effects on partners of unresolved issues from childhood, unconscious motives, unrealistic expectations, attachment fears, blame-oriented thinking, poor boundaries, vicious circles, emotional reactivity, and so on.

A therapist with a Collaborative Couple Therapy approach seeks to impart knowledge, in particular, about intimate conversations. When I double for partners, I describe the principles I use to translate their fight-provoking comments into intimacy-inducing ones. Describing these principles makes it more likely that partners will use some version of them by themselves at home. I tell partners that I’m:

1. Changing the tone. “I’m going to repeat what you just said but change the tone.”

2. Revealing the wish, fear, hurt, shame, or other tender feeling buried in the complaint. Paul says to Georgia, “You’d never think to call me during the day.” I say, “Paul, I’m going to restate your complaint as a wish and see what you think of it. Here, I’m you, talking to Georgia, and for you, I’d say, ‘Georgia, I’d love to get a call from you during the day. I wish I were more on your mind.’ Does that at all fit how you feel, Paul, or am I missing the point?”

3. Making acknowledgements. When I speak in behalf of a partner, I typically include an acknowledgement. “Wendy, I’m going to make a statement for you and see what you think of it. And I’m going tobegin with an acknowledgement, which is almost always a good idea—since it makes it more likely that Alice will be able to listen. Here, I’m you, talking to Alice and for you, I’d say:

• ‘Alice, you’re right that….’
• Or, ‘Alice, I can see why you’re saying that….’
• Or, ‘Alice, I get that you’re saying that….’
• Or ‘I agree with a lot of what you’re saying and, in particular…’
• Or ‘I know I’ve got a role in this problem, too, and it’s that….’

Dorothy Kaufmann called my attention to the central role of acknowledgements in turning fights into conversations, and I use the word frequently in my sessions with couples. Angela complains to Jose, “Do you always have to throw your clothes on the floor?” Jose stiffens. Angela adds, “Of course, I’m not so easy to live with, either.” Jose immediately relaxes. I point out the effect of Angela’s “acknowledgement.” (Of course, if Angela had reversed the two elements of this statement and added a “but”— “I know I’m not so easy to live with either, but do you always have to throw your clothes on the floor?”—Jose would not relax. He’d take the admission as simply the setup for the real message, which is about his throwing his clothes on the floor.)

4. Creating a platform—a compassionate shared overview. When partners are caught in a gridlocked exchange, I may say, speaking as one of them talking to the other:

• ”We’re caught again in this argument that’s sapped so much good will between us. Are you as discouraged about that as I am?”
• Or “This is hard. I don’t know how we’re going to fix this, and it’s so important that we find a way.”
• Or “This is heartbreaking. We’ve finally found the person we could really be happy with and it looks like it may not work because of our difference over whether to have a child.”
• Or “What a shame that people who love each other keep getting caught in things like this.”

I’m creating a vantage point above the fray—a platform—from which partners can commiserate about their relationship impasse. I explain to them what I’m doing. If they get the general idea, they might be able to create such a platform on their own at home. I tell them:

• “I want to give you the experience for the moment of commiserating about the situation—of being sad together about it—rather than just angry at each other.”
• Or, “I want to show you how this looks to someone, like me, who is viewing this from the outside, appreciating the difficulty of the situation, and feeling compassion for both of you.”
• Or, borrowing from Eli Finkle, I might say, “here’s what a compassionate and dispassionate observer might say who has the interest of both of you at heart.”

It is difficult for partners to commiserate in the middle of a fight. More realistic, although still difficult, is to come back later when they are no longer angry and hold a recovery conversation. To guard against such an attempted conversation turning back into a fight, it is best for them to wait until one of them can come to other with good news—that is, with an acknowledgement of the other partner’s point of view rather than just with a renewed effort to make his or her own point.

In this and the previous blog, I’ve described the tasks the couple therapist needs to accomplish and the decisions he or she needs to make. These include:

• Management of the session
• Who talks to whom
• What roles to take
• What skills to develop in the couple
• What knowledge to impart

A therapist with a Collaborative Couple Therapy approach:

• Uses doubling—speaking on behalf of each partner—to establish rapport, create a space of gentleness and safety, control the intensity of the exchange, and establish therapeutic leverage.
• Functions as advocate for each partner and mediator between them, reshaping what each says to make it more satisfying to that person (the advocacy aspect) and less provocative for the other partner to hear (the mediating aspect).
• Looks past the demanding, scornful, defensive, withdrawn, or other off-putting behavior of partners to track the inner struggle of each.
• Recognizes his or her (the therapist’s) slippage from listening to judging and from evenhandedness to taking sides as an indication of having lost sight of this inner struggle.
• Is co-constructor of the couple’s reality, combining what s/he can see looking at the relationship from the outside with what the partners can see looking from the inside.
• Is co-manager with the partners, appealing to them at times as consultants in dealing with the questions and issues that come up in the therapy.
• Considers conversation to be the principal relationship skill and the chief means for developing the other crucial relationship skills: problem-solving capability, closeness, personal agency, and a joint vantage point above the fray.
• Imparts knowledge, in particular, about what makes an intimate conversation, focusing in particular on tone, tender feelings, acknowledgement, platform, recovery conversations, and good news.