Couple therapy

Couple life is not always all milk and honey and sometimes even the most balanced individuals can feel that the couple’s equilibrium cannot be brought back with just the two partners working through the situation. In these cases, couple therapy is a promising alternative for restoring harmony to the individual’s and the couple’s life. Couple therapy addresses both those who are married but also those who don’t have an official relationship and sets out to help individuals in overcoming their relationship distress.

When to search for couple therapy?

There is no one key moment to wait for in order to go to couple therapy. Whenever the two partners feel that they have a problem that they can’t overcome by themselves despite their common wish to do so is a good moment. Problems may come in various shapes and forms, starting with communication deficiencies and up to health problems of one of the partners that invariably affect the couple’s dynamics (alcoholism, schizophrenia, cancer etc).

According to Gurman (2008) the issues that are more often approached in couple therapy could fit in the next categories:

1. rapture and repair of relational bonds: affairs, divorce, violence and remarriage.
2. couple therapy and the treatment of psychiatric and medical conditions: alcoholism and drug abuse, depression, borderline disorder, sexual dysfunctions
3. couples in a larger context: gay and lesbians couples in therapy (problems regarding minority stress, relational ambiguity and families of choice); group minorities couples (religious, ethnic etc).

The efficiency of couple therapy based on various studies:

According to the meta-analysis of Snyder, Castellani and Whisman (2006), many studies proved that couple therapy had a moderate to high significance in treating problems such as:

• sexual difficulties: for example, sex therapy positively influences both sexual and marital problems; couple therapy used for treating women with orgasmic disorders showed improvement rates ranging from 65% to 90%;
• physical aggression: couple therapy proved to be effective in treating mild to moderate levels of aggression through improvement of anger management and communication skills within the couple;
• extramarital affairs: diminution and even elimination of emotional and marital distress through therapies that help the individuals in: a) coping with initial emotional and behavioral disruption of the functioning of the individual and relationship following discovery or disclosure of the affair; b) in exploring the individual, the relationship and outside contextual factors contributing to the initial onset or maintenance of the affair and c) in reaching an informed decision about how to move on, either individually or as a couple.
• substance use disorder: couple therapy aims to alter couple and family interaction patterns in order to promote a more supportive family context as well as abstinence and sobriety.
• mood disorders: behavioral couple therapy for depression is effective in relieving depression when applied to distressed couples with a depressed partner
• anxiety disorders: one of the partners, suffering from such a disorder can heal better and more rapidly if assisted by the partner as well, not only by the therapist (eg, in phobias) (Byrne, Carr, Clark, 2004).
• pain and physical illness: couple therapy can help both the injured partner to better cope with his/her pain and the physical healthy partner that is indirectly affected by the suffering of his/her beloved one.

Therapy models and preparing to enter therapy:

It is really important that both partners agree on consulting a therapist for their couple issue. The sheer will of one to cure the couple is most of the time not enough. Next, finding the right therapist should be a shared experience and a total agreement of your choice should be reached before proceeding to an appointment.

Being well informed about different types of couple therapy could also ease your choice. However, you are not the ones who will put the diagnostic and prepare the therapy scheme. The therapist, as an objective individual meant to help you find the easiest way to solve a particular problem, has an important word to say when choosing the therapy approach for your specific problem. Next, a list of models of couple therapy approaches, as presented in Gurman (2008), can be found:

• behavioral approaches: cognitive behavioural therapy; integrative behavioural couple therapy
• humanistic-existential approaches: emotionally focused couple therapy and Gottman Method couple therapy
• psychodynamic and transgenerational therapy: object relation couple therapy and transgenerational couple therapy
• self-constructivist approaches: narrative couple therapy and solution-focused couple therapy
• systemic approaches: brief strategic couple therapy and structural couple therapy
• integrative approaches: affective-constructive couple therapy and integrative couple therapy

Whatever choice you make, what is crucial is to deeply involve yourselves in the recuperation process and to expect the results to appear only after real progress is made. Certainly there will at times be resistances, meetings that brings up difficult emotions and you may even be tempted to give up the therapeutic sessions altogether. As a couple should consist of two people who are mature at least age-wise, it is necessary to understand that you have to stick with your decision of searching help outside the couple, be willing to fight and overcome episodes of resistance and to not give up as soon as the situation slightly improves. Respect, trust and commitment are the mandatory conditions for real and long-lasting improvement to take place.

References:

Byrne, M., Carr, A., & Clark, M. (2004). The efficacy of couples-based interventions for panic disorder with agoraphobia. Journal of Family Therapy, 26, 105–125
Gurman, A.S. (2008). Clinical Handbook of couple therapy. New York: The Guilford Press, Inc.
Snyder, D. K., Castellani, A. M., & Whisman, M. A (2006). Current status and future directions in couple therapy. Annual Review of Psychology, 57, 317-344. doi: 10.1146/annurev.psych.56.091103.070154