I am asked all the time if couples therapy is effective, I respond easily, ‘ Most definitely!’ However, at least two ingredients must be present.
1) The person providing the help must understand how relationships within couples work AND be able to prescribe methods for helping couples get connected to each other.
2) The couples seeking help must be good students with enough trust to learn new habits. If these things are present in the couples or pre-marital therapy, saving relationships in couples therapy is not a problem.
The problems arise either when therapists don’t know or don’t think they should tell individuals within couples what to do differently. .OR, couples get good advice and don’t listen.
If I had only to give advice one time to couples, I could leave pamphlets at the door. In fact, it takes usually, much repetition to teach people new ways of dealing with each other,
In fact, the first part of working with couples is a class in how couples relationships work. However, when there is much repetition while seeing the couple and little change, I then think in terms of removing the emotional blocks that keep couples doing the same things repetitively that don’t work.
Alice and George met in high school. They did experimental drugs together and drank. George comes from a family of heavy drinkers . His mom overdosed on narcotics. Everyone was so busy drinking and drugging in George’s family, George was left to figure things out on his own. It wasn’t much better in Alice’s family. Her parents divorced when she was ten. Her parents were too busy fighting to notice her. She was the grown up.
Alice became pregnant. She stopped drinking and drugging. The couple later got married and had a second child
There is no longer time nor inclination for Alice to abuse substances. The kids need her.
However, George continues to indulge and the couple fight about this. Alice wants George to join her in an adult world. He says he needs to be reminded that she needs him! He has no sense of importance.
Alice says she isn’t his mom. She has been the mom in her family to both her parents. She is tired AND she has two children of her own. She sees reminding George to stay clean and sober as parenting him and she refuses.
Alice misses the need to help. George structure himself. She sees the help as beneath her. George should structure himself. The truth is that he doesn’t know how. If Alice could relate to her role as part of the couples team being to help George it would improve. “George, honey, I love you and I need you. Please don’t drink when you play poker tonight. We all need you to come home and to be sober”. George would do it. But as it stands he feels unimportant and Alice feels put upon so no one does what would work. This is a work in progress.
Though I am prescribing what would work, this couple holds a lot of anger and the existing lack of trust going back to emotional abandonment on both sides, keeps both sides of the couple in the therapy from listening. Fortunately, most couples are not like this!
The success rate in my office is about 90 percent. My clients learn new habits quite well- some quicker than others.
I believe in “problem-solving” couples therapy. If I can understand what people do that doesn’t work, I can prescribe what couples can do differently to work better. It is very effective because it is behavioral and clear!