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NP0038: Who’s Afraid of Couples Therapy?
Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work.
What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work.
How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions.
What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists.
Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation.
Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection.
Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy.
Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships.
Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries.
After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.
Whole Psychiatry: Alternatives to Conventional Psychopharmacology with Robert Hedaya
Meds: Myths and Realities: NP0035 – Session 4
Is psychopharmacology is a 'go-to' in your practice? Join Robert Hedaya as he discusses how to treat the bodily systems that underlay many mental health issues while avoiding medication. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.Tough Customers: Is It Them or Us?
By Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people! Does This Kid Need Medication? with Ron Taffel
Meds: Myths and Realities: NP0035 – Session 3
Do you feel like you could be a more effective therapist with your younger clients? Do you find it hard to determine when interventions--psychological and pharmacological--might be needed? Join Ron Taffel and learn to identify key diagnostic signs that indicate medications could be helpful when dealing with depression, anxiety, AD/HD, and affective disorders. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.
 NETWORKER EXCHANGE The Ethical Dilemmas No One Talks AboutRemember when setting appropriate boundaries in psychotherapy was a no-brainer? “No” was the operative word--no gifts, no sex, no self-disclosure, no financial or social connection whatsoever outside the hermetically-sealed cloister of the consulting room. The rules were simple, direct, and unambiguous. But in today’s more informal therapy marketplace, the rules often don’t seem as clear anymore.
So what’s a therapist to do when a client anxiously offers a diamond-studded token of appreciation for all of the positive change you’ve helped him achieve? Do you accept a not-so-valuable gift--a tin of holiday cookies--from a vulnerable client to express thanks? What’s your decision when your therapeutic instincts conflict with the rulebook? I highly recommend one article in particular--Ofer Zur’s “The Ethical Eye” is a refreshingly sane and practical discussion of how to reconcile risk management with humanistic values. You can read this article free or you can read it as part of our 3-CE Ethics Reading Course. How does today’s culture make ethics more (or less) complicated in your practice? What resources do you consult in order to make the best possible therapeutic decisions? Does communications technology--Skype, e-mailing, text messaging, Facebook, or even the telephone--pose any ethical issues to our therapeutic practice? Which modern ethical dilemmas would you like to hear more about--or are there any of your own that you’d be willing to share? Rich Simon Comments  |
© 2013 Psychotherapy Networker
If this is where the level of discussion is in psychotherapy, then we clearly have a long way to go in terms of "getting it." If being human and doing something out of concern for a patient rather than being rigid, coloring inside the lines, defensive, and protecting ourselves at the expense of our humanity and our patient's humanity is wrong, then I am wrong and I will be happy to be wrong.
Many of the issues that Zur discusses -- and I agree with his assessment of these issues -- appear to be psychoanalytic nitpicking. What we should be concerned about is truly unethical people who do take advantage of patients (i.e., take advantage of them sexually, steal their money, manipulate them for the therapist's own personal gain, etc.), not someone who takes a tin of cookies as a holiday gift. This lunacy is what, at times, makes therapists look like fools to the layperson and does a disservice to our profession.
SELF-PROMOTERS WHO WANT THE WORLD TO KNOW HOW THOUGHTFUL, CONCERNED, AND GOOD THEY ARE. (IS THERE SOME DOUBT?)
She in fact did leave him at the peak of a depression caused by severe physical injury on the job, rendering him disabled. I shepherded him through many hospitalizations and recovery to the point where he was able to regain his hope for a better life and a return to physical activity.
He was a truly delightful gentleman and on a personal level, I found him to be rather exciting (my counter transference) since he was the Santa Claus I’d never known in my young life.
However, I held on to my clinical/ethical/sane/ known self and sacrificed my momentary, yet powerfully compelling, desire to discontinue therapy and/or accept the gift he offered. It shocked me how much this required of me, this wild ride on the therapy boat, steering it through rapids. I dragged into the therapy issues of need, power, and love. Both of us found it difficult to admit culpability, but if there was ever was a chicken or egg question, it was clear that the reason for his coming to see me never did include looking for a wife in the yellow pages of therapists.
What was the gift? Deprived of asking me to marry him, my client told me he’d visited his attorney and arranged to leave his (considerable) acreage and home – yes, to me - in his will! I told him I can’t accept it – pure and simple. I love my work, I told him, and I don’t want to lose my license. He told me his attorney told him this happens all the time and it’s fine– it was a gift of gratitude for my services, etc. I was still hooked on “being given to” and it took all my strength to say no again and again.
In the weeks that followed, all documented, we slugged through a number of painful issues with more candor than I knew I had in me - his need for control, his lack of belief that he is a lovable human being without having to prove anything, his unwillingness to take no for an answer and the resultant lack of authentic connection, my appreciation for his generous spirit and, yes, for him, and finally the goal of all therapy and transferences of love and need – the joy of knowing and feeling your human heart. His job was to take that inside himself and be open to new life outside of our work together, for it would surely happen, I told him.
He was wounded, but realistic about what therapy can and cannot be. This, of course, opened the door to growth.
During this time, I consulted with colleagues. Some of them joked, does he have a brother? But, I never would have taken this to a risk management/ethics conference, which usually creates and feeds paranoia with a focus on harm and pathology. I think I speak for a number of us who did not come into this field for those purposes. I completely agree with and applaud Dr. Zur’s writing that this healing work we do cannot be held to rigid, fear-based applications of “rules” that keep us away our humanity.
That said, I heartily concur with Zur's suggestion to document our work thoroughly and contemporaneously as the primary measure of self-protection. However, I disagree with the commentator above who noted "no financial gain" as an acceptable ethical principle for therapists. It might be appropriate for prients or monks who have taken a vow of poverty and depend upon the charity of others for their daily bread, but as for those of us who do this work for a living, a reasonable financial gain is fair payment for services rendered. As for the example cited, how harmful the gift is all depends upon the circumstances of the giver: taking the plate of cookies from someone who doesn't have anything else to eat may be far more harmful than accepting the diamond from the obscenely wealthy, however they earned their money.