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|Clinicians Digest July/Aug 2008 - Page 7|
Conventional wisdom says that when there's any indication of physical aggression in a relationship, couples therapists should focus on violence prevention, lest the violence escalate and someone suffer serious injury. But since a 1996 study by Miriam Ehrensaft and Dina Vivian estimates that as many as 74 percent of couples seeking therapy have experienced some kind of physical assault from their mate, that wisdom may need some close examination. Now a study led by Lorelei Simpson of Southern Methodist University suggests that automatically focusing on the violence is sometimes unnecessary and may even be counterproductive, driving couples out of therapy.
Simpson's study, reported in the February 2008 Journal of Family Psychology, finds that for couples who've exhibited low levels of physical aggression, couples therapy focused on other relationship problems doesn't result in more physical violence. The study excluded partners who'd committed severe acts of aggression (like choking, scalding, and forced sex); two or more acts of moderate aggression (like slapping or causing physical pain that lasted more than a day) in the last year; or at least six acts of mild aggression (like pushing or shoving) in the past year.
Up to two years after treatment ended, couples who received therapy directed at the usual issues, like closer emotional attunement and better communication, showed no increase in physical aggression and significantly higher levels of individual and couples satisfaction. Simpson argues that automatically turning couples therapy into violence-prevention therapy may actually chase couples with a history of occasional, mild physical violence out of therapy. Many couples don't label such aggression as a problem, so focusing therapy on it may cause them to feel their therapist isn't listening to their concerns. Or they may leave therapy because they don't want to be labeled as abusers or victims.
Those who insist that there's no such thing as "mild" violence, and that any physically aggressive acts call for violence-prevention therapies may not be convinced by the study. After all, although Simpson's couples reported no instances of increased physical violence after therapy, there wasn't a decrease either, even though the therapists in the study were free to address the physical aggression in sessions. But for now, couples therapists may want to reconsider the conventional wisdom and look at mild physical violence as a warning sign, not a fire alarm.