Case Studies Mar/Apr

 

 

Case Studies

By Steven Stosny

 

Male-Friendly Couples Counseling

Finding love beyond words

You've heard the jokes. Every couples therapist has skid marks at the front door from husbands being dragged into the office. Or this one: A man is convicted of tax evasion, claiming that he had to do it because his wife spent too much. The sentencing judge gives him a choice: "Do you want to go to federal prison or marriage counseling?" The guy asks, "Could I have a private cell?"

You've also heard the usual explanations for male resistance to couples therapy: socialization discourages men from seeking help of any kind, but particularly in the mental health system; men are uncomfortable talking about emotions, especially with a wife present: it's her turf! Men tend to be more instrumental in the way they express emotion: they prefer to do something to show their feelings, rather than talk about them. Men expect to be blamed for everything that goes wrong in a relationship, so why even try explaining themselves or talking about how they feel? "Let's skip the prosecution and get right to the sentencing."

Even highly skilled therapists can have trouble handling male resistance. Some bend over backward to engage the guy, which can make him drop out early, convinced that his wife is the problem. Sometimes frustrated therapists are tempted to do just what men say their wives do: blame them, but in the language of psychopathology—he won't talk about how he feels because he's narcissistic, depressed, passive-aggressive, sociopathic, emotionally unavailable, phobic about intimacy—and that's why therapy isn't working!

It was because couples therapy has such a hard time engaging men that I began what I call "boot camp" couples therapy—a tough, concentrated format, consisting of three eight-hour days with a one-year follow-up. Men seem to prefer this approach to drawn-out weekly therapy with no conclusion in sight. The vast majority of the couples I see are therapy veterans, whose former therapists have thrown up their hands in defeat and referred them to me. When these couples come to my office, the women are exhausted, or bitter, or both; the men cynically describe what they've learned in their previous therapy: "To save my marriage, I have to become a woman."

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