Case Study

Taking Sides in Couples Therapy

The Importance of Ditching Neutrality

Magazine Issue
May/June 2024
Illustration of two people on a giant scale | ILLUSTRATION BY SALLY WERN COMPORT

Case study by Enrico Gnaulati

So much of our training as couples therapists encourages impartiality, but what of the times when one partner is clearly in the wrong—and the other needs clear backing and support if there’s going to be any hope of undoing relational damage?

After many years of working with couples in various states of division, I’ve learned there can be real therapeutic benefits in not suppressing our natural impulses to point out and remediate ethical imbalances in the relationship. Contrary to our training, in which we’re told never to take sides, we can in fact share our determinations in the moment of who’s been harmed the most and who’s owed support at a particular juncture, or whose virtuous reparative gestures deserve recognition. After all, those imbalances are often at the heart of couples’ problems.

As counterintuitive as it seems, when one partner really crosses a line with their actions, inflicting palpable emotional harm, the therapist’s task isn’t to seek neutrality, but to seize upon and amplify any guilt manifested in the wrongdoer—which can be thought of as therapeutic guilt-inducement. That way, the aggrieved person directly witnesses their partner feeling badly for having acted badly, rendering the original hurt caused more bearable, and perhaps forgivable over time. Yet doing this is rarely easy for therapists trained to balance empathy for both partners equally in couples work, and it requires walking a delicate line.

Taking the Risk

Within days of being released from a rehab center, 64-year-old Landon called me to set up couples therapy for himself and his wife. “I’ve really messed up, man,” he confessed. “Big time. The marriage is in tatters. I’ve gotta save it.”

Jill, his 56-year-old wife, would be joining us remotely, since she’d decamped to her mother’s house six hours away after Landon’s latest drunken escapade, in which a happy hour with colleagues had resulted in his passing out in front of a strip joint, his phone showing repeated unanswered calls from Jill, and his shoes and wallet nowhere to be found.

“You’re overreacting,” he’d screamed at her when she told him she wouldn’t consider coming back until he’d gone to rehab. “Do you think you’ll be better off without me?! I could shoot myself in the head, take all the pills in the house! Would we have some peace then? I mean it: I will!”

Jill had hung up and called the police, who placed Landon on an involuntary hold at a local psychiatric facility for three days. After, he’d checked himself into a nearby rehab center. But once he was released, humiliated and alone, a sense of self-righteous indignation welled up in him. He convinced himself that Jill had been the wrongdoer for abandoning him in his hour of need and told several of their mutual friends that she was a “heartless gold digger.”

It was only when he started individual therapy to get his head around what looked to be the end of his marriage that he realized he didn’t want an end to his marriage. That’s when he begged her to join him for couples therapy, saying, “I’m ready to make some serious changes.” Although unconvinced, she’d agreed to a single session with me.

From the start, I knew that if couples therapy was to have any chance of saving their marriage, it couldn’t be your run-of-the-mill, exploratory approach to creating change. At least on the surface, this was a case of lopsided culpability—and therapy would have to function temporarily as a court of last resort. Jill needed immediate proof that Landon’s commitment to change was genuine, so Landon needed to walk the walk, not just talk the talk. I couldn’t make that happen through neutrality and symmetrical support, so I’d have to silence the voices of past supervisors in my head telling me not to align with anyone—and just to track, acknowledge, process feelings, and help them source family-of-origin issues along the way. I’d also have to do something that risked alienating Landon but would almost certainly help keep Jill in therapy: use guilt as a therapeutic tool. In order to change, Landon had to feel guilty—the right amount of guilt to lead him to make amends, but not so much that it would tip him backward into the anger, resentment, or shame that would disconnect him from our therapeutic process.

I chose to begin our session by overtly bearing witness to how badly Jill had been wronged, not just by acknowledging how she felt wronged.

“At first, I was filled with anxiety not knowing where he was or if he was in danger,” she said. “Then, when I knew what had happened, I felt disrespected, betrayed, angry.” She bit her lip. “On top of that, he blamed me for it, threatened suicide, and put me in the embarrassing position of having to call the police. Later, he threw me under the bus with his friends! It’s hard to see a path in which we can come back from all this.”

I thanked Jill for letting me hear her story. Then I turned to Landon and said, “Please don’t assume I won’t eventually see some things from your perspective, but do you realize that by agreeing to come to therapy, and even contemplating staying married to you, Jill is showing a level of loyalty that because of your actions you might not deserve? I know you felt abandoned in your hour of need, but for now, I want you to feel your way into how frightening it must have been for Jill to go through all this. To put it bluntly, Landon, it sure looks like you’re in the wrong here, and it’s on you to make things right!”

The risk I took worked. Rather than storming out, Landon got teary. “When things are good,” he said, “when Jill and I talk over dinner or watch shows together, I feel alive, like we could grow old together as best friends. It’s stupid of me to let alcohol get in the way of that. I’m so ashamed. I’m really sorry.”

Here was a bit of the therapeutic guilt inducement I was going for with Landon. He needed to connect with the emotional harm he’d caused Jill, feel contrite, and make amends if they were to have a chance of recovering from what he’d done. This was a start, one that seemed to surprise Jill.

“I hear you,” she said. “But it’s hard to let myself believe you. Plus, you shouldn’t just want to stay sober to keep me. You should do it for yourself.”

The Power of Guilt

Much ink has been spilled in the therapy literature about guilt being a toxic emotion, but we tend to forget that guilt is one of the primary social emotions that keep us socially aware and adequately self-conscious. More often than we want to believe, that ache in the pit of the stomach, those sleep-disrupting ruminations in the middle of the night, are signals that we’ve acted badly and need to make amends to get our relationships back on track.

As philosopher Herant Katcha-dourian notes in Guilt: The Bite of Conscience, “Guilt makes us feel bad to make things better.” It has the potential to redistribute the suffering caused by hurtful actions in relationships in ways that feel fair and equitable. Knowing that the person who’s hurt us feels miserable about their actions makes the hurt they’ve inflicted more bearable. The pain is shared. Knowing this tends to make the aggrieved party more accepting of apologies and receptive to making amends.

I’d guessed correctly that Landon was chagrined enough about his behavior and desperate enough to get Jill back that he’d hang in with an initial therapy focus of animating his guilt, but I knew Jill would need more than guilty apologies from him.

“I get that you don’t have a lot of freedom here, Landon,” I said. “You’re up against a mandate of committing to AA meetings, but it’s where we are if you want to right wrongs and rebuild marital trust.”

Landon nodded. “I can do it.” He paused. “I want to do it.” He paused again. “But I need her help.” He turned toward the computer screen, “I need your help,” he said to Jill.

From what I could tell by her body language, Jill seemed more conciliatory toward him than at the beginning of the session, but she was rightly suspicious. In response to his plea, she simply clenched her lips.

“Jill, I can tell you’re holding back from responding to Landon’s need for you to be more emotionally available. It’s understandable. Maybe you’re not feeling safe, or you’re doubtful he’s serious about wanting to be a kinder version of himself. Would it help if you knew he’d completed rehab, is attending AA meetings, and is willing to email you regular breathalyzer readouts?”

She nodded.

Later in the session, when we were discussing Jill’s sense of betrayal over Landon allying their friends against her, I interjected. “I hear what you’re saying, Jill. Those types of betrayals can be very hard to come to terms with. Does it make any difference that he later met with those friends and explained how wrongheaded this was?” Here, I was testing the waters for any nascent forgiveness from Jill, but it backfired: I’d tilted too far toward Landon too soon.

“You know, it’s not like we haven’t been here before,” she said, her eyes narrowing. “I agreed to try to save the marriage, but sometimes it feels too hard.”

I backpeddled. “Your reaction is justified, Jill. I’d probably be saying the same thing in your shoes. But to be perfectly honest, I worry that if Landon feels we’re defining him by his worst mistakes, there may not be any hope here.”

Landon chimed in. “I’m guilty, I’m ashamed, but I’m doing my best right now!”

Both of them looked at the floor. This burst of emotionality wasn’t engendering closeness in the moment, but it did clear the air just as the session was ending.

Highlighting Kindness

In subsequent sessions, as Landon continued to stay sober, acknowledge guilt, and make amends, I continued to give preferential treatment to either Landon or Jill, but mainly when they’d softened and displayed kindness to one another. I said things like, “I know rebuilding trust is a delicate issue right now, Jill. It takes courage and generosity to praise Landon for maintaining six weeks of sobriety!” “You resisted the urge to fall back on defensive sarcasm, Landon. That’s something!”

Nowhere does the therapist need to be more partial to a client than when he or she is generous with goodwill. As we’ve learned from the Gottman Love Lab, when troubled couples overlook kind actions—bids for connection—it can register as rejection and fuel more tit-for-tat snark and withholding of affection. I’ve learned that a willingness to be partial to whichever member of the antagonistic couple thaws and shows overtures of kindness is helpful. Although I wasn’t always neutral, Jill and Landon trusted me to be honest—which is why the moments when I highlighted signs of genuine positivity between them had such an impact.

“I just noticed that you, somewhat shyly, mentioned it was nice having Jill go on a walk with you this weekend,” I told Landon when Jill had ventured back from her mother’s house for a trial run at living with Landon again. “What about that made it nice?”

Later, I said to Jill, “You smiled when Landon said he’d be happy to babysit the dog this weekend. Can you elaborate on how this made you feel?”

Then again to Landon, “I’m impressed by how well you took note of what Jill said last session about not pulling your hand away in public when she reaches out for it!”

My therapy with Landon and Jill is ongoing, and the news isn’t always stellar. It’s two steps forward, one step back. There’s the perpetual risk that if I push Landon too hard into guilt, he’ll stop experiencing himself as a good person who acted badly but has a path to redemption, and instead experience himself as irredeemably bad, a hopeless case who shouldn’t even bother trying to improve because he’ll forever be a target of judgment.

In contrast, if my interactions with Jill lean too heavily toward her calling off the dogs, seeing the good in Landon, and making the best of a bad situation, she’ll rightly feel I’m “blaming the victim” and may call it quits. Not only that: if I’m too attached to my own agenda, I may inadvertently harm her by encouraging her to forgive prematurely and expose herself to more irresponsible behavior from a partner who hasn’t truly changed.

That said, Landon and Jill have told me they appreciate my efforts to exhaust all the possibilities for them to preserve their marriage. Jill’s said, “I wouldn’t be in this office right now if it weren’t for the fact that you take seriously how disrespected and betrayed I was by what Landon did. I don’t know where we’ll end up, but for now I’m willing to show up here.”

Landon’s told me, “I know it’s on me to keep up my sobriety, express regret, and take real action to rebuild trust. It helps when you go out of your way to point out my positive efforts to break through to Jill, who I hope can find her way back to me.”

We’re still working on it together with honest fortitude, as they vacillate between hope and hurt. Such is the nature of couples therapy as the court of last resort.

Case Commentary

by Terry Real

I read Enrico Gnaulati’s well-reasoned, clinically sound argument for taking sides in couples therapy with mixed emotions. On the one hand, it was wonderful to see the acumen of both his thinking and technique; on the other, I confess it felt oddly akin to the approach I’ve been teaching for decades: Relational Life Therapy (RLT).

RLT was born in the two-day relational interventions I constructed to help couples on the brink of divorce. Often, their relationship exhibited an emphatic power asymmetry. As with Gnaulati’s clients, one partner was usually egregiously anti-relational in terms of their addiction, repeated infidelity, or verbal or physical abuse, while the other partner, often fed up and in a codependent position, was ready to pull the plug. I called the former blatant and the latter latent. Most of these couples had been to two, three—the record was eight—therapists, who, under the rubric of neutrality, had thrown the latent under the bus.

In RLT, we have a saying: “We want the weak to stand up and the mighty to melt.” Just as Gnaulati did, RLT therapists first move to empower the latent by definitively throwing our weight behind her (often it’s the female in a heterosexual couple). “She’s right. Your behavior is not tenable. Where did you learn this from?” Using the leverage of the potential negative consequences of his behavior, coupled with the reward of transforming the legacy he can pass on, we help bring the grandiose partner out of his entitlement into remorse. Remorse, unlike shame, has the power to heal.

The key is understanding grandiosity and how to help people divest of it. Currently, we hear a lot about so-called narcissistic partners who are both abusive and untreatable. As Gnaulati has discovered, that’s nonsense. Grandiosity and narcissism, in all but very rare extreme instances, has proven eminently treatable by RLT. But the treatment must be relational, not individual.

Legendary psychiatrist George Eman Vaillant once said, “There are two types of people in the world. There’s the guy who walks into an elevator, gets claustrophobic, and turns green. And there’s a guy who walks into an elevator, lights up a big fat stogie, and makes everybody around him turn green.” That’s the difference between shame and grandiosity.

For more than 50 years, psychotherapy has been obsessed with helping people come up from the one-down position of shame. And we’ve done a poor job of helping people come down from the one-up position of selfishness and narcissism into connection and intimacy. As is well-illustrated in this case, both self-esteem disorders need to be dealt with in order to bring people into true intimacy. You cannot love from a position of superiority or inferiority. Love demands democracy.



Enrico Gnaulati

Enrico Gnaulati, PhD, is a clinical psychologist who’s been in private practice for more than 25 years and authored four books, including his latest, Flourishing Love: A Secular Guide to Lasting Intimate Relationships.

Terry Real

Terry Real, LICSW, is an internationally recognized couples therapist, speaker, author, and founder of the Relational Life Institute (RLI). His latest bestseller is Us: How to Get Past You and Me to Build a More Loving Relationship. He’s also the author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression (Scribner), the straight-talking How Can I Get Through to You? Reconnecting Men and Women, and The New Rules of Marriage: What You Need to Make Love Work.