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Rocking the Boat: Facing the Challenges of Couples Therapy

Treating the Anxious Client

By Rich Simon Back in the 1970s, as boomers like me came out of grad school and flooded the psychotherapy field, the big challenge to the mainstream tradition of psychodynamic orthodoxy was posed by the iconoclastic family therapists like Salvador Minuchin, Virginia Satir, and Carl Whitaker. Their version of therapy seemed like a thrill-a-minute joyride in comparison to the staid predictability of therapy-as-usual. They welcomed the loud, messy, and revealing stuff that happened when real, highly imperfect families got together. They argued this was exactly the reality that individual therapists, lost in their tidy theories, were missing about troubled relationships and what was needed to change them.

Thirty years later, despite all of our advances in understanding how deeply interconnected human beings are with each other, it is still standard practice to see clients individually. With relatively few clinicians still identifying themselves as family therapists these days, the biggest challenge to the prevailing individual orientation of psychotherapy is posed by therapists who work with couples. They are the ones most likely to rock the boat and exhort their colleagues to reconsider their insistence on individual treatment rather than more challenging–and perhaps more impactful–modes of therapy.

Several of these boat-rockers are represented in a webcast series we are bringing back by popular demand called “Who’s Afraid of Couples Therapy?” The series leads off with Ellen Bader and Peter Pearson who argue that most therapists are initially “unprepared for the degree of hostility, bitterness, distrust, and occasional homicidal rage” they encounter in working with couples. In fact, according to them, the primary reason that individual therapy remains our field’s dominant mode is that couples therapy makes too many clinicians nervous. But beyond that, Bader and Pearson assert that individual therapy can actually be detrimental to clients because it “too often leaves [them] ill-prepared to take on the gritty, emotion-charged real world of a troubled relationship.”

In their own way, each of the contributors to the webcast series argues that turning up the heat in the therapy room is the key to having real therapeutic impact with couples. None is more provocative than David Schnarch, who offers the decidedly unsentimental view that the most respectful way to help clients grow up and improve their marriages isn’t by endlessly soothing their wounded inner child, but by challenging them to pull themselves up by their own psychic bootstraps. As he puts it, “I don’t try to convince clients that my office is a ‘safe place.’ Instead, my office, I’m clear, is a place ‘where change happens.’ Of course the first rule of therapy is ‘Do no harm.’ But ineffective therapy isn’t harmless, and systematically underestimating clients’ abilities, whitewashing darker motives, and squandering clients’ time, money, and patience isn’t a safe clinical stance.”

The clear takeaway from this challenging webcast series is that couples therapy isn’t easy. It requires more energy, more hands-on minute-to-minute involvement, and–in the final analysis–probably more guts than other kinds of therapy. Whether it leads to more effective therapy (however that’s defined) is an empirical question that remains to be answered. But what is certain is that therapists who take on this kind of work are in for an exciting and stimulating ride.

Who’s Afraid of Couples Therapy?
New Ways to Work Effectively With Tough Couples
All Sessions Available May 23rd
Click here for full course details.

Save $19.99 When You Register
Before Midnight, Wednesday, May 1st
Use Code: COUPLES19

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One Response to Rocking the Boat: Facing the Challenges of Couples Therapy

  1. DSM V is coming out soon. Is it too early to expect someone to explain the final changes?

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