In Consultation

In Consultation

Old Habits Die Hard: Making couples therapy stick

By Steven Stosny

January/February 2010

Q: A year ago, I completed what I thought was successful marital therapy with a couple, but this week, here they are again in my office. How do you get marital therapy to "stick," once couples are back on their own?

A: Most therapists are highly focused on helping couples make significant progress during therapy, but don't do much to help them maintain these gains after therapy ends. Unfortunately, the assumption that couples will continue at home to employ the skills and insights they learned in their therapist's office ignores one of the most powerful of neurological principles: habituation.

Repeated neural associations become habituated, as summarized in Hebb's rule, "Neurons that fire together wire together." More recent neurological research suggests that habits never die: they merely hibernate. If cues that once triggered them recur, the habituated response returns, even after years of dormancy. In fact, under the stress and distractions of modern living, even our more successful couples are likely to revert to their pretreatment interactive habits and forget what they learned in therapy. They'll certainly have lapses that can easily turn into full-scale relapses.

How can you possibly counteract ingrained neural associations, you may rightly ask. In fact, a growing literature on relapse prevention suggests that you can help the couple retrain their brains, so to speak, by instituting new…

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