Couples Counseling is a form of therapy for established partners that seeks to resolve problems that have arisen in the relationship. It is based in part on the premise that when one aspect of a system is altered or changes, the functioning of the entire system is affected.
I have been providing solution-focused, task-oriented counseling to couples for over twenty years. Currently, almost fifty percent of my practice entails work with couples. My clinical orientation in working with couples is similar to that with individuals: viewing the couple in the context of their environment; taking into consideration psychological, biologic, socioeconomic, ethnic and individual concerns; identifying realistic goals, and developing a collaborative and accountable strategy to meet these goals. Couples counseling is fairly short-term, as a rule. It identifies and addresses dysfunctional or non-productive patterns, and creates a space in which the partners can practice new behaviors and modes of interaction that are healthy, nurturing and supportive. (However, one should bear in mind that the length of treatment is linked to the duration and depth of the problems.)
With my assistance, couples in counseling identify and agree to rules and guidelines for participation at the beginning of the treatment. Significant work is required outside of the therapy sessions, and it is important for the couple to understand and take responsibility for the ground rules in order for the therapy to be effective. The actual process of establishing and agreeing upon particular rules as a part of the therapy, presents an excellent opportunity for the couple to act out their issues (and for me to observe them), which often mirrors the reasons that bring the couple into treatment. Observing this interaction creates “real-time” material to address and explore.
While many couples have particular problems that need to be addressed, there are two primary elements that continuously disrupt and rupture relationships: trust and communication. Naturally issues such as sex, work, finances, child-rearing, religion and other elements can and do affect the quality of relationships. However, I have yet to see a relationship flourish without consistent attention to the quality and depth of the communication, and the degree of trust that is cultivated and maintained between the partners. Upon examination, identified problems that couples bring into counseling are seen to have their roots in breaches of trust and dysfunctional or insufficient communication. And, naturally, any form of overt abuse of any kind needs to be addressed before treatment can proceed.
So, I assess the quality of communication between the partners and relate it to the issues that they bring to treatment. By listening to how couples communicate, I not only get a sense of the quality of their communication, but can also derive a sense of the level of trust in the relationship, and where some of its weak links may be.
As well, I watch for indications of co-dependency, authoritarianism, poor listening, and avoidance of intimacy that may be related to a number of issues. Substance abuse often contributes to conflict in couples, particularly when there is covert “permission” given to abuse or when both members are abusing. Having one’s mood altered by chemicals is an almost certain method of disrupting communication.
