By Lawrence Kaufman, Florida Licensed Marriage and Family Therapist (LMFT) 561-302-0568
7301 W Palmetto Park Road, Suite 201A, Boca Raton FL 33433-3456
So, you have decided to give couple therapy/ counseling a chance (perhaps, once again)? Or perhaps you have already started? I commend you for your courage, openness, and hopefulness to take advantage of this valuable therapeutic service. Hopefully, both of you will give it, your partner, yourself, and your therapist, a fair try.
Couple therapy (as any psychological therapy or counseling) takes time to demonstrate and give clear evidence of its full effectiveness. Somewhat like taking antibiotics, you need to take your doses of therapy regularly, for a long enough period of time, in order to get the fullest benefit.
Below, I have listed a number of additional points for you to keep in mind to help you get the maximum benefit from your participation in couple therapy:
What You Can Do Prior to Meeting with a Therapist
If you haven’t already started couple therapy, make sure to select a therapist/counselor who specializes in this form of therapy. Similar to selecting an appropriate type of physician to see, you need to make sure that your therapist of choice is specially trained and experienced working with couples. For example, if you were having a problem with your heart you would see a cardiologist, not a dermatologist. Many therapists either do not work with couples or infrequently work with them. Couple therapy is not a particular specialty for them.
Before contacting a therapist, check out his/ her website. Some therapists have a separate page on couple therapy on their website. This can be filled with important and revealing information on how the therapist thinks and works with couples. Also, this will give you an opportunity to see what does and does not appeal to you. Different therapists have varied theoretical orientations (different ways of understanding and conceptualizing [or thinking about] clients’ problems and difficulties) and different methods or approaches to working with clients.
If you haven’t already selected a therapist, you may wish to consider having a consultation with more than one professional. This way, you will have the opportunity to compare and contrast their styles and levels of competence, and your sense of “fit” with them. You can start forming some initial impressions as to how much you think they might be able to be of help to you.
If you decide not to see more than one therapist before you make a decision (let’s say because of the cost, time, and energy involved), you (and/ or your partner) can briefly speak with several therapists, over the phone, without cost, before you make an appointment with one of them.
How Long Does Couple Therapy Take?
This is an important question. Many therapists/ counselors — even those who specialize working with couples — say they work “briefly”. (For example, from the beginning of your work together, they will inform you that you will be meeting a set or limited number of times — perhaps 10 -12 sessions.) This is appealing and sounds tempting to many prospective (potential) clients. But beware! Some people are looking for “a quick fix” or seriously underestimate just how long it might take to effectively produce significant and lasting results in couple therapy.
I, myself, work in an open-ended way. I cannot predict beforehand “how long it [the process of therapy] will take.” Every couple has their own story to tell, their own history, their own set of problems that are a challenge to them, their own goals, and differing psychological resources they bring into the therapy setting.
I view every couple as being unique. I realize that what works for one couple may not work for another. Couple therapy needs to be tailor-made (individualized, customized) in order to be most effective. This is opposite to what has been called a “cookie cutter” approach where clients are expected to fit into a preexisting mold — as a particular, favored theoretical approach or method of a therapist. Put another way, I use my extensive theoretical knowledge and experience to fit the specific and unique needs of a couple client as opposed to fitting a couple client into a narrow, preconceived approach. (Note: I use the term “couple client” because I see myself as “treating” a relationship — not just two, separate individuals.)
Most couples I have worked with have longstanding and complex problems — together and individually. Clients and therapists need to be realistic as to how much time it usually takes to get to the roots of the couple’s problems, and to supplement the couple’s old patterns, stories, “tapes,” and “programming,” with new patterns, stories, “tapes,” and “programming.” In this way — gradually, and step-by-step — old unhealthy, dysfunctional, ineffective, and unproductive ways of relating to one another are replaced by healthy, functional, effective, and productive alternative ways of relating.
Meet with the Couple Therapist Together or Alone?
Once you meet with a therapist in person, you can decide together (and this is indeed a joint decision) how much you and your partner want to meet in conjoint sessions (ones in which both of you are present) individual sessions, or a combination of the two. There are advantages and disadvantages of meeting in each modality. (Note: A “modality” is a format or form of therapy — as with individual, couple [conjoint], family, or group sessions.) If individual sessions are included in your therapy/ counseling, make sure ahead of time how the therapist you work with will handle confidentiality. Therapists have different policies in this regard. Some will share what you say in individual sessions with your partner, while some will not.
What Happens Between Sessions?
Therapists work in different ways with regard to what happens between sessions. For example, some couple therapists often give their clients “homework” assignments, while others do not. Some therapists and clients believe that homework speeds up their therapy process while others consider this a burden — especially in a very busy life. This issue can be negotiated with your therapist. Consider what will/ might work best for you. In general, the more time and effort you commit to putting into practice what you have learned in sessions, the more successful the therapy is likely to be for you. How structured or unstructured, or time-consuming this work at home will be, will be up to you.
If you feel motivated and committed to speeding up the therapeutic process, you can plan and participate in regularly scheduled relationship centered discussions in-between the sessions with your therapist. For help with this effort, see my article (which can be found on this website) entitled “Guidelines for Talking with Your Partner About Significant Shared Relationship Issues.”
Giving Feedback to the Therapist and the Therapist Adjusting to This
As the therapy sessions go on, make sure you give a great deal of feedback to your therapist as to what is working well, and what is not, for the two of you. Your therapist very much needs this feedback in order to best help and respond to you. Each couple’s needs and preferences are unique. All therapy that is effective must be adjusted and tailored to these unique needs and preferences. One size (with regard to therapy approaches) does not fit all! An effective and competent therapist needs to be flexible in his/ her approaches with you, and needs to know many different possible ways of working with you. Put metaphorically, a highly skilled therapist has more tools in his/her toolbox with which to work.
Assessment of problems and devising possible solutions are ongoing processes. As clients, you are assessing your therapist as much as he or she is assessing you. This is indeed a “two-way street” — an ever-growing, changing, and evolving, working partnership. Continuous communication between therapist and clients needs to be direct, honest, comprehensive, and clear.
How to Best End Work with Your Therapist
How you end work with you therapist is crucial. It is extremely important that you inform your therapist at the beginning of a session, that you plan to discontinue your sessions with him/ her. Just as it is so important to thoroughly talk things out with your partner before you decide to “break up,” separate, or divorce, it is so therapeutically important for you to talk openly and without censorship about the reasons why you want to “terminate” sessions. This kind of upfront and direct communication is a challenge for most people.
There is a great deal to be learned by “putting everything on the table” before ending the relationship. One of the least effective things you can do (but quite tempting for some people) is to “take the easy way out” by avoiding any direct “confrontation” with the therapist. It is my strong opinion that it is not in your medium or long-term best interest to quit therapy by leaving a message on the therapist’s voice mail canceling the next scheduled appointment — with no intention of ever talking to the therapist again.
So very much can be learned about your relationship with your partner, and about yourself, by having a final session with your therapist. To not have such a session is a significant, lost opportunity. I strongly believe that assertively talking out your points of view directly with a therapist is far more beneficial to “enacting” (or “acting out” as it was termed in the past). In an enactment, one expresses oneself through one’s actions or behaviors as opposed to communicating directly by using words.
An example of an enactment would be the following: Instead of Carl telling Angie in person that he no longer wanted to remain in a relationship with her, explaining why, and then listening to her response to what he had just told her, he left a note on the kitchen table informing her that he no longer wanted to talk to her — and that he didn’t want her to contact him. How do you think you would feel if you were in Angie’s position/ role? Have you ever experienced this type of enactment in the ending of a relationship with someone your cared about? How wounded or traumatized were you (or still are) by this method or approach to ending a relationship? Why do you suppose that people end relationships in this way? If you have been the one who enacted (instead of talking) in the past, how do you now feel about handling the situation in this way?
As difficult as it might be for you, I would suggest that you give much thought to how you go about stopping your work with your therapist. (In expressing these thoughts, I hope I have not offended you or put you off. This was not my intention. In perspective, I realize that it is sometimes in a client’s best interest to find another therapist — or partner.) I’m making an important distinction here between what you decide and how you go about carrying out this decision. One broader issue to consider is how psychologically mature you and your partner are going to be in saying or doing anything in your relationship.