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The main therapeutic mistake here would seem to be the therapist’s failure to attend to the negative affect that continued to be actively expressed between the couple. Therapy remained at a largely cognitive level, without the opportunity for the couple to access or experience their deep feelings of vulnerability and missed connection with each other. Although attempts were made to increase positive interactions, these interventions were probably premature, given that the couple remained engaged in a cycle of mutual resentment, blame, and fear. Any number of techniques based on BMT, EFT, IBCT, or Gottman’s sound marital house could have been applied here.
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A White, middle-class, childless, dual-income couple, Amanda and Roger presented for therapy to resolve issues regarding infidelity and poor communication. They had been dating for two and half years and had been married for one year. Amanda brought a history of childhood and adolescent sexual abuse, as well as current problems with alcohol abuse. She initiated a short-term affair that was the crisis that brought the two to counseling. Roger used both alcohol and marijuana when stressed, and self-identified as wanting to avoid conflicts. Roger desperately wanted to stay in the relationship, but reported feeling helpless and ineffectual. Both expressed a wish for more closeness and affection, although Amanda had no sexual desire for Roger and also talked about ending the relationship. Amanda had been in individual therapy previously working on her sexual abuse concerns. In the first session, the therapist, a relatively inexperienced clinician, conducted a half-hour interview to get the history behind the couple’s presenting concerns. They reported difficulty for the past six months, with Amanda attending classes part-time in a nearby city and Roger working 12hour days to make ends meet. Roger admitted resentment over Amanda’s new interests and friends at school; Amanda complained about Roger’s What the Research Tells Us 447 448 SPECIAL ISSUES FACED BY COUPLES lack of responsiveness to her in the evening. Roger felt unappreciated for all his hard work. Amanda would try to engage Roger, usually in angry ways, which would be followed by Roger’s shutting down and withdrawing. Amanda would then withdraw as well, and eventually chose to turn to an extra-marital relationship for support. Amanda had stopped the affair before the couple entered therapy and expressed anger and impatience that Roger did not appear to be over it yet. The therapist made no specific interventions in the initial session. In four following sessions, the therapist taught and coached the couple on communications skills and had them practice using the skills in session to discuss something positive in their relationship and then to discuss more difficult issues. The therapist helped the couple to identify negative patterns of interaction and reframed or challenged dichotomous thinking and dysfunctional relationship beliefs. For homework, the therapist asked the couple to come up with a time they could do something fun together at least one time during the week and made a concrete and specific plan tailored to their preferences and schedules. The couple was also asked to have check-in conversations with each other each evening, with each partner alternating the initiation of that conversation. Amanda and Roger complied with all assignments, but remained hostile and frustrated in sessions. The therapist constructed a genogram with the couple in their fourth session to explore family-of-origin patterns that might be related to their own relationship. The couple failed to attend the next two sessions and appeared to have quit with their core issues unresolved.
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OUTCOME LITERATURE A series of recent reviews continue to find that couples therapy is modestly effective, although concerns remain regarding both the proportion of couples who make progress and the duration of changes . A number of specific treatment modalities have enough replicated support to be designated as EVTs/ESTs. Behavioral marital therapy and emotionally focused therapy have the strongest current research base, and have been accepted as empirically validated . A newer therapy that is gaining empirical support is integrative behavioral couples therapy . Also called just integrative couples therapy , IBCT goals are both emotional acceptance and behavior change. The first is brought about via the revelation of vulnerable feelings, which enhances empathy. The second is accomplished by identifying problems as externalized situations couples get into with each other versus blaming each other for the bad things you do to me . This allows the couple to more objectively identify the specific triggers for their cycles of negative interaction and to then intervene. The scientifically based marital therapy developed by John Gottman and colleagues deserves inclusion on any list of effective couples therapies. Based on his sound marital house theory and well-executed in-house clinical research over the past decade, Gottman’s work has garnered substantial support. Reviewers list IBCT along with cognitive-behavioral marital therapy , strategic therapy, and insight-oriented marital therapy as being better than no treatment for couple distress, although these four therapies do not have the degree of empirical support that BMT and EFT do. Epstein offers additional support for cognitive-behavioral approaches. Marital and premarital enrichment/enhancement programs, including couple communication , relationship enhancement , the prevention and relationship enhancement program , and PAIRS continue to enjoy empirical support as well . Couples participating in these programs, especially those with a strong skills base, report satisfaction with relationship education as well as gains in communication, quality of relationship, and changes in the way they handle conflict over time. As with couples’ therapy per se, effects of these interventions past the 6to 12-month mark are less well-documented, with the strongest support for PREP . A recent metaanalysis , provides support for premarital enhancement programs as well. Overall effect sizes were moderately large , indicating that couples who participated in What the Research Tells Us 443 444 SPECIAL ISSUES FACED BY COUPLES such programs were better off than 79% of those who do not. Premarital enrichment leads to immediate and short-term gains in relationship quality and interpersonal skills. Two recent additions to the prevention/enhancement ranks were found. One, called the Marriage Checkup gives couples a two-session motivational interview consisting of assessment and feedback . Even two years after participation, MC resulted in moderate changes for the better in couples’ relationships, and increased levels of therapy-seeking by wives. The second, Couples’ Coping Enhancement Training , takes a cognitive-behavioral and couples’ coping skills approach. Couples who completed the 18-hour course maintained gains in marital adjustment at one-year follow-up. Couples therapy has been shown to be helpful in the treatment of a host of mental health disorders and difficulties . For example, in the treatment of depression, Kung notes that couples therapies that attend to four dimensionsmarital stress, support, role expectations, and interactional dynamicsare likely to be the most effective. In particular, Kung recommends Teichman and Teichman’s cognitive marital therapy . Mead finds the strongest empirical support for BMT in the treatment of co-occurring marital distress and depression. Denton, Golden, and Walsh note that although couples and individual therapies seem equally effective in treating depression, couples therapy is typically superior in enhancing relational adjustment. In special sections of the Journal of Marital and Family Therapy devoted to MFT effectiveness, support is noted for the treatment of schizophrenia , substance abuse , alcohol abuse , and affective disorders , with mixed results in studies of couple counseling for adult chronic illnesses . In a related vein, Cloutier, Manion, Walker, and Johnson found EFT to be effective over the course of two years in helping couples cope with the marital distress generated by caring for chronically ill children. In a multicase qualitative study, Trute, Docking, and Hiebert-Murphy found brief conjoint therapy helpful for couples in which the female partners were both recovering addicts and survivors of childhood sexual abuse. A review by Sexton and colleagues supports the effectiveness of couples therapy in the treatment of depression, substance abuse , and to a modest degree for sexual disorders. Johnson adds agoraphobia and obsessive-compulsive disorders to the list. Lantz and Gregoire report that traumatized Vietnam veteran couples responded well to existential couples therapy, with treatment gains maintained at one-year follow-up. From a cultural perspective, Santisteban and colleagues emphasize that it is important to match relationship patterns to treatments. Couples who embrace cultural patterns of symmetrical and egalitarian relationships are likely to do well in therapies that emphasize direct negotiation. In contrast, couples who organize their relationships along complementary lines may do better with more indirect interventions such as those promoted in strategic models or in therapies that focus on acceptance. PROCESS LITERATURE Couples therapy process research looks at what happens inside therapy sessions that makes a difference to outcome. Frielander, Wildman, Heatherington, and Skowron conducted a seminal review of this literature in 1994. These authors concluded that important processes in couples work should include an active therapist; client changes in cognition, behavior, and especially affective states; the therapeutic bond as experienced by the client; and client’s level of engagement in therapy. At the turn of the millennium, Lebow concluded that the therapeutic alliance was the primary empirically supported change process in couples therapy. More recently, authors such as Diamond and Diamond have suggested that from a transtheoretical approach, common key tasks in the process of couples therapy would include building alliances, reattribution/reframing, reattachment, and for those couples with children, attention to parenting practices. However, Sexton and colleagues caution: In its present state, the trends and specific findings of couples therapy process research provide no more than provocative possibilities . They do identify three empirically supported change mechanisms, including the reduction of negative communication/blame, the therapeutic alliance, and a therapy structure in which the couple is allowed substantial responsibility in guiding their sessions. Factors such as clients’ level of distress or psychopathology and therapist experience may moderate the effects of couples therapy. Getting more specific, Heyman , in his impressive review of approximately 200 studies on couples’ observation research, concludes that critical interventions are based on teaching couples how to monitor and then exit their poor communication cycles. Core processes that need to be assessed in therapy include: How does the conversation start? Does the level of anger escalate? What happens when it does? Do they enter repetitive negative loops? Do they indicate afterward that what occurred during the conversation is typical? Is their behavior stable between . . . discussions? Do their behaviors differ when it is her topic rather than his? Do they label the other person or the communication process as the problem? Using concepts derived from the sound marital house theory, Gottman and colleagues note that building positive affect is a crucial task in the process of therapy. Telling partners to just be nice to each other doesn’t work; Gottman and colleagues recommend rebuilding the couple’s friendship in three ways. The first is through deeply knowing one’s partner . The second is expressing fondness and admiration for one’s partner. The third is to turn toward one’s partner in everyday interactions, rather than ignoring or discounting. It is important that these processes be carried out in nonconflictual contexts. Additionally, couples must be helped to exit negative cycles of interaction. This can be accomplished in four ways: softened startup, accepting influence, repair and deescalation, and compromise . If couples become gridlocked in negative sentiment override and eventual emotional detachment, Gottman recommends techniques such as creating shared symbolic meaning and honoring life dreams to reconnect the partners. Such reengagement is accomplished through exploring each person’s experience history with the basic emotions . . . the meaning of everyday rituals, as well as the meaning of fundamental roles in their family of origin and their own marriage and family . Johnson , from the perspective of EFT, has identified a number of key therapy processes related to successful outcomes. Clients in EFT report that crucial sessions involve deep experiencing and positive self-focused statements, which tend to allow their partners to come closer and to respond with reciprocal self-disclosure. Johnson refers to such moments as softening, which refers to a previously hostile and blaming spouse’s asking for an affiliative response from the other in a vulnerable and congruent fashion. The other spouse, previously withdrawn, is then able to be accessible and responsive, thus creating emotional engagement . A recent qualitative study by Helmeke and Sprenkle examined pivotal change moments in couples therapy. They found that these moments were characterized by being highly individualized, personal, and private, [r]ather than being emotionally charged moments that were shared by or at least evident to all the participants . Pivotal moments in early sessions often gave hope, clarified, or reframed couple problems. Additionally, therapists often needed to revisit core emotional themes across a number of sessions before pivotal moments occurred later in therapy. This study is noteworthy for its focus on couples’ immediate postsession reports of important changes experienced from their own perspectives. SUMMARY/SYNTHESIS It should be clear at this point that many forms of couples therapy are effective modes of intervention. In keeping with the idea that affective processes are key in couple relationships, attention to both interrupting cycles of negative emotion and to rebuilding emotional connections in therapy seem pivotal in all effective therapies. Evidence for this can clearly be seen in EFT, and in the recent modifications of BMT to include more focus on emotion , and in Gottman’s approach. However, it should be noted that certain types of couples do better in therapy; those who are younger and who don’t have children, those who start therapy with less negative affect, those who are less gender-traditional, those with less individual psychopathology, those who are not yet seriously disengaged from each other, and those who are economically advantaged . Another indicator of overall effectiveness is that couples therapy has been shown to reduce the utilization of other health care services . However, although couples therapy has now clearly demonstrated a basic level of success, some cautionary notes are in order. As Johnson and Lebow note, most client couples are White and middle class; thus, so is most of the research on couples therapy. Although diversity issues are beginning to be addressed in the basic literature regarding couples’ adjustment, relational satisfaction, and relational stability, the field of couples therapy research has lagged behind. Some studies have started to address the particular personal/therapist qualities and skills needed to deliver effective couples therapy to specific populations, such as rural couples , ethnically diverse couples , and gay, lesbian, or bisexual couples . Additionally, more research linking process and outcome would be helpful. Newer, complex models and statistical techniques are allowing for more sophisticated work to emerge in this area. Likewise, creating sustained changes in couples therapy remains a challenge.
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OBJECTIVE CHARACTERISTICS OF THE COUPLE It has been long assumed that similarity on a variety of variables such as personality, age, socioeconomic status, education, values, religious beliefs, ethnicity, and so on is conducive to relational satisfaction and stability . However, the recent research in these domains is mixed. Religion Regarding religious similarity, Heller and Wood found no differences in levels of intimacy between intramarried Jewish couples and intermarried couples with one Jewish partner. Interestingly, when interviewed, the intramarried couples saw their ethnic/religious bond as a source of mutual understanding, while intermarried couples found that the negotiation of their differences deepened intimacy for them. Also studying interand intramarried Jewish couples, Chinitz and Brown discovered that disagreement on religious issues, versus a couple’s status as interor intramarried, predicted marital dissatisfaction. Ethnicity Recent research on interethnic couples challenges the stereotype that these relationships are doomed to instability. Gaines and Brennan provide evidence that interethnic couples can be successful when differences are appreciated rather than just tolerated, when partners actively create their own unique relationship culture, and when each partner views the other as contributing to her or his personal growth via their cultural differences. For example, no differences in marital satisfaction were found between Mexican American couples, White American couples, and couples with one Mexican American and one White American partner , interracial White/Asian and intraracial Asian couples , or among interethnic African American/White couples in comparison to both monoethnic African American and monoethnic White couples . Regarding monoethnic couples, Allen and Olson developed a fivecategory typology of African American marriages, and tested their associations with marital satisfaction and stability. Each of the five types had unique profiles. Santisteban, Muir-Malcolm, Mitrani, and Szapocznik address variation within an ethnic or cultural group in terms of acculturation. Instability in a couples’ relationship is likely to occur when partners move through the acculturation process at varying rates. They note, an abrupt and accelerated reconfiguration of a couple’s egalitarian versus complementary relations dimension . . . cannot help but disrupt family functioning and affect their ability to reach joint decisions and set clear and consistent rules and consequences . Kelly and Floyd discovered that racial perspectives were key predictors of Black couple adjustment; again, conflicting attitudes held by Afrocentric Black men were associated with deterioration in Black couple relationships. Psychopathology Individual differences in levels of psychopathology, including trauma history, have been related to couple functioning. Regarding trauma, Nelson and Wampler compared clinic couples in which one or both partners had a history of childhood abuse with couples in which neither partner had a trauma history. Those couples in which one or both partners experienced early trauma reported lower levels of marital satisfaction and family cohesion. Similarly, Lev-Wiesel and Amir find that in couples where one member has been a Holocaust survivor with a posttraumatic stress disorder diagnosis, spouses report declines in marital quality, especially when the traumatized partner shares reminiscences or displays hostile behavior. In a study of over 1,300 Palestinian women, Haj-Yahia found that all forms of abuse were associated with lower levels of marital commitment, satisfaction, affection, happiness, and harmony. In a slightly different vein, Watt confirms that couples who come from alcoholic families report more marital instability and dissatisfaction. A great deal of attention has been given in the couples literature to the relationship between depression and couple functioning; recent studies continue to support this link in a variety of ways . In couples where one partner is depressed and the other is not, Benzon and Coyne identified spousal burden as key elements in the nondepressed partner’s mood. When the depressed partner was male, both patient and spouse had higher levels of depression. Katz, Monnier, Libet, Shaw, and Beach found that medical students’ depression was related to increased levels of depression in their spouses, as well as to reduced marital satisfaction. In an examination of women who had experienced a severe marital stressor What the Research Tells Us 433 434 SPECIAL ISSUES FACED BY COUPLES , Cano, Christian-Herman, O’Leary, and Avery-Leaf determined that 16 months after the event, levels of marital discord, depression, and relationship dissolution were elevated. Children Another variable of interest is presence or absence of children in couples’ lives. Recent research confirms that marital intimacy declines between one month and three years after children are born , regardless of whether or not it is a first child. Differences in attitudes toward child rearing were associated with drop-offs in marital intimacy as well. In a review of the research on families with young children, Demo and Cox indicate that after a period of initial adjustment, most couples regain satisfactory levels of marital quality. This is more likely when the marital bond was strong to begin with, when neither partner was depressed, when solid problem-solving communication skills were in place, when parenting expectations were realistic, and when fathers played an active role in caregiving. Negative relationships with inlaws have also been shown to erode marital satisfaction and stability . Relationship Status The status of a couple as married or cohabiting has also been examined in terms of relational happiness . These investigators compared dating, cohabiting, and married couples on indices of intimacy and dyadic adjustment. Married couples had lower levels of affectional expression and engagement in comparison to cohabiting or dating couples. However, levels of intimacy were similar across all three groups. Both married and cohabiting couples had high levels of agreement regarding intimacy and relational adjustment factors in comparison to dating couples. Gender Gender is a complex and multifaceted construction, and its influence on intimate relationships has been very widely studied. It would be impossible to comprehensively review this literature in this chapter ; thus, only select studies relating to couples’ relationship quality and stability will be included. For example, Acitelli finds that women see relationship talk as a routine way of maintaining relationships, while men only value such discussions when problems arise. Men may see the need to share activities as more important to relationship maintenance than women. She views the key to relationship duration as agreement on what it takes for each partner to maintain the relationship. Kiecolt-Glaser and Newton note that men and women’s experiences of conflicted versus well-functioning relationships have differential effects on health. Although both men and women experience negative health effects in conjunction with poor marital quality, in general, the associations between relational dysfunction and poor health outcomes are stronger for women than for men. Kiecolt-Glaser and Newton found this to be true in regard to cancer, heart disease, acute and chronic pain, and general rates of morbidity and mortality. Marital conflict/ hostility has been linked to higher levels of physiological arousal and more sustained arousal for women than for men; this may be a factor in women’s suppressed immune functioning when marital functioning is poor. Broadly speaking, both men and women benefit from supportive couple relationships, which facilitate both health-promoting behaviors and health itself. Croyle and Waltz report that women had higher levels of emotional awareness in their relationships than did men, and this higher awareness was associated with less marital satisfaction. In particular, women were aware of hard emotions . When partners had differing levels of emotional awareness, lower relational satisfaction was evident for both men and women. Soft emotions such as fear and sadness showed no relationship to marital satisfaction for either gender. Sexual Orientation Like gender, sexual orientation and sexual identities are intricate biopsychosocial constructions. The literature on the nature of well-functioning gay, lesbian, and bisexual couples is small, but growing. Ossana summarized the literature from the previous decade and concluded that lesbian and gay couples have relationships that are as satisfying as those of heterosexuals and that the mechanisms for relational satisfaction are similar across sexual orientation. This appears to be true despite the fact that same-sex couples face unique challenges. Kurdek , reports that gay and lesbian couples report higher levels of comfort with closeness than heterosexual-nonparent couples. Lesbian couples had higher levels of equality, satisfaction, positive problem solving, and dyadic cohesion in comparison to heterosexual-nonparent couples, as well as lower levels of relationship costs. Gay couples reported lower levels of relationship commitment than heterosexual-nonparent couples. In an earlier study with both gay/lesbian and opposite-sex couples, Kurdek found that the degree of commitment in close relationships over time could be predicted by individuals perceptions of their own constraints, their own attractions, and their partner’s attractions. Constraints are those factors that keep people from leaving relationships, while attractions are those factors that draw people into relationships. In a qualitative study looking at the relational challenges of HIV-serodiscordant gay couples, Palmer and Bor note that partners must negotiate a series relationship of shifts regarding caregiving, boundaries, sexual behaviors, and their futureall within a context of loss and often a hostile environment. Palmer and Bor cite mutuality and openness to communication as key for couples to cope together and for their relationship to remain intact. Intersections A recent trend in the couples’ literature has been to study more than one status variable at a time. Hall and Greene investigated class differences in African American lesbian relationships. They discovered that class differences were cited as a primary cause of relational strain and dissolution. For African American gay men, McLean, Marini, and Pope found racial identity to be unrelated to relational satisfaction. Beals and Peplau determined that lesbians who were mismatched on levels of political activism were less satisfied in their What the Research Tells Us 435 436 SPECIAL ISSUES FACED BY COUPLES relationships; those who had similar and moderate levels of political activity were most satisfied. Jordan and Deluty determined that when lesbian partners had discrepant levels of identity self-disclosure, they experienced lower levels of relationship quality. Dillaway and Broman found complex relationships between gender, race, and class in their study of marital satisfaction in almost 500 dualincome couples and suggest that studying these variables in isolation is problematic. Inequalities among the structural variables they measured were related to lower levels of couple adjustment. Haddock , who likewise investigated dual-income couples, found that these couples do better when divisions of labor are equitable and when they were not locked into traditional gender-role expectations. Personality Individuals’ personalities may also contribute to couples’ satisfaction and stability in relationships. Asendorpf reviews the literature showing an association between higher levels of neuroticism and lower levels of marital quality. Lykken makes an argument for the heritability of negative personality traits, noting that when one member of a pair of identical twins divorces, the chance that the other twin will do so as well is extremely high. Trait hostility is also reliably linked to poor relational functioning, especially for men; men’s hostility likewise influences their female partner’s emotional health . Watson, Hubbard, and Wiese examined associations between the Big Five personality traits , positive and negative affectivity, and marital satisfaction. As predicted, people high in positivity rate their relationships as more satisfying and those high in negativity rate their relationships as much less satisfying. Extraversion, agreeableness, and conscientiousness were also reliable predictors of satisfaction; neuroticism was associated with dissatisfaction, and openness was unrelated to marital quality. When rating their partners, the only reliable indicator of relationship satisfaction was partner negativity. Personality and affectivity explained up to a third of the variance in marital satisfaction scores, indicating that individual personality does make a difference in the extent to which couples are happy. The work of Robins, Caspi, and Moffitt shows similar trends. Each individual in the couples they studied contributed independently to relationship outcomes. Relational happiness was associated with partner’s low negative emotionality for both men and women. Women’s relational happiness was also predicted by her partner’s high positive emotionality and constraint . AFFECTIVE PROCESSES More than one researcher has noted that positive affect is curiously understudied in the literature on couples adjustment ; however, that is changing. Findings are converging on the discovery that relationship dissolution is not so much a function of high levels of negativity per se, but of declines in positivity over time , especially when predicting the dissolution of long-term relationships . Gottman and colleagues have found that couples use positive affect to both soothe themselves and to deescalate conflicts; engaging in such a manner is predictive of successful relationships. The ratio of positive to negative interactions in couples’ interactions is also predictive of relationship success or failure. Gottman discusses the concept of positive sentiment override , in which couples make global, positive judgments regarding their relationships as well as interpreting negative messages from their partners as neutral. These processes are critical in maintaining happy relationships; similarly, the opposite processnegative sentiment overrideis destructive. Gottman also cites a ratio of 51 positive to negative interactions as indicative of wellfunctioning couples. Similarly, Flora and Segrin note a positive global sense of the relationship protects couples from feeling negative affect, even during complaining interactions. Attachment processes have been extensively studied in regard to adult romantic relationships. As noted by Scott and Cordova , adult attachment has been consistently related to marital adjustment. In their particular study of adult attachment, depression, and marital adjustment, Scott and Cordova determined that depressive symptoms are more strongly related to marital distress when husbands or wives reported anxiousambivalent attachment than when they are securely attached or when they report avoidant attachment styles. In another recent study of attachment, marital interaction, and relationship satisfaction, Feeney discovered that both greater attachment security and frequency of positive spouse behavior were related to marital satisfaction. Insecure individuals, especially those with anxious attachment, were more reactive to both positive and especially negative spousal behaviors. This pattern was also evident for those low in comfort with closeness. Secure people appear to hold more stable and global positive views of their partners, which allow them to be less reactive to day-to-day fluctuations in their partners’ behaviors. Interestingly, Feeney found these patterns to hold for those in long-term marriages but not for those in shorter-term marriages. COGNITIVE PROCESSES A variety of cognitive processes, particularly attribution, have been indicated in couples’ adjustment. Perceptions, attitudes, and a number of social-cognitive biases have likewise been examined. Over a 15-year course of research, Frank Fincham and associates have established a clear association between attributions and marital satisfaction. In summary, locating the cause of negative relationship events in the partner, viewing the cause as more stable and global, and seeing the partner’s behavior as intentional, blameworthy, and reflecting selfish motivation are more likely What the Research Tells Us 437 438 SPECIAL ISSUES FACED BY COUPLES among distressed partners . However, in their recent work, these researchers found that attributions were linked to satisfaction because they influence couples’ efficacy expectations . This suggests that therapists might do better to target efficacy versus attribution per se. Expanding on the extensive work of Fincham and colleagues, Karney, McNulty, and Frye found that when couples make positive and global evaluations of their relationship, these broad ways of thinking about their bond can carry them through specific negative events in the course of day-to-day interactions. When couples start to see their partners as responsible for specific negative events, their global evaluations of the relationship may also decline over time. Similarly, selective attention to negative partner behaviors, as well as interpreting neutral or positive partner behavior through a negative cognitive filter, is clearly related to marital distress . Challenging the assumption that people have an ingrained and stable attibutional style , Karney and Bradbury determined in a four-year longitudinal study that spouses’ attributions change over time along with fluctuations in their marital satisfaction and ongoing experiences in their relationships. This doesn’t mean that attributions are irrelevant to marital satisfaction, just that they are so interrelated that one can’t be said to cause the other. However, Karney and Bradbury found that if spouses started out with maladaptive attributions early on in their relationships, this did predict sharper declines in satisfaction over time. Recent work also shows that couples have hindsight biases when reporting relationship events over the course of a week . Marital satisfaction was measured at the beginning of the week, and couples then kept diaries of positive and negative relationship events for seven days. They were then asked to talk about what they remembered over the course of the week about their relationship. Those individuals who recalled mostly negative information were the same ones who had reported lower marital satisfaction at the beginning of the study. Obviously, this finding has implications for therapists who routinely ask similar questions. Carrère, Beuhlman, Gottman, Coan, and Ruckstuhl found that the perceptions of newlywed spouses predicted the stability of their marriages with a high degree of accuracy up to nine years after marriage. Selective attention to positive or negative aspects of one’s partner, or to the marriage itself, appear to influence the course of the relationship. Using the Oral History Interview, the authors found that spouses who had strong positive perceptions of their initial marital bond were more likely to remain together versus those who had negative perceptions . The authors theorize What the Research Tells Us 439 that positive perceptions of the marital bond may serve as a buffer during times of conflict or transition. BEHAVIORAL PROCESSES AND VERBAL INTERACTIONS A number of mutual, reciprocal processes are key in the maintenance of romantic relationships. Likewise, specific mechanisms and choices in couple interactions maintain cycles of conflict. Positive Processes In examining relationship-enhancing dynamics, Mills and Clark discovered that well-functioning relationships are communal relationships, which are defined as a relationship in which each member has a concern for the welfare of the other . . . [and is] motivated to provide benefits to the other without expecting a specific benefit in return . This differs from basic equity or exchange relationships in which more of a keeping score mentality is the norm. Strong communal bonds include understanding each other’s needs, compatibility of needs, agreement about the primacy of couple bond over other relationship connections, and benign interpretations of a partner’s intentions when needs are not met . This is not to say that equity has no role in relationship satisfaction. Equity theory has a long and well-substantiated history. Recently, Canary and Stafford have examined how perceptions of equity are related to specific relationship maintenance behaviors, such as openness, positivity, assurances, social networking, and sharing tasks. Well-functioning couples engage in these behaviors proactively to sustain their bond. A similar processpreemptive relationship maintenancehas been identified by Simpson, Ickes, and Oriña . Preemptive relationship tactics involve premeditated actions taken to avert problems before they develop, routinely addressing small issues so that they don’t escalate into larger ones, and cognitive strategies that focus on positive inferences about one’s partner and relationship. In long-term relationships, Aron, Norman, and Aron found that when couples periodically engage in mutually agreed on selfexpanding activities, marital quality increases. Self-expanding behaviors are novel, arousing, or exciting, rather than just being routinely pleasant; they serve to mitigate boredom and monotony. Interestingly, the opposite is also true; having established and cherished couple rituals and routines has been associated with marital satisfaction . Using interdependence theory as a base, Rusbult, Olsen, Davis, and Hannon note that people become more dependent on their relationships when their levels of satisfaction and investment are high, and when the quality of their potential alternatives is low. Higher dependence leads to increased commitment; that is, we are more motivated to stay in our 440 SPECIAL ISSUES FACED BY COUPLES relationships. This sustained level of commitment is then maintained by behavioral accommodation to one’s partner, willingness to sacrifice and to forgive, as well as by cognitive mechanisms such as a focus on interdependence, positive illusions, and derogation of alternatives. When both partners engage in such activities over time, trust is enhanced, and couples’ well-being results. The negotiation of the contradictions inherent in couple relationships has been shown to have important associations with relationship commitment and quality. Sahlstein and Baxter found that the working through of such basic couple dialectics such as autonomy-connection, openness-closedness, and stability-change are part and parcel of the process of commitmentcommitment is not a one-shot promise or an unchanging aspect of emotional investment. Sahlstein and Baxter suggest that living on friendly terms with paradoxes and contradictions is key in relationship maintenance. Behaviors such as denying contradictions or passively giving up in the face of contradictions leads to relationship decline. Functional strategies for handling contradictions include turn taking, compromise, integration , recalibration , and reaffirmation . In a similar vein, Whitton, Stanley, and Markman find that individuals who are successful in their intimate partnerships are willing to make sacrifices and report satisfaction about sacrificing itself. They define sacrifice as acts in which individuals give up some immediate desire in the interest of bettering their relationship or benefiting their partner . Such sacrificing often takes the form of stepping back from the immediate conflict to consider actions that will have a positive long-term impact on the relationship versus being reactive in the moment, or to return negativity with neutral or even positive affect. A number of studies find that rates of conflict are often relatively stable and that many couples engage in what Roloff and Johnson call serial arguments. Surprisingly, these enduring and often repetitive conflicts do not necessarily lead to relationship dissolution. In some cases they do, and in others they don’t. For example, Roloff and Johnson note that the more a couple is together, the higher their investment, the fewer important issues remain unresolved, and the more partners learn to be proactive in deterring conflict in the first place or to develop ways to temper conflict with positive affect. Gottman and colleagues likewise discuss what they call perpetual problems ; these are unresolvable, longstanding disagreements that are probably based on couples’ personalities. However, such perpetual problems do not contribute to relationship dissolution if they are handled with affection and amusement. Negative Processes Couples who develop destructive conflict patterns early on are more likely to dissolve their relationships . Heyman presents a concise summary of what these distressed couples’ verbal interaction patterns look like, stating that such couples: are more hostile, start their conversations more hostilely and maintain it during the course of the conversation, are more likely to reciprocate and escalate their partners’ hostility, are less likely to edit their behavior during conflict, resulting in longer negative reciprocity loops, emit less positive behavior, suffer more ill health effects from their conflicts, and are more likely to show demand-withdrawal patterns. Similarly, Gottman and colleagues conclude, The most consistent discriminator between distressed and non-distressed marriages is negative affect reciprocity . Negative interactions identified by Gottman and associates include criticism, contempt, defensiveness, and stonewalling . Both the perpetual problems noted earlier and potentially resolvable problems do become predictive of relationship failure when couples choose to handle them in the unproductive ways noted above. Additional support for the idea that initial negative views of one’s relationship can distort the perception of later interaction comes from Flora and Segrin . Individuals who began interactions with negative sentiment override did not respond to changes in the topic of conversation with their spouses. Not surprisingly, both spouses in this study reported declines in marital satisfaction with increased complaining; this was especially true for husbands. Relationships were happier when spouses could talk through complaints with more gazing behavior, less negative emotion, less wife talk time, and more husband talk time. The trends noted in the section above, both in terms of positive and negative interactions, were recently supported by Stanley, Markman, and Whitton in a creative study using a national random sample of over 900 participants and a phone survey. Through this atypical method, the researchers confirmed that [n]egative interaction was negatively associated with every index of relationship quality and positively associated with thoughts and talk of divorce . Their work also gives credence to the idea that for men, negative interaction is more predictive of divorce than for women; for women, lack of positive interaction is more predictive of divorce. Men also withdrew from interaction more often than did women, and for both genders, withdrawal was related to loss of connection and increased negativity. Furthermore, Stanley and colleagues conclude that conversational process is more important than conversational topic. However, Sanford found that topic difficulty did make a difference in couples’ communication, although indirectly. He suggests that difficult conflicts decrease relational satisfaction, which then leads to poor communication styles. For both members of the couple, discussions of their most difficult 442 SPECIAL ISSUES FACED BY COUPLES issues were accompanied by more negative forms of talk ; husbands also showed poor listening when discussing the couple’s most difficult topics. SEX Reviews of the literature on the association between sexual satisfaction and relational satisfaction generally support the expected positive link between these two aspects of couples’ lives . In a more recent study, Sprecher notes that most of the previous work has been cross-sectional, so changes in sexual satisfaction and relational satisfaction cannot be tracked across time. Sprecher’s 2002 study investigated sexual and relational satisfaction over a five-year period, allowing for more predictive tests. Although Sprecher continued to find that sexual satisfaction and relationship satisfaction were related for both genders and across both dating and married couples, predictive analyses failed to provide useful information because sexual satisfaction and relationship quality may influence each other almost simultaneously . Regarding staying together or breaking up, sexually dissatisfied couples broke up more often and sexually satisfied couples had longer-lasting relationships. Associations between relational and sexual satisfaction were stronger for men than for women; Sprecher states, I would speculate that men are more likely than women to use the quality of their sexual relationship as a barometer for the quality of the entire relationship . SYNTHESIS AND THERAPEUTIC IMPLICATIONS It is the opinion of this reviewer that affective processes are emerging as the central organizing element in understanding successful and unsuccessful coupling. How couples choose to react to discrepancies, demographic differences, or inequities in their relationships, the ways in which harmfully toned perceptions and cognitions influence couple judgments, and cycles of poor communication and conflict all seem to share a common link in the generation and maintenance of negative affect. Likewise, consistent positive affect appears to buffer couples against temporary fluctuations in their relationships and to maintain vital connections through its interrelationship with both cognitive processes and with pleasing behaviors. So it is not simply differences in personality, ethnicity, acculturation, values, religion, or what have you that matters; it is what each couple does with their differences that matters. Although it is no doubt true that all behavior, cognition, and affect interact in complex ways, emotion appears to provide a conceptual and practical starting point that is eminently useful.
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Following key tasks of restructuring and adjustment engendered by divorce, therapy can focus more on ego reparation tasks: regaining self-esteem and confidence, coping with loneliness and aloneness, and building a social support network of friends and intimates. These tasks are immeasurably helped if the person has gained a realistic understanding of the causes of the divorce, his or her contributions, and unraveling the patterns of unconscious childhood strivings in the marriage and other relationships as well as family of origin issues. This is the so-called marital autopsy. Alvin and Pearson further point out that the relationship system before the divorce is likely to continue to be perpetuated in the divorce, which may lead to continuing painful conflict for all parties involved. Thus, an ambitious second-order goal of postdivorce therapy is to change this pattern of dysfunctional relating and to resolve old narcissistic wounding. Such goals can improve the likelihood of better co-parenting and family relationships. The general goal is to help the person use the trauma and changes wrought by the divorce to effect further developmental change and growth. A minority of individuals appear in postdivorce therapy many years after the divorce, still obsessed and stuck in the divorce trauma. They may have had severe psychopathology prior to their divorce or have become severely depressed and dysfunctional postdivorce. They cannot resolve their rage, projection of blame, and desire for retaliation. They are nowhere near completing the emotional and psychic divorce necessary for adjustment and healthy development. This type of high-conflict family and parent who cannot empathize with the other parent is often damaging to children’s long-term adjustment. Reviewing a large body of research and the mediating variables in postdivorce adjustment, Hetherington et al. concludes that family process emerges as the key variable. It is largely negative, continuing dysfunction in family relationships between parents, children, and siblings that accounts for differences in children’s adjustment. Pathological adjustments to divorce-related ego wounding can involve a perceptual distortion of reality and being rigidly stuck in childhood conflicts. Thus, the child within the parent is perceived and projected onto the real child. Any assault on one’s self is perceived as an assault on the child. Furthermore, the person projects his own anger with the ex-spouse onto the ex-spouse, maintaining instead that the ex-spouse is the angry person . The perception of the ex-spouse’s anger acts to justify continuing retaliation, sometimes to the point where no differing opinion can be accepted, leading to a stalemate in therapy. Fortunately, such high-conflict families and individuals represent a minority of postdivorce therapy clients, but they are memorable enough to warrant careful screening before the therapist becomes involved in an essentially intractable dispute. When clients, through the help of therapy, can finally realize how damaging this continuing blame, projection, and conflict are to themselves, they are better able to give up the secondary gains of maintaining the delusion and conflict. Such realization brings relief, forward movement, and the breaking of the developmental impasse. Postdivorce adjustment changes may involve role restructuring tasks as well as ego reparation, particularly if one spouse remarries. Kinship structures and roles within blended or binuclear families are often ambiguous and fraught with ambivalent expectations and uncertainties . Consider the 57-year-old man with two children and four grandchildren who marries a 35-year-old woman with two young children, one of whom is adopted. He may be a grandfather, a new husband, and a new father simultaneously, but his role is even more undefined with his new children, his old in-laws, and his new in-laws. Yet, he may want his inlaws, wife, and ex-wife to recognize all these children as members of their families, although each of these people draw their kinship webs somewhat differently from his. Thus, postdivorce therapy often focuses on mediating the ambivalence and conflicts produced when previously mapped-out relationships of the nuclear and extended family are transformed by divorce, producing competing and contradictory depictions and expectations of kinship. Divorcing Couples 425 426 SPECIAL ISSUES FACED BY COUPLES Well-known protective factors in postdivorce adjustment and resilience include not only a supportive new partner, but higher education, satisfying, stable employment, financial security, and supportive social networks . Goals in therapy often include helping the client initiate new friendships with single friends, repair old friendship and family relationships, join various clubs or groups, and explore new interests and hobbies. The person may question previously held beliefs about his or her talents and work goals. A change of job or a return to school for new tools and skills may be very beneficial in raising self-esteem and confidence as well as in providing necessary financial security postdivorce. Men may have to be encouraged to learn child rearing, cooking, and housekeeping skills to make a comfortable home for themselves and their children. Women may have to learn new skills in financial management, car repair and maintenance, or other areas that a former spouse controlled. Children may have to become more responsible and share in household tasks. The potential for challenge and growth is obvious. Transitional Relationship At some point, sometimes early in the postdivorce adjustment process, the client may become involved in a new relationship. Sometimes, this person is waiting in the wings prior to the divorce. The person often represents a contrast to the old partner. Superficial personal, physical, or situational characteristics draw the divorced person in. The opportunity for some ego repair and regaining of confidence in one’s attractiveness and worthiness can be valuable in these relationships, but often they are transitory and do not represent a real change of direction or pattern in the person’s development of intimacy and identity. It is useful to explain to clients the dynamics of the transitional relationship, even though they may want to bask in the feeling of temporary love and security without analyzing their motives or the similar variables in that relationship and the unsuccessful marriage. It takes many clients a while to understand that they need a period of being alone, of introspection and change after a divorce, to successfully transcend old patterns of choice and unresolved strivings. The primary losses in divorce, ego/object loss and role loss result in major challenges to the clients’ self-esteem, identity, and the capacity to be intimate. Ultimately, a therapist must help the person get to the point where he or she can say, I love myself without the love of that other and I can love myself without being the spouse of that other .
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After a decision to divorce has been made, the therapist’s initial job is to help the couple, and particularly the one who was not the initiator stabilize emotionally and accept the reality of the divorce. Divorcing Couples 421 422 SPECIAL ISSUES FACED BY COUPLES Some individual therapy and medication may be necessary if emotions are disturbing or as in a minority of cases, there are symptoms of acute breakdown or possible violence. Normalizing the feelings of dysfunction, disbelief, and disorientation helps clients realize they are experiencing a temporary, albeit intense, crisis for themselves and their families. If there is significant anger or acting out, using crisis management tools as discussed in the prior section is useful to de-escalate the conflict and stabilize emotions. Ego Reparation Even couples who manage to negotiate feasible divorce agreements and amicable postdivorce relations must first overcome an initially hostile, oppositional dynamic . This conflict stems from many sources that all lead to ego loss. There may be resource or power differentials affecting separation decisions. The adversarial legal system may generate more conflict. Conflict is also engendered by feelings of being hurt, humiliated, abused, or betrayed by a divorcing spouse or shamed and stigmatized by divorce. The sacred is coming undone, and the dream/fantasy one had about the partner and what he or she would do for one is hard to give up. Thus, the symbolic dimension in divorce is also useful to explore in helping parties understand their strong reactions and resistance to divorce. Ego reparation is a primary goal of divorce therapy and a need stemming from the ego loss or object loss in divorce leading to narcissistic wounding. Ego reparation is more easily achieved if the person gives up not only the blame mentality, but the unrealistic ideas and symbols of what the partner and marriage unconsciously represented. Narcissistic repair of self-esteem can become maladaptive to the degree that a person must distort reality to regain a sense of equilibrium. This dynamic work is not typically achieved in the divorce therapy sessions with both partners. These sessions are generally brief and more focused on practical readjustments. Repairing self-esteem is more readily explored in postdivorce individual therapy . In the middle of divorce, however, both parties need to realize they must accept the inevitable and make some necessary plans to move on. Here is where the therapist can help clients in making necessary personal and pragmatic adjustments to being single and living alone. Role Restructuring The practical tasks necessary during and after divorce directly relate to the second primary goal of divorce therapy, helping clients with role restructuring stemming from the multiple role losses in divorce, all of which can lead to disorientation. Role loss after divorce involves more than losing the marital role as husband or wife. The client realizes that there is the potential for loss of extended family, family of origin , a partner in parenting, couple and personal friends, and the societal status of being married. The latter involves both financial and social status. Taking on the single-adult role, although certainly an adjustment, is easier than assuming the single-parent role. For many fathers, it may be the first time they are solely responsible for their children, although for mothers it may be the first time they cannot be in an overseeing role of the father’s parenting behaviors. Another look at Table 23.1 in the Therapeutic Tasks category shows how so much of good divorce adjustment for children involves cooperative co-parenting, parenting that is both affectionate and authoritative by both parents, and that does not parentify the child . When parents cannot achieve this goal, referral to preventive intervention divorce groups for children can be highly effective and lead to less substance abuse, mental health problems, and social maladaptation in later years . The therapist also needs to strongly encourage fathers to stay involved with their children and needs to work with the couple in accepting this necessity and implementing its reality. This may also involve reeducation work with mothers, particularly gatekeeper mothers. Some research has found that the degree of parental support from the former spouse is the most important predictor of continued involvement in a father’s co-parental involvement and interaction, since 70% of mothers retain custody . Mothers may feel greater security and be more cooperative in custody arrangements when there is adequate, regular child support from fathers. In the past 30 years, however, there has been no change in the proportion of eligible children receiving child support, hovering at only 30% in the United States . Therapy discussion can include the fact that children’s well-being has been found to be significantly associated with fathers’ payment of child support . Relationships with same-sex parents may be particularly vulnerable in the event of parental separation, such as when boys experience father loss. Opposite-sex parents constitute a significant influence on adolescents’ depression, leading most clinicians to work toward involving both parents in joint custody . Exceptions occur when there is violence, mental instability, parental abuse or rejection, substance abuse, or problems with relocation. The advice to clients is that their adjustment to separation and divorce and that of their children depends in large part on how the divorce is positively managed. This advice bears frequent repeating in therapy. Parents can be reminded that despite the dissolving of the marriage, they still have one common goal: the welfare of their children. I find it makes an impact in divorce therapy when I tell parents that we have solid research demonstrating that children fare better when they maintain a good relationship with preferably both parents; when they are kept out of the middle of parental conflicts; when there are fewer disruptions in their lives, including economic ones ; and when there are flexible and adaptable custody and child support arrangements that can be easily modified as the life and financial situations of the parents change . Divorcing Couples 423 424 SPECIAL ISSUES FACED BY COUPLES
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The transition to divorce therapy is not as clear as a therapist might like, often involving a fairly lengthy period in which the clients go back and forth about whether to stay together. Finally, a time comes when the therapist can offer the observation that the issue the couple is discussing has been repeatedly addressed without resolution and that neither party has desired to or been capable of making necessary changes and accommodations to preserve the marriage. The implicit question is whether the marriage is ended and there is a need to make a decision to move forward. Often, this point of no return occurs after clients see a continuous pattern, a marital flip-flop, sometimes over months, sometimes over years, of repetitious emotional partings, bondings, and partings again. If the couple has gone to therapy and tried to conscientiously do what they feel they could to preserve the relationship, then subsequent postdivorce guilt and regret may be lessened. Thus, it behooves the therapist not to abort this process, but also to be a realistic observer and reporter about when a couple is simply repeating patterns and is locked into a status quo that is hurting themselves and perhaps their children. What unhappy, dissatisfied couple doesn’t actively fight or manifest dysfunction in front of their children? Recent research has shown that children do better when parents divorce in high-conflict marriages, but stay married in low-conflict, unhappy marriages. This is, of course, a dilemma for the therapist: whose interest to put first. Whatever your personal bias, the therapist should conscientiously help the couple discuss the consequences of a decision to divorce for the children as well as for themselves. Sometimes, the decision will be to wait until the children are older, but more often in today’s milieu of high expectations for personal fulfillment, individual needs are put first. Rarely is there anything anyone can do to dissuade a spouse who is determined to sever the marital ties . . . the therapist can suggest a trial separation, which can serve as cooling-off period during which to make more rational choices . Structured Separation The likelihood is high that a divorcing couple will experience a period of separation. This separation can serve several functions. It can be a conflict management toola means of de-escalating anger and irrational decision making, and a protection against escalating physical or emotional violence. It can be a temporary vacation from the dispute. It can afford a structured, time-limited period for decision making or breaking an impasse, and it can be a period for new learning and value clarification in which to explore other options in relationships, work, and living independently and to acknowledge there are choices. Most importantly, the therapist needs to help the couple openly acknowledge whether the separation is really a dress rehearsal for divorce, in which the partners are buying some time to make the emotional and behavioral adjustments necessary for divorce. Conversely, it can be agreed that the separation is a tool to continue to work on preserving the marriage by reformulating the marital contract, breaking old perceptions, and working on independence and personal growth conducive to helping the marriage. The latter case involves a structured separation with counseling. Both parties agree they will continue couple therapy on a regular basis while physically separated. Most often, the couple agrees that financial arrangements stay in place and no big life changes will occur except Divorcing Couples 419 420 SPECIAL ISSUES FACED BY COUPLES for one spouse’s moving out. Sometimes, an arrangement can be made where the spouses take turns living in the house or other temporary housing. If the parties agree not to bring in lawyers right away, the process is far more likely to remain nonadversarial, and the therapist can better help the couple to maintain or achieve a nonblame attitude that is far more conducive to personal and familial healing. The therapist basically continues to do couple counseling. The couple should be informed that more than half of couples who decide to physically separate do go on to divorce. Knowing this, the noninitiator may strongly oppose a separation, fearing it signals the reality of a divorce. Mixed messages about separating may be given by both parties, and the therapist needs to help the couple not only sort out those messages, but to explore the advantages and disadvantages of a separation. A legal separation involves essentially all the financial and custodial decisions of a divorce, but may be preferred by couples who feel there need to be very clear guidelines in these areas and who want the relief and security of having these decisions in place. Whether a separation is a dress rehearsal or acknowledged prelude to divorce or an alternative attempt to change perceptions and save a marriage, it is important for the therapist and clients to go over the ground rules of the separation. In this author’s experience, amazingly few couples openly talk about all the practical ramifications and decisions of a separation, other perhaps than to discuss what happens with the children. Issues that must be decided include length of initial separation, time of evaluation and follow-up, continuing counseling, placement and visitation, child support and finances, whether to involve lawyers, how to tell the children, which individuals outside the family will be told about the separation and by whom and how, and whether the couple will see other people or remain monogamous. The latter decisions can be the cause of much conflict and misunderstanding, and damage control can be prevented in therapy by clear ground rules. These areas, of course, must also be addressed if and when the parties go on to a final divorce. In this author’s experience, a structured separation with counseling needs a minimum period of three months and is often six months to one year in length.
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It is important in working with divorcing couples to have a realistic understanding of one’s own attitude and possible bias toward marriage, divorce, and alternative families. One must ask oneself about one’s own beliefs about divorce when children are involved, about one’s own religious values, family history, and marital/divorce experience. A therapist should be willing to refer a couple to another therapist if he or she is uncomfortable in making the transition from marital to divorce therapy. A related issue is the therapist’s own feelings of failure if marital therapy has not been effective in saving a marriage. A therapist who measures success rate by how many couples stay together may feel like a failure much of the time. Thus, it is important to come to terms with such feelings and to appreciate that helping a couple to divorce more comfortably and with less emotional sequelae for themselves and their children is a worthy goal. Feelings of dissatisfaction, disappointment, or impatience are likely to compound the clients’ existing feelings of failure and rejection. Several issues and value judgments also arise in conjunction with vested interests in one member of the couple. Usually, it is very difficult to remain neutral toward either party when one spouse has been the victim of abuse and violence, and the therapist must carefully explore whether he or she is projecting personal anger and judgment that could influence the decision to separate or divorce. More commonly, vested interests are a key issue when, after a decision to divorce is made, the therapist also worked individually with one of the spouses, usually during the separation period. Unless the therapist has previously established rapport and trust with both parties and has carefully and openly discussed the rules and parameters of confidentiality in the individual versus the couple therapy, it can be difficult to get the other spouse back into treatment to explore divorce and postdivorce issues. It may be necessary to see the other spouse at least once or twice in individual therapy to reestablish the therapeutic alliance. Another related issue is pressure for the therapist to take sides in the divorce when difficult legal and custody issues are involved, or a party’s lawyer feels the therapist has critical information to support his client’s position. In this case, it is fortunate when the therapist has continued to see both parties, can maintain that both are clients, and that choosing sides is not fair or ethical . All these strategic issues underscore the importance of seeing both individuals in the divorce process and divorce therapy. This may not always be easy when during marital therapy the hidden agenda has been divorce all along, and once a decision to divorce is made, usually by the initiator, the initiator wants to leave therapy. The initiator may also want to hand over the ex-spouse to the therapist, who becomes the substitute spouse. Often, when it is clear there will be a divorce, clients abruptly terminate treatment. 418 SPECIAL ISSUES FACED BY COUPLES
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Intimacy Intimacy/communion redefined by closeness to peers and others outside family. Mistrust of others. Reluctance to trust, bond. Peer attachment is buffer to parental conflict. Development of empathy for parent . Affectionate, authoritative coparenting. Rebuild trust and respect. Identity Increasing self-differentiation and identification with peers and others outside family. Over-identification with a parent. Rejection of parent or stepparent. Role model of parent achieving healthy separation/individuation. Appropriate familial responsibility. Support parental patience, perspective, and constancy. Aid conflict de-escalation and management. 416 SPECIAL ISSUES FACED BY COUPLES
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If therapy for divorcing couples is defined as involving the mediation of interpersonal conflict, the management of crisis, or the working through of grief, one has basically only a first-order change situation. That is, surface issues have changed, for example, economic and custody issues are presumably settled. Yet, no significant change in the person’s level of personal and interpersonal functioning and development may have been accomplished. The individuals are often still struggling with a particular developmental task of individuation or intimacy and are likely to reenact the developmental struggle in future relationships. When a marriage comes apart because two people do not or cannot grow together or are frozen in the status quo, then divorce can be a powerful and positive release of energy and development. In the case of significant interlocking developmental blocks, the decision to divorce is more problematic unless the individual and dyad dysfunction is explored and carefully worked through. Although almost all marital therapists understandably share a promarriage bias, separation and divorce can be more realistically viewed by the therapist as increasingly common milestones in adult development that bring potential for both stress and growth. When half of the people in a society experience a significant personal and interpersonal life event, there is an obvious need to integrate that event into our thinking about what is normative experience in the individual, marital, and family life cycle. Two decades ago, Carter and McGoldrick discussed divorce as a paranormative event in the family life cycle. A basic reader on marital and family therapy published in 2000 described the stages of normative marital life cycle as courtship and marriage, and defined the stages of the family life cycle entirely by the presence of children and the state of the child’s development, for example, child raising with no mention of divorce or remarriage or even cohabitation . These traditional models presume one major lifetime relationship, one marriage, one commitment. They are also predicated on the view that the individual and marital tasks of establishing autonomy and intimacy are defined mainly through bonding, rather than through an actual cycle of bonding, separating, and rebonding. Intimacy and Identity A more useful approach to conceptualizing a marital/ family life cycle model applicable to all people, married or divorced, in Divorcing Couples 413 414 SPECIAL ISSUES FACED BY COUPLES alternative or emerging family forms, and from different cultures and ethnicities, is to employ general concepts of development that all family members must accomplish at various points in their marriages and families. David Rice and I earlier published this model in greater detail . In sum, a parsimonious model of life cycle development is based on the assumption that there are but two key tasks of all human development. These key tasks may recur and need to be reworked and redefined over the course of a lifetime of passage through perhaps several significant relationships. The first is intimacy in which one works to achieve communion, that is, closeness with another person; and the second, identity, in which one works to achieve successful separation or differentiation of self from others. These two tasks are basic to all human development. They are also interlocking: The goal is to be close, yet separate; to be intimate, yet autonomous; to find the self, yet to merge with the other . The basic themes of intimacy/communion and identity/separation recur over and over again in the life cycle, but with different meanings in each period of life, necessitating redefinition and transformation. The adaptive solution for one period of life may not be the best one for the next. Unlike traditional marital and family life cycle conceptions, the proposed model is nonlinear and multileveled, and the sequence is not rigid or necessarily predictable. Key marker events like marriage and divorce have the potential for impeding individual development in intimacy and identity and conversely to stimulating further growth in these tasks. Paradoxically, in divorce it is the very breakdown of intimacy, of the task of communion with a significant partner, that has the potential to lead to a better-defined individual identity and differentiation of self, yet also involves the danger of permanently blocking growth in intimacy if other issues are not resolved. Table 23.1 provides a conceptualization of this model as applied to divorce, noting the developmental tasks, dangers, and opportunities for the divorcing adult or child of divorceand the corresponding goals for therapy. The model does not seek to oversimplify the complexities of human development over the lifespan. The concepts of intimacy and identity have enormously rich complexity and interaction. Nonetheless, a basic understanding of these concepts helps us see individual development as a continuous unfolding of basic themes that have always had historical, cultural, and interpersonal meaning. A further advantage is that the model can be easily applied to a multicultural context. Lyle and Faure have taken the model and used it very effectively to integrate concerns about ethnicity and divorce, incorporating the parallel elements of acculturation and enculturation. In multicultural counseling with Hispanic families, they note that using a recursive, nonlinear developmental model has many benefits and shifts attention away from the completion of a particular stage toward the process of development. Divorcing Couples 415
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Less a theory and more a convenient description based on the usual sequence of events, stage theory categorizes common phases of divorce, employing both actual events or the psychological sequel and practical tasks to describe the process of divorce. The conceptualization of the divorce process may be simple like Sprenkle’s three stages and Glick and Patel’s four stages or more complex like Swartz and Kaslow’s seven stages . Despite the differences in the number and labeling of the stages, basically all these conceptions refer to three phases: a predivorce period ; a restructuring transition period ; and a postdivorce recovery period . Although presenting the therapist with some convenient markers in the divorce therapy process, stage theory, to this author’s mind, suffers from an oversimplification of the divorce process. Being linear and assuming predictability of process, stage theory can also be very misleading to the marital and divorce therapist who wishes to do effective therapy. To understand effective divorce therapy, one must go beyond the discrete, fairly predictable tasks and adjustments defined by the legal system and society to a consideration of the underlying psychological issues and processes. The important psychic processes in divorce are better conceptualized as developmental in nature and therefore continuous and multileveled.
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Because divorce involves object loss and intense ego injury that leads to depression and mourning, some investigators in the field have used elements of grief theory to define the stages of divorce. The four-phase sequence of grief behavior that follows separation is derived from attachment theory . Love and passion may erode or die, but attachments may still persist and resist dissolution despite anger, betrayal, and hurt. This is a common pattern in divorce and makes emotional divorce harder to achieve than legal divorce. Denying or abridging the necessary initial grief work may only perpetuate unrealistic attachment to the ex-spouse, and therapists must be very patient in working with such clients.
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The decision and process of divorce often engender such acute anxiety in clients that they may temporarily lose their bearings and ability to function on a daily basis. A client may voice that he feels he is going crazy. Thus, some therapists in the field have viewed divorce as primarily a crisis, that is, an event or circumstance that the person feels requires accommodations or solutions beyond his or her capacities . Certainly, events that may precipitate or accompany a divorce like the escalation of violence or alcoholism, the discovery of an affair or gross financial irresponsibility, or a child’s reactive problems may contribute to intense acute anxiety and Divorcing Couples 411 412 SPECIAL ISSUES FACED BY COUPLES disorganization. There may be an immediate need to employ crisis management techniques and an intervention plan that ensures the safety and well-being of the family members. This would involve an assessment of initial risk for suicide or homicide, problem definition, the clients’ strengths and resilience and prior coping strategies, de-escalating intense emotion, a possible referral for medication, and an action plan with the concrete steps agreed to by all parties involved. It is also important, however, for marital therapists not to mistake the acute grief, personal stress, and disorganization accompanying the decision to divorce as indicative of more serious underlying psychopathology or endogenous depression. A period of reactive depression and intense grief is normative in the divorce process, and a task of the therapist is to give repeated reassurances to clients that time to heal from losses is necessary and beneficial.
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The trauma of postdivorce adjustment also can be effectively eased by using structured educational group interventions. Parent education programs and school-based divorce intervention programs for children have become commonplace and are often very helpful in both facilitating effective co-parenting and helping children adjust . Other divorce adjustment groups aim to help participants understand the practical adjustments necessary to heal from divorce and to develop interpersonal, communication, and social skills facilitating the recovery of selfesteem and the building of a new social network. Role playing, nonverbal exercises, directed reading, writing, keeping a journal, problem-solving and decision-making exercises, and referrals to other educational and community resources may be involved. An advantage of the group approach is that participants gain validation for their disturbing feelings and supportive opportunities for mutual problem solving with peers who may become friends. The author has found that such groups can be a very effective adjunct to postdivorce psychotherapy.
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The behavioral models applied to marital therapy have had considerable impact on the practice of divorce therapy and mediation, particularly in managing and resolving the often intense relational conflict engendered by the decision to divorce and by the divorce itself. Most therapists helping divorcing couples utilize behavior management techniques to control conflict within the divorce process and to de-escalate postdivorce conflict. The divorce mediation movement developed in reaction to the adversarial nature of the legal system. Despite no fault divorce, the legal system works toward specifying the winner and loser in divorces. Divorce mediation borrowed heavily from conflict management techniques largely based on behavioral change approaches . Divorce mediation, although not therapy per se, may be therapeutic for both parties involved, and a marital therapist can often effectively refer a divorcing couple to a divorce mediation specialist when they both agree to keep the legal adversarial process to a minimum. A behavioral exchange framework can also be applied in deciding whether to divorce and recognize the point of no return, when the disadvantages of the marriage heavily outweigh the advantages.
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Divorce can be treated as part of a larger family system problem. It is often unproductive to work on a marital relationship in individual therapy without the actual presence and contributions of both partners. Similarly, in working with divorcing couples, it is often most advantageous to work through and understand the marital autopsy history as well as the divorce decision and postdivorce adjustments involving the welfare of children with both individuals present. Since each member of the family interacts within a system of operation, during divorce therapy the children or extended family members may also be brought into treatment as appropriate. This contextual system helps the therapist to make more informed, realistic assessments and to better ensure the goal of positive lasting change within the individual family members and within any future blended family. Divorce has the power to alter radically the individual and familial relationships of people within a system and thus to change the nature of the system itself. This is readily apparent in continually evolving new family forms and kinship structures . Conversely, if ex-spouses continue to repeat old games and dyadic stratagems and never divorce emotionally, then the family system itself may not be altered significantly, except to replay versions of the old dysfunctional patterns. Triangulating and parenting the children offers many opportunities for maintenance of the old family system.
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A basic premise of most psychodynamic approaches in treating marital and family conflict is that partner and family difficulties are often seen as symptoms of unresolved childhood conflicts. These conflicts may be repeated across generations, paralleling the idea of fixation or regression to earlier less mature developmental levels. The idea of the intergenerational transmission of divorce is also predicated on the assumption that unresolved personal, relational, and familial conflicts get played out in succeeding generations of the family. Much of the initial phases of treatment in working with divorcing clients focuses on ameliorating the crisis and traumatic aspects of the divorce decision and adjustments. Later in treatment, a careful exploration of the history and patterns of individual and family dysfunction is critical in helping clients understand the dynamics of the problems and in gaining insights and tools to break old patterns and to make healthier choices. Thus, both practical problem solving and dynamic exploration need to be part of the divorce process in therapy. A tenet of psychodynamic couple therapy is that the root of most couple problems can be found in the failure of one or both partners to individuate Divorcing Couples 409 410 SPECIAL ISSUES FACED BY COUPLES and master the developmental task of separation and differentiation. This concept has had a great impact on the theory and practice of divorce therapy, requiring that client and therapist explore the person’s history of separations, to work through and master the most difficult separation of all, the loss of the partner. The underlying theme of these therapeutic strategies revolves around understanding how earlier conflicts are manifested in the marriage and later in the divorce . The therapist, however, also takes into account that marital conflict and dissolution may occur in the absence of significant individual psychopathology and may be the result of the cultural and situational constraints on the partners and the interaction between the partners. Such a view respects a family systems approach.
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There is an almost total absence of writing that outlines and analyzes the theoretical underpinnings of divorce therapy from related disciplines and other interventions strategies. A brief summary is presented here that should help marital therapists who are seeking to understand the foundations of the strategies employed in doing divorce work with couples and clients. However, for an in-depth discussion of the theoretical origins and debts of divorce therapy, the reader is referred to our earlier book . Divorce therapy is still in its early stages of defining itself as a specialized form of therapy, but most marital therapists find themselves employing some strategies of divorce therapy as they help their clients work through the decision about divorce and the adjustment to divorce, once it is clear that the marriage is going to be dissolved. Sprenkle has written that divorce therapy can be described as relationship treatment whose goal is to diminish and eventually dissolve the marital bonds, in contrast to marital therapy that seeks to enhance and preserve the marital bond. Of course, such a dichotomy is rarely apparent in clinical practice. More often, the therapist finds himself or herself in a period that may be lengthy and ambiguous of alternating back and forth between exploring preservation and uncoupling, reflecting the normal ambivalence of the separating partners. Couples may present with goals of saving the marriage, when, in actuality, at least one partner is fairly certain and committed to dissolution. The opposite may also be the case. The point is that the distinction between divorce therapy and marital therapy is not tidy, and the therapist must continue to help clients assert their real desires and must sensitively monitor the goals and commitments of the clients, and be flexible to changing strategies appropriate to those goals. There are essentially five areas from which divorce therapy, as currently conceived and practiced, has derived: marital and family therapy, including both psychodynamic systems and behavioral approaches; crisis-intervention treatment; grief and bereavement counseling; educational-supportive counseling; and developmental psychology . My approach incorporates elements of all these areas, but I find it most valuable to work with divorcing clients from a family life cycle perspective that will be elaborated later in greater detail.
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