The divorce rate is 20% to 30% higher among African Americans, even when controlling for socioeconomic status . College-educated Black women, like their White counterparts, are more likely to divorce . Black mothers are not only less likely to remarry, but also to receive less alimony and child support. They are more likely to have full custody, to live in poverty, and to face economic and social oppression than White divorcees . The higher divorce rates among Blacks have been explained in both economic and cultural terms. There is less of a social taboo on separation and single-parent living among African Americans. Multigenerational parenting is normative, and cooperative kinship networks and sharing represent a traditional strength of African American society . Cultural patterns and economic trends are linked, however, and the choices of Black families have been made under conditions of economic hardship . Any social or cultural advantage for Black women in initially coping with marital dissolution is diminished in the long term, and longitudinal research indicates five years after a divorce White women evidence greater personal mastery, informal and overall happiness, as well as the economic advantages of a higher probability of remarriage. Marriage is a temporary state for most Black women, lasting about 22 years, and is followed by increasingly longer periods of single status, before and after marriage . As they age, Black women also may have to raise grandchildren alone on limited incomes and with significantly lower retirement benefits than older White women . Although gay marriages have not yet been widely sanctioned legally, children and adults in these marriages have few benefits of the protection of the law nor from public scrutiny. There are varying estimates of from 6 to 14 million children being raised by lesbian or gay male parents . No studies have found that children of gay and lesbian parents are disadvantaged in any important respect compared to children of heterosexual parents . Legal recognition of these marriages, however, would be very beneficial to these children in terms of protecting their economic interests and guaranteeing custody and stability of caretaking in the event of a death or divorce .
Global rising divorce rates have been attributed to a multitude of causes, including changing religious, legal, economic, and social factors, and prior psychological dysfunction. Certain factors appear repeatedly in the divorce literature, such as the liberalization of laws permitting marital dissolution , increasing secularization, the greater acceptance of alternative families, and increased social and economic freedom for women. Male violence has been found to significantly increase the likelihood of marital disruption . Women are more likely to initiate divorce today than are men, being more financially able and willing to leave unhappy, inequitable, or abusive marriages than in the past, and divorce can be interpreted as a form of gender resistance to oppression . Economists also note that the opportunity costs of marriage have decreased, resulting in lower marital rates and a greater willingness to divorce and explore other choices and opportunities. Another line of research considers prior psychological dysfunction or a marital selectivity hypothesis . Prior psychiatric disorders have been found to be associated with a substantially higher risk of divorce, but these associations cannot be interpreted unequivocally as causal . Divorce must also be understood in relation to the culture of which it is a part. Western cultures such as ours increasingly emphasize individualism, emotional self-fulfillment, and autonomy. It seems likely that divorce will continue to be a frequent event and painful process in American culture, which strongly values emotional bonding between spouses and increasingly downplays and devalues economic and religious ties. There is a large body of research now that also documents the costs of divorce. Early research has been widely disseminated to the public with fearful admonitions about how children of divorce are irrevocably scarred . This research, however, was seriously flawed and, as Dreman summarized, suffers not only from temporal confounds and failure to employ control groups of intact families, but also from the fact that it is of a mainly descriptive, clinical and non-quantitative nature employing a small nonrepresentative sample of 60 divorced families from an affluent community in northern California . Other earlier research on divorce outcomes have been criticized for a reliance on static, cross-sectional assessments, personal accounts, small, unrepresentative samples, no comparison or control groups, and a lack of consideration of mediating and confounding variables such as length of the divorce and marriage, locale, socioeconomic status , income, and the significant effects of family dysfunction before the divorce . Fortunately, we now have other longitudinal research based on decades of meticulous, multivariable study with broad-based national samples that gives us a much clearer picture of the outcomes of divorce and length of recovery. In their landmark, comprehensive study of 1,400 families over a period of three decades of research, Hetherington and her colleagues present a more balanced summary of the problems and challenges of divorcing families . They find that most adults and children go through a very difficult period of crisis and may often experience traumalike feelings and adjustments. Very young children of both sexes are likely to exhibit behavior problems, and boys may show problems for longer periods than girls. Problems for adolescents tend to center on depression, low self-esteem, and antisocial behaviors. Adolescent girls may have problems with precocious sexual behavior and adolescent boys with defiant, aggressive behaviors. There is less agreement on the magnitude of these effects. It usually takes from two to five years of adjustment to stabilize to more normal positive feelings and behaviors, but the good news is that most people, including children, are remarkably resilient, suffering no long-term psychopathology as a result of divorce. Divorce is certainly painful for children, and the effects are not to be taken lightly, but six years after a divorce, the vast majority of children emerge, without permanent scars or significant diminution of trust in others, and are functioning within the normal range of adjustment . A key consistent factor that emerges for children’s adjustment is the degree to which the divorcing parties cooperate and avoid involving the children in the divorce conflict . This latter finding has tremendous implications for clinicians helping divorcing parents and will be discussed at length in the section on clinical strategies. In a very careful review of the past two decades of divorce research, Amato concludes that both perspectivesdivorce as lingering disaster for individuals, families, and society versus divorce as a benign force for change and growthare one-sided representations of reality. Divorce benefits some individuals, leads others to experience temporary psychological detriments, and exacerbates the problems of others, who experience a downward decline from which they never recover. Women and children still bear the economic brunt of divorce, and their subsequent incomes are 56% that of their former husbands . An increasing number of men, especially lower-income men also suffer a reduced standard of living following separation . Children suffer the loss of fathers, because fathers still are less likely to receive custody and are frequently less involved in their children’s lives. Men suffer also from that parental loss. Remarriage rates after divorce continue to be higher for men than for women .
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My theoretical and therapeutic approach throughout has been integrative , comprehensive , and multimodal . I have tried to work judiciously from whatever theoretical set of assumptions most illuminates what he is sharing and what is transpiringalways within a family systems perspective so that what we discuss and what he decides to do have a beneficial impact on his significant others. My basic psychodynamic view of personality structure and diagnosis undergirds how I interpret what I see and hear. Sometimes, I use a narrative approach ; other times my work veers toward cognitive behavioral , or humanistic and existential . What has become glaringly apparent in my treatment of dozens of rich and famous couples or families is the sense of privilege and entitlement they have. For example, they start out by expecting the therapist to be at their beck and call regarding appointment times and to accept their cancellations when something comes up at the last minutebe it a business meeting or a tennis or fishing engagement . Extreme narcissism and impulsivity is manifested in I want what I want whenever I want it and it should be bigger and better than what anyone else has, whether it be a canary, diamond ring, or a yacht. The conspicuous consumption first described over a century ago by Veblen is rampant and unabashed. Many of these couples treat au pairs and nannies as modern-day slaves, often underpaid and expected to be available for extra hours and tasks whenever requested without additional compensation. The portrait presented in The Nanny Diaries is all too typicalnannies have very little leverage for bargaining, and since they often become devoted to the children they care for and have few other job options or time off to go on interviews, they are easily, and at times, heartlessly exploited. The affluent are sought as board members for boards of directors of corporations, hospitals, philanthropic organizations in the health and welfare arena, and by cultural organizations. They bring prestige to the role, are expected to make sizeable contributions and to convince their acquaintances to do so also. Some, like Mr. A, bring plenty of experience and know-how to the table. Treating Couples across the Socioeconomic Spectrum 401 Returning to Maslow’s hierarchy of needs, we would expect the basic survival requirements of Level 1 would have been fulfilled, but this is not always the case. Despite all of the material possessions, some of the rich feel emotionally deprived, empty, and insecure. This is particularly true of those who have had everything given to them financially by their parents while growing up, even if they were not available emotionally. They have never really acquired the kind of self-esteem and sense of self-worth that come from working to achieve mastery, making mistakes, losing out in competitions, and then trying again. When status is ascribed and not achieved, people are uncertain about their own capabilities. This is true of many of the women who circulate in this social scene and worry about what might happen if they became divorced single moms at age 40 and had no one to support them in style. They know their attractiveness for rich, older men may wane soon. Many of the trust fund babies I see grew up living off inheritances, scoffing at those who work, partying to excess, and being supercilious on the outside, while feeling worthless underneath. I often see couples in which one or both members suffer from eating disorders, substance abuse disorders, and poor self-concept. They often lack a framework that gives a sense of purpose and meaning to life, and they may be plagued by uncertainties about whether their friends are true friends who would stand by them in times of financial and emotional crisis. With them, therapy may focus on issues such as: Who am I, who are we, what do I want to do and be, what values do I hold and want to transmit to my children, how much do I want to raise them versus turning their care over to a nanny? Some are able to attain Maslow’s Level 4Self-Actualization. They become free, through therapy, to pursue their dreams, fulfill their potential vocationally or avocationallyand to be philanthropic in the fullest sense of altruism and humanism. When they reach this level and have developed true self-confidence based on real achievements and contributions, their D needs have been replaced by their B needs and therapy is terminatedby mutual agreement . When couples achieve this plateau, they radiate health. Clearly, it is easier to become self-actualizing without being narcissistically self-absorbed when people have the financial resources to embark on any undertaking they want and to be beneficent in many different ways. Treating the wealthy is challenging. They expect a great deal from the therapist and won’t settle for less. Like poor and middle-class clients, they need to feel accepted and respected and to know that the therapist understands their values and lifestyle, and appreciates the fact that being wealthy does not preclude having problemsincluding uncertainties, jealousies, affairs, addictions, anxieties, and depressions. They just may be better able to mask their doubts, fears and hurts, and it may be harder to penetrate their defenses, since putting on a good act is an art in which many of the well-to-do are quite proficient. But once they do form a 402 SPECIAL ISSUES FACED BY COUPLES therapeutic alliance and like the changes they see in themselves, they stay in treatment until they feel and function substantially better, They often refer their friends.
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In the first session, as in most subsequent sessions, he presented as a pleasant, affable man. He is Caucasian and considers himself very much a WASP. He looks younger than his real age and keeps himself in good shape physically. Like many of his Palm Beach peers, he owns a large yacht, a private jet, and a mansion on the ocean . He owns one other large residence, in this case in Newport . There are nannies for the children and *The case presented is an amalgamation of several cases. Camouflage has been used to protect the identity of the several individuals/families used to develop this prototypical case. But the essence of the substance and issues has been retained to render an accurate kaleidoscopic portrait. 394 SPECIAL ISSUES FACED BY COUPLES ample staff to take care of the homes and grounds. Either the chauffeur or a nanny takes the children to and from the private schools they attend . The chauffeur or nanny also do sundry errands. It had become obvious to him that the cost of supporting such a staff is staggering and that frequently they slough off doing their chores unless they are carefully supervised by a house manager. He prefers not to worry about such details and about being short-changed, but is not always able to ignore staff machinations. He knows that he relies heavily on his staff at home, as well as in his businesses, just as he relies on his several attorneys, to manage his affairs and make his complicated life run as efficiently as possible. Nonetheless, he remains very much in charge, and all around him know this. In this era of cost cutting to offset huge losses attributable to the major stock market decline experienced from 2000 to 2003, he feels pressured to do substantial cost cutting, but without sacrificing the luxuries of life to which he is accustomed. Mr. A had five children who ranged in age from 2 years to 30 years when he commenced treatment with me. The 30-year-old son was married and living in Palm Beach with his wife and a child about the same age as Dad’s youngest son. Todd was born during Dad’s first marriage and was now involved in one of Dad’s thriving businesses, which he hopes to take over when Dad retires. He has resented Dad’s involvements in the past decade with women in their thirties, whom he sees as being in his generation and not in Dad’s, and he perceives them to be gold diggers. Dad likes his son Todd, but doesn’t believe he is smart enough, or ambitious and hardworking enough, to become president or CEO of the business he is currently engaged in, or any of Mr. A’s other numerous enterprises. He revealed he is disappointed in his first-born offspring. He believes his son is jealous of his lavish lifestyle and the beautiful women he escorts and has married, while his son lives a more stable and sedentary lifestyle. This eldest son was not as indulged as the younger children have been because Mr. A was not as wealthy when this child was in his formative years, and his first wife was more conservativeuntil it came to putting forth her demands for alimony and child support when he sued for divorce to end the boredom and stuckness he felt. Wife number 1 continued to reside in Philadelphia and had had primary custody of Todd. Mr. A had visited monthly, had flown his son down to visit him in Palm Beach whenever possible, and gladly taken him during agreed-upon vacations. He had paid child support willingly and been generous with presents. Whenever he thought his ex-wife was contentious about matters pertaining to their son, like visitation, which private school he should attend, and laterwhich colleges were suitable to apply to, he would threaten to take the matter to court to have it settled. She usually succumbed to his wishes to avoid such a battle Treating Couples across the Socioeconomic Spectrum 395 and to not jeopardize the generous monthly allotment, that she was slated to get as long as Mr. A livedthat is, she had been awarded permanent alimony. She had kept his name as hers after the divorce, as did his two subsequent wives, since the name provided instant recognition for getting hard-to-come-by reservations in toney restaurants, coveted theater tickets for hit Broadway shows, and for opening certain social doors for themselves and their children. Prager indicates that wives and girlfriends of the ultrarich often continue to have a seductive package of perks even when the love affair is over. It appears that some of them plan their strategy for this to be part of the aftermath. His threats of resorting to legal action whenever an ex-wife challenged him or disobeyed his wishes about a child continued as a major ploy in his repertoire with wives number 2 and number 3. His children from his second marriage were Bart, age 14, and Bettina, age 12. Lonnie, his mistress for several years after his divorce, had assured him she did not want children but that she was using birth control nevertheless, so he had nothing to worry about. When she decided she didn’t want to risk losing him if and when he became bored or disenchanted with her, as he had with her predecessors, she decided not to tell him she had stopped taking the pill. He recounted to me that when she announced to him that she was pregnant, he had experienced multiple mixed emotions, including shock, annoyance, pride , and excited anticipation. Her ruse worked. She had figured out, correctly, that he would not want a child of his aborted and that his code of honor was such that he would marry her under these circumstances. He did. Lonnie came from a lower middle-class split family and was brassy, crass, overtly seductive, and not well versed in social graces. She had been fun to date, but he never intended the relationship to move beyond fun and games. But Mr. A doted on being a dad and adored the son she gave birth to, so he overlooked Lonnie’s shortcomings and had a member of his staff attempt to teach her how to become a better, more appropriate stepmother and partner for him. Lonnie was enthralled with her new social standing and extravagant lifestyle and decided, secretly, to become pregnant again quickly to ensure that Mr. A would not leave her. Numerous times in therapy we have probed how he , who is so shrewd, brilliant, and tough in business, can be so easily bedazzled by women whom he is aware are not potentially good partners for him, and how once having become involved because they are fun and offer great sex, he can then be tricked into fatherhood and marriage. It took many months before we were able to break through his denial and he could see the pattern well enough to ponder the kind of choices he has made and how gullible he has been . Despite his love for Bart and his infatuation with their second child, Bettina, 396 SPECIAL ISSUES FACED BY COUPLES his first and only daughter, he had reached a point in this marriage where he could not tolerate Lonnie’s crudeness and chicanery. When Bettina was 2 years old, he opted for a second divorce. He had insisted on joint and fully shared custody, which Florida law permits, and which Lonnie willingly granted, since she had no burning desire to raise the children alone and wanted at least half of her time free to do her own thing. To her friends, she had allegedly added and not be saddled with his two brats. She insisted on a huge settlement, and knowing how much he dislikes negative publicity, she threatened to tell all to the tabloids unless he agreed to her astronomical demands. He did, unwillingly and angrily, and vowed to never marry again unless an airtight and very restrictive prenuptial agreement was signed . He entered therapy several years later, still harboring much animosity and resentment toward Lonnie, and he wanted to continue retaliating whenever possible. After his divorce from Lonnie, he dated all kinds of women, from young, never-married party girls, to more mature and successful career women who had achieved high stature in their own right. Although he had convinced himself that he now preferred an independent and self-supporting career woman as a partner, he continued to be drawn to statuesque and lively single moms, some divorced, some never married, some with a child out of wedlock. He reported never having done drugs, but he participates readily in the heavy drinking that is a major part of the party scene he frequents, and he admits that he imbibes quite a bit. He only likes the best vintage wines and considers himself a connoisseur of gourmet cuisine. Following several years of dating while juggling his far-flung and diverse business empire and seeing his three children as often as possible, he again began to yearn for a slightly more settled lifestyle. At that time, around 1998, he saw a gorgeous, earlythirties woman at a local soiree. He immediately found her so alluring that the night matched the lyrics of Some Enchanted Evening. He introduced himself and found her very responsive to his overtures to dance and then to be his partner at dinner. As local legend has it, she was out on a proverbial big game hunt , and he qualified. In addition to his wellpublicized fortune, he is good looking and has a casual, nonarrogant charm and versatility, so it was easy for her to be, or act, smitten by him. He reported that they had had an idyllic whirlwind courtship, and he was enthralled by her. She treated his children wellwhich meant a great deal to himbut this only lasted until about six months after they got married. Dawn’s beauty, and what turned out to be her superficial sweetness and kindness also captivated his friends. Initially, she was affectionate and Treating Couples across the Socioeconomic Spectrum 397 appreciative, flattered him skillfully and frequently, and appeared to be genuinely in love with him. He considered himself to be the luckiest guy in the world to have met her and to have his intense attraction to her reciprocated. Despite protests from his oldest son, and some warnings from several friends who thought the age difference was too great and that it was really his bank account and other assets she desired, he was in a great hurry to make her my own. They were married within five months of having met, after a very romantic, storybook courtship. She received a dowry of sorts from him a week before the wedding; that is, a gift of $2 million put in her name only, a gift he made at her request when he was deliriously in love with her, because she wanted to feel really secure. Once they were married, Dawn told him how much she wanted to bear his children. As his business enterprises were growing, he envisioned creating a dynasty that would carry his name for decades to come, with each child ultimately running some branch of the vast family empire. He also relished recreating his image in the children he sired and thought they would be superbeautiful with Dawn as their biological mother. So her declaration of intent to have several A-babies pleased him enormously. Once again, he totally failed to recognize that this was her way of ensuring her continuing wealth, whether or not the marriage lasted. Although she had signed a very generous prenuptial agreement, she was reasonably certain from the first that she could retain an attorney who would be able to find loopholes, which is what she did several years and two children later . According to Mr. A, during her pregnancies she was irritable, demanding, and totally self-centered. Whenever his other children came to visit, she no longer was nurturing and welcoming; she had turned into the wicked stepmother. She told him stories about their obnoxious and disrespectful behavior, most of which turned out to be fabricated. But she did succeed in driving a wedge between Mr. A and his three children, who had predated her in his life and to whom he had always felt strong love, loyalty, and a deep sense of commitment, which now became highly tinged with guilt . He now saw them less often. In therapy, he finally recognized that her primary motive had been to alienate him from his other children so the ones he had with her would be the only heirs to inherit his throne . By the time their adorable daughter was 4 years old and their mischievous son was 2, he was totally disenchanted with Dawn. Her vanity, deceitfulness, manipulative ways, and unscrupulousness could no longer be overlooked, and he had ceased to see her as beautiful now that he found her character to be despicable. He also had learned, from several reliable sources, that she had been cheating on him. Thus, he embarked on his third divorce, and an ugly, bitter, protracted battle began. Both hired top-notch, high-profile, combative attorneys who fought valiantly on their client’s behalf in this high-stakes litigated break-up 398 SPECIAL ISSUES FACED BY COUPLES and division of tangible and intangible assets case . Mr. A resented having to pay a settlement of $10 million in violation of the prenuptial agreement. Dawn’s sense of entitlement and her greed , overwhelmed and repelled him. He wanted to retaliate and destroy her for her deceit and all of the disillusionment she caused him. As the legal contest was drawing to a close, it became obvious to his warrior attorney that Mr. A was emotionally depleted, disillusioned, stripped of confidence in his judgment about women, and a very angry man. It was at this juncture that he had referred him for therapy. Over the years that he has been in treatment, we have shifted back and forth, exploring these interlocking themes and the knots they have caused in his psyche and soma . He has proven capable of forming a strong, positive therapeutic alliance. He seems to welcome the knowledge that I am available by phone as necessary and on time when we have an appointment; that I am tuned in, listening with the third ear , and that I am observant of his body language and interpret the cues I am picking up back to him and ask that he confirm or disconfirm what he is feeling and unknowingly communicating. He is extremely bright and is fascinated by the process of learning more about himself, why he does what he does, and how to create a happier, less conflict-ridden present and future. He realizes how often he has felt abandoned, rejected, unloved, and unappreciated for himself, and is determined to break the pattern of choosing beautiful, narcissistic, demanding, sexy, manipulative yet dependent partners. During the several years since he started treatment, he has been seen an average of once every other week. Like many of my other Palm Beach patients, he prefers to pay a large sum up front, have me keep a record until that amount is used up, and then give him the receipts in a packet and let him know that the next payment is due. When he is out of town for any length of time, we do sessions by telephone. Like many of the other men in this locale, his appointments are often made by and cancelled through his secretaries. It is the secretary who keeps his schedule and reminds him of appointments. I have gone over confidentiality issues carefully with him and have given him the HIPAA privacy regulations and had him sign for this, but the secretaries remain the point people. Refusal to accept this as part of his modus operandi would be the death knoll to therapy. In treatment, we have focused on various themes episodically. These include: His fear of being abandoned as he was emotionally in childhood by both parents, which is reflected alternately in his desire to strike back Treating Couples across the Socioeconomic Spectrum 399 and his desire to pleaseso that any love and attention, even if contin gent on his wealth, is better than no love at all. How he contributes to setting himself up to be exploited financially. Why he seeks recourse through the courts to settle his interpersonal and intrafamilial disputes instead of trying to negotiate solutions more peacefully through one-on-one discourse or with the help of a therapist or mediator. Whatclingingtooldslightsandhurtsandinternalizedangerdotohis ability to let go and become healthier and capable of developing mutual and reciprocal caring relationships in the here and now. Why he craves retribution and being exonerated from responsibility for his choices, which later boomerang. Why he gravitates toward the type of woman he still prefers, knowing that their lack of good breeding, their narrow range of interests, their self-absorption, and their lust for material possessions ultimately alienate his affections . Hischildrenandwhathewantstoinstillinthemregardingvalues,responsibility, acceptable behavior, a work ethic, goals for the future, and the importance of being philanthropic. His parenting style and the necessity of setting reasonable limits and insisting these be adhered to. Not overindulging the children with thingsthe big and costly items the wealthy give their children, often as a substitute for love. His desire to be well respected in the community, which has led to our devising a plan through which he has achieved this by acting in an exemplary fashion at social events; by contributing to local and national charities in a leadership role as well as with huge contributions, and through hiring a publicist to improve his image in the press. Currently, he is on the brink of another involvement, but has moved more slowly. He has joint-shared custody of the four younger children and delights in being with them and is much more hands-on in their childrearing than he was with his oldest son, Todd. He has sought out relationships that have somewhat more substance and depth. He realizes that being a billionaire can buy big toys, but not happiness or physical or emotional health, even if he has access to the best doctors. Frequently, he has discussed complex business affairs with me, primarily about possible mergers and acquisitions and about problems with staff. He knows that I do family business consultation and am conversant with the issues he raises . One time, when I queried why he was discussing a possible risky new acquisition with me instead of with his attorney or accountant, he answered, You are quite knowledgable and more objective, honest, and trustworthy, since you have no personal gain at stake, because you would not be an investor or receive a percentage cut of any deal. He has also commented on how refreshing and enlightening it has been to work with a female therapist whom he sees as an equal. 400 SPECIAL ISSUES FACED BY COUPLES Periodically, he has brought in one of the women he is dating for therapy sessions with him. Currently, he is being seen conjointly with the woman with whom he is involved. This relationship seems a little less tumultuous. But she too is about 25 years younger than he is and has not worked since graduating from collegeexcept at her hobbiestennis and skiing.
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In the winter of 2001, Mr. A called me, based on a referral from his highly esteemed and expensive divorce lawyer. The attorney, who has, as if by osmosis, taken on many of the mannerisms of his wealthy clients, had not apprised me of the pending referral. He assumed I would feel fortunate to have the opportunity to treat someone of the stature of Mr. A, and so decided no direct referral was needed. During the telephone intake, Mr. A told me his name and that his attorney, Mr. C, had just handled his muchpublicized divorce. Mr. C thought there were some important issues concerning his children, his postdivorce adjustment, and his relationships with women about which he should consult me. I indicated that I would not have an opening for about two weeks, but we could set an appointment in advance. He sounded miffed and said, You don’t recognize my name, do you? Since I rarely read the society pages of our local newspaper and don’t read Fortune magazine regularly, I did not. He hastened to let me know who he is, his various claims to fame and fortune, and the size of the monumental settlement that wife number 3 had been awarded; it was substantially over $10 million. I realized that his assets had to be of staggering proportions.
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Because there is a dearth of literature on treating couples who are rich or famous, the rest of this chapter highlights this realm of therapy. The case illustration is based on a composite of various cases having similar themes and dynamics, drawn from the author’s private practice in affluent Palm Beach County, Florida. It seeks to analyze this specific patient population as typified in this prototypical case.
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Much of the couples literature has tended to focus predominantly on White, middle-class couples. There is a great deal available that is drawn from clinical experience based on typical agency or private practice case loads. Although socioeconomic status and money rarely are mentioned as variables , descriptions of the couples’ lifestyles would seem to place them mostly in the vast middle class . Willi discusses the collusive nature of many marital patterns that represent the unconscious interplay between partners who maintain their repetitive battles. Writing from a psychoanalytic perspective, he elucidates how troubled couples triangulate their relationship to stabilize it , and develop psychosomatic illnesses to serve as neutralizers to the conflict or as a joint defense system. The latter tends to elicit sympathy from extended family members and friends. In The Good Marriage: How and Why Love Lasts, Wallerstein and Blakeslee describe four types of marriage and the tasks associated with each: 1. Romantic Separating from family of origin Building togetherness and creating autonomy Becoming parents 2. Rescue Coping with crises Making a safe place for conflict 3. Companionate Exploring sexual love and intimacy Sharing laughter and keeping interests alive 4. Traditional Providing emotional nurturance Some of the tasks cut across several of the types of marriages, rather than typifying only one. This classification schema is useful and is quite applicable for the vast array of middle-class couples. Those who are poor have the more basic tasks of survival to contend with, which often entail coping with crises these authors associate with the rescue marriage. Either or both partners in lowerand middle-class couples may need huge amounts of emotional nurturancein traditional and nontraditional cohabiting and marital relationships. 392 SPECIAL ISSUES FACED BY COUPLES Most of the literature on understanding and counseling the culturally different, that is, those who are not White Catholics or Anglo-Saxon Protestants, is either about individuals , or families . However, since couples are the architects of families, these two volumes are informative about couples from enormously diverse ethnic, racial, and religious backgroundsmost of whom, on a bellshaped curve, would fall in the broad middle-income range. Returning to the paradigm articulated by Maslow, the majority of middle-class couples are able to provide their Level 1 basic needs for food, clothing, shelter, safety, security, and protection. They will want to, and will be able to, fulfill their Level 2 needs for belongingness to family, community groups, their tribe, business or professional organizations, special interest groups, and so onsome of these separately, and many of them together as a couple. The more financially and emotionally secure they feel, the more they are likely to want to ascend up to Level 3 on the hierarchy of needs scaleseeking to gain approval and respect from others, and having good self-esteem. They crave friendship, affection, and love from one another and from others close to them. Financially, they value having a home and may move from renting to owning, or from owning a small house to purchasing a larger one. In therapy, they may argue because there is never enough money for all they want to do, and they may need help in prioritizing and taking turns getting what they want and in determining what they most value in life. If they are postponing having a first or second child because they believe we can’t afford it yet, time in treatment may be spent on how much is enough, how long do you wish to delay parenting, and are money worries camouflaging other doubts and problems. Often, they quarrel over how much should be spent versus what percentage should be saved. Frequently, one partner is a here-and-now, pleasure-oriented person, and the other is more conservative and future-oriented. The therapist may strive to help them find a way to enjoy both, and not to continue arguing over the polarities of either/or. They may also disagree about whether or not the woman will continue working after they have children, and it is important to discuss what her working and the income this produces means for both of them. Often middle-class couples share traditional values emphasizing fidelity, the importance of the extended family system, being very involved with their children, obtaining a good education, and striving for upward mobility.
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There have been several excellent books written about poor, lower-class families on therapy with African American inner-city families. The poor and underclass everywhere frequently include struggling refugee and immigrant couples, the unemployed, and the homeless. In brief, treatment, which may include home-based services for those who cannot or will not come to an agency, must be reality-oriented and nonjudgmental. People need to have their stories heard and accepted, and their strengths as well as their crises and weaknesses assessed. It is their strengths and resiliencies that will provide the foundation for improving their life situation and engendering hope . Since their daily problems in living may be huge, solution-focused problem-solving efforts may constitute the treatment of choice . Often, such people need to be connected to an array of community resources, and the therapist may need to intervene to see that the recipient referral sources, like hospitals and employment training agencies, are receptive to these clients’ requests for service. The therapist may need to stay with the client to teach follow-up and follow-through skills, and compliment them when an agreed upon course of action is taken. Helping the partners appreciate and support each other is vital if the marriage is to last. And helping the couple rebuild relationships with or tap into their extended family and community support system, often including the church, is central to countering their sense of Treating Couples across the Socioeconomic Spectrum 391 alienation, isolation, and loneliness. Sometimes, guidance needs to be given about budgeting and how to begin saving, when money becomes less scarce. It is essential that the therapist be optimistic and believe that her clients can improve their life circumstances and are entitled to a sense of wellbeing, security, and happinesswhatever that means for them.
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Maslow’s hierarchy of needs seems a useful conceptualization that in some ways ties in with one’s socioeconomic status. He posited that at Level 1 people are concerned about meeting basic subsistence needs for 390 SPECIAL ISSUES FACED BY COUPLES food, clothing, and shelter. Meeting these needs is the motivation that drives poor couples to work extra hard, sometimes at two or three menial jobs each. Striving to make ends meet often leaves them depleted at the end of the day and without time or energy on the weekends for relaxation and fun. They are often frustrated in their efforts to pay the rent, have enough to eat, and keep from becoming homeless. When they use drugs or alcohol to assuage the pain of feeling like a failure or to drown sorrows caused by too many early losses of loved ones, the problems of poverty, marital discontent, and sometimes physical abuse may become exacerbated, leading to trouble with the police and soon the legal system. When these severe difficulties are further complicated because someone is African American , Native American, or Hispanic and has been subjected to prejudice and discrimination in school, in the work world, or in the community, the stresses this places on a couple’s sense of safety and security and well-being may seem so insurmountable that the marriage cannot survive.
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A bevy of issues have already been mentioned and will be addressed further in the following pages. These include: Love, marriage, and money. Is there ever enough, and the many shades of meaning of moneyfrom poverty and a sense of failure, being middle class and always running short for unseen expenses, to having wealth and the power and prestige that often accompany it. Socioeconomic status and marriages in lower and middle-class couples. Typical and atypical problems, therapeutic issues, despair versus hope, confronting weaknesses and building on strengths. Marriages and other unions of the rich and famous. Treatment issues and implications emanating from financial status and personal values about money of both patients and therapists. Does being wealthy ensure greater marital bliss and less conflict? Does it bring about a greater sense of well-being, of responsi bility to, and helping of those less fortunate? Given the page limit set for this chapter, it is not possible to explore each of these issues in depth; nonetheless, every effort will be made to provide a succinct discussion.
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IN THE FIRST decade of the twenty-first century, family psychologists/ therapists around the world are seeing couples who range financially from very poor to very rich. Most articles and books on this topic have been geared to couples who cluster at one specific rung of the socioeconomic ladder, such as poor, inner-city families, in books such as the now classic S. Minuchin, Montalvo, Guerney, Rosman, and Schumer volume, Families of the Slums , and Sharlin and Shamai’s treatise on intervening with poor and disorganized families, which is based on an Israeli population. Some clinicians specialize in working with a particular population segment and find this specificity of focus very relevant. Yet, many other clinicians treat people who fall along different rungs of the socioeconomic ladder, ranging from their pro bono patients, who are worried about surviving at a bare subsistence level, through those who are middle class, working diligently and trying to make their lives meaningful and to find time to be together, to the fabulously wealthy, who superficially seem to have it all. Talking and writing about money and economic status seems to make many therapists and psychology researchers uncomfortable, and so this topic frequently is avoided in our professional literature. One rarely sees copies of Money Magazine or Forbes in therapists’ waiting rooms. In fact, Krueger called talking about money The Last Taboo. This is strange in light of the changing demographics of the American family , attributable in part to the feminist revolution and to the entry of so many women into the paid labor force, after receiving their high school or college degree, seeking to be a wage earner because money does matter. The revolution has had reverberations in many other countries also. Being paid and recognized for one’s contributions increases one’s motivation, enhances one’s self-esteem and confidence, and is conducive to a stronger sense of self-sufficiency and independence. In dual wage earner/career couples, this has changed some of the marital dynamics irrevocably. It has decreased a woman’s dire need to stay married if her husband is abusive or unfaithful. When a woman can support herself, and her children if necessary, her desire for a husband shifts away from mainly needing him as a source of support to wanting her husband to be a lover, friend, good conversationalist, fine companion, as well as a person who is competent in the career or money earning dimensions of life. Interestingly, some women who have chosen to remain financially dependent may resent the career woman for all of her achievements, which make them look lazy or inadequate by comparison, for creating a different kind of role model that they do not wish to follow, or because their husbands refuse to allow them to work and they are jealous of the freedoms working and earning an income can bring. Still others, after working a while, may envy their nonworking counterparts whose partners give them everything, including nannies to watch the children while the moms play and closets full of fashionable clothes, and fabulous jewelry. It doesn’t seem fair! And these differences in the covert and overt desires of women regarding whether they wish to work or be totally taken care of financially by a husband or sugar daddy must be kept in the foreground when there are discussions about what women want in general, and in specific, what does this particular woman want who is part of a dyad in couple therapy. Then, too, the female lawyer, engineer, or psychologist who wanted desperately to acquire an advanced degree and pursue her dreamed-of career and break through the glass ceiling is in a very different stratum from the lower-class woman who works because she has no choice, when the family is poor, the husband is unemployable, unemployed, alcoholic, severely impaired, or nonexistent, and she is responsible for providing for her daily subsistence needs and those of her children. Low-paying or low-status work, such as being someone else’s house cleaner or a waitress in a fast-food restaurant, may be boring, routine, demeaning, and unexciting, but the money is essential. For some, having any job is better than being on welfare; for others, it supplements the welfare or other social relief program checks, or replaces benefits when they expire. Thus, money has a multiplicity of meanings from providing for survival to purchasing luxury items, to ascending to positions and circles of power and prestige. Perhaps this chapter will represent a giant step forward in shattering the taboo about discussing money, particularly before many couples get married, except in global 388 SPECIAL ISSUES FACED BY COUPLES economic terms and college economics courses, which may raise such concepts as Veblen’s theory of the leisure class and their Conspicuous Consumption , which is quite apparent with many well-to-do patients. Money does matter! Financial concerns and disagreements over who should earn the money; to whom the money belongs; and how it should be saved, spent, or disbursed often surface in treatment. Obviously, there are substantial differences in terms of the financial issues of concern to couples in therapy who are lower class, middle class, and upper class , and how these issues are lived with, played out, and resolved or allowed to remain an area of submerged resentment or overt continuous contention. The use of the classification system of lower, middle, and upper is generally accepted in economic classification schema, and is in no way meant to be pejorative. No specific cutoff points are utilized herein to differentiate the three major classes, given that this book is intended for a multicultural and international audience, and various ethnic and cultural groups define poor, rich, and inbetween quite differently. Money, and all of its attendant meanings and usages, affect the couple’s relationship; their perception of self and other and those in their social and family networks; who their friends and neighbors are; what kind of residence and car they can or cannot afford to rent or buy; what kind of education they want to, and are able to, provide for their children; what kind of therapy they seek and with whom; and how they view health insurance and/or fee-for-service therapists; and a multitude of other daily concerns. The meaning and usage of money is also an expression of one’s personality pattern, with thriftiness and withholding styles of dealing with money being seen psychodynamically as being typical of anal retentive or compulsive individuals, and excessive spending being an expression or characteristic of the anal explosive or impulsive personality. It is also a characteristic of many with addictive personality disorders who squander money to satisfy their addiction of choice, unconcerned about the consequences of their spending binge, and of some individuals during a manic phase of an affective disorder . Thus, a chapter on socioeconomic strata and money issues was deemed useful for inclusion in this volume on couples therapy. If a couple is contemplating divorce and they are rich, issues arise about division of assets, including what constitutes premarital assets that are exempt, whether jewelry and family heirlooms were gifts to one or both, whether inheritances belong to both, and what claims are or are not legitimate on either one’s trust funds or pension plans. Conversely, if the couple is poor or lower middle-class, there may be almost nothing to divide. It is impossible to divide one car. If they have been barely able to pay rent on an apartment, a serious dilemma confronting them is how they can possibly afford two places to live and essential clothing and food Treating Couples across the Socioeconomic Spectrum 389 . Frequently, one or both see no alternative but going back to live with their parent in a home that may already be overcrowded. There may be woefully inadequate space there for him or herplus for several children to live or visit. Some senior-generation parents respond to the breakup and request to return home with the reply, We’re all family and will do whatever we need to for each other in times of crisis. Others say, You’re an adult, and you’ll have to manage on your own. It’s not our problem. This may leave people emotionally desolate and financially desperate, and they turn to shelters, public welfare, and other relief programs to keep themselves alive. By contrast, in a rich couple there are sufficient funds for the partner who is moving out to rent or buy a condominium or house, or to stay in a friend’s guest house until he or she has decided where to live and what direction he or she wishes to pursue. Middle-class couples fall in between; they are not destitute, but each will have to manage with considerably less than they did when married.
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If much of the professional literature on male couples has focused on disengagement, it is also true that literature on female couples has focused on the oppositefusion. The earliest writings on the subject proposed that women, socialized to attend to the needs of others, would tend to lose their boundaries and enter a state of undifferentiation . Sometimes this merger was explained in terms of the female couple turning inward as a response to a hostile, homophobic environment . Nevertheless, the discussion seemed to hint at a pathological nature to this arrangement. Perhaps some of the discourse that followed from this early literature was founded on assumptions that two women in a couple cannot possibly be happy together, that the male model of independence and individuation is the preferable state, and that two people attending closely to each other’s needs will naturally produce dysfunctional relationships. Recently, there has been a reevaluation of this assessment. In fact, research shows that female couples are not struggling to achieve a demonstrated male ideal. In their influential research, R.-J. Green et al. report that lesbian couples are more flexible and cohesive than heterosexual and gay male relationships, that less flexible and cohesive female couples are more likely to break up in the first two years, and that lesbian partners are actually quite satisfied with their relationships. Perhaps women enjoy their relationships more because female socialization actually produces benefits. Perhaps women are able to leave behind patriarchal assumptions and use their relational abilities to produce empathy and intimacy, making possible both closeness and independence . Similarly, therapists must be careful not to assume that all female couples are suffering from lesbian bed death, the frequently used term to indicate the lack of sexuality in lesbian relationships. Iasenza persuasively argues that this myth may have come from a hasty reading of Blumstein and Schwartz’s American Couples , where empirical evidence found that lesbian couples had less sex than the other three types examinedgay male couples, heterosexually cohabiting couples, and heterosexually married couples. Part of the problem, Iasenza argues, is how we define sexuality. If sex is defined in terms of genital acts leading to orgasm, then we are adhering to sexist and heterosexist assumptions. In a review of the research, Iasenza reports that lesbians are found to be more sexually assertive; sexually arousable; verbally and nonverbally communicative about sexual needs, desires, pleasures, and distractions; and more satisfied with the quality of their sexual lives than are heterosexual women . If they prefer, two women together are able to enjoy many ways of relating sexually that do not fit traditional notions of intercourse, penetration, and climax. This is not to say that some lesbian couples are not vulnerable to particular pressures in their intimate relationships. Nichols asserts that women may develop sexual patterns that do not mimic patriarchal models, but this can also interfere in individual sexual pleasure; women may be trapped in egalitarian models that do not allow for playful domination and submission; and having internalized the cultural messages that suppress female sexuality, lesbians may not have the language for discussing sexual difficulties with their partners or with their therapists. In their clinically based, six-stage model of the development of lesbian relationships, Clunis and Green explain that couples may naturally experience tension in their sexual relationships as they enter the stage of conflict management and struggle for power, especially after the early periods of prerelationship acquaintanceship and romantic immersion. Women do not seem to grapple with questions of sexual exclusivity in the same predictable way that gay men do, most likely due to female socialization, and research shows that most female couples are monogamous . Slater’s model of lesbian lifespan development also explains that as women confront the necessary middle years and the stage of generativity , avoidance and tension can also interfere with sexual communication. Slater cautions that some partners may avoid the work of their relationship’s middle years by engaging in outside attractions, perhaps to deal with menopause, symbolize an act of individuation, revive early attachment affects, or rebel against oppressive cultural narratives. Other dynamics may increase conflict in lesbian relationships. Differences in lesbian identity acquisition may interfere with intimacy. Some Working with Same-Sex Couples 379 380 SPECIAL ISSUES FACED BY COUPLES partners who enter a same-sex relationship directly out of a heterosexual marriage may have mixed feelings about being with another woman. Some partners self-identify as bisexual, and this can frustrate a feminist partner who proudly identifies as lesbian. Also, lesbians may have children from a previous heterosexual marriage, creating challenges for a successful blended family. Women who have not had children but want them must prepare themselves for a time-consuming, often expensive process in a medical establishment that often does not value alternative families. Another dynamic that might create conflict relates to recovery from sexual abuse. Because rates of sexual abuse of female children are very high, the odds are doubled that one of the women in a lesbian partnership may be dealing with recovery from such trauma . Finally, power differentials, isolation from other couples, female socialization that cultivates dependency, and heterosexist oppression may all contribute to high rates of domestic violence . A brief case study illustrates some of these therapeutic issues facing female couples.
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By more clearly identifying what they were missing, the partners were able to describe it in language that both could understand. Through careful clinical observation and description, the problem came into focus. The issue was primarily about a loss of intimacy in their relationship. Since what they both missed was intimacy, their words had previously intellectualized away their experience. By focusing on the here and now of their nonverbal experience, they were able to let themselves slow down, feel each other’s presence, and communicate the language of feeling. Learning how to just be together was essential for this couple. When habits set in, couples can make assumptions about who the other person is or used to be. Structuring time together and creating rituals for closeness is part of a spiritual perspective. A soul perspective on couples therapy would help them rediscover each other in the living reality of their lives. Through the intense period of childrearing, this couple had become used to spending their time together checking in during the day on their travel plans, the children. I noticed that when they greeted each other in my office after a separation, their conversation was immediately about schedules. Not even acknowledging that they missed each other, their conversation lacked intimacy. Therapy therefore consisted of various ways to rediscover intimacy. It combined communication skills training, sitting in silence together, with new rituals that create shared space like reading to each other before bed. Part of the therapy, therefore, consisted in carving out a time of day when they would both leave their very active work lives behind and practice simply being together. Their conversation was not to be instrumental about work or arrangements. They designed a bedtime ritual of lighting a candle and sharing new and old poetry and music favorites. After the first week, they came in with a renewed interest in rediscovering each other. 366 SPECIAL ISSUES FACED BY COUPLES
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The following two case studies illustrate how elements of religion and spirituality can be integrated into psychotherapy practice. The first case is of a highly competent professional man who found himself in an affair. Waking up to the need to revitalize his marriage, he wanted to avoid his previous dysfunctional patterns of coping. Instead of being passive-aggressive and withdrawn, he longed to speak with his own authentic voice, and meet his wife with power and presence. 364 SPECIAL ISSUES FACED BY COUPLES His usual posture of anxiety and despair was of a sunken chest and constricted body. Relaxation and meditation suggestions included the following: Relaxation. Learning to sit upright, he could sense his weight and breath. As he let tension out with the exhalation, he was able to release some of the claustrophobic struggle. Letting go of familiar inner critical voices and depressing scenarios, he was able to let himself experience new possibilities in the situation. Breathing. Slowing down the breath slowed down his whole body physiology and calmed his anxiety. As he felt his breath travelling up his spine, it expanded his lungs, opened his chest and heart. He began to experience his heart and listen to its voice. Imagery. Opening his heart and lungs, he opened his arms. He experienced this as a basket, with the strands of his life holding all the tumultuous experience. He had created a holding container, so that he could experience and contain his emotions. Carrying this gesture and image through the next week gave him a physical touchstone that helped him stay strong and present in his interactions. Communication. Feelinghisheart,hewasabletoexperiencemoreemotion. Slowing his breath, he was able to slow down the overwhelming feelings and take space to sort them out. Once sorted out, he could address them one at a time. With time, he was able to know more clearly what he needed to say and to whom. Over time, this man began to feel more centered, was able to trust his perceptions, speak his truth, and act more responsibly and compassionately. He is rebuilding trust and intimacy with his wife, while taking steps to resolve the affair. The second case involved a couple who had been married for over 25 years and had four children. They were becoming estranged and had been referred by a divorce lawyer. Part of the presenting problem was that she is interested in spiritual things and he is not and she was worried about their children growing up with two different points of view on spirituality and religion. This configuration has familiar gender roles: The wife is increasingly attracted to spiritual studies and meditative quiet, while her husband is a very rational, successful scientist. She wants more depth in their communication. When she doesn’t find it, she withdraws. When she withdraws, he experiences her as cold and sexually unresponsive. She says: It’s a little hall of mirrorshe wants me to be more sexual, and I want him to be more spiritual. He doesn’t understand what more she wants; she thinks they don’t speak the same language anymore.
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What would proficiency in religious and spiritual issues in psychotherapy look like? The following section presents some basic principles of a religious and spiritual approach to couples therapy distilled from across Western and Eastern approaches to couples therapy. They will then be applied to two case histories. The following elements characterize a spiritual approach to psychotherapy: Here-and-now. Buddhism teaches about the truth of impermanence. Facing our mortality allows us to live more fully in the moment; a spiritual approach to psychotherapy emphasizes the present moment, and the development of presence . We learn that we are always home in ourselves. Spiritual practices teach concentration and ways to calm the mind. Spiritually oriented psychotherapy practices emphasize the importance of fit in clinical work rather than using prestructured sessions . These practices build on strengths and help people find their own voices, similar to postmodern, feminist, and narrative therapies . Therapy is discovery-oriented, and the therapist is not an authority figure. The therapeutic reality is coconstructed, in line with a collaborative approach to therapy . Identity. Most people normally identify with their bundle of personality traits and neuroses, jobs, or roles as their identity; a spiritual approach knows that we can be more. A spiritual approach teaches that even if these things change, we have a deeper identity. Beyond the narrow perspective of our insecure egos, or the self with a small s as Jung observed, lies a larger egolessness and panoramic awareness, or vipassana, which Jung called the Self with a large S’. . Developing a larger awareness helps us get perspective on ourselves and our problems, and provides space for change to occur . Transcendence. Most psychological histories and diagnoses start with a history of symptoms; transpersonal therapists assume that one goal of therapy is to facilitate growth of the self toward these higher levels of experience and that there is a natural, spontaneous movement toward Religious and Spiritual Issues in Couples Therapy 363 wholeness . Behind the confusion of the neurosis is usually a deeper level of clarity that is available to most human beings. This wakefulness goes beyond the usual Western dichotomies of good and evil, of images of human nature as either basically good or positive, or else teeming with conflicting drives seeking tension reduction. Instead, a spiritual approach to psychotherapy embraces paradox , and the ability to stay present in the midst of life’s inevitable challenges. Meaning. The search for meaning is an essentially human activity, but life may often feel meaningless. Victor Frankl , coming out of a concentration camp, developed an approach, which he called Logotherapy, that showed how the search for the meaning of even these events can overcome despair. Spiritual practices also help us face the void and discover new meanings in the new spaces or emptiness. Compassion. Seeing and accepting ourselves as we truly are allows us to develop compassion toward ourselves, and then extend that compassion to others. A spiritual practice trains the mind, which develops the discipline and courage to face life squarely. Through spiritual practices such as active love , we can honor our kinship with other human beings. Through the crucible of our own suffering, we transform passion into compassion. Home. Seeing a larger context than the self, we rediscover our larger connection to community and the universe. We find our sense of place: we belong. Some family therapists have developed practices such as spiritual genograms and spiritual ecomaps to help couples perceive these connections in their own families and extended families. A spiritual approach to psychotherapy can bring what has been called psychological maturity to couples in therapy. A spiritual approach to psychotherapy has been positively correlated with decreased anxiety and conflict , enhanced creativity, increased health and longevity, deeper empathy, and greater marital satisfaction and resiliency .
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Because the Buddhist method of inquiry into the phenomenology of mind is experiential, it includes the bodily experience of mind: namely, emotions . A Buddhist approach to psychotherapy, therefore, integrates body and mind through meditation and cultivation of the mind. In Sanskrit, for example, the words for heart and mind are part of the same reality or citta . The expanded mind brings expanded awareness, which lets us see things in perspective as they truly are, and with expanded compassion. The essence of Buddhist psychotherapy is the cultivation of compassion, or maitri. In the encounter between client and therapist, both hearts awaken. The awakened heart is called bodhicitta , and the awakened state is called Buddha nature. A commitment to relationship from a Buddhist point of view is a commitment to using the relationship as a path for awakening two hearts together in a conscious relationship. What is awakened in conscious relationship is the goodness and strength already present in us . Rather than staying in habitual patterns of flight-or-fight response, a warrior of the heart cultivates the three aspects of warriorship: awareness, courage, and gentleness . A spiritual approach to psychotherapy helps couples harness this desire to grow and views intimacy as an opportunity to awaken and bring forth our finest human qualities, such as awareness, compassion, humor, wisdom, and a fearless dedication to truth . Couples are committed to change, seeing relationships as teachers that show us where we need to grow. The act of falling in love is understood as an expression of the desire to realize the fullness of one’s own being. Psychotherapy for conscious relationships consists of transformative practices to foster compassion, courage, and awareness.
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Abraham Maslow, president of the American Psychological Association in 19671968, helped establish transpersonal psychology in the United States. He theorized that human beings need to first satisfy their basic needs for food and shelter, but then experience a drive for higher states of consciousness . Maslow identified such extraordinary states of mind as metavalues of wholeness, perfection, completion, justice, aliveness, richness, simplicity, beauty, goodness, uniqueness, effortlessness, playfulness, truth, and self-sufficiency . In 1969, Maslow and Sutich founded the Journal of Transpersonal Psychology and the Association for Transpersonal Psychology to explore the farther reaches of human nature. The first issue of the Journal of Transpersonal Psychology defined it as: Transpersonal Psychology is the title given to an emerging force in the psychology field by a group of psychologists and professional men and women from other fields who are interested in those ultimate human capacities and potentialities that have no systematic place in positivistic or behavioristic theory , classical psychoanalytic theory , or humanistic psychology . The early transpersonal theorists believed that consciousness exists as a phenomenon that can be systematically studied by science and used clinical and experiential methods such as meditation to study inner states . Transpersonal psychologists critique Western psychology for not going far enough. Western psychology can help us recognize dysfunctional patterns Religious and Spiritual Issues in Couples Therapy 361 and free ourselves from our pasts, but it lacks theory or practices to help us move beyond these patterns. Western psychology has a well-developed taxonomy of mental disorders, but almost nothing about mental order or, as the Buddhists say, basic sanity. Tibetan teacher Chogyam Trungpa’s term for the Western psychological approach that reduces everything to categories of internal disorder is psychological materialism . Through 2,000 years of intense introspection, Buddhist monks and scholars have developed an extraordinarily sophisticated taxonomy of normal, as well as abnormal, states of mind called the Abidharma . Most important, they developed a road map to go beyond normal to extraordinary states of mind.
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The most famous Sufi poet of devotional love, Rumi, taught that love is a madness that is not an illness to be fixed: This that is tormented and very tired. tortured with restraints like a madman, this heart. Still you keep breaking the shell to get the taste of its kernel.
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The Emmanuel Movement in Boston was one of the clergy’s first attempts to help the sick through mental, moral, and spiritual methods . After this movement faded, the clinical pastoral education and pastoral counseling movements emerged. Current organizations include the American Association of Pastoral Counselors and the Association of Mental Health Clergy. Christian psychiatric hospitals and psychology internship sites are available at the Fuller Theological Seminary’s Psychological Center, the Mennonite mental hospital, and the New Life Christian psychiatric hospital .
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The treatment of couples where there has been womanizing differs from that of couples whose marriage has included an affair. Chronic womanizing may be seen as a type of personality disorder. DSM-IV describes a personality disorder as An enduring pattern of inner experience and behavior that differs markedly from the expectations of the individual’s culture. This pattern is manifested in two of the following areas: cognition ; affectivity ; interpersonal functioning; and impulse control. The diagnostic criteria for Narcissistic Personality Disorder, particularly the qualities of grandiosity or self-importance, a belief in the person’s specialness, need for excessive admiration, entitlement, exploitativeness, and lack of empathy are often present in chronic womanizers. Unlike an affair, whose roots may lie in problems within the marriage, womanizing is a quality that, for the most part, long precedes the marriage. As indicated earlier, womanizing is a planful behavior, in contrast with most affair behavior. Many womanizers experienced narcissistic deprivation in their childhood, and because of it develop a great need for something that creates a sense of self-importance and of being desired. Some womanizers come from an environment that provided a surfeit of attention . Some begin as deficit narcissists, but their careers, for example, sports or entertainment figures, governmental officials, strongly inflame the tendency toward womanizing, because they experience some social approval in this context. Couples where womanizing has been discovered require a very different mix of individual and conjoint sessions than do those in which there has been an affair. The diagnosis of womanizing may be made by using the Humphrey schema as a checklist. It is urgent that the initial meeting include some consideration of the possibility that womanizing, rather than an affair, is the problem. If there is agreement that the problem is womanizing, it is important to clarify for the couple the differences between womanizing and affairs, and the consequent differences in treatment. Although it is hard to believe that the wife of a womanizer is consciously unaware of the womanizing, it is often the case, and for this reason, the trauma of discovery is a significant factor in treatment, and is in no way different from the treatment of discoverers of affairs. Infidelity: Theory and Treatment 345 346 SPECIAL ISSUES FACED BY COUPLES