How Relationships and Therapy Met
Couples therapy originated in Germany in the 1930s, when three clinics opened to service married couples experiencing difficulties adhering to traditional gender roles.[1] The clinics were service- and education-oriented as the closest aspect to theory at this time were ideas borrowed from psychoanalysis. While most of this therapy was conducted as individual sessions, some therapists began experimenting with conjoint sessions in 1931.[2] Between 1963 and 1985, family therapy became popular, sparking theoretical ideas to explain couple and family dynamics. Notably, Bowen (1954) founded a multigenerational approach to family therapy to explain the differentiation, triangulation, and projection processes within a family.[3] Since 1986, couples therapy has been condensed, tested, refined, and retested by analyzing new theories such as Integrative Behavioral Couples Therapy, Emotionally Focused Therapy, and Solution-Focused Therapy. Presently, the theories utilized in couples therapy have shown empirical support for treating depression, anxiety, alcoholism, among other mental health issues.[4]
Common Conflict Dynamics
Each individual that makes up a romantic relationship has their own assumptions about what “being a couple” means. Tensions are likely to rise in a relationship as differences between each individual’s expectations occur. A common issue resolved in couples therapy is the feeling of a loss of autonomy for each person involved.[5] For some, monumental life experiences (e.g., moving in together, having a child, and pursuing new career opportunities), can magnify anxieties about losing one’s identity. Wachtel (2017) notes that to bridge the gap between different motivations and desires in a relationship, a balance must be established to accommodate each person’s identity in a relationship.[6] Gehrke (2022) underlines the importance of establishing ways to relate to one another in a relationship by recommending that, “Couples should have hobbies both individually and together to see where priorities lie in a relationship.”[7] Individuality in a relationship is important for maintaining a sense of self, however, it is also essential to understand and support one’s partner by showing an interest in their hobbies, as well.
Couples commonly experience issues regarding the lack of feeling loved and valued by one another. Additional conflict dynamics can be embedded in dissatisfactions or disappointments regarding the amount of quality time spent together in a relationship. As Wachtel explains, if one partner is unhappy with the amount of time their spouse spends working, it can lead to feelings of resentment and insecurity.[8] In certain cases, attachment issues and expressions of love can be side topics that surround the main, focal issues that bring couples to therapy. Significant issues such as extramarital affairs and volatile occurrences are among the more severe issues couples can work through in therapy, and typically require more work to unravel the basis for these troubles.[9]
A popular approach used in therapy for understanding and resolving conflict between couples is the Gottman Method. Gottman and Gottman (1980) determined four conflict styles that can predict the breakdown of a romantic relationship with 93% accuracy.[10] Known as the “Four Horsemen” of conflict, these styles include:[11]
Criticism - Attacking one’s core character versus offering a critique or expressing a complaint. Due to the harmful nature of criticism, it can lead to feelings of contempt towards an overly critical partner.
Contempt - Occurs when one is disrespected, ridiculed, or mocked with sarcasm in a relationship with the goal of putting one down. Gottman and Gottman (2022) note that contempt is the single greatest predictor of divorce and must be eliminated when present in a relationship.
Defensiveness - A common response to criticism that reverses blame onto the partner who is asking a question or expressing concern. For example, a partner expresses their concern with their spouse not helping around the house and is met with a response that blames the expressor. Instead of blaming others, one should take responsibility for their actions and try to remedy the situation moving forward.
Stonewalling - A response to contempt that involves a hurt partner withdrawing from the interaction, shutting down, or simply ceasing all response to the other partner.
Theories and Modalities
Couples who seek out therapy have their own unique issues and situations that need to be worked through, and there are numerous approaches that can be utilized during couples therapy. Four well-known and effective methods include: psychodynamic; humanistic; behavioral; and integrative.[12,13]
Psychodynamic - This counseling technique was developed from the research and findings of Sigmund Freud; it is used to understand one’s conscious and unconscious needs and desires.
Humanistic - This approach is based on one’s response to life experiences, and aims to explore thoughts and feelings to reach solutions.
Behavioral - This method is based on the idea that one’s environment has a direct influence on one’s behavior. Behavioral counselors are taught that behavior is learned, and therefore, can be unlearned.
Integrative - This approach uses methods from each of the afore-mentioned three types of approaches as a combination to resolve conflict.
It is crucial for a therapist to become familiar with a couple’s unique situation and issues before choosing the best approach to utilize with them.
What to Expect in Couples Therapy
When first meeting a therapist, a couple can expect to provide an oral history of the relationship such as how you met, memories of dating, and experiences of becoming parents (if applicable). An oral history helps the therapist to understand the journey that a couple has been through together so far.[14] Additionally, each individual will meet with the therapist separately to “vent” about issues without having to filter thoughts for the other partner. This practice is not done to keep secrets from one another, but to build a relationship with the therapist one-on-one as well as share worries and hopes for what therapy can accomplish.[15]
A classic and well-researched activity to try in couples therapy involves “mutual eye-gazing”. A study at Clark University in Worcester, Massachusetts (1989) found a significant increase in feelings of mutual attraction and passion among 72 couples that engaged in eye-gazing for only 2 minutes.[16] Empirical research suggests that prolonged eye contact encourages one’s nervous system to release oxytocin which is associated with bonding and attachment. In addition, the neurotransmitter phenylethylamine was noted to increase feelings of interpersonal attraction after prolonged eye contact.[17] Relationship and sex therapists often recommend extended eye-gazing for couples that feel alienated from one another or those who hope to strengthen intimacy.
Generally, couple’s can expect to gain various skills in therapy, including communication skills and coping skills to manage stress. Licensed marriage and family therapist, Moshe Ratson, found that couples therapy assisted himself and his wife to deal with fears, expectations, anger, and passive-aggressive behaviors.[18] Specifically, Ratson learned how to recognize triggers that brought up negative emotions and distressing memories. Moreover, couple’s therapy taught Ratson and his wife to replace blame with compassion and how to be proactive instead of reactive.[19] Coping skills like proactiveness and compassion help couples to understand one another instead of blaming each other when topics of conflict arise.
When couples experience long-term issues in relationship dynamics, steps should be taken to reduce such negative experiences by contacting a licensed mental health professional for further guidance.
Contributed by: Tori Steffen
Editor: Jennifer (Ghahari) Smith, Ph.D.
References
1 Niolon. (2011). The History of Marital Therapy. PsychPage. http://www.psychpage.com/family/history_of_couples_therapy.html
2 Ibid.
3 Ibid.
4 Ibid.
5 Wachtel, E. (2017). The Heart of Couple Therapy : Knowing What to Do and How to Do It. The Guilford Press.
6 Ibid.
7 Gehrke, G. (2022). Interview with Certified Personal Trainer and Wellness Coach on Relationship Therapy.
8 Wachtel (2017)
9 Ibid.
10 Moore, M. (2022, February 24). 4 relationship behaviors that often lead to divorce. Psych Central. https://psychcentral.com/blog/predicting-divorce-the-four-horsemen-of-the-apocalpyse#:~:text=John%20Gottman's%20Four%20Horsemen%20are,help%20you%20take%20proactive%20steps.
11 Gottman, J., & Gottman, J. (2022). Why Gottman Method Couples Therapy? The Gottman Institute. https://www.gottman.com/students/
12 BetterHelp. (2022). 6 common counseling approaches in couples therapy and how they can help your relationship. ReGain. https://www.regain.us/advice/counseling/6-common-counseling-approaches-in-couples-therapy-and-how-they-can-help-your-relationship/
13 Ibid.
14 McNeil, D. (2023). What to expect when you go to couples therapy. The Gottman Institute. https://www.gottman.com/blog/what-to-expect-when-you-go-to-couples-therapy/
15 Ibid.
16 Lancaster, V. (2021). Why gazing into a partner's eyes boosts intimacy and sexual pleasure. Psychology Today.
17 Ibid.
18 Ratson, M. (2017). 6 critical things marriage counseling taught me. HuffPost. https://www.huffpost.com/entry/6-critical-things-marriag_b_13134268
19 Brenner, B. (2022). What to expect from Couples Counseling. Therapy Group of NYC. https://nyctherapy.com/therapists-nyc-blog/what-to-expect-from-couples-counseling/