Couples Therapy – How can you tell if you need couples therapy?

Healthy Relationships and Couples Therapy

The previous blog on couples therapy in New York City reviewed the efficacy rates of couples therapy. It is clear that some therapies have the potential to help the majority of couples improve. This is good news, but there may be even more pressing questions for husbands, wives, boyfriends, and girlfriends, i.e.,:

1. Is what I’m experiencing in my relationship normal?
2. Is how I’m being treated typical?
3. Do I deserve more, do healthier relationships really exist, or do they all descend into what I’m experiencing? Maybe this is as good as it gets.
4. When is the time for change (either improving this relationship by each partner learning new behaviors or improving life by leaving the partner) and when is the time for acceptance?

Regardless of your creed, hopefully the serenity prayer’s request to know the difference between the things we can change and those that require acceptance is wisdom we would all like to acquire. Both change and acceptance can be difficult and applying them to the wrong things is certainly a waste of resources.

So how do we know if the relationship could use some work in terms of change or acceptance? First let’s touch on a few things that a healthy relationship may possess and then we can look at a few questions in different areas that are similar to what you might hear from a couples therapist if you begin marital counseling or couples therapy.

Here are some of the hallmarks of a healthy relationship according to some couples theorists (Jourard & Landsman, 1980):

1. Good communication
2. Realistic expectations in the relationship and reasonable demands on your partner
3. Genuine concern for the well being of your partner
4. Freedom to be oneself

While some of us may take these four components to be common assumptions, others may struggle with a few of them. At a minimum, even with both partners endorsing the component, partners may disagree about the meaning, or have difficulty successfully executing.

Good Communication

Few clients I have seen in couples therapy in NYC have ever said they believe good communication is a bad idea. But the vast majority of couples have at least one partner who believes his or her partner does not communicate enough, communicates too much, or communicates incorrectly, and often both partners take one of these views. The stereotype that men do not communicate as much about their feelings is something supported in the research, and is something I have seen men in heterosexual and homosexual relationships.

With that said, I prefer not to operate with that assumption, as I have seen enough exceptions in couples therapy, in terms of women who do not share and express certain if not all emotions, and some men who are very emotionally expressive. It becomes very obvious in early sessions how comfortable and how able each individual is at identifying his or her emotions, wishes, desires, frustrations, etc. and how willing and able he/she is to express them to the partner.

One fundamental skill that can be taught as a communication skill in couples therapy is assertiveness training. Simply put, assertiveness is comprised of both communicating feelings, thoughts, wishes, wants, desires, and requests in an effective way and accepting the response or lack of response from one’s partner.

The second part is often something that is not emphasized enough. But it is critical that each of us learn to accept (that does not mean agree or endorse), i.e., acknowledge and effectively take appropriate actions. Specific statements can be learned and certain provocative language is to be avoided when assertively communicating.

Once these skills are learned, it still takes lots of practice to reliably execute them. For most of us making requests of others or making ourselves vulnerable by sharing our intimate wishes is an extremely charged experience, and so it takes doing it again and again, even while having emotions to make it a dominant, fluent way of communicating.

Expectations and Demands

These are components of a relationship that are highly variable both in partners in a particular couple and between couples. While each partner doesn’t have to share the same expectations and demands for the other, agreement is necessary to make the partnership satisfactory.

Fairness is a theme that comes up a lot in couples therapy, and it often elicits feelings of anger, resentment, and at times guilt. It is rare that two people will have the same strengths, weaknesses, or tendencies. So the division of labor may differ, their capacity to be emotionally intelligent may vary, and one may be more equipped to financially support them both.

Fairness then is unlikely to mean each does the same thing for each other, but rather that it is clear and acceptable what each expects and demands from him or herself and the partner.

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I have seen many couples where deep resentment exists as a result of an admittedly slight difference in the workload between them. Likewise I have seen perfect harmony achieved when one partner is clearly burdened with the majority of responsibilities in the relationship. What is critical is that each is transparent about what is expected and required and that there is open communication about this, which can include appreciation.

Welfare of others

In couples therapy work, you do find times when the resentment has been growing for so long or a recent transgression has elicited so much anger that concern may not be something that is readily exhibited.  But even in the latter case, when a sincere conversation explores the topic, there is often concern for the general well being of the other (although not always).

What I see more often in couples therapy, is a partner who says, “He clearly isn’t concerned about my feelings or well being, or he wouldn’t treat me like this.”  This requires both individuals to do some work.  And this is not always easy to hear, especially for the person who believes he/she isn’t being cared for.  Without question the couples therapy has to address the behavior that is or isn’t occurring that leads one partner to believe the other doesn’t care.

The other piece though, may include both partners, as they uncover what attributions are being made about that behavior. For example, one partner may state, “He doesn’t care about me because I tell him how stressed I am about making my work deadlines in order to get my next promotion, yet he is constantly guilt tripping me to leave the office. If he cared about me, he would support me right now, instead he says the very things he knows hurt me.”

In a case like this, uncovering what each believes the other’s reasons are for the behavior, i.e., calling her to come home and staying late away from home to complete work, is going to be critical for them to achieve understanding, and change the emotional and behavioral pattern in which they have become stuck.

Free to be me

Some of us may find this component to be one that shouldn’t be included in what makes a couple healthy.  Isn’t being in a relationship about merging? Shedding our individuality in search of a more meaningful union?  In fact, I have treated many couples where one complains that the partner’s very desire to “be him/herself,” is the problem.

There is a fine line to walk when it comes to understanding what this freedom constitutes.

No matter how open a couple is, clearly some expectations of each partner change when couplehood is undertaken. But what that looks like varies greatly. Does that mean every guys’ night is eclipsed by a date night, or girls’ weekends can never happen because weekends are family time? Those are questions very much in need of discussion and often times, negotiation.

I have seen people in couples therapy where the presenting problem centers on this issue. One partner doesn’t believe the other has changed enough, or matured enough. “He will never grow up and put away his toys, it is like nothing has changed- there is no growth.” Meanwhile some partners give up activities or relationships that are central to who she or he believes she or he is.  This can create resentment or depression- and some times both.

Healthy romantic relationships certainly take on an identity of their own, but it does appear to be critical for them to thrive that each partner also has an identify of his/her own and has time and aspects of his/her life that are his/her own. It is easy to see how frequently there is interplay among the four components of a healthy relationship. To balance this component there needs to be clear communication and negotiation as well as explicit expectations and an understanding of what it means for each partner to maintain certain aspects of his/her identity or to preserve certain activities or relationships. Depending on what the activities are or who the relationships are with, the decision to maintain these may be more or less acceptable to the partner. But before a lot of communication is required on this topic, self-inventories are a good idea. Each partner really needs to understand what these activities and relationships (e.g., time with friends, coworkers, family, etc.) mean to him or her and how dissatisfied s/he would be without or with less of each.

Once it is clear to each partner how much of a priority each of these are, communicating about what it means to the partner begins the dialogue. Again attributions are crucial to the negotiation process, as it is often what the partner believes it means that is more important than how many guys’ nights occur. Likewise, once it is clear why the freedom bothers the partner, there may be practical tradeoffs that can be made in order to satisfy both parties. Maybe two guys’ nights are acceptable, as long as that partner takes care of breakfast on the weekends.

Couples therapy is a process of identifying areas of dissatisfaction, understanding the function of each problematic behavior, and recognizing what strengths can be built upon, and what behaviors may be missing that can be added. With those targets in mind, it can be an exciting process. Of course, there are many apparent barriers that present themselves- but with careful self-inventories, an understanding of the meanings that are being made, and communication and negotiation many of these can be overcome, and some of those that can’t be, can be accepted, leading to greater personal and relationship satisfaction. If your relationship could benefit from couples counseling, you can contact a couples therapist at New York Behavioral Health.