Practice and Methods

Working with Couples

My psychotherapy practice is primarily working with couples. It is best when both parties attend the sessions where each learns to stay out of their partner’s issues and is coached to discover his/her own contribution to the overall marital issue.

Each party learns:

• to reframe the presenting problem as a multigenerational problem that is caused by factors beyond the individual
• lower anxiety and the “emotional turmoil” that floods the family so they can reflect and act more calmly
• increase self-differentiation, increase ability to manage anxiety, transition more effectively to adulthood, and fortify the family emotional wellbeing
• use the therapist as part of a “healthy triangle” where learning to manage anxiety, distance, and closeness in healthy ways
• form healthy marital and family relationships”the problem” to help them separate from the family and resist unhealthy triangulation and emotional fusion
• open closed ties with cut off members
• focus on more than “the problem” and include the overall health/happiness of relationship
• evaluate progress of the family in terms of how they function now, as well as how adaptive they can be to future changes
• address the power differential in heterosexual couple based on differences, for example, in economic power and gender role socialization (this is a contribution of those who have reconsidered Bowen’s theory through a feminist lens)

Through the sessions the client learns to give less attention to specific problems they present, and more attention to family patterns of emotions and relationships, as well as family structures of dyads and triangles by:

• lowering anxiety (which breeds emotional fusion) to promote understanding, which is the critical factor in change; open conflict is prohibited as it raises the family members’ anxiety during future sessions
• remaining neutral and de-triangulated, and in effect models for the parents some of what they must do for the family
• promoting differentiation of members, as often a single member can spur changes in the larger family; using “I” statements is one way to help family members separate their own emotions and thoughts from those of the rest of the family
• developing a personal relationships with each member of the family
• encouraging cut off members to return to the familymay use descriptive labels like “pursuer-distancer,” and help members see the dynamic occurring; following distancers only causes them to run further away, while working with the pursuer to create a safe place in the relationship invites the distancer back.

The sessions begin to become more of a coachingthat encourages the client to consult with the family, which interrupts arguments, and models skills to the entire family system.

Family Therapy with One Person