We stand on the shoulders of giants (as Sir Isaac Newton observed). I was going to start this post with John Saxe’s “The Blind Men and The Elephant,”[1] but that felt less than honoring to the great therapists and theorists who have contributed to marital therapy. Having said that, I find that each of the theories and modalities for treating distressed couples are an important part of the picture, but not the whole picture.
For the layperson who is not familiar with the realm of couple’s therapy, not all therapists are looking at couples’ relationships from the same theory or treating problems in the same way. There are various theories that have differing views to the nature of the problem and what to do about it when a couple is distressed. Here is an overview. Recognizing that most people won’t read a blog post that is too long, I will try to be concise. I have had specialized training in each of these[2] so I am not speaking as a member of a given camp that sees the others as anathema, but rather one who finds value in each.
Gottman Method Couples Therapy. Theorists: Drs. John & Julie Gottman. Gottman method is mostly helping the couple develop relationship skills. The Gottmans have been researching couple relationships for decades. Through their research, they have been able to identify those things that the “masters of relationship” do that the “disasters” do not, and vice versa. Through various exercises and psycho-education distressed couples learn the skills that happy couples use.
Emotionally Focused Therapy. Theorist: Dr. Susan Johnson. EFT is the most empirically validated marital therapy. The concept is that distressed couples are stuck in a negative cycle that is driven by core emotional experience and unmet attachment needs. The job of the therapist is to first get the couple to recognize the negative cycle and the underlying emotional experience, and recognize the negative cycle as the enemy of the relationship rather than your partner. Couples are given the corrective experience of being able to turn to their partner for the care, comfort, and support they have longed for, and experience their partner as safe.
Restoration Therapy. Theorist: Dr. Terry Hargrave. Dr. Hargrave is a professor of marriage and family therapy at Fuller Theological Seminary. RT bears some resemblance to EFT in that is recognizes that couples get stuck in a pain cycle. Couples do not have 100 arguments, but 1 argument over 100 different topics. When painful feelings are triggered, the way in which each partner responds is a coping strategy for coping with their own pain. The process involves couples recognizing their pain cycle. Each partner is helped to reclaim truth that helps them choose to respond differently to their partner. Where EFT is about co-regulation with your partner, RT helps with self-regulation to be able to respond in ways that avoid the pain cycle and move into a peace cycle.
Collaborative Couple Therapy. Theorist: Dr. Dan Wile. Dan Wile’s method has been highly praise by the Gottmans. Collaborative Couple Therapy is a method for helping the couple have a constructive conversation. The therapist “doubles” for each partner, essentially coming alongside each partner and speaking on their behalf. The therapist takes what the partner has said, reframes the statement without the criticism and contempt, acknowledges the other partner’s point, and adds the need or hope that was unspoken by the partner. The therapist then checks with the partner for whom he or she is speaking to make sure that the therapist has captured what they intended to say and that nothing was missing.
Solution-Focused Therapy. Theorists: Drs. Steve De Shazer and Dr. Insoo Kim Berg. Solution Focused Therapy is considered a “strengths based” theory in which it is assumed that clients have within their repertoire the solution for the problem. The therapist asks clients how things would be if a miracle occurred and the problem were solved. Clients are asked to scale from 1 (the worst things have been) to 10 (the miracle) where they currently see their situation. Clients are also encouraged to note exceptions when the problem is not a problem and to build on those exceptions.
This is a gross simplification of each of these, but hopefully the essence of the treatment plan comes across.
When I was in 6th grade, I took Jethro Tull’s Aqualung to school for one of those times when they let us play music in class. Aqualung is a masterpiece, but nobody wanted to hear it. By 8th grade, everyone wanted me to bring Aqualung.[3]
I have had a similar experience regarding marital therapy. My EFT colleagues all but pulled out the silver crosses and wooden stakes when I shared that I was also trained in Gottman Method. Then a few years ago, the Gottmans and Sue Johnson started doing seminars together. Suddenly being trained in both became very fashionable.
As Abraham Maslow observed, “If all you have is a hammer, everything looks like a nail.” All of these theories have value. Partners need the skills to master their relationship (Gottman). From cradle to grave, human beings need someone they can turn to for the care, comfort, and support they need. Consequently, couples need to develop secure attachment and experience each other as safe (EFT). It is much easier for your partner to respond to you constructively is you can self-regulate enough to express your needs in constructive ways (RT). There should be no topic that couples cannot discuss in a productive fashion. Partners need a model of what that looks like so that their needs get heard and their points acknowledged (CCT). People are actually quite resilient and capable. Articulating the ultimate goal (the miracle) and working toward it together (noting that there are times when you things are good between you) can open up new paths to healing (SFT).
As you can gather, I am not a purist of any of these theories. Each has made great contributions to helping distressed couples. Though I would hate to be without any of these tools in my bag of tricks[4], ironically, the treatment modality the therapist uses is not the greatest predictor of success in therapy. The greatest predictor is the relationship between the therapist and the clients. If you feel like the therapist gets you and that the treatment is relevant to your problem, you have the greatest success.
[1] If you are unfamiliar with the poem, here you go. https://en.wikisource.org/wiki/The_poems_of_John_Godfrey_Saxe/The_Blind_Men_and_the_Elephant
[2] There are other theories. These are the ones in which I have been trained.
[3] When you have older siblings, your musical tastes tend to be a little ahead of your cohort.
[4] I had a client recently get my Felix the Cat reference about reaching into my bag of tricks. It was a great moment for me.
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Posted on February 2, 2019
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