The Couples Therapy Companion

A Cognitive Behavior Workbook

Russell Grieger

• Publisher: Routledge
• Year: 2015
• Topic: Psychology
• eBook ISBN:
  9781317573586
• Subtopic: Cognitive Behavioral Therapy (CBT)
• Index: Psychology

Learn to look at marriage and couples counseling through the lens of Rational Emotive Couples Therapy. Dr. Russell Grieger walks the reader through the RECT process and includes numerous exercises that are appropriate for clinicians to use with their clients, for those couples who are in therapy and need a little extra help, and for couples working to improve their relationship on their own.
Along with explaining the process of Rational Emotive Couples Therapy, Dr. Grieger makes the distinction between relationship difficulties, which are small disagreements and dissatisfactions, and relationship disturbances, which occur when a couple becomes emotionally distressed and entrenched in negativity. He walks readers through the couple diagnosis and presents eight powerful strategies for helping resolve both couple difficulties and disturbances to find relationship harmony.
Dr. Grieger addresses such issues as ridding hurt, anger, fear, and insecurity, enhancing closeness and intimacy, win-win conflict resolution, and building couple commitment and connection. Replete with exercises that empower couples to take action and solve their problems, The Couples Therapy Companion also helps readers to sustain the positive momentum learned in therapy in everyday life.

Part I
Diagnosing and Goal Setting

Chapter 1
The Couple Diagnosis

Ring out the old, ring in the new;
Ring happy bells, across the snow;
The year is going, let it go;
Ring out the faults, ring in the true.

—Alfred Lord Tennyson

Most couples who walk into my office began their relationship with deep, passionate love. They saw each other as their best friend. They held boundless hope for their future. Then, gradually, disappointments, slights, even unkindnesses mounted. Hurt and resentment grew. Trust faded, passion cooled, love and friendship waned.

Worse yet, most of these unhappy couples hold at best a limited or distorted picture of what went wrong. They may be clear about their individual complaints, yet they are often unaware of their own contributions to the relationship woes. They rarely see the reciprocal interactions that perpetuate their dysfunctional patterns. They have little idea what to do to get their relationship back on track.

Confronting this, my first RECT chore is to understand exactly what are the relationship problems they’ve created and how they went about doing this. Without a clear picture of the ins and outs of their breakdown—a couple diagnosis, if you will—I am handicapped in what to do to get them back on track. Once I figure this out, my second chore is to educate them about the particulars of their problems and the strategies for remediation. When the couple understands all this, they can then see a way forward, feel hope, and enroll in the therapy process of remediation.

Rect Diagnosis

This may seem basic for the seasoned clinician, but it bears emphasizing that a therapy session is nothing more than a conversation between two or more people. The difference between a social and a therapy conversation is that, in the case of the latter, one person, the therapist, has a mental template as to how to guide the conversation and to organize the information gathered.

What follows is the template RECT therapists carry in their heads as they conduct the diagnostic conversation. I present the five components in logical order, but I emphasize that the gathering of diagnostic data does not typically follow such a lock-step sequence. Data often comes flying at the therapist at random, so that these categories represent as much an organizing schema as an interview process.

If you are a clinician, you can conduct your couple diagnosis in two ways. One is to supply the couple with “The Couple Diagnostic Workshop” found later in this chapter and then follow up with a clarifying discussion. A second is to conduct the diagnostic interview cold, initiating the discussion with such open-ended questions as: “What problems do you want to fix in your relationship?” “What brought you to the point of seeking help?” “What ails in your relationship?”

If you are a couple, do “The Couple Diagnostic Workshop” with or without the assistance of your therapist. If you do so on your own, be sure to complete Step Five, “Strengths/Weaknesses Questionnaire.” This step guides you directly to the chapters in The Couple Therapy Companion designed to remediate your specific couple problems.

Regardless, once you, the clinician, or you, the couple, capture accurate information in each of these categories, you are then only one step removed from fixing the problems. Here they are.

Relationship Dissatisfactions

Most couples begin their therapy by voicing complaints about each other. For example, he displays little affection, or he controls her every move, or he pulls up porno on the Internet after she goes to bed; she frivolously spends money, or she spoils the children, or she drinks too much. These constitute the couple’s relationship dissatisfactions. Whether accompanied by strong, negative emotions or not, the presence of these dissatisfactions can erode love and had best be catalogued for problem solving.

Relationship Disturbance

The RECT therapist stays alert for expressions of destructive emotional over-reactions throughout the diagnostic conversation—the hurt and anger, the fear and jealousy and insecurity, the bitterness and depression. These disturbances can soil people’s happiness, prompt dysfunctional behaviors, and make the resolution of relationship dissatisfactions inordinately difficult. If these disturbed emotions are not volunteered, I always follow up the expression of dissatisfactions with a string of questions designed to uncover them:

• How do you react emotionally when he does that?
• Feeling that way, how do you typically respond?
• When you act like that, how does he react in turn?
• Does your reaction help the situation and the relationship or does it make things worse?

Notice that these questions go beyond simply making explicit the presence of relationship disturbances. They also serve to reveal the negative consequences of acting out these disturbances, in terms of both their effect on the other person, the existing troublesome situation, and the long-term viability of the relationship itself.

Vicious Circle

The RECT therapist is always alert for the presence of a vicious circle in a relationship. A vicious circle occurs when one person presents a dissatisfaction to the partner that stimulates the partner to get upset and act badly in return, which in turn prompts bad behavior from the original person, further stimulating the partner to again act badly, and so on. Typically each partner contends that the resolution calls for the other person to shape up.

Spotting the vicious circle is critical. For, so long as each partner holds the other responsible for the relationship breakdown, victimhood and blame will prevail, leaving little possibility for a breakthrough.

Irrational Beliefs

Uncovering a couple’s irrational beliefs holds a special place in RECT diagnosis. Remember that, following RECT’s ABC model, the cause of all relationship disturbances (the C) is not the relationship dissatisfactions (the A), but the absolute, perfectionistic demands—the musts and shoulds—couples hold (the B). These drive the hurt, anger, fear, insecurity, and low frustration tolerance that lead to relationship destruction.

A (Dissatisfaction) + B (Irrational Beliefs) = C (Disturbance)

The RECT therapist thus keeps a keen ear open for these demands, particularly: (1) I must be unconditionally loved, approved, and favored by my partner; (2) my partner must always act appropriately toward me and treat me well; (3) my relationship must always be rewarding and never present hassles or frustrations. Without eliminating these irrational ways of thinking, there is little hope for couple happiness and harmony:

• If the couple does not stop their irrational thinking, they will continue to suffer the emotional miseries they do, thereby threatening couple survival.
• If the couple does not eliminate their irrational thinking, they will find it difficult to work cooperatively together to resolve their relationship dissatisfactions.
• If the couple does somehow find a way to eliminate their relationship dissatisfactions, despite suffering a relationship disturbance, they may temporarily find interpersonal peace, but they will likely fall back into their disturbances once they encounter new dissatisfactions. Why? Because they still hold their irrational “musts” and “shoulds.”

Additional Information

The RECT therapist also finds it important to get clarity on the following, each of which is relevant for therapeutic planning.

• Individual Emotional Disturbance—Do either of the partners suffer from a severe emotional problem? Such disturbances as depression, a borderline personality disorder, or a substance dependency may require individual therapy for the affected person, either preliminary to or concurrent with the couples therapy.
• Resistances—Are one or both of the couple partners resistant to couples therapy? To taking responsibility for their portion of the relationship problems? What irrational beliefs drive this resistance? If present, it behooves the RECT therapist to figure the best way to address the resistance so as to fully enroll both people in the therapy process.
• Commitment and Love—Do the couple partners love each other? How committed are they to each other and to fixing the relationship? People sometimes seek couples therapy for a number of reasons other than improving their relationship: (1) to prove the partner wrong; (2) to get help in deciding whether to stay mated; (3) to get support in leaving the relationship; (4) to sabotage the therapy as a justification for leaving; (5) to get an ally to get the partner to change.
• Impulse Control—Can the partners exert control over their emotions and impulses in session so that they can participate productively in the couple’s therapy process? What causes the lack of control? Low frustration tolerance? ADHD? Bitterness?
• Therapy Format—Is it better to work with the couple conjointly or individually? Conjoint sessions are desirable in most cases, but sometimes it is better to meet with one or both of the partners for one or more individual sessions. Some of the reasons for doing so are: when anger is so palpable that debating and arguing dominates; when one of the partners is so defensive he or she cannot take responsibility for his or her dysfunctional behavior in the presence of the other; when it appears that one or both of the partners harbor a hidden agenda; when one person unduly inhibits the partner from expressing his or her feelings and opinions; when one of the partners is seriously disturbed. When meeting separately with one or both partners, I take care to emphasize two things to the couple beforehand: (1) I hold no agenda, except to eliminate their disturbances and resolve their dissatisfactions so they are free to make sound decisions about their relationship; (2) I will honor the confidentiality of what is said in private as I need each person’s total openness and honesty to be of help.

Diagnosing Tom and Erica

An unusually attractive 37-year-old, Erica burst into tears the instant she sat on my office couch next to her husband, Tom. Dabbing her eyes with a tissue, she stated that her “world had fallen apart” when she discovered that Tom had become intimately involved with another woman. She described herself as unable to eat or sleep, staying in bed a good deal of th...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• About the Author
• Introduction
• Part I Diagnosing and Goal Setting
• Part II Prescribing Solutions
• Eliminating Relationship Disturbance
• Building Relationship Harmony and Satisfaction
• Part III Following Through to Success
• Bibliography
• Index