Building Intimate Relationships

Bridging Treatment, Education, and Enrichment Through the PAIRS Program

Rita DeMaria, Mo Therese Hannah, Rita DeMaria, Mo Therese Hannah

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781135454388
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

The PAIRS course acts as a kind of bridge between marriage education and therapy, working both with couples in healthy relationships hoping to improve intimacy, and with distressed couples trying to save their marriages. Building Intimate Relationships is an edited work with contributions from the creator of the PAIRS program and the most experienced PAIRS leaders. It describes the elements of the PAIRS course and discusses the application of the theories and techniques taught in the PAIRS program. Chapters include discussions on intimacy, communication, conflict resolution, emotional literacy, sensuality and sexuality, spirituality and gender issues.

PART ONE

The PAIRS Program in Context

CHAPTER 1

An Overview of the PAIRS Program

RITA DEMARIA

PAIRS can be best understood within the structure of the history of the field of marital and couples therapy. This chapter will position PAIRS in the context of behavioral health services for couples, as well as discuss how PAIRS contributes to the practice of couples education and therapy. A detailed description of the PAIRS program is provided that includes a discussion of group composition, methods, the role of the PAIRS leader, and the influence of Daniel Casirel, MD, as well as an exploration of the psychodynamic, behavioral, and systems theories that undergird the PAIRS program. This chapter, along with others in part one of this text, will help the reader in the journey of exploring the PAIRS program and in determining how the PAIRS program can be applied to the practitioner’s unique practice needs.

A historical perspective is helpful as we explore overlaps between treatment, education, and enrichment. As marital therapy was being recognized as a viable treatment for couples during the 1970s and 1980s, a few clinicians and researchers examined the overlap between group programs and marital therapy. In 1976, P. G. Schauble and C. G. Hill called for a skills-based marriage lab to supplement traditional marriage counseling. As opposed to viewing enrichment as a separate service, they believed that marital treatment should take a variety of forms, with the laboratory approach to communication skills training providing a valuable treatment component. One of the earliest studies of marital therapy suggested that group methods could be effective with couples at high risk for divorce (Fahs-Beck, 1976). These studies, however, received little attention.

Guerney (1977) was one of the first to discuss an educational model as treatment. Although Guerney used the traditional one-on-one model in his development of Relationship Enhancement (RE; 1977), PAIRS adapted RE-like concepts for use in a group model. Similarly, Gershenfeld (1985) emphasized the importance of a microlab (a group training model) for couples. She suggested that microlabs, which used professionals as leaders, differed from marriage enrichment programs, which were led by laypersons. L’Abate and McHenry (1983) also suggested that marital interventions fall along a continuum, ranging in structure from preventive skill-training programs to unstructured remedial therapies.

Despite the innovations that PAIRS provides in the delivery of clinical services for couples, Lori Gordon was not alone in her effort to develop a course on intimacy. Although marriage enrichment flourished in the 1960s and early 1970s, in the mid-1980s a new generation of programs began to emerge. In contrast to earlier marriage enrichment programs, which had been developed primarily by and for religious denominations, social workers, psychologists, and family therapists like Gordon based the newer generation of programs on behavioral, psychodynamic, developmental, cognitive, and emotion-focused therapeutic models and practice methods (i.e., the Imago Relationship Workshop, “Getting the Love You Want,” Couple Communication [CC], Relationship Enhancement [RE], and Prevention and Relationship Enhancement Program [PREP]). (See Berger & Hannah, 1999, for a comprehensive review of these programs.)

Through such programs, marital therapy reconnected with its early roots (1930s) in education for marriage, and, as Meador (1991) pointed out, marriage enrichment (the term education was not being used at that time) emerged as a specialty within the field of marriage counseling. Confirming this emergence, in 1996 the Coalition for Marriage, Family, and Couples Education (CMFCE) held its first annual conference, with presentations by representatives of over 100 programs along the entire spectrum of marital interventions, ranging from premarital prevention approaches to therapeutic workshops for highly distressed couples. Thus, marriage education, in contrast to marriage enrichment, arose as a coherent model of practice.

PAIRS is a contemporary relationship intervention program that incorporates elements of enrichment (group process), education (instruction), and treatment (affective, behavioral, and cognitive changes). Hoopes, Fisher, and Barlow (1984) were the first to distinguish these interventions in this manner. As yet unaware of the nascent educational movement that would form, David Mace, a pioneer in both the marriage counseling and the marriage enrichment movements, repeatedly called for greater attention by the professional community to the marriage enrichment model because he believed in prevention (Mace & Mace, 1986). Mace believed that a group model offered several advantages: skill-building, greater public access and lessened stigma, group process for modeling and support, and suitability for research. Although the PAIRS program delivers all of these elements, many practitioners continue to believe that group support and educational models are useful with mildly distressed couples and are, at best, an early intervention. The experience of PAIRS leaders and the impact of the PAIRS program for couples suggest otherwise.

THE CONTRIBUTION OF PAIRS TO THE THEORY AND PRACTICE OF COUPLES THERAPY

Although PAIRS is designed as an educational program with ties to enrichment models in its use of peer support and modeling, this program is also an effective option for distressed couples. Mainstream clinical belief holds that individuals must be relatively healthy to benefit from a program like PAIRS (Hof & Miller, 1981) and that marriage enrichment (and education) programs are used by couples in relatively stable and satisfying marriages (Riehlmede & Willi, 1993). However, a number of studies have suggested that many participants are, in fact, seriously distressed (DeMaria, 1998; Wampler, 1982; Zimpfer, 1988) and can benefit from these programs (Durana, 1993; Giblin, 1985; Hawley & Olson, 1995; Mattson, Christensen, & England, 1990). Giblin’s (1986) meta-analysis, in particular, revealed that distressed couples participating in marriage enrichment programs experienced positive effects. Unfortunately, an updated meta-analysis of contemporary marriage education programs has yet to be completed.

Current marital/couple intervention theories are working toward the integration of psychodynamic, interpersonal, intergenerational, and sociocultural models (Shackelford & Buss, 1997). The Intersystem model (Weeks, 1989), for example, combines intrapsychic, interpersonal, and intergenerational perspectives. Hendrix’s (1988) intrapsychic model combines object relations and other depth theories with a psychospiritual perspective on the healing nature of marriage. Other models (e.g., Bader & Pearson, 1988; Johnson & Greenberg, 1994; Schnarch, 1991) emphasize the advantages of the marital relationship in fostering individuation and differentiation, as well as in promoting personal satisfaction and meaning in adulthood. In addition, increasingly there are efforts to integrate sex and marital therapies (Weeks & Hof, 1987; Schnarch, 1991).

Although there has been no meta-theory guiding the development of marital interventions, several unified theories have provided an understanding of marital distress and of the variables that improve marital relations (see, for example, Stuart’s [1980] social-learning approach and Johnson’s [1996] emotionally focused model). Many recently developed marital and couples therapies are eclectic, focusing attention on diverse aspects of marital interaction, including affective, behavioral, and cognitive components. Likewise, with its focus on multiple forms of intimacy, such as empathy, communication skills, bonding, sexuality, and the use of group process, PAIRS represents an integration of diverse theoretical perspectives. In developing PAIRS, Gordon incorporated conceptual advancements from various models of marital interaction. By this eclectic integrating of various theories, some marriage education programs, but PAIRS in particular, have blurred the distinctions between relationship education, enrichment, and therapy.

Theoretically, the PAIRS program integrates affective, behavioral, and cognitive models. The conceptual strength of PAIRS comes from its emphasis on bonding—defined as emotional openness and physical closeness. In this model, bonding is considered essential for establishing and maintaining both emotional literacy and secure attachment for individuals, which frees them to explore important cognitive/attitudinal shifts, behavioral change, and emotional maturity. Although a comprehensive, theoretical delineation of the theory of PAIRS is beyond the scope of this chapter, in a previously published case study (DeMaria, 1998), I explored four dimensions of the PAIRS program from a clinical vantage point: psychodynamic influences (Casriel), object relations theory, systems theory, and behavioral methods. The PAIRS program model is comprehensive and inclusive.

DESCRIPTION OF THE PAIRS PROGRAM

PAIRS (Practical Application of Intimate Relationship Skills) was designed by social worker Lori Gordon, who first developed and taught it in 1975 as a graduate course in marriage and family therapy at American University. As she describes in detail in chapter 2, in 1977 Gordon transformed the curriculum into a course in intimate relationships, which she began to teach to couples in her professional practice through the Family Relations Institute (Gordon, 1993). Incorporating the work of leaders in the family and individual psychotherapy and human potential fields, including Ivan Boszormenyi-Nagy, George Bach, Daniel Casriel, and Murray Bowen, PAIRS was strongly influenced and supported by social worker Virginia Satir.

In 1984, Satir helped Gordon and her husband, Rabbi Morris Gordon, establish the PAIRS Foundation and the Professional Training program. Since the establishment of the PAIRS Foundation, over 800 mental health professionals have taken the PAIRS Professional Training Program. To become certified as a PAIRS leader, one has to be a mental health professional and complete a three-week professional training program. Currently, more than 150 active PAIRS leaders are teaching the course throughout the United States, Canada, France, England, Russia, Israel, Australia, Costa Rica, Italy, Taiwan, and South Africa. More than 20,000 people have taken the PAIRS course since the program began.

The PAIRS semester-long program consists of 16 weeks of classes, totaling 120 hours. The course provides information, as well as experiential exercises designed to generate attitude reassessment, skill development, and emotional release. Each class session includes discussions of theory, experiential exercises, and opportunities for group and individual processing and sharing. The leader serves as a nurturing and structuring guide and role model. Gordon’s description of the course underscores its focus on nurturing and mutual appreciation: “The objectives of the course are to know and nurture oneself and one’s partner, to enjoy differences rather than see them as a threat, and to learn to view one’s relationship as an ongoing source of mutual pleasure” (1993).

GROUP COMPOSITION IN PAIRS

PAIRS classes range in size from as few as 10 to as many as 40 participants. Prospective members attend a PAIRS preview, where a PAIRS leader also briefly interviews them. Follow-up phone calls are made to all prospective participants, further screening is conducted through informal interviews, and referring therapists are also consulted at this time. However, because only experienced and certified marital and family therapists teach the semester course, no formal screening instruments are considered necessary. Seriously troubled individuals or couples are not accepted into the course. For such persons, therapy is recommended or specific recommendations are given to enable their future participation. Generally, groups are heterogeneous in terms of age, stage of relationship, needs, and problems. A mixed group composition contributes to greater learning, because a wide variety of issues are likely to emerge during the course. The reasons that participants cite for enrolling in PAIRS vary; some have always wanted to take an enrichment course, whereas others have already tried many forms of therapy or have attended other enrichment programs. Goodwill and a positive attitude toward working to better one’s relationship are the key criteria used to determine whether or not a couple should register for the course. Some participants also continue their ongoing therapy, either individually or as a couple, for the duration of the course.

Although designed for couples, PAIRS has enabled many single persons to address their relationship difficulties while learning from the couples in the group. Many singles report that the PAIRS course was their first opportunity to observe the resolution of conflict by a couple. The PAIRS course thus can provide singles with an important corrective emotional experience, especially if they did not witness intimate relating by their parents.

Group support evolves during the PAIRS course. Initially, group members are generally reserved with one another. During the first few weeks, communication skills are emphasized and practiced, and as participants begin leveling with each other, a sense of trust begins to develop as couples recognize the universal nature of their issues and struggles. As the course builds upon these skills, a variety of exercises creates opportunities for participants to work in same-sex groups and in small teams. A sense of community develops among the members by the end of the course, and many participants establish ongoing social relationships. The extended time frame in the PAIRS course encourages group cohesion. Post-PAIRS opportunities are available to PAIRS graduates to maintain group cohesion and provide a forum for refreshing and updating relationship skills. The chapter on research, chapter 12, highlights these impacts on participants.

PAIRS METHODS

The PAIRS course provides a comprehensive structure and a set of tools and language couples can use to address their individual needs and problems. PAIRS offers a wide variety of methods to allow for different learning styles among participants. The combination of weekly classes and intensive weekends maximizes the opportunity for attitude and behavior change. Designed to enhance personal awareness, to effect attitude change, and to develop communication and conflict-resolution skills, PAIRS methods include lectures, role-play, small group sharing and task work, guided emotional expression, guided imagery, and homework assignments like readings, journal-writing, and practice sessions. In addition, the PAIRS course includes four intensive weekends, which are key to the effectiveness of PAIRS. The first weekend focuses on conflict management, using peer support and professional guidance. The second weekend addresses bonding as a biologically based human need and provides opportunities for emotional expression and reeducation. This focus on bonding distinguishes the PAIRS course from most other enrichment and psychoeducational programs, as well as from many models of therapy. The third weekend, which highlights issues related to sexuality and sensuality, includes discussions of sexual needs, desires, and conflicts. The fourth and final weekend addresses the need for conscious agreement between partners, using clarifying expectations and contracting as primary methods.

A variety of homework assignments helps to promote the attitude and behavioral change and skill development that is begun during class sessions. For example, one assignment is the “Letting Go of Grudges” letter and the letter of response that is written by one partner to the other. In this exercise, partners identify a problematic issue and explore the assumptions and feelings associated with the problem. Here, partners share the thoughts and feelings, needs, and expectations of which they have become aware. This type of homework assignment helps couples to ground relationship tools into their day-to-day lives, increasing the likelihood of changes in habitual patterns.

THE ROLE OF THE PAIRS LEADER

Teaching the PAIRS course is a demanding professional activity. The PAIRS Teaching Manual (Nissen, 1989) specifies the four roles of the PAIRS leader: class administrator, lecturer, exercise facilitator, and role model, and group facilitator and processor. The ...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• Foreword
• Preface
• Introduction to PAIRS (Practical Application of Intimate Relationship Skills)
• Part One The PAIRS Program in Context
• Part Two The PAIRS Program Through the Voices of the Leaders
• Part Three Special Populations and Adaptations
• Part Four Practical Realities
• Appendix Resources Used By Lori Gordon To Develop Pairs
• Contributors
• Index