Positive Couple Therapy

Using We-Stories to Enhance Resilience

Jefferson A. Singer, Karen Skerrett

• Publisher: Routledge
• Year: 2014
• Print ISBN:
  9780415824460
• eBook ISBN:
  9781135957650
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Positive Couple Therapy: Using We-Stories to Enhance Resilience

is a significant step forward in the couple literature. Utilizing a strengths-based approach, it teaches therapists and couples a unique method for uncovering positive potential within a relationship. The authors demonstrate how "We stories"–created, recovered and made anew–provide essential elements of connection. With vivid imagery, these stories capture the couple's sense of "We-ness," highlighting memorable moments of compassion, acceptance, and respect. A shared commitment to the "We" simultaneously builds the relationship and enables each individual in the partnership to feel a greater degree of both accountability and autonomy. Couples that can find their stories, share them with each other, and then carry them forward to family, friends, and a larger community are likely to preserve a sense of mutuality that will thrive over a lifetime of partnership.

Positive Couple Therapy

provides simple and practical instruction for reclaiming positive stories that can catalyze hope in relationships that have become stressed and strained. The authors weave together cutting edge thinking and research in attachment theory, narrative therapy, neuroscience, and adult development, as well as their own research and clinical experience to present vivid case histories, step-by-step strategies, exercises, questionnaires, and interview techniques. They cover a range of contemporary couple experiences: couples in conflict, LGBT partnerships, deployed and discharged military couples, and couples at various points across the life span. The authors' unique Me (to US) Scale, a 10-item tool that assesses the degree of mutuality a couple possesses at the start of treatment, gives therapists of any theoretical orientation the ability to put this intervention to immediate use.

1
What is the “We”?

We begin our investigation into We-Stories by reviewing key features of the most important contemporary approaches to couple therapy. All of these couple therapies share an underlying emphasis on the importance they place on trust and positivity in the couple relationship. We argue that the root of this trust and positivity is consciousness of the “We” in the relationship. But what exactly does it mean to have a We-consciousness? We provide a more formal definition of the seven key elements that constitute the “We,” drawing on research and clinical examples. Once we have elaborated our understanding of the “We,” we shall be ready to focus on the critical role of stories for couples, and how therapists can help couples leverage these stories to build a more positive and more resilient relationship.

Contemporary Trends in Couple Therapy

The last two decades have been an exciting and in some ways revolutionary period for psychotherapists who work with couples. As Gurman and Fraenkel (2002) detail, couple therapy in the form of “marriage counseling” began in the 20th century as an almost informal practice offered by clergy, physicians, family life experts, and other sundry advice-givers. Equally problematic, a small discipline of “marriage counselors” associated themselves with the tenets of psychoanalysis and dispensed psychoanalytic interpretations of marital problems, often in individual rather than conjoint therapy. Finally, by the early 1960s, with the advent of family therapy and a family systems perspective on marital problems, couple therapy, as we currently understand it, began to take hold. Therapists began to look at the power dynamics, boundary concerns, and communication patterns that define the contours of couple relationships (Bowen, 1961; Haley, 1963; Minuchin, 1974; Satir, 1964). Still, the major theorists of family therapy of the 1960s, 1970s, and 1980s were mostly trained in psychiatry, and their approaches drew less on empirical advances in psychological research and more on their own clinical experiences and personal charisma. Couple therapy borrowed from these theories but did little to carve out a distinct presence in the larger landscape of psychotherapy. The late Neil Jacobson, a psychologist and a pioneer in the scientific study of couple therapy, surveyed the field, including his own efforts at a more rigorously based behavioral couple therapy, and found that only 35% of the couples he was treating were improving and 30–50% were relapsing within one to two years (Jacobson, 1984; Jacobson & Addis, 1993).

Fortunately, since the mid-1990s we have seen successive waves of couple therapy approaches that incorporate advances in scientific findings regarding cognition, behavior, emotion, attachment, and couple interaction (Gurman, 2008). For example, Christensen and Jacobson introduced and provided empirical support for Integrated Behavioral Couple Therapy (IBCT), a cognitive-behavioral approach to couple therapy that features traditional behavioral skills training, but more crucially, an emphasis on mutual acceptance of long-standing emotional concerns or vulnerabilities that each partner brings to the relationship (Christensen et al., 2004; Christensen, Atkins, Yi, Baucom, & George, 2006; Christensen & Jacobson, 1998; Dimidjian, Martell, & Christensen, 2008). In the late 1980s and evolving over the next two decades, Susan Johnson (2004, Greenberg & Johnson, 2010) along with her collaborator, Leslie Greenberg, developed Emotion-Focused Couple Therapy (EFCT), a humanistic-experiential–based therapy that zeroes in on individuals’ immediate emotional responses to attachment concerns in their relationship. Similar to IBCT, Johnson’s approach addresses the repetitive negative interactions associated with each partner’s attachment vulnerabilities and highlights how partners can develop compassion and understanding in the face of these conflicts. Once again paralleling IBCT, EFCT has been tested and found effective in treatment-outcome studies (Denton, Burleson, Clark, Rodriguez, & Hobbs, 2000; Greenberg & Goldman, 2008; Johnson, Hunsley, Greenberg, & Schindler, 1999).

A third groundbreaking force in evidence-based couple therapy can be traced to the well-known studies that emerged from John Gottman’s marital laboratory at the University of Washington (what has become commonly known as the “love lab”). Using video coding techniques, questionnaires, and physiological measurement, Gottman had couples spend 24-hour sessions in his laboratory and studied their interactions, emotional responses, and perceptions of their own and their partners’ feelings, thoughts, and behaviors. These studies have produced voluminous writings, by Gottman (e.g., Gottman, 1999, 2011; Gottman & DeClaire, 2001; Gottman & Gottman, 2008; Gottman & Silver, 1999) and about Gottman (see Malcolm Gladwell’s (2005) account in the bestselling book, Blink [2005]), but their take-home message is that conflict in marriage is inevitable; however, it is how we respond to negativity, and even more, our ability to generate positive interactions, that will predict the stability and well-being of long-standing partnerships (Gottman, 1999, 2011).

A fourth critical force in contemporary couple therapy that draws more on philosophical and cultural analysis than psychological science is Narrative Therapy (Freedman & Combs, 2008, Madigan, 2011; White & Epston, 1990; Zimmerman & Dickerson, 1996). Narrative Couple Therapy zeroes in on the internalized cultural “stories” that partners in a relationship have learned to adopt as a mutual reality and that often lead to repetitive frustration and disappointment (e.g., “we should have it all”; “we will only be loved if we are beautiful”; “we can find happiness in food and/or alcohol”; “we must outperform our parents”). Its therapeutic focus is to help couples “externalize” these stories and join together in battling their toxic influences. One strategy in this shared effort is to highlight “unique outcomes” or “sparkling events” from past encounters when the couple has effectively united and overcome these negative beliefs and messages. As Freedman and Combs (2008) note, narrative therapy, as a social constructionist and non-positivist perspective, does not tend to engage in quantitative research to support its work; rather it relies on “co-research” and the collaborative testimony and information provided by its participants (clients and practitioners). However, unlike earlier non-empirically based grand theories of family therapy, it is more modest about its claims to a single Truth or theoretical supremacy.

The Common Threads Among Contemporary Approaches

Each of the four major approaches to couple therapy just reviewed defines the emotional process of a relational breakdown slightly differently, but all four emphasize that festering negativity and dilution of positive energy are at the root of marital discord and alienation. And all four see the solution to these problems as based in a greater emotional flexibility and trust during periods of conflict.

More precisely, IBCT sees this relational impasse as a problem with acceptance. For example, Christensen and Jacobson (Jacobson, Christensen, Prince, Cordova, & Eldridge, 2000, p. 352) promote “empathic joining, unified detachment, and tolerance building” as methods of acceptance in place of efforts to change one’s partner. Empathic joining means an emotional compassion for the other’s concerns; unified detachment is an ability to see a relational problem or conflict as a common adversary to be confronted; and tolerance building is an increased patience with the other person’s behavior that allows for a constructive and modulated response to what is normally a provocative gesture or comment.

EFCT sees moments of severe marital distress as a two-stage reaction to fundamental concerns about safety and security in the relationship. In other words, each partner is experiencing a threat, whether abandonment and/or rejection, to their attachment bond. Once an emotional response to this threat is experienced, security strategies (most often some form of pursuit or withdrawal) are initiated. In this way strong negative emotional responses (anger, fear, sadness) are coupled with defensive relational cycles that perpetuate or worsen the rift between the partners rather than draw them closer together. As Johnson (2004) writes,

A distressed couple is in an absorbing state of compelling, automatic emotional responses and a corresponding set of rigidly organized interactions, both of which narrow and constrict interaction and experience. (p. 41)

EFCT responds to this destructive cycle by a strategy of what Johnson calls “within” and “between.” In other words, the therapist seeks to evoke strong emotion within each partner during the session and then works on expanding his or her experience of that emotion to support the reframing of the interaction between the partners. For example, a wife may bear great anger at her husband for his emotional remoteness and often criticizes him for his “cluelessness.” The husband responds to this frequent negativity by even greater efforts to withdraw and avoid close contact. In the session, the emotion-focused couple therapist may help the wife to explore her anger and find the sadness and hurt beneath her frustration. In accessing this hurt, the wife may also speak more vulnerably about her loneliness and of her softer desire for closeness with her husband. In turn, the therapist may ask the husband to register emotionally what it is like to be needed so deeply and then ask him whether he had previously realized how much he is loved. The husband may find new compassion and encouragement from this awareness and resolve to take new steps to change the attack/withdraw pattern that has been dominating the couple interaction. Undergirding what Johnson (2004, p. 315) calls the “softening process” is a willingness to trust—to believe that there will be reciprocity if one member of the couple finally reaches out to the other.

A foundation of trust and a belief in the value and viability of the relationship is also what Gottman (1999, 2011) sees as the key to the sound “marital house.” In one of his more remarkable findings, Gottman and colleagues (Gottman, Coan, Carrère, & Swanson, 1998) determined that they could predict whether a newlywed couple would be together and happy, together and miserable, or divorced six years later. The basis of this prediction was a 30-second difference in positive emotion during a 15-minute conflict discussion recorded in the love lab in their first year of marriage. The key aspect of this difference is that stable and happy couples learn to use positive emotion to deescalate their arguments and fights. Through humor, affection, and genuine interest in the concerns of the partner, the couple moves the “negative needle” in a more positive direction, allowing each partner to take a breath and engage in self-soothing. Gottman calls these shifts toward the positive in the midst of a negative interaction repair efforts resulting in a positive sentiment override that defuses the conflict.

For practitioners of Narrative Therapy, the building up of trust in distressed couples is through their ability to develop an alternative story to their current experience of conflict and unhappiness. The raw material of this more positive story can be found in their past recollection of unique outcomes. For example, Freedman and Combs (2008) described a couple who are both writers and have been undergoing power struggles and competitive conflicts, magnified by their impending move to take joint positions in an English department. By helping the couple to identify recent “sparkling events” where they worked together and appreciated each other outside the realm of their writing careers, the therapists encouraged the “reauthoring” of the couple’s story to highlight their complementary differences and strength as a part of the same team. Equally important, the telling of their story promoted a better vision of the couple’s future together. This positivity was clearly being overlooked due to the “problem-saturated” narratives that had dominated the couple prior to treatment. Freedman and Combs (2008) wrote,

We work to help couples notice the influence of restrictive cultural stories in their lives, and to expand and enrich their own life narratives. We strive to find ways to spread the news of triumphs; to circulate stories of accomplishment, fulfillment, and meaningful struggle in order to keep them alive and growing. (p. 232)

Across these four diverse therapeutic perspectives, the critical element of change for the couple is recourse to positive feelings and a shared faith in each other. But how does the couple access this positivity so that it can emerge like a life preserver in the nick of time and save them from a sea of hostility and recrimination? Clearly, most distressed couples that come in for treatment do not have the magic “5 to 1” ratio of positive to negative emotion that Gottman uncovered in stable and happy couples. To appropriate a metaphor from Gottman (1999), we are essentially asking, what provides the positive energy to keep the “marital house” warm, inviting, and livable for the couple? If acceptance, attachment security, repair efforts, and sparkling events are key resources to overcoming marital distress, from what marital resource do troubled couples derive this fuel?

The “We”

Our answer is that the source of positive energy for couples lies in a shift in consciousness that translates into a series of daily practices. Distressed couples will learn to tap ...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• CONTENTS
• About the Authors
• Acknowledgments
• Preface
• Introduction: Positive Couple Therapy: Using We-Stories to Enhance Resilience
• 1 What is the “We”?
• 2 The Power of Stories in Our Lives
• 3 Assessing the “We” in Therapy
• 4 Helping Couples Cultivate Their We-Stories
• 5 Stuck Stories: Helping Couples Confront and Move Beyond Them
• 6 Building We-Stories Across the Life Cycle
• 7 Living and Telling the “We”: Giving Our Stories Away
• Author Index
• Subject Index