A Life-Cycle Approach to Treating Couples

Anne K. Fishel

• Publisher: Momentum Press
• Year: 2018
• Print ISBN: 9781946646149
• eBook ISBN: 9781946646156
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

A Life-Cycle Approach to Treating Couples draws on 30 years of clinical work and a rich body of research about lifecycle theory to offer couple therapists a guide to helping couples traverse six developmental stages—dating and commitment; transition to parenthood; midlife couples; launching and retiring couples; late-life couples; and relationship endings. For each stage, the author offers clinical vignettes as well as questions and strategies for the clinician to pursue. In this clear and authoritative book, Fishel provides examples and research about clients who are diverse in their marital status, sexual orientation, race, ethnicity, SES, and health.

CHAPTER 1

Applying the Life-cycle Perspective to Couple Therapy

To everything there is a season, and a time to every purpose, under heaven.

—The Book of Ecclesiastes

If I were young again, I’d pay attention to that little-known dimension

A taste of endless time.

Just like water—it runs right through our fingers,

But the flavor of it lingers—Like a rich, red wine.

—Chris Smithers, Leave the light on

As therapists, we hear an abundance of stories, information, and anguish shared by couples during an initial evaluation and even more so, in ­therapy. This outpouring of data is a challenge for couple therapists to organize and render into a coherent framework for treatment. A life-cycle perspective locates every couple on a developmental timeline that starts with courtship and ends at death, divorce, or a relationship break-up, and offers context and a compass for what may feel like a confusing and cluttered landscape. Once the stage of development has been identified, a particular couple can be compared to the millions of other couples who have faced similar challenges at that same stage of development. Couple therapists, guided by the research on different life-cycle stages, can find their footing as they explore the challenges of a particular couple.

The couple’s clinician can use the research on each stage of development in much the same way that the clinician trained in individual therapy uses research on diagnostic disorders. If, for example, an individual patient complains of low energy and a sad mood, a clinician will bring to bear all that is known about depression and ask questions accordingly—about feelings of worthlessness and guilt, disturbances in sleep and appetite, and difficulty concentrating. Most likely, every individual experiencing depression will not respond affirmatively to all of these queries, but the panel of questions will direct the therapist to explore a wide swath of experiences common among depressed individuals.

A couple therapist, with a focus on relationships rather than on individuals, does not rely on diagnostic categories like depression or anxiety. Instead, the couple therapist will compare a couple who presents at a particular stage of development with large groups of other couples who have been studied at that same stage. So, for example, when interviewing a couple with an infant, a couple therapist will ask about increases in fighting and decreases in sexual activity, as these behaviors have been identified as common features of thousands of couples making the transition to parenthood. A particular couple with a newborn may not endorse all the same experiences found in studies, but questions, rooted in research, will help orient the therapist to ask about a baby’s temperament, sleep, and eating behavior, as well as to normalize disruptions in the couple’s relationship. These questions can offer respectful, normative explanations of a couple’s challenges. For example, “Most couples experience a decline in their sexual relationship in the first two years after becoming parents. How has this adjustment gone for you?” If a couple responds that they have transcended the normative expectations of this transition by avoiding fights about who is doing what and are having frequent and satisfying sex, it is an opportunity to inquire about their strengths and resources that have made this possible. If, on the other hand, they describe having the worst fights of their lives, the couple therapist can normalize the fights as a developmental event and offer suggestions for making the fights less toxic and damaging.

What Is the Life-cycle Perspective?

The notion that there are universal, predictable stages in human development has long been a cornerstone of the field of child development, as evidenced in the widely accepted writings of Erikson (1951) and Piaget and Inhelder (1969). It is a somewhat newer idea that adults continue to develop past college years (Dawber, 1980; Friedman & Martin, 2011; Levinson, 1978; Sheehy, 1976; Vaillant, 2012) and newer still that relationships in a family follow a developmental arc (McGoldrick, Preto, & Carter, 2016; ­Carter & McGoldrick, 1989).

One longitudinal study of 80 years duration (and still ongoing) has focused on both the individual lives of men, and later, on their marital relationships. The study is composed of two groups of men. The first is the Grant study, which began in 1938 as an attempt to study optimum health and potential by focusing on privileged and healthy men at Harvard: They were sophomores at the start, and now many are in their 90s. The second group, the Glueck cohort, made up of young men from low-income urban neighborhoods in Boston, was added in 1940.

Writing about this research, Vaillant (2012) cautions that “stage is a metaphor.” While one can see clearly delineated stages in how the embryo develops, adult development is not nearly so step-wise and predictable. In particular, the life trajectories of both the privileged and the low-income men revealed that childhood experiences did not reliably predict what happens in the future. Lives did not unfold smoothly from strong, positive early experiences through happy mid-life and onward to a satisfying old age.

Those looking at resilience over the cycle also note the absence of lives progressing in lock-step from a negative start to a disastrous end nor from a charmed childhood to a ripe and happy old age. Rather, people have many opportunities to turn their lives around when a good ­marriage, or gratifying work, or the advent of parenthood can disrupt what seemed like a negative march through time (Walsh, 2016). Drawing on longitudinal studies, Werner and Smith (2011) also found that difficult early experience did not doom later-life trajectories. Rather, a supportive marriage or satisfying work could interrupt a negative start to life and catalyze a more positive spiral. This view suggests that stages do not need to be completed successfully before moving on to the next, but rather that each stage offers another chance at altering a couple’s narrative.

Relationships have a beginning, middle, and end. Time is the river that flows through all couples’ relationships. But rivers, like relationships, get dammed, form oxbows, make detours, circumvent obstacles, shoot over waterfalls, settle as swamps, and pick up and deposit detritus and sediment as they meander, so their journey is never a straight shot. Just as a river rushes, or meanders toward the ocean, so time propels every couple through terrain with recognizable landmarks. Time, or biological aging, has an impact on all aspects of a couple’s life—work, sex, health, ­conflict, connection, and caregiving. There are six major life-cycle stages that ­couples typically traverse from dating to death, divorce, or separation. These stages are rooted in a westernized view of relationships and may look different across cultures and across historical periods ­(McGoldrick, Carter, & Preto, 2016; Carter & McGoldrick, 1989).¹

• The first one begins with opening up to a stranger, falling in love, often cohabitating, and deciding to commit to a future together. The central task of this stage of courtship and commitment is for each member of the couple to separate enough from families of origin so that the couple can make decisions jointly.
• The second stage is the couple’s transformation from a dyad to a triad, with the addition of a baby where work and relationship needs are renegotiated, and the couple makes room for a new person.
• Stage three is about maintaining the couple’s bond at midlife as work commitments deepen, increased flexibility is required in parenting adolescent children, and aging parents may need caregiving.
• The fourth stage, now the longest adult stage, begins with children’s leaving home and ends with the start of the couple’s retirement.
• In the fifth stage, retirement, grandparenthood, and aging are the focus; couples’ tasks include maintaining their connection in the face of health problems, adjusting to more time together, and finding meaning as time runs out.
• The sixth stage centers on the loss of the relationship through death, divorce, or separation.

This trajectory is, of course, not the only one that couples take, and not all couples traverse all these stages. Other transitions—like migration, traumatic losses, and disability—may be much more formative than these developmental ones. There are also many variations of life experience for couples who stay together on a long developmental arc. Three variations are particularly important in clinical practice. First, the inclusion of parenting in stages two, three, and four of the life-cycle stages requires that clinical attention also be provided to represent the experience of the many couples who will choose not to have children, but who stay married over the same period of time as couples with children. Second, the legalization of same-sex marriage (Supreme Court, 2015) is so recent that there is scant longitudinal data on long-term same-sex marriages, so we must wait for research data on how the developmental stages may differ or overlap with those of heterosexual couples. In the meantime, clinical knowledge and an emerging body of research on same-sex marriages can offer guidance about same-sex couples. Divorce and remarriage is a third normative variation over the life span. In the last 30 years, divorce has supplanted death as the endpoint for the majority of marriages. This shift has prompted some couple therapists to regard divorce as a normative life-cycle event that may be positive or negative (Pinsof, 2002).

Life-cycle theory posits that couples experience the most stress at the transition points, as one stage turns into another, and often as family members are added, as in marriage and the transition to parenthood, and lost, as during the launching stage and at the death of a spouse. When moving from one stage to the other, the organization of the couple must change. It is not, however, merely the transitioning from one stage to the other that creates strain on a relationship. If, in addition, there is an accumulation of stressors that coincides with a transition point, as when a couple is expecting a first child at the same time that the husband’s mother is diagnosed with metastatic cancer, and the couple has to relocate to a new city without any supports, they may struggle. A transition point can also be exacerbated if it resonates with difficulty encountered in a previous generation at a similar stage of life, as when an expectant couple grew up in families where there were miscarriages or deaths of children. This couple may anticipate the transition to parenthood with an extra burden of anxiety and apprehension.

At the core of this life-cycle perspective is the notion that family relationships shape our identities, with each generation connected to the ones behind and ahead. The generations are mutually influencing and informing of one another so that is not only that parents guide their children’s development, but it is also the case that children’s unfolding lives reverberate in the life choices made by their parents and grandparents. Take, for example, the way that adolescents’ burgeoning sexuality and dreams about their open-ended futures may inspire their middle-aged parents to take stock of their more limited time that lies ahead.

There are two other dimensions of time that are critical to an understanding of life-cycle theory. First is the historical context of each cohort of couples who is experiencing a particular life-cycle transition, as people born at a given time will share certain opportunities and sociopolitical experiences (Elder & Giele, 2009). Consider, for example, the cohort differences of same-sex couples born in 1990 who came of age seeing gay marriage legalized, compared with couples born in 1950 when gay and lesbian identities were often regarded as signs of mental illness, and sodomy laws could be used to criminalize individuals. When lesbian and gay teens were recently surveyed about their attitudes toward marriage and parenting, 92 percent of lesbian youth and 82 percent of gay youth stated that wanted to be in a long-term monogamous relationship within the next 10 years (D’Augelli, Redina, Grossman, & Sinclair, 2007), while more than half of these same young men and women stated that it was very or extremely likely that they would be raising children. These attitudes among current lesbian and gay youth stand in stark contrast to the closeted and constricted attitudes of similar youth in the 1950s whose best hopes for marriage and a family were to hide their identities and enter a heterosexual marriage.

The second dimension of time is the subjective one that all humans experience, an internal clock that tells whether one is traversing a given life stage at the expected time and provides an awareness of how much time one has left. Bernice Neugarten, a psychologist, is credited with identifying the notion that we each have a sense of what is a normal time to accomplish different stages of the life-cycle (Neugarten, 1979). Comparing ourselves to friends, siblings, work colleagues, and parents, we have an idea of when is the best time to move in with a partner, marry, have a child, settle on a career, or retire. This sense of timeliness is historically constructed, contextualized by the experience of our families and by our particular cohort. So, for ex...

Table of contents

• Cover
• Half
• Title
• Copyright
• Abstract
• Endro
• contents
• Ack
• 01_Chapter 1
• 02_Chapter 2
• 03_Chapter 3
• 04_Chapter 4
• 05_Chapter 5
• 06_Chapter 6
• 07_Chapter 7
• 08_References
• 09_Bios
• 10_Index