The Art Of Psychotherapy
Does Couple Therapy Work?
Jan. 04, 2019 11:04 AM
Couple therapy is not a passive endeavor; it requires specific kinds of intention and attention to the matter at hand from both therapist and client couple. As is often said, ‘You get out of something whatever you put into it.’ It’s no different with couple therapy. If you value your relationship and want to better understand, grow and strengthen it, it will be necessary for you and your partner to intentionally tend to its cultivation just as a one tends to a garden’s fruits and weeds alike.
And what’s the therapist’s role? It’s complex and, in the hands of a master therapist, often more art than science. You read that right; with all that’s been made of Evidence Based Treatment the most important variables determining successful therapeutic outcomes are still ‘relationship factors’.* Specifically, how do clients experience the therapist?
For example, do I trust the therapist? Is s/he interested in me as a unique individual? Does s/he strive to embody the values s/he professes? Does s/he take responsibility for her mistakes? Do I feel increasingly free to express my authentic self in her presence? Can s/he clearly and consistently describe her particular therapeutic model? Do I feel safe to disagree with or question her perspective?
Obviously none of these qualities can be satisfied in just one therapy session and I believe it is the therapist’s responsibility to intentionally cultivate, over time, a therapeutic environment in which clients may increasingly answer such questions in the affirmative. Such intention by the therapist necessarily persists throughout the course of the therapeutic relationship. Furthermore, couple therapy requires therapists satisfy these and other domains for two people, not just one. As you might imagine, that can be a tall order. After all, therapists are just as human as you are and, when you and your partner disagree, the therapist’s response to each of you as individuals (from within the therapist’s own experiences and biases) will determine whether only one or both of you feel safe, cared for and respected.
Does couple therapy work? Yes, especially when both therapist and client couple cultivate sincere intention and attention to specific factors. However, the quality of the therapist’s repeated attention to satisfying questions like those above can go a long way toward inspiring clients to authentically engage in the process. I put the quality of your experience with me, my relationship with each of you, as my continuing priority in each session as I also help each of you make your relationship with each other your priority. ~Doug
*The Heart & Soul of Change: What Works in Therapy, Mark A. Hubble, Barry L. Duncan, Scott D. Miller, Washington, D.C.: American Psychological Association, 1999.
And what’s the therapist’s role? It’s complex and, in the hands of a master therapist, often more art than science. You read that right; with all that’s been made of Evidence Based Treatment the most important variables determining successful therapeutic outcomes are still ‘relationship factors’.* Specifically, how do clients experience the therapist?
For example, do I trust the therapist? Is s/he interested in me as a unique individual? Does s/he strive to embody the values s/he professes? Does s/he take responsibility for her mistakes? Do I feel increasingly free to express my authentic self in her presence? Can s/he clearly and consistently describe her particular therapeutic model? Do I feel safe to disagree with or question her perspective?
Obviously none of these qualities can be satisfied in just one therapy session and I believe it is the therapist’s responsibility to intentionally cultivate, over time, a therapeutic environment in which clients may increasingly answer such questions in the affirmative. Such intention by the therapist necessarily persists throughout the course of the therapeutic relationship. Furthermore, couple therapy requires therapists satisfy these and other domains for two people, not just one. As you might imagine, that can be a tall order. After all, therapists are just as human as you are and, when you and your partner disagree, the therapist’s response to each of you as individuals (from within the therapist’s own experiences and biases) will determine whether only one or both of you feel safe, cared for and respected.
Does couple therapy work? Yes, especially when both therapist and client couple cultivate sincere intention and attention to specific factors. However, the quality of the therapist’s repeated attention to satisfying questions like those above can go a long way toward inspiring clients to authentically engage in the process. I put the quality of your experience with me, my relationship with each of you, as my continuing priority in each session as I also help each of you make your relationship with each other your priority. ~Doug
*The Heart & Soul of Change: What Works in Therapy, Mark A. Hubble, Barry L. Duncan, Scott D. Miller, Washington, D.C.: American Psychological Association, 1999.
Why I'm A Couple Therapist
Mar. 17, 2017 11:09 AM
Couple therapy has been universally described as the most difficult form of counseling for therapists to do. No doubt there are many reasons for this sentiment. Often there is just so much invested on a successful outcome to therapy that emotions run deep and very raw for the couple; the therapist can’t help but be impacted by that intensity too. It’s good that therapists are impacted because experiencing those emotions with awareness keeps therapists grounded in the truths of that relationship. Those truths are often universal and the therapist can use experiences from her/his own life to remain connected with what the couple experiences.
In 2014 I decided to stop working with individuals and families and focus only on counseling couples. I could list several reasons (personal, philosophical, and practical) for why I made this decision. Fundamentally, however, it’s because I realized just how greatly I enjoy the work and appreciate the vulnerability of my client couples. Furthermore, to continually improve my skill with couples takes time and focus. (See my continuing education hours.)
Couple therapy is different from individual and family therapy for many reasons: The unique intensity, the inherent and diverse issues of intimacy, and because two adults are simultaneously yearning for love, confidence, and understanding. As a couple therapist, I help the individuals in the couple communicate their fears, hopes, and hurts in ways that reveal their tender hearts without attacking their partners; those are moments of deep intimacy and connection.
There are many reasons I only work with couples and here’s one other that’s more personal: Experiencing relationship as a source of joy is something I repeatedly work on in my own life. Everything I present to you in our couple sessions is something I am actively attending to. Our work together is never about unfounded theory; it reflects on my life too. --Doug
In 2014 I decided to stop working with individuals and families and focus only on counseling couples. I could list several reasons (personal, philosophical, and practical) for why I made this decision. Fundamentally, however, it’s because I realized just how greatly I enjoy the work and appreciate the vulnerability of my client couples. Furthermore, to continually improve my skill with couples takes time and focus. (See my continuing education hours.)
Couple therapy is different from individual and family therapy for many reasons: The unique intensity, the inherent and diverse issues of intimacy, and because two adults are simultaneously yearning for love, confidence, and understanding. As a couple therapist, I help the individuals in the couple communicate their fears, hopes, and hurts in ways that reveal their tender hearts without attacking their partners; those are moments of deep intimacy and connection.
There are many reasons I only work with couples and here’s one other that’s more personal: Experiencing relationship as a source of joy is something I repeatedly work on in my own life. Everything I present to you in our couple sessions is something I am actively attending to. Our work together is never about unfounded theory; it reflects on my life too. --Doug
Ties That Bind
May. 29, 2015 05:11 PM
It’s been a while since I’ve written. Shortly after my last blog entry my father became ill and then died on December 1st, 2014. Since November my practice has been all but closed due to my need to repeatedly travel between Portland and Rockville, Maryland where dad lived. I am very slowly returning to full-time practice as I write this. As many of you already understand, my experience is a journey of both beauty and pain as I attend to the life and the legacy of my father. He is my first parent to die.
Dad’s life and death are relevant to my practice with couples in many respects. Perhaps I’ll write more about this in the future. Here are a few particulars that stand out now.
To begin with, my father, H.D. Johns, was also a therapist and he is my original mentor in the art of psychotherapy. The tributes I’ve heard these last few months to dad’s skill as a therapist, from former students and clients alike, are stunning. A few comments were nearly word for word identical in their praise for his uncanny ability to understand someone’s experience. One of dad’s colleagues said to me, “Your father was a natural therapist. He was the best I’ve ever seen.”
Many years ago, when I was first embarking on my career, dad told me a story about his early days studying therapy at the Menninger Institute in Topeka, Kansas. Like a lot of young therapists he was working hard to help people change problematic behaviors. Before particularly difficult sessions dad would sometimes pray, “God, please help me change this person.”
Anxious about his abilities at first, something eventually shifted inside my father and his prayer changed: “God, please help me understand this person.” Placing understanding as the foundation of his therapeutic work made all the difference; clients naturally began to make decisions to improve their lives the more clearly dad could express accurate understanding for their unique experiences. Dad also strove to never “contest” a person’s subjective experience; he validated clients’ experiences as relevant.
Collaborative Couple Therapy is a refreshing fit for me. Its originator, Dan Wile, Ph. D., has created a therapeutic model that inherently deepens a therapist’s understanding of each individual within the couple relationship while simultaneously strengthening intimacy within the couple. Dan’s respect for individual experience, intentionally exemplified by not “rebuking” clients in even the smallest ways, echoes my father’s intention to never contest a person’s subjective experience. When I ‘double’ for clients they sometimes respond with, “I never realized I felt that way until you spoke for me.”
Understanding your partner and being understood, through collaborative and intimate conversation, is a powerful map for couples to heal their relationships and for individuals to grow and thrive. That is a thing of beauty! —Doug
Dad’s life and death are relevant to my practice with couples in many respects. Perhaps I’ll write more about this in the future. Here are a few particulars that stand out now.
To begin with, my father, H.D. Johns, was also a therapist and he is my original mentor in the art of psychotherapy. The tributes I’ve heard these last few months to dad’s skill as a therapist, from former students and clients alike, are stunning. A few comments were nearly word for word identical in their praise for his uncanny ability to understand someone’s experience. One of dad’s colleagues said to me, “Your father was a natural therapist. He was the best I’ve ever seen.”
Many years ago, when I was first embarking on my career, dad told me a story about his early days studying therapy at the Menninger Institute in Topeka, Kansas. Like a lot of young therapists he was working hard to help people change problematic behaviors. Before particularly difficult sessions dad would sometimes pray, “God, please help me change this person.”
Anxious about his abilities at first, something eventually shifted inside my father and his prayer changed: “God, please help me understand this person.” Placing understanding as the foundation of his therapeutic work made all the difference; clients naturally began to make decisions to improve their lives the more clearly dad could express accurate understanding for their unique experiences. Dad also strove to never “contest” a person’s subjective experience; he validated clients’ experiences as relevant.
Collaborative Couple Therapy is a refreshing fit for me. Its originator, Dan Wile, Ph. D., has created a therapeutic model that inherently deepens a therapist’s understanding of each individual within the couple relationship while simultaneously strengthening intimacy within the couple. Dan’s respect for individual experience, intentionally exemplified by not “rebuking” clients in even the smallest ways, echoes my father’s intention to never contest a person’s subjective experience. When I ‘double’ for clients they sometimes respond with, “I never realized I felt that way until you spoke for me.”
Understanding your partner and being understood, through collaborative and intimate conversation, is a powerful map for couples to heal their relationships and for individuals to grow and thrive. That is a thing of beauty! —Doug