Close Adult Relationships Week 7

Why Couples Seek Therapy

Relationship Conflict:

• power struggles

• communication difficulties

• abuse and violence

Emotional disengagement and reduced commitment

Threats to security:

• Jealousy

• infidelity

Life crises affecting the couple couple

Couple Therapy Help-seeking

• Couples wait, on average, aout 6 years before seeking help

• only 37% seek couple therapy prior to divorse

• Men more reluctant to seek couple therapy than women

1. conformity to masculine norms

2. self-reliance

3. stigma and shame about seeking help

Barriers to Relationship Help-Seeking

• Location, lack of transport, financial situation

• perception of service as irrelevant or not needed

• Lack of adequately trained professionals stigma

Commonly Styles Of Unhappy Couples

• Pursue-pursue

• pursue-withdraw

• withdraw-withdraw

Hostile Couples

• Contempt

• defensiveness

• criticism

• stonewalling

Couple Therapy Approaches

• behavioural couple therapy

• cognitive-behavioural couple therapy

• integrative behavioural couple therapy

• emotionally focussed therapy

• Insight-oriented couple therapy

Common Factors in Couple Therapy

• explanation for couple distress

• insight into the factors that are maintaining the distress

• therapeutic relationship with therapist (trust and safety, agreement on goals)

• Tasks that couple engage on to improve their relationship

Behavioural Couple Therapy

Early in a relationship there is much opportunity for positive reinforcement

1. couples generally do many positive activities together

2. sexual appeal generally present and novel

3. working with limited information of each other, generally notice positives, and minimise/don't notice negatives

As relationship Continues, partners may:

1. become aware of differences between partners previously unknown

2. engage in less reinforcing/enjoyable activities

3. not have necessary skills to deal with relationship changes

Each partner attempts to maximise benefits of relationship, and minimise costs

1. rewards: attractive partner, finically stable, loving

2. low costs, few arguments, financially stable

Cognitive-Behavioural Couple Therapy

retained focus on increasing positive behaviour and teaching relationship skills

• added focus of the ways partners think about and appraise their relationship, and modifying those that are unhelpful

1. selective attention - notice some things and ignore others

2. attributions for positive and negative partner behaviour

3. relationship standards, beliefs and expectations

Relationship Expectations

Expectations about how relationships should be → often not spoken about:

• boundaries

• power and control

• investment

• communication

• conflict styles

Where do Boundaries Come From

• observing other couples growing up

• other couples we know

• past experiences in relationships

• role models of relationships

Couple therapy Challenges

around 1/3 of couples presenting for therapy state that their goal is to clarify whether or not to remain in relationship

• proceeding with relationship enhancement strategies without clarifying the goals of the couple can be problematic

• if couple decide to seperate, assisting them to have a low conflict separate is a valuable goal

• impact on mental health and impact children

• triadic consensus

• lack of agreement is between partners is common

• whats the problems are and how best to resolve them

• lack of consensus between therapist and couple (what the problems ae and how best to resolve them)

• couple therapts needs to establish a shared conceptualisation of what the probems are and what to do about them

• managing coupek conflict in session

• conflcit can escalate intherapy sessions

• allowing coupls to vent abput criticisms of their partner will not lead to positive change and may do harm

• setting ground-rules to prevent and deescalate high cnflcit session

Emotion Focussed Couples Therapy

Early research large ignored emotion

• views relationship distress as being maintained by levels of negative effect

1. Makes emotional intimacy and engagement difficulty

2. emotion is target of change

• heavily influenced by attachment theory

Emotion

Indicate when our needs are not being met and provide information about state of intimate relationships + bonds

• action tendency

• fear → escape

• Anger → flight

• Sadness → withdrawal and seeking help

Primary Emotion

Deeper, more vulnerable emotions

• hurt fear and shame

• generally draw individuals closer to each other when expressed

Secondary Emotion

Reactive emotion, and occurs in response to primary emotion

• anger → frustration, jealously

• generally push individuals away when expressed

Conceptualisation (EFT)

Maintaining factors/treatments targets

• negative cycle which both reflects and perpetuates insecure attachment bond

• many of the common artner conflict management styles

• unacknowledged attachment emotions

• avoidance of the expression of attachment needs and emotions

Stage One of EFT: De-escalation Of Negative Cycles

• identify negative cycle of interaction

• access unacknowledged primary emotions

• reframe cycle in terms of struggle to meet attachment needs

• negative cycle is the eney, not the other partner

Stage Two of EFT: Changing Interactional Patterns

• facilitate expression of disowned attachment emotions and needs and support partner to hear and understand

• enactments and reframes

• help the withdraws to reengage in the relationship and the critical blamer to soften his/her pursuit

• both partner learns to ask for attachment needs to be met in the congruent way

Stage 3 of EFT: Consolidation And Integration

• new solutions to old problems

• consolidate new positive cycles of attachment behaviours

Key Skills of EFT

Empathy + reflection -> its hurtful when john turns away from you

• empathetic conjecture → tell me if i’m wrong, but its my guess it’s really hard for you to hear that she was very hurt by your comments

• evocative reflections + questions

• heightening emotion + attachment fears and needs

1. negative cycle as the problem

2. withdrawer withdraws because its scary/difficult/overwhelming to stay in interaction -> form of self-protection

3. pursuer pursues because they are afraid the other will be unavailable, or reaction to available partner, and an attempt to bring partner closer

• Blame softener

Enactments

Ask partner to turn to partner express attachment

• needs/primary emotions → not secondary emotions