Couples therapy
Couples therapy is a form of psychotherapy that seeks to improve intimate relationships, resolve interpersonal conflicts and repair broken bonds of love.
History
Marriage counseling began in Germany in the 1920s as part of the eugenics movement. The first institutes for marriage counselling in the United States started in the 1930s, partly in response to Germany's medically directed, racial purification marriage counselling centers. It was promoted by prominent American eugenicists such as Paul Popenoe, who directed the American Institute of Family Relations until 1976, Robert Latou Dickinson, and by birth control advocates such as Abraham and Hannah Stone who wrote A Marriage Manual in 1935 and were involved with Planned Parenthood, as well as Lena Levine and Margaret Sanger.It wasn't until the 1950s that therapists began treating psychological problems within the context of the family. Relationship counseling as a distinct, professional service is thus a recent phenomenon. Until the late 20th century, relationship counseling was informally provided by close friends, family members, or local religious leaders. Psychiatrists, psychologists, counselors and social workers historically dealt primarily with individual psychological problems within a medical and psychoanalytic framework. In many cultures, the institution of the family or group elders fulfill the role of relationship counseling; marriage mentoring mirrors these cultures.
With increasing modernization or westernization and the continuous shift towards isolated nuclear families, the trend is towards trained and accredited relationship counselors or couple therapists. Sometimes volunteers are trained by either the government or social service institutions to help those who need family or marital counseling. Many communities and government departments have their own teams of trained voluntary and professional relationship counselors. Similar services are operated by many universities and colleges, sometimes staffed by volunteers from among the student peer group. Some large companies maintain full-time professional counseling staff to facilitate smoother interactions between corporate employees and to minimize the negative effects that personal difficulties might have on work performance.
There is an increasing trend toward professional certification and government registration of these services, in part due to duty of care issues and the consequences of the counsellor or therapist's services being provided in a fiduciary relationship.
Basic principles
It is estimated that nearly 50% of all married couples divorce, and about one in five marriages experience distress at some time. These numbers vary between countries and over time; for example, in Germany only 35.74% of marriages ended in divorce, half of those involving children under 18. Challenges with affection, communication, disagreements, and fears of divorce are some of the most common reasons couples seek help. Couples who are dissatisfied with their relationship may seek help from a variety of sources including online courses, self-help books, retreats, workshops, and couples' counseling.Before a relationship between individuals can be understood, it is important to recognize and acknowledge that each person, including the counselor, has a unique personality, perception, opinions, set of values, and history. Individuals in the relationship may adhere to different and unexamined value systems. Institutional and societal variables which shape a person's nature and behavior, are considered in counseling and therapy. A tenet of relationship counseling is that it is intrinsically beneficial for all the participants to interact with each other, and with society at large with optimal amounts of conflict. A couple's conflict resolution skills seem to predict divorce rates.
Most relationships will experience strain at some point, resulting in a failure to function optimally and causing self-reinforcing, maladaptive patterns to form, sometimes called "negative interaction cycles." There are many possible reasons for this, including insecure attachment, ego, arrogance, jealousy, anger, greed, poor communication/understanding or problem-solving, ill health, and third parties.
Changes in circumstances, like financials, physical health, and the influence of other family members can significantly influence the conduct, responses, and actions of the individuals in a relationship.
Often, it is an interaction between two or more factors, and frequently, it is not just one of the people involved who exhibit such traits. Relationship influences are reciprocal: each person involved contributes to causing and managing problems.
A viable solution to the problem, and setting these relationships back on track, may be to reorient the individuals' perceptions and emotions - how one views or responds to situations, and how one feels about them. Perceptions of, and emotional responses to, a relationship are contained within an often unexamined mental map of the relationship, also called a 'love map' by John Gottman. These can be explored collaboratively and discussed openly. The core values they comprise can then be understood and respected, or changed when no longer appropriate. This implies that each person takes equal responsibility for awareness of the problem as it arises, awareness of their own contribution to the problem, and making fundamental changes in thought and feeling.
The next step is to adopt conscious, implement structural changes to the inter-personal relationships, and evaluate the effectiveness of those changes over time.
Indeed, "typically for those close personal relations, there is a certain degree in 'interdependence' - which means that the partners are alternately mutually dependent on each other. As a special aspect of such relations, something contradictory is put outside: the need for intimacy and for autonomy."
"The common counterbalancing satisfaction these both needs, intimacy, and autonomy, leads to alternate satisfaction in the relationship and stability. But it depends on the specific developing duties of each partner in every life phase and maturity".
Basic practices
Two methods of couples therapy focus primarily on the process of communicating. The most commonly used method is active listening, used by the late Carl Rogers and Virginia Satir. More recently, a method called "Cinematic Immersion" has been developed by Warren Farrell. Each helps couples learn a method of communicating designed to create a safe environment for each partner to express and hear feelings.When the Munich Marital Study discovered active listening was not used in the long run, Warren Farrell observed that active listening did a better job of creating a safe environment for the criticizer to criticize than for the listener to hear the criticism. The listener, often feeling overwhelmed by the criticism, tended to avoid future encounters. He hypothesized that people are biologically programmed to respond defensively to criticism, and therefore the listener needed in-depth training with mental exercises and methods to interpret as love what might otherwise feel abusive. His method is Cinematic Immersion.
After 30 years of research into marriage, John Gottman found that healthy couples almost never listen and echo each other's feelings naturally. Whether miserable or radiantly happy, couples said what they thought about an issue, and "they got angry or sad, but their partner's response was never anything like what we were training people to do in the listener/speaker exercise, not even close."
Such exchanges occurred in less than 5 percent of marital interactions and they predicted nothing about whether the marriage would do well or badly. What's more, Gottman noted, data from a 1984 Munich study demonstrated that the exercise itself didn't help couples to improve their marriages. To teach such interactions, whether as a daily tool for couples or as a therapeutic exercise in empathy, was a clinical dead end.
Emotionally focused therapy for couples is based on attachment theory and uses emotion as the target and agent of change. Emotions bring the past alive in rigid interaction patterns, which create and reflect absorbing emotional states. As one of its founders, Sue Johnson says,
Forget about learning how to argue better, analyzing your early childhood, making grand romantic gestures, or experimenting with new sexual positions. Instead, recognize and admit that you are emotionally attached to and dependent on your partner in much the same way that a child is on a parent for nurturing, soothing, and protection. From the book, "Hold Me Tight" by Sue Johnson, Page 6.
Imago Relationship Therapy, developed by Harville Hendrix and Helen LaKelly Hunt in the 1980s, offers another communication-focused approach. The term "Imago" refers to an unconscious composite image of one's primary caregivers that Hendrix theorizes influences partner selection. According to this model, individuals are drawn to partners who embody both positive and negative traits of their childhood caregivers, unconsciously seeking to heal early relational wounds through adult partnerships.
The central technique of Imago therapy is the "Imago Dialogue," a structured communication process with three components: mirroring, validation, and empathy. This structured format aims to create safety for vulnerable communication by ensuring each partner feels heard before any response is offered. Hendrix and Hunt describe three relationship stages—romantic love, power struggle, and conscious partnership—with therapy aimed at helping couples move from the conflict of the power struggle into conscious partnership where each becomes "the other's healer."
While these approaches differ in emphasis—Gottman focusing on behavioral patterns and interaction ratios, EFT targeting attachment emotions and relational cycles, and Imago exploring developmental origins of partner selection—researchers and clinicians increasingly recognize their complementary nature. Attachment theory provides the underlying explanation for why humans need secure bonds; EFT applies this therapeutically by accessing vulnerable emotions beneath defensive behaviors; Gottman offers specific behavioral interventions for daily interactions; and Imago addresses how childhood experiences shape adult relationship patterns. Many contemporary couples therapists work integratively, drawing from multiple frameworks based on what each couple presents.