3 Things Your Therapist Must Do in Couples Therapy

I recently submitted my first response to Help a Reporter Out (HARO). If you don't know what HARO is, it's a subscription service that connects inquiring journalists doing research for stories to experts hungry to provide them with a few good quotes (and get some publicity in the process).

Now, chances are I'm not going to get picked because these reporters get a lot of responses. So in the offchance I don't get instantly famous, I thought I'd share my thoughts with you. Here's the response in its entirety.

Hi So-and-So,

My name is Jeremy Mast (jeremymast.com) and I’m a licensed marriage and family therapist in Sierra Madre, California with experience in working with couples, especially those affected by infidelity and sex addiction.

I was intrigued by your excellent question about couples therapy. In response, let me offer the following thoughts:

There are a number of critical tasks that both the therapist and the couple participate in together. The behaviors of both the therapist and each partner can either contribute to or detract from these tasks. The treatment is in danger if these tasks cannot be achieved; likewise, the treatment is also in danger if they cannot be reestablished or repaired during the lapses in each that are inevitable in the course of therapy.

Couples Therapy Must-Do #1: Establishing Safety

Couples enter treatment in crisis. There may be a danger of domestic violence, abuse, or some other threat to physical safety. In cases of domestic violence, couples therapy may actually heighten the likelihood of abuse and therefore couples therapy is contraindicated. However, most couples need to begin to feel emotionally safe before the healing in conjoint treatment can begin.

To establish safety and build trust, the therapist early in treatment often needs to be more directive, limit negative exchanges between partners, and set help partners set boundaries in cases of infidelity or sexually compulsive behaviors. (In these cases, the offending partner can rebuild trust by sticking to the boundaries and being an “open book” to his or her spouse.) Therapists also need to help couples talk about their emotional pain differently. When they fight about finances, sex, family relationships, or anything else, partners are really fighting about their feelings about these topics, the topic’s meaning to each of them, and their emotional needs attached to and expressed through the topic being debated.

Therapists fail to help couples feel emotionally safe when they are misattuned to one or both partner’s feelings, so that one partner feels misunderstood. Therapists can also bring in their own “stuff” unawares, and if the therapist is not able to make this transference dynamic talkable, the couples therapy can end abruptly when one partner pulls out.

Couples Therapy Must-Do #2: Fostering Hope

Couples frequently come in to treatment years after they should have, so that the cancer of resentment, contempt, and pain has often metastasized and is well-advanced. Couples entering therapy often do not have much hope that the relationship can change, and even if they do, they have no idea how to change it. Therapists need to immediately offer hope to the couple that change is possible, even if it’s just a different experience of the relationship while they’re in the consulting room with the therapist.

The therapist can offer hope to the couple in two ways. First, the therapist must provide a strategy for managing and recovering from the current relational crisis. Such a strategy will help to contain the couple, providing them with new and different ways of managing their dysregulated emotions. Secondly, the therapist needs to help the couple “unpack” what is emotionally present for each partner in the conflict, which is usually centered around one or two really intractable problems that they have argued about for years. When a therapist can tune in to what is emotionally true for each partner, helping the couple track their feelings and needs, especially during conflict, each partner will begin to feel understood, and that with the therapist’s help, he begins to hope that his partner could understand too.

Couples Therapy Must-Do #3: Create Curiosity

In healthy, vibrant relationships, partners constantly explore each other’s emotional worlds. As the coupleship grows and each partner has new life experiences, partners stay interested in each other’s needs and feelings and freely discuss them with each other. Healthy couples feel free to be their most vulnerable selves with each other in an authentic way that creates connection, being empathically curious about each other’s experiences and promoting each other’s emotional growth.

Couples who start counseling have lost the ability to attune to each other with such curiosity. Instead, they get caught in vicious cycles of conflict where blaming, shaming, controlling, or withdrawing behaviors win the day. A key element of creating curiosity? Each partner needs to be recognized as the arbiter of what it emotionally true for him or her in the moment. The therapist can do this by validating the partner’s feelings in light of the current conflict and their relational and family history. The therapist can also foster curiosity by not “pulling rank,” offering her interpretations about what is happening as more true than what the partner understands about his experience.

If you are interested in talking to me further about the therapist’s and couple’s behaviors in therapy, please email me or call me at jeremy@sync.org or (626) 275-4607.

Sincerely,

Jeremy Mast, MS, MDiv, LMFT