Issues Treated in Therapy:
All relationships require work--the work of communication, compromise, and compassion. When a relationship seems to require more work than the partners can offer on their own, but there is a desire to maintain the relationship, a couple may seek professional assistance. People may also seek relationship counseling for premarital counseling, parenting issues, changes in the nature of the relationship (regarding monogamy and other commitments, for instance), divorce counseling, terminal illness of one partner, and many other reasons.
People seek relationship counseling for a variety of reasons. The most obvious reason people attend couples counseling is when the partners in a relationship are having difficulty getting along. Couples often present with communication troubles, frequent arguments, emotional ups and downs, feelings of distance, betrayal, or contempt, affairs, or disagreements over basic relationship issues such as children, money, sex, or time. Couples often come in to counseling hoping a therapist can help in some way--though they may not know just how they expect the therapist to help. Some may expect the therapist to choose sides and decide “who’s right.” Other couples may want a mediator for their arguments, or to learn communication skills. It’s important to discuss expectations with your therapist, to ensure they are realistic and agreeable to all parties.
Therapists have different philosophies. Some therapists see relationship work as generally being intended to preserve a relationship, unless there is very serious, prolonged abuse or infidelity. Other therapists believe that dissolving relationships is often best, and are more apt to allow the therapy process to unfold naturally without a predetermined goal of “saving” the relationship. Healthy relationships are mostly full of joy and peace. Ending one that is not might be the healthy choice, even if it is difficult.
Despite these different approaches, therapists as a rule respect client self-determination. Most relationship counselors will neither recommend preserving nor dissolving a relationship; instead, they will help each partner communicate more clearly their needs, thoughts, and emotions, and listen more carefully to the other partner, and they will help the couple as a couple, by supporting the goals the couple agrees to--whether the goal is to “stay together forever,” “stop fighting”, “make the transition to being friends”, or just “learn more about each other and ourselves.”
Some therapists may recommend to a particular couple that the partners engage first in individual therapy, separately, before engaging in couples work. If both partners are not able to maintain a certain level of insight, responsibility, and maturity in their communications, couples work may be ineffective. For relationship counseling to significantly help a relationship, each partner needs to have a commitment, if not firmly to the relationship, at least to the relationship counseling for the time it continues. Each partner must be generally honest, self-aware, and interested in doing relationship work. Each must be willing to take responsibility for part of the troubles of the couple--and for the couple’s goals.
Ordinary rules of confidentiality raise unique issues in relationship work. Some therapists will only engage in relationship counseling if both partners waive their right to privacy from the other partner. This prevents one partner from sharing a “secret” with the therapist and undermining the trust and equality of the therapy relationship by keeping the secret--and forcing the therapist to keep it--from the other partner.
All couples argue sometimes. However, relationships where fighting has crossed into abusiveness may be especially unsuitable for relationship counseling, until the abuse has ended and each partner has received individual therapy. In relationship work, honesty, assertiveness, healthy boundaries, and the safety of each partner are paramount and encouraged. In an abusive relationship, honesty and assertiveness can be a risk to safety. Healthy boundaries are not present in an abusive relationship. Some therapists will not engage in relationship counseling if violence has occurred, unless and until both partners show tremendous growth in the areas of boundaries and safety.
There is no actual diagnosis for a relationship problem; instead, some professionals (and insurance companies) may note a “condition” known, imaginatively enough, as “partner relational problem.” However, relationship problems can be associated with diagnoses in two ways. First, chronic relationship conflict or emotional difficulty can certainly contribute to clinical mental health conditions like depression or anxiety. Second, the presence of certain illnesses may seriously impede the health of a relationship.
Rachel and Paul, in their 30’s, enter counseling because they have been “fighting” often. Inquiry reveals the fights are verbal and very emotional but not physical. In sessions, the couple is affectionate but anxious, and the two make little eye contact with one another. They interrupt one another but don’t seem to mind. They report fighting about “everything” and “stupid things.” Both profess a desire to “make it work.” The therapist approaches the work in several ways. First, he encourages the partners to speak directly to one another, and helps them choose language that is honest and tender. Second, he facilitates the uncovering of patterns of thought, emotion, and action that are not working, and offers alternatives. Third, he interprets the family of origin issues that may have led to those patterns, enhancing the mutual empathy and understanding between Paul and Rachel.
Please note that pre-marital counseling, affair recovery, emotional abuse, domestic violence, reproduction, sex and sexuality, and other topics pertinent to marriages and relationships are covered in separate sections of GoodTherapy.org.
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Last updated: 05-14-2013
Relationships and Marriage Articles