Face It Head On

SUMMARY

This article focuses on key clinical ideas to help couples face directly the painful issues brought about by infidelity. The author discusses key relational processes related to infidelity along with desired outcomes. The emphasis is on helping couples change key relational dynamics that facilitate the healing process. Couples are encouraged to engage in the healing process head on, and not avoid or skirt around the issues. The article illustrates these desired changes by means of a case Study.     

Marital Problems Occurring in Midlife: Implications for Couples Therapists

The ability of therapists to adequately address the presenting problems of couples impacts the process and outcome of therapy. Although research has examined the types of problems that couples commonly experience, little is known about problems among midlife couples. Midlife marital problems were examined using data from a national random sample of 632 married people between the ages of 40 and 50. The results indicated that the most common problems were financial matters, ways of dealing with children, and sexual issues. Values, commitment, spiritual matters, and violence were the least common problem areas. There were few differences when gender, remarriage, and length of marriage were considered.     

Multiple approaches to the treatment of violent couples

Abstract

The relationship of the discrepancy between couple's actual level of intimacy and desired level of intimacy and marital adjustment was explored using data from 185 randomly selected couples who completed the Personal Assessment of Intimacy in Relationships and the Marital Adjustment Test. Multivariate and univariate regression analyses indicated that the discrepancy between actual and desired intimacy of husbands and wives was highly predictive of marital adjustment (R²=.665). Particularly interesting was that couples with low intimacy scores who did not desire more intimacy had good marital adjustment. The relationship between intimacy and marital adjustment was curvilinear, and wives' marital adjustment was more affected by intimacy than husbands'. Implications for marital therapy are discussed.     

The areas of change questionnaire: A cross-cultural comparison of israeli and american distressed and nondistressed couples

Abstract

This study examines Israeli couples' presenting complaints about their relationship, their perceptions of one another's complaints and perceptual accuracy between actual and perceived complaints, using the Areas of Change Questionnaire (ACQ). Samples were obtained of both distressed and nondistressed couples. Each sample met stringent criteria for categorization as distressed and nondistressed. Normative data for both samples are examined and areas of similarities and differences are discussed. The instrument is found to discriminate distressed and nondistressed Israeli couples. Results are compared with a previous study of American distressed and nondistressed couples. The American finding that women desire more change in marriage is not replicated in the Israeli sample, nor the American finding that distress and stage in the life cycle are related. However, there is an indication in both samples that men, compared to women, perceive more requests for change. Men in both cultures also feel more change is asked of them than they themselves ask in return.     

Self-Compassion and Forgiveness: Major Predictors of Marital Satisfaction in Young Couples

Abstract

This study examined self-compassion and forgiveness versus marital satisfaction in 200 couples aged 20-40?years, with a marriage history of 1-10?years. We collected the data, using the Enrich couple, self-compassion and family forgiveness scales. Pearson’s correlation and multiple regressions for women showed that marital satisfaction was associated with self-compassion; however, forgiveness predicted marital satisfaction in men. Self-compassion primarily and forgiveness, to a lesser extent, could predict marital satisfaction in the total samples. These variables were the predictors of marital satisfaction in the young couples. Family counselors should encourage couples to improve upon these attributes to enhance their marital relationships.     

A communal approach to sexual need responsiveness in romantic relationships

ABSTRACT

Sex is a crucial factor that impacts the quality and stability of relationships, yet many couples report recurrent sexual issues – such as discrepancies in their desired sexual frequency or levels of sexual desire – that detract from their relationship quality. This article describes how applying the theory of communal motivation from relationship science to the sexual domain of relationships can shed light onto understanding how couples can maintain desire over time, remain satisfied in the face of conflicting sexual interests, and decline one another’s sexual advances in ways that protect their relationship. We integrate a decade of research on communal motivation, sexual rejection, and responses to sexual rejection to provide a better, and more holistic, understanding of how partners can successfully balance their sexual needs to ultimately reap the powerful rewards of a fulfiling sexual connection.     

The differential effects of acute marital distress on emotional,physiological and immune functions in maritally distressed men and women

Abstract

We examined the impact of acute marital conflict on emotion, cardiovascular arousal, and immune function in men and women. Subjects were 10 heterosexual, distressed couples, who panicipated in exchange for marital therapy. Each couple participated in a 40 minute conflict induction regarding an area of difficulty in their relationship. During this induction, blood pressure and heart rate were monitored and blood samples were drawn pre- and post-induction for analysis of immune change. Women responded to the experimental induction with significantly greater increases in depression and hostility, and with significantly greater increases in SBP than men. Women also responded to the acute marital distress with slight decreases in lymphocyte proliferative response to PHA, while men displayed an increase in PHA response. The sex by time interaction was significant Change in PHA was associated with change in hostility and SBP.     

Appraisal of Memory Functioning and Memory Performance in Healthy Ageing and Early-Stage Alzheimer's Disease

ABSTRACT

Background/Aims: To compare memory evaluations in healthy older people and people with Alzheimer's disease (AD) and present standardised individual and dyadic methods for classifying degree of memory awareness in the participants with dementia. Methods: Cross-sectional study evaluating awareness of memory functioning and performance and providing normative data for healthy individuals and couples, together with comparison data from people with AD. Results: As a group, older people are reasonably accurate raters of their own memory functioning and performance, although considerable individual differences can be observed, and control dyads show good comparative accuracy. Comparing normative data from the control group to data from participants with AD confirms that significant overestimation is a frequent feature among people with dementia, with approximately two-thirds showing this pattern, although significant under-estimation is also reliably observed in a small proportion of people with dementia. Different types of measure elicit different profiles of memory awareness in participants with dementia. Conclusion: Normative data from older individuals and couples provides useful percentile-based indices for determining level of memory awareness in people with dementia.     

Anxiety across the transition to parenthood: change trajectories among low-risk parents

Background and Objectives: A number of sources suggest changes in anxiety across the transition to parenthood may be experienced by parents in different ways, yet no studies have examined whether new parents experience changes in anxiety in distinct subgroups. Design: We conducted a longitudinal study of 208 first-time parents (104 couples) from a low-risk population. Parents were interviewed from the third trimester of pregnancy to nine-months postpartum. Methods: The current study utilized latent class growth analysis to explore subgroups of change in symptoms of anxiety. Based on stress and coping theory, we also examined a number of personal and social prenatal predictors of subgroup membership. Results: We identified two distinct change trajectories: (1) moderate and stable and (2) low and declining. We also found prenatal depression, expected parenting efficacy, and relationship satisfaction were significantly associated with subgroup membership. Conclusions: Our results suggest a majority of new parents adjust well to parenthood in terms of anxiety, while a smaller subgroup of parents experience continually higher levels of anxiety months after the baby is born.     

Changes in Neuroticism Following Trauma Exposure

Using longitudinal data, the present study examined change in midlife neuroticism following trauma exposure. Our primary analyses included 670 participants (M_age = 60.55; 65.22% male, 99.70% Caucasian) who completed the NEO Personality Inventory at ages 42 and 50 and reported their lifetime exposure to traumatic events approximately 10 years later. No differences in pre‐ and post‐trauma neuroticism scores were found among individuals who experienced all of their lifetime traumas in the interval between the personality assessments. Results were instead consistent with normative age‐related declines in neuroticism throughout adulthood. Furthermore, longitudinal changes in neuroticism scores did not differ between individuals with and without histories of midlife trauma exposure. Examination of change in neuroticism following life‐threatening traumas yielded a comparable pattern of results. Analysis of facet‐level scores largely replicated findings from the domain scores. Overall, our findings suggest that neuroticism does not reliably change following exposure to traumatic events in middle adulthood. Supplemental analyses indicated that individuals exposed to life‐threatening traumas in childhood or adolescence reported higher midlife neuroticism than individuals who experienced severe traumas in adulthood. Life‐threatening traumatic events encountered early in life may have a more pronounced impact on adulthood personality than recent traumatic events.     

The Longitudinal Association of Marital Confidence,Time Spent Together,and Marital Satisfaction

Using three waves of dyadic data collected at 18‐month intervals from a community‐based sample of 610 newly married heterosexual couples (1 220 individuals), we examined the relationship between marital confidence, time spent together, and marital satisfaction using a modified actor‐partner interdependence model. Results indicate that after controlling for marital satisfaction and time spent together at Time 1, marital confidence around the time of marriage was associated with marital satisfaction approximately 3 years later. In addition, marital confidence was associated with how much time husbands and wives spent together at Time 2, which was related to marital satisfaction at Time 3. Tests of the mediating paths from marital confidence to marital satisfaction trended toward significance. The results suggest the importance of assessing for relationship confidence when working with couples in the early stages of their relationship.     

Interracial Relationships in Hawaii

SUMMARY

Given the increase in rates of intermarriages, it is vital that we understand the issues and benefits of interracial relationships and the ways in which therapists might assist interracial couples. Our focus in this article is on interracial relationships in Hawaii. Because of its history of promoting interracial ties and its plural character, Hawaii is, in many ways, a unique setting for interracial relationships. At the same time, there are relational issues, benefits, and needs faced by both mainstream U.S. interracial couples and interracial couples in Hawaii. There are a variety of therapeutic interventions that could be used to help interracial couples. This chapter examines the factors in Hawaii's past and present that contribute to its particular history of interracial relationships, the common challenges that face interracial couples, personal and relational benefits of interracial relationships, and the therapeutic interventions from which interracial couples may benefit.     

"If I had it to do over again...": midlife review, midcourse corrections, and women's well-being in midlife

Regrets about early adult life choices, expressed in midlife, are examined as a source of motivation for life changes in later midlife in 2 samples of women. Replicated findings with longitudinal data indicate that regret motivates goal setting but is not associated with actually making desired life changes. In both samples, women who had regrets about early adult life choices but did not make relevant life changes were lower in later well-being than both women with regrets who did make such changes and women without regrets. Compared with women who transformed regrets into life changes, women who did not were lower in effective instrumentality and higher in rumination, though they did not appear to face more barriers to change. Analyses with longitudinal data indicated that both rumination and effective instrumentality mediated the relationship between regret and well-being for women who did not translate regret into life changes.     

Dependency and Counter-Dependency in Couples

SUMMARY

There is a tendency on the part of many men in couples to deny their dependency needs, and for the women in these couples to view themselves as excessively needy. These uneven subjective perceptions are examined, as are the ways contemporary gender socialization interferes with the attainment of the ideal of mutual dependency in couples. Some implications for couples therapy are explored.     

Early life adversity potentiates the effects of later life stress on cumulative physiological dysregulation

Background and Objectives: Previous research indicates that early life adversity may heighten stress reactivity and impair mechanisms for adaptive coping, suggesting that experience of stress in early life may also potentiate adults' physiological vulnerability to stress in later life. The study tested this hypothesis by investigating whether the experience of stressful events and circumstances (SEC) in childhood or adolescence amplified the effect of adulthood SEC on physiological dysregulation (allostatic load, AL) in later midlife. Design: Observational data were used in the present study. Physiological functioning was measured in later midlife (participants' age ranged from 49 to 63 years). Both childhood/adolescence and adulthood SEC were reported retrospectively on the same occasion. Methods: Participants were 5309 Danish men and women from Copenhagen Aging and Midlife Biobank (CAMB). SEC included socioeconomic and family factors. The AL index was based on nine cardiovascular, metabolic, and immune biomarkers. Results: Experience of SEC in both early life and adulthood independently predicted higher AL. In men, experience of SEC in early life also potentiated the effect of SEC in adulthood on AL. Conclusions: The results provide further insight into the mechanisms behind the “biological embedding” of childhood stress.     

Assessing and treating sexual dysfunctions in Orthodox Jewish couples: a summary of 41 consecutive cases

ABSTRACT

Orthodox Jews are a distinct subgroup with specific beliefs and values towards sexuality, reproduction, modesty, and openness to mental health treatment. This paper reviews the treatment of 41 Orthodox Jewish couples who presented for sex therapy. Most couples were referred by a rabbinical leader. The most common presenting problem was an unconsummated relationship; present in 27 couples. In 34 couples the initial presenting complaint was a male sexual problem yet in 20 of 41 couples both partners described having some sexual problem. Almost 50 per cent of both men and women were also diagnosed with a comorbid psychiatric disorder, which was almost always previously undiagnosed. The most common presenting problems were vaginismus, male inhibited arousal, and/or inhibited male orgasm. Two case examples illustrate some adaptations to assessment and treatment that can be helpful in treating sexual problems in Orthodox Jewish couples.     

Editorial: The Future and the Cutting Edge of Family Therapy

Abstract

In this exploratory study, we examined psychophysiological arousal when partners engaged in the common practice of discussing romantic trials with one another and with friends. To capture stress, we measured Galvanic Skin Response (GSR), Heart Rate Variability (HRV), and Respiration Rate (RSP). Paired t-tests from a dyadic sample of 71 heterosexual couples revealed talking about romantic problems, in general, was accompanied by elevated psychophysiological stress. GSR scores suggested partners were more stressed when speaking with friends than to one another about relationship challenges. Universally, males had higher GSR scores and females higher RSP. We discuss therapeutic implications and future directions.     

Profiles of dyadic adjustment for advanced prostate cancer to inform couple-based intervention

Objective: The purpose of the study is to describe from a relational perspective, partners’ psychological adjustment, coping and support needs for advanced prostate cancer.

Design: A mixed methods design was adopted, employing triangulation of qualitative and quantitative data, to produce dyadic profiles of adjustment for six couples recruited from the urology clinics of local hospitals in Tasmania, Australia.

Methods: Dyads completed a video-taped communication task, semi-structured interview and standardised self-report questionnaires.

Results: Themes identified were associated with the dyadic challenges of the disease experience (e.g. relationship intimacy, disease progression and carer burden). Couples with poor psychological adjustment profiles had both clinical and global locus of distress, treatment side-effects, carer burden and poor general health. Resilient couples demonstrated relationship closeness and adaptive cognitive and behavioural coping strategies. The themes informed the adaption of an effective program for couples coping with women’s cancers (CanCOPE, to create a program for couples facing advanced prostate cancer (ProCOPE-Adv).

Conclusion: Mixed method results inform the development of psychological therapy components for couples coping with advanced prostate cancer. The concomitance of co-morbid health problems may have implications for access and engagement for older adult populations in face-to-face intervention.     

Introduction

Abstract

This article provides a beginning exploration of the pro cess involved in becoming an emotionally focused therapist. The under lying assumptions of emotionally focused therapy (EFT) are identified and examined in relation to how the theory affects therapeutic practice with couples and families. A number of themes are outlined including fit between the therapist and EFT, the challenges of working within this model and transference issues. The authors utilize examples from their supervisory experience in training therapisLs to illustrate common strug gles, pitfalls and the necessary clinical set required in becoming an emo tionally focused therapist.     

Sexual well-being and perceived stress in couples transitioning to parenthood: A dyadic analysis

Background/ObjectiveThe transition to parenthood encompasses several psychological and relational changes that might contribute to couples’ high levels of stress postpartum. Although common across the postpartum, couples’ sexual changes are frequently overlooked.MethodWe surveyed 255 mixed-sex new parent couples to examine the associations between sexual well-being—sexual satisfaction, desire, and postpartum sexual concerns—and perceived stress postpartum. Couples completed self-report questionnaires assessing perceived stress and sexual well-being.ResultsFor both mothers and fathers, greater sexual satisfaction was associated with their partners’ lower perceived stress and, for fathers, this was also associated with their own lower perceived stress. For mothers, greater partner-focused sexual desire was associated with their own lower perceived stress whereas, for fathers, greater partner-focused sexual desire was associated with their partners’ higher perceived stress. In addition, greater solitary sexual desire and postpartum sexual concerns were associated with both parents’ own higher perceived stress.ConclusionsThis study highlights the association between sexual well-being and couples’ postpartum stress, suggesting that more positive sexual experiences are linked to lower perceptions of stress across this vulnerable period. Couples’ sexual well-being may be an important target for interventions aimed at helping postpartum couples cope with stress.