Intimate Relationships and Psychopathology

Relationship functioning and individual mental health and well-being are strongly associated with one another. In this article, we first review the cross-sectional and longitudinal associations between relationship discord and various types of psychopathology, We then review findings suggesting that relationship discord is associated with poorer outcome for individual-based treatments for psychopathology and that, generally, relationship discord does not improve following individual-based treatments for psychopathology. Finally, we present a model for conceptualizing work with couples in which one partner has a psychiatric disorder and review the efficacy of couple-based interventions in the treatment for psychiatric disorders, with a focus on substance-related, mood, and anxiety disorders.     

Couples Therapy

The authors propose a more comprehensive definition of couples therapy since parenting and individual issues can impact so forcefully on spousal relationships. Couples therapy, is redefined as a therapy with both spouses concerning their individual, parenting, and marital functioning which is conducted in conjoint marital/family sessions and individual meetings with each spouse. A case example illustrates this approach which is called Comprehensive Family Therapy.     

Relational Couple Therapy with Post-Traumatic Survivors: Links Between Post-Traumatic Self and Contemporary Intimate Relationships

The present article describes a clinical case study of relational couple therapy with post-traumatic spouses. Survivors, who were infants and toddlers during the Holocaust, disclose tremendous difficulties in their intimate relationships. The early loss of parental figures, and cumulative traumatic experiences throughout survivors' lives in the post war era hampered their capacity for intimate partnership despite its ultimate necessity. Relational couple therapy creates an unfamiliar experiential space with the couple's bond. This experiential space enables each partner to change destructive emotional patterns within one's inner psychic reality as well as the couple's emotional system. In addition, the therapeutic triangle creates partial transformational boundaries between past traumas and the couple traumatic bonds.     

Treating Obsessive-Compulsive Disorder in Intimate Relationships: A Pilot Study of Couple-Based Cognitive-Behavior Therapy

Although cognitive-behavioral therapy (CBT) involving exposure and response prevention (ERP) is an established treatment for obsessive-compulsive disorder (OCD), not all patients respond optimally, and some show relapse upon discontinuation. Research suggests that for OCD patients in close relationships, targeting relationship dynamics enhances the effects of CBT. In the present study, we developed and pilot tested a 16-session couple-based CBT program for patients with OCD and their romantic partners. This program included (a) partner-assisted ERP, (b) techniques targeting maladaptive relationship patterns focal to OCD (e.g., symptom accommodation), and (c) techniques targeting non OCD-related relationship stressors. OCD, related symptoms, and relationship functioning were assessed at baseline, immediately following treatment (posttest), and at 6- and 12-month follow-up. At posttest, substantial improvements in OCD symptoms, relationship functioning, and depression were observed. Improvements in OCD symptoms were maintained up to 1 year. Results are compared to findings from studies of individual CBT for OCD and discussed in terms of the importance of addressing interpersonal processes that maintain OCD symptoms.     

Couples in Therapy: Actor-Partner Analyses of the Relationships Between Adult Romantic Attachment and Marital Satisfaction

This study was the first to investigate the relationship between adult romantic attachment and marital satisfaction in a clinical sample of 172 distressed couples seeking therapy. Fifty-six therapy-seeking nondistressed couples were also assessed for comparison. Analyses of variance showed that attachment avoidance was a distinctive characteristic of distressed couples. Actor-partner analyses revealed that attachment avoidance (for men and women) and attachment anxiety (for women only) were predictive of marital dissatisfaction for distressed couples. Gender-stereotype discordant partner effects were also found. Results suggest that attachment orientations (especially avoidance) are relevant predictors of marital dissatisfaction in distressed couples seeking therapy, and that couple therapists can gain important information by assessing partners’ attachment orientations.     

Adult Intimate Relationships and Psychological Adjustment

This study explored relations among perceived acceptance and behavioral control by intimate partners, remembrances of parents’ acceptance and behavioral control in childhood, and adults’ psychological adjustment. The study was conducted on 98 American adults (50 men and 48 women) between ages 18 and 50 (mean 26 years). Measures used were the Adult version of the Parental Acceptance-Rejection/Control Questionnaire for Mothers and Fathers(Adult PARQ/Control: Mother and Father); Intimate Partner Acceptance-Rejection/Control Questionnaire (IPAR/CQ); and, the Adult version of the Personality Assessment Questionnaire (Adult PAQ). Results showed significant positive correlations between psychological adjustment and perceived partner acceptance and parental acceptance for both women and men. Results also showed significant negative correlations between psychological adjustment and perceived partner control and parental control for both women and men. Regression analyses, however, revealed a significant independent effect of only paternal acceptance (but not of maternal and partner acceptance) on the psychological adjustment of men. Regression analyses also revealed significant independent effects of both paternal and maternal acceptance (but not partner acceptance) on the psychological adjustment of women.     

Couples Relationships of AFDC Mothers

SUMMARY

Virtually nothing is known about AFDC mothers and their relationships with their male friends. Yet such men are clearly an influence in their lives. Findings from a sample of 275 Baltimore AFDC mothers provide important exploratory data about the characteristics of these relationships and about how women who have a long-term male friend differ from AFDC mothers who do not. Implications for work with these couples are also presented.     

Mutual Exploitation in Intimate Relationships

SUMMARY

This article describes a systemic intervention designed to empower women who present individually in therapy and who perceive themselves as victims of exploitation within an intimate relationship. While appreciating the difficulty in recognizing, understanding and altering ingrained problematic interactional patterns, attention is rendered to the unwitting participation of women in the perpetuation of undesirable behaviors. Central issues surrounding constraining client cognitions, inculcated gender stereotyping, mutual invitations and therapist ethical/legal responsibility are discussed.     

Styles in Intimate Relationships: The A-R-C Model

From a continuum of differentiation in intimate or close and prolonged relationships the author derives a model based on three styles: Abuse-Atrophy (A); Reactive-Repetitive (R), and Conductive-Constructive (C).     

Core Energetic Couples Therapy

SUMMARY

Core energetics is a method of psychotherapy that seeks the integration of all aspects of humanity: the emotional, physical, mental, and spiritual. Based on a deep understanding of the ways in which energy and consciousness work together, the therapy, developed by John C. Pierrakos, MD, invites couples to experience their inner truth and to identify their universal life goals and core feelings. Core energetics emphasizes wholeness and unification without loss of individuation for the couple. This article describes core energetics as it is used in couples work; the theory, therapeutic stance, methods of diagnosis, and energetic techniques are discussed, as well as the focus on sexuality and Spirituality.     

No Fault Couples Therapy

A conceptual framework for treating couples who come into therapy desirous of changing the behavior of their partner. A case history is cited wherein sensitivity towards equality of input, power and responsibility for the couples' plight is continuously emphasized for each member of the pair. The histories of both partners are described in order to stress the no fault nature of the couples' conditions.     

Assessing Attachment of Couples in Therapy: A Factor Analysis of the Experiences in Close Relationships Scale

The overall goal of this study was to examine the factor structure of the “Experiences in Close Relationships” instrument (Brennan et al. 1998; ECR) for assessing adult attachment among a clinical sample by conducting a series of exploratory factor analyses (EFA). While the measure demonstrated high reliability and strong validity among the original sample of college undergraduates (Brennan et al.), the factor structure had yet to be examined among participants involved in therapy. It is unclear if any results obtained using the ECR extrapolate to populations other than the original sample. Our findings support the factor structure of the ECR for assessment of attachment anxiety and avoidance among a more diverse, clinical population. Noteworthy differences between men and women also were found in the clinical sample. Finally, clinical implications for use with clients participating in therapy are discussed.     

亲密关系中的日常冲突及其解决

亲密关系中的日常冲突常常会影响关系的质量,解决不好可能会导致关系恶化。本文回顾了亲密关系冲突研究的进程,特别对亲密关系日常冲突产生的原因、发展过程、冲突中的行为、解决冲突的方式等做了简要介绍。     

Perfectionism and Sexual Satisfaction in Intimate Relationships

This study sought to provide information on the relations between trait perfectionism and perfectionistic self-presentation and sexual satisfaction in married couples. A sample of 74 married or cohabiting couples were recruited from the community to participate in the study. They completed measures of perfectionism, perfectionistic self-presentation, sexual satisfaction, dyadic adjustment, and depression. The results showed that the interpersonal dimensions of trait perfectionism were negatively related to general sexual satisfaction and sexual satisfaction with the partner for both husbands and wives. After partialing out marital satisfaction and depression, the husband's sexual satisfaction was significantly negatively correlated with his own socially prescribed perfectionism and with his wife's ratings of other-oriented perfectionism. The wife's satisfaction was significantly negatively correlated both with her husband's socially prescribed perfectionism and with her own socially prescribed perfectionism, other-oriented perfectionism, and perfectionistic self-presentation. Regression analyses suggest that the wife's other-oriented perfectionism is a unique predictor of her general lower sexual satisfaction and her husband's lower satisfaction with her contribution to the sexual relationship. Overall, the findings suggest that perfectionistic expectations have an important role to play in sexual satisfaction in married couples.     

儿童的两种亲密人际关系:亲子依恋与友谊

以城市三所普通小学四、五、六年级的505名学生为被试,用问卷调查、团体施测的方式,探讨儿童亲子依恋与其友谊的关系,结果发现：在儿童友谊质量方面,父、母均有影响,在友谊的数量,如好朋友提名分方面母亲的作用也是显见的;亲子依恋特质的两成分(信赖、亲近)对儿童友谊质量的积极特征和冲突水平有相对不同预测力。     

EMDR and Emotionally Oriented Couples Therapy

When reviewing past and current research on the role of emotion in couples therapy, there appeared to be a lack of articulation concerning how emotional expressions and relational dynamics are affected by emotional trauma that has not been accessed. The authors demonstrate how emotionally and experientially oriented therapy with couples can be enhanced by accessing stored trauma through the use of Eye Movement Desensitization and Reprocessing (EMDR). This approach is called Eye Movement Relationship Enhancement (EMRE) therapy and includes key clinical areas such as accessing and tolerating previously disowned emotion, reprocessing emotional experiences, and amplifying couple intimacy. These key areas are discussed and illustrated with case examples.     

Sexuality and Intimacy in Couples Therapy

SUMMARY

In ages past, spiritual seekers left their close relationships for the seclusion of a monastery or a solitary journey, facing their dragons essentially alone. Today, however, many of us face the dragons within us as we undertake the tasks of differentiation and individuation. Thus, our relationships, if we allow them, can become the loci of our deepest self-exploration, leading to deepening intimacy with our partners.     

Evaluating Three Models of Intimate Relationships

The purpose of this study was to evaluate three models of intimate relationships: attachment, elementary pragmatic, and selfhood. These models were evaluated with three instruments respectively constructed to evaluate the validity of each model. One convenience group of functioning individuals and three experimental groups of inpatients and outpatients were administered the three instruments. All three instruments showed relatively high internal consistency and discriminated among the four groups. Significant correlations were found among the measure of attachment with measures of the pragmatic elementary and selfhood models. These correlations indicate that all three instruments were measuring similar aspects of intimate relationships. Clinical and preventive implications and applications of these models are briefly discussed.