Heterosexual, lesbian, and gay male relationships: a comparison of couples in 1975 and 2000

This study examined the differences among lesbians, gay men, and heterosexuals at two points in time (1975 and 2000) using responses of 6,864 participants from two archival data sets. Groups were compared on variables representing equality of behaviors between partners in seven realms: traditionally "feminine" housework, traditionally "masculine" housework, finances, support, communication, requesting/refusing sex, and decision-making. In addition, the current study compared monogamy agreements and monogamy behaviors reported by the two cohorts of couple types. Overall, the results indicate that on the equality variables, there have been many statistically significant behavioral shifts among the different sexual orientations across 25 years. In addition, all couple types reported substantially greater rates of monogamy in the year 2000 than in 1975. The present study has important clinical implications for therapists working with couples because it provides new baseline evidence regarding how couples now interact with one another (especially about monogamy) and how this has shifted over time. In addition, it elucidates the differences that still exist between different couple types, which could serve to inform couple therapists as they strive to become more culturally competent working with same-sex couples.     

A Combined-Constructionist Therapeutic Approach to Couples Experiencing Erectile Dysfunction: Part II

This paper is Part II of an exploration of the treatment and conceptualization of Erectile Dysfunction (ED). In the past two decades, there has been a shift in the treatment of Erectile Dysfunction to more medically based approaches. Part I of the paper presented the role of biomedical and organic factors involved in ED. However, although important for the couple therapist to understand, by focusing only on the bio-medical aspects of ED, the couple may face new issues in their considerably different relationship with sex now a part of their lives. The current paper, while respectful of the medical model approach, emphasizes the overall quality of the couple relationship, presenting information on the psychological and systemic therapies and issues that may be related to Erectile Dysfunction, encouraging a combined-constructionist approach.     

Wives' and Husbands' Cortisol Reactivity to Proximal and Distal Dimensions of Couple Conflict

Poor marital quality has been linked repeatedly to spouses' health problems, with alterations to physiological stress response systems, such as the hypothalamic‐pituitary‐adrenocortical (HPA) axis, as one putative mechanism. This study assessed wives' and husbands' HPA axis (i.e., cortisol) reactivity to marital criticism during laboratory‐based conflict discussions, in the context of marital aggression experienced during the previous year. Ninety‐five couples provided one saliva sample prior to—and three samples following—a triadic family conflict discussion involving their teenage child. Marital criticism during the conflict discussion was related to heightened HPA reactivity for husbands only. For wives, an interaction emerged between criticism during the conflict and previous‐year marital aggression: only those wives who had experienced high levels of marital aggression demonstrated a positive association between criticism and cortisol output. Husbands thus appeared to be more physiologically reactive to the in‐the‐moment critical behaviors, whereas wives' responses to proximal conflict were related to previous and perhaps more chronic experiences of marital aggression. These findings shed light on ways in which within‐couple processes during family conflicts involving children contribute to individual physiological functioning, enhancing our understanding of the role of family relationships in physical health outcomes.     

The Brief Accessibility,Responsiveness, and Engagement (BARE) Scale: A Tool for Measuring Attachment Behavior in Couple Relationships

This article describes the purpose, reliability, validity, and potential clinical applications of the Brief Accessibility, Responsiveness, and Engagement (BARE) scale. In addition to focusing on the central attachment behaviors of accessibility and responsiveness, this instrument highlights the key role of engagement in couple bonding. The BARE is a short, systemic, self‐report measure of attachment behaviors in couple relationships. Both classical testing theory and Item Response Theory were used to test the psychometric properties of the instrument. The BARE demonstrated appropriate reliability and validity while maintaining its brevity and potential usefulness for clinicians and researchers. The BARE also accurately predicted the key relationship outcomes of stability and satisfaction. The data for this study were collected from the RELATE assessment (see www.relate-institute.org ).     

Couple Therapy in the Presence of Mental Disorders

Abstract

Mental disorders and relationship discord commonly occur together and couples where one or both parties suffer from a mental disorder are commonly seen in couple therapy. Symptoms of mental disorders can usefully be conceptualized cybernetically and viewed as part of negative feedback loops that couples become trapped in without denying the potential contribution of biological or other types of knowledge. Most of the existing research focuses on couples and depression and couple therapy has been found to have efficaciousness as a treatment of depression especially when depression occurs along with relationship discord. There is less research on couple therapy and other mental disorders but general guidelines are offered that couple therapists can use with any of the mental disorders.     

Gendered Power in Cultural Contexts: Part II. Middle Class African American Heterosexual Couples with Young Children

When race and gender intersect, understanding gendered power may be complicated. The authors first describe the historical context that serves as important background for understanding gender and power in heterosexual African American relationships. Then they show how family solidarity in the face of social injustices often overrides gender equality as a goal for middle class African American couples with young children. The findings illustrate pragmatic equality within couple relationships and the willful suspension of gender roles for the well-being of the family as a whole. However, gendered power impacts couples in a variety of ways. Sometimes a woman's fear that the man might leave, for example, diminished her power in the relationship. Often a woman accommodated a man's greater power in the family because of her perception that he was often denied power in the larger society. Societal discrimination of women was less visible to couples. Implications for practice are provided.     

Perceived Match or Mismatch on the Gottman Conflict Styles: Associations with Relationship Outcome Variables

Gottman has proposed that there are 3 functional styles of conflict management in couple relationships, labeled Avoidant, Validating, and Volatile, and 1 dysfunctional style, labeled Hostile. Using a sample of 1,983 couples in a committed relationship, we test the association of perceived matches or mismatches on these conflict styles with relationship outcome variables. The results indicate that 32% of the participants perceive there is a mismatch with their conflict style and that of their partner. The Volatile‐Avoidant mismatch was particularly problematic and was associated with more stonewalling, relationship problems, and lower levels of relationship satisfaction and stability than the Validating matched style and than other mismatched styles. The most problematic style was the Hostile style. Contrary to existing assumptions by Gottman, the 3 matched functional styles were not equivalent, as the Validating Style was associated with substantially better results on relationship outcome measures than the Volatile and Avoidant styles.     

Vulvar pain: a phenomenological study of couples in search of effective diagnosis and treatment

Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of ... the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships.     

How Race Matters and Does Not Matter for White Women in Relationships with Black Men

SUMMARY

Drawing on a qualitative research study, this article provides a beginning exploration for how race both matters and does not matter in white women's relationships with black men. As a means of protecting themselves and their families from pathologizing stereotypes about interracial couples, women make claims that race does not matter. At the same time, they describe ways that stereotypes impact their self identities and their couple interactions. Different situations and relationships create shifts in racial interpretations, and contact with extended family members can change racial meanings. The article offers suggestions for how to create a therapeutic space for discussing race without over-determining its significance.     

Bisexual Issues in Same-Sex Couple Therapy

SUMMARY

The bisexual identity of a partner in a same-sex couple may not be an issue in the relationship, or it may introduce fear, mistrust, and divisiveness. Mixed-orientation couples face problems stemming from the dichotomizing of sexuality, negative myths and stereotypes, and lack of awareness of models and resources. It can be particularly problematic when a partner's bisexuality is first addressed within a committed relationship. Case examples illuminate some of the issues. Therapeutic tasks include addressing the context of oppression, assessing developmental stages of sexual identity and the relationship, clarifying personal meanings of bisexuality, providing education and resources, and, possibly, facilitating negotiations regarding safer sex and polyamory. Optimal couple therapy provides affirmation of bisexuality, validation of same-sex relationships, and reflection of the partner's and relationship's strengths.     

Integrating Sex and Couples Therapy: A Multifaceted Case History

Traditionally, sexuality has not been a focus in couples therapy training, research, or practice, although it is an important, often complex issue for many couples. This article tells the story of a couple presenting for sex therapy due to their unconsummated marriage, and is told to exemplify how sex therapy and couples therapy can be integrated in order to best meet the needs of couples. As the story unfolds, the multilayered facets of the presenting issue are revealed. The therapy incorporates and weaves together family of origin history, intrapsychic and cognitive issues, relational dynamics, patterns of interaction, and physiological/medical concerns into a postmodern couples therapy with behavioral interventions. This combined approach recognizes the value of each method on its own and their greater usefulness when blended together.     

Reconsidering the Term <Emphasis Type="Italic">Marriage</Emphasis> in Marriage and Family Therapy

This article presents a consideration of whether the term marriage in the title of the marriage and family therapy (MFT) profession continues to reflect the work that MFT professionals do. The authors describe relevant historical and professional identity issues, a rationale for revising the title of the profession (including demographic trends related to marriage and relationships, patterns of clinical practice, and the political context surrounding marriage), and a rationale for maintaining the current title of the profession (including administrative costs, value and ideological differences within the MFT profession, and the importance of a cohesive professional identity). The article concludes with recommended future directions for the profession’s decision makers, researchers, and practitioners.     

The limitations of "vulnerability" as a protection for human research participants

Vulnerability is one of the least examined concepts in research ethics. Vulnerability was linked in the Belmont Report to questions of justice in the selection of subjects. Regulations and policy documents regarding the ethical conduct of research have focused on vulnerability in terms of limitations of the capacity to provide informed consent. Other interpretations of vulnerability have emphasized unequal power relationships between politically and economically disadvantaged groups and investigators or sponsors. So many groups are now considered to be vulnerable in the context of research, particularly international research, that the concept has lost force. In addition, classifying groups as vulnerable not only stereotypes them, but also may not reliably protect many individuals from harm. Certain individuals require ongoing protections of the kind already established in law and regulation, but attention must also be focused on characteristics of the research protocol and environment that present ethical challenges.     

A Combined- Constructionist Therapeutic Approach To Couples Experiencing Erectile Dysfunction: Part I

Marked changes have occurred in the conceptualization and treatment of Erectile Dysfunction (ED) in the past two decades. Emphasis has shifted to the role of biomedical and organic factors using medical and surgical interventions in the etiology of sexual dysfunction, deemphasizing the quality of the overall couple relationship. However, by using only a medical approach, the couple is left with balancing the positive and negative facets of a considerably different relationship with sex now in their lives and their relationship. This paper is Part I of a two part article on erectile dysfunction. Part I presents information on the bio-medical factors that may be related to ED and the medical model treatment approaches. Part II presents information on the psychological and systemic issues that may be related to erectile dysfunction, encouraging the use of a combined-constructionist framework.     

A gender-informed model of couple and family therapy: Relationship enhancement therapy

The key elements of gender-informed couple therapy are discussed with an emphasis on the significance of empathy and dialogue and the structuring of a context in which both can occur. Relationship Enhancement therapy, a psycho-educational and client-centered approach developed by Guerney (1977) is described and illustrated as one method of operationalizing a constructivist-systemic approach to couple therapy in which a conversation toward profound changes in gender relationships can take place.     

I Said,You Said: A Communication Exercise for Couples

The “I Said, You Said” technique leads the couple through a series of communication exercises that emphasizes the power of verbal and non-verbal cues. Initially, non-verbal cues that a couple uses to interpret each other’s spoken words are decreased to reduce the outside influences of attributed meaning. This allows the couple to focus on the clarity of the spoken message. Additional steps in this technique include restructuring speaker and listener roles, education about communication patterns, and learning how to communicate with more clarity and effectiveness, even when topics are emotionally laden. A brief vignette using the intervention follows this discussion.     

The Contribution of Emotionally Focused Couples Therapy

This article describes emotionally focused couple therapy and the contribution of this model to the field of couple therapy. A focus on emotional processing in the present moment, on process factors and on a genuine empathic connection with both clients is at the heart of this model. The creation of new patterns of emotional responses results in the creation of key new interactional responses. EFT is empirically validated on several levels: on the level of treatment outcome, and on the levels of the relational theory in which it is based and key moments and factors in the change process.     

Gendered Power in Cultural Contexts: Part III. Couple Relationships in Iran

Sometimes therapists assume that gender equality is not relevant when working with couples from traditional cultures. This study of couples in Iran suggests more complexity. The authors identify a variety of views and practices regarding equality between men and women in relationships. Some aspired to traditional roles; others attempted to create mutually supportive relationships. Yet others were somewhere in-between. This study helps identify important dimensions that may be overlooked when we define couple equality only by American standards or understand it only through a Western lens. The study provides insight into the dilemmas couples face when ideals of equality intersect with societal structures that maintain gendered power and offers suggestions for addressing gender when working with couples with traditional cultural backgrounds.