Control of the Mind Edited by Seymour M. Farber and Roger H. L. Wilson

Abstract

This article describes an innovative model of couples therapy designed to mitigate marital instability. The authors suggest that combining ongoing couples therapy with a separate relationship-focused group for each partner favorably impacts each person’s neuropsychophysiological regulation and their ability to participate in a stable intimate marriage.

The neurobiology of attachment theory is seen as providing understanding of the affect regulation issues operational in many couple relationships. The safe and secure attachments worked out in the relationship-focused group therapy are seen as improving neuropsychophysiological integration and regulation.     

Basic Considerations in the Application of Therapy and Education to Parent Groups

This article presents a couples group therapy treatment approach that uses analytic object relations concepts such as transference/countertransference, projective identification, containment, and the holding environment. Object relations theory is seen as the most useful theory with which to view couple interaction because it is based on a two-person psychology and focuses on the impact of relational systems on the development of the person. This includes the idea that the person grows within the attachment to another person. Group therapy is seen as a more effective treatment approach because the group is a resilient holding environment that provides an avenue in which projective identifications can be understood and contained, power can be redefined, isolation of the couple can be decreased, and the couple's responses can become more versatile. The model described is illustrated with clinical vignettes from an open-ended couples group.     

Solution-focused Couples Therapy Groups: An Empirical Study

The professional literature contains numerous theoretical and case study articles regarding the development and use of solution-focused therapy. However, as with many models of systems-oriented therapy in use with couples, very little has been subjected to empirical investigation. This project was designed to make a contribution to the empirical literature regarding the effectiveness of solution-focused therapy in use with couples' groups. This study utilized pre-test comparisons of treatment and comparison groups, and examined pre- to post-test changes in the scores of the treatment group couples. Twenty-three treatment group couples participated in a six-week solution-focused couples therapy (SFCT) group. A separate group of thirteen couples served as a comparison group. The Dyadic Adjustment Scale (DAS) was used to assess changes in the couples' relationships. Scores on the Marital Status Inventory (MSI), as a pre-test measure indicating the couples' likelihood of divorce, indicated no significant differences between groups. The remaining analyses revealed significant improvement in DAS scores. Self-reports from the couples involved indicate improvement in a variety of areas after completing the six-week solution-focused couples group therapy process.     

Coping with interpersonal stress: role of big five traits

Seventy-one couples living in a stepfamily context reported interpersonal family stressors and related coping strategies daily for 1 week in a daily process study. The role of personality and of the stressful context in each of the spouse's coping was examined. Personality was assessed via the Five-Factor Model (Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness). Two types of stressors emerged as primary dimensions of stepfamily stress: marital conflict and child misbehavior. These were treated as contextual factors in multilevel modeling analyses examining the independent and interactive effects of personality and situation on coping. Nine subscales of coping were examined based on three main functions of coping: problem-, emotion- and relationship-focused. Both the situational context and the five dimensions of personality examined were significantly and independently related to coping-strategy use. Moreover, there were significant personality-by-context interactions. The present study highlights the importance of considering personality in context when examining coping behaviors.     

A comparison of attachment outcomes in enactment-based versus therapist-centered therapy process modalities in couple therapy

Attachment issues are viewed by many therapists as lying at the heart of couple distress. It is critical to empirically validate therapy processes that facilitate couples in responding to each other's attachment needs. This study examined enactments as a therapy process and change mechanism to promote secure attachment in couple therapy. Sixteen couples were randomly assigned to 1 of 2 experimental groups--1 group received 3 therapist-centered sessions followed by 3 enactment-based sessions, and a second group received 3 enactment-based sessions followed by 3 therapist-centered sessions. To measure between-session and within-session change, each spouse completed presession and postsession measures of attachment security each week. Results showed that couples who received enactment-based sessions first reported greater increases in attachment security than those receiving therapist-centered sessions first. These same couples continued to show improvement after switching to the therapist-centered sessions. Conversely, couples who received therapist-centered sessions first did not increase attachment after switching to enactment-based sessions. For wives, enactment-based sessions produced the greatest improvement in attachment, yet both therapy process modalities led to some improvement. Conversely, for husbands, attachment improved only when they received enactment-based sessions first. Enactment-based sessions may therefore be more important for husbands than wives. Overall, with some qualification it appears that enactment-based therapy process may improve attachment more than a therapist-centered process. These observed trends and findings are generally consistent with previous research supporting use of enactments in couple therapy.     

Negotiating an Open Marriage in Couple Therapy

Open marriages as arrangements between married couples to explore sexual and emotional intimacy with partners outside the marriage have been documented in research in other countries. This paper focuses on two case examples of couples seen in therapy to negotiate an open marriage. This is a new therapeutic trend in India, driven by various social and cultural changes. The therapeutic processes and the key challenges in working with couples in open marriages are outlined. Implications for couple therapy practice in the Indian socio-cultural context are explored.     

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.     

Treatment of alcoholic couples in outpatient group therapy

This paper summarizes special issues that group leaders are likely to encounter when adapting their skills to outpatient group therapy with alcoholic couples. More specifically, the paper: (a) discusses the advantages of treating alcoholic couples in a group as opposed to individual couple's therapy; (b) outlines the parameters of a couples group with alcoholic members that differentiate it from working with other kinds of couples in group; and (c) provides guidelines and techniques for tackling some of the specific kinds of problems and situations that arise.This paper was presented at the Annual Meeting of the American Group Psychotherapy Association, New York City, February, 1985.The author wishes to acknowledge the contribution of Geraldine Alpert, Ph.D., whose thoughtful comments and discussion helped to crystallize the concepts presented.     

The Effect of Problem-Solving Based Family Therapy on Emotional Intimacy and Marital Quality of Cultural Couples in Tabriz

Abstract

This study aimed to investigate the effect of problem-solving based family therapy on the emotional intimacy and marital quality of cultural couples in Tabriz. The research method was quasi-experimental by designing the pretest and post-test with the experimental group. The statistical population of this research consisted of all cultural couples with marital problems referring to counseling centers of Tabriz Education in 2019. The research sample based on The Cochran formula consisted of 32 couples that were selected by purposeful sampling and were randomly assigned into two experimental and control groups. The experimental group was exposed to 10 sessions of problem-solving based family therapy and the control group received no interventions. The research tool was the Marital Quality Index and the Intimacy Questionnaire, which was completed by both groups at the beginning and end of the intervention. The collected data were analyzed using SPSS software and inferential statistics of covariance analysis were also investigated. The results of covariance analysis showed that problem-solving based family therapy had a significant impact on the emotional intimacy and marital quality of cultural couples. Therefore, problem-solving based family therapy can be used as a treatment in couples with marital problems.     

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.     

Infertility, “Experientially Oriented” Couples Therapy and Subsequent Pregnancy

SUMMARY

Four couples who had been diagnosed as clinically infertile were seen in experientially oriented couples therapy. Each couple conceived a baby shortly after a particularly powerful session. These ' sessions are described. The commonality across these sessions involved opening up the clients' inner experiencing and enabling these clients to actualize and integrate whatever was deeper within. The conventional biomedical and psychoanalytic approaches to infertility are described. The experiential model provides an alternative way to understand the timing of pregnancy or lack thereof. It also offers a holistic approach to working with infertile couples.     

Implementing a teacher-student relationship program in a high-poverty urban school: Effects on social, emotional, and academic adjustment and lessons learned

The primary purpose of this investigation was to examine the effects of a program designed to improve adolescents' relationships with at least one teacher in an urban high school. All participating students were nominated by teachers as having significant emotional and behavioral problems and approximately half of these youth were randomly assigned to an intervention that included increased positive involvement between each student and one teacher within the school. Teacher ratings of students' social, behavioral, emotional, and academic adjustment at pre- and post-intervention indicated that students in the intervention group had higher grade point averages than did students in the control group following the 5-month intervention but no differences were observed on other variables. Challenges associated with conducting school-based, relationship-focused interventions in high-poverty urban environments and several lessons that were learned in the process of initiating this project are discussed.     

Depression and power in mariage

To investigate the association between depression and power within marriage, fourteen couples in which the female partner was depressed were compared with fourteen non-depressed couples on a range of variables which assessed power bases, processes and outcomes, three domains identified in Cromwell and Olson's (1975) analysis of marital power. Compared with non-depressed couples, those containing a depressed female partner had distinctive profiles, and a subset of the characteristics of these couples was uniquely associated with depression and quite distinct from the couples' levels of marital satisfaction. The results are discussed in terms of theories of power in relationships and are seen to highlight the importance of including marital therapy as part of a treatment package for married women with depression.     

Initiating a Couples Group

Couples-group therapy is thought of as a helpful treatment for most couples, and as a primary treatment for married couples who have longstanding problems of a rigid and chronic nature. It is most useful for couples for whom blaming, power plays, and suppression of anger are prominent modes of interaction. Couples-group therapy is helpful to these couples because the group is a microcosm of society, provides a wide variety of coping styles, and offers observable alternatives to dysfunctional behaviors. A group dynamic also decreases the couple's sense of isolation. Issues relevant to starting a couples group--indications, contraindications, policies and balancing a group--are discussed. Clinical vignettes from ongoing open-ended couples groups are presented to illustrate the points made.     

A substantive and methodological review of couples group therapy outcome research

Outcome research on couples' group therapy is reviewed and discussed in terms of substantive findings and relevant methodological components. Research to date has found couples group therapy to be as effective as either individual, conjoint, or non-spouse group formats. These results, however, are based on the findings of only five studies, all of which displayed methodological limitations. Suggestions for future research involving couples groups are discussed.     

Enhancing social relationships through positive psychology activities: a randomised controlled trial

Despite the robust relationship between well-being and social relationships, the latter has received little examination within positive psychology activities (PPAs). This study aimed to test whether kindness- and gratitude-based PPAs, through positive social interaction with peers, enhanced relationship satisfaction. Using a longitudinal randomised controlled design, 225 participants were assigned to one of three conditions (relationship-focused, self-focused or control) and completed measures of relationship satisfaction, social support and happiness on three occasions (baseline, post-intervention and six weeks). The experimental PPAs were relationship-focused (involving social interaction) or self-focused (no social interaction). Those who completed relationship-focused PPAs had greater increases in relationship satisfaction than the self-focused and active control activities at six-week follow-up. Additionally, only those in the relationship-focused condition felt their existing friendships had improved at intervention cessation. Regardless of participants’ initial levels of social support, the intervention effects remained. In conclusion, PPAs fostering social kindness and gratitude significantly strengthened relationship satisfaction.     

Therapeutic Assessment with couples

Therapeutic Assessment can be helpful to many types of couples, including (1) those who are considering marriage and wish to know each other more deeply, (2) long-term couples who are in distress and considering separating, and (3) couples who have decided to separate but wish to better understand why they were unable to stay together. This article comprises the first complete case study of Therapeutic Assessment (TA) with couples. I describe how those steps common to all forms of TA (initial sessions, extended inquiries, assessment intervention sessions, and summary/discussion sessions) differ when applied to couples. I also discuss the use of the Consensus Rorschach as an assessment intervention with long-term distressed couples engaged in problematic projective identification. The case example involves a young heterosexual couple married for 12 years who were at an impasse in couples therapy. The assessment helped the partners explore mutual conflicts around the expression of anger and dependency needs, and to resolve a power imbalance within the couple. Long-term follow-up showed that the Therapeutic Assessment helped the couple have more compassion for each other and move beyond the destructive role-lock they had fallen into. Also, the referring therapist reported that the TA helped resolve the impasse in the couples’ therapy.     

A comparison of sexually dysfunctional, maritally disturbed and well-adjusted couples

Married couples seeking sex therapy, marital therapy, or no form of therapy were compared with respect to personality, sexual and marital functioning. The Sexual Dysfunction and Marital Difficulties groups (15 and 10 couples respectively) were obtained from the waiting lists of a sexual dysfunction service and marital therapy unit. Non-Problem subjects (15 couples) were from a volunteer sample. Personal adjustment, sexual and marital functioning were assessed by means of the Eysenck Personality Inventory, a Sexual Behavior Questionnaire, the Locke-Wallace Marital Adjustment Survey, and the Azrin Marital Happiness Scale. Results indicated that although all three groups were within the normal range, problem couples had higher ‘neuroticism’ scores than did Non-Problem couples. Marital Problem couples were the most debilitated. Their marital adjustment was lowest, and their sexual functioning was comparable to the Sexual Dysfunction group. Marital adjustment of the Sexual Dysfunction couples was significantly higher than that of the Marital Difficulties couples. Therapeutic and theoretical implications of the differentiating characteristics in the three couple categories are discussed.     

The Impact of a Digital Recorder Intervention in Pragmatic/Experiential Therapy for Couples: A Pilot Study to Assess Emotional Flooding

The present study explored the effectiveness of a unique intervention for couple therapy, the Canned Attitude Method (a technique developed by Brent Atkinson), which utilized a digital recorder in and between therapy sessions. Participant dyads were randomly assigned to the intervention group utilizing the digital recorders or the control group, in which Pragmatic/Experiential Therapy for Couples (Atkinson in J Syst Ther 17:18–35, 1998) was conducted without the use of digital recorders. Both the intervention and the control groups were composed of five couples each for a total of 20 participants. This study hypothesized that the use of the Canned Attitude Method in couple therapy would produce a significant change in marital satisfaction, emotional flooding, and positive psychological tendencies associated with intimate relationships. Findings approached significance, demonstrating decreases in the experience of emotional flooding, gains in relationship satisfaction, and a shift towards positive attributes within the couples’ relationships.