Clinical Issues with Gay Male Couples

SUMMARY

Although gay male couples share with all couples three essential tasks of couplehood-creating boundaries in order to form a couple identity, negotiating closeness and distance, and accommodating to their individual differences-gay male couples face special complications in each task. These complications, examined herein, are largely the result of the marginalization gay men experience from living in a homophobic culture, and male gender acculturation that makes male-to-male intimacy difficult. A model of brief couple therapy for gay men is presented that is designed to honor, as well as challenge, the relationship the men have co-constructed and specifically addresses the difficulties men have in maintaining intimate bonds. A case study illustrates the treatment of clinical issues presented by male couples.     

Relationship Patterns and Role of Religion in Elderly Couples with Chronic Illness

ABSTRACT

This study was designed to explore the various relationship patterns and the role religion plays as a coping resource for elderly couples in which at least one spouse has a chronic illness. Elderly couples were interviewed and also completed marital satisfaction and couple communication inventories. Five different relationship patterns emerged from the data: active couples, short-term caregivinjg couples, long-term caregiving couples, survival couples, and live-in caregiver couples. Various aspects of religion emerged as an important coping resource among the different relationship patterns. Ideas and questions for research and practice, generated by the study, are presented.     

Therapeutic handling of marital infidelity

Abstract

In working with couples and families, the occasional clinical use of mental imagery techniques can frequently promote therapeutic breakthroughs. When sessions focused on a couple's (family's) current communication problems reach a point where progress seems slow and laborious, a therapist can encourage the couple (parents and perhaps even older children) to try one or more imagery sessions to understand their interactional patterns within the context of their own developmental periods. This article describes how imagery can lead couples to new and more constructive perspectives on the meaning of their interactions.     

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.     

Parental grief of a perinatal loss: A comparison of individual and relationship variables

Abstract

This study focuses on the comparison of individual variables of bereavement, depression, and stress with variables associated with the couple relationship, including cohesion, adaptability, communication, satisfaction, and partner support. In total, 24 couples completed self-report instruments within 2 weeks after a miscarriage. Mothers had significantly stronger grief reactions than fathers. Fathers and mothers perceived their relationships similarly as highly functional. Except for mothers' depression and their satisfaction with the couple relationship, the correlations between individual and relationship variables were rather weak. Implications of the results for family professionals are discussed.     

From Application to Approach: A Systematic Review of 50 Years of Psychoanalytic Couple Therapy

ABSTRACT

This systematic review of contributions to peer-reviewed journals in the area of couple interventions aims to provide a comprehensive and intensive overview of this evolving field, within psychoanalysis. Using a pan theoretical systematic review methodology, 113 peer-reviewed journal articles were reviewed, dated between 1963 and 2014, addressing the topic of couple therapy and psychoanalysis. This article addresses a number of specific questions including, where authors have published their work, what methodologies they have used, with which couples psychoanalysts have been working, how writers from within different theoretical orientations talk about their work with couples, and how the field has changed over time. It also explores emerging themes of the relationship between couple and individual therapy, sex, and co-therapy. This review of writing over the past 50 years suggests that although Classical contributions have waned over time, couple psychoanalysts from within Object Relations, Self Psychology, Intersubjectivity, and Relational orientations have evolved in their discourse about couple distress, from an application of psychoanalytic concepts to full-bodied, well-articulated, clear, and concise approaches to diagnosis and treatment. The first 50 years of writing in the field of couple psychoanalysis has brought us distinct treatment models, which have opened the door for greater communication and sharing within and between orientations.     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

Danger or Opportunity

SUMMARY

Countertransference is the sine qua non of all human relationships. The manner in which the couples therapist deals with countertransferential feelings can have a powerful impact as either a force for healing or a force for destruction. Based on the tenets of Integrity Therapy, this paper offers a philosophical and clinical examination of countertransference in couples therapy. Focusing on the areas of rigid adherence to therapeutic dogma, emotional expression at all costs, negative countertransference and projective identification, teaching unauthentic ways of interacting, and co-therapy issues, this paper explores the ways in which traditional dynamic, humanistic and emotionally centered couple therapies can both therapist and patient into a betrayed of self and of the couple relationship.     

The Tao of Creating Sacred Relationships

SUMMARY

This article articulates the major premises of Sheldon Z. Kramer's book, Transforming the Inner and Outer Family: Humanistic and Spiritual Approaches to the Mind-Body Systems Therapy(The Haworth Press, Inc., 1995). This overview briefly introduces and explains the power of meditation in psychotherapy, meditation and the use of the body, creating congruent communication, working with incongruence in couples and bridging the inner and outer couple.     

Identity and Cultural Narrative in a Lesbian Relationship

SUMMARY

The dynamics of a specific lesbian couple are explored in terms of identifications, identity, and cultural narratives. Problems within couples can arise from challenges to the organization of identifications and to identity within and between the individuals as a couple moves from one cultural narrative to another. Female masculinity is especially vulnerable to these transitions, as it lacks legitimization from the culture at large.     

Affect Regulation and Attachment Focused Treatment of a Husband with Obsessive-Compulsive Disorder and His Wife

Abstract

In this paper, the author presents an overview of Obsessive-Compulsive Disorder (OCD), an affect regulation and attachment framework for treatment of couples and families, and a case study illustrating how this framework can be used to work with a couple in which the husband has OCD symptoms.     

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.     

Feminist Issues in Couple Therapy

Abstract

The authors reviewed the feminist couple therapy literature from 1995 to 2006. They summarized this large body of work into several key themes. The first revealed that feminist couples therapists are continuing to discuss and deconstruct gender issues in couple therapy. The second showed that feminists believe that therapists should be educated both academically and personally about culture and diversity so as to support couples in their therapy around their own issues of diversity as well as learning to deal with issues of social justice as a couple. In the third theme, the authors introduced readers to feminists' emphasis on connection and empathy within couple and sex therapy. And, in the fourth, the authors explored feminists' work with power in couple therapy as they applied to couple therapy in general as well as around the specific topics of: balancing family and work and therapy for familial violence.     

Structural couple therapy in the treatment of inhibited sexual drive

Abstract

This paper presents a study of a structural couple therapy approach to the treatment of inhibited sexual desire (ISD). ISD is first conceptualized as a relational phenomenon that may be most effectively treated in a couple context. Structural couple therapy is advanced and applied to the treatment of a clinical sample of couples presenting with ISD. Results of the study suggest that a structural couple therapy approach to ISD is effective in reducing symptoms of the sexual disorder and in increasing couple satisfaction.     

Life Cycle Crises

ABSTRACT

As couples are worked with in therapy, the issues they bring, both individually and as a couple, may reflect important developmental crises. This paper describes some of these issues from the perspective of Erikson'S epigenetic theory. Brief case examples are provided to illustrate the presentation and therapeutic course with these issues. While these issues will present strains that bring the couple into therapy, their understanding can also provide considerable motivation for strength and growth, particularly when worked with in the therapeutic arena.     

Remarital Issues in Couple Therapy

Abstract

Remarriage and cohabitation after divorce are becoming societal norms. Given the increasing numbers of these couples, mental health professionals will encounter them in their clinical practice. There are unique issues associated with remarriage (e.g., role and boundary ambiguity, unrealistic expectations) that can hinder the family reorganization process and exacerbate typical communication problems experienced by couples. Therefore, therapists must have knowledge of these challenges to provide the most effective treatment. A brief overview of the remarriage and stepfamily literature, and recommendations for clinicians are presented.     

Description and First Steps Toward the Empirical Validation of the Plan Formulation Method for Couples

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple’s plan for the therapy, which includes the couple’s goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple’s resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple’s plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges’ ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists’ interventions with the couples’ and partners’ plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple’s plan formulation (average ICC?=?0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists’ interventions compatible with couple’s plans could help partners achieve good outcomes.