How can I get the most out of Couples Therapy? | Boston Couples Therapist

Couples will get the most out of the process if they are willing to learn new skills, apply them outside of sessions, invest in developing more self-awareness, acknowledge their role in negative patterns, and if they are willing to be emotionally vulnerable with one another. Some couples are well equipped to do these things while other couples are limited in these skills but are in invested in changing in order to save their relationship. Here are 4 critical factors that will strongly predict success in couples therapy:

1. If you are in a relationship where your fights escalate quickly and you end up yelling, saying things you wish you could take back, or behaving in ways you regret, it will be important for you do some work regulating your emotions on your own. Emotion regulation also applies to individuals who are cut off or not able to access their emotions. Dialectical behavioral therapy offers several tools for identifying, naming, and managing emotions in less unhealthy ways. DBT also helps individuals get in touch with more vulnerable emotions, such as sadness, hurt, or fear, which are often masked under anger, defensiveness, and avoidance. This involves incorporating mindfulness techniques into your daily life, catching your triggers and what your partner does or says that sets you off or shuts you down and why, and taking steps to manage heightened physiological arousal so your emotions so not speak for you. I’ve worked with many high conflict couples who were unable to stop their arguments from de-escalating in session, even with my best attempts to intervene, and this ultimately does more harm than good. An equal amount of harm is done when one partner completely shuts down and is unable to stay present with a conflict.

2. Focus on your role in the problem. Many couples come to therapy with an agenda to make the other person change. This will often fail. Even if one partner feels more like the problem, there’s a dynamic at play and important not take a stance of “I’ll change when they change.” Are you too impatient or do you steamroll your partner when disagreement arises? What can you do to change your passivity, avoidance, control issues, or lack of initiative? Do you avoid feelings and go straight to problem solving? Though the primary goal of couples therapy is to improve the relationship, I strongly believe it’s also an opportunity to invest in being the best version of yourself. It is the not the job of couples therapist to fix your relationship, rather, the therapist's job is to teach you how to fix your relationship.

3. Sometimes, couples believe showing up the one hour of weekly therapy will be all the work they need to do. The vast majority of work occurs outside the session. Couples are expected to apply insights and suggested changes discussed in sessions outside of sessions. Changing how you relate or communicate to your partner is a challenging task, especially when distancing or negative cycles have been the norm for months or years. All too often, couples return to therapy the next week stating they reverted back to their old ways after the session ended and did not think about the session at all during the week. Understanding the barriers to change may also be a central focus of the couples work for some period of time and may involve simultaneously investing in individual therapy.

4. Some couples say they need to make fast changes. This is understandable given many couples come to therapy at a point of desperation. Even if highly invested couples make significant changes early in therapy, sustaining new patterns it the bigger challenge. Having realistic expectations is extremely important given therapy is not a magic bullet. Creating a more satisfying and loving relationship sometimes calls for healing past wounds and practicing communicating in ways that are brand new or strongly go against ingrained patterns, which often take time to change. Trying to get to a happier place quickly may also be the very thing that is exacerbating the problem.

Communication Tools for Conflict | Cambridge Couples Counselor

Conflict often arises during a disagreement and turns into an emotionally fraught interaction when couples begins to engage in what is called the the four horsemen. In addition to implementing the antidotes proposed by the Gottman Method, here are a few additional communication tools to help de-escalate a conflict and resolve disagreements or address complaints more effectively:

1. Practice asking for what you need

   Too often, couples exacerbate fights because they are not explicit in what they are asking from the other person. It’s important in the aftermath of a fight to narrow down what the underlying need was and to keep this need conscious next time a similar argument ensues. For example, when tension rises, one might say “I really want validation for my perspective and to be told it makes sense.”

2. Incorporate reflective statements and validation.

   Often, when one partner is done speaking, the other one launches into what they want to say. Disrupt “listening” with the intent of waiting your turn to speak and practice active listening. Underlying most conflicts is a desire to have one’s dignity, reality, and feelings validated. I often tell couples it can feel like a heroic act to hold your partner’s reality in mind (even when it doesn’t make sense to you) and empathize with their feelings when you’re feeling misunderstood and deeply hurt or invalidated by them, but doing so can have a positive ripple effect on the relationship.

3. Turn “right checking” debates into future requests

   One of the most ineffective interactions I witness is two people arguing about the “truth” of a past event or using superlatives (such as you always or you never) that lead to a hot potato debate of “no I didn’t” and “yes you did.” The reality is, two people will not remember a past event in the same way as subjective filters are stronger than objective assessments. And when a motivation to defend oneself is present that filter is even stronger. When this occurs, I urge couples to stop the “right checking” of history and make a future request. This can look like: “we clearly do not agree on who washes the dishes more but I’d like to ask you to do them more frequently than I perceive you doing them right now. Maybe we take days, what ideas to you have?”

4. Acknowledge impact.

   One of the most healing things a partner can say to a past or current wound is “I acknowledge what I said or did hurt you, I can account for that.” Once again, you can account for an impact without agreeing with your partner. Many of us were socialized to think that if our intent is good and we do not agree with what was said or done, we do not need to acknowledge the pain it caused another person as that is their problem. This is a recipe for emotional disconnection. The pain is there and telling your partner that they can choose to interpret events differently isn’t going to erase the fact that the pain is there. We look to our partners for emotional security, so acknowledging pain we caused is imperative in maintaining that secure bond and trusting our partners care about our feelings more than being right.

Tips for Developing Self-Awareness | Cambridge Psychologist

Self-awareness is an important skill that is ideally developed and strengthened throughout any  therapy process. It involves monitoring internal experiences and responding with intention to outside stimuli. The most simple definition involves knowing what one is feeling and thinking and choosing to respond in a way that will meet one’s goals versus being swept up by an emotion and having no conscious awareness of behaviors that follow. Self-aware people also understand how their reactions impact others and can modify their responses to more effectively meet a situation or person. I also like to think of self-awareness as having an internal dialogue with oneself and conversing with one’s automatic reactions with their more authentic or true self. Self-awareness is linked to a host of positive outcomes, including higher levels of self-confidence, self-worth, emotionally maturity, and higher academic and relationship success. Here are 3 tips for developing self-awareness:

Develop an “outside eye” that can observe yourself from a distance. This is a classic mindfulness exercise that involves being able to notice thoughts, feelings, and reactions without judgement. Keeping a thought journal and analyzing why a particular thought, emotion, or behavior occurred is a good starting point.

Do post-reflections on events that produced strong emotions or negative consequences. Cognitive behavioral therapy has a few useful and concrete exercises for breaking down your mood before an event, what automatic thoughts or interpretations you had when an event occurred, and how these cognitions influenced what you felt, how you behaved, and what consequences followed. My favorite is the chain analysis.  

Solicit feedback from friends, family, or therapists. Getting honest feedback about your personality, behaviors, and flaws can be difficult and simultaneously asking for positive qualities and strengths can help absorb what may be hard to hear. I often encourage clients to get information from others about how their words or actions make loved ones feel or to imagine the impact of their words and behaviors on others in therapy to avoid falling into a trap of constantly blaming others or externalizing issues.