Couples Therapy: What 5 Ingredients Create a Great Outcome?

Does your therapist provide these essentials?

Posted Jul 26, 2019

monkeybusiness/fotosearch
Effective couples therapy can enable most couples to enjoy a long and loving marriage.
Source: monkeybusiness/fotosearch

My book for therapists called From Conflict to Resolution, and Prescriptions Without Pills for self help, explain the critical interventions that enable troubled spouses to be able to develop and enjoy a strong and loving relationship. 

What does that outcome look like? The husband in the couple I referred to at the beginning of an earlier blog post told this story in their last therapy session:

This morning we were all backed up, rushing and running around. My wife got up late. I didn’t start my workout earlier as I had hoped because I had a bunch of stuff I had to do. Realizing we were going to be late for our final therapy session, I ran down the hall and stepped into the shower. I looked around. No towel. 

“Where’s my towel?” I growled in frustration. So I jumped out of the shower to get a towel.  

Suddenly a gal with an impish grin appeared, holding a towel up high.  

I smiled, thinking “Oh she is so sweet, look at that!” 

Then I thought, “How would I have responded before?"

In the past, I would have been pissed. Assuming my wife had moved my towel, I would have given her the stink eye. Now my reaction was to see a wife with an impish, happy grin and to think, “She is so cute."

This is the essence of why you get married—so you can share the playfulness. The opportunity to get irritated, or blaming, or critical was still there, and instead, we turned it into a moment of affection. I get emotional just thinking about it.

What had this couple's therapy included that enabled them to transition from an angry and all-but-divorced partnership to a loving and lovable duo?

Just like a good cake almost always includes flour, sugar, leavening, eggs, and flavoring, couples therapy generally yields predictably good outcomes when it includes at a minimum the following five ingredients:

1. Two spouses who both are coachable, that is, open to learning how to be better at the role of a life partner.

2. Resolution of all the conflicts, that is of all the situations that had been generating tension, irritation, or fights. Therapists need to be experts in cooperative dialogue skills and collaborative conflict resolution so that they can guide the way. As the title of my book on therapy says—from conflict to resolution—therapy is a process of transitioning from adversarial tensions to feelings of calm, mutual goodwill as each issue gets settled with a plan of action that is fully responsive to the concerns of both partners.

3. Coaching, especially of collaborative dialogue and win-win conflict resolution skills. By the end of treatment, you want to be able to discuss future areas of differences effectively without direct guidance from the therapists. If you knew better, you would do better as a couple. 

The following brief video, for instance, clarifies the three steps to win-win problem-solving.

The therapist also, as part of being a good coach, is responsible for keeping the therapy experience safe. Good coaches intervene quickly in response to even small moments of foul play. They then restart the interactions within the boundaries of calm and mutually empathic interactions.

4. Understanding the templates formed in earlier-in-life experiences. Situations that a person has experienced earlier in life form sensitivities and response templates may cause dysfunctional emotional eruptions and habits. I especially like the exercise I refer to as That Was Then, This Is Now for enabling each spouse to quickly identify the origins of problematic emotional reactions and behaviors.

5. Removal of psychopathology, that is,

What can you do if your therapist is not including one or more of these elements in your treatment?

For starters, ask your therapist if this ingredient is one that s/he could add. Ask too if s/he has training in that arena. If not, you might want to augment your couples therapy with self-help resources such as the books and blogposts on the links above. Alternatively, gain what you can from your current therapist, and then move forward with another who is equipped to add the missing pieces.  

Good couples therapy can be life-changing, marriage-saving, and an ultimate blessing. Go for it!