Working with couples and families requires a different stance from working with individuals. I like that I can experience the relationship dynamics directly by being in the same room with the couple. It’s so different seeing the dynamics in action as opposed to having one individual describe it to you from her or his view. With couples work, you can witness how quickly one person’s response is cued by the other. Before you know it — before the couple knows it, for that matter — they launch into defensiveness and negativity almost as if you weren’t there. When you try to mediate, it either makes it worse or they both become angry with you. It quickly escalates.
I have learned to cope with this by acknowledging from the beginning that the relationship (or as Harville Hendrix has called it, the “in-between”) is my client. I like to think of it as a circle, the reciprocal nature of all relationships — in this case, close and intimate relationships.
I often describe relationship to couples as a dance in which they have to coordinate their actions so they won’t kick each other in the shins. The more they practice with each other, the smoother it becomes, the less they hurt each other and the more satisfying it is. If the music changes — as it often does in life — they have to adjust their rhythm with each other to recover the smoothness (stability) and satisfaction. For as long as they dance with each other, this will be a lifetime pursuit. I know! My wife and I have been married 50 years, and we are still adjusting our dance.
I work with relationships because I believe that everything we experience occurs in relationship. Without relationship, there is no existence. It’s the stress of relationship that keeps us alive — just not too much stress.
There is no more significant relationship than the couple relationship. It is unique because it’s a peer relationship, not hierarchical like most other relationships. It is an intimate friendship that can become the basis for our security and fulfillment. But as Murray Bowen said, a two-person relationship is inherently unstable — too close or too distant, too intimate and vulnerable or too disengaged and threatening. We never get it right. We just learn to adjust it so it doesn’t become too emotionally extreme.
I believe the primary objective in couple therapy is to help couples improve the stability and satisfaction in their relationship and learn to stay flexible, not rigid. It’s important for couples to maintain a context of intimacy and engagement that allows them to experience a sense of trust and security in which they can be “safely vulnerable.” Couples can do this if they feel attached, which in turn depends on their ability to emotionally engage with each other. The quality of emotional engagement enables people to develop in healthy ways, to trust themselves and each other.
I believe that our personalities are shaped by our relationships, and particularly formed in our earliest attachment relationships. Out of this experience, we tend to trigger the same kind of responses from others that we learned beginning in childhood. These responses operate mostly beyond our awareness (implicit emotional memory). To understand any couple interaction, it’s important to consider that there are cues from each person that elicit a response from the other partner, which in turn elicits a reciprocal response from the original partner, ad infinitum. These are the habits that we see in all relationships.
What draws us together can also push us apart
In marital and couple relationships, I believe it is typical to form a bond with someone most like ourselves. However, what draws us to each other are opposite characteristics — the complementary aspects of our relationship — that are then difficult to live with the rest of our lives. These difficulties become the themes of our relationships, repeated over and over again as long as we are together. For example, one partner comes from a distant and noninvolved family of origin, while the other comes from a close family. It’s likely that this couple will continue to have differences concerning the involvement of extended family in their lives. This is an example of the reciprocal responses (habits) we see in all relationships.
So, the habitual way couples learn to relate to each other is derived from how each individual learned to relate to others from childhood. Partners in a couple pick each other because they fit complementary to each other, and the habits derived from this become the underlying forces driving the process of their relationship.
If couples have the skills to transform the emotions responsible for the negative patterns in their relationship to more positive ones, they will improve their recovery from the defensiveness and hurt derived from these negative cycles. If their recovery is improved, they will have “softened,” thus strengthening the intimacy and stability of their relationship. It is important for the relationship to be flexible enough to cope with these forces. At the same time, couples have to remain sufficiently emotionally engaged to maintain the trust and security of the relationship. If this becomes a consistent pattern over their life span, they will have achieved a stable and satisfying relationship.
The key in couple therapy is not to directly help couples solve problems but rather to have them skillfully remain emotionally engaged when under stress. In fact, it is likely that the difficulty couples face in resolving conflict has more to do with emotional disengagement than with an inability to solve problems.
Consider what John M. Gottman and Robert W. Levenson wrote in their article “How Stable Is Marital Interaction Over Time?” for the Family Process journal in 1999: “It’s not the problems a couple solves but how they deal with their emotions connected to the perpetual problems they never solve that leads to stability and satisfaction in their relationship.”
It’s important to help couples become resilient in the face of the many stresses, challenges, disruptions and developmental changes that threaten to disengage them. This involves helping them remain softened to each other and equipping them to recover when life’s experiences create disengagement. Being able to recover restores the emotional engagement (intimacy) of the relationship. Quicker and more frequent recovery reduces the likelihood of disengagement, defensiveness and hostility. This, in turn, leads to satisfaction and stability.
Emotion-focused relationship enhancement therapy
Relationship enhancement (RE) focuses on emotion as the transformative agent in therapy and relationships. How couples manage their emotions — a reciprocal process — is central to maintaining an intimate and satisfying relationship. The struggle around the emotions elicited by the couple’s differences becomes the vehicle that changes the relationship, improves its flexibility and keeps the couple safely engaged. Learning the skills to improve this process is the objective of emotion-focused RE therapy.
Relationship skills, particularly in close, interdependent and attached relationships such as couple relationships, are essentially emotional regulation skills. Underlying each couple interaction are deeply important and implicit (nonconscious) reciprocal emotional cues and reactions that emerge spontaneously. These constitute the “interpersonal habits” discussed earlier.
To get a grasp on these nonconscious, emotional habits that contribute to stress and conflict in couple relationships, it is useful to understand how couples communicate. Essentially, one person in the relationship, motivated by emotion, is trying to convey information and perceives that the other person understands the importance (meaning) of what is being expressed.
What most needs to be understood is the underlying feeling that motivates the expression. For example, if one partner says to the other, “You forgot to bring milk home,” both parties recognize the feeling (disappointment) as the reason (meaning) for the statement. The arousal, which is physiological, in the partner’s emotion (disappointment) is the cue for how the couple subsequently will engage. If the other partner feels criticized and becomes defensive (arousal), there will be a “fight.” However, if the other partner listens by recognizing and accepting the partner’s disappointment, the arousal and defensiveness are reduced, and they are in a better position to collaborate and restabilize their relationship. This is the “softening” so often acknowledged in couple therapy.
The primary skills in couple interaction have to do with expressing one’s self so that the other person recognizes the underlying feeling that motivates the expression and having the other person acknowledge it. So, speaking and listening constitute the first two skills of emotion-focused RE. Essentially, the speaker is learning to improve self/emotional regulation (owning expression), and the listener is learning to accept and acknowledge an understanding of the other person’s emotional motivation (empathic understanding).
In RE, the partners who make up a couple learn to understand themselves and each other by exploring the emotions that motivate their behavior. When people perceive that their relationship is safe enough, they are freer to reveal these underlying, primary feelings to themselves as well as to their partners, which softens the relationship. By revealing these deeply owned feelings to themselves, individual partners are better able to understand their experience and regulate their emotions, giving them a sense of greater mastery. And when these deeply owned feelings are accurately recognized without judgment and with acceptance by their respective partners, a context is created that fosters deeper sharing of feelings and understanding.
I have observed that when couples create such a context, the partners feel closer, more trusting and more open with each other. This does not secure the relationship, however, unless the couple also practices the third and probably most important RE skill, known as the relationship (emotional engagement) skill. This skill asks couples not only to take ownership of their feelings and respond empathically with acceptance and without judgment, but also to acknowledge the meaning of the relationship (“Your feelings affect my feelings”). This skill is taught when they switch roles (listener and speaker). The instruction to the new speaker is, “How does it make you feel to know that she [or he] feels that way — good or bad?” Together, these three skills constitute the basic training of RE.
Generalization and maintenance
In RE, each member of a couple practices expressing his or her feelings and owning these feelings; this then enables each person to accept the other. By reciprocally practicing the skill of acknowledging the feelings (internal experience and emotional motivation) of the other through empathic listening, a context of acceptance and nonjudgment is created. Ultimately, through supervised and then unsupervised practice, couples learn to create an ongoing relationship context of acceptance, nonjudgment and emotional engagement that operates in their day-to-day lives. Establishing this context is a critical outcome of RE therapy.
The success of any therapy lies in the ability of clients to take what they have learned and make it a part of their everyday lives. That is why the next two skills, generalization and maintenance, are essential for an optimal outcome. The development of clients’ generalization and maintenance skills begins with the very first session of RE.
Taken together, the five core RE skills allow couples to maintain a reciprocally stable relationship and become more emotionally engaged. However, couples will internalize these skills only after they have attained a certain level of proficiency and experienced enough satisfaction from incorporating the skills regularly. Thus, homework assignments of various kinds are systematically included in the program to encourage generalization into everyday life. Homework is described to couples as an acknowledgment of their responsibility for the therapy and, ultimately, their relationship. From the beginning, it establishes the value of home practice.
Supervision of this homework is designed to improve and reinforce generalization and maintenance of RE skills. If clients encounter difficulties applying the skills in everyday life, role-playing is used in the therapy session to improve the couple’s ability to use the skills in a variety of challenging situations.
Homework assignments are designed to review the principles and skills learned in the sessions, encourage clients to set aside specific times for additional skill practice and help participants use the skills in their daily lives. Thus, at the beginning of each session, valuable time is devoted to a report by the couple about their homework assignments and their use of RE skills outside of the therapy session. Often, couples must first be taught to set aside a consistent time in their busy lives to devote to their relationship and to practice. A simple homework exercise (often the first homework assigned) is to have the couple schedule a “playtime” each week at the same time. In this context, play should be defined as spontaneous and not outcome-based.
Probably the most critical method of generalization and maintenance is home practice of the first three emotion-focused RE skills. After a period of skill training that involves a tutorial process, couples are encouraged to schedule home practice sessions for an hour at the same time each week. The decision to move to home practice is a collaborative decision between the couple and the therapist. Couples are informed at the beginning of therapy that this will be part of the structure. Prior to starting this process, couples are given a home practice handout, which includes a time-out procedure, to review together. (For a copy of this handout, contact me at firstname.lastname@example.org.)
At this point, the therapy shifts from an emphasis on office sessions to home practice, with the weekly home practices being taped. Subsequent in-office sessions focus primarily on home practice and involve a coaching process. Emphasis during these sessions is placed on identifying underlying positives and improved skills. Once couples develop a confidence and consistency in home practice, the office sessions become less frequent. Couples understand that subsequent sessions will be devoted to reviewing the most recent home practice tape, and therapy shifts to a consultative process, with couples taking responsibility for their own therapy and relationship. Couples can then choose to come in for booster and/or refresher sessions if they haven’t seen the therapist for a period
Through the years, I have attended workshops and conferences, taken various training programs and fulfilled my continuing education requirements. I marvel at how often I keep returning to the RE model. It seems to me that it achieves the best outcomes for couples.
Barry G. Ginsberg founded the Center of Relationship Enhancement (CORE) in 1981. He serves as the director of CORE and Ginsberg Associates, a child and family clinical practice. He received the 2011 Research/Practitioners Award from the International Association of Marriage and Family Counselors, a division of the American Counseling Association. Contact him at email@example.com and visit the CORE website relationshipenhancement.com
Letters to the editor: firstname.lastname@example.org
I totally agree with your view. For the past several years we, as a team of US and French trained psychologists and psychoanalysts, have helped English speaking couples in Paris to resolve their family and couple issues. The approach here in France is extremely psychoanalytical. But as someone who has both US and French training I do often mix other techniques and find it extremely efficient.
The idea of reducing office sessions could be of great help too in this age where professional and family constraints keep a majority of people from consulting. Although I have to admit that in France anything that does not happen in the office is pretty much of the question. Here we live with the inertia of tradition and a very slow pace of change that makes psychological approaches less and less adapted to the necessities of our modernity.
Many thanks for this informative article. Dr. D.F.
Thanks for your kind words in response to my article. I appreciate your interest in a brief approach like Relationship Enhancement. I recognize how frustrating it is to encounter the rigidity of tradition. I think that we experience a lot of that here in the state too. In the early years of Relationship Enhancement, an educational skill learning approach was considered superficial by many in the therapeutic community. It was very frustrating for me to try to convey my experience of the effectiveness of RE. What a relief these days that there is more openness and acceptance of educational-skill training approaches.
One thought that I had in response to your comment had to do with respecting the cultural context in which couples are embedded. I try very hard to be sensitive to the cultural and ethnic backgrounds and contexts of my clients and convey RE in a way that is acceptable to them.Under this circumstance, it seems practical to me to mix other techniques.
Hi Dr. Freeman.I just read your response again. I’m interested in the work that you are doing and I’d love to hear anything of your experiences in using RE. Thanks again for your supportive comments.
This is beautifully written and clearly defines the elements of relationship that can be challenging, as well as how to conceptualize intimate relationships and how to help couples reach deeper understanding through the psychoeducational approach of the therapist. I think that Relationship Enhancement is a powerful approach to help couples work through this unending dance so that it becomes or remains a mutually satisfying source of support and caring. Thanks for this excellent article – I’ll be sharing it with some of my clients and colleagues!
Rise VanFleet, PhD