Abstract
This chapter begins with a case example, the common situation of couples beginning therapy when one romantic partner, in this case the wife, has previously decided that if therapy does not “work” quickly to change her husband, she will leave him. Other situations are described, such as when one partner insists on engaging in therapy and the other partner actively resists treatment and when the partners’ gender or religious differences play a role in their difficulties. We discuss the specific challenge of working with couples that cross-blame, that have differing motivations for help seeking, and that define their conflict as a polarizing “zero-sum problem,” where one person is expected to “win” and the other to “lose” (e.g., decisions about whether or not to marry, to have a child, to relocate, to separate/divorce, etc.). Additionally, we describe particular alliance challenges in working with high-conflict couples: a lack of safety in the conjoint context, poor within-couple alliances, and the potential for split alliances (where one partner is notably more connected with the therapist than the other partner). Finally, we recommend strategies to use the alliance with each partner to foster a within-couple alliance, such as reframing the zero-sum conflict in terms that can facilitate a compromise. An extended case example, with dialogue, illustrates successful therapeutic work with a heterosexual couple that began therapy with contradictory, blaming problem definitions related to the frequency of sexual activity (his perspective) and the loss of self in the relationship (her perspective).
An eye for an eye only ends up making the whole world blind.
—Mahatma Gandhi
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Notes
- 1.
A careful assessment of a history of intimate partner violence is necessary before undertaking conjoint therapy, which is contraindicated in these cases. The discussions in this chapter only reflect conjoint therapy in which violence is not a concern.
- 2.
See Chap. 4 for a discussion of the challenges of working with one parent when the other parent is absent or not involved with the children.
- 3.
Client responds defensively to another family member.
- 4.
Family members try to align with the therapist against each other.
- 5.
Therapist draws attention to clients’ shared feelings.
- 6.
Client comments on the therapist ’s inadequacy.
- 7.
Client responds defensively to another family member.
- 8.
Family members blame each other.
- 9.
Client shows vulnerability (e.g., discusses painful feelings, cries).
- 10.
Therapist expresses empathy for the clients’ struggle.
- 11.
Therapist explains how therapy works.
- 12.
Therapist draws attention to clients’ shared experiences and feelings.
- 13.
Therapist acknowledges that therapy involves taking risks.
- 14.
Client leans forward.
- 15.
Client avoids eye contact with the therapist .
- 16.
Therapist provides structure and guidelines for safety.
- 17.
Client describes a plan for improving the situation.
- 18.
Client varies her emotional tone during the session.
- 19.
Family members share a lighthearted moment with each other.
- 20.
Therapist draws attention to clients’ shared experiences and feelings.
- 21.
Client shows vulnerability (e.g., discusses painful feelings, cries).
- 22.
Therapist encourages clients to show caring, concern, or support for each other.
- 23.
Therapist helps clients talk truthfully and nondefensively with each other.
- 24.
Client complies with therapist ’s request for an enactment.
- 25.
Therapist asks clients whether they are willing to do a specific homework assignment.
- 26.
Client expresses optimism.
- 27.
Therapist expresses optimism.
- 28.
Client indicates that a positive change has taken place.
- 29.
Client mentions the therapeutic process.
- 30.
Client implies that therapy is a safe place.
- 31.
Client introduces a problem for discussion.
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Escudero, V., Friedlander, M.L. (2017). Couples’ Cross Complaints: “I Want… but She/He Doesn’t Want to…”. In: Therapeutic Alliances with Families. Focused Issues in Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-59369-2_2
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