If it's BS, call it BS
October 30, 2009 9:12 AM   Subscribe

What is the purpose of couples therapy...from a therapists perspective (specifics inside)?

I'm trying to take view of couples therapy from 35,000 feet rather than from in the trenches. Before going into therapy, I thought the therapist would get to know us a bit, including inquiring about our past(s), see what the conflicts were and then assist in working through them. In addition, I thought a therapist would "call out" either of our beliefs/hangups/bellyaches as BS and say something to the effect of (and this is totally made up), "Yes, being married and having kids did kinda preclude you from becoming an explorer in Antarctica, but it is not his/her fault." Instead, I feel like our therapist will take anything we say is earth-shattering and just go down the road of, "So how do you feel about what your spouse said?" Frankly, it reminds me of a lot of political discourse you see on TV nowadays (e.g., intelligent design vs. darwinism) where one person has science on their side and the other a belief system, and the media just portrays it as a debate with equal merits.

So, therapists, how do you approach therapy? Do you call people out on their BS? is it counterproductive? is it productive?

And the rest of you (non-therapists), what do you think is valuable to do is couple therapy? Would you expect your therapists to call you out?
posted by teg4rvn to Human Relations (23 answers total) 11 users marked this as a favorite
Non-therapist. Experience with therapy, as a member of a couple and as an individual.

To me, the purpose of therapy has always been self-improvement or healing. Frequently, getting called out on a false assumption or misunderstanding has been valuable to those ends.
posted by ZakDaddy at 9:40 AM on October 30, 2009

Sounds like you have an old-fashioned, outdated therapist, or at least a very lazy one. The psychiatrist/Freudian model of therapy used to be that the therapist would sit there, take notes, and say, "so what do YOU think?" My reaction to this was always "I don't know, I'm asking you, that's why I'm here!!" I think the idea was that by talking about it, you could figure it out for yourself, or something like that. A newer, more effective model of therapy, sometimes referred to cognitive behavioral therapy, sometimes not, is exactly what you describe, where the therapist takes a more active role. My latest therapist was quite helpful in this way, saying to me things like, "now, wait a minute. You said earlier this, but now you're saying that, I'm not seeing how you can reconcile the two." And that would help me see the flaws in my thinking. (This was not in couples therapy.)

Best of luck to you.
posted by Melismata at 9:58 AM on October 30, 2009

I'm just parroting what I heard Dr. Drew say several times on his radio show, but--the purpose of couples therapy is to provide and maintain an environment for open communication where each person feels safe enough to express herself without fear of being attacked or judged. So, yeah, maybe a bit like the moderator of a debate who is unlikely to point out if one side has a logically flawed argument, because then that person is less likely to continue express his views.
posted by bluejayk at 10:01 AM on October 30, 2009 [1 favorite]

Therapist. Different couples therapists work differently and have different goals. I usually start by seeing "why" the couple isn't communicating well. (Usually they communicate some things well and not others.) Sometimes I need to confront (i.e. call someone out), but it's rarely a good way to start out. Whether something is or is not someone's fault is usually less of an issue than the fact that people think that finding out who to blame is a useful goal.

I imagine you don't like "equal merits" because you think you're the darwinist married to a religious person. In other words, you think it's the other's fault and are frustrated that the therapist doesn't go along with you. You haven't been called out on that (yet) so, since IANYT, I'll do it. Your need to be right/vindicated/the smart one is part of the problem.
posted by Obscure Reference at 10:03 AM on October 30, 2009 [8 favorites]

I agree with what Obscure Reference said. Consider that the purpose of therapy is not necessarily "calling people out". Not even individual therapy. Many people cannot actually tolerate being "called out" until a certain level of trust within the therapeutic relationship has been reached, and some can't tolerate it at all because it just isn't what's helpful to them or what they need. Maybe it will help you to understand that perhaps your situation is not one of unequal merits, that your partner and your partner's feelings, opinions, ideas, etc. are as valuable as you/yours are, and a therapist is not a mediator of little arguments about who should take out the trash, or who should yield to whose relational style, or who "wins" a fight.

So, then, in your case: what if couples therapy is actually about disproving the idea that only one person can ever be right in a relationship?
posted by so_gracefully at 10:24 AM on October 30, 2009 [1 favorite]

I'm not a therapist, but I have been a client. Whether it's individual, couples, or family counseling, I think the purpose is to have an open and honest dialogue, and reflect on what we think and feel, why we think and feel that, how that helps or hurts the current situation, and what changes could be made to improve things. I see the therapist's role as being the person who keeps the conversation on track, mediates so everyone has an opportunity to be heard, and sure, challenges what is said, but not by calling it BS, or so explicitly taking a side. Everyone's perspective has value, whether its flawed or not.

In my view, the therapist creates the environment, guides the conversation,and assists with implementing change, but the patients are the ones who need to do the hard work. Some therapists give suggestions or exercises to help facilitate communication about an issue, and some do not. It's possible that you would do better with a more interactive therapist, but if your frustration is caused by your therapist's unwillingness to provoke some sort of revelation about how wrong your spouse is and how right you are, well, then no decent therapist is going to satisfy you. You might also want to consider individual counseling (with this therapist or a different one), so you can address the issues that you think are BS on your spouse's part. You very well could be right that your partner is equivocating, not participating in good faith, or needs an attitude adjustment, but the person who ultimately needs to come to that conclusion is you, not your therapist. Best of luck to both of you!
posted by katemcd at 10:35 AM on October 30, 2009 [1 favorite]

Different therapists, different approaches. Different clients, different needs. Partly it's about matching your needs with a therapist that can meet them. Couples' therapy can address each person's needs (with input from the other), the needs of the couple-relationship, one or both partners' communication skills, or a combination.

An old proverb says, "if you don't know where you're going, you'll end up someplace else." You'll need to know what you want from therapy if you expect to get it, and you'll need to know that to select an appropriate therapist. The focus of the first meeting should be to assess whether the therapist and clients are a good fit for each other, and to agree, at least initially, how to work together. It's not too late to have this conversation, yourselves individually, between yourselves, and together with the therapist. Taking a short detour now might set a more productive direction for your future work together.
posted by TruncatedTiller at 10:46 AM on October 30, 2009

I'm not a couples counselor, but I do work in the counseling field. I should mention now that I have a built-in bias against CBT. I do use certain techniques in my work, but do so sparingly for reasons too numerous to go into here.

I think celebrity "therapists" like Dr. Phil (who is a psychologist, but not a counselor) have popularized the idea that therapy is and should be a confrontational exchange wherein the counselor whips the client into shape by "calling him/her on their BS." I strongly disagree with this on a number of levels.

My view of counseling is this - it should help people learn to live at peace with themselves - according to their own values and beliefs (within reason, of course). I want to help my clients develop insight into their own lives - how they think, feel, act, relate etc. I want to help them learn how to use this insight to change their lives in ways that are meaningful to them. If I am calling people on their BS, I am essentially doing the work for them when part of my job is to help folks recognize for themselves when they are acting in bad faith. I don't want to rob my clients of this ability.

I also think confrontation undermines the safety people need to be completely honest about themselves, which in turn makes substantial insight and change difficult. I firmly believe that people have a right to go into therapy knowing that they will not be judged, evaluated and defined by the therapist. Clients often have a strong desire to please their therapist. If I voice my disapproval at something a client has done/said/thought etc., there is a good chance I will drive whatever it is I am criticizing underground.

Finally, confrontation isn't all that effective - in my opinion. It creates resistance. It is usually more about the person doing the confronting and less about the person being confronted. If the client is putting a lot of effort into resisting me, they are not putting that energy into themselves - where it belongs.
posted by space_cookie at 10:49 AM on October 30, 2009 [1 favorite]

Response by poster: OP here...

@Obscure Reference

Upon completion of my question, I wondered how long it would take for someone to respond as you did, and thank you for that. Of course, we all want to be right and think we often are.

If I thought I was right about everything, though, I would have politely declined going to couples therapy and sought out a divorce. I know that I cannot possibly be right about everything, and I really, really, really want a third party to call me out on something, 'cuz obviously I can't see it for myself, and my spouse can't articulate it, hence the therapy. How can I improve myself if nothing I say requires a "call out"? Is it really unrealistic to expect a therapist to say (again, same made-up premise), "Don't you hear how ridiculous it sounds for you be upset that your spouse doesn't want you to quit your job, leave your family with no income, and you run off to Antarctica to study penguins?" Heck even in your response to my dopey Darwinism/ID example, you took a side...so why not take a side, as a therapist, during therapy?

I really want it to cut both ways. Maybe we (I) need a different therapist.
posted by teg4rvn at 10:59 AM on October 30, 2009 [2 favorites]

It's not a matter of thinking you're right. All scientists (you're the darwinist in this relationship) will tell you that they are exploring and could be wrong, but on a feeling level, they may be very attached to particular points of view--even more attached to them than they may be to their spouse. "Don't you here how ridiculous" is probably not a useful way to address someone who is attached to some point of view. It's crypto-name calling. More useful in your (hypothetical) example is ask "What will you do for money without a job?" As a question, not an accusation. Do you see your spouse as irresponsible? Are you afraid that she will make bad decisions? What is your spouse afraid you might do? E.g. insist she (the scientists are usually male and the believers female) give up her lifelong dream of studying penguins to work as an executive assistant?

It's not a matter of taking sides in an argument, but rather exploring how you two argue, that will lead to resolution. E.g. do you belittle her for taking ridiculous positions? Does she feel belittled, even though you are doing nothing of the sort?

I can already see that you have a belief that the way people change is by being confronted. Some people (perhaps you) do change that way, but others feel attacked, pretend compliance, or 'defend' in some other way that makes everything more difficult.

Do you address your concerns with the therapist (call him out)?
posted by Obscure Reference at 11:24 AM on October 30, 2009 [1 favorite]

In my experience (as a client), the best couples therapy is individual therapy. Separate sessions focusing on producing two healthy and actualized individuals without regard for whether the relationship ends up in reconciliation or in divorce.
posted by rocket88 at 11:27 AM on October 30, 2009

An acquaintance who does individual therapy once said that he finds couples' therapy to be difficult to practice because it's hard not to choose sides. The point of relationship counseling isn't to declare a winner. Depending on the topics you and your wife are discussing during sessions, your therapist no doubt has opinions or sympathies that align more closely with one or the other of you, but it isn't his/her job break the tie.

However, I think it would be entirely legitimate to bring up in the next session the fact that you don't feel like the goals of this therapy, or the means of assessing progress, are clear.
posted by Meg_Murry at 11:27 AM on October 30, 2009

Response by poster: @Obscure Reference

Well said.

Indeed, I think I need to call out our therapist!
posted by teg4rvn at 11:32 AM on October 30, 2009

It's possible that another therapist may have a different approach that you like more.

Have you considered that your spouse AND the therapist may, in fact, be asking you to do something differently, but because it isn't in this language of "calling you out", you simply aren't listening to it? Rarely is life so simple that a black and white "stop doing it that way" is appropriate.
posted by so_gracefully at 11:33 AM on October 30, 2009

I am not a therapist, but -- something you said struck me oddly.

You've been accused of "wanting to be right," but it sounds to me like it's more like what you believe is "intellectually I know I'm NOT right, I just don't know what I'm 'not-right' about and want someone else to point it out to me."

If I WERE a therapist, I wouldn't try to figure out the 'not-right' part of your thinking -- I'd be more interested in getting to the bottom of "why is it that you're so convinced that there IS something you're wrong about?"

Maybe that's what's going on here -- you're living with the belief that there is a "right" and a "wrong" and that it's a matter of finding out what's right and what's wrong. Where, in truth, there IS no "right" or "wrong," there is only "being honest about what I want" and "being honest about what you want", and once you finally sort that out, then there is "can we make them both work together so we're BOTH getting what we want." Because if there IS a way to figure out how to work together, then you BOTH are "right" and NO one is "wrong," and thus no one needs to be "called out."

Maybe the therapist isn't calling you out on anything because the therapist is waiting for you to come clean about what you really want, without your second-guessig yourself about whether you're allowed to want it or whether it's "wrong" to want it.
posted by EmpressCallipygos at 11:34 AM on October 30, 2009 [1 favorite]

I do couples therapy. Unfortunately, calling people out on the BS, especially at first, is not terribly beneficial. Even if it really seems like one person is more at fault than the other, the system gains nothing from the therapist singling out one of the members. Yes, eventually irrational beliefs and cognitions, as well as tendencies to make harmful attributions toward the partner, will be questioned, because they are really detrimental to relationships, but with caution and minimal confrontation. The therapist's aim is usually to make both members of the couple feel comfortable, and as though the therapist is working for their benefit. So yes, harmful beliefs and behaviors will be changed (that's the form of therapy,) but it would take an idiot therapist to be confrontational or offensive about it. Most clients wouldn't stand for that.
posted by namesarehard at 11:42 AM on October 30, 2009

Consider too that the desire to be "called out" is, in a strange way, a desire to not have to take responsibility for yourself.

I'll risk a huge generalization and say that all of us have a dark, icky side to ourselves. For some that it is a side that wants to manipulate others (like our spouses) towards our own ends, for others it is a wish for complete freedom without obligations. For others still it might be abject meanness and cruelty when we don't get what we want.

To be a full adult, we have to take responsibility for the uglier aspects of our nature. To rely on the therapist to recognize and label this for us dodges that basic responsibility.
posted by space_cookie at 11:44 AM on October 30, 2009

Based only on my own experience, couples therapy is a lot less about sorting out who's "right" and who's "wrong" than it is about finding better ways for you and your spouse to communicate with each other effectively -- which honestly based on this and some of your previous questions it sounds like you both have a real problem with.

We had one session with a therapist whose entire strategy revolved around an infuriatingly simple-minded technique: getting one of us to say something, "I feel X about Y", then turning to the other and asking them to repeat it back, a la "I hear you saying X about Y." Which felt really stupid, except for the fact that it actually worked really well, because most often it'd come back as "I hear you saying W about Z," and sorting out how X turned into Z forced you both to face the ways in which you weren't communicating, or weren't listening, or both.

the media just portrays it as a debate with equal merits.

In this case, it is a debate with equal merits. Your marriage is not Fox News.
posted by ook at 11:53 AM on October 30, 2009

I am a Marriage and Family Therapist in training. Really, couples therapy is about finding a therapist you trust and whose method (CogB, Extistential, Pyscholoanaltic, or Systems) makes you feel comfortable.
posted by CatherineK at 12:10 PM on October 30, 2009

Therapist here. Some people have a desire to be "called out" and some therapists like to call people out. My experience of that is that it's exciting, dramatic, and usually not helpful unless it's done by someone who is *very* experienced and can do it at the right time, and in a way that doesn't humiliate anyone. I have found that many of the people who want to be called out grew up in families where people were yelled at a lot, and it seemed like that was the only way to get anyone's attention.
Most often, it just ends up making someone feel stupid and someone else (often the therapist) feel clever and right. Helping people feel stupid or clever is not really a good place to do therapy from.

I have certainly told people that I don't believe what they just said, or that it contradicts other things that they've said, but it's in the service of getting people be able to reflect about themselves enough that they can "call themselves" out.
posted by jasper411 at 12:34 PM on October 30, 2009 [1 favorite]

Non-therapist, I'm going to agree with the person who said that the best couple's counseling is individual therapy. I'm actually in Dialectical Behavioral Therapy right now, which is working really well for me.

I've had bad experiences with couple's counseling though, and I wished that I'd listened to my gut earlier.

My attitude is that insights really, really don't matter. The couples counselor I went to had a ton of insights, but a year later, we weren't in any better position than we were at the start.

OTOH, 4 months of DBT have helped a ton. Sessions feel more like coaching than plumbing the depths of my psyche. There's no "Well, what do you think about that?", instead there's a focus on keeping my own emotions under control, breaking judgements down into their component pieces, (Rahter than saying this is bad, explaining what exactly it is that I don't like about something), and learning good interpersonal communication skills.

It's like you don't learn a foreign language by taking history and culture classes, even though they may be related. Sometimes being in a relationship feels like learning how to communicate in a foreign language.
posted by fnerg at 1:22 AM on October 31, 2009

Not a therapist. A relationships-skilled person lives the "calling out" (doing it, but also being called out/"hinted"/"nagged at") in their relationship through the process of empathizing with the partner.

When communication lines are broken (empathy temporarily off the table), or when at least one of personalities involved 'organically' lack empathy, it is not only being "called out", but also the job of "calling out" in a compassionate manner is not done. It may look like a third party doing that job may be a solution, but it is really impossible to get to a lasting improvement that way. Beneath the layer of "calling out" are two individuals, their skills and their motivation/attempts to work things out. The therapist is getting down to there. Recounting the conflicts that were there does not give the therapist that information.

p.s. An article that stuck in my memory as a good explanation of how couples' therapy should be different from individual therapy.
posted by Jurate at 2:07 AM on October 31, 2009

You have to learn to "call out" yourself.

Your awareness of the problem and your desire to be "set straight" indicates that you are already on the path you are seeking.

Maybe a different therapist will provide more of whatever feeling you "think" you should have in therapy, but the bottom line is that YOU have to fix YOURSELF.

Of course, the obvious thing is to talk about this with your therapist. If he or she doesn't give you the "answer" they are probably giving you the chance to figure it out on your own, which means YOU are doing the work, which means they are doing their job.
posted by Locochona at 9:36 AM on October 31, 2009

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