The Relationship Vision, Part 2

In an earlier article, I described how a couple reached common ground by establishing a shared vision of a relationship. They created the following guiding principles, arranged in order of agreement and importance:

We respect each other.
We help each other with our problems.
We fix each other’s faults.
We cherish each other.
We listen to each other.
We look out for each other’s best interest.
We make each other better and strive for more.
We realize what we can lose.
We watch out for each other.

Establishing a mutual vision is just a start. After developing some common goals, a couple may run into some long-held beliefs that can serve as obstacles to realizing such a vision. Core beliefs are extremely rigid, long-standing cognitions, often formed as a result of childhood experience. They can play a powerful role in the treatment of couples.

One couple I treated came to therapy with a litany of complaints:

He shouldn’t gawk at girls, be so hooked on online porn, keep trying to convince me that this is okay, be so self-absorbed, keep bringing up his past conquests, relate everything to his own experiences, be so intrusive, talk in such a condescending tone, be so selfish, or make things all about him.She shouldn’t be so insecure, cut me off or try to control me, bombard me with questions when I come home from work, ignore my needs, complain about me, be so bothered with what I do, try to shut me up or shut me out, or devalue her own worth.

The couple grew up in different families with different sensitivities and different definitions of what constituted normal actions. She grew up in a conservative religious family with a father whom, although successful in his business, she saw as somewhat neglectful of the family. She fought for attention and did not want to repeat this pattern in her marriage. As a result, she would often shut down when she perceived that she was being devalued. He grew up in a more progressive home with parents who were both teachers, who had their separate interests but whom he saw as thoroughly accepting of one another. He grew up believing that relationships should be free of any efforts to control the other. He suspected his father had had outside relationships, but claimed it never affected family life.

Below are some important principles in my treatment with this couple.

Principle #1: Build rapport by starting where they want to start.

The couple arrived with ample material, so I asked them where we should start. They were in agreement: his attraction to adult sites on the internet. She was sensitive to neglect and saw his use of porn as unacceptable. He was sensitive to control and saw his actions as part of “natural law.” Even after weighing the costs and benefits of his actions, he was still a true believer.

Principle #2: Identify a dysfunctional pattern.

When she complained about his use, he felt hurt and controlled. I asked him what went through his mind.  He said, “She’s so insecure! I can’t do anything!” He overgeneralized her actions, and as a result, saw himself as helpless and out of control. In response, he would withdraw, which triggered her fear and anger.

SituationThoughtEmotion/Behavior
She complains about me watching porn.She’s so insecure! I can’t do what I want!
(I’m helpless, controlled.)
Hurt, withdraw

His hidden assumptions were: “If she doesn’t accept what I do, I’m out of control, helpless. If I withdraw and distance myself, I can gain control.”

I asked what went through her mind when he did this. She said, “Is this my marriage? I’m nothing to him!” This thought reflected both mind-reading and all-or-none thinking. She would respond by questioning him, which triggered his hurt and anger.

SituationThoughtEmotion/Behavior
He withdraws from her.Is this my marriage? I’m nothing to him!
(I’m neglected, unloved.)
Fear, interrogates him

Her hidden assumptions: “If he withdraws, he has lost interest in me. I’m unloved, worthless. If I question him, I can find out if he’s truly committed, and feel loved.”

I asked him what went through his mind when she did this. He said: “Here we go again. No matter what I do, it’s the same. I might as well go back to doing what I want.” He saw himself as being unfairly vilified for normal behavior and was insensitive to his wife’s perspective. “It didn’t bother my mom. Why should it bother her?”

Principle #3: Encourage the couple to focus on what they control.

Their disagreements follow a pattern. She invades. He evades. And each controls 50% of the interaction.

She controls 1) how she behaves and 2) how she interprets his behavior. She doesn’t control how he behaves and how he interprets her behavior. Likewise, he controls 1) how he behaves and 2) how he interprets her behavior. He doesn’t control 1) how she behaves and 2) how she interprets his behavior. I have them focus on the 50% they control, rather than the 50% they don’t control.

Principle #4: Speak to the couple’s values.

They both had this relationship vision in mind: “We help each other with our problems.” He truly cared for her and wanted to help her with her insecurities. She truly cared for him and wanted him to overcome this addiction. This is leverage for therapy. And this is fuel for them to empathize with one another. In a reverse roleplay, I had him articulate her thoughts and gave her a chance to respond to them. The benefits were twofold.:

1) He can step outside his frame of reference and put himself in her shoes.

2) She can distance herself from her own thoughts, look at them more objectively, and respond.

Then I had him voice her thoughts. He said: “What if he turns to someone else?”

She responded: “I’m living with him. He loves me. He tells me that he loves me. He’s more positive about life. We had a serious talk. He really does care about me.”

I then had her embody his thoughts: “She should value her own worth, compromise, and not be upset about my use of porn.”

He responded: “I’m happy. I’m confident. She’s listening. She’ll hear my perspective without getting defensive. She doesn’t let situations get out of control. I’m able to ask myself, “Is it worth it?”

We continued in this vein over the course of several sessions, with each stepping into the shoes of the other and then learning to empathize. They wanted to connect. They wanted to contribute to one another’s lives. She used this value to weaken her feelings of deprivation and encourage love in the relationship. He used this value to weaken his feelings of helplessness, increase his sensitivity to his wife’s needs, and commit to the betterment of his marriage. This was a step towards self-control. And the internet porn? He decided that it wasn’t worth it.

References

Baucom, D.H., Epstein, N.B., Kirby, J.S., & LaTaillade, J.J. (2015).  Cognitive behavioral couple therapy.  In A. S. Gurman , J. Lebow, & D. K. Snyder (Eds.), Clinical handbook of couple therapy (5th ed.) (pp. 23-60). New York: Guilford.

Dattilio, F. M. (2013). Cognitive-behavioral therapy with couples and families: A comprehensive guide for clinicians. Guilford Press.

Gottman, J. M., & Silver, N. (2018). The seven principles for making marriage work: A practical guide from the country’s foremost relationship expert. Harmony.

Upcoming Workshop

CBT for Couples

September 27, 2018