janecropped16aWhy do the words marriage counseling and couples’ therapy strike terror into the hearts of so many husbands and wives?
Certainly an interest in salvaging relationships has been a media topic for many decades in our culture. A column such as “Can this Marriage be Saved?” is only one of many in popular women’s magazines. Today even men’s magazines offer relationship advice.

As for the subjects of psychotherapy and marriage counseling, television has recently offered inside views of the process. Witness Dr. Melfi in her valiant attempts to engage Tony in the HBO hit “The Sopranos.” Even more recently HBO has offered us “Tell Me You Love Me,” an intimate look at the marriage counseling sessions of several couples. In fact, these expose’s make it easier for people to seek help, reducing the stigma and erasing some of the mystery.

However, all too often couples view seeking help for their troubled marriages as a last resort or worse, an admission of failure. The former is unfortunate while the latter is simply inaccurate.



Couples and individuals need to understand that conflict, inevitable in a long-term relationship, need not be a sign of danger, but rather an opportunity for increased understanding and communication. If a relationship is to last or thrive, change will be a necessary if somewhat frightening component.

Particularly for men the idea of seeking help for problems is anathema. In American culture men are still raised to believe they must do everything unaided. Further, they are not taught to express their feelings (except for anger). In fact they often still consider it a weakness to do so, especially sadness or tears or an admission of needing help. This poses a tremendous burden for men, often resulting in physical ailments including heart attack, ulcers, high blood pressure, and stroke.. Would Tony Soprano have sought the services of Dr. Melfi were it not for his panic attacks? An educated guess says no.

This do-it-yourself play it close to the vest mentality is also a burden for men’s partners who are often left to nag them to visit the doctor, or, apropos of marital woes, feel cut off, lonely, or in the dark as to what their husbands are thinking or feeling. Often both partners are reluctant to bring up issues or just don’t know how. And broaching the subject of marriage counseling can be even more anxiety provoking. They don’t realize how much relief can be found by airing their concerns to an interested but objective third party.

What, then, are some of the issues couples bring to the consulting room?

The number one reason for seeking help is lack of communication, communication breakdown, He (she) won’t talk to me anymore”, “We have nothing to say to each other”. Faced with this type of complaint, a couples’ counselor must help each partner define what “lack of communication” really means to each. Wives as well as husbands often had trouble, even before marriage, identifying or expressing their own needs. Each partner in couples ‘counseling is given the opportunity, often for the first time, to explore these and then learn, in an atmosphere of safety, to communicate them to their spouse. People are often amazed at how increased understanding can lead to more closeness.

The second most common reason for seeking help is escalating fights. Couples fight instead of talking. It may be their most comfortable form of communication.  They do not listen, they tune out. Often it is not even the words that matter so much; rather the situation becomes intolerable because things have devolved into a power struggle. A single unit has become two warring factions. This situation requires learning how to listen without interrupting and without increasing the decibels. What is the power struggle really about? How did two lovers become enemies? Problems must be reframed as something to work toward resolving together for a win-win outcome rather than a win-lose competition.


Other common areas of strife are in-laws and child rearing practices. Why mention these together? The long and short answer is that both involve “baggage’ that each spouse brings to the table left over from each one’s family of origin.

In the first case one doesn’t have to look far to see how the “meddling” of in-laws causes difficulties. Perhaps it will come as a surprise to learn that it is not the in-laws themselves that are the problem. Rather it is that one or the other spouse has not sufficiently “separated” from his or her family, most commonly parents. In order for a couple to thrive, the marital relationship must be the primary attachment, the priority. If a spouse values parental input over that of his/her partner the marriage will certainly suffer. Many are startled by this revelation and changing it can be hard work. The results, however, can be dramatic, going a long way toward decreasing one partner’s feelings of neglect or resentment and increasing a feeling of togetherness and “teamwork”. A couple must be united strongly enough to withstand the slings and arrows of overly involved relatives.

With regard to child rearing, again the long and short of it is that how we are raised, the quality of our relationships with our parents, are huge determinants of how we believe our children should or shouldn’t be raised. Disagreements can abound. While this may seem obvious to the reader, what is more obscure, often unconscious, is the degree to which we form identifications with our children. Clients are often amazed when they begin to realize that when son Johnny is five, or seven, or ten, conflicts that arose at those same ages for one or both parents will get reactivated. Suddenly that parent is once again responding internally to long-repressed memories. Just as suddenly a wife is no longer the wife but has become big bad Mommy. A couple will disagree about how to handle Johnny’s temper tantrums because it is now Johnny and Mommy calling the shots, not Dad and Mom, husband and wife.

All effective work with couples requires an examination of both childhoods in order to minimize seeing each other through the lenses of the past. Our ability to turn our spouses into our parents cannot be underestimated and it can happen with the rapidity of a reflex. That reflex must be looked at in slow motion to find out what components are there causing unfortunate distortions.

Very important, and present to one degree or another in any troubled marriage, is the issue of sexual difficulties. The types of sexual difficulty encountered run the gamut and are as numerous and unique as the couples themselves.

Most prevalent, however, is a lack of desire on the part of one or both partners, resulting in infrequent or nonexistent sexual relations. This situation is often rationalized as due to lack of time, children, or exhaustion. While these certainly can be legitimate factors, scratching the surface usually reveals more significant reasons for a lack of intimacy.

A frank and detailed assessment of the sexual difficulties is necessary. And certainly organic factors need to be ruled out if, for example, erectile dysfunction, premature ejaculation, inability to orgasm, or even fatigue or lack of desire are present. Often a referral to a physician to rule out physical problems is necessary before addressing the issues in a couples’ treatment.

More often than not avoidance of sex is the issue. Many couples simply do not know how to talk to each other about their needs and desires, likes and dislikes. Anxiety and resentment can build up and it may seem easier to avoid sex altogether. Anger is a common reason for avoidance and is definitely a killer of libido. Or, as mentioned earlier, if a spouse is being perceived as a parent rather than a peer, sex will go out the window.

Perhaps surprisingly, even couples who are very close in other ways or who “do everything together” may avoid sexual intimacy. Often it turns out that persons in a couple who spend a lot of time together may actually be in need of some psychological space. A sense of separateness is essential to healthy bonding. If one doesn’t feel secure as a separate individual it may feel scary to be intimate. Often people talk about fear of losing a sense of self and create distance in order to preserve it. Sex is often avoided for this reason though it may not be conscious.

As anxiety-provoking as it can seem at first, the chance to talk openly about sex can be very freeing . And it can reduce the elephant in the room that no one is talking about to a manageable set of smaller issues.

Finally, but certainly of major importance, is the issue of infidelity. For many spouses this is a deal breaker. For many others, however, as long as an affair has ended, a couple can recover, working through anger and betrayal. By discussing the situation in detail a tremendous amount can be learned about each other and how their relationship devolved to this point. Infidelity can be viewed as a symptom, not just a violation. Healing is possible for many.

Regardless of the reason for seeking help, the first step in effective marriage counseling is an extended evaluation.

This involves an initial joint session, followed by two individual sessions, and then a second joint session for the purpose of sharing impressions and making recommendations. It is often tempting for couples in distress to jump right into the fray and they may feel impatient with the evaluation process. The therapist must have a chance to get to know the two individuals involved and the couple must have a chance to decide if they feel comfortable enough to proceed.

Sometimes a spouse may object to the individual sessions for fear of the revelation of something unwanted, or that a partner might try to paint a negative picture of the other. It should be made clear that an individual session is not an opportunity for blame. Further, anything revealed in an individual session can, at an appropriate time, be shared with the spouse. There can be no secrets.For anyone contemplating couples’ counseling, they should be aware that the presence of domestic violence, alcohol or drug abuse trumps anything else and must be addressed first by the most appropriate specialist. Nothing else will be resolved until any of these issues is under control.

What then is the common thread among all the reasons for seeking marriage counseling or couples’ therapy? It is a universal human struggle; that of trying to strike a comfortable balance between closeness and distance. Every individual struggles with this and every couple, happy or unhappy. There is no shame in this and if a couple is out of sync it can be very helpful to involve an interested but objective third party.

Finally, the role of the marriage counselor is not to save the marriage, but rather to help two individuals clarify what they may or may not be able to achieve in their particular and unique partnership. While this is hard work and there are no guarantees, it is those who are unwilling to examine themselves or their relationships when in trouble who are likely to end up divorced with no understanding of what really happened or remain unfulfilled in a marriage that is calling for change.

If you have questions about this article or think you might be interested in pursuing marriage counseling or couples’ therapy call Jane Adelman at 973-783-6977ex59.

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