Relationship Theory Used In Couples Counselling

Introduction

In this paper I will look at what is means to be a couples’ counsellor. What theories apply to this mode of counselling and how can these can be utilised during the sessions. I will also consider some of the aspects that need to be considered with couples counselling including tools and key focus areas to support the effective sessions.

Equality, Perception and Exchange of Goods

‘The heart of good couples counselling is the facilitation of each person’s story and their partner’s listening to that story’ (O’Leary). O’Leary goes on to talk about the counsellor being a translator, moderator and host. What he means by this, is the ability to facilitate sessions through:

Understand different modalities, personalities and history in order to translate what one client may be saying into another’s language. Moderate the session in such a way that clients’ freedom to speak, whilst respecting the ‘space’ of the other and that of the counsellor. Ensure clients are aware that you are hosting the sessions in order to manage timings and contracted approach.

Social Exchange Theory

The theory suggests ‘social change and stability as a process of negotiated exchanges between parties’ (Wikipedia). This means a cost and benefit approach for any involved party developed as the relationship develops. If this balance is compromised, the individual who feels they are giving more than they are receiving will invariably feel resentment and may, ultimately, dissolve the relationship. It takes into account that the value given to a certain cost or reward varies person to person. Originally coined by George Homans (1958). Peter Blau, Richard Emerson, John Thibert, Harold Kelley and others developed various aspects of the theory. We are interested primarily in the four stage process behind the development of a relationship; shown below (Thibaut/Kelley):

Figure 1 – Integrated Socio Psychology: 4 Stages

As the saying go ‘people change’ and often as a relationship grows then the definition of what an individual needs or is willing to give will change. ‘When we evolve in our relationships, we create new ideas of costs and benefits within that given relationship, and must communicate those new needs in order to reduce discontentment and risk of relationship breakups, and increase our happiness.’ (Owen, 2012). Such costs and benefits come in many forms, but all fit into Maslow’s Hierarchy of Needs:

Figure 2: Maslow’s Hierarchy of Needs

For some, basic physiological or safety needs may be key. For others, subjects such as intimacy, feeling valued or even supported in actualizing one’s potential may come into play. Many factors will affect these needs, depending on the client’s environment, culture, beliefs and values to name a few.

Conversely, costs can also be broken into key areas; Investment (mental energy and emotional investment), Direct (time, financial and material investments) and Opportunity (personal sacrifices to benefit the relationship).

Equity Theory

Equity theory contrasts favorably with Social Exchange Theory in the fact that there is a balance between two parties and a sense of fairness or equality. Originally coined by John Stacy Adams in 1963, whilst looking at job motivation. Equity theory suggests motivation when an individual feels fairly treated, and demotivated when not. The theory takes into account the fact that this view comes about when individuals compare themselves with others of a similar situation (business balls).

There are various aspects to this theory. Walster, Walster and Berscheid (1978) contributed further to Adams work through their ‘principles’ and personal positioning. I’ve highlighted in the diagram below a visual representation of this for use with couples when considering this theory:

Figure 3 – Z Foster’s Interpretation of Equity Theory for use with Couples Counselling (Wikipedia / Business Balls / Huseman)

Social Exchange Theory considers how a relationship changes during its progression. Equity Theory considers how individuals view themselves in relation to others and considers their belief system. For the latter, an individual may simply move from a satisfied to unsatisfied state through discovery that another in a similar situation receives more reward. For example, a husband discovering a friend’s wife is happy for her husband to stay out at the pub every night and feeling he should be able to do the same.

As a result of this social interaction aspect, I believe, there must indeed be a strong interlock to other theories:

Psychosocial (Erikson):Considering individual belief of each client through their language. Trust vs Mistrust, Intimacy vs Isolation, etc. Understanding each of your clients’ mindsets and how they relate to each other. Moral (Kohlberg):Similar to above. But looking at moral aspect; obedience, self-interest, social conformity, etc. Differences in perception for each client and how they work through differences. Personality:How introverts and extroverts communicate and perceive their needs given/met. In particular the judging vs empirical personality and its perception of rewards vs effort. Behaviour:Different behaviours and responses by each client to the same stimuli. Considering hot thoughts behind these and the preferred outcome for both parties. Gender Socialisation:Awareness of how influence around gender from family, culture, religion and educationas well as the considered biology factors. How this dynamic affects the current relationship. (SparkNotes) Benson, McGinn and Christensen

Three UCLA psychologists published 40 years of research on couples’ therapy (Psychology Today) and identified five underlying principles that a couples therapist should consider. I feel these support the two theories above:

Perception of relationship by each partner
Help each client to see the relationship more objectively. Perhaps to use tools such as ‘decentering’ to ‘hear’ and understand each other’s needs, stepping away from blame. Working with the couple to understand contextual challenges, such as finances and perception as such. How the clients interact with each other; sharing with the clients how they share information with each other ‘I notice that …’ The key is to altering the way the relationship is understood and perceived in order that the couple can consider each other’s interactions and adaptive ways to compromise. Modification of dysfunctional behaviour

Benson, McGinn and Christensen’s evidence suggests effective couples change the way that they behave with their partners. Meaning that further to improving couple interactions, therapists need to ensure that their clients are not engaging in actions that can cause physical, psychological, or economic harm. This can be as simple as one partner’s behavioural response to the other partner’s upset or on the other end of the scale perceiving a safety issue. The latter may involve recommending individual counselling or specialized treatment such as anger management, individual counselling, drug rehabilitation or GP involvement should is the issue involve conditions such as depression or borderline personality disorder. Reducing emotional avoidance

Discussed in Social Exchange Theory section above; couples avoiding discussions around feelings that result from needs not being met tend to build resentment. Effective communication of emotions help couples feel less afraid expressing of expressing their needs for closeness. This can relate back to development periods for some around comfort levels when considering intimacy, attachment and fear of rejection. Evidence suggests that clients who express their true feelings will draw them closer together. There is a STRONG health warning here – the level of fear of rejection or even past abuse may need to be dealt with outside of the session involving the partner. Giving the client an option to deal with a past issue affecting their current relationship through 1-1 counselling (with another counsellor) may be important. As with all such decisions, supervision advisory is key. Improving Communication

The three ‘C’s” of intimacy (Closeness, Communication, Commitment). Working with couples to communicate more effectively; avoiding abuse or ridicule when expressing true feelings. This is when at times, the counselling moves into a “coaching” role from time to time. It’s important here that a counsellor steps carefully to avoid their ‘view’ of how to communicate to cloud their coaching, but instead work through using their ‘translator’ in the main and backing up with sharing known knowledge such as listening, empathy, theories such as Transactional Analysis (Parent, Adult, Child) or tools. Promoting Relationship Strengths

Similar to 1-1 counselling; identifying and using key strengths builds self-esteem in particular relating these to goals in order to build resilience. Re-focusing upon areas in which couples function effectively can help promote strength, especially if this creates a sense of pleasure. Building on this the couple may identify individual pleasure areas that can be supported by one another; in other words where they can please one another. This could be emotional, activity or historical. Again, it is important that the suggestion of strengths comes from the couple themselves and NOT an interpretation of the counsellor.

It’s key to note that the evidence shown above does not consider couples counselling with the successful outcome being separation. The separation of the couple by the realisation that needs are not and will not be met, may well be the outcome that one or both may want to achieve ultimately. Of course, if this decision is made by only one party, it may mean the other party will need additional support.

Therapeutic Approach

Initial Sessions

All of the above models and research suggests that a mainly client centred approach at the outset is most appropriate, in the main, for couples counselling. A clear ‘contract’ needs to be in place. Something the counsellor and clients can return to if necessary. Examples, would be:

Both clients need to be committed to the counselling to get the best out of it. If one party is there under duress, the sessions will not be effective. Honesty – open and honest reflection and honest learning from the sessions from both parties. Space and equality to speak and be honest about feelings and emotions without prejudice from the other. One at a time talking, allowing the other to finish, both for clients and counsellor. Respect for each other, to discuss challenges using feelings and emotions rather than blame. Allowing the counsellor to intervene and ensure the sessions are facilitated fairly – with a return to contract if necessary.

Carl Rogers Six Core Conditions

Due to the unique nature of couples counselling, the counsellor could easily allow their gender, values and perceptions to create a judgment and perhaps end up favouring one or other of the clients. Counsellors must be self-aware and take any challenges to supervision (for example transference/counter-transference).

1. Client and therapist must be in psychological contact. It is about discussing inner feeling focused on the self. 2. The client is in a state of incongruence. The client is emotionally upset. 3. The therapist is congruent in the relationship. The therapist must be genuine and aware of their own feelings. 4. The therapist experiences unconditional positive regard for the client. Therapists must not judge the client but value them. They have worth simply because they exist. 5. The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavors’ to communicate this experience to the client. 6. The client perceives the therapists unconditional positive regard for them and the therapist empathic understanding of their difficulties.

Figure 4 – Created from resources on cgjj.wikispaces.com (Rogers 2007)

Learning Styles & Communication

Given the above; a counsellor needs to be aware of differences in how either party thinks and communicates. The counsellor must understand why the clients have chosen counselling at that particular time; i.e., are they fairly self-aware and want to resolve a key issue or are the couple in a downward spiral of expectations and resentments?

Use of peripheral vision; be aware of the response of the second party whilst speaking to the first. Take into account the demeanor of the ‘whole person’ as well as the language. This of course takes into account areas such as:

Modality:Visual, Kinesthetic, Auditory in the main, but also Gustatory, Olfactory and Audio Digital cues. Be aware of the language used and how perhaps the counsellor can reflect what is said by one client in the language of the other. Multiple Intelligences:Similar to above with additional categories such as interpersonal and moral. Encompasses typical roles and focus tasks by someone who errs towards each of the key cues. (Business Balls, Howard, 1967) Language:Consider how use of certain words, whether they are the same words used by both clients or different words for the same thing and why. Perhaps this is something for an ‘I notice that …’ style intervention. Projection:Be aware of these statements. Attributing one person’s negative feelings onto another, especially common in relationships. ‘It’s your fault I’m not able to …’

Life Changes and Conditions

There are many well documented reasons as to why relationships break down. Pressures of raising children and maintaining a relationship. A returning veteran with PTSD or even the same veteran finally being discharged from service and stepping into a family environment where they need to carve out a role. Loss of job, an affair, a same sex couple under pressure having come out to their families. Challenges with mental health such as depression. Dependence, merging, bereavement, the list goes on. What is important is to understand what needs to be dealt with in the room and what needs to be dealt with one to one with another counsellor.

Sex and Relationships

It may be that sex is indeed part of what the couple have come to discuss. This may include dysfunction, varied sexual appetite, need for change/variety or perhaps medical issues that affect sexual function. A counsellor would need to expect to use the clients’ terminology in the main, although clinical terminology can also be used.

Understand how the sexual health of the couple affects the other issues or concerns being raised. It may be that the challenges faced root from the current relationship or past issues. Be mindful always of what is best for the client(s), use supervision, and if necessary the couple may need to be referred to a qualified Sexual Therapist (qual. College of Sexual and Relationship Therapists).

Abuse and Trauma

Trauma may be simple or cumulative and/or a consideration around abuse. It may be a red flag indicator from one client regarding the other. It could be an indicator of past experience affecting current relationship. It is key to understand if one or both of the clients are at risk of harm or harming others. Always seek advice and supervision. It may be that one of the clients need to deal with the event(s) via one to one counselling.

Additional Considerations and Tools

Many of the challenges faced within the realms of the relationship relate back to many of the areas we have focused on so far. Although it’s worth being aware that in some cases, one or other of the clients may need to deal with the specific challenge via individual counselling:

Self-Defeating Behaviour:Reviewed in last essay and taking into account that many SDB’s may have started as coping strategies in order to manage a challenge in the relationship. Use of HINDSITE/TIME Models. Cognitive Behaviour Therapy:Maybe key to understanding emotions, feelings, behaviours and ‘hot thoughts’ during key periods. Counsellor needs to be aware that using ‘Thought Diaries’ may not be ideal for couples, but perhaps other tools such as the vicious flower or drawing their feelings/situation can support discussion around self-defeating cycles. Decentering/Empathy:Requires coaching of the clients, but supportive of getting each client to step in the others shoes and truly view the thought processes and emotions in a non-judgmental fashion to understand one another’s needs and feelings. Role-Play:Especially important where clients can test communication and active listening approaches, learning to question rather than challenge. Perhaps earning to talk in ‘Adult’ through understanding the TA model.

Closing Out Sessions

I believe closing out the sessions in a constructive manner is key in couples counselling. From all the research and papers I have read, due to the changing nature of our lives, jobs, expectations, etc; things will always change for the individual. This will impact relationships in different ways and couples will from time to time find themselves at odds with each other. It’s only natural.

I would consider setting expectation of the timelines through the closing sessions and exploring with the couple their ongoing process of communication to maintain the health of the relationship. Perhaps even, to start working with the couple to look at ways they would like to handle any new challenges faced. What would they like that to look like and how could they communicate whilst remaining respectful? Working to build confidence around the couples abilities based on the strengths and learning points identified during the sessions.

Equally, if the ultimate goal or outcome of the sessions is separation then it may be that each will need to consider what they would like to take from the sessions in terms of learning or whether they feel they need further one to one counselling.

Conclusions

Fear, expectation, personal beliefs or values can all create an environment where one or both in the relationship feel they cannot not discuss their discontent should the situation ‘worsen’. However, the status quo, can instead, create resentments that fester and grow. These then become increasingly difficult to resolve.

It’s possible, however, that an unequal relationship may continue ‘successfully’ for years in lieu of an attractive other option, through fear or dependency. An unequal relationship is a strong breeding ground for self-defeating behaviours, which often that start out as coping strategies. Core to the clients is how the issues, relationship dynamic and goals affect both clients’ self-esteem and confidence. One can easily see, how then, the counsellor needs to draw upon a ‘Translator, Moderator and Host’ role in
order to facilitate effective couples’ sessions.

There are perceptions around couples counselling and its success. New York Times columnist Elizabeth Weil in her column “Does Couples Therapy Work?” (Whitbourne) suggests there is a problem in couples counselling of ‘couples waiting until ‘very late in the game’ to seek intervention, and by then, one or both have decided to call it quits’.

In contrast to this, Relate have just released an article sharing an independent evaluation of relationship support services. The factors of loss of time at work and the need for benefits due to breakups, divorce and single parenting are economic cost. The report suggests ‘Relationship breakdown is estimated to cost the UK economy £46 billion each year, with often devastating and long-lasting emotional effects for individuals and families’. It goes on to say that ‘Relate’s couple counselling and Marriage Care’s marriage preparation services deliver £11.40 and £11.50 of benefit respectively for every £1 spent*. This is calculated by looking at what costs are saved by reducing the likelihood of relationship breakdown.’ (Relate, 2014)

I feel I’ve only touched on the surface of couples counselling. There are so many aspects to take into consideration. Couples counselling is acknowledged as a difficult and stressful area of profession. Being able to hold the ‘space’ between clients and ensure the session does not descend into a ‘shouting’ match, requires practice and skill. Accepting that this area can be perceived as ineffective by those who believe the couples separating after counselling have been let down by the service. It may in fact be the best solution for the couple involved or that one party simply did not want to take part.

There are fine lines as to what subjects remain within the couples’ session or is taken away to one to one counselling. Emotions are focused and can be raw, meaning the counsellor has to work to ensure their own health is maintained effectively. I can see why specialist training is in place to ensure a ‘safe pair of hands’ when dealing with couples’. ‘There are so many strands to keep track of – being attuned to each partner’s emerging experience, staying in touch with one’s own feelings and imaginings and sensations, tracking the pattern that is being created between the partners, attending to the technical details of effective enquiry, making decisions about if and when to encourage the partners to describe their own phenomenological experience or to move back into enquiry about the other.’ (Erskine)

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