Archive for July, 2006

The essence of marriage counseling is in team work, not only among marriage counselors themselves, but also between them and suitable members of a comprehensive panel of consultants. As already mentioned these consultants are professionally trained people of special competence in an appropriate field related to marriage, who are willing to see clients referred to them, generally at their own professional rooms or offices, under a mutually acceptable financial arrangement.

As we have seen they can be divided into two groups, those who are especially competent in the counseling and psycho-therapeutic fields, such as psychiatrists, psychologists, and some pastors and social workers; and those with little or no training or experience in the psychological areas but expert in some limited field such as gynecology, urology, medicine, pediatrics, social casework, law, ethics, religion, vocational guidance or child guidance. Other specialists, in such fields as finance and “home economics” or “domestic science” may have a part in some special cases. As also emphasized these consultants should have some continuous contact with the marriage counseling agency with which they work, and some acquaintance with the principles and goals of the work.

The main reason for referral is that the apparent difficulty for which counseling is sought has some elements in it which are beyond the scope or the training or experience of the marriage counselor, and are within the special competence of the consultant. In this way the counselor can refer the partners to someone known to have the most adequate knowledge and experience for this portion of the situation, and can then use his own experience to help with the marital relationship itself. When there is smooth cooperation between the various members of the “team” the clients will receive the best available total help.

Much referral will naturally be governed by availability of the appropriate consultants, geographically, and from the points of view of finance and time. Marriage counselors are generally aware of the available resources in the community for such consultation, and the conditions on which clients are accepted, and this prevents disappointment and frustration.

The actual process of referral is one which needs careful and tactful handling by the counselor because it may cause some strain to any client who has “summoned up courage” to come originally for the counseling and experienced some rapport with the counselor. The prospect of going over some of the possibly painful material again, and the suggestion that referral means that the situation may be more serious than anticipated, may produce considerable anxiety and even resistance in the client.

Keywords: Marriage, Marriage Counseling, Marital Relationship, Marital Disorder, Marital Conflict

Appraisal

This is a better word than “diagnosis,” because it suggests the consideration of the many and varied complex factors in the disorder, and also the assets and liabilities of the partners regarding possible solutions of the conflicts.

As the interviews with each partner and any joint interviews proceed the counselor will be almost automatically arranging the facts and feelings presented to him in some kind of evolving pattern. He will also be assessing the various elements of the trouble, and the capacities of the two partners to deal with the situation and to make use of the counseling. It is vital that he make no attempt to disclose his assessments to the partners, because they are necessarily tentative in any case and open to continuing modification, and also because the partners would generally not be at all receptive of such disclosures. If he is pushed for some assessment it is generally possible to turn the question back by asking how the partner or partners feel about it.
As Dr. Paul Tournier has wisely pointed out in his book “A Doctor’s Casebook in the Light of the Bible” (S.C.M. Press, Ltd., London, 1954), there are two diagnoses in any illness.

The first is objective, made by the doctor from the data given to him, and ascertained by his examination and from special investigations. The second is subjective, made only by the patient, with help if need be through the quality of the doctor-patient relationship. Such inner feelings as resentment, guilt, anxiety, pain, love and hostility can be suspected but never adequately assessed by anyone but the person in whom they operate, and this subjective diagnosis or “insight” cannot be imposed or even conveyed to people in emotional disorder from outside.

Apart from this “automatic” arranging of the partners’ experiences and feelings about them and about each other it is often important for the counselor to pause at times, in and between interviews, to make a more detailed appraisal of the situation so far revealed to him. He can do this more clearly if he has in mind certain particular aspects on which it can be based.

a. The personal qualities and attitudes of each partner. One of the most important matters to consider, particularly when the partners are still living together, is whether either one can stand up to the conflicts for long enough for the counseling to have time to become effective. In many cases a partner will decide this for himself or herself and if it seems unbearable will walk out. But in some cases “walking out” is practically either impossible or appears too drastic to contemplate, and yet one partner may be on the verge of a breakdown in health or emotional balance. In such cases it may be of urgent importance for the counselor to refer that partner to a doctor for help, or to take some quite directive measures to avert a possible catastrophe. People under extreme stress often show quite surprising stamina, but there seems no adequate reason why anyone should be exposed to stresses which might prove too great for him to cope with.

Similar considerations might sometimes apply when it appears that any of the children are being exposed to extreme stress or danger. This may be difficult to assess from hearing the partners’ stories, and there is always some tendency for children to suffer from the conflict to some considerable extent. Here again when there is any suspicion of over-severe stress medical help should be considered, or in some cases when available the help of a social worker or a minister.

Apart from the risk of possible breakdown the counselor may well try to assess the capacity of each partner for reasonable insight through further counseling, and for avoiding desperate impulsive actions which might ruin the chances of reconciliation. Assessment of such matters will help the counselor to decide how much counseling to offer either partner, and whether any immediate referral is advisable. For example a partner who seems to be suffering from paranoid delusions is not likely to have any adequate capacity for insight, nor is any partner who may seem to be suffering from any psycho-neurotic, psychotic or psychopathic personality type. A psychiatric referral is generally advisable in such cases, if possible through the partner’s own doctor.

Other important matters for personal assessment are concerned with attitudes to sex, to personal relationships (possessive, dictatorial, judgmental, over-dependent, aloof, or over-sentimental), to parental attitudes, and to religion. Questions of rigidity or flexibility, and rationality and irrationality may be considered in all these aspects of personal attitude, and the general intelligence and maturity of each will come under some assessment, together with general sensitivity and vulnerability.

As before it must be emphasized that any such appraisal is entirely tentative, and that it is not disclosed to either
partner. It is constantly kept under review and modified with each further revelation in the counseling. In some cases the partner’s insight may be helped by a question such as, “Does your violent reaction to your wife’s remark suggest that you have a vulnerable point there?” and possibly later, “Did you ever have any experience like that as a youngster?”

b. The quality of the relationships between the partners. This may show many emotional elements which are not seen
in the attitudes of either partner to people other than the marital partner. Many a person shows the most charming manners and the most thoughtful consideration to everyone else but his marital partner. There are many emotional reactions which seem to be brought about by the very fact that the two people are “tied together” in marriage, a tie which may be resented as an “interference with freedom” even though it was accepted willingly and even with intense desire in the first place.

The relationships, for purposes of assessment, may be thought of as personal, sexual, parental, and sometimes specifically religious, for example in a “mixed marriage.” Questions of compatibility, cooperation and love can be considered in these fields, together with such matters as role perceptions in marriage, role expectations and consequent role frustrations. Such assessment will give the counselor some valuable data on which to base his continuing management of the counseling or his referral.

c. Environmental factors in the marital disorder. While not generally being the most decisive factors these can be
strong contributory factors to marital disorder, and it is important for the counselor to give them full consideration in his appraisal of the total situation. It may be that some atten
tion to housing, suitability of neighborhood, suitability of job, influence of “in-laws,” matters of finance and other such environmental factors will help in the reconciliation. Social agencies may be of great help in dealing with some “problem families” in this way.

Keywords: Marriage, Marriage Counseling, Marital Relationship, Marital Disorder, Marital Conflict

This section is concerned, however, mainly with the joint interviews which might be arranged by the counselor at some appropriate point in the series of interviews. There are two main reasons for his wishing to arrange such joint interviews. The first of these is when one or both clients tend to concentrate mainly on the objectionable attitudes and the misdeeds of the other, and seem unable or unwilling to face their own contributions to the disorder. If the counselor just goes on allowing them to talk about their grievances in this way the counseling may well reach a point of “stalemate,” unless their unburdening can go on well enough and for long enough for them to gain adequate insight. When this doesn’t seem to be possible it may be tempting for the counselor to bring up some point offered by the other one, for example, “Your wife seems to feel rather upset by what she thinks is your cruelty to her.” A common answer to such a statement is, “She’s exaggerating that, I’m not cruel at all.” What is the counselor to do then? Is he to take it up with the wife next time, and say, “Your husband thinks you’re exaggerating,” which would not be of any help to her or to the counseling because she would deny his remarks with indignation. The counselor cannot become a “tale bearer” without doing a lot of possible harm to the counseling.

When each client persists with accounts of the other’s misdeeds and doesn’t face any of his own it often helps to seek a joint interview, first asking the consent of each of them, and then asking whether each one would be able to bring up any matters which are distressing them. There are certain essential conditions of successful joint interviews which will be discussed shortly, and when these are fulfilled the counselor may find such an interview very helpful. Suppose in this joint interview “Mary” brings up her concern at “John’s” cruelty. John may then accuse her of exaggeration, and Mary will then say something like this: “But you remember on such and such an occasion when you got really mad with me and you grabbed me by the neck and nearly choked me. I still don’t think you realize how you scared and hurt me in your raging temper!”

In many such cases John might try to interrupt Mary’s account of something that he feels threatening to him, as he would have done in all of their previous attempts to discuss it with each other. But on this occasion the counselor can help each of them to get a good hearing by waggling a finger in this case at John, and saying, “Let her have her say, John, and then you can have the floor!” In this kind of manner he can keep the discussion from being swamped by the emotional components in the disorder. Under such good-natured control the particular grievance will be hammered out to some kind of mutual agreement, and then the counselor, who has shown full acceptance of the attitildes and behavior of each of them, can take up any such matter with the partner concerned in a subsequent individual interview. For example he might say to “John,” “What about those outbursts of cruelty that Mary brought up when you were both here last time? What sort of thing gets in your hair to stir you up in that way?”

From this point the counselor may be able to work with John backwards towards any frustrated role expectations, his habitual attitudes and responses, his uncritical assumptions, emotional needs and their frustrations, and also his childhood experiences with parents and others which might well provide him with the clues to the violent reactions which perplexed him as much as they upset his wife. Properly handled, such joint interviews can make the rest of the counseling move ahead in such cases as these, by bringing many important areas of conflict on to the “agenda.”

A second and generally later reason for joint interviewing is that when each partner has achieved reasonable insight it still may be a valuable way of clearing up many matters of mutual involvement, or offering appropriate information applicable to both of them, about some of the principles of personal relationships. These may be termed “mediational interviews,” as distinct from the “clarifying joint interviews” already discussed. There will not generally be as much emotional inter-relationship or interaction in the mediational interviews as in the clarifying ones, and there will be more constructive and practical discussion. At this point it is necessary to formulate the main conditions which need to be satisfied if a joint interview is to have the best chance of succeeding. It goes without saying that the willingness of both partners is necessary, and the additional willingness of each of them to bring up any matters which concern them is advisable. But there are some other quite important conditions.

From what has been discussed so far it seems clear that any joint interview is more likely to be helpful if it is left until the emotional tensions have largely subsided. If things become so heated in any joint interview as to be likely to hurt or humiliate either partner too greatly it may be wise for the counselor tactfully to terminate it, either by stopping the whole interview with a sympathetic gesture to each partner, or by suggesting that one of the partners retires for a time and the other (possibly the more hostile one) carry on with an individual interview in which he is encouraged to unburden his intense feeling.

So that the emotional tensions may have a chance of subsiding before any joint interview it is generally wise to have at least two or three individual interviews with each partner before arranging it. Another condition, more difficult to carry out in many cases, is that the counselor should have reasonably comparable rapport with each of the partners. If this is not achieved it is likely that the partner with whom there is less rapport will feel ill at ease and even “odd man out,” and that may well do more harm than good. In such cases a more intensive counseling with the partner with less rapport may be very helpful.

Keywords: Marriage, Marriage Counseling, Marital Relationship, Marital Disorder, Marital Conflict

The whole question of joint interviews needs to be considered in relationship with two important facts first, that nearly all marital disorders have very strong emotional components which by their very nature tend to take control of any discussions and to divert them from any “reasonable” path; and second, that the counselor will be carrying out with the partners something that they may have already tried many times without him, and generally failed to solve their conflicts in doing so.

But the presence of the counselor introduces a very influential element into any such discussion. Each partner will unconsciously as well as consciously relate his attitudes to the counselor in one way or another. He may try to win the counselor’s emotional support, and he may well restrain himself from many obviously absurd accusations which he might have made otherwise. From another point of view the counselor brings what can be a vital influence into such joint discussions in that if, say, a husband is deeply hurt in the counselor’s presence, the humiliation may put him so much on the defensive that he might not feel able to go on in any but a superficial manner with further counseling.

It seems clear therefore that joint interviews need careful consideration and even more careful and tactful handling if the dangers of excessive wounding on the one hand or of loss of rapport on the other are to be minimized. In some cases the two partners come together for the first appointment, and it may be helpful to consider some of the possible meanings of this action. As we have seen previously it may mean that they have a mutual willingness to look for a way through their difficulties, and are not aware of any great emotional conflict between them. In other cases they come together because they have the idea that this would be expected of them. There may however be some deeper reasons for their coming together. For example there may be in one or both of them a deep suspicion that the first one to be interviewed may gain some advantage by “getting in first,” which suggests their idea that the counselor is going to act as a kind of judge. There may be a desire to “answer” all criticisms and accusations the moment they are made, coupled with a fear of being discussed “behind their backs.”

In most cases when the two partners come together for the initial appointment the counselor will have them both in for the beginning of the interview, and will observe them closely while he is listening to whoever is doing the talking. When there is any indication of emotional tension in one or both, either outwardly expressed or less directly conveyed by sitting silently and looking away from the counselor and the partner, the counselor will generally suggest that it is mostly easier for people to talk freely in the absence of other people, and offer them the opportunity for individual interviews. When put in this way the offer is usually accepted, and it is either left to the partners to decide who shall be first, or the counselor suggests that the one who seems to be least anxious to talk might have the first opportunity. In many cases this person has been a bit overwhelmed by the more active partner, and if sent out may feel even more crushed.

If one of the partners has more difficulty in arranging convenient times for appointments it may be right to have that one in first, and in such cases the partners will often suggest that themselves. But in all cases when both partners come for the first appointment each of them should be given some time alone with the counselor, even if with the second partner it is only a short session which shows acceptance of some feelings and sets the stage for another fuller session within a short time. In this way neither partner is so likely to feel frustrated after summoning up quite a lot of will power to make the initial approach to the counselor. This first contact is, as we have seen, of the greatest importance as the foundation of the counseling relationship.

Keywords: Marriage, Marriage Counseling, Marital Relationship, Marital Disorder, Marital Conflict

Another possible and sometimes effective method of dealing with ignorance and misinformation is through books, booklets, pamphlets, and occasionally the provision of lectures. These need to be well chosen with regard to the suitability of the material, the manner and the spirit in which they are presented, and the capacity of the clients to profit by them. The appropriate time for offering such help through literature also needs careful consideration.

When literature or lectures are offered to clients it is well for the counselor to offer them the opportunity of discussing the material in subsequent sessions, encouraging them to mark any particular parts of the material which they may wish to discuss, and also eliciting from them their general impressions of the information that has been offered, and the application of the various matters to their own situation. General and specific information given in books or lectures or pamphlets needs to be applied to the particular feelings and needs of the clients if it is to be of the most practical value. Dealt with in this way it forms a very important part of the counseling process, and it has increased value because it can be taken up and studied at any future occasion if needed. Most if not all marriage counseling agencies keep a supply of printed material for distribution and sale, and also have lists of recommended reading material. Many of them also organize classes of instruction for those who may feel disposed to enroll.

In dealing with apparent immaturity of any kind in either partner the counselor will generally attempt to encourage the client to discuss his earlier background “conditioning,” and this has already been dealt with in a previous section. In seeking to find out what kind of relationships existed between the client and significant people in his childhood the question, “How did you get on with your mother (or other person)?” is likely to be answered in such a manner as “Oh all right,” which may tend to close the discussion. A more productive approach is through the question, “What sort of person was your mother?” and in answering that kind of question the client will generally bring out many important aspects of his relationship with her. With similar questioning about father, step-parents, aunts, uncles, grandparents, teachers, brothers, sisters, half-brothers and sisters, and “unofficial” uncles and aunts, and friends. As we saw in the first case record in this book it may help to obtain a two-dimensional view of the client’s background, from the client himself and from his partner, who will usually have some knowledge of it; and also possibly from anyone else with good knowledge. In such ways as this a fairly complete impression can be gained of the client’s “style of life” (as Adler called it), which may help in the further counseling.

An important aspect of immaturity is the “vulnerability” of the client, and his “rigidity” of thought, attitude and behavior. In his unburdening the counselor will gain some idea of what kinds of attitude and behavior in others upset him or stir up hostile reactions in him. The counselor may then be able to look with him behind the vulnerabilities to the uncritical assumptions and emotional needs and other inner factors which have contributed to them. They are better dealt with at this deeper level than at the superficial one.

When there are indications of any form of mental illness the counselor will necessarily consider the advisability of referral, but in some milder and less obvious cases he may be able to help the client to better insight and better relationships. For example many clients show indications of self-hate, self-disparagement or even self-punishment, which may be traceable back to the kind of conditioning which came from their parents. Others will show indications of projection or reaction formation, or other mental processes dealt with in a previous section. These are sometimes open. to counseling help, but when at all persistent or severe they generally need psychotherapy. Any apparently abnormal sexual attitudes or psychopathic manifestations will also bring the counselor to consider referral as long as the marital situation is being threatened or upset by them. Some attempt to find the background factors in the assumption of such attitudes may be justifiable, and occasionally this will make it possible for the client and partner to understand them better and to work out constructive ways of dealing with them.

Certain religious attitudes in one or both clients may appear to cause quite serious conflicts in marriage, and these are often very difficult to deal with because they are at a level of thought which is not altogether open to reason, and are the products of long continued childhood conditioning. But such difficulties are a challenge to mutual tolerance which is supposed to be one of the products of good religion, and the counselor might well try to help the partners to face their religious conflicts on that basis. If they can learn to do this it may develop their religious attitudes towards much greater maturity and practical relevance. In many cases of immature or rigid religious attitudes this may demand very great tact and patience; and a way of handling the situation which comes “not to destroy but to fulfill,” and which does not seek to impose any of the counselor’s religious attitudes on the clients.

Where the difficulty and conflict is in the kind of religious training which is to be given to the children it may be difficult to find a way through the trouble which is acceptable to both partners. It is much better when such difficulties are anticipated and worked out between the partners before the children come, but when this has not been done the counselor has to make the best of the situation in the face of all the emotional tensions which so often surround it. There is one general principle which may possibly be offered at any appropriate stage in the counseling, that in those cases where the differences are at all great it is better for the children to share the religious attitudes and denomination of their mother, with whom they naturally have closer ties, than those of the father. For children to grow up with religious attitudes at variance with those of their mother involves difficulties and adverse consequences beyond general awareness, and the counselor may feel it incumbent on him to offer this information.

Keywords: Marriage, Marriage Counseling, Marital Relationship, Marital Disorder, Marital Conflict