Questions of Appraisal

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