By Sharon Jackson

The recent New York Times article, “Does Couples Therapy Work?”   touched upon an interesting dilemma among practicing  therapists who treat couples.  That dilemma being how difficult it is to sit in a room with two people, who in most cases, are at war with each other.

Dr. Barbara Bartlik, M.D., has this to say about  whether couples therapy works: “A very wise couples therapist once advised me that, when treating a couple, the therapist should have the couple speak directly to him or her, and not to one another.  That way each will have the chance to tell their side of the story, and the conversation will be less likely to deteriorate into a fighting match.  The more volatile the couple, the more important it is to adhere to this strategy.  It is also important for the therapist to draw out the couples’ feelings by asking each person for their reactions to what the other has said.”

“In addition, it is helpful when the therapist prevents the couple from interrupting one another, makes sure that no one person is monopolizing, and tries to maintain a neutral stance.  By following these simple rules, many pitfalls described in this article can be avoided.”

It’s a very different experience from treating one person, compared to the tension in a room with two people who are terribly unhappy.  It’s the dirty little secret  that couples therapy stresses out therapists and can often be scary.  Family therapist, Terry Real says, “It’s frightening to be faced with the force of two strong individuals as they are colliding.”

In couples therapy there are so many variables to consider.  There’s an ever-present risk of winning one spouses allegiance at the cost of the other spouse.  One spouse may think the therapist is fantastic and the other a total crock.

Timing is another issue.  Especially when comparing individual therapy to couples. If the therapist allows a couple to interrupt each other for 15 seconds, they will usually end up screaming at each other at full throttle defeating the purpose of their visit.  Another aspect of timing is waiting until it’s too late.  The average couple is unhappy for six years, before they seek help.  In many instances that’s too long for a therapist to help fix relationship problems.

William M. Pinsoff, professor of clinical psychology and president of the Family Institute at Northwestern University in Evanston, Ill. is conducting a study that could prove most helpful in treating couples.  He is having his patients fill out questionnaires about their lives before their sessions and then after to help track behavioral change.  By keeping a database of information about his clients, it will give tangible evidence of their progress.  It’s a way to track and guide therapy.

Regardless of the approaches and issues to consider when treating couples, the bottom line, is that therapists will always  see a lot of fighting, anger and rage which is the nature of this kind of therapy.   And that will obviously bring up a lot of the therapists own issues.

Being a couples therapist is similar to being President of the United States in that both are high stress and involve creating a more harmonious rapport or solution between parties at war. Sometimes it’s successful and sometimes it’s not.