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The couples therapist relationship is complex because your couples therapist has a unique and important role.
The therapeutic alliance is the most important factor in couples therapy. The research confirming this point is solid.
Permit me to repeat myself…that’s why you should choose your couples therapist very carefully.
The ancient Chinese strategist Sun Tzu once said, “every battle is won before it is ever fought.” He also said, “victory usually goes to the army which has better-trained officers and men.” There is a direct connection between training, therapeutic skill and the capacity to form a solid therapeutic alliance.
The outcome of your couples therapy may rely on who you choose to be your couples therapist.
Your battle with marital unhappiness may be won or lost… before it is even fought.
Why Your Couples Therapist Relationship is Unique
Nearly 60 years ago, Dr. Ralph Greenson was a psychiatrist to many troubled but prominent Hollywood stars. He was also the clinical professor of medicine at the University of California in Los Angeles. A brilliant academic and scholar, in 1965 he opined that therapeutic relationships were different than ordinary everyday relationships in 3 specific ways:
The Relationship Has a Specific Purpose. The only reason you are even meeting with your couples therapist is that you are agreeing to work together for a clear and stated purpose.
The Relationship is Imaginative and Explorative. Dr. Greenson used the term “fictive.” We explore what is ardently desired, and what is actually possible. I think one of the most beautiful words in couples therapy is the word “instead.” We talk about what “instead” might look like in your marriage.
The relationship with your couples therapist explores alternative and aspirational versions of yourselves in a possible new relationship with each other.
If you’ve chosen well, your couples therapist can fully inhabit this expansive role. During a Couples Therapy Intensive, you are engaged in generative conversations which are both imaginative, but authentic and heartfelt at the same time.
The Relationship is Real. Good couples therapy involves 3 people being authentic and real with each other. The therapist uses their “self” as a tool, offering genuine responses and reflections. The skill required of your couples therapist is to fully participate… and yet carefully observe at the same time.
What Makes for a Solid Couples Therapist Relationship?
In a word…attunement. Each spouse must feel supported and feel that I deeply “get them.”
They should see me… seeing them.
I notice their emotional states. I respond. When it’s going well, they feel known. Heard. Seen.
Researchers Bruce, Manber, Shapiro & Constantino, (2010). described it simply but beautifully; they said when a strong therapeutic bond has been firmly established, clients “feel felt.”
When it happens, a solid therapist relationship may surprise clients.
Some, (men in particular), neither expect or comprehend this experience of attunement.
They were expecting to be ganged up on, and identified as the “designated problem.”
However, if I can hold their experience in the container of my own experience, space for something new can now emerge.
Fears can recede. A feeling of safety can abide. But first I must attend to accurately understanding their experience, and convey that understanding without judgment. They must notice their own feeling states in my responses.
What Does the Research Say about Your Couples Therapist Relationship Alliance?
Bruce Wampold is an Emeritus Professor of Counseling Psychology at the University of Wisconsin—Madison. Dr. Wampold carefully reviewed all of the known the research examining the quality of the therapeutic alliance.
“There is no other variable that has been assessed early in therapy that predicts final outcome better than the alliance” Bruce Wampold
Research Findings on the Importance of a Solid Therapist Relationship Alliance
- The average difference in therapist relationship alliance skills completely accounts for the difference in outcomes between one therapist and another.
- The client-therapist relationship is at the center of outcomes, no matter who rates the therapist relationship. But is always highest when rated by the clients.
- Early progress in couples therapy is related to a more favorable outcome, but the quality of the therapeutic relationship is a larger factor in predicting a favorable outcome than the actual early gains themselves.
- Amazingly, sometimes the therapeutic alliance trumps medication. One study on the therapist relationship discovered that if a psychiatrist with an excellent therapeutic relationship gives the client a placebo, the client feels better than when a psychiatrist with a poorer client-therapist relationship gives the client a real anti-depressant.
- The earlier the client-therapist relationship is established, the better the clinical outcome.
Two Pillars of a Good Couples Therapist Relationship: Attunement and Empathy
The therapist models empathy for each spouse so they can re-discover what it might feel like to have empathy for each other once more.
This is a core concept in Emotionally-Focused Couples Therapy.
Because we ask so much of our clients in preparation for a Couples Therapy Intensive, therapeutic attunement and empathy may begin before the first actual meeting.
That is why careful and complete assessment is such a fundamental part of science-based couples therapy.
I may know more about my couple as they are driving up the driveway to start our intensive than some of the most important people in their emotional worlds.
I only know because they want me to know. They took pains to tell me their story in their Big Big Book.
It’s an honor, a privilege, and a great responsibility to be chosen to help a couple mend and heal their intimate bond.
When I greet them I know that our meeting will have a purpose. We will explore the realm of “instead.” And we will be real.
About the Author Daniel Dashnaw
Daniel is a Marriage and Family Therapist. He currently sees couples at Couples Therapy Inc. in Boston, Massachusetts, three seasons in Cummington (at the foothills of the Berkshires…) and in Miami during joint retreats with his wife, Dr. Kathy McMahon. He uses EFT, Gottman Method, Solution-focused and the Developmental Model in his approaches.