So Many Different Therapies? What to Do?
Excuse me for being a bit skeptical about relationship therapies. Given that I work with many couples of all shapes, sizes, and ages, that may be surprising, or even confusing. Let me explain. Each year, more than 1 million new books about relationships are published. That does not include the more than 13 million previously published relationship books still available to you. While an exact count is difficult, educated estimates are that more than 50 different types of recognized therapies addressing relationship difficulties are in active practice. And this doesn’t count the more off-beat approaches that promise relief from every problem under the sun that is sure to be followed by eternal happiness and contentment.
Really? What is going on here? Aren’t there some basic, common sense, and proven truths about what creates relationship struggles and challenges and what can be done to help you to get back on track toward a more satisfying, rewarding, and fulfilling relationship? Thankfully, the answer is yes.
We Are Wired for Relating. But, Getting the Wiring to Work Well is Tougher
To gain an understanding of how to improve your relationship going forward, it is important to first go back – way, way back! Back to long before you met each other. Long before you or your parents were even born. Let’s go back to before human beings even walked the earth! That’s because understanding that ancient, built-in self-protection and survival systems deeply wired into your brain and body play a central role in healing or hurting your relationship can help frame how to get better. So, let’s briefly dive in to our shared past.
Approach or Avoid, the Perpetual Challenge
Life has been shaped by two very ancient, pre-wired impulses. We know that amazingly complex software programs are built from a binary code of 0’s and 1’s. Life’s version of this code is approach or avoid. Out of this binary simplicity emerges the enormous complexity that shapes human relationships, from birth to death.
Every relationship conflict, whether consciously or subconsciously, revolves around how communication signals are transmitted that inform each individual whether you’re safe or not, you should come closer or get away, you’re reliable or unreliable, you’re offering security and comfort or dangerous entanglements, and an endless set of other approach-avoid pairings.
Reptiles use approach-avoid decisions instinctively. Human decision-making is infinitely more complex, but it is still based on these pre-programmed perceptions, which are updated and refined through on-going learning from life experiences.
How Approach and Avoid are the Foundation of Relationship Safety and Conflict
Trust, for example, emerges from repeated experiences of forms of safety, security, and reliability, which are themselves different forms of the approach end of the continuum. Denial, on the other hand, emerges when a perception is too painful or threatening to accept. As a result, the “self” is protected from that perception by denying its accuracy or validity (“I never said that! I don’t act that way? I don’t know what you are even talking about!”). And, in the self-protective reaction, which is a form of avoidance, the other person in the relationship is rejected or invalidated. This results in a potentially harmful and lasting relationship rupture.
The specifics that couples bring to therapies vary widely. Infidelity, loneliness within the relationship, insecurity, threats of anger or potential violence, anxieties, depression, drug/alcohol use, compulsive behaviors, parenting conflicts, the residue of earlier life struggles (e.g., abuse histories), intimacy struggles, and many more.
Varieties of Therapies
Cognitively-based therapies (CBT) focus on the beliefs and attitudes that are acquired over time that shape how we respond to perceptions that trigger approach-avoid behaviors. Attitude matters, Beliefs shape what we expect. Sometimes, self-fulfilling struggles follow, but can be modified through CBT-based therapies.
Emotion-focused therapies (EFT), on the other hand, recognize how activated emotions, often out of direct intention or awareness, still have a powerful role in shaping the thoughts and reactions that follow. Learning skills necessary to “stay present” to uncomfortable and vulnerability-inducing emotions is an important part of this therapy.
The world of mindfulness, rooted in ancient eastern spiritual practices, when used with couples, trains them in practices related to attention, awareness, non-judgment, and reduced reactivity, all of which are very important elements of learning to be present to your own inner reactions as well as those of your relationship partner. In turn, the capacity to move beyond old habits of response to create new interactive possibilities is enriched.
There are, of course, many more variations and approaches, each of which has different names, and each of which may be just the ticket for a specific couple. So, how do you make the right choice, or more accurately, the right choice for you?
Helping You to Make an Informed Decision
Here are 5 factors to consider when couples are selecting someone to help you address your relationship concerns.
1. Connection is often more important than the specific approach the therapist offers. The approach-avoidance programming that may be impacting your relationship is also operating when you meet the therapist. How comfortable, curious, safely challenged, and respected do you feel? Find a person who meets these criteria and the odds of success can increase.
2. Couples who seek therapy often bring strongly developed ways of acting that are both about self-protection and about perpetuation of the problem they are seeking to change. Feeling comfortable and understood alone, without developing action-steps to practice outside of the sessions can lead to frustration and failure.
3. Growing and changing, individually and together depends on learning, and learning requires the ability to tolerate uncertainty and a bit of discomfort as you gradually let go of the old to allow in the new. Pick a therapist who understands these aspects of change and who can support you in your efforts to bring out your “best self” in and outside the relationship.
4. Effective therapy is not just about being listened to. There is a rapidly expanding world of scientific research into relationships and the pressures couples face to stay connected and fulfilled. Search for a therapist who can help you understand, in simple and compassionate language, some of the particulars of your approach-avoidance struggles that may be hindering you from reaching your goals.
5. Lastly, budgeting is an important concern. Many insurance plans will not cover couple’s therapies. Before embarking on a course of relationship therapy, make certain you understand what you may be getting into personally and financially. While it is impossible to put a price on a happier and joyful relationship, excessive costs can interfere with being able to stay focused on reaching your therapeutic goals. Talk to the therapist about this and be comfortable with the process before beginning to work together.
Stay tuned and take care…
To learn more about my services, click here. Dr. David Alter
David Alter, PhD
Alicia Viera, PsyD
Lois Fischer, MA, LMFT
Partners in Healing of Minneapolis
10505 Wayzata Boulevard, Suite 200
Minnetonka, MN 55305
763-546-5797 / Fax: 763-546-5754