Couples Therapy: Then and Now
Modern couples therapy has evolved. It now addresses the intersection of attachment, emotional expression, and psychophysiology. Our emotions, and their expression are the vehicles by which we remain connected, safe, and secure inside relationships.
According to Psychology Today, Modern Couples Therapy is effective 70-80% of the time to maintain romantic relationships. This was not always the case. In fact, efforts to provide relief for troubled couples was a distinct failure until the past 30 years. When therapists shifted to more emotionally-focused modalities, this improved significantly.
In the 1930s and 40s, couples with relationship problems were supplied with “marital education.” This was advice and training for women that encouraged maintenance of traditional family roles and adherence to moral and religious codes. Researchers attributed shifting familial patterns, role ambiguity, and unrealistic expectations around marital satisfaction as contributors to marital troubles.
By the 1950s, psychoanalytic and personality theories dominated. Typically, psychoanalysis for each marital partner would occur separately, with a goal of meshing their respective neuroses and personalities in more manageable ways to increase harmony. Not surprisingly, these approaches weren’t very effective.
The 1960s saw the development of modern couples therapy. Sessions began to occur with couples conjointly rather than individually. Murray Bowen’s systems theory became influential. Interactions between the couple, rather than individual dysfunctions became the focus. As applied to couples, the theory pointed to poor boundaries, feedback loops, unresolved anxieties, triangulation, dysfunctional patterns, and communication problems as causes of marital dysfunction. Cognitive behavioral (CBT) approaches sought to essentially control and limit emotional responses to help the couple become less enmeshed, less emotional, more individuated, and more “rational.”
Despite efforts to quiet emotional responses, couples yelled, and certainly weren’t calm. Bowen’s theory of emotion vs. reason, with reason being superior, was incorrect. It turns out that problems don’t get solved with reason alone, because humans are not purely rational. Human emotions are fully integrated and inseparable from the cerebral cortex, and are essential to problem-solving. To suggest that increasing, rather than decreasing, emotional dependence between partners was what kept relationships intact was radical indeed. The expression of emotions by one partner to the other does not suggest being “out of control,” but the nature of that interaction does predict outcomes of the relationship.
Beginning in the 1970s and 80s, increased observation of the emotions and affective responses of partner interactions began to take a central role in couples therapy. Through the 1990s and 2000s, with further development of The Gottman Method for Couples, and Sue Johnson’s EFT (Emotionally Focused Therapy), an emotion-focused approach is now considered standard of care in couples work. EFT is an experiential, humanistic approach with goals of increasing and improving the quality of emotional responsiveness between partners. Couples experience increased emotional security by identifying and changing dysfunctional patterns in their interactions. They recognize and address their own attachment needs as well as those of their partner. They learn to regulate themselves when activated, and assist their partner by co-regulating. They create strong relational bonds through openness, vulnerability, and emotional responsiveness.
By direct measurement of body responses, John Gottman’s groundbreaking research incorporated a psychophysiological aspect. He observed couples “diffuse physiological arousal” as they interacted, which handicapped their ability to process information, attend to emotional needs, or to show empathy and affection. Gottman was able to accurately predict which couples would divorce 90% of the time. Present in the emotional interactions of these couples, he identified “The Four Horsemen” (contempt, criticism, defensiveness, and stonewalling).
The Gottman Method provides antidotes for the Four Horsemen. It encourages partners to accept certain “perpetual problems,” to allow influence over one another, to respond to bids for attention, and to repair through emotional connection. Gottman trained therapists provide tools to build positive affect during and outside of conflict, to strengthen friendship, to create shared meaning, and to increase fun, play, and emotional / sexual intimacy. These ingredients bind and strengthen connection, and create a “Sound Relationship House.”
Therapy for couples has certainly evolved. Paternalistic instruction, detached psychoanalysis, and systems-based CBT were inadequate. Modern couples therapy recognizes the intersection of attachment, emotional expression, and psychophysiology. Our emotions and their expression are the vehicles by which we remain connected, safe, and secure inside relationships. It is a great honor to witness and support the remarkable progress couples make as we use techniques from these highly effective modalities.
Mary Evelyn Moore for Couples specializes in both Gottman Method for Couples and EFT (Emotionally Focused Therapy).
Contact me for more information and to book a session.
