What Is Therapy Really Like?

Some people are experienced consumers of therapy.  Others know little about how the process works other than what they have seen on TV or in movies.  A group of psychologists produced this series of videos to describe the process and perhaps demystify it.  

Check it out: 

http://www.momentsofmeaning.org/

Question: How Many Sexual Partners Maximize your Happiness? Answer: 1.

http://www.nytimes.com/2014/07/20/opinion/sunday/arthur-c-brooks-love-people-not-pleasure.html?emc=edit_th_20140720&nl=todaysheadlines&nlid=45274820&_r=0

Where Have I Been?

Where Have I Been?

It's been a long time since I posted, and despite many blog entries swirling in my mind, I've failed to record them here.  In the last two years, I've been busy expanding my practice, changing office locations to Folsom, and attending intensive trainings in Emotionally Focused Couples Therapy (EFT).  Developing new skills, even (and maybe especially!) after practicing couples therapy for 30 years, is both destabilitizing and exciting.  When I learn something new and different and really work to integrate it into my clinical practice, I get a glimpse into what it is like for my couples in therapy who are also struggling to learn something new and different in how they relate and connect to their partners. As much as we might want things to be better, it is a risk to stretch into something that feels really foreign. It's easy to fall back into the old and comfortable patterns that we're used to, and yet it is exhilarating to try something new and different and experience a positive shift in how you feel and how you function. The model is based on the work of Sue Johnson.  Listen to the clip below and you'll get a good sense of how the therapy model works:

Your thoughts?

Family Secrets: Part 4 - Conclusion

 
THE THIRD PHASE OF RECOVERY: TRUST BUILDING, ACCEPTANCE, FORGIVENESS AND ENVISIONING THE FUTURE
The third stage of the relationship is about moving forward and creating a vision for the relationship in the future. Frequently, recovery from the secret creates an opportunity for establishing new and better communication, greater depth of intimacy, and more satisfying connection.  The partners work on finding ways to create the kind of relationship they envision and long for.  It is at this stage that the betrayed partner will frequently work through the process of trust and forgiveness.
Initially, Roger continued to check Stacy’s cell phone logs and insisted he pick her up from work several times a week.  Because she agreed to complete transparency, Roger gradually stopped checking on her.  More importantly, their discussions and deep sharing allowed them both to see real differences in the way they related to each other, which provided the most compelling proof that they were secure in their connection. Even though Roger and Stacy became more open, Roger also had to accept that there will never be 100% certainty that he wouldn’t be hurt again. Most people experience the loss of illusion about absolute trust, and find a healthy balance between trust and self-protection
Accepting the loss of complete trust, and accepting that there will be permanent changes in both partners as a result of the secret and its revelation is part of this phase of recovery. Both partners work on sharing their softer feelings of vulnerability. The betrayer needs to express his or her experience of anger and loss and the betrayer must be able to hear the partner’s emotional experience without collapsing into shame so he or she can validate and soothe the betrayed partner’s feelings. This process can be a long and difficult one. 
The process of forgiveness is a transaction between the two partners in which forgiveness is earned, resentments decrease, and the partners form a “new” relationship.  Forgiveness is not a one-time occurrence, but rather a process of experiencing the partner as a safe and secure person who is actively engaged in supporting the vision of a healthy relationship. It is out of the ashes of the fallen relationship that a new relationship can be imagined and built.   

Family Secrets, Part 3

THE SECOND PHASE OF RECOVERY: MAKING SENSE OF IT ALL
The process of understanding why the secret behavior happened and what it means about the partners, their relationship, and their future begins the process of recovering from the shock of the secret.
In Roger and Stacy’s case, they agreed to an interim agreement in which Stacy would limit contact with the affair partner while they worked in couples counseling for 3 months with the goal of reconsidering the long-term viability of their marriage at the end of this time period. Unlike Roger and Stacy, some partners may feel that they want to end the relationship (or move into quick and unprocessed “forgive and forget”) at this point.  I generally encourage partners to withhold decisions about the future of the relationship until they have processed, explored and understood the meaning of the secret.
An examination of the factors, both inside and outside of the relationship, which contributed to the problem behavior, help couples uncover the meaning of the secret.  Both thoughts and feelings are shared as the couple explores together what has occurred and why. 
The following types of questions about what the secret meant to each of them are explored.

1.What were you searching for in the secret behavior?

2. What was gained from the secret?

3. How did engaging in the secret affect the betrayer?

4. How was the betrayer different when involved in the secret behavior?

5. How did the betrayer justify their behavior? 

6. What is the connection, if any,  between the secret behavior and the relationship?

7.How did the betrayer integrate the secret into the rest of their lives?

8. How did the betrayer cope with the lying and what did they tell themselves to make that OK?

9. Did the betrayer hope their partner would find out?  How did they each partner feel when the secret was revealed?

10. Do you think the secret and the understanding of it could benefit our relationship?

11. What permanent effects will there be for the individual partners and the relationship because of this?

It is usually at the end of this stage of understanding that partners can see the “big picture” and decide to recommit or end the relationship.

When Stacy realized that she was looking for greater emotional connection and less power struggles in her affair, she was able to see that her desire to return to her old relationship with Roger was not possible. However, she was willing to begin a new one with him.  Roger was also able to see what he was missing in the marriage and was willing to work on improving their connection. After this process of exploration, Stacy decided to end the affair and recommitted to her marriage.  
To Be Continued...

Secrets- Part 2

THE FIRST PHASE OF RECOVERY:  GETTING INFORMATION

The first therapy appointment in which the couple will deal with the discovery of the secret begins the first phase of treatment for the problem. The therapist structures a safe, calm, and supportive disclosure session where there is a conversation between the professional counselor and the couple.

In a structured disclosure therapy session, the counselor can moderate the discussion with the goal of providing information that will help the couple understand their situation and help them heal.  The betrayed partner is helped to clarify his or her goals and determine which details they need and want to know. Some betrayed partners want to know everything; others want to know very little or just want to know the behavior has stopped.  

In affairs or sex addiction, most counselors advise against telling all the details until there has been a chance to discuss how knowing these details will impact them.  Therapists discourage disclosure of specifics (e.g. locations, type of sexual activity) because it can cause increased pain, obsessive rumination, and reactivity. For example, passing a hotel where a person acted out or met an affair partner will trigger a recurrence of negative feelings and distress.

THE PROCESS OF DISCLOSURE

In Roger and Stacy’s disclosure session, Stacy described what general behavior had occurred with her and her affair partner, how it began, and how long it had been going on.  She told him that no one but her best friend knew about the affair.  She told Roger that she was not ready to give up the affair, but she also wasn’t ready to end the marriage.

Disclosure is an important task for the couple because it is the beginning of honest communication and resumption of trust and intimacy.  As painful as it is for the couple, it breaks the silence of the secret, it ends the lying, and allows for an honest examination of what actually happened and what needs to happen to move forward. The betrayer can reveal information while taking responsibility for the betrayal without blaming others.

Couples may cover the following in a disclosure:

1. Broad outline of the problem behavior
2. How long the behavior has been going on
3. The risks involved (e.g. STD’s, credit loss)
4. Legal issues (e.g. warrants for arrest, court actions, children from affair, fraud)
5. Who was involved? Who else knows about the secret?
6. Whether the behavior has stopped, or if it continues, in what way?

The betrayed may generate a list of questions in addition to the ones above that provide the basic information needed to understand the general scope of the problem.  More specific questions about the reasons for and meaning of the secret are explored in the second phase of the recovery.

Unfortunately, the betrayer may not be able to give the whole truth because of the shame and fear or because they may not even remember all the details.  Betrayers can often be skilled at compartmentalization, or the ability to separate one part of their lives from other parts, and have learned to detach and avoid thinking about their transgressions. Shame leads to emotional numbness and hiding, which means that specific details and memories of behavior may actually be forgotten. 

Even though the betrayer may not remember everything at the time of the initial disclosure, staggered disclosure should be avoided as it tends to be re-traumatizing for the betrayed. New information revealed later damages the fragile developing trust and creates doubt about whether the complete truth has been told and whether there is still more to come.  Each new disclosure can feel like starting all over.  

To be continued....

Secrets- Part 1

I recently appeared on a local news program about "family secrets."  It had been over 20 years since I last appeared on a news show, and my prior experience was kind of distressing.  During that show so many years ago, I had a kind of brain freeze, and it surprised me.  I've managed to avoid media appearances since then, but when I was asked to appear on this local program, I decided to try again but this time I would put my ideas in writing to avoid the strange and embarrassing sensation of not knowing what to say. I'm going to post my prepared notes in this blog, but due to its length, I will plan on presenting it in about 3 segments.  This is the first of the three.

We all have secrets. Sometimes they are necessary.  They can be part of the normal need for privacy or part of protecting ourselves or others from personal or emotional harm. Yet when your secret involves meeting an affair partner at a hotel, sneaking away to view internet pornography, or covertly spending thousands of dollars you can’t afford on luxury items, your secret is no longer harmless.  In fact, your secret has the potential to cause great pain and suffering to both you and others, and those kids of secrets should not remain hidden.

Through the case example of a couple I will call “Roger” and “Stacy,” I’m going to describe for you: 1) the ways in which secrets are revealed, 2). How couples deal with secrets, and 3). How couples can recover from these secrets and repair their relationships for good.

HOW THE SECRET IS REVEALED

 Roger noticed that Stacy was staying later at her new job than her usual working hours, and that she made excuses when Roger offered to pick her up at her workplace. When he showed up unexpectedly to take her to lunch one day, she was on an extended lunch break with a co-worker.  When asked her about the co-worker, Stacy became defensive and evasive and accused Roger of being “controlling.”  Roger noticed that Stacy was not wearing her wedding band at work and when he asked her why, she stated that it was getting in the way of lifting boxes at her job- an explanation that made no sense to Roger and left him confused and increasingly suspicious.  When he asked further questions, she got angry and refused to discuss his concerns, calling him “paranoid.” He began to secretly check her cell phone logs and saw repeated calls to a phone number he did not recognize.  He dialed the number on the phone, and when a man answered, “Hey Baby, is he gone?” Roger’s worst fears were realized. When he confronted Stacy with what he heard, she admitted that she was having an “emotional” relationship with her co-worker, but that they had not had sex.

Just as Roger accidentally discovered his wife’s affair by calling an unknown phone number, a family secret is usually discovered accidentally, perhaps by a computer screen left up or unpaid bills or statements found hidden in a drawer. Some partners have suspicions before they encounter evidence and deliberately go looking, like Roger did, but usually the discovery comes with little to no warning. 

Betrayed partners vary in how much they suspect or know about the betrayal. Some are completely unaware, while others notice cues that they overlook or ignore.  Some who notice these cues, however, start putting pieces together, and will begin to investigate, as Roger did. Some partners are persistent in tracking down information, even to the point of hiring private detectives, installing surveillance equipment, and hiring consultants to analyze computer files. 

Just as Stacy made excuses for abandoning her wedding band and coming home late from work, other people show signs that create suspicion, such as:

·         Unusual or increased demands for privacy.

·         Unwillingness to discuss certain kinds of information.

·         Schedule changes

·         Changes in personal habits or interests.

 The bottom line is that there is a continuum of knowledge with complete unawareness on one end and obvious clues and firm evidence on the other end.

Regardless of where one falls on the continuum of knowing about the betrayal, the betrayed usually experience extreme dismay when the secret is discovered or suspicions confirmed. In Roger and Stacy’s case, Roger reacted with rage at his wife’s admission.  He wanted to confront the affair partner and report the affair to their manager at work.  He wanted to call his and her family and tell them about the betrayal.  He was hurt and angry and wanting to work things out with her all at once.  She was scared and guilty and wanted to be left alone.  They were both riding an emotional roller coaster.  

Some may not feel as angry as Roger did. Some partners may even feel relief that they know the truth. However, almost all partners, both betrayers and the betrayed,  experience the discovery as a personal and relationship crisis. 

To be continued....