THERAPY SERVICES In my practice, I see individuals, couples, and families. Some people assume that because my Masters degree and license are in marriage and family therapy I don’t work with people one-on-one. That’s false. I have had extensive training and experience working with individuals as well as couples and families.
The individuals I work with experience a range of problems, including depression and anxiety; emotional, physical, and sexual abuse; negative relationship patterns; divorce; work problems; issues about sexuality; low self-esteem; and loss and grief.
For details on how I work with individual clients, see “Therapy 101” and “The Journey.”
I see a spectrum of couples: dating, living together, engaged, married, separated, and divorcing, gay and straight. Most of the couples are experiencing emotional pain. Each partner often feels that the other is unable to understand his or her feelings, unable to respond to his or her needs. Some couples fight; others grow distant. Some do both. Whatever their dance, usually the relationship is not a safe, supportive haven. In fact, partners often are reluctant to reveal their real selves to each other. One or both of them might be considering ending the relationship. This is fairly common in distressed couples.
Despite their pain, couples often avoid therapy because of their fears. They might fear being attacked by their partner and the therapist. They might fear being blamed for all the relationship problems, revealing them as a failure. They might fear change—either getting close again or discovering that the relationship is not salvageable.
When I see couples, I try to understand their fears about therapy. I also work to create a safe space during sessions, so that each partner knows that he or she will be respected and heard. Because it is essential that I clearly understand both partner’s perspectives and feelings, I strive to maintain an attitude of fairness and balance in the sessions.
In the beginning of couple’s therapy, I get to know the partners and learn about their relationship. I find out what is wrong in the relationship, what is working, and what partners want different. It is very important that I understand what the relationship is like for each partner.
Common relationship problems include the following:
Ways of dealing with anger and disagreement Feeling unheard Feeling unimportant Lack of trust Issues of togetherness and separateness Setting and respecting boundaries Sexual problems Power struggles Disagreements about finances Relationships with families, friends, and coworkers Expectations of each other Infidelity and other betrayals Alcohol or drug abuse/addiction Sex addiction Past disappointments and hurts Issues related to military deployment
Depending on the partners and their problems, strengths, and goals, I choose from several approaches how best to work in our sessions. Sometimes couples improve by learning new skills, such as how to really listen. Other times, they improve by exploring how they are repeating old relationship patterns in the present—and how to change those patterns. Sometimes change involves examining core beliefs partners have about themselves and relationships, as well as exploring their feelings and fears. I often draw from psychologist and researcher John Gottman's work, as well as from attachment theory.
During sessions, I share my perceptions and insights about the couple’s problems and dynamics. I also share my professional knowledge, and work collaboratively to help partners make the changes they want in their relationship. Therapy is most likely to be successful when both partners accept responsibility for what has happened in the relationship, as well as for changing it. Depending on the couple’s goals, therapy can last anywhere from several sessions to many months.
With engaged couples, I often use a premarital questionnaire called PREPARE. It includes 165 multiple-choice items that touch on important relationship issues such as marital expectations, communication, conflict resolution, sexuality, financial management, and spirituality. Together, we review the results, discussing the couples’ strengths and areas for growth.
Families come to therapy for many reasons. Some are dealing with stressful events such as illness or unemployment. Some are undergoing disruptive changes due to divorce or a death. Perhaps someone in the family has a drug or alcohol problem that affects everyone. Or perhaps a “blended” family is not blending at all.
In family therapy, we often work to resolve the following issues:
Boundaries Parenting Communication Handling differences Family rules and roles Life cycle changes Spirituality
Do you have chronic pain? Author Rebecca Rengo-Kocher, LCSW, offers 25 years of experience helping patients and their families. For more information, visit www.beyondchronicpain.com.