Love in Action: An Integrative Approach to Last Chance Couple Therapy

Love in Action: An Integrative Approach to Last Chance Couple Therapy

"“The postmodern and poststructuralist turn in family therapy has led to a greater focus on the importance of appraising the social construction of meaning between couple partners or among family members, over observation of and intervention upon interactional patterns (see Dickerson, 2016; Goolishian & Anderson, 1987; White, 1995). This has led to therapies that privilege therapeutic dialogue about problem understandings and solutions, expression of problem narratives, and verbal or written “re-authoring” of lives— strongly suggesting that meaning is encapsulated or “held” (and transformed) primarily in and through verbal language and conversation. In contrast, earlier-developed theories and practices of family therapy often drew upon metaphors like the “family dance,” the  “family orchestra,” the “family collage,” as well as asking couples to provide “video descriptions” of what happens when their interaction goes poorly or well—all suggesting that meaning can equally be represented, held, and expressed through nonverbal interaction.  (...) Case: (...) The following week, the couple arrived smiling and relaxed. Michael said, “After that
session, we both realized how silly we’d been with each other, and decided to stop being
hurtful to each other. We have so much good between us.” Ana smiled broadly and agreed.
Michael had bought her a gift that she felt was very thoughtful—starfish earrings and a
starfish necklace, which she was wearing that day. He explained with a warm smile: “A
starfish can regenerate an arm that gets cut off—in fact, it can regenerate its entire body
from just one arm. I think our relationship can be like that, we need to grow it back.” They
spoke of how they were now more ready to use the various practices they’d learned in therapy. There followed a lot of laughter among us on various topics, not all having to do with
them specifically.
The following 3 weeks were similar in emotional tone. We returned to their differences
in parenting beliefs, and found a workable compromise. We briefly touched on the emotion
style differences between them that had attracted them initially (he as more “rational”
and more contained, she as more expressive and spontaneous), but that had become polarized and then largely reversed, albeit in a distorted, unpleasant manner, through the
impact of Michael’s drinking, depression, and rage, leading Ana to become emotionally
shut down in a desperate attempt to calm him down and not provoke him. They recognized the virtue of them each being able to be rational and expressive, and they demonstrated this greater flexibility in the sessions. We were also able to return to Michael’s
feelings of being displaced when the boys were born, which although not uncommon in the
transition to parenthood, were accentuated by attachment issues due to his having been
adopted (it was not an open adoption, and he never learned exactly why his biological
mother had given him up). Michael continued to be engaged in his outpatient addictions
treatment, now quite enthusiastically, giving advice to men just starting in the program, and had remained sober, and Ana was now freer to express both genuine warmth
toward him and upset feelings. One year later, the couple contacted the therapist to report
they were doing well.
SUMMARY
Couple therapy is never a linear process of steady progress, especially with couples in
great distress and on the brink of relationship dissolution. Couples learn new practices
but do not necessarily put them fully into practice. But a therapy that offers such practices
early on plants the seeds of renewed capacity, a possible path forward, demonstrates the
therapist’s responsiveness to their concerns, and thereby, provides a sense of credibility to
the approach. Specific interventions are important, but in the end, it is also the researchdemonstrated nonspecific factors of the therapeutic relationship—a therapist who is caring, genuine, warm, structuring yet collaborative, flexible by virtue of having an integrative approach, willing to take chances and “get in there” with their feelings of pain and the
process of change, and who invites and supports the couple to courageously experiment
with new possibilities. ” (PETER FRAENKEL , Love in Action: An Integrative Approach to Last Chance Couple Therapy, Fam. Proc., Vol. 58, September, 2019)"