Couples Therapy Essay
In any marriage relationship, it is usual or rather natural to have some adjustments in its early stage. This is so because there is a high degree of expectations in both parties; and so, because these expectations are mostly “unrealistic,” to modify or adjust them are somewhat difficult to both sides. It is a fact that when two individuals come into a marriage union, they bring with them two different perspectives in almost all respects. Marriage and the fruit of the union – the family – is the basic unit of society and regarded as one of the most principal institutions of the social order.
When marriages fail and families disintegrate, there is without a doubt a “ripple” effect on the community’s functioning in terms of that community’s solidity, and law and order. Although many facets of the relationship operate as components to the enjoyment and development of the marriage bond, the common and usual fundamental rationale for the union is intimacy. It is this vital ingredient that draws couples from different persuasions, race, or creed together despite the potential drawbacks and heartaches that will soon shake the very foundations of that union.
This paper rests on a specific case on the couple this therapist named as June and Brady who are both in their 40s. Brady is June’s third boyfriend while June had been the only girlfriend Brady had until both decided to get married in a garden wedding. June and Brady had been together as a happy couple for fourteen years. They described themselves as relatively happy since they seemed to get along well like most couples and had weathered most of their marital woes. Their three children ages 12, 10 and 8 are witnesses to the time and effort that they spend to keep the ties closer.
They just don’t want to be average among the families; they wished they would somehow be envied by their neighbors and friends and that would be quite an achievement for June. As their fourteenth anniversary was approaching last year something happened that opened their eyes and made them discover that there was already a very wide chasm between the two. It was not the few and far-between intimate times that they spent together; for June, that did not quite bother her because she was tired almost all of the time being a full time homemaker.
Though she would hear those rare times that Brady would voice out load his thoughts wondering why she seemed uninterested anymore with sex. But since he did not pursue the matter, she did not even bother to explain why or what to do with the issue. March had arrived and June proposed to Brady to have their April dinner party anniversary with the relatives at the local restaurant. June received her extra earnings from her one of her joint entrepreneurial adventures and was willing to splurge this for their friends and loved ones.
It was late night after the children were in bed that Brady was already drowsily sipping his coffee when June asked for a neck massage from Brady. When Brady intimated more than a massage, June declined and Brady went into a fit June had never seen before. “Did you know it’s been two months? ” “Two months! ” “Why did you even get married in the first place? ” And with that Brady was in his silent self for the remainder of the week. Evaluation of the above statements alone of Brady reveal of the husband’s unhappy state of sexual relations.
Though in the assessment that the couple took, Brady admitted of a satisfied relationship per se, all he wanted was the frequency which his wife, June before counseling took place, never comprehended its importance. II. Review of Related Literature The reasons that couples are in disarray or are in state of flux are varied. Literature is rich portraying these factors why the couples do not come into a union and these include recently established studies on female sexual dysfunction and sexual difference among males and females accounting to intimacy difficulties.
Although the complications are being brought into the counseling setting whether these contributed to or actually caused the couples’ sexual problems or are mere symptoms of other problems will be discussed in the remaining portions of the paper. – Female Sexual Dysfunction According to Graziottin (www. alessandragraziottin. it/ew/ew_voceall/36/1397%20-%20Kari%20Bo%20-%20FSD%20assessment. pdf), it is only in very recent years that FSD (or female sexual dysfunction) has finally been recognized as legitimate concern or of utmost importance in the relationship within the marital bounds.
Her studies covered exhaustively this issue although of prime importance is the role of the pelvic floor in the sexual act and how this affects the wife’s response to pleasure or whether she will be reacting because pain during coitus. This illustrates in detail that when a woman finds her body specifically uncooperative during what could have her been normal functioning a domino effect is in motion. The husband may perceive of this in entirely different perspective; i. e.
, he may think that he’s not as good anymore, or that he cannot please his wife anymore, and so on. In her paper, Graziottin (p. 3/268), emphasized that there are nine (9) different classifications of FSD with perhaps, the mildest one labeled as women sexual interest/desire disorder to vaginismus which is pictured as the constant fear, bordering on phobia, of a woman for penetration even if she may be willing to go through the ordeal. – Male and Female Sexual Desire/Performance Differences
In many studies, much like the ones made by Lawrance et al. , (1996), women are expected to play or act the feminine role and men, the masculine role. This means that in communicating one’s preferences, almost always, studies reveal, males tend to be expressive and are expected to be so in sharp contrast to their female counterparts. This means that where expressions of orgasmic pleasure and things related to such physical, emotional, and even verbal expressions, male dominate and need not be embarrassed for these experiences.
However, women on the other hand, despite modernity and media influence still get embarrassed when urged to be more expressive to their spouses during coital relations. This has made their marital relationships difficult since inhibited wives after many years tend to see themselves as the dissatisfied persons in the partnership. III. Theoretical Framework Erikson is a key figure in the study of developmental psychology. He is instrumental with the current understanding of the different stages of a human life span.
This research work is a product of the attempt to expand on the understanding of Erikson’s major work with the integration of several others who are instrumental to a more updated and comprehensive appreciation of the changes and growth that proceed to the development of an adult personality specifically focusing on his emotional and social maturity. development of adulthood? It is indeed interesting to note the depth of the understanding of man’s multidimensional nature revealed by decades of research with each of the distinct aspects of his personhood.
Perhaps considered the most “important” years simply because everything seems to have reached its peak during these times, and perceived as the longest portion among the different stages in the lifespan with all its promise of achievement, productivity and procreation. Perspectives in psychology and philosophy in general, are developed to help explain and shed light on various human behaviors that not only boggle and are difficult to understand. There are controversies that ensue and these also make interventions difficult at the same time. Development does not end once a person reaches maturity, but continues throughout life.
Developmental psychologists seek to describe ad analyze the regularities of human development across the entire life span. It focuses primarily on these aspects of development that make us similar to one another (Berk, 2007). There is a necessity to introduce the observations made by social scientists through the decades after Erikson introduced his theoretical viewpoint on the eight psychosocial stages. It is essential to explain how Erikson elaborates on the two stages of adolescence and early adulthood in order to help accommodate on the theory proposed by Levinson and Arnett and others in their league.
Erikson’s psychosocial stages: Adolescence & Early Adulthood Erikson identified the period of adolescence with a corresponding challenge to achieve a sense of identity. Adolescents need to leave behind the carefree, irresponsible, and impulsive behaviors of childhood and to develop the more purposeful, responsible, planned behaviors of adults. If the individual is successful in making this change, he will develop a sense of confidence and a positive identity. If he is unsuccessful, he will experience role confusion, which will result in low self-esteem and become socially withdrawn (Berk, 2007, ch. 12).
This concept assumes that in general, children will progress towards adolescence with the all-important development of establishing his identity and those problems that normally are encountered around this stage basically are related around the individual’s search for identity. The period of early adulthood is a time for finding intimacy by developing loving and meaningful relationships. On the positive side, a person can find intimacy in caring relationships. On the negative side, without intimacy, the individual will have a painful feeling of isolation and his relationships will become impersonal (Berk, 2007).
The adult with a capacity for true maturity is one who has grown out of childhood without losing childhood’s best traits. As with one who has retained the basic emotional strength of infancy, the stubborn autonomy of toddle hood, the capacity for wonder and pleasure and playfulness of the preschool years, the capacity for affiliation and the intellectual curiosity of the school years, and the idealism and passion of adolescence, the mature adult incorporates these into a new pattern of development dominated by adult stability, wisdom, knowledge, and sensitivity to other people, responsibility, strength and purposiveness.
People who have approached maturity can feel that they have loved and been loved, have done their work, have made their mark on people, and have made the most of what there was. Arnett’s extensive studies identify a gap becoming apparent with distinct characteristics separate from the adolescent and that of formal adulthood. In Arnett’s observation, this transition in between the stages is non-existent in most cultures other than the western (Arnett, 2000). IV. Assessment
This therapist anticipated therapy sessions that would involve one or both spouses who are uptight about talking something which is usually an embarassing topic for many married people. It was important that the scale was honestly filled up and their answers thoroughly followed through during subsequent interviews, in individual and group setting. On June’s part, she mentioned some of her notions or ideas about sexual intercourse or intimate details of union came from what she overheard from friends, family members, movies and novels.
Novels were her ultimate guides and have given her confidence that she would do well in the sexual territory. However, all fell flat when the real “encounters” came; i. e. , when she cannot fathom those times when she doesn’t even want her husband to come near her. It was pleasurable those first few years, but she noticed that it involved cycles. This therapist discussed later the biological make up of females and her hormone’s contribution to these “feelings” involved in the cycles she mentioned. Walter W.
Hudson’s Index of Sexual Satisfaction Measuring Scale (2007) is by far one of the most significantly improved, applicable, practical and easy to measure and interpret among the diagnostic tools for the problem or issue concerned. The couple was urged to come in for an assessment with Brady who was most eager to have themselves diagnosed of what really had gone wrong in their very romantic marriage. June scored high in the scale while Brady scored low which surprised them both. June was stunned with herself and very apologetic to Brady when her score was discussed with Brady.
She was shocked to learn that Brady despite the recent outburst, was happy about their sexual life. She finds out in the therapy, she was the only one who got used to it. Brady was suffering silently of being rejected and alone and feeling lonely. Brady needed to understand as well what June was going through in her mind and with her body – her biological make up. His cooperation, patience and understanding will be crucial as they both start to experiment with the newfound knowledge concerning themselves at this particular junction of their married lives and stage of development.
V. Intervention – Cognitive-Behavioral therapy. In the cognitive approach alone, the therapist understands that a client or patient comes into the healing relationship and the former’s role is to change or modify the latter’s maladjusted or error-filled thinking patterns. These patterns may include wishful thinking, unrealistic expectations, constant reliving and living in the past or even beyond the present and into the future, and overgeneralizing. These habits lead to confusion, frustration and eventual constant disappointment.
This therapeutic approach stresses or accentuates the rational or logical and positive worldview: a viewpoint that takes into consideration that we are problem-solvers, have options in life and not that we are always left with no choice as many people think. It also looks into the fact that because we do have options then there are many things that await someone who have had bad choices in the past, and therefore can look positively into the future. Cognitive-Behavioral Therapy postulated primarily by Ellis and Beck “facilitates a collaborative relationship between the patient and therapist.
” With the idea that the counselor and patient together cooperate to attain a trusting relationship and agree which problems or issues need to come first in the course of the therapy. For the Cognitive Behaviorist Therapist, the immediate and presenting problem that the client is suffering and complaining from takes precedence and must be addressed and focused in the treatment. There is instantaneous relief from the symptoms, and may be encouraged or spurred on to pursue in-depth treatment and reduction of the ailments where possible (Rubinstein et al.
, 2007; Corey, 2004). Where the couple June and Brady’s sexual satisfaction problem is concerned, the problem is sorted out separately and together. Whatever beliefs June has had regarding sex she has to bring to the surface, share it not only with the therapist but especially with Brady and discuss together whatever, apprehensions and misconceptions. Once of the problems that was discovered even in the scale was for June, sex is not a priority, which she learned and accepted later as we processed that it is an important and a priority for Brady.
Because June spends a lot of time with preparations for the kids and their needs, she is constantly exhausted, and neglects to divide her time for recreation or leisure, meditation, or even thinking about how to please Brady. It all boiled down to resentment for all her endless cleaning tasks and cooking chores that by eight in the evening she becomes totally exhausted she even forgets to eat. Hence, here comes the hubby who also feels guilty at the same time sulks in secret for being taken for granted; hungry for attention, especially sexual attention.
Just as the cognitive-behavioral model also recognizes the concept of insight as well, this is only a matter of emphasis or focus. In behavioral/cognitive-behavioral therapies the focus is on the modification or control of behavior and insight usually becomes a tangential advantage. Techniques include CBT through such strategy as cognitive restructuring and the current frequently used REBT for Rational Emotive-Behavior Therapy where irrational beliefs are eliminated by examining them in a rational manner (Corey, 2004; Davison and Neale, 2001).
Whereas in insight therapies the focus or emphasis is on the patient’s ability in understanding his/her issues basing on his inner conflicts, motives and fears. Techniques then include reflection of feelings and free association; the former as employed in the client-centered therapy and with the latter in psychodynamic therapy. Cognitive Strategies are utilized to promote functional thoughts which are likely to result in adaptive and healthy habits (Corey, 2004; Davison and Neale, 2001).
Employing the cathartic method, teaching the client to examine his/her thought patterns, to discern the errors of judgment and gain insight into him/herself, and to handle with patience the whole process are fundamentals in the process. When the therapist is able to shift effectively in various standpoints and enables the client to gain a better, realistic and eradicate unrealistic expectations of the self and others, they are both on the way to achieving wholeness and healing that which the client so need and aspire.
This requires practice, or constant training and endurance on the part of the therapist (Rubinstein et al. , 2007; Corey, 2004). Client-centered therapy avoids the imposition of goals on the patient or client during therapy. It is the client who takes the lead in the session and of the conversation. It is the job of the therapist to create the conditions conducive to the client’s positive judgment of those experiences that are intrinsically satisfying to the client. The ‘goal’ then is to reach the point where the client desires to be a good and “civilized person.
” Unconditional positive regard enhances this atmosphere however, and although the goal may be difficult to achieve, unconditional positive regard eventually, according to Rogers, encourages even the “`unbehaved” to conform or even transform (Corey, 2004; Davison and Neale, 2001). Rational Emotive-Behavior Therapy where irrational beliefs are eliminated by examining them in a rational manner (Corey, 2004; Davison and Neale, 2001). Whereas in insight therapies the focus or emphasis is on the patient’s ability in understanding his/her issues basing on his inner conflicts, motives and fears.
Techniques then include reflection of feelings and free association; the former as employed in the client-centered therapy and with the latter in psychodynamic therapy. Cognitive Strategies are utilized to promote functional thoughts which are likely to result in adaptive and healthy habits (Corey, 2004; Davison and Neale, 2001). June must understand why she has become what she developed as a person-which shows her attitude towards sex in general and towards the needs of her husband, so that she is empowered to go back to normalcy and health. VI. Recommendation
To verify whether the couple did make some improvements or benefited from the interventions, there are subsequent follow –up calls or interviews be made or visits to the couple’s residence. It would be best if a post – test be made using the same scale (Hudson’s Index of Sexual Satisfaction Measuring Scale, 2007) to ensure that there are indeed better results. Then again, the findings be given as a feedback to the couple, whether they did better, or worse, or no improvement at all. After the counseling or therapy, follow up is given after three (3) months, and five (5) to six (6) months thereafter.
VII. REFERENCES 1. Atkinson, R. L. , R. C. Atkinson, E. E Smith, D. J. Bem, and S. Nolen-Hoeksema. Introduction to Psychology. 13th Ed. New York: Harcourt College Publishers, 2000. 2. Berk, Laura E. 2004. Development through the Lifespan. Allyn & Bacon, Pearson Education. 3. Corey, Gerald, 2004. Theory and practice of counseling and psychotherapy. Thomson Learning, USA. 4. Davison, Gerald C. and John M. Neale. 2001. Abnormal Psychology. Eighth ed. John & Wiley Sons, Inc. 5. Graziottin, Alessandra. www. alessandragraziottin. it/ew/ew_voceall/36/1397%20-%20Kari%20Bo%20-%20FSD%20assessment.
pdf. Accessed May 21, 2008. 6. Hudson, Walter. 2007. Index of Sexual Satisfaction Measuring Scale. Oxford University Press. 7. Kaplan, HI, BJ Saddock and JA Grebb. 1994. Kaplan and Saddock’s Synopsis of Psychiatry: Behavioral Sciences clinical psychiatry. Baltimore: Williams and Wilkins. 8. Lawrance, Kelli-an, David Taylor, E. Sandra Byers. 1996. Differences in men’s and women’s global, sexual, and ideal-sexual expressiveness and instrumentality. Vol. 34. 9. Papalia, Diane E. , Sally Wendkos Olds, Ruth Duskin Feldman. 2002. Human Development. 8th ed. McGraw-Hill Education. pp. 539-540.