Couples seeking relationship and couples therapy in Seattle sometimes ask a particular question when we set up a first appointment on the phone: “How long will couples therapy take?” I’d like to discuss some common reasons for that question, and then offer a different take on it.
The Common Reasons
The usual curiosity behind that question has to do with the duration and financial cost of treatment. Those issues are also about the effectiveness and efficiency of the therapist. As the sayings go, “money does not grow on trees.” And, “time is our most valuable resource.” Yet on that first call, it’s nearly impossible to give an informed or comprehensive response to these questions. There are too many unknown factors.
A background for these questions is often the clients’ prior experience in therapy (in Seattle or elsewhere.) Prior therapies may have lost their forward drive, meandered into advice sessions, vague questions about feelings, forgettable homework, excessive therapist self-disclosure, ‘small talk’ or passive listening (the so-called therapist “blank screen.”)[2. Clients usually tell me that they did not disclose to another therapist the reasons they suddenly stopped seeing him/her.] Difficulties in developing the therapeutic relationship can manifest in many ways:
©The New Yorker, January 27, 2014. Cartoonist: Harry Bliss
Couples often feel badly or anxious about being in treatment. The idea of getting as little help as possible seems sensible, avoiding stigma. I’ll often hear that:
- the problems are “about communication”
- the goal is to “fix” the relationship
- the solution is receiving “tools” from the therapist.
It can sound like a car needing repair due to a constant noise. The actual relationship situation is usually a bit more dire than how it’s originally described. But beginning treatment can soon reveal the depth of the problem and what hope exists for improvement. Even the more superficial start to therapy can soon lead to greater depth and meaning.
Intense Worry, Then Relief
At the other end of the scale, I get calls from partners who are emotionally injured, alienated from each other – and actively making it worse. They wonder if help is even possible, or years might pass before they find a happier, more secure place. Sometimes, “enough” improvement arrives faster than any of us expected at first. [4. Never underestimate the value of a really strong complaint.] The clients sometimes terminate treatment at that point out of a sense of immediate relief, though the amount of personal & relational growth is fairly minimal.
Different Strokes For…
So, I take a different approach to the question of “how long will therapy take?”
My practice experience reveals that the shape of the relationship I build with relationship clients differs according to several factors. Each committed relationship has its own set of stories of personal development. It’s also a story of relational development. Where and how I fit into an improvement in each partner’s functioning is different, even when the presenting issues are familiar to me.
Putting Out “Fires”
Some clients want me to “put out fires.” They begin treatment, leave when they feel better and achieve some new sense of security. They might return when the next “fire” is burning. That fire might look different to them, even when I can link the nature of the crises fairly closely.
Long Term Role
Some clients seek a longer term relationship. I occupy a position where I provide a range of interventions. We work together to find linkages between different “issues.” Time is spent with each partner’s personal development, as well as keeping pace with whether, or how, they can raise their level of differentiation.[4. an idiosyncratic weblink that fairly deftly positions classic Bowen theory with the advances brought about by Schnarch.] The longer term presence of the professional can bring about a gradual but durable change in the interaction between partners. I believe this observation to be mostly true, and, one of the less well understood phenomena in this work.
The question “How long will it take?” doesn’t take into consideration “how often?” Typically, I work more frequently with clients early on in the relationship, and less frequently as the relationship develops. But there’s no single pattern: I’ve worked monthly with some couples, or every two weeks, for anywhere between three months and ten years.
The duration or frequency of therapy is not the only criterion. Sometimes it’s about the (flexible) structure of how the therapist will influence the client.
Some relationship clients want a therapist that they can work with individually as well as relationally. To my thinking, this requires the most skill and experience that a therapist can bring to the office. Most couples therapists have been taught that they should never give partners confidentiality from one another, or only see them together.[3. the primary exception is using individual interviews to assess domestic violence] The fear is that keeping a secret will over-identify the therapist with that client, as well as risk a mistaken disclosure of the secret.
Your ‘Private Space’
The approach that has developed allows for each individual to have their private ‘space’ in therapy. This privacy links to the individuality that partners rightfully retain in a relationship. This way of working is often useful with couples who have lost sexual desire for one another. It can heighten their differentiation, which allows for two secure adults to actually become far closer while being more self-disclosing.
A Helpful Preview?
I hope this provides a helpful preview to people seeking relationship therapy. I mean to address all types of relationships, from 30 year long monogamies to 6 month-old polyamories. It’s not easy to know ahead of time how our relationship(s) should be structured, much less how long they might last. Yet if you can settle into a form that makes sense to you, it should deepen our common purpose, provide a useful orientation and a clearer contract for seeking and receiving help.