Boston Marriage Therapy — Marriage Conflict

When Lauren and Les argue, they do so with gusto! Voices are raised, they talk over one another, and in the end they rarely come to any agreement. However, the next thing anyone knows they’re sitting snuggled up on the couch whispering and giggling to one another. A friend asks them, “You were just at each other’s throats. How can you now be laughing together?” “Oh that,” Les comments, “We forgot about that fight 10 seconds after we stopped yelling.” “Yeah. Why would we let a silly disagreement destroy our relationship?” Lauren adds.

“You never listen to me!” Gwen cries. “I never listen? I never listen!? Well I’m listening right now aren’t I? I listen, let me tell you. I listen to you who won’t stop nagging me every second of the day!” …The newlywed couple knew they had a problem with conflict. They come to you to ask if you can help them stop their terrible wars with words.

Marriage Therapy in Boston, MA: Definitions and Key Thoughts

Every marriage has conflict. The idea that some couples never disagree is crazy.

John Gottman, in his groundbreaking book, Why Marriages Succeed or Fail, writes that there are three perfectly acceptable conflict styles couples can use: volatile, affirming, and avoidant.

Volatile Conflict Style: 

With this conflict styles, conflicts erupt often, and they result in passionate disputes. Both parties voice their position, challenging and refuting their spouses. Hence the conflict is rarely resolved. However, the conflict is counteracted by all the good times in the marriage. When looking at the whole picture, the couple is well-satisfied with the marriage relationship.

Validating Conflict Style:

This is the conflict style psychologists and counselors have traditionally taught to their clients. With this conflict style, couples talk, listen, compromise and calmly work out their problems to their mutual satisfaction.

Avoidant Conflict Style:

With this conflict style, couples rarely if ever confront a conflict head on. Instead, the marriage motto is “agree to disagree.” The couple acknowledges that they are different, strong willed, independent individuals, and that they will have different opinions on some issues. As long as the couple agrees on most things, the relationship can continue to grow.

Historically, many mental health professionals have considered Avoidant and Volatile conflict styles to be destructive to marriages. However Gottman’s research suggests that all three styles are equally acceptable for maintaining or building a healthy marriage. (1)

Gottman has found that it doesn’t really matter what conflict style a couple uses. What matters is that there are enough positive interactions in the marriage to counter the negative ones. It is believed that between 4-20 positive interactions are necessary to counter one negative interaction.

However, arguments can sometimes lead to dirty fighting between husband and wife. A dirty fight is one that alienates or hurts a spouse. When this happens, bitterness, anger, resentment, and even thoughts of divorce or violence can take root in a marriage. Often when spouses are fighting dirty they are doing so because of a profound ‘heart problem.’

Patients with bad heart conditions need to change their unhealthy habits. Heart patients who have “hardening of the arteries” receive regular examinations. Like medical doctors, counselors can help those who need a “heart examination.” We can help to diagnose the problem by testing eight potentially problematic areas:

1.     Pride: “Do I focus on how much I’ve been wronged?”

2.     Faultfinding: “Do I rehearse the faults of others?”

3.     Avoidance: “Do I avoid being around people with whom I have conflict?”

4.     Silence: “Do I refuse to share my feelings in a healthy way?”

5.     Isolation: “Do I withdraw emotionally?”

6.     Unfaithfulness: “Do I share unnecessary information about my opposer?”

7.     Hopelessness: “Do I lack faith that God can work in any situation?”

8.     Resentment: “Do I hold on to my anger until it turns to bitterness?”

Thankfully, in the pursuit of marital peace, there are a great many skills couples can learn to fight fair when conflict shows up in their relationship.

Boston Marriage Therapy: Assessment Interview

Asking the following questions will help you to get a better picture of the spouses’ conflict styles and the impact conflict has had in their marriage:

How often do the two of you fight?

Do you have more good times or more bad times?

Are your fights ever violent?

Are your fights heated?

Are your fights more or less discussions or negotiations?

Are either one of you “hit below the belt” when having conflict (see below)?

Do you stay calm when you fight?

Boston Counseling Insights

Rules for Fighting Fair

No matter what conflict style the couple has (and be aware each spouse can have a different style), anyone can benefit from learning the following basic rules to fighting fair.

Staying calm.

Make sure the spouse does not overreact to the situation. By remaining calm the spouse will be more likely to consider their partner’s perspectives. This could eliminate a conflict before it even starts, especially if the conflict is based on a misunderstanding (and many are). If a spouse feels he/she is so angry or upset that they will not be able to deal with the conflict in a healthy manner, instruct him/her to take a “time out” or help the spouse put the matter back into perspective. This one conflict is likely a small matter in the lifespan of the marriage.

One conflict at a time.

If a couple is having trouble resolving one issue, why would they be able to resolve more than one at a time? Some couples try to fix every problem in their marriage at the same time, and in the end they feel exasperated and overwhelmed. Hence, it is best to address one matter of conflict at a time, leaving all others off-limits until the matter at hand is resolved (or let go).  Note: If the couple has a lot of problems stored up, it could be challenging to pick one problem to begin. Sometimes many little problems will feel very intertwined because they are really parts of a larger overarching problem.  

Avoiding accusations.

The quickest way to make someone defensive is to accuse them of something. Therefore, instead of accusing a spouse (e.g., you hurt me!) of something, instruct the couple to emphasize how the spouse’s action(s) have made the other feel (e.g., when you said that it hurt me!).  

Don’t generalize.

Have the spouse be specific when they voice what the trouble is. It is imperative to have a clear understanding of what is bothering the spouse? Vague complaints are impossible to resolve. Moreover, the words “never” and “always” are two of the worst words to use during a conflict. The reason is that it is almost always an exaggeration. “You never pay attention” or “you are always late” are statements that—though they might feel true—over emphasize a less severe situation. “I would like you to pay better attention” and “It upsets me when you are late” are two much better ways to frame the same issue.

Don’t hit below the belt.

It’s a rule in boxing, and it’s a rule for marriages. While in boxing it refers to hitting the opponent in the, ehem, crotch region, hitting below the belt in marital conflict is an attack on the spouse as a person, not an attack on the issue. Moreover, it is usually an attack on a spouse’s area of personal sensitivity, delivered with intent to hurt the spouse, not resolve an issue.

Don’t stockpile.

Storing up small grievances is counterproductive to marital health. Therefore, it is best to deal with problems as they arise. This isn’t always possible of course. Sometimes the time is just not right to begin a conflict; such as right before bed, while someone is at work, or in front of company, family or friends. So, to help resolve small issues that pile up, some couples practice something called “withholdings time” where they can verbalize small grievances that have occurred such as “you offended me when our guests were over last night,” or “you forgot to turn off the heat when you left again this morning.” If not discussed (or just let go of) these small grievances build up and often explode with a wave of emotion when the couple has conflict regarding something more major. 

Boston Marriage Therapy - Conflict Action Plan

Damage Control

If a couple comes to your office, chances are a bad conflict has already occurred. Perhaps one spouse (or both) said or did something that hurt the other deeply. If this is where you find the persons you are counseling, have the couple implement the following guidelines.

Begin Reconciliation

The process of reconciliation can occur when both parties are willing to listen without interrupting. They both need to be respectful and understand that there are two sides to every story, two sets of feelings that need to be understood, and two hearts that need to be healed. The following lists of do’s and don’ts will be helpful to those who are trying to guide two people in reconciliation:

In the “do” column:

(1) See the situation from the other’s point of view.

(2) Repeat back: “I hear you saying . Is that correct?”

(3) Use words that encourage.

(4) Be respectful, even if you are not treated respectfully.

(5) Realize that you have the power to change only yourself.
(6) Be at peace, knowing that you have the Prince of Peace in your heart.

Now for the “don’ts”:

(1) Don’t forget that your opposer is also God’s creation. 

(2) Don’t harbor resentment, bitterness, or hatred.

(3) Don’t use “you” statements: “You make me mad . . . you should . . . you always. . . .”

(4) Don’t get drawn into useless arguments.

(5) Don’t expect an immediate change.

(6) Don’t assume that reconciliation is always possible.

Apologizing

Physical healing cannot take place unless the person chooses to do what is healthy. Similarly, the healing of two wounded hearts will not take place if both parties defiantly refuse to ask forgiveness. But since there are wrong ways and right ways of asking, you may need to explain the difference:

(1) Don’t make excuses: “I couldn’t help it.”

(2) Don’t use the blame game: “You made me do it.”

(3) Accept full responsibility: “My attitude was inexcusable.”

(4) Accept full blame for your part: “No one can make another person sin. I acknowledge that I sinned against you.”
(5) With a humble heart say, “I’ve tried to see our relationship from your point of view. I realize that I’ve been wrong in my attitude of . Would you forgive me?”

Forgiving

Some persons have a wound that will not heal because they won’t leave the wound alone. Just as a wound needs to be allowed to heal, a person needs to allow forgiveness to do its work. As the counselor, you can be effectively used by God to present practical steps in the healing process. Some of these steps include:

(1) Realizing that forgiveness is not letting the offender “off the hook,” but an act of releasing the offender from your hook and onto God’s hook. 

(2) Deciding that you want to be free from the pain of the past.

(3) Recognizing the unmet need(s) in the one who hurt you.

(4) Listing every offense, and then, instead of “picking” at the wrongs, releasing each offense and the offender into the hands of God.

(For more see the section on forgiveness and reconciliation)

Enlisting a Mediator

If a doctor has been consulted and the medical condition seems uncertain, a “second opinion” is often sought. Sometimes another mediator is needed. Seek a person whom both spouses can respect. Say to them, “At times an outside person brings to the table a different perspective. Would you consider a mediator to help us think through the problems to reach a successful end?”

Each person must be prepared to experience the possibility of a negative outcome from the process of reconciliation. Ultimately, a relationship may not work out between two people. One person cannot be responsible for the outcome of a relationship. However, each person is responsible for handling the reconciliation process in a responsible manner.

 (1) John Gottman, Why Marriages Succeed of Fail, 

Thrive Boston Therapy and Life Coaching in Cambridge, MA helps hundreds of couples every year save and improve their marriages. To schedule an appointment, or for more information about therapy services, call 617-395-5806.

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Can My Marriage be Saved?

True Stories of Saved Marriages

Mae Chambers and Ericka Chambers

 Pass it On Publications, 2008

Mae and Ericka Chambers are an unlikely duo to write a marriage book. Or are they? This blue grass singing, guitar playing, mother-daughter duet doesn’t have any training in marriage and family therapy, but what they do have is real life experience.

Mae Chambers’ marriage had problems from the Opening Bell, and by its 7^th year, the stock was at an all time low. Three out of four counselors said it was time to sell. Mae writes,

“The first three counselors, after hearing of John’s re-involvement with drugs and alcohol, his raging verbal abuse, and his adamant refusal to seek help, all advised me to go along with the divorce…But I simply couldn’t accept their conclusion…so I found myself in yet another counselor’s office…she [the fourth therapist] challenged me to go home, get alone with God, and honestly ask Him to show me what I had done to cause problems in my marriage. My face flushed with anger, but I held my tongue. Obviously she had missed the fact that I was a victim in this mess of a marriage. John was the guilty one.

While John was obviously out of control, Mae began see subtler ways she had contributed to the marital mess. She sought forgiveness and then, as she describes it, began to “stand for her marriage” by remaining faithful to a prodigal husband. In time, her marriage improved.

Real Marital Problems

The book, Can My Marriage be Saved?, is a collection of 22 auto-biographical accounts of severely troubled marriages that survived. The problems are severe, and true to life: cheating husbands, cheating wives, a spectrum of verbal and physical abuse. Some couples describe being estranged for years before reconciliation. Warning, Disney boycotters: its sex, drugs, and blue grass.

He Said, She Said

In each story, the spouses take turns writing from their own point of view. This provides good perspective, though the frequent changing of literary voice can damage a story’s flow—and it gives me a migraine. Still, the drama is a page-turner, and the narrative is far superior to the anonymous vignettes typical for a marital help book.

Real Marriage Solutions

How do you save a marriage? In the book, some couples used therapy, many used prayer, and all had a unique path to healing. Consider this excerpt from the story of Gary and Mona,

…the counselor had suggested I read a book on codependency. I had almost laughed out loud…I remember looking at him and saying, “You think I’m codependent?” He looked at me calmly.

“I know you are.”

I went ahead and took the book home, but just to prove him wrong. I read it, and before long I realized he was probably right.

In the story of Bev and Tom, after an argument where Bev lost her composure, she met with a professor for a lesson on neurobiology. She writes,

I wasn’t sure what neurobiology had to do with my marriage, but I was about to find out. “Brain function has a great deal to do with how we respond to real or perceived pain…Beneath the new brain lies the brain stem, or old brain. Painful memories from childhood can trigger the old brain’s fight-or-flight response.”

“You mean I’m not crazy?” I asked, heaving a huge sigh of relief, unable to hold back a floodgate of tears.

“No, you are not crazy, just reactive.”

Final Word

In Can My Marriage be Saved?, the reader is never told what to do to save their marriage; just what 44 other people did. The book drips inspiration. I challenge you to read this book, and when you’re done, close it and reread the question on the front cover. Then, answer the question yourself. 

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Rest assured, this book barely mentions the five love languages—keeping it to a minimum of just two pages in the first chapter, two pages in the back. Done. Finished. Life moves on. Finally.

In Desperate Marriages, Chapman promotes a philosophy he refers to as “Reality Living,” of which there are six rules: (1) I am responsible for my attitude, (2) My attitude affects my actions, (3) I cannot change others, but I can influence others, (4) My emotions do NOT control my actions, (5) Admitting my imperfections does not mean I am a failure, (6) Love is the most powerful weapon for good in the world.

Basic Impressions:

This book is well put together. It is quality material. The reader with real marital problems and needing real information will get real information. For instance, the book speaks about divorce in chapter one—a smart move, for this is certainly on the mind of someone who is in a desperate marriage. Chapman states, “while divorce removes some pressures, it creates a host of others.” Moreover, the book contains some good psychology (which any counselor reader will recognize as being of the CBT persuasion), and Chapman aptly references William Glasser (i.e., creator of Choice Theory/Reality Therapy). Chapman borrows Glasser’s concepts when he states every person has a need for love, freedom, significance, and peace with God (wait, what happened to power, fun, and survival?).

After a few introductory chapters, the book employs a by-topic format, each chapter coaching the reader on how to apply the six “reality living” rules to marriage with a difficult spouse. The chapters are labeled:

·         The Irresponsible Spouse

·         The Workaholic Spouse

·         The Controlling Spouse

·         The Uncommunicative Spouse

·         The Verbally Abusive Spouse

·         The Physically Abusive Spouse

·         The Sexually Abused/Abusive Spouse

·         The Unfaithful Spouse

·         The Alcoholic/Drug-abusing Spouse

·         The Depressed Spouse

My feeling is mixed about the by-topic format type. On one hand, there’s something for everyone; but on the other hand, at some point everyone gets left out in the cold. What I mean is, I would find it hard to recommend this book to a client without the caveat, “It’s a useful  book, but a lot of these chapters won’t apply to you.”

Bottom Line

Bottom line, if you’ve been looking information on the topic of troubled marriages, give Chapman’s new book a read. It’s a good reference, and the idea of “reality living” provides a significant philosophical foundation. And stay tuned, with any luck Desperate Marriages of Children should be out by fall. 

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This is a decent video about how a good relationship can go bad. It is less than 5 minutes long, and references some of the findings of Marriage and Relationship researcher John Gottman. 

http://ultimaterelationshipblog.com/2009/02/stressors-2.html?ec=136764-4

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Many research studies, including the June 14 issue of The Archives of Internal Medicine, indicate that elderly persons are at a higher suicide risk than other age groups.

Suicide currently ranks the 11th leading cause of death.

A link to the recent news article is here: http://www.msnbc.msn.com/id/28704127/

**

Anthony Centore Ph.D. is Founder of eCounseling.com and Thrive Counseling LLC

Boston Counseling

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PORTRAITS

Julie had never thought that her husband would ever hit her, but here she was starring at the bruise on her forehead.  He had apologized to her over and over again, and had promised that is would never happen again if she could gave him another chance.  She didn’t know what to do.

Lately Anna’s boyfriend was becoming more and more controlling.  Whenever he wasn’t with her, he wanted to know where she was and what she was doing, and was becoming jealous when she chose to spend time with her girlfriends.  Whenever she tried to talk to her about his recent behavior, he would become angry and physical with her.  She was becoming afraid of him and worried that he might never calm down.

Adam was afraid.  His wife had a bed temper and occasionally slapped him when she was angry, but last night she had been drinking and she really tried to hurt him.  Adam knew better than to fight back, but he wasn’t sure how much more he could take.

DEFINITIONS & KEY THOUGHTS

Domestic violence often follows a three-step circular pattern.  In the first step, tension rises until the abuser loses control.  Second, the abuse occurs.  It is often accompanied by feelings of rationalization by the abuser (i.e., thoughts that it is deserved by the victim) and minimization of the consequences of the abuse.  Third, the abuser feels remorse.  They do not feel the tension that they had before and are sorry for their actions.  They often beg for forgiveness, make promises to never do it again, and behave very lovingly toward the victim.

While the third stage of the pattern often appears to be true repentance, it is only due to the abuser’s absence of tension and their feeling that the victim has “learned their lesson.”  Once these feelings disappear and tension increases again, the battering is likely to reoccur.

Domestic violence is often fueled by the abuser’s need to control.  Unfortunately, a victim can become in danger of more battering by trying to break the cycle.

It is common for abusers and victims of domestic violence to have grown up in an abusive home.

Most of the predictors of domestic violence are present very early on in a couple’s dating relationship.  These predictors can include: use of violence or force to solve problems, rigid ideas regarding the roles of men and women in a relationship, an potential abuser’s need to prove himself by acting tough, and fears of a potential abuser’s anger.

It is not uncommon for abusers to be very personable and charming when in public, but to behave entirely differently behind closed doors.  Abusers may attempt to appear reasonable by tying to influence others of their wives’ irrational and rebellious behavior, and trying to get others to see their side.

There are several negative consequences of domestic violence.  Physical abuse can result in higher rates of all types of health problems including chronic pain, irritable bowel syndrome, gastrointestinal disorders, and more.  It also can result in unwanted pregnancy, gynecological disorders, of premature labor for pregnant women.  Victims of physical abuse generally tend to have more heart and circulatory conditions, as well as sexually transmitted diseases.  As for psychologically abused individuals, they are more likely to suffer from depression, anxiety, problems with low self-esteem, substance abuse, antisocial or suicidal behavior, and other adverse mental health conditions.  Consequences of social abuse include limited access to public life and health services, and little emotional support from friends and family.  Finally, children who witness any form of domestic violence are more likely to develop psychiatric disorders, low self-esteem, violent behaviors, developmental disorders, and academic difficulties. 

There are several factors related to domestic violence.  Among the many include poor family functioning, male dominance in the family, marital conflict, prior injury from the same partner, a history of physical abuse, having a verbally abusive partner, partner history of drug or alcohol abuse, economic stress, being under the age of 24, and a history of childhood abuse. 

ACTION STEPS

1.     Provide for safety.  When it comes to cases of domestic violence the victim’s safety is the number one priority. Reassure the victim of their safety and help the victim to feel empowered enough to separate from their abuser if need be. 

2.     Have a plan.  For some individuals, the only thing that keeps them in an abusive situation it their lack of resources to escape.  Work out a plan to for the victim to follow the next time that abuse occurs.  Be sure that they have numbers to call- police, a hotline or family shelter, a counselor, or a trusted friend.  Determine who the victim will call or where they will go if they choose to leave.  Advise the victim to pack their essentials in a bag that is easily accessible if they need to leave an abusive situation quickly; include in bag, photocopies of any important documents and predetermine how the victim will access money or car keys in the event that they need to leave suddenly.  Last, inform the victim that if they need to leave after an abusive incident, it is best to do so calmly and without any argument or discussion.

3.     Reassurance.  Reassure the victim that abuse is never deserved and is always wrong.

4.     Relationships.  Determine how much support the victim has and encourage them to seek help from others.  Encourage them not to isolate themselves no matter what the reason.  

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PORTRAITS

Henry was served with divorce papers after his wife had an affair.  He was devastated and begged her to attend counseling, but his wife had no desire to save their marriage.

Mary’s husband walked out on her and their four-year-old daughter three months ago.  He said he didn’t want to be a father anymore and Mary hasn’t heard from him since.  She thinks it may be time to file for a divorce and to move on with her life.

Sonia’s husband began beating her three months after they were wed and has continued to ever since.  Every time he beats her he apologizes immediately afterward and promises that it will never happen again.  Sonia has always forgiven him, but lately the beatings have become more frequent and more intense.  She feels that divorce may be her only option.

Lou and Paula are constantly fighting.  Paula is beginning to worry that their fights are taking a toll on their two children.  She wonders if her and her husband should divorce for the wellbeing of their children.

DEFINITIONS & KEY THOUGHTS

Separation occurs when a married couple makes the decision to live apart as two single people.  When separated, some couples seek counseling as a means to restore their relationship, while others seek new relationships altogether.  Of those couples who separate, 75-80% never go back to the relationship.

Divorce is the death of a marriage.  In legal terms, divorce is a court judgment to end a marriage.

No one expects his or her marriage to end in divorce, although it has become very common.  It has also been found that nearly half of the Baby Boomer generation has experienced a marital split, and the numbers are not expected to decrease.

Divorce does not only effect the couple involved, it has also been found that many children of divorce can battle with resulting unhappiness for up to ten or fifteen years afterward.

ACTION STEPS

For couples that are contemplating divorce it is important to make sure that they understand that divorce is not their only option, but that it is merely one of them.  They should understand that the restoration of their marriage is possible so long as true forgiveness and repentance take place.  Empathize with both spouses regarding the hurt and pain that they are suffering.  Last, be sure that they realize the realities that may come with getting a divorce (i.e., custody battles, financial difficulty in providing for two separate households, single parenthood, sending children back and forth, guilt from watching their children be torn in two, loneliness, grief, anger, or even hopelessness.

Two immediate action steps that couples contemplating divorce should follow are:

1. Put the divorce on hold.  The couple should seek the guidance of a mentor or professional counselor before making any rash decisions.
2. Stop the pain.  The couple should identify the issues that have been hurting their relationship and should make an effort to reduce their conflict.  Each person in the relationship should try to do away with any negative patterns that they have been using as a way to control or change their spouse.  They should seek forgiveness from one another and work on establishing new patterns to relate to one another and build trust.

For victims of divorce it is important to make sure they understand the importance of the grieving process and the time that it requires. Often it will take an individual two to five years to undergo the five stages of grieving- denial, anger, bargaining, depression, and acceptance.  An individual may even go through the stages multiple times and in different orders before healing is complete.  It is also crucial to validate the pain that the person is going through and to emphasize that they will get through it.  Emphasize that they should not ever feel shameful or guilty being a victim of divorce, and that they must truly forgive themselves and their ex-spouse- letting go of any anger or resentment they may have towards them- before they will truly be able to heal.

A few actions steps that may be helpful to victims of divorce are:

1. Join a recovery group.  Begin to attend a divorce recovery group to meet and learn from other victims of divorce.
2. Go to counseling.  Start attending individual counseling each week, month, or even year. 
3. No major decisions.  Do not make any major life decisions when still in turmoil.  Run important decisions by a counselor can help you to avoid making poor decisions while you are still emotionally vulnerable.
4. No new relationships.  So not rush into any new romantic relationships.  Focus on yourself and healing before entering another relationship.
5. Get involved.  Seek out friends to whom you can talk to and do activities with.  Help others whenever you feel up to it.

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PORTRAITS

Tom and Sara each stood in the foyer or two very different restaurants waiting for one another.  They had planned on going to lunch together, but once again their plans had failed.

 When Melanie cried to her husband, “It’s terrible here! You are never in this house- you have no idea what it is like to be here all alone!” Bill thought her complaints were about hating the house itself.  What Melanie was actually trying to communicate was that she wants him to spend more time at home with her.

When Rita’s husband withdraws, she badgers him to open up.  As a result, he ends up withdrawing even more than before.  Eventually, they both end up losing their tempers.  Rita always begins yelling and her husband leaves the house to go to the bar.

DEFINITIONS & KEY THOUGHTS

According to some marital experts, communication problems are a source of trouble for nearly 90 percent of all couples that seek counseling.

Even during heartfelt talks or serious discussions, couples may completely confuse one another.

Encouraging and effective communication holds major potential for enhancing the intimacy of a marriage.

The human communication process can better understood and analyzed by breaking it down into five basic parts:  (1) A message from an individual or group that is (2) sent in written or verbal from to (3) another individual or group that (4) receives the message and (5) understands the meaning of the message in a particular way.

Perfect communication occurs when the receiver of the message understands the intended meaning of the message sent exactly and in full.

Imperfect communication occurs when there are distractions or misunderstandings at any point in the five-part process.  For example, the message constructed might not be a good representation of the intended meaning of the sender, the message may be sent poorly or incompletely, the receiver of the message might not be listening well, or the understanding of the message could be clouded by the emotional, historical, gender, or value filters of the receiver.

ACTION STEPS

There are many ways to better the quality of one’s communication.  Empathy, genuineness and respect are critical to improving communication in marriage.  The following are some other techniques and suggestions for improving communication between spouses: 

1. More time talking.  Many couples spend only minutes of their day in meaningful conversation with one another mostly due to lack of time.  Some spouses attribute this lack of time to being overloaded with commitments and responsibilities.  In this case, couples need to examine all of their commitments to determine what their current priorities are and what they should be.  Another problem is that couples don’t make the time for communication with one another.  They fill the time they should spend talking to their spouse with television, phone calls, shopping, friends, and other activities. Finally there are the couples that shut their partners off out of anger or bitterness.  In this situation, by not talking these couples are doing themselves and their marriage nothing but harm.   
2. Be wary of non-verbal communications.  Even without words, spouses are constantly sending positive and negative messages to one another.  As a result, it is important for coupled to be aware of and to gain control of their negative communications.  Married couples must always make every attempt to keep their communication and intentions clear. 
3. End bad communication strategies.  There are four major types of unhealthy communication strategies that every couple should do their best to avoid.  They include the following:
   1. Criticism.  Criticism can be thought of as a global complaint and at times can take the form of a question implying a certain flaw in character. 
   2. Defensiveness.  Upon receiving criticism, it’s often second nature to respond with counter-criticism or “whoa is me” attitude.  Both of these are forms of defensiveness.   
   3. Contempt.  Contempt occurs when criticism and defensiveness are taken to the next level.  It can include put-downs, derogatory comments, or extreme disrespect.
   4. Stonewalling.  Stonewalling occurs when the intensity of a conversation gets too strong for an individual to handle and they simply decide to shut down or no longer participate in the conversation.  It can include physically leaving a room or just staring off into space.

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PORTRAITS

Kerri desperately wanted to trust her husband, but she constantly found herself thinking that there might be another woman in his life.  One afternoon she was cleaning up their home office and found a credit card statement detailing hotel and restaurant charges in Chicago.  She could not recall her husband ever talking about traveling to Chicago.

Nina enjoyed really enjoyed talking with her friend, David.  Their conversations always seemed to be interesting and uplifting. Somewhere along the line, their relationship became about more than just talking.  Nina can hardly remember when they developed feelings for when another or how their affair began.  She never had intentions of being unfaithful to her husband.

DEFINITIONS & KEY THOUGHTS

Adultery occurs when person has a sexual relationship with a person other than their spouse.  Such a relationship may or may not involve an emotional connection.

Adultery may also occur when a person has an emotional affair with a person other than their spouse. It occurs when a person turns to someone outside of his or her marriage for primary emotional support (i.e., a person turns to an opposite sex friend for support, companionship, and sharing of personal matters when they are experiencing hostility, conflict, or distancing with their spouse). This type of an emotional affair can actually be more detrimental to a marriage than physical adultery.

Sadly, infidelity in marriages is become increasingly common among both of the sexes.

Key reasons for extramarital affairs include unresolved conflict, poor communication, and unrealistic expectations that lead to marital dissatisfaction.  When such occur, the perceived need that is unfulfilled in the marriage seeks fulfillment elsewhere.

People may become involved in extramarital affairs because they find themselves in situations for which they have not set wise boundaries or are unprepared for.

Often affairs begin so gradually that the people who began as well meaning friends are unaware of the changes in the relationship until a significant behavior occurs.

Infidelity can also originate from emotional deprivation during childhood from which a person can develop a constant hunger for attention and approval.  If this is the case, when a person’s spouse cannot fulfill that hunger, that person will feel let down or cheated, and will seek attention from someone outside of the marital relationship.  Many adulterers believe that they are seeking love when all they are really desire is to feel better about them selves.

Whether a person is conscious of it or not, adultery may also occur as an act of retaliation or anger against their spouse. 

For some people, when money or positions of power increase, their sense of sense of entitlement to life’s pleasures also increases.  Not surprisingly, this sense of entitlement can also extend to the sexual realm. 

Overall, adultery is a self-centered choice in which a person intentionally ignores the needs of their spouse in order to satisfy their own selfish desires and often involves a lifestyle of deception.

ACTION STEPS

Healing after infidelity is not impossible.  More and more couples are enduring the difficult healing process in attempt to restore their marriages.  To begin the healing process, it is important for both spouses to:

1. Understand why the infidelity occurred.  This may require a long look at the development of marital patterns and the contributions that each person made to the breakdown of the marriage.  Although it is difficult, each spouse should concentrate on their own issues instead of criticizing or blaming one another for the infidelity.
2. Rebuild trust in one another by being truthful and accountable to each other.  It is important for each spouse to keep their word and to follow through in their promises.  Gestures of affection and nonsexual touch can also be helpful in the rebuilding of trust through their expression care and affirmation.
3. Take time to restore and enrich the marriage.  The restoration process involves remembering and reestablishing the good things about the marriage before the adultery occurred.  The enriching process involves learning and utilizing new behaviors and skills that can be used to help strengthen the marital relationship.

If the person in counseling is the faithful spouse:

It is important to realize that there is a normal process of grief that occurs when someone has been truly wounded.  This process includes:

1. Shock/Denial.  At this stage, the faithful person is unwilling to accept their spouses’ unfaithfulness and may blatantly deny any facts that are presented to them regarding their spouse’s activities.
2. Anger.  The faithful person is aware that they have been violated and hurt and may express deep rage and resentment toward their unfaithful spouse.
3. Bargaining.  The faithful person wants to use changes in behavior as a way to avoid further pain, rather than addressing the deeper ramifications of the infidelity.
4. Depression.  The faithful person full realizes the impact of the infidelity on their marriage and mourns the loss of their previous relationship with the unfaithful spouse.
5. Acceptance.  The faithful person comes to terms with the consequences of the infidelity and is willing to move past it. 

It is critical to note that these stages are experiences at a pace unique to each individual.  One must evaluate the particular stage that a person is at and be sensitive to them in encouraging them to work though that stage.  These stages can be experienced repeatedly, out of order, or several at once.  One should encourage the person not to make any rash long-term decisions before they have completed the grieving process.  It is not unusual for the hurt person to want to end the marriage rather than taking on the difficult task of rebuilding the relationship.  Separation, may be a better option that will allow both spouses the emotional space and time necessary to clarify the situation and process their own feelings.  The ultimate goal of separation is for the couple to reestablish trust and to build a friendship.

If the person in counseling is the unfaithful spouse:

1. Require the unfaithful spouse to disclose all of the steps leading to their affair, any information that was kept secret, and details of their relationship.
2. Remind the unfaithful spouse that it will not be easy to break their connection to the third party.
3. Inform the unfaithful spouse that they must re-engage emotionally with their spouse by spending as much time at they can with him or her.  The unfaithful spouse must also begin to account for all of his or her time in order to rebuild the trust of their spouse.
4. Tell the unfaithful spouse that the process will take time.  The healing process will involve developing new patterns and commitments to learning about oneself and their spouse on a deeper level.
5. Make it clear to the unfaithful spouse that seeking forgiveness involves restoration and making a deeper commitment to honor and love their spouse that they had previously given.

There are a few last important actions steps for both spouses to follow during the process of overcoming adultery.  They include the following:

1. The unfaithful person must make no contact at all with the third party.
2. The unfaithful person must be willing to make a major commitment in order to regain their spouse’s trust.
3. The unfaithful person must commit to a lifestyle of honesty and transparency, having no area that is off limits to inquiry.
4. The faithful person must fully commit to the difficult process of forgiveness. 
5. The couple must understand that forgiveness is necessary but reconciliation is based on true repentance and remorse- some may never be able to heal.
6. The couple must commit to working with a professional counselor who is able to help them identify the communication patterns that may have led to the affair.

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As a teenager, Tim got very little privacy. If he masturbated, to avoid getting caught he would rush through it as quickly as possible. Now as an adult, he finds that for his body rushing through sexual activity is the norm, not the exception.

Brian is nervous about sexual performance. A while ago he had erectile dysfunction (ED). Now, he becomes erect without a problem, but he’s so worried about the ED he can’t seem to keep ejaculation under control.

Definitions and Key Thoughts

Premature ejaculation is the most common sexual problem among men, and is said to affect between 25%-40% of men at any given time. The Mayo Clinic estimates that premature ejaculation effects one out of every three men.[i]

Masters and Johnson defined premature ejaculation as the condition of a man ejaculating before his sex partner achieves orgasm in more than 50% of sexual encounters. However, there is no medical standard for how long it should take a male to ejaculate during sex.

The American Psychiatric Association, in the DSM-IV, lists the diagnostic criteria for Premature Ejaculation as follows:

A. Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity.

B. The disturbance causes marked distress or interpersonal difficulty.

C. The premature ejaculation is not due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).

Premature ejaculation is sometimes known as “rapid ejaculation.”

Even though premature ejaculation is a common problem and very often treatable, many men are embarrassed to seek treatment for the problem.

Premature ejaculation was once thought to be a purely psychological issue. However, the sexual problem is now considered both psychological and biological.[ii]

Premature ejaculation is classified as either primary or secondary:

Primary premature ejaculation refers to having the sexual problem since one has become sexually active.

Secondary premature ejaculation refers to the onset of the sexual problem after a previous sexual relationship without ejaculation problems.

Causes of Premature Ejaculation

Psychological causes
Some doctors believe that early sexual experiences may lead to premature ejaculation. Such experiences include:

• Situations in which a man may have been hurried to reach climax, such as to avoid being discovered having sex or masturbating.
• Being made to feel guilty about sex could move a male to rush through sexual experiences.
• If a man suffers erectile dysfunction or concerns about sexual performance, anxiety during sexual intercourse could bring a man to have less control over when he ejaculates.

Biological causes
In addition to psychological causes, biological causes can cause premature ejaculation. Biological causes include:

• Abnormal hormone levels
• Abnormal levels of brain chemicals / neurotransmitters
• Abnormal reflex activity of the ejaculatory system
• Specific thyroid problems
• Inflammation or infection of the prostate or urethra
• Genetic factors

Action Steps and Treatment Plan for Premature Ejaculation

For many men, treatment for premature ejaculation includes a combination of medication and sexual therapy.

1. Sexual therapy

Sexual therapy can be an effective tool for overcoming premature ejaculation. Three sexual therapy techniques include:

1) Masturbating within one hour to two hours prior to sexual intercourse may delay ejaculation, during sex.

2) Focusing on foreplay and the experience of sex, instead of sexual intercourse and orgasm, can help one to overcome premature ejaculation.

3) Practicing oral sex, or manual stimulation, on your sex partner will facilitate female orgasm, which will take the pressure off of the man who is worried about ejaculating before his female sexual partner.

2. The squeeze technique

A four-step method known as the “squeeze technique” can help one to delay ejaculation.

Step 1. Begin sexual activity as normal, until the man feels that he is about to ejaculate.

Step 2. Before ejaculation occurs, squeeze the end of the penis at the point where the head (glans) joins the shaft. Hold the squeeze for several seconds—until the urge to ejaculate passes.

Step 3. Once the penis is released, wait 30 seconds before commencing sexual activity. Squeezing the penis may cause it to become less erect. However, when sexual contact is resumed, a full erection will return.

Step 4. Repeat process when approaching ejaculation.

After numerous trials and practice using the squeeze technique, the man with premature ejaculation will learn how to control ejaculation without using the squeeze technique.

4) Control Breathing

Controlling one’s breathing can help delay ejaculation during sex. By consciously slowing one’s rate of breath, and taking longer and deeper breaths, ejaculation can be delayed.

5) Control Anxiety and Stress

Since premature ejaculation often occurs in moments or high anxiety, using techniques that lower anxiety (or decrease stress) will help to control ejaculation.

6) Anesthetic Creams

Some topical anesthetic creams are used to treat premature ejaculation. These creams usually contain either lidocaine or prilocaine, which dull the sensation on the penis.

7) Medications

Certain medications, such as some antidepressants, have a side effect of delayed ejaculation. This makes them useful to persons trying to overcome premature ejaculation.

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