Dr. Val Farmer
Rural Mental Health & Family Relationships

Therapy May Be Hazardous To Your Marital Health

July 14, 2003

William J. Doherty, PhD, of the University of Minnesota Family Social Science Department believes that when therapy is poorly done, it helps undermine people’s commitment to their marriages. Here are some of the problems he has observed.

Individual therapy for marital issues. First of all, people go to individual therapists when they are depressed, anxious or having trouble in their lives. Many times the feelings of distress and unhappiness stem from marital difficulties. When that is the case, couples therapy should be strongly considered.

The way to help couples is much more active, psycho-educational and structured than individual therapy. Different skills and a different mindset are required. The alliance is to the marriage and not to one of the partners.

The skills for individual counseling are empathic and passive. People tell their story. The counselor listens and validates concerns. The individual feels understood and accepted. With the help of the therapist, the client thinks through his or her concerns, and explores options. The therapist wants to alleviate the pain and help solve the problem.

A spouse who chooses not to come to marriage counseling makes a dangerous decision. The same can be said for one partner who refuses to return for couples counseling after the first or second session. There are two sides to every story. The unhappy spouse is left with telling his or her side of the problem. Also it is much more difficult to create change without the goodwill, understanding and cooperation of the both parties.

Individual therapy is powerful. The contrast of the therapeutic relationship with the pain and misunderstanding that is occurring in the marriage subtly undermines the marriage.

And what do the therapist and the client talk about - the unhappy marriage. With time, there is a natural bias against the marriage as the person’s unhappiness persists and the inability to get needed changes persists. Out of a sense of hopelessness, it is a temptation for the therapist to liberate the client from his or her source of negative influence. A therapist can even label and imply pathology to an absent spouse without having had direct contact.

The same factors apply when an unhappy spouse attends group therapy and gets support and reinforcement. A group therapy experience can develop an anti-marriage bias similar to individual therapy.

Doherty believes therapists are also heavily influenced by the individual fulfillment culture of the 70s and the consumer culture of the 80s. If that is the case, therapists support people with their beliefs that marriages can be discarded in favor of individual self-interest. Unless the therapist has a strong pro-marriage bias, the language and attitudes of individual fulfillment will mirror the cultural mainstream.

Poor marriage counseling. A second reason Doherty believes therapy can be hazardous to marriage is the poor quality of couples counseling. Most therapists have not been trained to work with couples. Eighty percent of all private practice therapists in the United States say they do marital therapy but only 12 percent are in a profession that requires even one course or any supervised experience in marital or couples therapy.

If a couple goes to marriage counseling and repeats the same old martial arguments in front of a therapist who doesn’t take charge of the situation, they aren’t getting what they need. Marital therapy needs structure and guidelines to help a battling couple to stop their in-session conflict and to gain communication skills they can use at home.

Incompetent therapists may side with one of the partners and label the other one as flawed and pathological. They can subtly undermine a marriage by asking a series of provocative questions and challenges that lead to a conclusion of incompatibility. A poor experience in couples counseling may lead a couple to conclude that their marriage is hopeless when in fact the problem was with the quality of the counseling they received.

In choosing a marriage counselor or therapist, Doherty recommends asking the following questions:

1. "Can you describe your background or training in marital therapy?" If the therapist is self-taught or workshop-trained, and can’t point to formal supervised training in this work, then consider going elsewhere.

2. "What is your attitude toward salvaging a troubled marriage versus helping couples break up?" If the therapist says he or she is "neutral," or "I don’t try to save marriage, I try to help people," look elsewhere.

3. "What is your approach when one partner is seriously considering ending the marriage and the other wants to save it?" If the therapist responds by focusing only on helping each person clarify their personal feelings and decisions, consider looking elsewhere.

4. "What percentage of your practice is marital therapy?" Avoid therapists who do mostly individual therapy.

5. "Of the couples you treat, what percentage would you say work out enough of their problems to stay married with a reasonable amount of satisfaction?"

After reviewing all these pitfalls, Doherty states, "I have come to believe that people first need support people, mentors, other couples in their lives, and then they need marriage educators and then they need therapists - in that order."