Saturday, May 26, 2012


Improving couples’ attachment security, intimacy, stability and satisfaction

June 2012 | Knowledge Shar



Working with couples and families requires a different stance from working with individuals. I like that I can experience the relationship dynamics directly by being in the same room with the couple. It’s so different seeing the dynamics in action as opposed to having one individual describe it to you from her or his view. With couples work, you can witness how quickly one person’s response is cued by the other. Before you know it — before the couple knows it, for that matter — they launch into defensiveness and negativity almost as if you weren’t there. When you try to mediate, it either makes it worse or they both become angry with you. It quickly escalates.
I have learned to cope with this by acknowledging from the beginning that the relationship (or as Harville Hendrix has called it, the “in-between”) is my client. I like to think of it as a circle, the reciprocal nature of all relationships — in this case, close and intimate relationships.
I often describe relationship to couples as a dance in which they have to coordinate their actions so they won’t kick each other in the shins. The more they practice with each other, the smoother it becomes, the less they hurt each other and the more satisfying it is. If the music changes — as it often does in life — they have to adjust their rhythm with each other to recover the smoothness (stability) and satisfaction. For as long as they dance with each other, this will be a lifetime pursuit. I know! My wife and I have been married 50 years, and we are still adjusting our dance.
I work with relationships because I believe that everything we experience occurs in relationship. Without relationship, there is no existence. It’s the stress of relationship that keeps us alive — just not too much stress.
There is no more significant relationship than the couple relationship. It is unique because it’s a peer relationship, not hierarchical like most other relationships. It is an intimate friendship that can become the basis for our security and fulfillment. But as Murray Bowen said, a two-person relationship is inherently unstable — too close or too distant, too intimate and vulnerable or too disengaged and threatening. We never get it right. We just learn to adjust it so it doesn’t become too emotionally extreme.
I believe the primary objective in couple therapy is to help couples improve the stability and satisfaction in their relationship and learn to stay flexible, not rigid. It’s important for couples to maintain a context of intimacy and engagement that allows them to experience a sense of trust and security in which they can be “safely vulnerable.” Couples can do this if they feel attached, which in turn depends on their ability to emotionally engage with each other. The quality of emotional engagement enables people to develop in healthy ways, to trust themselves and each other.
I believe that our personalities are shaped by our relationships, and particularly formed in our earliest attachment relationships. Out of this experience, we tend to trigger the same kind of responses from others that we learned beginning in childhood. These responses operate mostly beyond our awareness (implicit emotional memory). To understand any couple interaction, it’s important to consider that there are cues from each person that elicit a response from the other partner, which in turn elicits a reciprocal response from the original partner, ad infinitum. These are the habits that we see in all relationships.
What draws us together can also push us apart
In marital and couple relationships, I believe it is typical to form a bond with someone most like ourselves. However, what draws us to each other are opposite characteristics — the complementary aspects of our relationship — that are then difficult to live with the rest of our lives. These difficulties become the themes of our relationships, repeated over and over again as long as we are together. For example, one partner comes from a distant and noninvolved family of origin, while the other comes from a close family. It’s likely that this couple will continue to have differences concerning the involvement of extended family in their lives. This is an example of the reciprocal responses (habits) we see in all relationships.
So, the habitual way couples learn to relate to each other is derived from how each individual learned to relate to others from childhood. Partners in a couple pick each other because they fit complementary to each other, and the habits derived from this become the underlying forces driving the process of their relationship.
If couples have the skills to transform the emotions responsible for the negative patterns in their relationship to more positive ones, they will improve their recovery from the defensiveness and hurt derived from these negative cycles. If their recovery is improved, they will have “softened,” thus strengthening the intimacy and stability of their relationship. It is important for the relationship to be flexible enough to cope with these forces. At the same time, couples have to remain sufficiently emotionally engaged to maintain the trust and security of the relationship. If this becomes a consistent pattern over their life span, they will have achieved a stable and satisfying relationship.
The key in couple therapy is not to directly help couples solve problems but rather to have them skillfully remain emotionally engaged when under stress. In fact, it is likely that the difficulty couples face in resolving conflict has more to do with emotional disengagement than with an inability to solve problems.
Consider what John M. Gottman and Robert W. Levenson wrote in their article “How Stable Is Marital Interaction Over Time?” for the Family Process journal in 1999: “It’s not the problems a couple solves but how they deal with their emotions connected to the perpetual problems they never solve that leads to stability and satisfaction in their relationship.”
It’s important to help couples become resilient in the face of the many stresses, challenges, disruptions and developmental changes that threaten to disengage them. This involves helping them remain softened to each other and equipping them to recover when life’s experiences create disengagement. Being able to recover restores the emotional engagement (intimacy) of the relationship. Quicker and more frequent recovery reduces the likelihood of disengagement, defensiveness and hostility. This, in turn, leads to satisfaction and stability.
Emotion-focused relationship enhancement therapy
Relationship enhancement (RE) focuses on emotion as the transformative agent in therapy and relationships. How couples manage their emotions — a reciprocal process — is central to maintaining an intimate and satisfying relationship. The struggle around the emotions elicited by the couple’s differences becomes the vehicle that changes the relationship, improves its flexibility and keeps the couple safely engaged. Learning the skills to improve this process is the objective of emotion-focused RE therapy.
Relationship skills, particularly in close, interdependent and attached relationships such as couple relationships, are essentially emotional regulation skills. Underlying each couple interaction are deeply important and implicit (nonconscious) reciprocal emotional cues and reactions that emerge spontaneously. These constitute the “interpersonal habits” discussed earlier.
To get a grasp on these nonconscious, emotional habits that contribute to stress and conflict in couple relationships, it is useful to understand how couples communicate. Essentially, one person in the relationship, motivated by emotion, is trying to convey information and perceives that the other person understands the importance (meaning) of what is being expressed.
What most needs to be understood is the underlying feeling that motivates the expression. For example, if one partner says to the other, “You forgot to bring milk home,” both parties recognize the feeling (disappointment) as the reason (meaning) for the statement. The arousal, which is physiological, in the partner’s emotion (disappointment) is the cue for how the couple subsequently will engage. If the other partner feels criticized and becomes defensive (arousal), there will be a “fight.” However, if the other partner listens by recognizing and accepting the partner’s disappointment, the arousal and defensiveness are reduced, and they are in a better position to collaborate and restabilize their relationship. This is the “softening” so often acknowledged in couple therapy.
The primary skills in couple interaction have to do with expressing one’s self so that the other person recognizes the underlying feeling that motivates the expression and having the other person acknowledge it. So, speaking and listening constitute the first two skills of emotion-focused RE. Essentially, the speaker is learning to improve self/emotional regulation (owning expression), and the listener is learning to accept and acknowledge an understanding of the other person’s emotional motivation (empathic understanding).
In RE, the partners who make up a couple learn to understand themselves and each other by exploring the emotions that motivate their behavior. When people perceive that their relationship is safe enough, they are freer to reveal these underlying, primary feelings to themselves as well as to their partners, which softens the relationship. By revealing these deeply owned feelings to themselves, individual partners are better able to understand their experience and regulate their emotions, giving them a sense of greater mastery. And when these deeply owned feelings are accurately recognized without judgment and with acceptance by their respective partners, a context is created that fosters deeper sharing of feelings and understanding.
I have observed that when couples create such a context, the partners feel closer, more trusting and more open with each other. This does not secure the relationship, however, unless the couple also practices the third and probably most important RE skill, known as the relationship (emotional engagement) skill. This skill asks couples not only to take ownership of their feelings and respond empathically with acceptance and without judgment, but also to acknowledge the meaning of the relationship (“Your feelings affect my feelings”). This skill is taught when they switch roles (listener and speaker). The instruction to the new speaker is, “How does it make you feel to know that she [or he] feels that way — good or bad?” Together, these three skills constitute the basic training of RE.
Generalization and maintenance
In RE, each member of a couple practices expressing his or her feelings and owning these feelings; this then enables each person to accept the other. By reciprocally practicing the skill of acknowledging the feelings (internal experience and emotional motivation) of the other through empathic listening, a context of acceptance and nonjudgment is created. Ultimately, through supervised and then unsupervised practice, couples learn to create an ongoing relationship context of acceptance, nonjudgment and emotional engagement that operates in their day-to-day lives. Establishing this context is a critical outcome of RE therapy.
The success of any therapy lies in the ability of clients to take what they have learned and make it a part of their everyday lives. That is why the next two skills, generalization and maintenance, are essential for an optimal outcome. The development of clients’ generalization and maintenance skills begins with the very first session of RE.
Taken together, the five core RE skills allow couples to maintain a reciprocally stable relationship and become more emotionally engaged. However, couples will internalize these skills only after they have attained a certain level of proficiency and experienced enough satisfaction from incorporating the skills regularly. Thus, homework assignments of various kinds are systematically included in the program to encourage generalization into everyday life. Homework is described to couples as an acknowledgment of their responsibility for the therapy and, ultimately, their relationship. From the beginning, it establishes the value of home practice.
Supervision of this homework is designed to improve and reinforce generalization and maintenance of RE skills. If clients encounter difficulties applying the skills in everyday life, role-playing is used in the therapy session to improve the couple’s ability to use the skills in a variety of challenging situations.
Homework assignments are designed to review the principles and skills learned in the sessions, encourage clients to set aside specific times for additional skill practice and help participants use the skills in their daily lives. Thus, at the beginning of each session, valuable time is devoted to a report by the couple about their homework assignments and their use of RE skills outside of the therapy session. Often, couples must first be taught to set aside a consistent time in their busy lives to devote to their relationship and to practice. A simple homework exercise (often the first homework assigned) is to have the couple schedule a “playtime” each week at the same time. In this context, play should be defined as spontaneous and not outcome-based.
Probably the most critical method of generalization and maintenance is home practice of the first three emotion-focused RE skills. After a period of skill training that involves a tutorial process, couples are encouraged to schedule home practice sessions for an hour at the same time each week. The decision to move to home practice is a collaborative decision between the couple and the therapist. Couples are informed at the beginning of therapy that this will be part of the structure. Prior to starting this process, couples are given a home practice handout, which includes a time-out procedure, to review together. (For a copy of this handout, contact me at barry@relationshipenhancement.com.)
At this point, the therapy shifts from an emphasis on office sessions to home practice, with the weekly home practices being taped. Subsequent in-office sessions focus primarily on home practice and involve a coaching process. Emphasis during these sessions is placed on identifying underlying positives and improved skills. Once couples develop a confidence and consistency in home practice, the office sessions become less frequent. Couples understand that subsequent sessions will be devoted to reviewing the most recent home practice tape, and therapy shifts to a consultative process, with couples taking responsibility for their own therapy and relationship. Couples can then choose to come in for booster and/or refresher sessions if they haven’t seen the therapist for a period
of time.
Through the years, I have attended workshops and conferences, taken various training programs and fulfilled my continuing education requirements. I marvel at how often I keep returning to the RE model. It seems to me that it achieves the best outcomes for couples.

Source: http://ct.counseling.org/2012/06/improving-couples-attachment-security-intimacy-stability-and-satisfaction/

For English couple therapy in Paris, please contact : therapie.de.couple.paris@gmail.com

Wednesday, December 1, 2010

Nos choix de cabinets

Thérapie de couple à Paris

Une crise, un différend, une perte de désir… Dans un couple, on passe par des hauts et des bas. Mais que se passe-t-il quand chacun ne voit plus que les problèmes que l'autre lui apporte et quand on sent qu'il ne s'agit plus d'une simple crise passagère ? Introduire un tiers dans la relation pourra vous aider.
Il ne s’agit pas de savoir qui a tort ou qui a raison pendant la thérapie de couple, mais plutôt de rétablir la communication entre vous et redonner à votre relation son caractère épanouissant et agréable. Apprendre à écouter l’autre. Chez Psychologue Paris nous vous donnons les moyens d'exprimer vos insatisfactions par rapport à la relation et non par rapport à l'autre. Ce changement de perspective permet de revoir la relation sans viser à changer l'autre.
Il ne s’agit pas de savoir qui a tort ou raison pendant la thérapie de couple, le but c’est plutôt de rétablir la communication entre vous et d’assurer que votre relation soit à nouveau confortable et agréable. Apprendre à écouter l’autre. Je vous donne les moyens d'exprimer vos insatisfactions par rapport à la relation et non par rapport à l'autre. Ce changement de perspective permet de revoir la relation sans viser à changer l'autre. Lors de la thérapie de couple il se peut que des causes plus profondes et inattendues surgissent qui sont également la cause des problèmes dans votre relation. Par exemple une dépression, un épuisement ou un trauma non résolu chez l’un des deux partenaires.
Pendant la thérapie de couple, les deux partenaires peuvent finalement décider de mettre un terme à leur relation, ou de vivre séparément. Si c’est le cas Psychologue Paris peut vous aider afin que ce processus se fasse le mieux possible.


Thérapie de Couple


Psychologues cliniciens et psychanalystes, spécialistes de problématiques de couple, diplômés des Universités américaines et françaises, accompagnent les couples - mariés ou non - pour comprendre et résoudre leurs conflits et améliorer leurs relations.
Il s’agit de fournir au couple les clés de compréhension de leur problème et leur donner des outils pour mieux communiquer, négocier les différences, résoudre des problèmes et même des conflits d'une manière plus saine.

La thérapie de couple, ou conseil conjugal, est assurée par un thérapeute agréé qui offre les mêmes services de santé mentale comme tout autre thérapeute, mais avec un accent particulier - une relation de couple.
La thérapie de couple peut être de courte durée. Vous aurez peut-être besoin de quelques séances seulement pour vous aider à traverser une crise. Ou bien vous pourriez avoir besoin de thérapie de couple pendant plusieurs mois, surtout si votre relation s'est considérablement dégradée. La fréquence des séances peut aller d’une fois par semaine à une fois par mois.

La maladie, l'infidélité, le sexe, la colère, des problèmes de communication - tous peuvent contribuer à la détresse dans les mariages ou d'autres relations. Le conseil conjugal ou thérapie de couple peut aider à résoudre les conflits et guérir les blessures.

La thérapie de couple peut vous aider à reconstruire votre relation, ou décider que vous serez tous les deux mieux si vous vous séparez. De toute façon, une thérapie de couple peut vous aider à mieux comprendre votre relation et 
à prendre des décisions bien réfléchies.


https://sites.google.com/site/therapiedecoupleparis/

Le désir dans le couple

Le désir occupe une place très importante au sein du couple, pourtant chacun des partenaires peut avoir dès l’origine des désirs différents, ils évoluent et parfois ils seront blessés. Un passage difficile ou une grise au sein du couple sont des périodes qui facilitent le manque de désir chez les partenaires, et dans une société où la sexualité n’est plus tabou, la stimulation peut être cherchée dans des aventures ou autres substituts, qui au final ne pourront apporter aucune solution au sein du couple. Dans une relation où le désir manque aux deux partenaires, ou à l’un des deux, il y aura alors forcément un manque, qui peut se traduire avec le temps, par des reproches.

Ce manque résulte souvent d’une “routine” qui peut s’installer dans le couple, même si l’amour est là, cela ne suffit pas à donner du désir, de l’envi à l’autre. La peur de “l’échec” sexuel est une cause qui apparaît chez les hommes qui ont connus pannes sexuelles ou problèmes d’érection, chez les femmes les hormones ont une influence, notamment après un accouchement une baisse de libido peut se faire sentir.

Pour garder le désir actif il y a des “stratégies” connues, à mettre en place comme avoir son jardin secret, faire des activités sans l’autre, le/la surprendre… Parfois cela ne suffit pas, il peut y avoir des causes plus profondes, qui ne concernent pas forcément l’autre directement et il est alors difficile de pouvoir trouver l’origine du mal-être. Le partenaire qui a une baisse de libido sans qu’il y ait d’explications directs avec son partenaire, mais qui ne vas pas bien pour des raisons qui lui sont propres (stress, fatigue, déprime, problèmes au travail…), aura tout intérêt à communiquer avec son partenaire, car les conséquences qu’il y aura au sein du couple ne concerneront pas que les problèmes de désir qui surviennent, mais tout l’ensemble du couple. La communication trouve encore ici une place très importante car c’est elle qui pourra permettre à chacun des partenaires de comprendre ce que l’autre ressent, et cela s’adresse aussi au manque de désir. C est un sujet qui peut être difficile à aborder, autant par le partenaire qui ressent le manque, que celui qui se sent ” cause” du manque de désir. Consulter un sexologue aidera à la mise en place d’une communication au sein du couple, le fait de parler dans un lieu neutre, qui sera réservé à ce sujet, sensible dans certains cas, peut être la solution pour une communication établie sur l’échange et l’écoute.

Chacun est différent et même dans sa vision de voir les choses, mais lorsque l’on est deux à vouloir avancer dans le même sens il faut réussir à trouver le mode de communication du couple qui le fera avancer dans la direction souhaitée, en prenant en compte chacun des deux individus.

source: http://www.mon-psychotherapeute.com/le-desir-dans-le-couple/

Sunday, November 7, 2010

Thérapie de couple : analytique ?

Un article par VINCENT GARCIA dans Dialogue 166, pp. 60-65

Psychologue, psychothérapeute, thérapeute… Les tentatives politiques actuelles de la loi visant à définir le titre de psychothérapeute, dont la vocation semble davantage être de protéger le malade que le sujet en souffrance psychique, nous convient à repréciser notre positionnement de manière claire et concise dans le champ varié du soin « psy ».

« Psychothérapeute psychanalytique de couple » est la dénomination officielle des thérapeutes de couple de l’AFCCC. Et, plutôt que d’entrer dans le classique débat « analytique » ou « non-analytique » de cette pratique, j’ai choisi de transcrire ce qui, de ma littérature et ma pratique usuelle d’analyste, s’harmonise avec celle du thérapeute de couple que je suis, essayant par là de mettre brièvement en évidence pourquoi la PPC (psychothérapie psychanalytique de couple), telle que transmise au sein de l’Institut de formation de l’AFCCC, me semble, dans son essence, analytique.

Le dispositif analytique

Il est d’usage de revenir, dès que l’on s’interroge sur le dispositif thérapeutique analytique, à la définition de José Bleger (1979) : « Je propose de nommer “situation psychanalytique” la totalité des phénomènes en jeu dans la relation thérapeutique entre analyste et patient. Cette situation comprend des phénomènes qui constituent un processus, lequel est objet d’études, d’analyse et d’interprétation ; mais elle comprend en outre un cadre, à savoir un “non-processus”, en ce sens qu’il représente l’ensemble des constantes à l’intérieur des limites duquel le processus lui-même se produit. »

En 1974, André Green (1990) propose une autre définition qui, dit-il, « complète celle qui est donnée par Bleger » : « La situation analytique est l’ensemble des éléments compris dans la relation analytique, au sein duquel un processus est observable dans le temps, dont les nœuds sont constitués par le transfert et le contre-transfert, grâce à l’établissement et à la délimitation du cadre analytique. »

Ces définitions concernent au premier chef la cure-type, mais demeurent la pierre d’assise de toute psychothérapie psychanalytique.
Voyons donc ce que nous faisons de ce cadre, rituel et non processuel, puis du processus analytique lui-même, dans le champ de la PPC.


Thérapie de Couple vous apporte différentes références sur ce sujet régulièrement. Très prochainement la deuxième partie de l’article Vincent.