I am a mental health therapist who sees both adult individuals and couples. A lot of individual therapists believe they can cross over into couples work seamlessly, but I think the role of the therapist is quite different when working with couples. Here are some of the ways these therapeutic relationships can be very different:
1 - Goals
When working with individuals, the client sets the goal for their treatment. The therapist can influence the client, but if you come in with anxiety you are probably going to want to reduce your symptoms of anxiety. In contrast, almost all couples come in wanting to have a better relationship. There are a few exceptions to this rule. Some couples come in wanting to either make a decision or prepare for a break up, but the vast majority of couples are looking to improve their relationship. In fact, every couple that I’ve worked with has wanted to “improve their communication.” This might be controversial, but I think, regardless of the people involved, good relationships all have the same components. There’s a Leo Tolstoy quote that goes, “Happy families are all alike. Every unhappy family is unhappy and its own way.” I think the same thing is true for couples. The goal is always the same, but the journey to get there is different for each couple and for each person, for that matter. In short, for individual therapy, the client sets a goal which could be any number of things, but in couples therapy, the goal is almost always to have a better relationship.
2 - Who changes?
In individual therapy, the client knows that, in order for things to change in their life, they will probably have to make some changes internally. This is not the case in couples therapy. Most couples come in thinking that, in order to improve the relationship, their partner needs to change. As a therapist, this can make it messier to get buy-in for each individual partner to make their own autonomous changes.
3 - Motivation source
Sometimes, in individual therapy, motivation can get lost. Clients can have an internal conflict or maladaptive coping strategy that make them feel stuck and obscure any motivation to move forward. With couples, this can also happen, but the partner is right in the room hoping and expecting that their partner will find the motivation to make those changes. Motivation can certainly get lost, but if both partners are committed to saving the relationship, there is a built-in push to get to a better place.
4 - More info
With individual clients, my knowledge of their situation is entirely dependent on what they choose to tell me. Not so with couples! I will immediately get a much better sense of each partner and their contribution to the dynamic since there’s another person in the room. And that person is usually all too happy to fill me in on what their partner does wrong.
5 - Experiential
With individual clients, much of what we are doing is talking about things that happened previously and formulating different approaches to take outside of the therapy room. It is true that the relationship between client and therapist is experiential, particularly if the client is not used to having a deep emotional connection; however, couples therapy is inherently experiential. In other words, the couple can, in real time, have a different kind of interaction right there in the room. As a result, couples can feel differently about each other as they each take those steps towards growth. Human beings tend to learn from doing as opposed to hearing about or talking about, so any kind of real time experience is going to push faster growth.
6 - Faster Progress
Because of this experiential learning, and the fact that I have access to more information, individual progress and growth tends to be faster than it would be in individual therapy.
7 - More coaching
As a therapist for individual clients, I listen, reflect back, validate, teach skills, and occasionally challenge. But as a couples therapist, I do a lot of coaching. Once we identify individual goals, I get permission to provide real time guidance. As a couple interacts, I coach each partner — as though I’m coaching skills at a tennis clinic. I tell my couples that they should be prepared to be pissed off at me. If they never feel that way, I’m probably not doing my job properly. After all, if they just wanted to argue like they do in their own kitchen, why would they pay me to watch it? My goal is to provide a lot of feedback at the beginning, but gradually less and less as they each become stronger and healthier until they are doing all of the talking and I am simply witnessing it.
8 - More Tension
And here’s the main way, in my mind, couples therapy differs from individual therapy — and that is, it works best with a certain amount of tension. Let me explain. Everybody tends to get along when you agree on things. The problems come when you disagree. My philosophy, and I’ll say more about this in other blogs, is that maintaining a certain amount of tension is required when discussing difficult matters. Some couples are conflict avoidant and my job is to turn up the tension with them. Other couples are hostile fighting and my job is to turn down the tension with them. Either way, I have to maintain a certain amount of tension in order to have healthy, vital discussions. I don’t feel much stress before most individual sessions, but I always feel some degree of stress when heading into a couples session for this reason.
So for me, couples therapy and individual therapy are entirely different practices. They differ in terms of who makes the goals, who is required to change, where the motivation comes from, the amount of information available, the level of experiential learning, the speed of progress, the amount of energy and coaching required from me, and the level of tension needed for a healthy discussion. I also feel pretty strongly that couples therapist should get specific training in order to practice, but that is a topic for another blog. Let me know what you think — comments are always appreciated!
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