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Block 3 Unit 3 Psychodynamic Couple Therapy

1) Define couple therapy.

Couple therapy, also known as marriage or marital therapy, focuses on the problems existing in the relationship between two people. While focusing on the relationship, it also addresses individual symptoms and problems that often accompany relationship conflicts. The aim is to identify conflict issues and decide what changes are needed for both partners to feel satisfied with the relationship.

2) Describe the nature of couple’s therapy.

The nature of couple's therapy involves addressing relationship problems that include individual symptoms, as well as relationship conflicts. For example, constant arguing may lead to anxiety, anger or depression. Couple's therapy can assist with identifying conflict issues, and deciding what changes are needed, including:

• Different ways of interacting.
• Individual changes related to personal psychological problems.
• More effective communication and listening skills.
• Avoiding competition, identifying common goals, and sharing responsibilities.
• It can be similar to individual therapy, mediation, or education.

3) Discuss the different approaches to couples counselling.

There are several different approaches to couples counselling:

• Psychodynamic approach: This approach attributes problems within a marriage to the unresolved conflicts and needs of each spouse, focusing on each client’s personal history and underlying motivations, and applying the principles of psychoanalysis.
• Systems approach: This approach focuses on the interaction between partners as the origin of marital difficulties, analyzing behaviour and communication patterns and the interlocking roles portrayed by the couple.
• Client-centred approach: This approach, also known as humanistic therapy, emphasises open communication and sharing of feelings. Couples work on improving their speaking and listening skills to enhance emotional honesty.
• Behavioural approach: This approach focuses on identifying problematic behaviour patterns, often by recording behaviour, and coaches couples in modifying strategies to achieve positive interactions. This approach also focuses on improving a couple's problem-solving and conflict-resolution skills.

4) Elucidate psychodynamic approach to couples counselling.

The psychodynamic approach to couples counselling is based in a highly developed theory of human development and interaction. It is an insight-oriented approach that focuses on unconscious emotions that manifest in behaviour. It identifies emotions that manifest in behaviour, allows the focus to be on the unique situation of each client, and takes into account how past relationship experiences affect current relationships. The therapeutic relationship is based on acceptance, empathy and understanding, with an emphasis on developing a good working alliance that fosters trust.

5) What is systems approach to couple counselling?

The systems approach to couples counselling emphasises the interaction between partners as the origin of marital difficulties, rather than their individual actions or personalities. It analyses behavior and communication patterns, as well as the roles played by each member of the couple or family. It views the difficulties of one member as symptomatic of an unhealthy pattern in which all members play a part.

6) Discuss the application of behavioural approach in couples counselling.

The behavioural approach in couples counselling focuses on identifying and modifying problematic behaviour patterns, often using systematic recording of behaviour. The therapist coaches couples in strategies to achieve positive, mutually reinforcing interactions, and focuses on improving problem-solving and conflict-resolution skills.

7) Discuss psychodynamic couple’s therapy as an object relations approach.

Psychodynamic couple's therapy, using an object relations approach integrates past and present, conscious and unconscious, and the intrapsychic with the interpersonal. It helps couples understand how past life experiences can limit their present possibilities as a couple. It clarifies how unconscious processes can promote conflict, and helps partners take ownership of their individual perceptions, fears and motivations. The therapist looks beyond the manifest content of an argument to understand the unconscious factors that may have triggered the conflict. When "bones of contention" are reactivated, this approach explores the triggers of the current conflict to develop an understanding of underlying issues.

8) What is projective identification?

Projective identification is a mechanism where individuals unconsciously project unwanted aspects of themselves onto their partners, and the recipient of these projections are influenced to behave in ways that correspond with the projection. This process can create difficulties for couples because it reinforces and perpetuates maladaptive patterns and conflict.

9) Discuss empathy and transference in psychodynamic couple’s therapy.

Empathy and transference are key concepts in psychodynamic couple's therapy:

• Empathy: The therapist uses empathy to understand each partner's internal experience, and to help them understand each other.
• Transference: Feelings and behaviours from past relationships are transferred into the therapeutic relationship with the therapist and also between partners, often reflecting the couple’s problematic patterns. Transference is a form of projective identification that occurs in the therapeutic relationship.

10) In couples therapy how are transference feelings and marital issues interrelated?

In couples therapy, transference feelings and marital issues are often interwoven. Because couple's therapy is a three-person relationship, there are increased variations of transference. These variations include:

• Each partner’s transference toward the therapist, based on their internal object world.
• A triangular transference where each partner seeks to be preferred by the therapist over the other, which can replicate sibling rivalry for parental favour.

11) What is three person group interactions in couples therapy?

Three-person group interactions in couples therapy refers to the dynamic where the therapist becomes part of the relationship system. Each partner may compete to be favored by the therapist. Often this dynamic re-enacts sibling experiences in competition for the favour of their parent. The therapist needs to be aware of this dynamic and maintain neutrality.

12) Discuss counter transference experience in couple’s therapy.

Countertransference in couple's therapy refers to the therapist's emotional reactions to the couple. Because of the emotional power of the group dynamic, strong countertransference experiences are expected, and it is often a challenge to convert these feelings into stimuli for constructive therapeutic reflection and intervention. Countertransference can include feeling the need to energise the interaction with frequent superficial interventions.

13) Discuss active behavioural interventions in couple therapy.

Active behavioral interventions in couples therapy focus on encouraging partners to communicate directly with each other rather than through the therapist, and by giving homework to encourage experimentation with physical intimacy. Rather than generic exercises prescribed by the therapist, homework should be the product of the couple's imagination.

14) Discuss object relations couples therapy

Object relations couples therapy attends to both interpersonal and intrapsychic dynamics, tailored to the specific nature of relational difficulties and the developmental level of each partner. The treatment is an approach to formulating and intervening rather than a prescription of specific tasks, and it focuses on the way early internalised relationships have come to life again in the couple’s current life. The therapy aims to foster reinternalisation of projected aspects of the self. The therapist seeks underlying issues that precipitate conflict rather than focusing on resolving the conflict's manifest content.