Updated: Mar 19
There is no question that the top reason for an individual seeking therapy today is “relationship counseling.” There are more callers of every age who are looking for a therapist to help them “get along better” with their partners, parents, children, boyfriends, roommates, girlfriends, stepchildren, siblings, in-laws, ex-husbands, ex-wives, co-workers etc., than anything else.
At the moment I am seeing Molly, a 65 year old mother and grandmother, and Cynthia, her 35 year old married daughter, together in therapy, both of whom agreed to seek help after years of estrangement. Cynthia’s parents had divorced when she was much younger, Molly remarried at about the time Cynthia gave birth to her first child, and much to Cynthia’s dismay, who had hoped that her mother would be able to devote at least some of her time to her grandchildren, Molly chose to devote all of her time and attention to her second husband. A few months ago, Molly’s second husband died, she now feels very much alone, and wants to re-establish a relationship with Cynthia and the children. Cynthia, understandably, has so much resentment and bitterness that she is hesitant and conflicted about letting her mother back in her life; “What if it doesn’t work… what if she finds another man and abandons me and my children again?”
Outcome: After a lot of venting about hurt and unresolved feelings from the past, a lot of repair work and forgiveness, and a potential template for a healthier future together, both Molly and Cynthia agreed that therapy had been a success, that they felt relieved to be reunited, and that their relationship was better than it had ever been. Molly was now being invited and included in all family events, welcome in Cynthia’s home, and beginning to enjoy new relationships with her 3 grandchildren. Everyone is working on rebuilding trust and open communication, and Molly is looking forward to her new role as babysitter, so Cynthia and her husband can go out on a date and not worry about the kids!
In a recent unsolicited email from Cynthia, she writes, “I just wanted to thank you for seeing me and my mom over the last few months. I do believe it has made a big difference in our relationship. On a personal note, it was refreshing for me to be able to feel so comfortable to be absolutely honest in my feelings---something I have wanted to do for a very long time. So I feel that it was amazing for me personally. I am sure we will be in touch. Thanks again, Cynthia.”
I am also currently seeing a young man, Christopher, age 27, who, after a long and secretive battle with drugs, and six months in a residential treatment center, has just completed his first year of sobriety. Now, much against his parents’ wishes, instead of pursuing the coveted law degree that they had always envisioned and agreed to pay for, he has decided to seek a degree in interior design, a profession that he believes is much more suited to his talents, tastes, and sensibilities. I have engaged his whole family in family therapy, not only his parents but also his older brother, all of whom are attorneys, in order to help them challenge and broaden their values and understand that Christopher is “marching to his own drummer,” and that it is time for them to support Christopher’s decision-making and new plans for his future.
Outcome: In family therapy, Christopher was able to confess something else to his parents…that he was gay, that his long battle with drugs had been an unsuccessful attempt to deny and deal with his sexuality, that he has “known” since he was an adolescent, and that he has recently “come out” to everyone but his own family. Once the family recovered from the initial shock, they were able not only to support Christopher, but actually champion him and become involved in a support group for parents of gay and lesbian children. His career aspirations began to make sense to them, and they encouraged him to explore fashion as well as interior design, because he has always had such a “flair for clothes.”
And now we’ll turn briefly to couples and couples therapy. When it comes to couples, unmarried, engaged, living together, married (first, second or third time around,) same sex, separated, divorced or divorcing, there is no end to the reasons for seeking therapy, the kinds of problems that are uncovered, and the solutions that are found. Each couple is unique, whether the stated problem is communication, trust, boredom, sex (too much or too little!), infidelity, relentless bickering, drugs, alcohol, parenting, inequality, cultural or religious differences, or, in most cases, some combination of all of the above.
Suzanne, age 32, sought therapy because after two children and 7 years of marriage, she was becoming increasingly unhappy, contemplating having an affair, wanting to return to her career after agreeing to be a stay-at-home mom for a few years, and no longer enjoying sex with her husband, Wayne, who had gained 60 pounds since they were married. She claimed she still loved him and her goal in therapy was to figure out how to rekindle the spark and save her marriage.
Carolyn, age 35, no children, married for 10 years, sought therapy because she was anxious and depressed, no longer in love with her husband, Drew, and having an affair with a married man, father of three, who promised to leave his family if and when Carolyn divorced her husband. Her goal in therapy was to find the strength to leave her husband, who was “such a decent guy,” despite the hurt and embarrassment it would cause, the disapproval of both families, and the guilt she anticipated.
Richard, age 45, father of three and married for 19 years, sought therapy because he was “simply not happy,” felt he was missing out on “love and laughter,” and wondered whether he was just having a “mid-life crisis,” as all of his friends and even his wife seemed to believe. It turned out, after a great deal of soul-searching and exploration, that he had really been deeply unhappy in his marriage for years, but had been in denial, focusing all of his energy on his three children. He and his wife, Susanna, who did not want the marriage to end, agreed to 12 sessions of couples therapy in order to give the relationship every chance possible, and to see if Richard could rekindle some of the love he knew he felt in the early years of their marriage. Despite earnest attempts by both parties to open up in therapy, try to figure out what went wrong and attempt to repair it, and work towards a better future, Richard was simply unable to rekindle the flame.
Daniella, age 31, came into our first session with a broken heart. I had seen her 14 years earlier for an eating disorder, and now she was fully recovered and an accomplished physician in an oncology practice. After a two year relationship with Donald, he had broken up with her, claiming that she was just “too difficult,” and she was now convinced that there was “no one out there” who could ever take his place. She began questioning herself…was she too difficult, was she too smart, was she too intimidating, was she destined to spend the rest of her life alone.
Outcomes: Suzanne completed therapy without her husband ever coming in to a session. She uncovered the real reason she was losing respect for him, that he came from a family of great wealth and she resented his accepting money and gifts so easily from his parents, rather than really working for the things they had both agreed they valued. She was able to communicate her feelings to her husband and they agreed that she would use some of his inheritance to start a family foundation and become more involved in young philanthropy. She has also enrolled in school with his full emotional support. And finally, they have both begun jogging again, something they used to enjoy before they had kids, and to date, Wayne has dropped 15 pounds. Suzanne claims, “The marriage feels very good again, more honest and more solid than ever.”
Carolyn was offered a job out of state, which she accepted, hoping Drew would remain behind and they would gently ease into a separation which would eventually lead to divorce. Her relocation made it easier to see the man with whom she was having the affair; however, it was at this point that he announced that as much as he loved her, he would and could not leave his family. Carolyn, devastated on all fronts, agreed to “let her husband follow her,” they saw a counselor twice in their new location, and Carolyn filed for divorce. She has taken it upon herself to explain her decision to Drew’s family, and much to her surprise, they completely understood and “forgave” her. She is geographically closer now to her own family, and is delighted to be seeing her Mom and sisters again on a more regular basis. Drew moved back home, he is dating, and Carolyn has found a new love.
Richard, in a very conscious and deliberate way, first found an apartment for himself that would comfortably accommodate the children, and then made the decision to leave his family. Despite Susanna’s feelings of anger and helplessness, the three of us were able to sit together and work on how best to tell the children and the extended families. Susanna is hoping that with some time apart, Richard will “come to his senses” and realize he has made a terrible mistake; she claims that she is prepared to welcome him back into the home. Unfortunately, according to Richard, his mind was made up long ago, and he has finally “come to his senses,” dealt with his guilt about leaving the children, and is looking forward to finding a new partner with whom he will be more compatible.
Daniella is finally ready to move on. After doing a careful inventory of her strengths and weaknesses, and an analysis of her relationship with Donald, we agreed that he had been projecting his own insecurities onto her, that she needed a man who was her intellectual equal, and that she was “just fine the way she was”…no need to dumb herself down in order to please a man. After a great deal of resistance, I encouraged her to try internet dating and she has recently met some very interesting men, one of whom has “distinct possibilities” for the future. The surest way to mend a broken heart is to find someone new, different, and exciting…and to learn from past mistakes.
As you can see, outcomes in couples therapy are as varied as the couples themselves. What matters is that each party in therapy feels safe, validated, heard and respected, and that the outcome reflects the wishes of both sides as much as is humanly possible. There are no perfect solutions, and unfortunately, it may seem that when one party wins, the other loses. Not everyone gets what she or he ultimately wants and when the decision to separate occurs during the course of or as a result of couples therapy, it is painful for all of us, including me. Acceptance of a new reality and a new future then becomes part of the ongoing work, which I will continue to do if one partner wishes to remain in therapy.
"The names in case studies and testimonials have been changed in order to protect patient confidentiality."
See what some of colleagues have learned about relationship counseling: