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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
Perhaps the greatest trauma one may experience in married life, with the exception of a mate's or child's death, is the discovery of a partner's infidelity. Because most people enter into marriage with the unquestioned belief that both partners will remain faithful to one another, the discoverer's basic beliefs about the relationship are painfully questioned and trust in the partner is virtually destroyed. The discovered partner often experiences intense shame and behaves defensively as a result, leading to a further downward spiral in the relationship. Couples therapy in these cases must begin with an acknowledgment of the trauma experienced by the discoverer. The therapist must help both partners understand the precise nature of the trauma occasioned by the infidelity and its predictable effects. Integrating this psychoeducational focus with a strongly empathic attitude toward the discoverer's pain models for the offending mate the empathy needed to support his or her partner and provides a basis for understanding how healing can occur. The therapist can also provide useful structure during this emotionally chaotic time by explaining to the couple a stage or phase model of how therapy will proceed. In the first phase of treatment, the goal is to restore trust; in the second, to examine the underlying marital conflicts that contributed to the affair. These two phases of therapy typically take between 5 and 10 sessions. The final phase of therapy is devoted to building communication skills, increasing partner empathy and support, and resolving any issues that remain. The outcome of the process is for the couple to have a healthier marriage or a more constructive divorce. In the first phase of therapy, the therapist takes a very active role. Almost invariably, the discoverer enters therapy with the profound sense that he or she is the offending mate's victim. The therapist begins by accepting this perception, rather than labeling it as irrational or interpreting continued mistrust of the partner as pathological jealousy. The therapist then proceeds to engage the offending mate in helping the partner transcend the "victim" role. This transcendence will require the partner who had the affair to show genuine empathy for the discoverer's loss of trust; the partner must be willing to answer honestly all questions the discoverer poses and to tolerate the expression of anger the answers often elicit. During this emotionally charged process, the therapist challenges the offending mate's frequent attempts to deflect the discoverer's hurt and anger and to avoid blame; concurrently, the therapist supports this partner's genuine expressions of remorse over the lying that is always at the heart of the trauma caused by an affair. Once the discoverer is able to believe the partner is genuinely remorseful, the therapist can help the couple explore the dynamics in their relationship that set the stage for the affair. Previous to this, attempts to explore the marital conflicts are often experienced by the discoverer as attempts by the mate and therapist to deny the discoverer's pain. Now, however, as the rage and mistrust decrease in intensity, both partners can begin to look at their marital history, including the normative and unusual crises that occurred during the marriage and how these might have been mishandled over time. Particular emphasis is placed on the importance of mutual and honest disclosure of feelings because the inability to talk honestly about feelings of distress increases the likelihood of infidelity. Family-of-origin issues that may have led to impasses in emotional communication are explored, sometimes leading one or both partners to seek individual therapy in addition to couples work. These explorations help the couple place the affair into a meaningful context and to view their situation more dispassionately over time. In the final stage of therapy, some couples decide that it is not worth the effort to work on their marital conflicts; in these cases, the therapist can help them negotiate a healthy separation or divorce. For many other couples, however, surviving the crisis of infidelity provides them with the opportunity to build a much better marriage than they had before. For these couples, the last phase of therapy can help them enhance their communication skills, express empathy and affection more openly, and provide each other with the kind of nurturance and support that will see them through the inevitable problems that arise as part of married life. Dr. Lusterman identifies his approach as both empathic and psychoeducational. What does this imply to you? More specifically, what do you expect of him? Will Dr. Lusterman be active or passive? Will the session be structured or unstructured? Directive or nondirective? Will it focus on the past or on the present? Will the session focus on behaviors, on thoughts, or on feelings? What do you expect to be the relative balance between attention to technique versus the interpersonal interaction? |
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