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The purpose of this article is twofold: to encourage couples who genuinely want to improve their situation and save their marriage, and to present a summary of successful therapies that offer solutions for repairing the emotional bonds that unite them.
Initially, couples often enjoy sharing activities as they get to know each other. The first meeting is filled with expectations and fantasies, and people tend to overlook each other’s flaws or negative traits.
Marital satisfaction is said to equal the distance between the current status quo and the expected situation (Asadi M., Ghasemzadeh N., Nazarifar M., Sarvandani M. N., 2020). The closer these two states are, the higher the chances of a happy relationship. However, over time, negative aspects often become more prominent in how partners judge each other. If these issues, fears, and inconveniences are not addressed and discussed, conflicts are likely to arise. This widens the gap between the current situation and the expected one, increasing the likelihood of disputes. Therefore, communication is crucial for improving and maintaining a healthy relationship.
Statistics show that by the age of 50, approximately 85% of people have been married at least once, and a third of couples separate or divorce. About half of all divorces occur within the first seven years of marriage. Additionally, about 20% of remaining marriages experience relationship distress (A. Carr, 2018). These statistics highlight the significance of relationships in society and their impact on individuals’ lives, underscoring the importance of providing resources and strategies for achieving successful marriages.
Beyond the statistics, emotional suffering from relationship issues is challenging for most couples and can lead to serious trauma. This often results in symptoms such as depression, anxiety, anger, and other emotional disorders associated with relationship distress.
One of the most critical issues couples face is extramarital relations (EMR), which refer to any sexual or emotional relationship that occurs outside the framework of a committed partnership. EMR can lead to severe psychological disorders, such as depression and stress, and can have effects similar to Post-Traumatic Stress Disorder (PTSD). Emotional reactions such as fear, anger, dismay, distress, and frustration are common among those facing EMR. Studies indicate that 34% of men and 24% of women engage in sexual activity outside their marriage. The main reasons for sexual infidelity include more permissive sexual values, stronger sexual interests, weaker ties to their partner, lower satisfaction with their partner, and greater sexual opportunities (Ghochani M., Safarian Toosi M.R. & Khoynezhad G.R., 2021).
In such cases, couple therapy has proven very effective in alleviating emotional pain and improving relationships. Below, I will present some of the most effective evidence-based therapies from the third wave of cognitive therapies, known for their high success rates.
Benson (2012) has identified five principles that any couple therapy should incorporate:
Altering the couple’s view of the presenting problem to be more objective, contextualized, and dyadic.
If you find yourself in uncomfortable situations with your partner or feel that they do not listen to you, this can generate negative perceptions. Therapy focuses on going beyond superficial judgments to foster a better understanding and avoid immediate negative reactions.
Decreasing dysfunctional emotion-driven behavior.
If you don’t interrupt negative thoughts or are driven by painful situations, your responses may perpetuate a dysfunctional cycle. We could summarize it as “Negative Attitude + Negative Response = Negative Outcomes,” creating a vicious cycle.
Eliciting emotion-based avoided, private thoughts.
Therapy encourages both partners to share private thoughts about each other that usually go unspoken but significantly influence feelings. This often leads to revelations that enhance understanding and improve attitudes.
Increasing constructive communication patterns.
Understanding is crucial, but the most significant change occurs when couples learn to replace old interaction patterns with more comprehensive and open ways of listening and feeling. This fosters positive feelings like closeness, affection, and commitment.
Promoting strengths and reinforcing gains.
Once new positive responses are learned and practiced in therapy, they need to be reinforced to ensure they persist outside of sessions. This involves a learning process and commitment from the couple to experience their relationship with renewed pleasure, happiness, and security.
Therapies
Acceptance and Commitment Therapy (ACT) consists of six core principles aimed at generating psychological flexibility:
Cognitive defusion: Stop negative thoughts that provoke destructive responses.
Acceptance: Learn to live with unchangeable aspects, altering their significance to cope more tolerantly.
Contact with the present moment: Focus on living in the present rather than dwelling on past or future fears and uncertainties.
Self as context: Evaluate if your thoughts align with your personal values and whether you are being true to yourself.
Values: Act in ways that are meaningful to you and align with your beliefs about happiness and peace.
Committed action: Take responsible steps towards valuable achievements.
In couple therapy, ACT helps partners allow unwanted private thoughts and feelings to pass without struggle and clearly identify meaningful goals (Ghochani M., Safarian Toosi M.R. & Khoynezhad G.R., 2021).
Emotion-Focused Couple Therapy (EFCT) emphasizes that the expression of fears and attachment needs is a precise indicator of future conflicts. Couples need to communicate their discomforts and needs to cultivate a more secure attachment. EFCT aims to identify and address avoidance and anxiety attachment issues to increase trust and emotional depth. This therapy has been shown to improve relationship satisfaction, reduce anxiety, and decrease distress in couples by addressing incompatible interaction patterns and teaching new, positive ways of responding to each other (Asadi M., Ghasemzadeh N., Nazarifar M., Sarvandani M. N., 2020).
EFCT is divided into three stages:
- De-escalating destructive interaction patterns.
- Facilitating authentic expression of attachment needs.
- Consolidating adaptive patterns outside of therapy sessions (Carr A., 2014).
Behavioral Couple Therapy (BCT) focuses on developing communication and problem-solving skills to negotiate a fairer relationship. By identifying the triggers of disagreements and how they are reinforced, BCT teaches new ways of responding and communicating effectively, aiming to replace destructive beliefs and expectations with constructive ones.
Integrative Behavioral Couple Therapy (IBCT), an evolution of BCT, emphasizes building tolerance for a partner’s negative behavior, accepting irresolvable differences, and fostering empathetic connection. IBCT involves identifying incompatibilities and working on core issues such as power, control, and distressing behaviors to foster tolerance, acceptance, and empathy (Carr A., 2014).
Affective-Reconstructive Couple Therapy helps partners understand how patterns from their families of origin or past relationships influence their current interactions. It aims to replace these patterns with more constructive alternatives, addressing unconscious defenses and relational patterns that underpin relationship distress and conflict. Studies show that only 3% of couples who completed this therapy were divorced four years later (Carr A., 2018).
Systemic Couple Therapy offers a method to understand reciprocal interactions by analyzing the context of both partners’ symptoms within the triad of Emotion, Thought, and Behavior. For example, if a husband watches TV for many hours (behavior), the wife might feel neglected (emotion) and think he doesn’t care about her (thought), leading her to yell at him (behavior). This cycle can be intervened at multiple points to change the dynamics and improve mutual understanding (Davis S. D., Lebow J. L., Sprenkle D. H., 2012).
I hope this exposition helps those concerned about improving their relationships see that there are many effective therapies available and provides therapists with a summarized and updated overview of how to address couples’ conflicts.
This article was written by Guido Cataldo, who offers counseling in Copenhagen. Check out his profile here.
Bibliography
Asadi M., Ghasemzadeh N., Nazarifar M., Sarvandani M. N., “The Effectiveness of Emotion-Focused Couple Therapy on Marital Satisfaction and Positive Feelings towards the Spouse”, IJHS (2020) 6(4):36-40.
Benson, L., McGinn, M. and Christensen, A. (2012) “Common Principles of Couple Therapy”, Behaviour Therapy, 43: 25–35.
Carr A., “The evidence base for couple therapy, family therapy and systemic interventions for adult-focused problems”, Journal of Family Therapy (2014) 36: 158-194.
Carr A., “Couple therapy, family therapy and systemic interventions for adult-focused problems: the current evidence base”, Journal of Family Therapy (2018) 40: 492–536.
Dattilio F. M. & Padesky C. A. (1990) “Cognitive Therapy with Couples”, (6) Descleé De Brouwer.
Davis S. D., Lebow J. L., Sprenkle D. H., “Common Factors of Change in Couple Therapy, Behavior Therapy (2012) 43: 36-48.
Ghochani M., Safarian Toosi M.R. & Khoynezhad G.R. (2021) Investigation of the Effectiveness of the Combined Couple Therapy for Couples on the Improvement of Intimacy and PTSD, The American Journal of Family Therapy, 49:3, 299-320.
