Finding Acceptance, Promoting Change: Why Couples Therapy May Be Right For You:

Answering Your Questions about Integrative Behavioral Couples Therapy and Emotionally Focused Couples Therapy

By Tory Tomassetti, CBT/DBT Associates Staff Psychologist

“Why won’t you just go with the flow?” “You’re so disorganized!”  “Why did we even get married?”

Here’s a better question: How can couples therapy work for every couple? 

15048146-a-couple-on-a-bench-under-umbrellaLet’s face it: sometimes, familiarity breeds contempt. The spontaneity that you used to love about your partner now feels like a great obstacle between you and a well-planned family vacation.  The affection that you once craved now feels like suffocation—or worse—is completely absent.  You’ve asked your partner to change, but conversations feel like accusations and promises go unfulfilled.

When your most intimate relationship provides more heartache than bliss, it may be time to consult a professional.  Problems with communication, finances, sex, and parenting are common sources of distress in romantic partners.  Differences in personal philosophy, communication style, or ability to express emotion often lead partners to consider whether they will ever get along.  Many couples feel stuck in a less-than-ideal partnership and find that their efforts to work it out have been futile. Those early feelings of joy and excitement turn to frustration, anger, isolation, and hopelessness. 

Imagine this scene: A spur-of-the-moment picnic has been arranged by your free-spirited partner. The vista is picturesque. You are relaxed and enjoying the first warm day of the season. And then suddenly, the sky opens and you’re stuck in a downpour without an umbrella or shelter.

Adding some context to the scene above, let’s imagine this was your third date with your partner.  How do you react? Do you enjoy the irony? Are you able to laugh?

Now imagine this same date occurring today. How do you react? Are you angry? Is this yet another example of your partner’s lack of foresight to check the weather? 


"I knew my partner and I had differences when we met, but I didn't think they were this extreme. What happened?"

Early in a relationship, most partners make an effort to put their best foot forward: the typically Type-A partner makes an effort to be flexible, while the laid back member of the duo attempts to conform to a more structured lifestyle; the talker practices listening, while the reticent finds his voice.  Partners are more patient, kind, and empathic.  Early in a relationship, partners are more likely to forgive minor transgressions, interpreting small offenses as misunderstandings rather than blatant malefactions.  

Initially, differences between partners are viewed as exciting, challenging, and providing balance. The early career finance executive feels freed by her partner’s spontaneous travel plans.  The artist feels grounded by his spouse’s attention to detail for matters of personal finance and household obligations. Partners from different cultures see the value in one another’s upbringing and are eager to give their own children a rich, multicultural experience.  

However, over time, many couples find that they become polarized by these differences.  Rather than feeling intrigued and balanced, they feel trapped, misunderstood, and disconnected. Efforts to bridge the gap seem only to widen it, and feelings of hopelessness increase. 


"What are my options?"

Integrative Behavioral Couples Therapy (“IBCT”) is a scientifically proven (Christensen, Atkins, Yi, Baucom, & George, 2004) treatment to help couples in distress.  Through IBCT, couples learn to reinterpret those behaviors that were once considered endearing but have, over time, become sources of discontent.

IBCT aims to foster both acceptance of partner differences and increase opportunities for change.  This dual focus- increasing acceptance and opportunities to reinforce change- has been shown to significantly reduce couple distress and increase marital/partner satisfaction (Christensen et al., 2004).

0 Emotionally-focused couples therapy is another evidence-based option for couples who are seeking to deepen their connection and increase warmth, empathy, understanding, and flexibility (Johnson, 2004). The primary goal of emotionally focused couple therapy is to improve the bond or the secure attachment between two partners.  Emotionally focused couple therapy (“EFT”) techniques are used to help partners deescalate emotionally fraught (or emotionally devoid) interactions and replace those problematic interactions with more effective tools.  Partners learn to identify – and verbalize- their needs in the relationship. 

Similarly to IBCT, a major aim of EFT is to increase opportunities for positive interactions between partners.  In EFT, couples learn to express their desires, take emotional risks in the relationship, and give one another an opportunity to fulfill a previously unmet need.  

Imagine another scene: you’ve just arrived home from a long commute.  You’re exhausted, slightly irritable, and rather hungry.  Your spouse has been home all day with your young children and eagerly hands them off the moment you walk in the door.  You’ve asked your spouse many times to give you ten minutes to decompress after work, but the situation plays out the same way every day. You don’t press the issue, because you feel guilty for being gone all day, knowing that your partner has been single-handedly managing household chores and childcare. Later, after the kids are in bed, the same argument commences and it sounds like a competition of “who’s got it worse.”  You each keep trying to explain your point of view, but your partner just doesn’t get it. You both feel unappreciated, misunderstood, and emotionally isolated. 

Many couples get stuck in a pattern of trying desperately to explain themselves to one another.  They may even use “I statements” to minimize blaming language.  But this emphasis on the self is sometimes counterproductive.  When partners move away from explaining their own point of view and move towards attempting to understand their partner’s experience, a shift occurs in the couple dynamic.  Empathy increases and conflict decreases.  By focusing on your partner’s experience, rather than your own, opportunities arise for listening and problem solving. Through EFT, couples learn to spend less time explaining, and more time listening. 


"I've been trying but my partner refuses to acknowledge their contribution to the problem. How can couples therapy help us if one partner is unwilling to do the work?"

This is another common theme in many treatment-seeking couples. Often, one partner is significantly more motivated to begin therapy than the other.  This obstacle to treatment is addressed right away and discussed frequently throughout the therapy process.  Together with the therapist, the couple will identify treatment goals.  Even the most reluctant partner can identify a desire for less conflict, better sex, more freedom, or improved communication.  These mutually identified goals will establish the foundation of our work together. When things get tough, the couple will revisit their reasons for initiating therapy and use this as motivation to keep moving forward. 


"We have so many problems, how do we choose where to begin?"

In both IBCT and EFT, treatment begins with an assessment of both the individuals and the couple. During the initial meeting, both partners and the therapist will meet as a group to discuss an overview of the primary problems.  The initial meeting is a good time for all parties to get to know one another and begin to develop expectations for the therapy process.  After this initial meeting, the therapist will meet with each partner individually to gather background information. Following the individual meetings, all subsequent sessions will occur with both partners present. The first few sessions will then be used to continue describing the problem and identifying treatment goals. Using her knowledge of the treatments and experience applying couple therapy techniques, the therapist will assist you with ordering and prioritizing treatment goals to meet your specific needs.  

Using the tools of IBCT and Emotionally Focused Couples Therapy, I’ve successfully treated couples in all stages of life.  Whether you’re dating, considering marriage, or approaching your golden anniversary, it’s never too late to improve your relationship. 

Christensen, A., Atkins, D. C., Yi., J., Baucom, D. H., & George, W. H. (2006). Couple and individual adjustment for two years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.  Journal of Consulting and Clinical Psychology, 74, 1180-1191.
Johnson, S. M. (2004). The practice of emotionally focused couple therapy. 

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