Monday, June 4, 2012

Val's reflection.

Val’s reflection:

While I have worked with many clients with a variety of presenting issues over the years, I have never worked with couples. I decided to attend this workshop because although there is only one person in the room with me, ‘the relationship’ is often also present in the session. For a while now I have wondered how to adequately address and provide time in therapy for working on relationship issues, which were clearly impacting on the individual and the issues they sought therapy for. It was thus very heartening to hear Michelle Weiner Davis’s resounding ‘it takes one to tango’ in starting to realise that in fact effective work could occur. How issues are raised in the relationship, how one partner communicates with the other and taking time to identify their own goals for the relationship are all relevant steps in beginning to make positive changes in relationships and these can all start with one person.

I can see how I will use other information covered in the workshop, particularly much of what Gottman’s research has contributed to this area. To appreciate the level of difference that exists and disagreement that is likely to remain in the relationship was elucidating. For one it highlighted the need to avoid becoming stuck on problem-solving strategies when working with relationship issues. This and the negative interaction cycle in particular, illustrated for me the importance of integrating ‘acceptance work’, even if using more traditional behavioural couple therapy. How using strategies that encourage increased understanding and acceptance of each others emotional experience will inherently assist to combat the negative behavioural patterns that have become the predominant interaction provides me with a thoughtful way of understanding relationship issues. Further, articles by Christensen and Jacobson in which they examined differences and similarities between integrative behavioural couple therapy and traditional behavioural couple therapy and specific research examining the effectiveness of IBCT were of considerable interest. The fact that changes in behaviour were also seen in couple who completed the acceptance strategies was particularly interesting and made me think about what really drives lasting behaviour change.

Finally, to illustrate the application of the IBCT approach I will briefly discuss an existing client. I have been working with this client for an ongoing addiction issue and the last month in particular has focused on relapse prevention following his decision to quit his addiction. His relationship had become a topic in therapy because of his partner’s choice to continue to use when he decided to stop. The addiction was an activity they had for many years enjoyed together. In therapy to date we had explored the impact on him of her decision, the difficulties this created in the relationship and the need for his understanding that she needed to get to that decision on her own. In our last session I introduced the idea that this choice, this difference between them may in fact not be resolved. This facilitated a healthy discussion about what that would mean for him, for his decision to remain abstinent and for their relating. Although difficult for him to consider initially, by the end of the session he had begun to identify preparatory steps he could use to begin to manage this given the importance it placed on his own decision. It moved work with this client from a slightly stalled place of focusing on his partner and her choices, to a place of him beginning to consider what the relationship would be like and what it would mean to him if this difference remained between them. With much still to learn and put into practice, I am encouraged about the knowledge and resources available for working with relationship issues, with or without both parties.

 Val Markovska

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