Ann Arbor therapist offers counseling, helping clients achieve satisfying life.

Counseling for Individuals and Couples

Category: Couple counseling

How you can improve your relationship

I must admit that for a long time I refused to read Gotman’s book; The Seven Principles for Making Marriage work. It sounded like an article the you page through quickly while waiting for the checkout line to move through in the supermarket, before surreptitiously stuffing the glossy magazine back and unloading your groceries on the belt.

Well, I was wrong.

John Gottman has revolutionized the study of marriage by using rigorous scientific procedures to observe the habits of married couples.  Over many years he interviewed couples and videotaped their interactions. He used physiological measures to record their stress levels during these interactions. His study is based not only on couples that came to therapy which would not be a representative sample, but randomly selected couples as well. He observed them right after marriage and could predict with a large degree of success, who would stay together and who would not.

He derived some simple but effective rules for a successful marriage. When put down on paper, they seem obvious and deceptively simple, but he has distilled down behaviors that need to be focused on to insure a happy marriage.

1. Get to know your partner really well. Know the details of their life . Everything from their work situation, taste in food and books, and secret dreams. It sounds trivial. but sometimes people live together and are not really interested in their partner’s work situation, preferences and taste. Over the years this creates a distance between them.

2. Nurture your fondness and admiration. There is this romantic notion that you either feel love towards someone, or you do not, and there is nothing you can do about it.  This is not exactly right. We can concentrate on the positive qualities of our partner, or on those qualities or habits that irritate us. We have a choice here. happy couples respect each other. When this basic ingredient is lacking, Gottman says that the marriage cannot be saved.

3. In times of hardship turn towards each other instead of away., it is very important to stay in touch and communicate, even if the hardship stems from the relationship itself.

4. Acknowledging your partner’s small moments in life and orienting yourself towards them will maintain that necessary connection that is vital for the relationship.

5. Let your partner influence you:

“Happy couples work as a team. They make decisions together and search out common ground. Letting your partner influence you isn’t about having one person control the others; it’s about mutual respect  … It is important to maintain your own identity in a relationship, but it is equally important to yield to your partner and give in. If both partners allow one another this influence, then they will learn to respect one another on a deeper level.”

This principle is directed towards men in a straight relationship. Women tend naturally to listen and allow themselves to be influenced by the men in their life. Men tend not to. Research shows over and over again that those  men who listen to their wives, have better relationship, and many times other advantages.

Gottman got criticized over this principle more than for any other that he formulated, because it sounds so moralistic. But again, research backed his principle. Actually, Daniel Kahenman, the Nobel laurette,  showed in his research that women tend to be better investors because they are not as convinced as men that they know everything and hence tend to lose less money in the market.

6. Create shared meaning – family rituals.  “Marriage isn’t just about raising kids, splitting chores, and making love. It can also have a spiritual dimension that has to do with creating an inner life together — a culture rich with rituals, and an appreciation for your roles and goals that link you, that lead you to understand what it means to be a part of the family you have become,” Gottman says.

7. The last two principles sound a bit like the serenity prayer: Learn the difference between solvable and unsolvable problems. Learn to cope better with the first one, and learn to live with the later – with all the idiosyncrasies of your spouse.

Gottman warns us that we should avoid the worst types of communication: contempt, and stone walling.

Some myths that Gottman debunks:

1. “Affairs are the root of many divorces”.  I completely agree . In my professional experience, affairs are a symptom of something that did not work well in the marriage prior to the affair. I have seen couples that were able to work their issues out in therapy after an affair, and arrived at a much better place in their relationship than before the affair.

2.” It is all about communication.” Well, it is not. Many emotionally intelligent couples learn to manage their life without having a long discussion about their relationships.

3. “Arguments are bad”. Not really. According to his research, it depends on the kind of argument. If it does not involve humiliation and contempt, there is nothing wrong with arguing. Actually, there is evidence that couples that tend to fight a lot have a better sex life than couples that do not.

4. Men and women come from different planets.

Actually for both, the most important factor in marriage is the quality of friendship that they share.

5. You should never avoid conflict in your marriage.

For unimportant and small matters it is better to avoid conflict. Conflict should be reserved for the truly meaningful questions.

6. Common interests strengthen the bond in a relationship.

It can strengthen the relationship, but it depends on how you interact around that common interest.

Adapted from Gottman, J: The Seven Principles for Making Marriage work. Crown publishers, 1999, New York.

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Side Effects of Psychotherapy

I am a therapist and I believe in the power of therapy to alleviate suffering and contribute to people’s quality of life. I have seen it happen many times. In this post I would like to discuss some of the potential risks and  side effects that are not widely discussed.

  1. Dependence: Some clients start to depend on their therapist for every decision they need to make. A related issue is when the client effectively channels the therapist in his everyday interactions with friends and family. When the client overly identifies with the therapist it can lead to awkward social interactions and impedes the quest of the clients in finding their own voice. It is up to the therapist to point out excessive dependence, to explore its meaning and to prevent it.
  1. Reliance on the connection with the therapist as a sole resource to meet emotional needs, instead of expanding a support network. Therapy should help a person improve their social skills, expand their social network and not serve as a substitute.
  2. Not knowing when to terminate therapy: I have heard countless stories about patients wanting to stop therapy, and well-intended therapists have convinced them to stay. My policy is clear. I greatly respect the clients’ wishes to terminate therapy. There are times at which I initiate the discussion on stopping therapy. Similar to the role of a parent, there often comes a point that the client needs to be gently pushed out to stand on their own two feet.
  3. Expense. – This is probably the most recognized issue. .The money that you pay towards therapy, may prevent you from pursuing other activities that could improve your quality of life, and contribute to your growth as a person.
  4. Time – the time and energy you invest in therapy, could have been spent with loved ones, on meaningful activities that could contribute to your quality of life. No, I do not recommend avoiding psychotherapy, if you could benefit from it. I work as psychotherapist because I believe therapy can change people’s life. I had the privilege to witness people’s growth.  There is a large body of empirical evidence that supports the benefits of therapy,  above and beyond what medication alone can offer.

However:

It is OK to gauge whether there is a fit between you and your provider.

It is OK to check from time to time with your provider about the approach, directions, goals and the need for continuation.

It is OK to weigh the benefits of psychotherapy against the cost – what does it prevent you from doing because of the investment in both time and money.

It is OK to see your provider on less than a weekly basis, or as needed – provided it works for both of you.

My policy on terminating therapy is that if a client decides to quit therapy, I do not try to dissuade them unless there is a clear indication of danger.

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The Rashomon effect- the psychology of relationships

The Rashomon effect is defined as the way in which different people may describe the same observed event in very different ways. This may happen while all observers of the event believe that they are being completely honest.

We are all familiar with this phenomenon to some degree, yet we are often uncomfortable when confronted with the extent  to which our personal perception is subjective, a lens through which we view reality.

This term originated in a movie by Kurosawa, a renowned Japanese director. In the movie four people meet in the forest; a young samurai, his beautiful wife, a bandit, and a passer-by. The young samorai is killed. The four people come to testify in the trial that follows, including the ghost of the samurai.  Strangely enough, three of them plead responsibility for the murder.  The event appears very differently in the story that is told by each of the four participants. Each of them is convinced that he or she is telling the truth, and the events are shown through the protagonists eyes.   In the movie there is no resolution.

Unfortunately, this happens all too often in relationships. When People describe  events that have led to a crises in a relationship, they often give completely different accounts of these events. Often the people involved are convinced that the other person is not telling the truth.

I often come across this phenomenon in my practice. When a couple is in a crisis and are recounting the events that led to the crisis, it is critical to first accept that, as a rule,  no one in the room is lying. The next step is to  listen to each other carefully and try to understand what lens each person is using to view reality. Understanding the distortions that these lenses impose upon our perception, can provide us  clues on how to repair a relationships that is ailing.
It is often humbling to discover how subjective our perception is.

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Premature Ejaculation – Sex Therapy

First it may be useful to define what premature ejaculation is. Although it may seem self explanatory, one problem may be that you or your partner’s expectation of sexual stamina, often nurtured by popular culture, are unrealistic.

Usually, premature ejaculation is diagnosed when a man frequently  ejaculates sooner during intercourse than he or his partner wishes, either  before penetration or shortly after.

If you do suffer from premature ejaculation there are behavioral approaches to the problem and medication. While medication, such as SSRI, may help – they  are effective only while being taken. Once you stop taking the medication the effect also passes. The other downside of taking these medications is that you will need to cope with their side effects. This is why it is better to start with the behavioral methods rather than start with medication. Those can be added later if needed.

Contrary to common beliefs the behavioral approach does not involve either mental numbing, such as distracting yourself from the sensations, or physical numbing with some form of  numbing cream. Somewhat surprisingly, the most successful approaches involve heightening your awareness to your physical sensations, while maintaining physical relaxation. Only by increased awareness and mindfulness, you can learn to regulate better your arousal level, and hence your ejaculation.

These two  self help books teach the basic sex therapy techniques for dealing with this problem.
How to Overcome Premature Ejaculation by Helen Kaplan

Coping With Premature Ejaculation: How to Overcome PE, Please Your Partner & Have Great Sex by Dr. McCarthy and Michael Metz.

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Low Sexual Desire – Women

One of the most common reason that women and couples seek sexual counseling is the women’s low sexual desire.

Surprisingly enough, many times the cause is the birth control pill. If you are on the pill, and you suffer  from low sexual desire, try to switch to a different birth control method, that does not involve hormones. You may want to consult your OB/GYN practitioner, or go to Planned Parenthood. Often the counselor at Planned Parenthood will dedicate more time to hear your concerns, and may suggest a wider selection of options to choose from. Be aware that it may take several months for your body to recover.

There are many other causes for  low sexual desire. But this one is relatively easy to eliminate.

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