Can Couple Therapy Harm Marriages? When Counseling Harms You . . .
Dr. Jill Manning is here today. I am so excited to have her. She is a Licensed Marriage and Family Therapist, and Certified Clinical Partner Specialist, who specializes in working with individuals impacted by sexual addiction, pornography, or betrayal trauma in their primary relationship.
In addition to her clinical work, Dr. Manning is a researcher, author, consultant, and activist. She has been featured in numerous television and radio programs and, in 2005, was invited to testify before a U.S. Senate subcommittee about the harms of pornography on the family.
She currently serves on the board of directors for the Association of Partners of Sex Addicts Trauma Specialists. You know that as APSATS. Our audience knows APSATS well, as well as the board of directors for Enough Is Enough. Dr. Manning is a native of Calgary, Alberta, and currently lives in Colorado with her family.
Will Couple Therapy Save My Marriage?
Anne: Women are wondering about couple’s therapy. They’re asking, “Hey, I need a good couple’s therapist, where should I go?” I’ve seen a few different situations with couple’s therapy that I’m just going to introduce this topic with, and then we’ll talk about it from there.
1. Many men are going to therapy, and the women aren’t seeing a big difference. They think, “Well, if we get a couple therapist, and I’m involved, then maybe I’ll see the improvements that I’m looking for.”
2. Women may be seeing their husband’s abuse issues as marriage issues, or communication issues, rather than as an abuse issue, or as a addiction issue. Lundy Bancroft does not advise couple therapy in any way, shape or form, unless the abuser has taken full accountability for his abuse, and there have been no abuse episodes in the last two years.
How Do I Know If Couple Counseling Will Help Us?
3. Some therapists want the wife going in to make sure the husband is telling the truth, because the addicts often lie, or minimize, even to their therapists. This is a very complex issue, and so I’ve asked Jill to help us make sense of it.
Jill: It is complex, and any time we’re dealing with human beings, and especially human beings in relationships, there’s so many moving parts. Situations are unique, and I’m sure there’ll be listeners that may find exceptions to every guideline and rule I’m going to outline today.
As a marriage and family therapist, who’s been working 17 years in this field, and specializing in partners for the bulk of that, this is an area I feel really passionate about because I see a lot of harm being done to individuals, and also to marriages themselves, when couple therapy is not timed well. The timing is really key, and we’re going to get into that today.
What Happens In Couple Therapy? The Rule Of Five
I want to introduce this idea of what I call The Rule of Five, meaning guidelines. First, let’s think of traditional couple therapy.
I believe, as a clinician, that a woman in an abusive situation has needs that depart significantly from traditional couple therapy. We need to have a good understanding of those differences. In traditional, your typical couple therapy situation, there are five key goals:
- Supporting a couple in identifying sources of conflict
- Helping each person in the relationship identify their own participation in conflict
- Helping a couple realize healthy expectations for the relationship and one another
- Defining how the relationship’s going to work: the boundaries, the roles, the division of labor, etc.
- Improving the skill set of a couple, whether that be communication, intimacy, conflict resolution
When Couple Therapy Makes Things Worse
Why Couple Therapy Won’t Help Your Husband’s Pornography Addiction Or Anger Issues (Abuse)
Here’s the thing—when sexual addiction comes to light, and there is a betrayal that surfaces, people like myself ask couples to do something very counter-intuitive: that is to not engage in couple therapy initially and sometimes delay for a long while.
That’s counter-intuitive because when lies and betrayal surface, the relationship is seriously, seriously compromised. It’s a major threat to the marital bond. The relationship itself takes a major hit.
It’s counter-intuitive for us to say, “Hey, all this stuff’s come up that’s really harming your relationship, and we’re going to ask you to hold off on couple therapy, perhaps for a long while.”
The Only Way To Save A Marriage From Abuse & Infidelity Is To Hold The Perpetrator Accountable
I understand, and really empathize and sympathize and support women in this situation. They think, “We need to get to a couple therapist ASAP, because we are in big trouble.” That makes logical sense, but here’s why—again, going back to the Rule of Five—it’s not a good idea.
When Is The Right Time For Couple Therapy? The Rule of Five
We know from research, Anne, that when couple therapy is not well-timed, it actually can put a couple-ship at greater risk for divorce and dissolution.
I take this really seriously. I want listeners to know that my personal stance, as a clinician, is that I do my very best to do all that we can to keep relationships intact, especially families intact, when that is healthy and desirable to do so.
When Couple Therapy Goes Bad
Let’s get into contraindications for traditional couple therapy. Listeners will start realizing, “Oh, okay, this fits with betrayal trauma and sex addiction pretty well.”
- Physical violence, or any type of abuse, emotional, sexual, physical, financial. Any type of abuse that’s going on, that is not a situation where we would want couple therapy. This would include lying.
- Mental illness or addiction problems, especially if they are active, and untreated, or in the early stages of being untreated.
- If one person continues to engage in a relationship outside of the marriage. Now, having done work with pornography for years, I’m of the opinion, and research backs this up that pornography is a very insidious type of relationship outside of the marriage.
- Is when one or both parties have decided to begin divorce proceedings.
- If there’s a lack of empathy. If one or both parties is either not wanting to, or incapable of being empathetic to the other’s reality, that’s not a situation we want them to be in couple therapy.
My Husband & I Went To Couple Therapy And He Became More Abusive
Anne: Absolutely. When things got really bad for me, we had never tried couple therapy before, and I was like, “Okay, we have to do this, because we have to do something.” Things got a lot worse, and then he got arrested.
He became more abusive because it was like, “Oh, now’s the time I can unleash all my resentments toward her, and all my feelings, based on all my erroneous thought processes”. He just became more and more abusive through that process.
Truth & Safety Are Essential In Couple Therapy
Jill: When couples enter couple therapy, there’s two assumptions that are really important for us to be aware of. There’s an assumption of safety, and there’s an assumption of equality.
In a situation with abuse and sexual betrayal, there is not equality. If there are any secrets, and dangerous secrets at that, and there is a lack of safety.
If you have a traditional couple therapist in the room, that is not well-versed in the dynamics of sexual addiction, gaslighting, and the emotional abuse, and also the physical risks that this issue can bring up, it’s not a good situation to be in.
The risk of gaslighting and the emotional abuse in really subtle, and sometimes blatant, ways can enter into that space. It pollutes the ability for that space to hold both people in an appropriate way, and for there to be healing to occur.
Will Couple Therapy Work For Our Situation?
Let’s talk about when couple therapy is indicated, when it is a good thing to do. This will shed light in the context of contraindications. In my practice, and when I look at the research, I see what’s working with couples around the country.
Again, Rule of Five: there’s five things that indicate couples can safely engage in couple therapy:
- There has been a disclosure. It’s common for that to be in a therapeutic disclosure and a therapeutic polygraph. Before going to couple therapy, the truth needs to be on the table.
- Trauma and mental illness have been appropriately treated and addressed, if those are issues in the mix. We know, in most cases, they are. Two-thirds of pornography addicts have a mental illness of some sort; 44% have a personality disorder, or traits, so chances are good that we do have mental illness in the mix. With partners, we know that, roughly, 70% experience PTSD symptoms and experience trauma. Again, number three’s a big one that trauma and mental illness be appropriately diagnosed and assessed and treated. That’s big in and of itself.
- Empathy. We all know with abusers and porn users, empathy is almost impossible. That can be a real process in helping them get back online with having healthy human empathy.
- Desire to reconcile.
When those five things are in the mix that can be—and I don’t want to say for everybody, but, generally speaking, that is a good basis for starting couple therapy.
Finding The Right Therapist To Treat Sex Addiction & Betrayal Trauma
Then, it’s also what type of therapy, and with whom. I really advise working with a couple therapist that’s very well-versed in addiction. If you can find someone that’s well-versed in abuse and sexual addiction, that can be enormously helpful. They’re going to understand the subtleties of manipulation and lack of empathy, even blame that occur when someone has a history of abuse and porn use.
Is He Faking Empathy Through Empathy Training?
Anne: Two things concern me: Faking empathy & using attachment therapy when abuse is occuring.
1. If empathy is not present, when a porn user gets empathy training, I’ve heard it just helps the abuser mimic empathy, not actually develop it, therefore they become even more manipulative and good a lying. They can learn the mechanics of empathy, and it enables them to fake it really well.
They end up learning scripts for empathy which can cause a wife to be more confused, because she might be more abused by the empathy, being jerked around by this, “Oh, he’s acting empathetic now,” but he’s really still acting out, and she doesn’t know.
Jill: One of the most important things that I want for partners to gain in their own recovery process is coming home again to their gut, reconnecting to their gut. Empathy really is hard for a human being to fake. If someone’s really connected, and they have a good working gut, you’ll know.
You need a strong therapist, who really understands how critical empathy is, both the reception of empathy and the giving of empathy.
Does It Help When A Couple Meets With A Therapist, But Not For Couple Therapy?
I do see a place for couples meeting with a therapist, but it’s not in a true couple therapy situation. It may be treatment planning, it may be psycho-education, it may be preparation for a disclosure.
I’ve met with many couples where they’re not ready for couple therapy, but I have two women that I’m working with now who are not involved in couple therapy, but they attend individual sessions with their husband. They are more of a witness and an observer of that process, which has been enormously helpful for them.
A Skilled Therapist Can Help Couples Address Abuse & Porn Addiction Safely
Again, you need a skilled therapist. Let’s say a husband who’s sexually addicted is struggling with empathy. There’s a scenario that I could see working really well in the early stages of empathy training.
Two therapists and the wife and husband meet together in a joint session. They have a very specific set of interventions set up, where she’s able to be fully supported, and that process is observed on her behalf. It’s not couple therapy, it’s a joint meeting. There’s specific work that’s being done around empathy. Again, not couple therapy, it’s individual work, but there’s a power in being able to witness, and be able to call on the other partner to maybe answer a question, or to respond.
It’s Not Couple Therapy; It’s A Joint Meeting
Anne: Would that be the situation where if he is minimizing or lying to his therapist that the wife could weigh in and say, “No, no, no. These things he’s telling you are not true,” so that the wife can know that what is happening in his therapy is leading to her safety, rather than he’s just spiraling in his own lies?
Jill: Yeah, again, there’d have to be a lot of safety built into that because I would never want a woman putting herself at risk after a session ends. We never want that. But, yeah, in answer to your question, there are ways we can set that up where she can be a reality check, and an important reference point for his therapist to get a read of what’s going on.
When There’s Sobriety & Good Recovery Work On Both Sides, Couple Therapy May Be Okay
With all of this said, I want listeners to understand that, when a couple is choosing reconciliation, and there is sobriety and good recovery work occurring for both parties, that I am passionate about people getting to couple therapy as soon as the five indicators are met.
I’ve had a couple of people recently suggest that I’m against couple therapy. It couldn’t be further from the truth. I am very much for it.
I think it’s actually essential that the couple relationship itself be exposed to good quality treatment and healing. That’s absolutely necessary.
Relationship Healing: The Weakest Aspect Of Recovery
In truth, Anne, I think it’s a part of the recovery process that we, as an entire community, are weak in right now. I think, across the country, we’re doing a decent job of helping bring people into sobriety and healing the trauma. I think the couple piece is the weakest aspect of recovery, right now, at least.
I think where I see a lot of harm done is when couple therapy is not timed well. Again, going back to the Rule of Five for contraindications and indications, if people use that as a guide. It really can help reduce the risk of timing that poorly.
When Attachment Therapy Leads To More Abuse
Anne: My second concern is attachment therapy. We did attachment therapy when the five indicators for couple therapy were NOT present, with the goal that attachment therapy would heal is attachment disorder. The therapist that we did attachment therapy did not say, “Oh, wait a minute, you have abuse and lies present, and so we should not do attachment therapy.” In his defense and my defense, we didn’t know about my husband’s lies and didn’t see his anger as abuse – even though it was. The assumption in those sessions was, if addiction is an attachment disorder then the solution is attachment therapy.
Jill: Again, it’s counter-intuitive because that’s the logic being used by many, many people seeking therapy and many therapists. If his abuse is rooted in unhealed attachment wounds, the solution would be attachment work.
But what they fail to recognize is that healthy attachment work must be founded on safety. Nobody attaches without safety. Unless it’s a really anxious, unhealthy, dysfunctional attachment, like a trauma bond.
Can Couple Therapy Promote Healthy Attachment?
In terms of healthy attachment, safety must be there. The abuser / porn user must respect his victim, be willing to tell the whole truth, give up his entitlements, honor her as an equal and ask for and receive her consent in a healthy way. All of the elements of healthy intimacy also apply to healthy attachment.
I recently spoke with an international trainer of Emotionally-Focused Therapy, which is one of the most common attachment-focused therapies right now, and it’s very well-supported in the research.
It’s actually one of the top types of therapy I recommend couples seek out. I expressed concerns around some of the harm that I’m seeing done with attachment-focused therapy in sexual addiction recovery. Namely that people are engaging in that before safety, honesty and sobriety have been established.
Anne: Before the emotional abuse has 100% stopped.
Jill: Right. They 100% agreed with what I’m saying today, that there must be sobriety, there must be honesty on the table, and some key things managed first, trauma, mental illness, addiction care, really put in place before we can help couples get to what they call softer emotions.
Here’s one thing, Anne, that I want to really, really stress, is that when couples go in for couple therapy, again, there’s this assumption of equality, and we look at patterns, okay.
He does something and it invites her into a certain stance or behavior and then that reinforces the pattern and behavior for him. There’s this infinity pattern, if you could draw that out—they go back and forth in a dance, a relational dance. Well, that works for a lot of common marital issues. That’s not a helpful perspective, though, if there’s such a serious power imbalance in terms of secrets, infidelity and abuse.
Should You Go To Couple Therapy When Abuse Is Present In The Relationship?
What I see happening is that if someone’s in attachment-focused care, and it’s poorly timed, or the therapist doesn’t understand the intricacies of the lies and abuse at work with sex addiction. There’s this really harmful dance, a suggestion that, “Well, she may be withdrawing or being too critical, and then that invites him into looking at porn and acting out with prostitutes. Or it causes him to become angry. The more he does that, that invites her into being more critical.” It’s ludicrous. It’s ludicrous to suggest that she, in any way, is to blame, for his abuse or infidelity. It does so much harm in having women feel blamed for those behaviors.
Anne: Absolutely, yeah. That’s what I worry about with couple therapy, is that very situation. It’s the dance of she asks him to cut the tomatoes and he feels shame, and so he yells at her and screams in her face – otherwise known as abuse.
When Therapists Use False Equivalency Couple Therapy Fails
Jill: There’s something that we call false equivalency. We’re making a false equivalent of two behaviors, she’s critical and he’s abusive.
Anne: Right, she’s critical and he’s punching walls.
Jill: Right, those types of false-equivalencies I see as highly dangerous and harmful for both parties, as well as the relationship itself.
Looking At Patterns To Determine Direction in Couple Therapy
Then we can look at certain patterns, and we’ve got a level playing field. We have equality in the room, we have safety in the room. We can identify patterns where there is equivalency. With sex addiction there is not equivalency.
She cannot cause or cure any of his acting out behaviors. I had someone recently suggest, “Well, I feel so much guilt and shame when she does this, that’s what causes me to act out with pornography.”
You need someone that can completely kibosh that. That is immature nonsense. “No, you acted out with pornography because you do not have good skills yourself for dealing with loneliness, anger, stress, and your emotions. That is an individual issue.”
Anne, actually, the irony is that as a licensed marriage and family therapist, I’m becoming more and more convinced that true couple therapy needs to be postponed until we have that Rule of Five in place.
How Timing of Couple Therapy Affects Everything
When couple therapy’s well-timed and we have that Rule of Five in place, I see people being able to really focus on attachment and really heal.
Let me give a positive and negative example. I’m working with someone right now who has been in couple therapy for two and a half years. The focus has been attachment work and working on trust and intimacy and communication.
She came to me two years into that two and a half years of couple therapy. She had some of the worst trauma I’d seen. She would be shaking in the room, uncontrollable shaking, that would seem to come out of nowhere. Extremely traumatized. Part of the focus of couple therapy was forgiveness, and I asked, “Do you have a safety plan? In your gut, do you feel that you have the truth?” The answer was no.
What Happens When Couple Counseling Does Not Help Us Move Forward?
None of that had been in place. It made sense to me, “Hey, as a couple, they’re not moving forward, because she’s still on the seventh floor of a burning building.” We have to get her out of that situation before they can really work on the couple-ship. So I advocated for a second disclosure. He had done a disclosure, but in her gut she didn’t feel that it was complete and it had never been polygraphed.
In a growing number of situations, we’re seeing polygraph have good results. In this case, she chose polygraph. Lo and behold, it comes out in a second disclosure, there was a whole category of acting out she knew nothing about.
A Foundation of Trust is Essential in Couple Therapy
It was impossible for that couple to heal. He was in the couple therapy holding secrets that were quite dangerous, and she was in the session not feeling safe at a very deep level, a cellular level.
It wasn’t until they put a stop to the couple therapy that he made progress. Couple therapy didn’t work because they didn’t have the foundation necessary to have it work. In the individual work, we’re finally getting some traction.
Focus on The Positive While Working Through the Negative In Couple Counseling
On the flipside, let’s talk about the positive. I’ve worked with a couple—she came to me, initially, I was able to collaborate effectively with his individual therapist. We were able to really do solid individual work, get trauma under control. His therapist was able to get the abuse and addiction under control.
We had a polygraph disclosure, it took him three tries on the polygraph test to get the whole truth out. Each time he would fail, there’d be another category of behavior disclosed the next time.
After that point, we had 90 days sobriety established. We had a disclosure, trauma, and mental illness—depression for him, trauma for her—were being managed. We chose a therapist that understood addiction, but focused exclusively on couples. We launched them into couple therapy, and, guess what, they’re doing beautifully well. They’re really moving forward.
Finding The Right Therapist is Vital in Couple Counseling
To me, it contrasts the power of timing that effectively. That’s when I see marriages really thriving and healing, and becoming stronger than they ever were. Timing is key, as well as finding a therapist that understands this issue.
You may have to shop around a bit to be a good consumer of mental health services, just like we are with dentists, doctors, lawyers, any professional service. Be a wise consumer.
How To Find The Right Counselor For Couple Therapy
Ask them what their approach is, share your concerns. Ask them, when you’re shopping for a therapist if there are any contraindications to couple therapy, in their view, and what the indications would be. I think that speaks volumes about someone’s theoretical background and approach to couple therapy.
Anne: I think, also, someone who has a way of assessing a woman’s safety. That’s why I think APSATS is so important. The Multi-Dimensional Partner Trauma Model establishes safety and stabilization first, in terms of abuse – lying is an abuse issue, trying to control the situation, rather than approaching the situation with honesty. It’s a consent issue. Lying is abusive in and of itself.
The therapist that I did couples work with there was absolutely no talk of are you safe, what does it mean to be safe, how do we establish safety. There was nothing like that. It was “attachment will solve all these problems.”
The Three-Phase Model In Betrayal Trauma Is Important When Working In Couple Counseling
Jill: Exactly. I’m so grateful that you brought up the three-phase model. Typically, it’s in the middle to the later second phase of that that couple therapy, from my perspective, works well, or even the third, in some cases, if trauma’s been really elevated and severe.
Certainly not in that first building safety and stabilization. In defense of colleagues that do couple therapy from the beginning, I’ve had them say, “Well, Jill, these couples are living together. Often, they have families together. We can’t deny the reality of their day-to-day world. They’re living as couples day-to-day, so we can’t just ignore that for months while they’re in individual therapy.”
I understand that. But if you have good individual therapists that have permission to collaborate and coordinate important details, or to have occasional joint meetings, it’s not couple therapy and those boundaries are clear. I’ve seen that work extremely well.
Safety Is Key For Strong Results From Couple Therapy
Without safety, being vulnerable with an abuser, sharing deep and vulnerable feelings, working on attachment, doesn’t have good outcomes.
Anne: Jill, you are on the APSATS board, and all of the coaches here, at Betrayal Trauma Recovery, are APSATS-trained. There are women who are a little jittery about seeing a coach in conjunction with a therapist, so, while I have you here, can you tell our audience why you think our APSATS coaches are so amazing?
Jill: I’m always happy to voice my support for what you’re doing, Anne, and APSAT coaches, because in my own practice, and I am a therapist, I see great benefit in coaches being included in a treatment plan. APSATS training is so effective in helping people have the background and mindset along the lines of what we’ve talked about today, and really understanding safety, and the nuances of this.
Therapists and APSATS Coaches: Both Have A Role To Play When Helping Women Heal From Betrayal Trauma
Ethically, I feel a need to distinguish—there is a difference between therapists and coaches. They’re not the same. That takes nothing away from either/or; they serve different roles. Speaking as a therapist, how I recommend and use coaches in my work with partners is coaches do not have the same limitations that I do legally and ethically, with cross state lines and work.
I can have a specialist out in California that’s an APSATS coach be part of a treatment plan, and she’s able to speak more personally about her own story, is able to do really good goal-work and effective support in ways that, as a therapist, I may be more limited. Also, everyone has a different skill set. I think it’s a team approach. I tend to be very collaborative in my work, so I like having as many supports as possible, realistically, and within budget of course, that we can.
In my experience, the APSATS coaches, and those associated with Betrayal Trauma Recovery have just really been able to meet needs that I, as a therapist, either am not specialized in, or don’t have the same experience with. It’s been a wonderful resource for my partners. I would encourage anyone that has concerns to, perhaps, work with both.
Find a clinician you really like, because clinicians are going to have training in diagnosing things and working clinically with someone, therapeutically. I don’t see them as mutually exclusive, Anne. I would encourage people that, as you said, may feel jittery, or anxious about that, to contact both, and to explore how maybe both could be used in different roles in their treatment plan.
Finding The Right Therapist Or Counselor After An Affair
Anne: We’ve had people contact us, for example, who have legal questions. We get random emails all the time, from women all over the world, and we’re not attorneys. None of our APSATS coaches have legal training.
What the coaches are really good at is helping women know, “Okay, these are the questions you may want to ask an attorney,” or if you’re looking for a therapist, coach them through picking the right therapist.
How do they know which therapist is the right therapist? How do they know that the treatment that they’re seeking is working for them? Coaching them through the process of maybe legal issues, or therapeutic issues, is what our coaches are really good at. Because a lot of women, when they first find out, or when they’ve been searching for a long time, they don’t know exactly where to go, or they don’t know what questions to ask, they’re not sure how to go about the process.
Our coaches are really good at helping them navigate this whole world of sex addiction and abuse, and all of these things that are very complex, in a way that works for them. Just having someone to walk you through the process is, I think, really important. I wish I would’ve had that in my journey.