This brochure aims to provide some information to help in choosing:
Individual psychotherapy or couples therapy
Being in a relationship while having psychological complaints generally means that two persons suffer (see also the book Een depressie heb je niet alleen: “You don’t have a depression all on your own” by professor F. de Jonghe, Ph.D.).
Starting individual therapy is already quite a big decision. Deciding together with your partner to go into couples therapy requires courage and bravery on both your parts. What you usually get in return, however, is clarity, more insight and change. In many cases the choice for individual or couples therapy is an easy one, but there are a number of borderline cases, several of which are discussed below with examples.
First, though, there are several general things to consider. If one person in a relationship develops psychological complaints such as nervous tension, depression, anxieties or tormenting feelings of inferiority, this can, after several exploratory sessions, give cause for starting a series of individual sessions aimed at decreasing or eliminating these complaints.
Sometimes there is also reason to invite your partner along to go over things like: is your complaint causing problems for your partner, what has your partner already done about it, how does your partner unknowingly and unintentionally maintain the complaint, and, possibly, what is the function of the complaint within the relationship? Individual troubles can disrupt the interaction within a relationship and can erode the quality of the relationship for both persons.
Feelings of guilt often play a strong and crucial role. The one having the complaint (the symptom carrier) often thinks: it’s me, or my past, causing this! By feelings of guilt: the partner may think: I’m doing something wrong since I can’t make my partner happy (or can’t take away the complaint). Unfortunately, guilt feelings which are too strong can sometimes be a reason not to go into therapy (discussing guilt feelings is the same as reliving them). The first step in therapy is often precisely the pushing away of that feeling of guilt, first by calling it by name the moment it is actually felt, and then by putting it in its more proper place. After all, BEING THE CAUSE OF IS NOT THE SAME AS BEING GUILTY OF!
When one of the couple is in love with a third person, for example, discussion in couples therapy can often open the way for getting back to the basis of the relationship, the relationship as it was at the outset.
An analysis of the history of the relationship along with the feelings felt toward one another during its various phases gives insight for answering questions like: Where did it go wrong? How did the arrival of children change the relationship? The death of a parent, how did that interfere with mutual communication and did this lead to very different grieving processes, such that you drifted apart? How in the recent past has sickness or depression afflicting one of the couple been dealt with?
A 41-year-old father of two children, aged four and six, comes at the advice of his family doctor because of feeling inhibited in social interaction and having difficulty taling about feelings with his wife. For the content of his work as a technician it is of no consequence, but it is for his interaction with his co-workers. His wife has previously had individual therapy from which she significantly benefitted. We arrange that the man brings his wife along next time. In that conversation it becomes clear how strong their relationship is and how much they care for each other. The woman has had some individual therapy to get rid of her fear of abandonment after her mother’s recent death. It seems as though her husband has come to mean even more to her since then. The man feels that his wife has indeed been making more emotional demands on him after his mother-in-law death, demands which he hasn’t been able to fulfill. We set up three couplex therapy sessions, afther which he comes four more times on his own.
This example shows that individual psychological complaints can only be effectively treated if your home front is supportive of the treatment and prepared to participate in it if necessary.
A 38-year-old stewardess, married, is referred by her family doctor because of a strong inferiority complex, fits of crying, not being able to handle criticism and an extreme eager-to-please attitude. She has two sons, three and five years old. Her husband has had an affair for half a year, which she herself discovered but which her husband deeply regrets. He is now going to great lengths to try and make it up to her. At age nine the woman lost her mother. Since her husband’s affair, she’s been feeling very inferior and terribly sad. We decide not to include the husband; he is supportive of the treatment, and is already utterly devoted.
Moreover, he already feels so guilty that at this point it isn’t advisable to make him “confess” again at the psychotherapist’s. In eight individual sessions we discuss -with the woman repeatedly very sad- that almost losing her husband reminds her very much of losing her mother at age nine. She can well recall the feelings she had then: is it my fault she died? Consequently we discuss how this with her husband has made her feel inferior again and brought an incompleted phase of grief to the surface once again. Her eager-to-please attitude and not being able to take criticism also have a lot to do with this.
This example shows that, althought there was a causal relationship between her husband’s behavior and the woman’s complaint, this doesn’t always point to couples therapy for etting over disabling, torturous complaints. After three weeks sick leave, the woman was able to resume working.
A couple in their late twenties who has been living together just fourteen months is referred by their family doctor because of much conflict in their relationship; additionally, the woman feels she is being constrained and impeded, and the man has various complaints of physical tension and unmanageable feelings of jealousy.
Five years before it was love at first sight, and they describe the early days as wonderful and relaxed with many vactions.
Both work hard and she mentions that she has given up girlfriends for the intensive relationship she has with her boyfriend; he works a lot of overtime.
Both have a slight preference for individual therapy. Right away in the preliminary interview I submit, with the help of a diagram, that it seems as thought they are strongly focussed on each other (which of couse has been and still is wonderful), but that there apparently isn’t enough room for having something of an individual live.
Figure A is a schematic portrayal of the relationship in example C: the shared relationship is too large and is at the expense of individual, personal development. After some six sessions together, we are able to effectuate solidification of the relationship of these two, who are wellsuited to each other. Two trees too close to one another receive too little air and light to really be able te grow!
Needless to say the shared area in the realtionship in fig. B, though smaller, is much stronger than the larger shared area in fig. A. In example C it was necessary that both partner came together. After all, the one’s justified desire for freedom fed the jealousy of the other, and vice versa! Precisely because of the too close bond involved -though it had its advantages- the one person couldn’t be treated without the other.
(The above-mentioned people gave permission to publish their stories as illustrative material).
To sign up and for referral consultation:
You can sign up for individual or couples therapy sessions Monday through Friday between 9:00 a.m. and 1:30 p.m. by calling 020 643 34 22 (both telephone and fax number).
We are also available during the day for consultation by phone.
INSTITUTE FOR FAMILY AND COUPLES THERAPY AMSTELVEEN
- PRIMARY PSYCHOLOGY PRACTICE
- MULTIDISCIPLINARY PSYCHOTHERAPY PRACTICE
located at Bevelandselaan 9, Amstelveen, The Netherlands
- A.K. Goulooze (clinical psychologist-psychotherapist, couple therapist)
- Mrs. D. Duyvis (clinical psychologist-sexologist)
- L. Cohen (clinical psychologist, psychotherapist)