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        Many therapists employ a communication model for couples work that assumes that most couples’ problems derive from dysfunctional communication. The assumption seems to be that teaching better communication should resolve their difficulties. Unfortunately, most well-controlled studies show that only about one-third of the couples going through marital therapy are reporting significant post-treatment benefits after one year. After two years, the benefits shrink another 50 %.  Those are not impressive statistics and they do not give much support for a simplistic communication therapy model. I find that a couple’s communication usually breaks down because of more complex emotional dynamics. Those dynamics can involve historical shame issues, personality deficits, knowledge deficits, and boundary interactions. These issues can be quite complex but are still understandable. Much of my couples work involves clarifying the emotional dynamics and then working with the couple to design a strategic intervention.  The necessary intervention will depend upon the needs of the couple.  My philosophy of treatment is to try the simplest feasible intervention first.  When we’re lucky, we can be successful on the most superficial level through mere education.  I’ve had some couples who merely needed 2 to 4 sessions to correct their problems.  This might involve educating the couple regarding the care and feeding of emotional needs within a relationship.  Assigning intimacy exercises would be a part of this type of intervention.  Teaching skills for managing mood states and conflict strategies would still operate on the educational level.  However, more time is usually needed, especially for learning conflict management strategies..  Three to 4 months is the norm for these types of cases.

   What people don’t like to admit is that communication and affection frequently break down due to issues of personal incapacity.  By personal incapacity I mean the inability of either individual to engage in certain mood states within their relationship.  These emotional states include the following:

a)     The ability to become curious about and to draw pleasure in exploring the mind of their partner.  This constitutes the highest form of loving because the mind of each partner constitutes their truest self.  When both partners love and relish each others minds, then both of them will feel “close.”

b)     The ability to express their desire within the relationship for various forms of fun and pleasure.   Unless this is happening, then one or more of the partners will feel “trapped” in the role of constant responsibility.  They may even begin to state that “they don’t know who they are” anymore.

c)     The ability to energetically confront their partner to prevent their partner’s desires from completely ruling their life and eclipsing their own desires.  Unless this confrontation takes place, the feeling of being dominated will usually result in losing sexual desire for their partner and even possibly displacing it outside of the relationship in the form of an affair.

d)     The ability to sooth themselves with a sense of higher emotional priority when their partners feel angry or hurt.  Unless a partner has this capacity for momentarily switching to a higher emotional priority, they cannot approach risking c) or possibly b) if it might lead to conflict.  They won’t be able to risk intimate exposure. 

   The model that I use for relationships is that both parties must have the emotional resources for dynamic balancing between the states of nurturance/connection and autonomy/self-reliance.  Decades of work have shown me that the best model for predicting the quality of relationship is the dynamic balancing between these two emotional states. 

   When either individual lacks the emotional capacity to engage in any of the 4 emotional states above, then marital or relationship counseling needs to shift to a deeper level.  This usually involves individual or group therapy to establish the missing capacity.  Group therapy is useful in training in a “theory of mind” so that the individual can become more empathetic and curious about what their partner is experiencing.  If a person’s background involves emotional trauma, then their anxiety may need to be reduced via EMDR therapy.  Anxiety reduction may be necessary before they can relax enough to become sufficiently curious about their partner.  When shame issues block a partner from expressing (or knowing) their desire, then individual hedonic inhibition therapy will be necessary for the individual to avoid feeling eclipsed in the relationship.  If a person is blocked from using healthy anger in the form of assertiveness, then EMDR may be used to reduce their sense of helplessness.  If a person is too fearful of feeling guilty about their partner’s anger or disappointment in any potential conflict, then conflict inoculation training may be necessary.  And if a person fears their own rage in potential confrontations, then conflict inoculation training again is the likely requirement.  In other words,  personal incapacity can take many forms.  The necessary intervention can take many forms as well. For a more in-depth description of any of these therapy interventions, please read about them under their own section headings.

   These chapters from my upcoming book will give you a good orientation to what's really happening in relationships.  Print them out for easier reading:

 Chapter 1 - The Great "No No"

            This chapter illustrates how our own fear of shame is the greatest obstacle we have to face if we want to improve an intimate relationship.

Chapter 2 - The Structure of Vital Relationships

            Love based relationships do not have as much stability or resilience as do integrity based relationships.   This chapter describes the strong foundation of a relationship that can stand the test of time. 

Chapter 3 - Balance and Paradox

            A vital relationship needs to be dynamic and not static.  Opposing needs and emotional states must be kept balanced over time.  This chapter unravels the paradox.

Chapter 4 - Nurturing Healthy Attachments

            Relationships must be fed.  It’s not enough just to feel.  This chapter explains the fundamentals about how attachment needs can be effectively met.

Chapter 5 - Love's HiddenAssassin

            A very common relationship killer operates far below our awareness.  It leads to the numbing loss of attraction and affection.

Chapter 6 - The Other Usual Suspects

            This chapter outlines the other most common relationship killers.  

Chapter 7 - Freeing and Strengthening Your Hedonic Self

            If you’re starting to numb out and lose attraction, this chapter suggests what you do to start resuscitating the part of yourself that’s going dormant.

 Chapter 8 - Defending Autonomy

                This chapter gives you tools to ward off covert inhibition that might otherwise strangle your affection.

The following are some of my writings that you might find interesting:

Intimacy & Boundaries Series

• The Paradox of Being Human
• Our Most Cherished Myths About Love
• Anger – The Misunderstood Emotion
• Rethinking Intimacy
• The Art of Negotiating for Space
• What About This Business of Falling in Love?
• When Empathy Becomes Codependence; When Disloyalty Becomes Growth
• Beyond Equality
• All in the Name of Honesty
• Letting Go of Harmful Relationships
• Misguided Hope
• When Trust is Not Enough
• Wise Mistakes

  Here are some of the types of therapy I do for specific problems:

    Healing emotional wounds (trauma resolution (EMDR)

    Raising self-esteem and reducing self-defeating shame (hedonic disinhibition)

    Anger management & assertiveness training (conflict inoculation)

Reciprocal Suppression in the Anterior Cingulate Cortex - A very technical article about the probable underlying neurology of EMDR treatment

Conflict Inoculation - A technical article I'm writing about a new type of treatment for rage behavior or conflict avoidance

Interactive Cognitive Motor Interweaves (A scientific paper currently being written relative to EMDR)

Background - Dr. Kaye is a psychologist with a license to practice in North Carolina. He obtained his license in 1979 after receiving his masters and doctorate from the University of Illinois with a specialty in personality. He completed his psychological internship at the Phoenix Veterans Administration Hospital in Phoenix, Arizona in 1976. From 1977 through 1983 he was the Director of Outpatient Services for Wake County Alcoholism Treatment Center. While there, he practiced counseling in substance abuse and authored and directed a federal research grant that developed the outpatient program. He also researched the effectiveness of treatment and developed the family program as a part of his research grant.

If You’re Interested

    If you want to explore the possibility of therapy with me, I usually recommend one session and then you can go home and think about it. One session is usually enough time for me to give you feedback about a recommended direction and strategy.  To schedule a meeting time, in the triangle call 919-467-1180.  If you want me to see you at Oriental Counseling Center, call me at 252-249-3099.  

04/27/2006