Unwise Counsel

This article appeared in the Sydney Morning Herald 5 July 2003.

Counsellors are supposed to help couples save their marriages. But is their main goal to fix the relationship or to rescue the individuals in it?

“They sit and judge you. You get the feeling it’s not a big deal if you stay together or if you don’t. The counsellors never seems to be pushing you to hang in there. I don’t think they treat as precious the history you have together or care that this man is the father of your children. It’s like it’s all a bit too hard. Why don’t you just leave?”

This is Linda Boswell*, 49, a Mosman physiotherapist married to a man prone to negativity and depression but still “a good, loving husband”. In their 19 years together, they have seen a number of marriage counsellors, particularly during the difficult early years, when they were struggling to conceive using IVF. While some counselling has been helpful, sometimes she’s emerged outraged at the failure of the counsellors to value her marriage.

She mentions one counsellor, who announced soon after they walked in that he was recently divorced. “I had the overwhelming feeling he wanted everyone else to end up in the same boat. He never said anything positive. If I mentioned my husband was being unsupportive, the counsellor would come back with: ‘Oh, that’s only going to get worse.’

Boswell feels her marriage has survived despite, rather than because of, the marriage counselling. It’s a sentiment also felt by people on the other side of the counselling room. Professor William Doherty, the director of the marriage and family therapy program at the University of Minnesota, says: “If you talk to a therapist about problems in your marriage, I believe you stand a good risk of harming your marriage. Doherty has just toured Australia, promoting his two latest books, A Strong Marriage and Confident Parenting (Finch Publishing).

Doherty says therapy can be “enormously helpful in the right hands” (“I do this for a living. My job is to train therapists”). But he also believes therapists and marriage counsellors can undermine marriages, through incompetence and by promoting individual fulfilment, rather than supporting commitment to the marriage. (“Counsellors”, in theory, are trained to deal with day-to-day problems, while “therapists” tackle more complex, diagnosable complaints. But, in practice, there’s little difference between the two. Unqualified people are able to use either label.)

Doherty takes issue with therapists who claim to be neutral, who see their job as simply helping each person decide on their best option. Being neutral is an undermining stance, he says, arguing that the therapist who uses the language of individual self-interest “I have needs, I have a right to happiness” tends to side with the more self-oriented spouse, colluding to undermine the marital relationship.

Certainly, judging the success rate of marriage counselling is complex. For a start, couples commonly wait until relationship problems are severe before seeking help to decide whether to stay in a marriage. By this time, says Kim Halford, the professor of psychology at Griffith University in Brisbane, counselling is less likely to be keep the marriage together.

But, first, to the question of competency. Doherty says the “dirty little secret” in the therapy field is that couples therapy may be “the hardest form of therapy and most therapists are not good at it”. As he explains, very few people who offer couples therapy or marriage counselling whether they trained as psychologists, psychiatrists, social workers or professional counsellors have had any systematic training in couples therapy. This claim is echoed by Australian counterparts. Most learn on the job, acquiring varying degrees of competence along the way.

Fumbling therapists can put marriages at risk, as a Sydney doctor, Karen Brown, recently discovered. She’s used to referring couples for marital counselling, who often report they find it helpful. But that wasn’t her experience when she went with her husband to a psychiatrist to sort out some minor marital issues. Looking back, she sees their problems as minor such as squabbles over the importance of family meals but enough to eat at their 20 years of contentment. The counselling was a fiasco.

“It was divisive, an utter waste of time. There was so much of he said/she said, picking up on the minutiae. He just let us talk, go round and round. In an argument, we all behave badly, we all say terrible, hurtful things. But if you then bring them up in a counselling session, you just get angry and bitter. We were given no strategies, there was no attempt to look at the positives what works in the marriage, rather than what doesn’t work. It made things worse for us,” she says.

Allowing clients to simply fight the fight is a disaster, says Doherty. “The most common mistake made by inexperienced couples therapists is providing too little structure for the sessions. These therapists watch and observe, and spouses speak for each other and read each other’s minds, making attacks and counterattacks . . . The therapist may end the session with something blandly reassuring, like “well, we have got a number of the issues on the table”, but the couple leaves demoralised.

Sometimes dangerously demoralised, says the Canberra University psychology professor Bob Montgomery, who mentions that some time ago it became fashionable for clinics to video-tape marriage counselling sessions and play them back to clients. The experiment came to a halt when a number of clients committed suicide.

“All many so-called ‘marriage counsellors’ are doing is encouraging distressed couples to practise their problem. They are already pretty good at conflict by the time they come in they don’t need practice,” says Montgomery. He believes much marriage counselling is “lightweight” and bears no resemblance to the couples therapy that research has shown to be effective. He agrees with Doherty that most counsellors have not have the systematic training needed for effective couples therapy.

Kim Halford, an adviser to the Federal Government on marriage and family policy, agrees there are real concerns about the competency of people offering marriage counselling. “People tend not to do in routine counselling what’s been shown to actually work,” he says, explaining the specific forms of couples therapy shown to be effective namely insight-oriented couples therapy, emotion-focus therapy and cognitive-behavioural therapy.

But most counsellors are not using these approaches. Even with these carefully evaluated, “state-of-the-art” forms of couples therapy (used mainly by clinical psychologists), Halford says there’s only about 50-50 chance of real improvement after counselling, and within a few years this drops back to about a third reporting that their marriages are in good shape.

The issue is further complicated by the fact that often one spouse also seeks individual therapy. While individual therapy can add to problems when individual growth threatens the relationship, it can also help people gain insights and develop new strategies for dealing with relationship problems.For Mary Lewis, a journalist working for a Melbourne newspaper, individual therapy proved more helpful than couples counselling. “My husband felt he could never win when we went to counsellors together,” she says. Her 16-year marriage went through a rocky period, including a separation, but is back on track.

Her husband’s reaction to separation made a big difference. “He so hated being on his own and vowed to change his behaviour. Somehow, the anger, the rages, just disappeared.” But Lewis found regular sessions with a clinical psychologist allowed her to find ways of working on her own behaviour, avoiding some of the nasty habits she’d learnt from her parents.

Yet marital problems have pretty good odds of turning themselves around, says Halford, referring to recent research by Linda Waite, a psychology professor at the University of Chicago. Her team followed a group of 645 people who described themselves as unhappily married. After about five years, 176 of them had divorced or separated and, of these, about half were happy. About two-thirds of those who stuck it out were happy.

Most couples in the study who reported improvement in their marriages said it was a question of endurance they didn’t resolve their problems, they outlasted them. Other couples reported success through “working on” their marriages, pursuing strategies for changing behaviour, improving communication and solving conflicts. And a third group found their marriages became more rewarding when they found ways of lifting their own happiness by personal change.

Rarely was marital counselling given credit for turning the marriage around. A third of Waite’s participants had seen counsellors. “Most reported it was helpful, but relatively few saw it as the key to turning their marriages around or avoiding divorce,” reported Waite, who also found a large number of husbands saw counselling as a threat to their marriages.

Indeed, it isn’t hard to find men who believe counselling gave the final push. David Phillips had a number of sessions with different marriage counsellors before separating from his wife early this year. He found the process painful. “I had the sense the counsellor was being used as a third party to try to convince me I was wrong. The kind of language I use is different from the way my wife and the counsellor wanted to talk. When I’d try to point out what I saw as the facts of the matter, my approach was devalued. It left me with a sense of not being heard or respected,” says Phillips, who works in the computer industry and describes himself as an analytical “techno” type.

Peter Llewellyn-Smith, the men’s services co-ordinator for Interrelate Australia, a government-funded counselling organisation, acknowledges there’s new recognition that couples counselling has failed to engage men. “There’s concern in the industry about whether therapists are skilled at working with men. New research is showing that a key to successful couples counselling is engaging men up front, exploring where their resistance is coming from and how to overcome it,” he says, explaining that the feelings-based language used in counselling favours women, who are more likely to be verbally expressive.

Brad Hawthorn is a Sydney actor who credits a Relationships Australia counsellor with giving his relationship new hope. His five-year relationship broke down last year after he had an affair. When the couple decided to get back together, they struggled. “She had real difficulty trusting me again and went through a lot of pain,” says Hawthorn, adding they also had sexual problems.They are now seeing the counsellor twice a month. “The counsellor is wonderful. She’s helped us learn a lot about ourselves. She doesn’t take sides, she levelled the playing field and allowed us to really start to hear each other. It’s made a huge difference.”

Llewelyn-Smith points out that often couples come in for counselling only as a last-ditch measure, when they are deciding whether to split up. In about 70 per cent of marriage break-ups, the wife decides to end the relationship and often her mind is pretty much made up by the time they reach the counsellor. “Sometimes, the best outcome is for the relationships to end and the role of the counsellor is to help the couple with that process.”

But, for the man who seeks counselling to try to save his marriage, it feels like a betrayal when a counsellor supports his wife in her decision to leave. Tim Bonner, a Sydney company executive, went with his wife to marriage counselling, hoping to shore up a struggling relationship. “Her agenda was to get me through it, to get the counsellor to help me accept it. From the start, I was given no hope of saving the situation. The counselling was all about where I was going to go, how I was going to see my child.”

Yet therapists, including Doherty, unite in arguing it can simply be too late. “Some marriages, of course, are dead on arrival in the therapist’s office, in which case the therapist’s job is to help with the healthiest possible untangling for all involved parties, especially the children.” Doherty’s real concern is with marriages that are teetering, in need of help, but end up on the rocks as a result of counselling.

His view is that the risk of such counselling has greatly increased as a result of a shift in therapeutic goals. Whereas marital counsellors once saw their task as “saving” marriages, this was replaced during the 1970s by a so-called “neutral stance” towards whether or not the marriage would survive.

According to the head of Relationships Australia, Anne Hollonds , counsellors at that time were swept up in an “exuberance” about divorce offering a solution to unhappy marriages by allowing people to “get in and out of marriage as they pleased”.

The result was that the focus of counselling shifted to what the individuals stand to gain or lose by staying married or getting divorced. Doherty argues that far from being “neutral”, promoting individualistic self-interest works against the commitment the partners have made to the marriage. So, asking “If you are not happy, why do you stay?” undermines the couple in a troubled marriage, implying there’s something wrong with valuing the marriage ahead of personal fulfilment.

“It takes extraordinary conviction to weather such ‘help’ from a therapist,” says Doherty.

Hollonds believes there’s been a recent shift away from the neutral stance. Experienced counsellors are now making their clients aware of the “horrendous consequences, the collateral damage of divorce, particularly on children”, and endeavouring to negotiate with couples for a period of time in which both commit to fight for the marriage. But she acknowledges Doherty’s criticisms do strike home and, with so many counsellors still in the system who were trained to believe in neutrality, couples are advised to be careful about who they choose.

Dr Jake Brown, who directs the counselling psychology programs at Macquarie University, disagrees with Doherty’s attack on counsellor neutrality. “I don’t agree there’s anything wrong with counsellors taking a neutral stance. I don’t have a vested interest in couples staying together. That’s for the couple to decide. As a therapist, I try to point out as many of the pros and cons as I can, but I can’t make the decision for them.”

Brown believes the counsellor has a moral obligation to do the least damage. “You can’t really say you do the least damage by keeping two destructive adults together.”

Wendy Harris is a Melbourne schoolteacher who feels her marriage was a casualty of cost-benefit analysis counselling. “My husband left because he was told by the counsellor that there was a nirvana out there that if he left me he would be in heaven. Apparently, the counsellor said the only reason he was experiencing agony and pain was me.” After 10 years of a marriage she describes as “glorious”, the couple hit a tough patch, her husband started an affair and he ended up in the hands of a therapist, who advised him to leave the marriage.

Evelyn Krieger is a psychologist working in Sydney’s eastern suburbs and believes couples sometimes have to be restrained from making precipitous choices they might regret. “One partner can run out of the marriage because they feel helpless and overwhelmed and don’t know how to resolve issues.” A veteran of a 38-year marriage, Krieger is concerned that young or inexperienced counsellors often feel helpless when confronted with warring couples and fail to understand that marriages can survive periods of bitter conflict.

Krieger was recently talking to a therapist’s supervision group about her difficulty getting through to a very aggressive young husband whose marriage was floundering. “Why are you trying so hard? Why don’t you just let him walk out?” said one of her male colleagues, whose own three marriages had failed. Krieger feels this response reflects the therapist’s inability to deal with couples experiencing marital conflict, partly due to his personal history.

Halford points out that when couples are really unhappy, they are often in no position to judge whether to go or stay. He compares it to asking a severely depressed woman to set ambitious life goals. A good therapist will help the couple assess their relationship, looking at strengths as well as weaknesses, and use proven strategies to work on the relationship to see whether their sense of commitment increases. Only then can the couple decide on their future.

But how to find such a counsellor? It helps to seek recommendations from couples who have found counselling helpful. But then feel free to grill counsellors about what formal training they have received in couples therapy, the approach they take and what research proves that the approach they take actually works. Also ask about their position on whether counsellors should support the marriage or be neutral.

In seeking to drive a consumer awareness movement about the risks of sharing marriage problems with a therapist or counsellor, Doherty is sounding a wake-up call for his profession to be aware of their moral responsibilities. “Most therapists are still behind the times. Like generals, they are still fighting the last war the one that freed individuals to leave unhappy marriages . . . But that war has been won. Most of us walk away from our marital commitment more easily than from any other.”

It’s a trend he believes therapists have the power to change.