By Dr Rod Benson, October 2002
At their best, counselling and counsellors facilitate healing, growth and wholeness in every field of human experience. The efficacy and goals of relationship counselling in general, and emotionally focused therapy, are usually more modest. In my experience healing is always a relative process, and absolute wholeness is an elusive ideal. But they are processes and ideals worth pursuing.
The arenas in which relationship counselling often takes place include individual, couple (or marriage), family and group counselling (Palmer & McMahon). In addition, a counsellor may utilise individual counselling in conjunction with marriage or group counselling in order to achieve specific goals that would be difficult to attain in a group setting.
According to Howard Clinebell, “the overall goal of marriage crisis counselling and also marriage therapy is to help couples learn how to make their relationship more mutually need-satisfying and therefore more growth-nurturing.” This applies also to other forms of relationship counselling.
More systematically, Gerald Corey identifies therapeutic goals as restructuring the personality, uncovering the unconscious, creating social interest, finding meaning in life, curing an emotional disturbance, examining old decisions and making new ones, developing trust in oneself, becoming more self-actualising, reducing anxiety, shedding maladaptive behaviour and learning adaptive patterns, and gaining more effective control of one’s life.
Corey places these goals on a generality/specificity continuum. Similarly, relationship counselling is the focus of a wide array of therapeutic modalities. Cognitive-behavioural approaches often stress the specific while relationship-oriented therapies tend to stress the general.
However, modalities such as emotionally focused therapy (EFT) emphasise the present and the specific, though not necessarily in a systemic or problem-solving context. The popularity and usefulness of EFT derives from its emotional (rather than cognitive or behavioural) approach to counselling, and from its emphasis on wholeness in the context of interpersonal relationships.
When is relationship counselling appropriate? Beavers and Hampsom refer to centripetal and centrifugal emotional and behavioural disturbances in clients as warranting relationship counselling. Observable qualities that may be addressed through relationship counselling include dependency needs, adult conflict, interpersonal proximity, social presentation, expression of closeness, assertive/aggressive qualities, expression of positive and negative feelings, and global centripetal/centrifugal style.
Relationship counselling based on David Olson’s circumplex model, which I have found pastorally useful in pre-marriage and marriage counselling, may de-escalate presenting problems and symptoms, and facilitate changes in cohesion and adaptability, separateness and togetherness, stability and change, communication skills, and the client’s ability to negotiate system change over time.
Referring specifically to marriage counselling, Rassieur argues that short-term therapeutic intervention can enable a couple to interrupt destructive relational patterns. His model involves counselling with a couple and individually. Rassieur offers a structured five-stage model (with up to seven sessions) for short-term marriage counselling with couples whose marriage is troubled.
A more detailed model is EFT, championed by Susan Johnson and colleagues. Johnson notes that marital distress is usually attended by a flood of negative emotions trapping the couple in narrow, constricting interactions. For Johnson, emotion is not simply part of the problem of marital distress but a powerful and positive change agent.
The essence of emotionally focused marital therapy is that “it helps distressed partners reprocess their emotional responses so that they can interact in new ways … [and] also shapes interactions that then evoke corrective emotional experiences.” In my opinion, this approach is equally suited to group and individual counselling.
EFT offers important insights and tools for relationship counselling, some of which are not addressed by other modalities. This approach synthesises experiential and systemic approaches to therapy, and places a strong emphasis on attachment theory providing keys for understanding and working with the emotional connections (or damaged or absent connections) between partners.
Essentially, EFT aims to look within (intrapsychically) and between (interpersonally). There also needs to be an awareness of the relationship (almost in the sense of a third party complementing both dyads of the couple).
Intrapsychically, EFT focuses on how individuals process their experience, privileging emotional responses over intellectual or volitional responses. Interpersonally, EFT focuses on how the partners organise and negotiate their interactions into patterns and cycles. In addition, EFT emphasises the present and the emotions to identify and express emotional feelings rather than making analytical or experiential statements.
EFT encompasses a longer-term approach to relationship counselling, structured in nine steps that may take as many as 26 sessions. The change process in EFT involves identifying the cycle of pursuit/withdrawal in the couple, cycle de-escalation, engagement of the withdrawer, and softening of blame on the part of the other person.
In my counselling practice, an awareness of the basic tenets of EFT theory and practice has helped overcome a natural preoccupation with analysis and problem-solving, helping me to identify (and identify with) the emotional identity and responses of clients. I have observed that what clients feel often determines how they behave.
Where a client can express how they feel in a situation, they are usually able to begin work on behaviour modification; and as their behaviour changes and becomes more positive, they gain new insights and generate internal synergies that are healthy and conducive to wholeness. EFT is most effective with clients who are capable of self-reflection and comfortable with emotional presence.
Relationship counselling may greatly benefit from strategic use of genograms and ecomaps. The creation of genograms, with or without active involvement from clients, are especially able to clear impasses and facilitate breakthroughs in relationship counselling. Hartman and Laird emphasise the complex array of resources (in addition to the actual counselling event/process) needed for individual and family survival. For family counselling, they advocate systematic exploration of a family’s relationship with its environment using an ecomap portraying the flow of resources and the nature of family-environment exchanges, and any lack or deprivation which erode family strengths.
Genograms and ecomaps will temporarily distract from the classic EFT focus on the present. They may unhelpfully shift the focus of therapy from emotional attachment to cognitive solution-seeking. I argue, however, that one of the blind spots of EFT is ironically its focus on the present at the expense of significant issues relating to family context and family of origin.
In this regard the eclectic incorporation of genogram and/or ecomap work, and selective borrowing of appropriate elements of Bowenian therapy, may enhance relationship counselling outcomes (Nichols & Schwartz). I have found genograms helpful in my personal experience as well as in counselling, as I endeavoured to trace intuitive notions and understand relational issues with which I have struggled.
The theoretical approach, counselling style and emotional sensitivity of the counsellor or therapist in relationship counselling are also important for positive outcomes. One of the most difficult aspects of relationship counselling is the need for the counsellor to operate on many different levels simultaneously while remaining present and empathetic toward the clients.
For example, a counsellor needs to maintain sufficient physical and emotional distance from the family to maximise objectivity. She/he must constantly assess inferences in terms of assessment and treatment direction with the salient processes emerging in clients’ interactional flow. Counsellors should also be aware of communication patterns among family members, between themselves and the whole family, and between themselves and each family member.
They also need to take note of body and behavioural clues such as a discrepancy between body messages and verbal expressions, and body movements of the whole family that seem inconsistent with speech.
Finally, and most importantly, counsellors need to be aware of their own internal feelings and intuition as they relate to all the above levels (Luthman & Kirschenbaum). It can be very difficult to effectively negotiate all of these levels, especially when working with many clients or with clients who are processing significant needs or issues.
Relationship counselling invites potential professional, ethical and practical problems of which counsellors need to be aware. In some cases it may be appropriate to try to be “blind” to the problem; in others it is better to acknowledge the issue with clients and clear the air. Some issues relate to cultural identity, gender, spirituality and other differences. Problems such as triangulation, transference, blaming (of self and/or others) and control may also reduce the therapeutic benefit of relationship counselling. Where several clients and the counsellor work together these issues can become complex .
Also, in my experience some counselling interactions can confuse or ignore the real interactions (such as a power imbalance or the true nature of the pursuit/withdrawal cycle) that take place outside counselling sessions.
The human experience is grounded in relationship, and prone to disharmony and deterioration. Relationship counselling provides a potentially effective way to renew harmony, encourage growth and pursue health and wholeness. It embraces a variety of theoretical and practical modalities. One that harnesses important relational and psychosomatic insights and offers useful therapeutic tools is emotionally focused therapy.
While effective in a range of therapeutic situations, EFT does not emphasise family of origin, and will prove most effective with clients who are not suffering deep hurts or major trauma, and with clients who are capable of self-reflection and comfortable with emotional presence.
Dr Rod Benson is Research Support Officer at Moore Theological College, Sydney. He previously pastored four Baptist churches in Queensland and NSW, and served for 12 years as an ethicist with the Tinsley Institute at Morling College. This article was written in 2002 and has not been revised to take account of later research.
References
Beavers, W. Robert & Hampsom, Robert B., Successful Families: Assessment and Intervention (New York: W. W. Norton & Co., 1990).
Clinebell, Howard, Basic Types of Pastoral Care and Counselling: Resources for the Ministry of Healing and Growth (revised edition; Nashville: Abingdon Press, 1984).
Corey, Gerald, Theory and Practice of Counseling and Psychotherapy (fifth edition; Pacific Grove, CA: Brooks/Cole Publishing Company, 1996).
Hartman, Ann & Laird, Joan, Family-Centred Social Work Practice (New York: The Free Press, 1983).
Hill, E. Wayne & Darling, Carol Anderson, “Using the family ecosystem model to enhance pastoral care and counselling,” Journal of Pastoral Care 55 (3), Fall 2001, 247-257.
Johnson, Susan & Greenberg, Leslie S., “The emotionally focused approach to problems in adult attachment.” In N. Jacobson & A. Gutman (eds), Clinical Handbook of Couple Therapy (New York: Guilford Press, 1995), 121-141.
Johnson, Susan, Creating Connection: The Practice of Emotionally Focused Marital Therapy (Philadelphia: Brunner/Mazel, 1996).
Luthman, S & Kirschenbaum, M., The Dynamic Family (Palo Alto, CA.: Science & Behaviour Books, 1974).
Macvean, Anne, McGoldrick, Monica, Evans, Jack & Brown, Jenny, “Genograms: Is it time for a change?” Australian and New Zealand Journal of Family Therapy 22 (4), 2001, 207-213.
McGoldrick, Monica & Gerson, R., Genograms: Assessments and Intervention (second edition; New York: W.W. Norton & Co., 1999).
Nichols, Michael P. & Schwartz, Richard C., Family Therapy: Concepts and Methods (fifth edition; Boston: Allyn & Bacon, 2001).
Olson, David H., “Circumplex model of family systems VIII: Family assessment and intervention” in David H. Olson (et al, eds), Circumplex Model: Systemic Assessment and Treatment of Families (Binghamptom, NY: Hayworth Press, 1989).
Palmer, Stephen & McMahon, Gladeana, Handbook of Counselling (second edition; London: Routledge, 1999).
Rassieur, Charles L., Pastor, Our Marriage is in Trouble: A Guide to Short-term Counseling (Philadelphia: Westminster Press, 1988).
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