Elements of Treatment Success Beyond our Control

Another way of thinking about this post might be the old adage, “You can lead a horse to water, but you can’t make him drink.”  Couples therapists are not responsible and cannot control the timing of a couple’s desire to be together or their readiness to use therapy.  Every person’s right brain (nonconscious) is completely in charge of their ability to tolerate the unearthing of childhood experiences and feelings.  Our brains are programmed to protect themselves, and they are absolutely correct every time about what might create mental disintegration.  So, our clients’ right brains are in charge of the treatment; not us therapists.

We are obligated to do everything we can to create an atmosphere of safety in the treatment, and one of the primary ways to do that is to respect our clients’ limits.  I was once treating a couple referred by the woman’s individual therapist.  The male partner stated very clearly in a session that he simply did not want to be in the relationship.  I accepted his courageous move to state his wishes, and we terminated the couples treatment.  I was seriously taken aback when the individual therapist released her rage at me for not convincing him to stay in the relationship.  Apparently, she and her client had decided that he would never “do any better” than her client.  The individual therapist seemed to have lost track of what she had control over and what she should not.

It is not our job to “make” couples stay together or split up.  That decision is beyond our control.  It is our job to safely guide a couple through an exploration of the feelings their right brains have brought to treatment at the pace they show us they can tolerate.  Their right brains will control the pacing of the treatment–sometimes faster and sometimes slower than we think it should go–and it is our responsibility to stay attuned to their pacing without judgment.  In the end, their right brains will control whether they stay or go with the treatment and with each other.

As we all know, an important element of safety in treatment is the way the therapist responds to physical violence between partners.  Some therapists feel too much responsibility if partners become violent during therapy, thinking something like “I should have seen this coming.”  We are not clairvoyants or police officers, and we are not responsible for keeping partners from becoming violent.  Professional standards about “duty to warn” or referrals to shelters might need to be followed to protect a client who seems to be in serious danger.  However, we are again under no obligation to “make” the violence stop.  What we can control is adhering to a no-violence policy in order to continue treatment.  I have seen many couples make their own decision to control their violent behavior because they genuinely want to be in treatment together.

Share this post: