Why might a therapist who works primarily with individuals consider studying couples’ therapy? If you work from an attachment perspective, as an increasing number of therapists do, then training in couples therapy may greatly inform and improve your work.

Many clients present to therapy for “relationship problems.” I’m sure all therapists who treat individuals have had the same experience I have of clients who want to spend their therapy hour talking about their spouse. Why do therapy on a relationship without both people present? Our training generally states that individual therapy will build resources in the individual, which they will then use to improve their relationships. But might an individual build resources faster and stronger with their partner present? Is working with the attachment dyad more efficient and powerful than working with the individual?

This hypothesis was presented at a recent training on Emotionally Focused Therapy for couples (EFT), an attachment-based approach developed by Sue Johnson, EdD . The presenters, Scott Woolley, PhD, and Rebecca Jorgenson , PhD, framed this question from an attachment perspective. They suggested that a client’s attachment system is more activated by and responsive to the client’s actual attachment figures than the therapist. Dr. Woolley quoted Dr. Johnson as saying, “As therapists we have 60 watt light bulb to bring light and healing to someone’s life, but the partner has a thousand watt search light!”

Attachment theory proposes that evolution has programmed us to be highly reactive to our partners, positively and negatively. “Relationship skills” learned in the presence of a soothing therapist might be no match for the tinderbox of a primary relationship. Likewise, there are risks in doing individual therapy. John Gottman, PhD, has found that people in individual therapy are much more likely to get divorced.

I emailed Dr. Johnson regarding this question. She replied, “A therapist’s empathy and validation are very useful -- but to be really seen and accepted by the most important person in your life -- that is transformational. The therapist is at best a surrogate attachment figure who validates.”

Victor Yalom points out that even if you plan to work individually, bringing the partner in for a single session provides invaluable data into the actual (versus reported) nature of your client's primary relationship and their interpersonal functioning, and can help broaden the frame of therapy. (Likewise with bringing in family members.)

Over time I have transitioned an increasing amount of my individual clients who present with relationship problems into couples therapy. Although the work is often harder, the results can come quicker, and I usually feel more confident that the results are lasting and durable.

File under: The Art of Psychotherapy, Couples Therapy, Therapy Training