Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction

Question 1 found at the bottom of this page
Answer Booklet | Table of Contents
Get Audio Track: Open a new window with Ctrl N,
Left click audio track to Listen, Right click to "Save..." mp3
Get PRINTABLE format of this page. This may take a few moments.
To print, if you do not have Adobe Reader, it's available via a free download here.

Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course is entitled, Couples Therapy Volume 1: Teaching Communication Strategies that Work!.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with helping couples relearn healthy communication patterns.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate and give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting.  Also I define “conjoint therapy”  as treating the couple as one unit, as a system where each part effects the other.

On this CD set we will discuss such topics as:  togetherness versus intimacy, types of “togetherness” marriages, optimizing the therapeutic alliance, communication danger signs, filters, the speaker-listener technique, navigating hidden issues, assumptions that help with problem solving, the address with respect technique, core impasses, preserving friendship, barriers to fun, protecting sexuality, and the process of forgiveness.

So  let’s get started

On the rest of this track, we will discuss teaching communication strategies that relate to couples choosing togetherness over intimacy. We will specifically discuss working definitions of ‘togetherness’ and ‘intimacy’ that can be introduced to couples to begin the process of changing the patterns of their relationship.

Not long ago, Christi set up a counseling appointment to discuss her depression. After conducting an intake interview, I asked her to bring her husband Eli to our next session. Eli was happy to come, and stated that he was happy to do anything that would help Christi. Eli was a successful freelance writer with a high annual income. Christi worked for a small garden shop near their apartment. Although she loved her job, her income was relatively low. Eli’s job required him to make frequent business trips, and he also regularly scheduled trips to exotic places ‘just for fun’. Eli grinned and stated, “but we were having too much fun. Christi has a thing about hedonism.” Despite the fact that Eli was smiling, Christi lowered her voice and murmured that although she enjoyed the trips, the frequent time off was putting her job at risk. Eli responded to me, rather than his wife, stating “oh, she knows she can get another job any day. It’s not like they pay her enough to deserve such loyalty anyway.” Clearly, Eli did not see Christi as a separate person, but as an extension of himself. He did not recognize that Christi’s job was very important to her. Instead, Eli dismissed her refusal to continue traveling with him as a strange idea caused by her depression. Christi believed that her marriage depended on her living Eli’s life as he wanted, even if it made her unhappy. Christi had originally planned to enter school to become a landscape architect, but had abandoned her plans to be more available for Eli’s trips.

I have found that many married partners believe in the principle that a married couple should be “as one”. As you will see with Eli and Christi, this belief undermined their intimacy.

I began my first conjoint therapy session with Eli and Christi by defining the terms ‘togetherness’ and ‘intimacy’. As I describe the working definitions I use for togetherness and intimacy, consider a couple you are treating. Are they confusing togetherness and intimacy? I stated to Eli and Christi, “Togetherness is when partners cling to each other in emotional dependency, scared to disagree because they fear their differences will break the marriage apart. One example of choosing togetherness might be a husband giving up watching Monday night football because his wife dislikes sports. Couples who choose togetherness are acting as if they are a two-headed unit who should think and feel the same about everything. They are frightened that exposing their differences will cause conflict.”

I explained to Eli and Christi, “Intimacy, on the other hand is when two partners, secure in themselves, are able to take care of their own moods and wishes. Each acts as a separate individual, autonomous but emotionally connected to the other. Couples who choose intimacy enjoy being close and sharing their lives. However, they also accept each other’s differences and separate pursuits, thoughts, and feelings.”

Obviously, it would have been ‘easier’ for Eli to have a wife who was always available to travel with him. By choosing togetherness, both Eli and Christi participated in the deception that Christi wanted Eli’s life, despite the fact that going along made Christi frustrated and depressed. However, Christi’s depression made her less available emotionally to Eli, even though she was more available to him in terms of time. Christi chose not to take care of her own moods and wishes, which prevented her from experiencing intimacy in her marriage. Likewise, if Eli had been secure in himself, he would not have been threatened by Christi’s desire to attend school, and spend less time on trips with him.

I stated, “It can be quite challenging for couples to confront their conflicting desires. However, doing so generally gives couples a greater insight into their mutual relationship. You may find that addressing your conflicting desires opens the door to greater mutual respect.” Although Eli might have less of Christi’s company if she were to pursue her dream of becoming a landscape architect, I feel that the couple would have a closer and more satisfying relationship.

I invited Eli and Christi to try the Separate but Intimate journaling technique. I find that this technique can help a couple who has focused on togetherness in their marriage begin a discussion about themselves as separate people. First, I had both Eli and Christi write separately about an event they found significant. I stated, “think about an event, interaction, or observation that happened to you as an individual. You could chose a major life event, or even a small aspect of your normal daily routine that is significant to you. Describe the event and the impact it had on you. Next, write why you feel it is important to remember and record this event.” After Eli and Christi had finished writing separately, I asked them to switch journals, and read what their partner had written. I then stated, “after what your partner has written, write your own answers to the following questions.
1. why do you think your partner has chosen to write about this event?
2. what significance does the event described have for you as a partner in this relationship, and why?
3. has the event chosen by your partner taught you anything about your partner or your relationship?”
I then asked Eli and Christi to share their responses with each other. Would your Eli and Christi benefit from using the Separate but Intimate technique to begin a conversation about themselves as individuals within the relationship?

On this track, we have discussed how choosing togetherness over intimacy can lead to conflict in marriage, and lead couples to seek therapy. We specifically discussed working definitions of ‘togetherness’ and ‘intimacy’ that can be introduced to couples to begin the process of changing the patterns of their relationship.

On the next track we will discuss four specific patterns by which couples commonly undermine communication. These four patterns are escalation, invalidation, negative interpretations, and withdrawal and avoidance.

QUESTION 1
What is a working definition of ‘intimacy’ that a therapist might use in conjoint therapy? To select and enter your answer go to Answer Booklet.