Couples IssuesDr. Perrotta

Working with High Conflict Couples: A Systemic Approach

Martha Cook, MSW, LCSW, LMFT, is one of the senior therapists at the Centers for Family Change, and our Director of Training. She is dually licensed as a marriage and family therapist and a social worker, is an AAMFT approved clinical supervisor, and has extensive experiencing providing couples’ therapy. Ms. Cook has and continues to provide training to Centers for Family Change therapists on how to effectively work with a range of issues involving couples therapy, including how to work effective with high conflict couples.  Ms. Cook’s emphasizes utilizing a systemic approach that draws heavily on the work of Dr. John Gottman, and his extensive research with couples.

In a recent training for Centers for Family Change staff Ms. Cook detailed how a systemic approach is critical in working with couples. A systemic approach conceptualizes the couple’s difficulties as a problem “between people” rather than as “within people.”  Therapists who work from a systemic approach seek to help the marriage (or relationship) and think about the marriage as the focus of therapy.  Unlike more traditional approaches that look at individual issues, a systemic approach highlights patterns of interaction, what goes on between people, how they relate, and seeks to intervene by helping members of the couple change how they interact with and engage each other.

Ms. Cook highlighted that in working with couples an active directive approach is needed. Couples therapy requires therapists to help members of the couple interact differently. Moreover, therapists working with conflictual couples need to actively intervene to help couples break negative patterns of conflict and find more effective (calm, empathetic and non-attacking) ways to relate to each other. Therapists need to be clear with couples they the therapist will not take sides in the relationship, but will advocate for the marriage or relationship.

In this approach the focus of treatment is not on solving all problems the couple presents with, but rather on helping goals learn to manage differences, and accept and cope with unresolved conflicts (what Gottman refers to as “perpetual conflicts”).  According to Gottman disagreements are not the key problem in marriages, but not being able to effectively manage disagreements is.

For more information on a systemic approach to couples therapy we recommend the works of John Gottman, Ph.D., Sue Johnson, Ph.D., William Doherty, M.D., and Michele Weiner-Davis, M.S.W.