Relationship Patterns in Couples Therapy

attachment theory word collage
Attachment Theory

This is a post about relationship patterns in couples therapy.  I’ve noticed a pattern when I work with couples to improve their relationship.  It has to do with how people learn to communicate with those who matter most. We seem to take the good and bad experiences with family and then apply those expectations and habits with our spouse and children.  If you ask most people, I suspect the idea that we develop a communication style over time and repeat it automatically is not a surprising pattern.  It’s certainly not surprising to psychology researchers and psychotherapists.  But interestingly enough, telling your significant other that most of your relationship problems started with your family can sound a lot like an excuse.  Almost like “it’s not my fault that I’m a bad listener, a jerk….”

Attachment theory, the science of love

The psychological community calls the phenomena that past relationships heavily influence the quality of our present relationships the theory of attachment, or more recently – the science of love.  John Bowlby, a psychoanalyst clinician, and Mary Main, a researcher, developed and tested attachment theory in the 1950’s.  In the 1990’s the Canadian psychologist Susan Johnson used Bowlby’s work to develop a treatment for couples in marital distress called Emotionally Focused Couples Therapy, EFT for short that has proved in clinical trials to be extremely effective (70% success rate; 90% improvement rate in clinical trials with couples).  I learned about attachment theory and EFT in graduate school and have come to rely on it as a foundation of my therapeutic work today.  In fact, I have found that EFT is an excellent treatment for relationship problems of all kinds with couples and individuals.

EFT’s effectiveness as an attachment informed approach to therapy is one of the reasons that I have developed a greater appreciation for the work of other psychoanalysts like Sigmund Freud, John Bowlby, Heinz Kohut and Michael Franz Basch. Freud, being the first psychoanalysts and also the most criticized, sought to understand why some people in 19th century Austria were acting neurotically, in more modern terms, experiencing a mental illness. He then worked on ways to treat it effectively.  Of course Freud’s theories about how the biological brain might work have proven incorrect, but his belief that we humans were not fully aware of the motivation behind many of our behaviors was on target then and I believe is just as on target now.  I think the best way to appreciate Freud’s contribution to effective psychotherapy is that he was the first loud voice in the modern world to proclaim that the unconscious must be made conscious for humans to function well, especially in relationships.

John Bowlby in the 1950’s and many more since have taken the idea that we are not fully aware of why we do what we do and applied it to problems in relationships.  Bowlby and other attachment theorists make a convincing case that for us human beings, we need relationships in order to survive.  Without connection we die.  This explains why people often choose bad relationships over no relationships most of the time.  I saw this repeatedly when I worked in a homeless shelter for battered women.  Until we started talking about attachment, they couldn’t explain why they kept going back to bad men.  In the hospital psychiatric unit where I spend part of my work week, those who’ve chosen no relationships are also the anxious and depressed.  I don’t think it’s an accident that mental illnesses like schizophrenia and other disorders with psychotic symptoms seem most severe in patients who are most isolated.

An example from cinema
Cast Away screen shot
Chuck and Wilson

In the 2000 film Cast Away, the character Chuck Noland, played by Tom Hanks, is a great example of how badly humans need relationships.  Chuck is stuck on a deserted island with no one to talk to.  Eventually he turns to a Wilson brand volleyball for friendship.  Chuck basically develops symptoms of a delusional disorder in order to function and survive.  “Wilson” becomes a human.  I believe you and I need relationships just as much and we’ll do almost anything to get some version of it.  If we go without a sense of connection, of being known and cared for by someone, for too long, then life stops meaning much.  It’s only a matter of time before that state of mind leads people to the suicide hotline and a visit to the ER.

Dealing with the past when it’s still too alive
happy stick figures

This innate need for connection to others is why I think couples therapy can be so helpful for people to safely explore their own adaptations in relationships and start making positive changes. After just a little exploration in a therapy session, most of people I work with start seeing how many of their defensive and aggressive responses to others are rooted in bad experiences from the past.  Once couples start learning with a good therapist to identify the feelings underneath their angry, defensive, critical actions, it doesn’t take long to start talking about those feelings and perceptions in much healthier way.  After a little coaching from a therapist coupled with enough time feeling safe while you talk and listen, relationships start to change.  It’s very hard work, don’t get me wrong.  Learning to do this usually starts off very rocky, but just like learning to walk, it doesn’t take long for healthy communication to make sense and seem much easier than fighting all the time.

Suggestions for growth

If you’re thinking that you may have learned some pretty bad lessons in your life about how to be in relationships, or if you’re open to the possibility that the way you respond to others seems to follow a pattern that may have developed a long time ago, I encourage you to consult with a therapist trained in improving relationships. Another good way to start learning about yourself and your need for good relationships is to read about attachment.  Susan Johnson is my go to sources for simple explanations for why we respond to others in all sorts of ineffective ways.  Love Sense is her latest book for the general public.  Another book of hers that I like is Hold Me Tight.  That’s her step-by-step manual for improving marriages.  I’ve read both and recommend them to clients all the time.

If you’re interested in a more scholarly work about attachment theory, I found this article by Inge Bretherton from the journal of Developmental Psychology – The Origins of Attachment Theory: John Bowlby and Mary Ainsworth.

The best scholarly resource I’ve read is Mikulincer and Shaver’s book Attachment in Adulthood.  It’s become my “go to” for attachment theory research.  I learned about it while attending an EFT training.

Finally, I recommend reading John Bowlby’s work.  There’s nothing like going straight to the source.  My favorite so far is a collection of Bowlby’s essays and speeches from 1956 to 1977 – Bowlby the Making and Breaking of Affectional Bonds.