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    Opening the Can of Worms, Complications in Couples and Couple Therapy
    Opening the Can of Worms, Complications in Couples and Couple Therapy
    Opening the Can of Worms, Complications in Couples and Couple Therapy
    Ebook143 pages2 hours

    Opening the Can of Worms, Complications in Couples and Couple Therapy

    By Ronald Mah

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    About this ebook

    The therapist must anticipate complications- anticipate uncovering a "can of worms," that confuse and overwhelm the partners and therapy. Issues arise or intrude that ignite intense emotional reactivity from beneath the psychic surface to make easy living difficult if not impossible. Often minor issues become major issues over time and/or with other contributing factors. The therapist is tasked to uncover how issues interact in complex, nuanced, and fluid ways to influence emotions, thinking, psychology, spirituality, and behavior. Therapy must adjust to discovering that the direction of lower emotional reactivity to reduce problematic behavior although appropriate is complex to activate. Therapy can direct clients how their emotional reactivity including as expressed in bipolar disorder, post-traumatic stress disorder, developmental trauma disorder, sexual trauma, self-medication, and personality disorders function as third partners in the couple that cause seemingly illogical behavioral changes. PTSD not just in warzones but also in family experiences, developmental trauma disorder, and the Predator-Prey-Witness triangle (aka Combat PTSD Trinity) are examined in particular for how they complicate later relationships. Gottman's Four Horsemen of the Apocalypse along with other theories of psychodynamic, attachment, family systems, and family-of-origin help direct important psychoeducation, therapy, and the partners' change. The therapist is guided how to anticipate and use inevitable therapeutic failures as well as issues of chronicity, grief, loss, and self-medication due to high emotional reactivity to hone and adjust the conceptualization, strategy, and direction of therapy.

    LanguageEnglish
    PublisherRonald Mah
    Release dateSep 23, 2013
    ISBN9781301660629
    Opening the Can of Worms, Complications in Couples and Couple Therapy
    Author

    Ronald Mah

    Therapist, educator, author and consultant combine concepts, principles, and philosophy with practical techniques and guidelines for effective and productive results. A Licensed Marriage & Family Therapist (licensed 1994), his experiences include:Psychotherapist: individual, child and teen, couples, and family therapy in private practice in San Leandro, California- specialties include challenging couples, difficult teenagers, Aspergers Syndrome, Attention Deficit Hyperactive Disorder, learning disabilities, cross and multi-cultural issues, foster children, child development, parenting, and personality disorders;Author: twenty-one project/books on couples therapy for a doctoral program, including substantial work on major complications in couples and couples therapy (including depression, anxiety, domestic violence, personality disorders, addiction, and affairs); articles for the Journal of the California Association of Marriage & Family Therapist (CAMFT) on working with teenagers, elder care issues affecting family dynamics, and assessing dangerous clients, online courses for the National Association of Social Workers- California chapter (NASW-CA) on child abuse prevention, legal and ethical vulnerabilities for professionals, and difficult children, “Difficult Behavior in Early Childhood, Positive Discipline for PreK-3 Classrooms and Beyond” (Corwin Press, 2006), “The One-Minute Temper Tantrum Solution” (Corwin Press, 2008), and “Getting Beyond Bullying and Exclusion, PreK-5, Empowering Children in Inclusive Classrooms,” (Corwin Press, 2009); Asian Pacific Islander Parent Education Support (APIPES) curriculum for the City of San Francisco Department of Human Services (1996), 4th-6th Grade Social Science Reader, Asian-American History, Berkeley Unified School District, Berkeley, CA, (1977), and trainer/speaker of 20 dvds on child development and behavior for Fixed Earth Films, and in another time and career three arts and crafts books for children: two with Symbiosis Press (1985 &1987) and one with Price, Sloan, and Stern (1986);Consultant and trainer: for social services programs working with youth and young adults, Asian-American community mental health, Severe Emotional Disturbance (SED) school programs, therapeutic, social support, and vocational programs for at risk youth, welfare to work programs, Head Start organizations, early childhood education programs and conferences, public, private, and parochial schools and organizations,Clinical supervisor: for therapists in Severe Emotional Disturbance (SED) school programs, child and family therapists in a community counseling agency, Veteran Affairs in-patient clinician working with PTSD and dual diagnoses, foster care services manager for a school district, manager/supervisor for the Trevor Project-San Francisco, and therapists in a high school mental health clinic;Educator: credentialed elementary and secondary teacher, Masters of Psychology instructor for Licensed Marriage & Family Therapy (LMFT) and Licensed Professional Clinical Counselor (LPCC) track students, 16 years in early childhood education, including owning and running a child development center for 11 years, elementary & secondary teaching credentials, community college instructor, and trainer/speaker for staff development and conferences for social services organizations including early childhood development, education, social work, and psychotherapy.Other professional roles: member Ethics Committee for six years and at-large member Board of Directors for four years for the California Association of Marriage & Family Therapist (CAMFT), and member Board of Directors of the California Kindergarten Association (CKA) for two three-year terms.Personal: married since 1981 after dating since 1972 to girlfriend/wife/life partner with two wonderful strong adult daughters, and fourth of five American-born children from immigrant parents- the older of the "second set" of children.

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      Book preview

      Opening the Can of Worms, Complications in Couples and Couple Therapy - Ronald Mah

      Opening the Can of Worms

      Complications in Couples and Couple Therapy

      Published by Ronald Mah at Smashwords

      Copyright 2013 Ronald Mah

      Ronald Mah's website- www.ronaldmah.com

      Smashwords Edition, License Notes

      This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

      ****

      Abstract:

      The therapist must anticipate complications- anticipate uncovering a can of worms, that confuse and overwhelm the partners and therapy. Issues arise or intrude that ignite intense emotional reactivity from beneath the psychic surface to make easy living difficult if not impossible. Often minor issues become major issues over time and/or with other contributing factors. The therapist is tasked to uncover how issues interact in complex, nuanced, and fluid ways to influence emotions, thinking, psychology, spirituality, and behavior. Therapy must adjust to discovering that the direction of lower emotional reactivity to reduce problematic behavior although appropriate is complex to activate. Therapy can direct clients how their emotional reactivity including as expressed in bipolar disorder, post-traumatic stress disorder, developmental trauma disorder, sexual trauma, self-medication, and personality disorders function as third partners in the couple that cause seemingly illogical behavioral changes. PTSD not just in warzones but also in family experiences, developmental trauma disorder, and the Predator-Prey-Witness triangle (aka Combat PTSD Trinity) are examined in particular for how they complicate later relationships. Gottman's Four Horsemen of the Apocalypse along with other theories of psychodynamic, attachment, family systems, and family-of-origin help direct important psychoeducation, therapy, and the partners' change. The therapist is guided how to anticipate and use inevitable therapeutic failures as well as issues of chronicity, grief, loss, and self-medication due to high emotional reactivity to hone and adjust the conceptualization, strategy, and direction of therapy.

      link to Table of Contents

      ****

      Linked Table of Contents

      Abstract

      Chapter 1: MAJOR COMPLICATIONS TO COUPLE THERAPY

      Chapter 2: FOCUS ON EMOTION

      Chapter 3: FOUR HORSEMEN OF THE APOCALYPSE

      Chapter 4: INTENSE EMOTIONALITY- BIPOLAR DISORDER

      Chapter 5: PSYCHOEDUCATION FOUNDATIONS TO TREATMENT

      Chapter 6: CHRONICITY, GRIEF, AND LOSS

      Chapter 7: SELF-MEDICATION INTERFERING WITH COUPLE THERAPY

      Chapter 8: POST-TRAUMATIC STRESS DISORDER (PTSD)

      Chapter 9: DEVELOPMENTAL TRAUMA DISORDER

      Chapter 10: DOMESTIC & FOREIGN WARZONES

      Chapter 11: SEXUAL TRAUMA

      Chapter 12: PERSONALITY DISORDERS

      Conclusion: THERAPEUTIC CAUTIONS

      Bibliography

      Other Books by Ronald Mah

      Biographic Information

      ****

      **Author’s Note: Other than public figures or people identified in the media, all other persons in this book are either composites of individuals the author has worked with and/or have been given different names and had their personal identifying information altered to protect and respect their confidentiality.

      Chapter 1: MAJOR COMPLICATIONS TO COUPLE THERAPY

      Molly had a problem at work. One of the newer employees was given a prime assignment that she thought she deserved. When she told her husband Cole about it, he asked if she was in good standing with her boss. She said she was. She'd been there for a long time and had a lot of important responsibilities. Her last review went very well. Molly had gotten a raise recently. Her boss had pointed her out as an exemplary employee when the big boss visited the department. After asking some more about her value to the company and her relationship with her boss, Cole came to the conclusion that Molly, you don't have anything to worry about. Relax. Cole described it later to the therapist, It was like I sold the children, flushed the wedding photos down the toilet, or abandoned her to slave traders! She exploded on me! She screamed that I was a jerk… an insensitive jerk. That I never… NEVER support her. Damn, I knew I might not get this 'supportive' stuff right and catch a little flak, but damn I didn't think I'd get nuked! I sure as hell didn't think I should have gotten massacred for trying to help. Something small and seemingly insignificant turned out to be huge, ugly, and explosive. Cole added, It should be simple. Molly tells me about a problem. I listen… and I do listen. And then give her some feedback… an opinion. But damn, it gets crazy. Don't get me wrong, this don't happen all the time. That makes it worse kinda, cause then I don't expect it. But then I step on some kind of emotional landmine and I get blown to pieces! I say anything and it opens a nasty can of worms.

      Molly has a problem at home. There are other times she gets annoyed that Cole does not get it. As she tried to explain how she felt slighted, Cole just could not make sense of it. Molly ended up feeling dismissed. Then she got mad at Cole. Now, he was really sure that Molly is irrational. She got upset over nothing serious at work and then, she got mad at him for pointing out her illogical reaction to the situation. From perplexed at her line of thinking, he got upset at being crucified for being logical. He argued how she's doubly illogical. And he's mad about it, but his anger is justified unlike her anger. In therapy, Cole tells the therapist that his wife Molly is too emotional. He is logical while she is illogical. Molly asserts the importance of her perspective and the associated feelings. In fact, what is important about her perspective is the emotional valence attached to it. In fact, Cole not getting her and his disagreement with her is important because he is her husband. If it were almost any other person, it would not be important.

      The therapist frequently finds that a couple does not readily fit into some model of therapy or respond to common interventions and feedback. Of course, Molly over-reacted to Cole's response. The therapist could guide Cole in how to communicate with Molly. And take the chance to challenge Molly's reaction as excessive. If the therapist judgment and action so limited, then Molly not only had a problem at work, that became a problem at home with Cole, but now Molly has a problem in therapy with the therapist! The therapist cannot just conduct regular therapy when major complications exist in the couple or one or both partners. 1 + 1 + 1 does not equal 10. The couple's can of worms is open and there are lots of slimy issues to deal with. There was one- the situation at work, another one- Molly wanting something from Cole, and the last one- Cole trying to give Molly what she wanted. Instead of adding up, it went crazy. However, psychological algebra knows that 1 + 1 + 1 = 3, not 10. What makes it add up? It has to be some X factor. Basic psychological algebra says 1 + 1 + 1 + X = 10. What is the X that makes it make sense? What is the underlying or other issue… the compelling factor that caused Molly to become so hurt and then, so angry? Metaphorically, that is the task of diagnosis in therapy. What should work will work! What should work will work… unless there is more to it. Molly is not crazy nor is Cole. Something or some things have complicated what could or would otherwise be relatively simple. Couple therapy that does not find and open the partners' can of worms is simpler to conduct. However, couples without complex underlying issues probably do not need to come to therapy.

      The therapist should anticipate or be on the alert for various complications in the couple therapy. Complications or challenges can overwhelm the therapist and frustrate the couple. Yet, to the experienced couple therapist such complications or challenges are not extraordinary issues but commonplace when working with couples. If they do not exist, the couple would have arguably been functioning sufficiently successfully or productively enough not to need the assistance of couple therapy. A couple such as Molly and Cole are sensible enough to communicate reasonably, follow boundaries, and otherwise operate functionally. And, they usually do so effectively and efficiently. That is, they do until they don't! In their life and relationship issues arise or intrude from beneath the psychic surface to make easy living difficult if not impossible. In some situations, complications or issues arise within the process of therapy and other times, individual issues had complicated the couple's relationship and then complicate the therapy. More often than not, there are multiple dynamics that contribute to relationship dysfunction and the complex therapeutic process. There are arguably minor complications that an individual can successfully deal with. However, the distinction between a set of major to supposedly more minor complications to the couple's relationship is questionable. Often minor issues become major issues over time and/or with other contributing factors. Since the issues interact in complex, nuanced, and fluid ways to influence emotions, thinking, psychology, spirituality, and behavior, the therapist is tasked to determine the most relevant issues from the spectrum of possibilities.

      The therapist overtly seeks and opens the can of worms. Some issues may be less influential. However, for an individual, couple, or family, one or more of those issues may be the major influence or influences upon their processing and functioning. This book examines some of the major complications or issues that commonly are of extreme impact upon an individual, couple, or family. In particular, issues that involve high emotional reactivity are considered. The therapist will often find that exploration in one or more areas will direct further examination of important, experiences, conditions, and disorders. Jansson

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