In the world of couples therapy today there are three big players, these are Imago Relationship Therapy developed by Harville Hendrix and his wife, Helen Kelly Le Hunt; Emotionally Focused Therapy, developed by Sue Johnson and Les Greenberg and Gottman method therapy developed by John and Julie Gottman. A variety of other approaches exist but none of them have generated the kind of enthusiasm and widespread support as the above approaches.
As a specialist marriage and relationship counsellor I have personally trained in all three of these approaches and am often asked by people contemplating training my thoughts on which approach I would recommend; or by practitioners of a particular approach for my endorsement of their particular model. From my perspective I see each of these approaches as having particular strengths and weaknesses and in an ideal world everyone would train in all three of them. What I would like to do in this article is to highlight what particular strengths and weaknesses I see in these approaches, with a view to informing others trying to make their choice. I should say by way of full disclosure that I am significantly more trained in imago relationship therapy.
When I think about what I like most about imago relationship therapy it has to be the dialogue. The story goes that Harville and his second wife Helen were engaged in conflict and Helen told Harville that they should take turns speaking and listening. They must have been a relatively OCD couple because they took this very literally and literally repeated every single word that their partner said word for word. And what they discovered was that something magical happened in their connection when they did this. This approach has been strongly validated by a series of findings in neuroscience which showed that the close gaze and mirroring activates mirror neurons in the brain. These mirror neurons are widely considered to be the basis of the human/mammalian capacity for empathy. Other findings indicate that seasoned practitioners of dialogue experience a brain state that is similar to meditation. All of our team have some training in Imago Relationship Therapy.
For a large number of clients, they may experience this in the first session. The core feature of the typical imago session is a sense of peace and calm stillness and deep listening. For a lot of clients this is incredibly powerful because it is a powerful counterbalance to the fear that they had coming into counselling that it would simply be an emotional boxing match. In my experience imago practitioners tend to be very passionate about the work they have done and it does seem to be work that they use practically in their own life. This has certainly been my own experience. It’s also noticeable that even clients who just are mirroring in the client sessions and don’t practice their homework, still notice a significant improvement in their ability to listen more deeply to each other. The question that remains because of the lack of research is how long this effect lasts for. It should be noted that this is a weakness present in all of the main models of couples counselling book which is a significant relapse rate among couples.
The weaknesses of the Imago. Imago is a lot easier for avoidant clients (often males) because the emotional intensity is lower it tends to help avoiders reduce their flooding and arousal (getting upset). This can be a strength of the model as the maximiser is so grateful to see the minimizer relax and opening up that they will cope with what they find difficult about the model. For maximisers, or insecurely attached ambivalent clients, they often find it difficult to manage this slower pace brought on by the need to mirror every word. A skilled imago practitioner can often handle that extremely adeptly and help the couple see the payoff for persisting, however there is a group of clients in my experience about 15 to 20% who simply do not love or enjoy the imago dialogue in my experience the most common reason for this is having highly intellectual or cognitive clients who don’t understand why they need to repeat word for word and so it’s possible to get into a bit of a power struggle or to have someone checking out because they simply don’t understand why they are mirroring word for word. Another problem with the dialogue process, is that couples often experience a sense of bliss in the connection in the session and then they go home fall into conflict and it often feels worse because they have just experienced a sense of love and connection. Some clients also so enjoy the newfound sense of peace and harmony that they now want to avoid conflict so that they don’t rock the boat and sometimes need to be coaxed and reassured that the dialogue can be used to help them deal more safely with difficult conflict and help them find that place of deep connection again afterwards. As you can see a lot of the weaknesses of imago are actually tied to its strengths but the fact remains that there is a definite subset of clients who don’t enjoy the imago dialogue process.
Gottman method therapy is based on 40 years of research by John Gottman and his wife Julie. Gottman is a psychologist with a background as a mathematician and I believe that the research he has done is absolutely crucial to success in couples therapy. Gottman started his research by setting up an apartment at the University of Washington and having couples come and stay for the weekend where they were recorded, their heart rates measured, their galvanic skin response measured (this is a good indicator of stress) and then they followed the couples longitudinally to find out which couples stayed together and which couples divorced. Gottman’s success was indicated in over 10 different research studies where he was able to predict with over 600 couples which couples would divorce in which couples would stay together in the next four years, with over 90% accuracy. He was able to specify four specific behaviours that predicted problems, that if not addressed would lead to a divorce. So the obvious strength of Gottman method is the fact that it is empirically evidence-based, and highly accurately predictive. I have found that using and referring to Gottman’s research really helps build credibility and trust with sceptical clients. Gottman’s dialogue and repair interventions are very simple and clients find them very easy to implement and incorporate. As a form of therapy to learn Gottman’s approach is definitely the simplest. Another strength of Gottman’s approach is that it can be easily incorporated with imago relationship therapy. Ironically Gottman is publicly a significant proponent of EFT. In my experience however EFT in its most pure form does not really leave much room to utilise Gottman’s work. All of our team have at least Level 1 training in Gottman Method - most have level 2.
What I see as a weakness in Gottman’s approach is that Gottman has significantly less aspiration for connection between his couples. He has said somewhat disparagingly that some couple’s therapy work (in other models) is about helping couples achieve nirvana together, but his goal was that a couple could sit at a cafe and have a croissant together. As a result, the therapy interventions are simple but in my opinion significantly less emotionally connecting than either of the other two approaches. Again it is possible for a skilled therapist and a willing couple to go to an emotionally deeper place but it is less guaranteed or certain with Gottman’s approach. Having said that for a more avoidant client the more low-key fact-based approach can be an appealing way to start.
EFT is an attachment based, couple’s therapy that posits that in relationships partners act as secure bases for each other. EF T is an approach that tends to sit most comfortably for therapists who are used to working with individual clients as the structure and format is quite similar to working with an individual client. Both Gottman and imago require the therapists to hold some organised communication structures like a coach, and this can be uncomfortable/unfamiliar for therapists. The strength of EFT is that it is the easiest therapy for the couple to do primarily because all of the work is done by the therapist. EFT with a skilled therapist will feel incredibly safe and connecting for each client in their connection with the therapist. The therapist acts like an ideal parent with two upset or wounded children validating and empathising with the importance and reality of their painful experience and helping them communicate that to each other without really requiring them to modify their message at all. The early sessions tend to be relatively conflictual and emotional. However, the clients feel incredibly understood and connected to the therapist. This approach is far more appealing and in line with the longings and hopes of an ambivalently attached partner. However, if the therapist is able to make a good connection with the avoidant partner in the first session the therapist becomes a secure base for the avoidant partner helping them tolerate their partner’s distress. Another strength of EFT is that they have continued a great deal of research. This has done a lot to promote their credibility as an approach to working with couples.
The weaknesses of EFT are that as an approach it is highly dependent on the individual skills of the therapist. A four-day training called an externship enables a therapist to call themselves an EFT practitioner. The externship involves less than two hours of actual practice time. It is my view that it is irresponsible to allow someone to identify themselves as a practitioner of a highly complex approach to therapy with so little practical experience. I feel reasonably strongly that a level II EFT practitioner should be the minimum level of experience required to be identified as an EFT practitioner. Compared with Imago and even Gottman Method the sessions tend to be noisier and more conflictual in the early stages. This increases the likelihood that the couple will become flooded and that the therapist will become flooded too. For me there is also a personal preference in that EFT does a lot of early work and even later work with the couple talking to the therapist and what often happens is you see beautiful moments of connection between the individuals and the therapist and what I would really like to see is that connection happening between the couple themselves. Most of our team has fairly basic exposure to EFT.
Having used all of these approaches I have found that they are all using very similar communication technology in both similar and different ways. It seems to me that there is more similarity than difference between the three approaches in both their underlying philosophical understandings and where they are trying to get to. I have tended to use aspects of each approach with all of my clients altering the mix according to my understanding and perception of what is enhancing the connection between them.
One of my projects for 2017, in collaboration with both our local relate counselling team and an international team of colleagues is to put together an integrated approach to working with couples that builds on the excellent work of Imago, Gottman, EFT, Schnarch, Siegal, Perel and incorporates it with neuroscience and a cross-cultural perspective. It is our hope that by integrating the findings and insights of these great therapists we will be able to develop a more robust culturally intuitive and accessible form of couples therapy that will be adaptive to differing attachment and temperament styles.
By Steven Dromgool
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