Looking for couples counselling in Hamilton?

Be pro-active:

As mentioned, couples wait an average of 6 years before seeking couples counselling. Waiting that long can mean that by the time the couple reaches out for support, there are more relationship injuries and more entrenched negative interaction patterns to work through.

To get the most out of couples counselling, be pro-active and reach out for couples counselling earlier on when you are first starting to notice any issues that take away from your ability to get along and feel connected as a couple. 

Be honest:

To help get the most out of couples counselling, it's important to be very honest and straight-forward with your therapist and partner. Your therapist will not judge you. Your therapist can only effectively address issues that are more openly discussed.  Remember to be open and honest, even if you find this uncomfortable or difficult. If this is a challenge, let your therapist know so that they can help.

Listen:

Try your best to use the therapy session to listen to both your partner and the therapist. You will have the opportunity also to be heard and understood, but you will get more out of the process if you focus on listening so that you can change current dynamics and understand yourself, your partner and your relationship better.

Let the counselling room be a unique space for your relationship:

When you attend couples counselling, it's important to use the time productively. Avoid the urge to focus on defending or explaining yourself or your side of the story to help prevent arguing during the session. As a couple, you can argue anywhere. The couples counselling room should not be one of those places because you do not need to pay a therapist to argue as a couple. You are seeking out couples counselling to improve your relationship. If this is an issue, after seeing some of your negative interaction patterns, your therapist will then help you both establish ways to make your sessions more productive. 

Make space for discomfort:

The process of going to couples counselling can feel uncomfortable for many people and may make you feel vulnerable at times. Your therapist will be there to help ease these feelings. As you work through things, be prepared to work on increasing your ability to tolerate some discomfort or feelings of vulnerability. This will help you get the most out of couples counselling and also help you grow as a person and as a partner.

Let the relationship be the client:

Couples counselling is unique in that ideally, the couple or relationship is the client and not each individual. What this means is that the intent is to help heal and improve the relationship. To best help your relationship, each partner must be given feedback on what they can do to improve the relationship. Focus on being open to feedback about what changes you could make to improve your relationship.

Put in the time:

Relationships are often not easy, but they can be the most important and rewarding aspects of our lives. Working towards a more satisfying relationship is worth the time and effort. The more you are willing to spend time attending couples counselling sessions and working on your relationship, the more rewarding the process will be. 

Focus on what you can do:

Very often, couples come into couples counselling with the intent of enlisting the therapist to help change their partner. To get the most out of therapy, and a more successful outcome, it is important to focus on the changes you can make to improve your relationship. If you both start to do this, you will be amazed at what can happen. 

Relationship ambivalence is a common reason that people come to see us in therapy or counselling. Although some level of doubt about a relationship may creep up from time to time, not feeling sure on a consistent basis about whether to stay or leave a relationship can cause extensive stress and inner turmoil for people. Often, except in situations involving abuse, there is not a straightforward or clear answer about whether someone would be happiest staying in or leaving a relationship. 

If you are struggling with indecision about your relationship, consider the following:

🌱 If you are seriously questioning whether to end your relationship, that may be a red flag that something is wrong. People vary in their level of comfort with commitment and their level of self-doubt. If you don't routinely question your relationships but find that currently, you feel uncertain, it may be wise to take that as a sign that it's time to step back and carefully evaluate your relationship.

🌱 Has there ever been physical violence in your relationship? If there has been physical violence in your relationship and you are contemplating leaving, consider that you will likely be much happier (and safer) if you leave the relationship.

🌱 Consider how the relationship makes you feel. If you frequently feel hurt or stressed or torn about the relationship, that may be a sign you would be happier leaving the relationship.

🌱Consider whether there are very significant impasses to conflicting values between you and your partner that are unlikely to change. For instance, do you continually disagree about things and have very different preferences in terms of lifestyle or values? If so, consider that you may be happier leaving the relationship.

🌱 Looking back at the happiest or best time in your relationship, were you truly happy and satisfied? If you weren't, consider that you may be happier leaving the relationship. 

🌱 Have you seriously tried to resolve differences in the relationship? For instance, have you attempted to discuss concerns at a neutral time (not when you are already arguing) and sought couples counselling? If you have, and you continue to feel the same or worse, even more uncertain, consider that you may be happier leaving the relationship. 

🌱 What do very close friends and family members say about your partner and relationship? It's important to feel free to make your own decisions, however, consider that family and friends know you well and may see the situation from a more neutral or unbiased perspective because they are not emotionally attached to your partner and those people in your life tend to want what's best for you. 

What to do if you reflect on the above questions and you still feel uncertain?

1) Consider rating your level of ambivalence (e.g., 50% want to stay and 50% want to leave, or 70% want to stay and 30% want to leave).

Use this rating to monitor your ambivalence over time.

2) Consider giving yourself a timeline to make a decision (e.g., two months, six months or a year). Establishing a timeline can help reduce day-to-day turmoil over feeling ambivalent.

3) Consider therapy or counselling. A therapist can help you by exploring factors that may help you decide. Sometimes just talking about your feelings and concerns is not enough. It is also possible to experientially work through your ambivalence through two-chair work, parts dialogue and/or EMDR to target and work through feelings of ambivelance. Contact us for more information.

4) View the resources on relationship indecision below for additional assistance.

Relationship indecision resources:

Books:

Too Good to Leave, Too Bad to Stay, By Mira Kirshenbaum. 1997

Stay or Leave? Six Steps to Resolving Your Relationship Indecision. By Beverley Stone, 2012.

Couples are facing increased stress and pressure because of the pandemic. Many couples are finding that there has been increased tension, and even conflict, in their relationship. 

Some of the challenges that couples face because of the pandemic include:

🌱 Having to spend more time apart because of physical distancing, or because of someone being more vulnerable to illness or working in a high-risk situation.

🌱 Having to spend much more time together. 

🌱 Having to manage without the usual supports from friends or relatives.

🌱 Having to cancel plans and deal with disappointments.

🌱 Having kids at home full-time for an extended period and having to navigate increased pressures around co-parenting. 

🌱 Having to cope with the impact of job loss.

All of these scenarios represent a required adjustment or increased stress on people's relationships.

To help cope with these increased pressures to help minimize the negative impact on your relationship, consider the following tips:

🌱 Keep work-life balance: Stick to a scheduled routine around work and set boundaries for time devoted to work, and time devoted to the relationship or family.

🌱 Plan: Ensure to plan time together to still do things you enjoy, such as listening to music, going for walks, going for a bike ride or playing a game together. Also, plan ways to keep the kids occupied and how to divide childcare responsibilities if you have kids at home.

🌱 Be mindful of increases in alcohol or substance use: Increased use of alcohol or other substances such as cannabis can lead to increased conflict in the relationship because of heightened emotions. Increased alcohol or substance use can also lead to depleted energy levels, which reduces our capacity to manage stress. 

🌱 Gratitude: Focus on expressing to each other what you are grateful for. Consider keeping a notepad on the counter and take turns writing down things you appreciate about the other.

Couples counselling can assist couples in navigating these new challenges and helping to minimize the amount of disruption caused to your relationship. 

To read about tips on how to manage increased stress on couples due to the pandemic- provided by Psychologist Dr. Jennifer Barbera and other relationship therapists and experts, see 'Lockdown Love Survival Guide'.

By Jenn Struth, M.Psy

Emotion Focused Therapy (EFT) for couples is an evidence based, humanistic, and experiential modality that values attachment and emotion in the treatment of destructive interpersonal patterns (Johnson, 2004). Although EFT for couples was not created specifically to treat infidelity, Greenburg, Warwar, and Malcom (2010), conducted a study using EFT to treat infidelity. 

The study demonstrated positive outcomes for couples by helping them move past the betrayal and make progress towards forgiveness (Greenburg, Warwar, and Malcom, 2010). This modality has substantial empirical validation based on years of research on attachment theory and the bond created between not only mother and child, but also romantic bonds between partners (Johnson, 2014). 

EFT for couples provides the therapist a guideline for what is important, what works well for couples and what is needed to create a healthy relationship (Johnson, 2014). Change happens in the present moment with the therapist guiding the couple to go deeper into their emotional experience, understand how they make sense of these experiences and assist them in communicating these feelings to their partner (Johnson, 2014). With deep emotional work the focus must be creating safety during each session through validation and support from the therapist (Johnson, 2014). 

Overall, the goal of EFT for couples is to guide the couple to change the way they argue, negotiate, increase satisfaction, and create a more secure emotional bond between the partners (Johnson, 2014). 

EFT for couples can be broken down into five major steps the therapist must focus on throughout intervention. The first step is to maintain focus in the present moment, both on an individual level and between the partners, and the therapist must keep the focus on current emotions and patterns of engagement (Johnson, 2014).

Second, the therapist must deepen the emotions being experienced during interactions by asking the couple to turn inward, focus on their bodily sensations, slowing them down, and encouraging a deeper look into their primary core emotions (Johnson, 2014). 

Third, the therapist must clarify the emotion and create a new interaction based on the primary core emotion that was experienced (Johnson, 2014). 

Fourth, the therapist guides the couple through this new process of interaction by asking each partner what it was like to engage in a different way, creating a corrective emotional experience (Johnson, 2014). 

Lastly, the therapist asks the couple to focus on the new process they created using the core emotions felt, thereby creating confidence for them in their ability to shape the way they interact (Johnson, 2014). The sequence of these steps will be repeated with different emotional intensity until each partner feels heard, understood and safe (Johnson, 2014).

EFT for couples highlights three basic stages of change during the therapeutic process. The first stage of change focuses on de-escalation of the couple's negative cycle of interaction at the onset of therapy, targeting behaviours such as mutual withdrawal or critical demanding of resolution followed by withdrawal (Johnson, 2014). Using an attachment style framework, the therapist can explore this negative cycle with the couple and highlight how each partner can raise attachment fears and insecurity in the other (Johnson, 2014). 

At the end of de-escalation, the couple can come together and help each other to recognize this cycle as problematic, rather than internalizing or blaming each other, therefore allowing the cycle to cease (Johnson, 2014). The initial de-escalation allows for a secure base to go deeper into the relationship during the second stage of change. Here, the therapist guides the couple to restructure their bond by creating powerful conversations during sessions (Johnson, 2014). 

Guided by the therapist, both partners express their fears about the relationship, such as rejection or abandonment, in a manner that brings the couple closer together and allows them to respond to their partner's fears in a more comforting way (Johnson, 2014). Once each partner can communicate their emotional needs, the bond can shift towards security allowing for open and responsive reactions (Johnson, 2014). 

The third stage of change can be characterized as the consolidation of what has been discovered through therapy and focus on the future (Johnson, 2014). The therapist guides the couple to look at the changes made and create a story of how they became stuck in a negative cycle but were able to work together to solve the problem (Johnson, 2014). 

EFT COMBINED WITH EMDR 

Emotion Focused Therapy (EFT) for couples can also be combined with Eye Movement Desensitization and Reprocessing (EMDR) as intervention for couples working through the trauma of an affair (Negash, Carlson, & Linder, 2018). In the context of treating infidelity, both EFT and EMDR guide the couple to revisit the betrayal, explore and process deeper emotions, and modify the narrative and emotions still attached to the memory of the affair (Schade & Sandberg, 2012). 

The therapist must use an EFT framework for couples and introduce EMDR only after the couple has identified strong secondary emotions and have demonstrated non-judgmental attunement and reassurance to each other (Negash, Carlson, & Linder, 2018). Couples who engage in criticism, defensiveness, contempt, and stonewalling will likely not respond positively to the introduction of EMDR as safety in the therapy room is necessary for effective processing (Negash, Carlson, & Linder, 2018). 

The therapist’s decision to introduce EMDR is based on the identification of either one or both partners experiencing persistent trauma symptoms related to the infidelity (Negash, Carlson, & Linder, 2018). In the absence of trauma related symptoms (e.g., reliving or ruminating on the affair or intense emotional distress still tied to the affair), the therapist would usually continue therapy using an EFT framework without the addition of EMDR (Negash, Carlson, & Linder, 2018).

EMDR as a stand-alone treatment is delivered in an eight-phase protocol that attends to past traumatic events, current situations causing disturbance, and creates templates for modification of problematic behaviour (Shapiro & Brown, 2019). Phase one and two focus on gathering information from the client, fostering a strong therapeutic alliance, and creating internal safety through introduction of resources for self-soothing (Shapiro & Brown, 2019). 

Phase three through six is when the therapist and individual work together to identify a target (e.g., a memory or a trigger) and process this using the EMDR procedure (Shapiro & Brown, 2019). Creating a target involves the individual identifying vivid imagery of a trauma related memory, the associated negative self-referencing belief, and related emotions and bodily sensations (Shapiro & Brown, 2019). 

During this time, the individual will also work with the therapist to create an alternative positive belief that will be used to replace the negative cognition (Shapiro & Brown, 2019). The individual is subsequently instructed to focus on all three aspects of the target while simultaneously engaging in bilateral stimulation (Shapiro & Brown, 2019). 

Bilateral stimulation, or what EMDR also calls sets, can be achieved through back and forth eye movements, taps or tones (Shapiro & Brown, 2019). After each set, the individual is instructed to let their mind go blank and notice whatever thought, feeling or image of the memory comes to awareness (Shapiro & Brown, 2019). 

Sets will be repeated until the individual reports no distress related to the target, at which point the focus is turned to the previously agreed upon positive belief (Shapiro & Brown, 2019). Phase seven and eight focus on closure and re-evaluation of the target to ensure no distress is lingering in the body related to the trauma target (Shapiro & Brown, 2019).

The combination of EFT and EMDR for couples consists of introducing EMDR during specific stages of change in the EFT framework (Negash, Carlson, & Linder, 2018). The couple must first identify and deconstruct their negative cycle, the partner who strayed must openly admit to the affair, and any long-standing power imbalances are addressed (Negash, Carlson, & Linder, 2018). 

Each partner must feel they can trust themselves and their partner to refrain from engaging in the already identified negative cycle during the EMDR sessions (Negash, Carlson, & Linder, 2018). The therapist must remain attuned to the couple’s interaction and attachment-based trauma symptoms throughout EMDR as both partners are in the room during processing (Negash, Carlson, & Linder, 2018).  

After attending to a couple's concerns at the outset of each session, the EMDR protocol is utilized (Negash, Carlson, & Linder, 2018). One partner actively engages in EMDR while the other functions as a witness and source of support (Negash, Carlson, & Linder, 2018). 

The witnessing partner must remain attuned and empathetic with what their partner is experiencing, allowing the witness to better understand the complexity of their partner's reaction to the affair (Negash, Carlson, & Linder, 2018). 

The witnessing partner is asked by the therapist to reflect on the impact their actions had on their partner and express their new understanding and compassion to their partner to promote safety and repair (Negash, Carlson, & Linder, 2018). 

After engaging in EMDR the couple should have a deeper understanding about their own and their partner’s emotional process and increased emotional attunement. 

Through this process the couple also creates a shared narrative of the affair that highlights the strength of the relationship (Negash, Carlson, & Linder, 2018). Couples who successfully complete EMDR may find it increasingly safer and more effective to engage in EFT and develop a deeper secure bond with one another (Negash, Carlson, & Linder, 2018).

Book an appointment with Jenn Struth

References:

Greenberg, L., Warwar, S., & Malcolm, W. (2010). Emotion-focused couples therapy and the facilitation of forgiveness. Journal of Marital and Family Therapy, 36(1), 28–42. doi: 10.1111/j.1752-0606.2009.00185.x 

Johnson, S. M. (2014, February 19). What is emotionally focused therapy (or EFT)? [Video]. Youtube. https://www.youtube.com/watch?time_continue=15&v=xQCg-jC25fo&feature=emb_title

Negash, S., Carlson, S. H., & Linder, J. N. (2018). Emotionally focused therapy and eye movement desensitization and reprocessing: An integrated treatment to heal the trauma of infidelity. Couples and Family Psychology: Research and practice. Advance online publication. http://dx.doi.org/10.1037/cfp0000107 

Schade, L. C., & Sandberg, J. G. (2012). Healing the attachment injury of marital infidelity using emotionally focused couple’s therapy: A case illustration. American Journal of Family Therapy, 40, 434– 444. http://dx.doi.org/10.1080/01926187 .2011.631374 

Shapiro, R., & Brown, L. S. (2019). Eye movement desensitization and reprocessing therapy and related treatments for trauma: An innovative, integrative trauma treatment. Practice Innovations, 4(3), 139–155. https://doi.org/10.1037/pri0000092