Common Problems that Lead to Therapy: Part II (V codes)

by Dr. Rob Burkham

Problems in marriages and other intimate partnerships

Most marital problems are not caused by lack of communication, but by lack of maturity.

Most couples come for help because one or both of them are trying to change their partner and their partner is not changing. This leads to frustration, blame, and anger. Often the member(s) of the couple who want their partner to change try to get the therapist to make their partner "better". If the therapist does take one partner's side and tries to make the other change, therapy will not be successful.

What makes change possible in an intimate partnership is if at least one of the partners is willing to change themselves so that they are different with their partner. They often need to give up on their efforts to change the other. It is not necessary that both partners want to work on themselves but it is easier when both are willing to make changes in themselves and give up on their efforts to change the other.

For partners willing to change themselves, they usually need to work on two difficult projects at once: (1) emotionally letting go of and accepting that their partner is the way he or she is and (2) learning to communicate clearly and without blame to their partner about their own thoughts, beliefs, values, feelings, and hopes for the relationship. This can be very difficult work, particularly if the partner doing the work is in the habit of trying to change the other and has spent little or energy working on themselves.

Divorce or Other Breakups of Intimate Partnerships

Breakups of intimate partnerships are some of the most painful events that we humans experience. People going through them roughly fall in to two categories: (1) those who are initiating the divorce and (2) those who do not want to end the relationship. Those who want to end the relationship often seek help thinking through whether or not they are dong the right thing. They have doubts about getting out and need a relatively neutral party to help them think through whether they are doing the right thing or not. Generally, they do not have as much distress as those whom they are leaving.

Those who are being left often come for treatment feeling an intense combination of anger, guilt, betrayal, and fear. Often they need to work through their pain as someone mourning the death of a loved one. Although no one has died, a relationship and the hopes and dreams surrounding it have died and they need to mourn. When their pain subsides to some degree, they also can be helped by looking at how they got into the relationship in the first place, how they might have contributed to the problems, and what they can work on so that they will choose a healthier partner in future relationships.

Abusive Partnerships

Being hurt physically, sexually or verbally by someone you love is a very confusing and wrenching experience. On one hand, you are bonded in love (or what you thought was love) with this person. You may have been with them many years and you may hope for many more years together. On the other hand, they repeatedly hurt you, control you and demean you. As you succumb to the control of an abusive partner, you can come to completely disrespect yourself.

Getting help is usually a process of regaining your sense of self, realizing that it is not good for you to be controlled by your partner, learning to not need their "love" and learning to move on with your life. This is such a difficult process because you have been bonded to them, perhaps for many years, and you are drawn towards them at the same time you are trying to move away from them. It is a heart-rending experience.

A therapist who appreciates both that you are emotionally tied to your partner and that you are trying to protect yourself can be very helpful. Too often therapists are so frightened themselves by what you have been through that they push too hard for you to get away and are not able to appreciate the forces that draw you towards them. It is up to you (not your therapist) to sort out when, how and if you move away from your lover/abuser.

Child Behavioral Problems

Bringing your child or adolescent for help is made difficult by the fact that your child usually does not want to go for help--it is usually your idea. You are concerned about some behavioral or emotional problem that your child has and you may want your child to want to get over it. But young children are not (with rare exceptions) motivated to get help for their problems. As a result, the change that will come has to come from your efforts, not those of your child.

It is important to go to a therapist who understands children and their problems and can carefully evaluate your child and give you some accurate and helpful information. Your child is not going to do the work to make the changes you'd like to see, even if they want those changes, too. You will need to work towards making the changes, whether that means changes in the way the child is dealt with at school, a need for medication, or changes in the way you parent your child. You may need to learn to be more consistent, firm, and authoritative (not authoritarian!) with your child. You may need to learn to listen better, pay more attention, or be more encouraging to your child. You may need to work on changing yourself and dealing with your own problems before you can be more helpful to your child. When you're on an airplane, the flight attendant will tell you that when the oxygen masks drop down in front of you and you are traveling with a child "put your own mask on first and then assist your child with their mask". If you're not getting any oxygen, you're of no help to them.

About the Author

Robert Burkham, Ph.D. is a clinical psychologist with 25 years of experience doing psychotherapy and 20 years of experience supervising other therapists. He has been a licensed psychologist in the state of Wisconsin since 1982 (License #991) and has practiced in Appleton, Wisconsin for 20 years. He is a member of both the American Psychological Association and the Wisconsin Psychological Association

The Therapy Triangle Robert Burkham, Ph.D. http://www.therapytriangle.com