Couples Therapy 2020: New Solutions for Old Problems

Wednesday, September 30, 2020 2:40 PM | Anonymous

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Luncheon Review by Marty Klein, PhD, LMFT

Dr. Marty Klein has been an MFT and certified sex therapist working with men, women, and couples for 39 years. He is an award-winning author and appears frequently in the popular media. Visit his website to learn more about him, and to sign up for his monthly newsletter:

Last fall, the SCV-CAMFT chapter asked me to do an all-day training program on couples therapy. I gladly agreed, and we scheduled it for mid-May 2020.

On May 15 & 16, eight weeks into the COVID lockdown, I gave that six-hour training program—by zoom. I noted how none of us was prepared to support clients while we ourselves were part of an active collective trauma. Regardless of prior experience, none of us expected that we’d be working while struggling with the same deprivations as our clients.

So I spent the first 90 minutes discussing therapy-by-video—which was then still pretty new to most therapists. I admit I don’t especially like video therapy, which feels like counseling with a condom on your head.

I started with logistics, and said we shouldn’t treat our professional needs as temporary. Spend some money, I said, on practical things to make video therapy more comfortable for you. Think about lighting, seating, privacy, the visual background, internet connectivity. Give yourself extra time between sessions, as video therapy is more tiring, both physically and psychologically. 

And think about clinical boundaries—perhaps talking to patients about starting and ending sessions on time, and gently challenging patients who are careless about privacy or interruptions. I discussed some of my own recent frustrations: patients who wanted to drink wine during session, allow their cats to jump on and off their lap during session, and who expected to supervise their kids’ playtime during session. 

With video therapy, unfortunately, some of our tools are diminished or lost. It’s harder to create the norm that clients do nothing else during session. It’s almost impossible to use our body to communicate. It’s much harder to use silence effectively. 

I even talked about one of my biggest clinical losses—my inability to require couples to sit separately, facing each other. On video, couples sit shoulder-to-shoulder and face me, which discourages disagreement and inhibits difficult conversation with each other. This drives me crazy. Of course, not every therapist feels that way.

After a break, I proceeded to discuss a wide range of issues in couples therapy. Here are a few highlights:

I.   Myths about intimacy—which patients sometimes have, too:

  • Gender stereotypes (women are more feeling oriented than men; men want sex more than        women),
  • Good attachment leads to good sex; poor sex results from poor attachment,
  • You can measure intimacy by the amount of time people spend together; by whether they share a bedtime; by how much sex they have; by how much they love each other,
  • Why we shouldn’t accept “more intimacy” as a therapeutic contract too soon.

II.  Communication

  • The importance of couples knowing when they’re discussing feelings and thinking out loud (“Wouldn’t it be great to leave the Bay Area one day?”), versus when they’re discussing policy (“I really want our kids to learn to swim”).
  • What ISN’T a communication problem:
  1. When couples don’t have the same values, or the same vision of the future,
  2. When one or both partners aren’t curious about the other’s reality,
  3. When one or both partners refuses to see anything in psychological terms,
  4. When one or both partners communicate their disrespect for the other by chronic lateness, “forgetting,” breaking agreements, or interrupting.

III.  Managing conflict

  • Dealing with couples who focus primarily on rehashing the Fight Of The Week
  • What does a real apology look like? Why is it important to NOT accept an apology too quickly?
  • Fair fighting:
  1. What are the goals of conflict?
  2. What are the rules of conflict?
  3. Why “bad temper” is primarily a narrative—and how we can reduce its power.

IV.  Labels and categories—patients’ and ours

  • Teaching couples the concept of “narratives”—and encouraging them to see their own,
  • Narratives of powerlessness are especially common in couples seeking therapy,
  • Examples of labels that couples use to avoid discussing their feelings: passive-aggressive; conflict avoidant; emotional affair; porn addict; trust issues. Such categories tend to end conversations,
  • How do therapists collude with the use of such categories, rather than gently insisting that patients describe their actual feelings?

IV.  Infidelity: After an affair, who owns the relationship? 

  • Power dynamics: Does Betrayer now have to do everything Betrayed wants? Has Betrayer incurred a debt that can never be fully paid off?
  • Why the Betrayer revealing every detail the Betrayed demands (which restaurants, how many birthday cards, etc.) is usually a mistake,
  • The Betrayed may feel conflicting agendas: I want to express my feelings AND I may want to explore reconciliation. When expressing your anger and hurt, don’t damage the relationship so much that reconciliation is impossible,
  • Reconciliation can’t happen between one good person and one bad person,
  • The importance of discussing a couple’s sex life—even if they don’t want to.

Along the way I presented several cases, giving examples of helpful responses such as reframing. And yet, COVID was in everyone’s thoughts, so I recalled these century-old words: “The undisguised brutality of our time is weighing heavily upon us.”  –Sigmund Freud (1920), whose daughter Sophie had recently died in the Spanish flu pandemic.

For a copy of my slides, go to


Marty is an invited Master Presenter at this year’s CAMFT Virtual Annual Conference. If you register for the conference, you can attend his live Q&A sessions on September 21 (on intakes) and October 9 (on sexuality).

Zur Institute is launching a 5-session zoom case consultation group featuring Marty starting September 17. For information see

Dr. Klein is the award-winning author of seven books on sexuality and relationships, including the ground-breaking Sexual Intelligence. Psychology Today simply says “To improve your sex life, buy this book.” Dan Savage says Marty's current book on pornography “makes me feel sane.”

Marty appears frequently in the popular media, such as The New York Times and The New Yorker, National Public Radio and The Daily Show. He recently gave two Congressional briefings on evidence-based sex education. Marty’s Sexual Intelligence blog and e-newsletter are frequently cited as sources of innovative thinking about sexuality, culture, politics, and the media.           

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