MC strategies

[maxsterling]

Thread is for a discussion of Marriage Counseling strategies and related issues.

Background:
- W wants us to do MC again.  She scheduled a teleappointment for this afternoon.
- We have seen 3 other MC in the past.  The first we went maybe 4 sessions, W claimed the T "took my side" and "had a crush on me".  After that I told W if she wanted to continue that she can find a T of her choice and I would go.
- 2nd MC we saw for over a year.  W liked her, but I felt we spent less time working on relationship issues and more time working on W individual issues.  Not necessarily bad, because IMO most of the relationship issues are impossible to separate from Ws issues.
- 3rd MC I thought was more constructive regarding relationship counseling, and I felt actually challenged W that some of her behaviors were at issue.  W then decided to quit abruptly after maybe 4-5 sessions.

Today's MC was chosen by W.  I have little faith that it will be any different.  I haven't met with my new T yet - that is tomorrow.  W seems to have anxiety about todays T session.  Last night as I was falling asleep she started about how if I demonize her in front of the T she will hang up the call, how I did that in the past (I don't think this is true - I think I have been as objective as possible).  W says that would be unfair to do to a new T that does not even know her.  Then she said that if I can do MC with her and not demonize her that the relationship is over.

Thoughts?  Any mention of anything that has gone one recently W would lead W to think she is being "demonized".  My feeling is for now just see where she goes with things (go down her own dark path so to speak), and work with that.  In other words, just answer questions. 

A backside - yesterday was the twins' birthday, and it was MISERABLE.  Pandemic was part of the reason, but I am now recognizing that this will always be a dysregulation day for W.  Childbirth was nearly fatal, W has a lot of shame/guilt over that.  W wound up spending the morning cursing at me and the kids, made D4 cry.  I took the kids outside to play away from W, while W spent probably an hour or more on the phone with T.  I did what I could to ensure the kids had an okay day.  The issue that set W off was when D4 said she wanted me to do something for her and not mommy.   Wound up finally doing something with the kids as a family in the afternoon, and eating cake, opening gifts.   Basically I felt W made the day about her.  W has mostly calmed down this morning, but still has little patience.

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[formflier]

OK..interpretation. 

"I would like to do MC and not talk about the things I'm doing that are not healthy in the relationship."

Why not start out the session by going over past therapy and allowing you and your wife to be upfront about your anxiety over the current MC starting again.

I would ask your wife...in session, about her concerns about what you may say.

My advice to you.  Be kind and direct.  Perhaps come across more as "befuddled"...than "judgmental".

"Hey babe..what did you want me to understand about your concerns regarding what or how I might say things to MC.  Did I hear you right that you would hang up the call?"

Maybe "curious" is a good way to be.

Best,

FF

[GaGrl]

FF answered first, and I was about to suggest the same approach. I think it is important for a new MC to hear the prior history of marriage counsrling, along with an assessment of the experience by each of you.

And having your W express her concerns to both you and the MC puts it on the table -- keep it transparent.

I like the curiosity approach...no blame or shame.

What she "feels" about demonizing is all about her shame.

[maxsterling]

Good thoughts.  I was thinking the same thing.  I am thinking something like this:

"You are now the fourth therapist we have seen.  Two were just a few sessions and did not work out.  One we had for awhile and I think both myself and W found her helpful.  Of course, our situation has changed now with new stresses such as children."

My hope is that that the T will then ask both W and myself about the Ts that did not work out, and will open an constructive discussion.  I think it is very important for W to mention what she thought was wrong with the previous Ts.

Thoughts?

[kells76]

My hope is that that the T will then ask both W and myself about the Ts that did not work out, and will open an constructive discussion.  I think it is very important for W to mention what she thought was wrong with the previous Ts.

I think if you can squeeze in that the new MC is MC #4, that will probably alert the T that there's some, um, history.

One idea is that you can spend a lot of these first sessions "giving space" to your wife. She may feel desperate to establish that "She is fine, she's not the problem, doesn't want to go over the past, doesn't want to be blamed" etc. That also seems like it would alert the T that there's some interesting stuff happening.

What if you gave W all the room she wanted to say all the stuff she wanted about how she's fine and the other T's were the problem? Not trying to jump in and "clarify" stuff. If the T steers the dialogue to you and asks for input, you can keep it brief and honest about you and yourself alone. Maybe keep this first session free of your personal "observations" about your W. I feel like she will probably share WAY more about herself than she thinks she is, just by "proving" she is "fine".

And, of course, if/when it's needed to comment on something from W, use the suggestions from FF and GaGrl of "wanting to understand her" / "wanting to make sure you get what she's saying".

I'd give W a lot of... rope, as it were, by giving her space/time/priority in this meeting.

I think that a 1st session where W "takes up space" proving she is fine and blaming past T's, and where you occasionally model "intent to understand", will tell the MC a LOT about what's going on.

[formflier]

"You are now the fourth therapist we have seen.  Two were just a few sessions and did not work out.  One we had for awhile and I think both myself and W found her helpful.  Of course, our situation has changed now with new stresses such as children."

Big picture..don't waste time and also don't directly trigger your wife's shame.  If she triggers it herself...that's not in your control.

I would suggest

"You are the fourth therapist we have seen over X years.  One lasted Y time and I believed it was productive.  I still don't understand the ending of each of the prior three.  I hope we can be proactive and discuss how to have a productive MC experience."

Then sit back, let your wife answer.  Don't argue about why she quit before.

Stick to the future.

"Can we agree as a group that if someone believes MC is becoming unproductive, we discuss this as a group before anyone stops participating?" (again...be curious...there will be a big chance for you to sound like a lawyer cornering a witness, stay away from that...remember, you don't understand this...and you want to)

Listen...if your wife bogs down in procedure or debate...step back.  

When she points at you as "the issue"...curiosity and befuddlement.  

"Oh babe...I believe there was a miscommunication, can we clear that up now?"  (then sit back and let MC deal with the reasons why "it can't be cleared up".

Then pivot to.."You know...I think we can use some strategies for when there is an obvious...unresolvable ..miscommunication?"

Do you get the idea?  Stick with principles.  Stay away from accusations..."she yelled for 30 minutes and turned me into a newt..."

And..Max...we are all glad it got better... (remember to keep it light on your end...light and hopeful)
Best,

FF

https://youtu.be/xzYO0joolR0

[maxsterling]

One idea is that you can spend a lot of these first sessions "giving space" to your wife. She may feel desperate to establish that "She is fine, she's not the problem, doesn't want to go over the past, doesn't want to be blamed" etc. That also seems like it would alert the T that there's some interesting stuff happening.

What if you gave W all the room she wanted to say all the stuff she wanted about how she's fine and the other T's were the problem? Not trying to jump in and "clarify" stuff. If the T steers the dialogue to you and asks for input, you can keep it brief and honest about you and yourself alone. Maybe keep this first session free of your personal "observations" about your W. I feel like she will probably share WAY more about herself than she thinks she is, just by "proving" she is "fine".

Can nearly guarantee that will happen.  If I just stick to answering questions, refrain from making accusations or judgements, W will go on about her issues.  She is usually upfront, she just wants to bring it up from her perspective and in her own words.

[maxsterling]

Do you get the idea?  Stick with principles.  Stay away from accusations..."she yelled for 30 minutes and turned me into a newt..."

Good advice thank you. 

[formflier]

  She is usually upfront, she just wants to bring it up from her perspective and in her own words.

Interesting...

Does she blame or just put it out there?

I think you have good advice here so far, if she really is upfront and "accurate", then I think that will modify what I was going to suggest for "act 2".

Best,

FF

[maxsterling]

I think she is usually upfront about her mental health issues.  Puts them on the table right away.  She downplays them, though, and seems to want validation for them.  I expect:

"I know I have a history of mental health problems, depression, PTSD, severe anxiety, and I am prone to anger.  I have sought treatment for it for years..."  Then it flips around to basically blame me for lacking proper communication skills for dealing with such a person.  Then when the T makes some kind of suggestion regarding boundaries that I already attempt, W gets upset.  So T might say, "when things get heated, maybe he can ask to take a walk for an hour."  That's usually when W will write of the T as taking my side.

I will give W a change to put her stuff on the table and see where it goes.  But I will stick to facts, answer questions, be objective, and positive.

[formflier]

So...have you ever had a discussion about why taking a break is unacceptable?

Maybe that's the strategy/goal.

Where EXACTLY has MC broken down before.  Quickly get to that point and figure out if change is possible. 

If it is..great.

If not...you haven't wasted time and money.

Best,

FF

[Notwendy]

Can I look into my crystal ball-----

When the last MC began to focus on your W's part of the relationship, your W quit abruptly. My bet is that this is going to be her response to any focus on her being in any way responsible for the issues in your marriage. I think this is one reason that any kind of MC that looks at her contribution is going to run up against her denial and shame mechanisms.

There is also the potential drama triangle where she will feel like a victim if the "two of you" appear to her to be forming a bond against her (real or not real)

As much as you would like to put the truth out there, I think you need to give this some time for the W to feel like she has a bond with the T against you.

This may feel counterintuitive, but if it's a skilled T- the T will see this pattern and also recognize the dynamics and help the situation by working with you on "your problem".

Because although we can't change another person, if the T works on changes through you, the dynamics between the two of you might change.

I honestly think this is the only possible way this kind thing can work, because the denial and projection and victim perspective of the pwBPD makes it hard to point out aspects of them they need to change. Yes, your wife is up front about her issues- from the victim perspective. She's the one struggling, she needs help, and love and support...

But true change may not come from affirmation of her point of view and affirming her. But to effectively gain her trust, it may have to be this way to begin with. It can come from having someone turn the mirror on them and show them what they need to change. Between the two of you, I'm going to bet that you might be the one for whom this might be effective.

The T won't get the whole picture in one session. It may take some time for the T to see it. Consider letting your wife tell her story the way she sees it and intervene as little as possible. Smile and nod. Say " honey, I am here to support you and I would also like to hear what you want to tell the T". Then, don't react. She may tell the T how horrible you are, how miserable things are. True or not, let her have her say. Anything else might send her running. Let the T manage this and if after a few sessions you will know how things go with this one. But you are going to have to tolerate being the source and cause of all the problems in her version.

I know you don't want to waste time and money but perhaps time spent letting the T hear your wife out might help, and if not, then don't continue.

[maxsterling]

So it went okay, and a bit as expected. 

T had to ask W questions for "insurance billing reasons".  W called the T, and the T needs to put codes on the bill.  So T needs to know if W has depression issues, etc.  This made W uncomfortable, T recognized this, explained it is for billing, understood the concern, etc.  Had T pressed for more details, I am sure W would have gotten angry and been "done".  T was smart enough to recognize this.

I tried to keep things positive and constructive and stick to real basic, general issues about feeling stressed out, lack of personal time, etc.  T kept things constructive.  I also did my best to not be too "wordy". 

When T knew we both had individual Ts, she suggested only meeting every other week because she wants us to have time to work on our own issues with out own Ts before she gets too deep.

I'm still trying to gauge what W expects out of this.  I got the feeling she was itching to give some kind of detail about how I piss her off and am the source for her stress, but T kept steering things away.

It's not a waste of money or time really on my end, so I am okay with how it went.  Afterwards W said she liked her and liked how she stayed focused.  Then she basically said that she has plenty of her own problems that she wants to keep separate from the r/s issues.

[Notwendy]

Seems like the T handled that. See how it goes. While I agree this could be more about you than her, if there's a way to tone down the conflict, it might be helpful.

[formflier]

I think it sounded liked a good session.  I'm hopeful the T "saw" the minefields she needs to be careful with.

Was your wife upfront about her issues?  Did she say anything that surprised you?

Best,

FF

[maxsterling]

I think it sounded liked a good session.  I'm hopeful the T "saw" the minefields she needs to be careful with.

Was your wife upfront about her issues?  Did she say anything that surprised you?

FF

Because W was the person that arranged the session, she was considered the "insured" and that means the T had to ask her diagnosis type questions for billing purposes.  I am guessing the same has happened with previous Ts.  In other words insurance typically does not pay for relationship counseling, so some Ts get around that if one of the parties has some kind of issue that fits on the chart.  So in that sense, W was upfront about her issues but did feel uncomfortable, and told T that she did not want this to focus on her issues. That's reasonable.

W did mention a PTSD diagnosis, and that probably alerted T to the "minefield".  W did not want to elaborate there, but I could tell that T's direction changed after that. 

W did not say anything that surprised me.  I am a little surprised at what she did not say.  I expected her to list various complaints about me in that I am the source for her problems.  She did say that my behavior "triggers" her, but kept it constructive.