I recently had an interesting discussion with a panel of colleagues about the value of couples therapy. The question was this: "Can all couples, even those who are happily married, benefit from working with a skilled couples therapist?"
Some of my colleagues made interesting points about prevention and maintenance and how pre-emptive therapy may give happy couples a chance to make sure they are taking good care of their relationship. My colleague's angle is compelling. Why wait for the problem to arise? Why not nip it in the bud by working on the relationship before potential problems have a chance to surface? Clinician's often site John Gottman's research that most couples are unhappy for years before entering therapy. Gottman likens waiting too long to seek therapy to walking around on a broken leg for years and therefore inflicting permanent damage that could have been fixed much more effectively in the beginning.
I agree that if a problem arises in a marriage, it is optimal to seek help sooner rather than later. However, achieving a happy marriage is a tremendous feat. For those who get there organically, I believe they have created something precious and important. If there is no reported problem, such as infidelity, poor communication, or loss of sexual desire, I believe a happy marriage does not necessitate a therapist's intervention.
I grew up with a surgeon for a step-father and his motto was: "If it's not broke, don't fix it." This message informs my perspective. My observation is that if both halves of a couple report that they feel happy and satisfied with their marriage, they have built something substantial and the value in seeking to tweak or modify such a union seems limited.
Where I do view universal value in some form of pre-emptive relationship counseling is during a couples' engagement, as they prepare to marry. Marriage is perhaps the biggest single decision an individual will make, and it's ramifications are extraordinary and lasting. While statistics are limited on the benefits of pre-marital counseling, an interesting study recently reported in the New York Times described significant benefits of brief counseling before or early in marriage. The study compared the CARE and PREP methods of couples counseling as well as film viewing followed by guided discussions. The CARE approach emphasizes building empathy while the PREP approach emphasizes communication skills. The film approach was extremely hands-off with minimal clinical involvement. All three groups were half as likely to separate or divorce three years later when compared to the couples who did not engage in any pre-marital intervention.
It is useful to make a slight distinction between therapy and counseling. Therapy is defined as "treatment intended to heal or relieve a disorder." Counseling, is defined as "the provision of assistance and guidance in resolving personal, social, or psychological problems and difficulties." Counseling's definition does not assume that a "disorder" must be present. Hence we refer to "pre-marital counseling" not "pre-marital therapy".
Whether couples seek counseling through their place of worship or through a trained clinician, pre-marital counseling provides a valuable platform to ensure that each person knows as much as possible about the other before making what will hopefully be a life-long commitment. (The clinician should have either certification or a license specific to couples therapy.)
Pre-marital counseling should be a place where each person acknowledges what they anticipate will be their relationship's greatest strengths and greatest challenges. A common fantasy that engaged couples may have is that certain challenges will resolve or disappear simply through the act of marrying. This is rarely if ever the case. In fact, most couples struggle with the same challenges throughout their marriage. What distinguishes the healthy marriages is an ability to take these challenges to a different level so that, over time, they become less problematic. Pre-marital counseling can be a safe place to identify these assumptions if they exist and to explore such assumptions sooner, rather than later.
For many couples, pre-marital counseling is a positive, affirming and bonding experience that enhances their commitment to marry. It is so easy to get carried away with meaningless but pressing details such as which cake flavor to choose, what floral arrangement works best and whether to send out save-the-date notifications. Pre-Marital Counseling can help couples keep their priorities grounded and focused on what the wedding preparations represent -- the decision to build a life together.
If you are engaged or contemplating engagement and do not plan to pursue pre-marital counseling, be sure to read Elizabeth Gilbert's Committed: A Skeptic Makes Peace with Marriageand Monica Mendez Leahy's 1001 Questions to Ask Before You Get Married. Many of my clients have found these resources incredibly helpful. If you are happily married but toying with the idea of couples therapy, be sure to read Elizabeth Weil's book No Cheating, No Dying: I Had a Good Marriage. Then I Tried To Make It Better.
Sometimes a good book can be a great friend and can save you time, money and emotional energy.