INITIAL CONTACT WITH MELANIE AND ALEX: A COUPLE IN CRISIS

This blog post will walk you through a couple counseling process, and hopefully allow you to imagine how this process might apply to yourself. If you want to listen or download the audio version of this post follow this link.

INITIAL CONTACT

In this case, since I work alone, your first contact will be directly with me, the therapist, but just so that you know, this wouldn't be the case in a counselling organization where many therapists work together. In  these centres, an administrator will book your first appointment with one or other therapist depending on your presenting issue, and you won't have the opportunity, as you have with me or other independent therapist, to discuss or present your concerns prior to even meeting for the first time. There are pros and cons to the personal or impersonal nature of your first contact with a counseling service, and so this is really a chance for you and your partner to feel already where you stand in relation to counseling and the counselor. Is a more personal, or impersonal process useful to your being helped?

Initial contact is really a crucial event in the therapeutic work, as it triggers the self-inquiry process even before the first time the counsellor and the client meet face to face. 

Now, obviously, the two partners cannot contact the counsellor simultaneously, so one or the other will always take the first step. Usually, it is the partner who is most concerned by the situation in the relationship who makes the first contact, but not uncommonly, the person who calls may also be the partner who is being accused by the other partner of messing things up, needing help, and needing to be fixed. 

When tension surrounds the decision to get counseling or not, sometimes a person will attempt to arrange a joint appointment without consulting his or her partner, so as a means of pressuring him or her to attend. In this case, if the partner who has been pressured into the counseling meeting comes, she or he will feel most likely manipulated or resentful, and in more or less explicit ways will respond uncooperatively. 

Thus, I always ask whether the partner of the person who is calling, knows of the request being made, and if not, I ask the contacting person to not only inform him or her as soon as possible, but also to ask him or her to phone me or email me personally. The other partner can then confirm whether they wish to come, and, since they have already also spoken to me, will not feel at a disadvantage when the first meeting begins.

During initial contact, I always divert any attempt to talk at length about the couple’s problems at the contact stage, though it is sometimes hard to stop the outpourings of an unhappy person who has been holding back worries and powerful feelings, for a long time. I always suggest that it will be best to leave the problem until the session, so that both partners have an equal chance to explain concerns. Most of the time this is accepted without an issue, and even with relief.

Now after these initial exchanges, I will ask the contacting person to book themselves in for a Preliminary Session of 15 to 30 minutes. These preliminary sessions are free of charge, and they are really an opportunity to see, if at core, we click with one another. Feeling our way forward in a mutually consenting way, is always going to be a fundamental part of the decision making process, something I will make my clients get very good at.  

COUPLE COUNSELING AS AN OUTCOME OF INDIVIDUAL WORK

Couple counselling can arise out of individual counselling already taking place. An individual who is unhappy in his relationship, and sees him or herself as the source of the problem, may come to counselling for help in overcoming their faults, hoping to be told how to make his or her partner love him again. Now,  certainly, there are times when the reasons for deterioration in the relationship lies much more with one partner than the other – it’s not always perfectly 50/50 – but in perhaps the majority of instances, both will, to some extent, contribute to the development of harmful patterns of interaction. This pattern is best addressed by both partners to maximize the possibility of change for the better, so unless there are issues of violence or abuse, I always suggest joint counselling at a point in individual counselling when this seems appropriate, often in the second or third session for instance.

INITIAL CONTACT WITH MELANIE

Melanie emailed me to request an appointment for herself and her husband Alex. She said she had become very unhappy in her marriage, and was thinking of leaving Alex. I asked if Alex knew she was asking for joint counselling, and she said he did and that he was keen to participate. I provided her with my link to book a Preliminary Session and saw her three days later. 

Melanie came to the Preliminary Session, but excused Alex for not being there, because she had not given him enough notice to free himself. Melanie then started to say how difficult she found Alex at the moment, and how disappointed she was with his efforts to make things right. I listened to her for several minutes but then had to suggest we wait until the first proper Session for details of the couple’s problems to be given. Alex, after all, might also want to tell me his side, and she agreed. 

Melanie did not need to ask me the regular round of  questions about my qualifications, training, supervision and so on, because her friend Jackie had given her my contact details and she was confident that I would be able to help. We arranged an appointment for a few days later, but I asked that Alex contact me personally and confirm that he was keen to participate. At this stage I also mentioned that if Alex turned out not wanting to work with me that Melanie and I would have to reconsider the whole situation in a proper individual counseling session.

MELANIE AND ALEX: FIRST SESSION EXAMPLE

Melanie and Alex arrived on time and together. Once they were seated, and because of Melanie and Alex's cultural background, I found it was acceptable to use first names, then spent a few minutes talking about  confidentiality and my legal duties as a counselor. I asked for a few details about their history and everyday circumstances, and Melanie explained they met through mutual friends, had been married for eight years, and had two girls aged seven, and six. Alex grinned in that moment and said, "They’re quite a handful" at which point Melanie looked at me, nodded and smiled. Alex said he managed a chain of stores, while Melanie was a nurse working part-time in the local health centre. Both of their sets of parents were alive but the couple saw more of Melanie’s parents than Alex’s.

As well as their length of marriage, family details and jobs, I noted two exceptions to their stories. The first is that both Melanie and Alex seemed to have similar attitudes to their children, loving but unsentimental, and when responding to my questions, they took turns without any sense of rivalry or tension. 

Once preliminaries talks were over, I asked if there were any issues that should be addressed immediately. This is not often the case, but couples with very urgent problems would need a more solution-oriented and intensive session, and would find the slower-paced and exploratory nature of the usual first session inappropriate. For instance, if I met a married couple where the wife had an appointment with her solicitor for the following day to start divorce proceedings, and her husband had brought her into the counseling session in a last desperate attempt to prevent this, there would be an immediate need to negotiate whether she would be willing to postpone her solicitor’s appointment or not. Another example would be if a couple needed to decide whether the wife would go ahead or not with an abortion given the legal limit of a few days. 

On the rare occasions when there is genuine urgency, I largely abandon the first session mindset, and spend the whole session assisting the couple to discuss possible actions, and weigh their likely outcomes, encouraging each person to listen to the other without interruption, and trying to create a thoughtful and objective atmosphere. Sometimes the couple reaches a decision in the session, but even if they do not, they may find their minds have cleared, so that conversation at home becomes easier and leads to an agreed conclusion about how to deal with the immediate dilemma or problem. 

In the case of Melanie and Alex, Alex said that their problems did seem pretty urgent to him, but that he could understand the distinction between their situation and real urgent matters, and would rather not hurry the process. Melanie agreed.

THE INTERVIEW

A characteristic of narrative therapy, but also my approach in general, is transparency, which among other things means demystifying counselling by explaining at every stage what I intend to do, giving the rationale behind my ideas, and gaining agreement from the client. The reason for doing this is to regard clients as equally capable of partaking in the healing venture. It also has practical benefits, as persons enter more fully and confidently into the various stages of the process than if they were treated as uninformed people to whom counselling is ‘applied to’.

At this point, I explained to Melanie and Alex that if they agreed, I would like to organize the first part of the session in a way that might surprise them. Instead of encouraging them to discuss their problem together, or jointly to discuss them with me, I would like to ‘interview’ each of them for about 15 to 20 minutes while the other partner listens without interrupting and takes notes on a pad. I explain that the idea behind this is to get away from the usual mode of interchange between two people who have disagreements, when each is probably so eager to put their point of view ahead of the other that they only half listen to each other. 

Possibly because they see the logic of trying a different way of communicating their concerns, I have never known a couple to question or refuse the suggestion of beginning by talking to me separately. Melanie and Alex readily agreed to my suggestion of individual ‘interviews’, and after a little hesitation, Melanie offered to go first. I gave them each a notepad and pencil, then faced Melanie and invited her to tell me what had brought her and Alex to counselling.

Now quite normally each partner is likely to want to convince both me and their partner that they are having a bad time, and perhaps to demonstrate that this is largely their partner’s fault, however, here I am largely concerned to discover exactly how the problem affects each partner, not only in their relationship to each other, but also in such areas as their health, their sleep patterns, their concentration at work, their relationship with others, such as children, relatives, friends and workmates. Thus, although 15 minutes each is not very much time, the timescale does encourage for brevity and focus.

Melanie said that lots of things Alex did, or didn’t do, made her feel unsupported and unloved, and that when she tried to make him understand her feelings, he just got angry and said she was imagining things or exaggerating. I asked for an example, and she said that one problem was his parents, who had never liked or accepted her and whose side he always took. At this point, Alex started to shift uncomfortably in his chair and seemed about to say something, so I turned briefly to him, and shook my head with a smile. He subsided. 

What did she mean about Alex’s parents, I asked – could she give more details? 

I continued to keep alert to clues to exceptions that I might have drawn on later when encouraging the couple to reconsider the image they have of their relationship and to identify and enhance its hopeful or positive elements. If no exceptions emerge at this early point of counselling, the power of the problem is at its height, and a problem-saturated description by both partners is to be expected. 

By means of the problem-narrative Melanie produced, both I and Alex gained a clearer picture of how Melanie experienced the relationship. 

I have known many occasions when the listening partner fully grasps for the first time the nature of things which their partner has often said, but was only half-heard, ignored, dismissed, or distorted defensively, and when this new realization occurs, it often begins a shift in attitude.

In Melanie's case, Alex's mother was always hinting about how Melanie should bring up the children differently. When Melanie had been ill in hospital for a week, Alex’s parents had only visited her once and had made an excuse to get away quickly, but all Alex could do was to thank them effusively for coming. He had helped her to write a letter of complaint when she had been incompetently treated in hospital, but undermined her attempts to discipline the children when they were naughty. 

How did this undermining affect her, I asked. "They always go to him when they want anything now!". They had started to ignore her and to be more and more out of her control. She was the bad parent now, and he was the good parent in their eyes. Sometimes Alex had to leave for work early and he never told her in advance, so on these occasions, she had to rush all the work of cooking breakfast, preparing the children for school, and taking them, without his help and their collaboration.

She said she felt angry and tense all the time, slept badly, had stomach cramps and was sometimes short tempered with patients at the health centre, which made her ashamed afterwards. Also Alex had stopped showing her any affection and they never had sex. The family had not had a proper holiday for several years. He was always accusing her of nagging, such as when she tried to face him with the need to sort out their credit card and debts. Her self-confidence was at rock bottom and she didn’t know how much longer she could stand the situation.

Although Melanie’s narrative was really problem-saturated, I detected three clues to exceptions, which indicated that it might be possible, with encouragement, for her to tell an enriched story which would more fully represent her experience of her marriage. For instance, Alex had helped her with her letter of complaint, he had gone to see her MP with her despite his doubts about this, and on mornings when he didn’t have to go to work early he took his share of the family’s morning preparations – something which not all family men do. She had presented these factors in a negative light but they had a positive ‘flip side’ which I felt might have potential for use later in the counselling.

Fifteen minutes later I thanked Melanie for her frankness, reminded her not to interrupt when I talked with Alex, and turned to face him.

I began by inviting Alex to comment on what he had just heard, referring to his notes, to give his own account of the problem. Alex said that in the life of the family, he was left to be responsible for almost everything, and that he was tired of this – literally exhausted, as he had a very demanding job with very long hours. Melanie had not gone back to full-time nursing since the children started school, and he was the main breadwinner, with a large mortgage and other debts to account for as well as family expenses. Affording a holiday was out of the question. It was part of his job to work long hours at short notice, and Melanie knew this, yet she nagged him endlessly for not being more available to her and the girls, and more or less ordered him around when he was at home. He found her irritable and unreasonable, with a tendency to be far too strict with the girls over trivial matters. He agreed that their sex life had deteriorated, and said he was unhappy about this, but he was surprised to hear that Melanie was unhappy about it too as he had assumed she just didn’t want intimacy anymore. He thought they had become so tense and annoyed with each other that it would feel artificial and over-deliberate, and on the occasions when he had thought of "making a move", he had been too apprehensive to try. She had always been distant and indifferent to his parents, and she never made allowances for the fact that they were both quite frail – it had been a real effort for them to visit her in hospital, especially as his mother was herself unwell at the time. He was fed up with the whole situation and was sceptical that counselling could help.

This is a typical situation at this point of couple counselling, with the same events interpreted and portrayed differently by each person. I began to suspect a pattern of differences building up and leading to increasing resentment as each internalized their own perception of the other’s ‘unreasonable’ behaviour. These perceptions had solidified, and over time the fixed stories had become so powerful that they fed back into their perceptions, confirming and reinforcing them, and exacerbating the couple’s sense of their relationship’s deterioration, seen as mainly brought about by the other’s refusal to see reason.

Now there was no way an objective assessment could be made of all the multiple interactions that had led to Melanie and Alex’s crisis, since these factors were past, unrecorded, complex and subject to the distortions of memory. Each person’s story was so embedded in their own minds, that they would in any case continue to interpret the evidence according to their perceptions. 

The task of counselling is not ‘investigative’ in the sense of trying to weigh evidence and to uncover "the truth". Therapy’s task is to build alternative stories, and in this case to encourage Alex and Melanie to gradually tell an amended, agreed version of their relationship which would undermine the power of their individual dominant stories, and reconnect the couple with aspects of their history that had been distorted, forgotten, sidelined, undervalued or misrepresented in memory. 

To this end, I noted further exceptions: Alex worked hard for his wife and family, was responsible about money and wished to resume his and Melanie’s sex life.

I asked Melanie to respond briefly to what her partner had said. Melanie made it clear she disagreed with most of Alex’s points. However, his saying his mother was ill at the time she herself was in hospital had given her pause, as she had since forgotten this. She was also surprised that he wanted to make love sometimes, as she assumed he had completely lost interest in a sexual relationship.

At this point I offered a brief summary of what each person had told me, sometimes failing to get this quite right, and so asking them to correct me until they were satisfied I had done justice to their accounts. 

Me: I’d like to try to sum up what each of you said, and please don’t hesitate to correct me if I get it wrong. Melanie you said that you feel angry and tense all the time. Alex doesn’t support you with the girls’ discipline and this makes you feel he doesn’t love you, and that the girls prefer him to you. His parents don’t accept you and he takes sides with them. Your self-confidence has been affected. There’s no sex and no holidays, and you’re often left coping alone with the morning rush ...

Melanie: No, not often, just sometimes, when he has to go to work early and doesn’t tell me so we can get up a bit earlier.

Me: OK, right. The other thing is that when he does help you, it’s grudging. He was OK about the letter though. Is that an accurate summary otherwise?

Melanie: Yes, that’s fair enough.

Me: Alex you feel put on and unappreciated. You work very hard in your job and at home, and are fed up and exhausted. You see Melanie as over-critical and inclined to nag and give you orders. You think she’s too harsh with the girls and unsympathetic to your parents, and you’re inhibited about initiating sex because you may be rejected.

Alex: Not so much that, more that I just don’t think she will want it. I don't want to impose myself.

Me: And you have to be careful with money, so no holidays. Anything I’ve forgotten?

Alex: No, that’s about it.

This negotiated summary enabled Alex and Melanie to hear the other’s points a second time, now in my own interpretation, and to settle on an agreed ground of discord.

FINDING A BETTER WAY TO DEFINE THE PROBLEM

I invited them to agree on a definition of the problem. ‘What shall we call this problem? Can we agree on a name for it?’ I asked. Usually, couples hesitate, but if one partner suggests something that implies blame (‘his bloody-mindedness’, ‘her unreasonableness’), I say that this is unsuitable as it clearly won’t be acceptable to the other person. If one partner suggests a definition that is general, non-blaming and (preferably) non-medical, such as ‘shared worries’, I check with the other partner and if they agree, suggest we use this term at least for the moment. When no suggestions are forthcoming, I offer ideas myself.

When we tried to think of a name for the problem for Melanie and Alex, it turned out to be difficult, so we settled for ‘unwanted tensions’.

Normalizing the situation, if done in a provisional and tentative way, can bring the couple some relief and add to their motivation. With this in mind, I said something like ‘I can see how hard things are for you, and there’s no way I want to give you any kind of premature reassurance, but it just might be helpful for you to hear that I know of couples with problems rather like yours who have managed to deal with them and come out the other side’. 

Glib optimism has no place in counselling. If a couple’s difficulties are complex, multi-faceted, severe, longstanding and bitter (or any combination of these), it would be cruel, unrealistic and unethical to give immediate reassurance that they have no need to worry. John Weakland, a pioneering family therapist, encourages to lower expectations to preempt the possibility of further disappointment, thus allowing the possibility for the partners to experience improvement should it occur. I very much concur with this view. 

Nevertheless, there are times when hope breeds hope, and when renewed hope provides the best condition for movement towards positive change. Many couples – perhaps most – come to counselling with problems which, although genuine and extremely distressing for them, could be placed around the relatively trivial and everyday (in which case they would not be having counselling anyway) to extremely severe and possibly intractable. The couple themselves, absorbed in their own unhappiness, will not have this perspective, and it can be helpful for them to know that other couples have faced similar issues and have eventually resolved them satisfactorily. 

SOME CHANGE WAS ALREADY UNDERWAY

At this point in counselling, the situation had considerably moved on from when Alex and Melanie  had walked into the counseling room. At least from my point of view. They had each gained a clearer idea of how their partner viewed the problem, and by the act of telling their own version of the story to a neutral counsellor, they had perhaps gained a more complete view of their own experience. They had discovered that the problems can be talked about without either of them lapsing into uncontrollable anger or incoherent despair. However, now that the problems and their results had been fully exposed, the next step loomed. 

Did Alex and Melanie wish to take the counselling process further, or did they have doubts about this? Had full exposure to the problem shaken them and made them wanting to back off, or had the problem now become less threatening, and something they could live with, or sort out without my help? 

I thanked Melanie and Alex for the full and frank way they had talked in their individual interviews, and for deciding on an agreed name for their problem. I continued:

Me: Alex, are you OK to let things run on as they are or would you prefer things to be different?

Alex: ‘No. Things have got to change.’

Me: ‘What about you, Melanie? Would you prefer to leave things as they are, or ...'

Melanie: Oh no, we can’t carry on like this.

Me: Ok, from what I gather you’ve both decided to persist with addressing the unwanted tensions that have invaded your marriage, so let’s continue.

At this point the common-sense thing to do would be to focus on the problems outlined by the couple, and to initiate discussion on what changes they might put into place to make things better. 

This approach often succeeds, however this way of addressing the issues has two limitations that I attempt to avoid. Firstly, focusing on problem does not openly and specifically highlight more hopeful and rooted aspects of the relationship which have been forgotten or ignored by the couple because of the power of the problem. Also, immediately veering into discussion of how to bring about change is likely to rely fairly heavily on the counsellor’s ideas, privileging the therapist’s position in terms of what he or she assumes is important, and neglecting perhaps in the process, some important preferences the couple may have.

What is the alternative? In the case of Melanie and Alex I explained that I would like to ask about some aspects of their relationship which I found intriguing, and after getting their permission, I explored one or two of the exceptions I had noted. 

I told Melanie and Alex that there were some things that didn’t quite fit the overall pattern of how 'unwanted tensions' had invaded their relationship. I turned to Melanie and said:

Me: Melanie, I understand that except on those rare occasions when Alex forgets to tell you he has to go to work early, he always shares the early morning tasks. Is that right?

She said it was, so I asked very specific and detailed questions about how exactly this worked. They each had set routines which complemented what the other did, which had been discussed and agreed. Usually, things went like clockwork; for example, Melanie was largely responsible for seeing to the children, and Alex laid the table, cooked the breakfasts, and afterwards loaded the dishwasher. I asked many more questions – what did Alex cook, who was responsible for deciding the breakfast menu, what other domestic tasks did Alex share, did he take equal responsibility for dealing with the girls or leave it to her, how long had these arrangements been in place, and so on, and this wider perspective released them from the entrapment and paralysis of their problem-saturated narratives. 

EXPLORING EXCEPTIONS

I prefer to explore exceptions that have been implicit in the persons’ narratives because this moves the session from individual interviews to a cooperative effort – and, importantly, this effort is focused on areas of the relationship that are not problematic.  What do I mean by ‘exploring’ exceptions? It is not enough to assist the couple to make exceptions visible, least the exceptions will soon be subjugated to the dominant stories and slip out of their memory, making little difference to how they conceptualize their relationship in the long term. So I explore the exception by:

1. eliciting a more complete and detailed description of the exception.

2. discover its effect in the couple’s life.

3. and ask the couple for their feelings and thoughts about it, and in particular whether they see it as positive or negative.

This exploratory conversation has the aim of reinforcing the sense that their own individual narratives may have a common ground after all, which means taking on a wider perspective that incorporates hopeful, positive, and encouraging elements. It is not an attempt to deny the distress and confusion – it is an enrichment of the couple's stories, based on their ‘telling’ a more accurate and inclusive portrayal. It allows for aspects of their relationship that have become obscured or sidelined to become re-authored. In future sessions, a considerable amount of time will be given to various forms of re-authoring, but in the first session of couple counselling, there is only 15 minutes for practice, so only one, or at most two, exceptions can be explored.

I asked Melanie if she thought all married couples shared these sorts of tasks, or was it rather unusual for a man to take an equal share in domestic routines and responsibilities? She said that with most couples they knew, the woman did all, or nearly all, of these things. So what did she think this might tell me about Alex? She didn’t know, she said. What does it say about him as a man and as a husband, I asked? What does it reveal about his values? With some prompting, Melanie replied that it showed commitment, good organizing ability, a caring attitude, the ability to ‘do things differently’ from many men and not feel ashamed about it, and consistency. His father was a nice man but very traditional in these matters and she thought Alex had decided not to emulate him. 

I wondered if Alex's consistently sharing domestic responsibilities was a good thing or a bad thing? Did this have a positive or a negative effect on his relationship with her? Positive, she replied; it was a good thing. Thinking about it now, how did it make her feel? "Pleased", she said, "even cared for". My next question was, ‘What else does he do, or has he done, to make you feel the same way?’ and Melanie gave several examples, including details of how supportive he had been while she was ill.

I then turned to Alex and asked him how it felt to hear Melanie paying him such tributes. He said he was quite surprised, and also moved. His impression had been that she just saw him as a rather remote and indifferent husband and father.

I continued to talk to Alex, selecting a second exception to explore. I said that I had been struck by Melanie’s asking him to help with her letter of complaint to the hospital. Why did he think she had asked him rather than just write the letter herself? Alex said that Melanie had always found writing formal letters difficult.

I realized that my wording had unwittingly invited Alex to make a criticism of Melanie! So I immediately clarified my question by rephrasing it. What was it about their relationship which had enabled Melanie to ask for his help in such an important matter? He thought for a moment then said he supposed she trusted him. What was the nature of this trust, I asked? What was it that she was sure he would do, and what was she sure he wouldn't do? He said he thought she knew he would take the letter seriously and that he would not make her feel silly for needing his help with it. 

I expanded this theme by eliciting and exploring various other times when there had been support and trust between them. Alex talked of a period when he had work worries and Melanie discussed them with him and was a great support. Although it was still Alex's ‘turn’, Melanie could not resist telling me of a time when they had helped one of their girls to overcome a bed-wetting habit. I asked whether Alex thought that these examples shone a negative light or a positive light on the relationship, and he said it was positive.

ENDING THE SESSION

As 70 minutes have now passed in the session, readers may be wondering when the problem is going to be addressed. The answer is – not yet, and maybe not even in a counselling session - but by the couple in their own time. Counselling is not likely to end after one session (though I have occasionally found one to be enough), but this first session has laid a foundation on which the couple’s own knowledge and skills can be built anew. A fresh perspective on the relationship has been brought about, a situation where both parties’ perceptions are less paralysing and less problem-saturated, and nearer to the complex reality of the relationship, a reality that has been fogged by the problem’s power to distort the couple’s memories and perceptions.

I have come to trust the ability of people’s minds to develop ways of resolving their problems, and I believe that this works on both conscious and unconscious levels. At an unconscious level, the mind is working towards solutions even if the person is not thinking of the problem; in fact, it even seems to work more efficiently if the person is not fiercely concentrating on it. 

By (1) revisiting the positive aspects of the couple’s history, but without excessive and precipitated optimism, and (2) sending them on their way at this point rather than bringing them back to problem-talk, the maximum potential for releasing their minds’ unconscious creative processes could, in my view, be attained. Once this starts to happen (and it can be almost at once), a conscious recognition and inclusion  of movements towards resolution will play an equally important part, with the conscious and unconscious elements feeding into and reinforcing each other. To promote this creative mental interaction, I often suggest a noticing task – a technique from solution-focused therapy, which I believe fits well with the narrative approach. 

With Melanie and Alex I suggested that before we meet again, they might find it interesting to notice anything, no matter how small or apparently trivial, that suggests there may be elements of their relationship that have not been defeated by the power of the problem. Not to try to make such things happen at this stage, which could feel artificial, but just to notice them if they occurred, and to tell each other what they had noticed. 

At this point, in the session, arrangements are made for the next session. It can be another joint session, or the first of two individual sessions, one for each person. It's often tricky to know how to proceed. There are instances when holding two or more individual sessions is appropriate, but I also find that having taken part in a couple of joint sessions, the partners know me well enough to be comfortable with the idea of each seeing me individually and in confidence.

Sometimes, in case there is violence or abuse which they have not dared to mention in front of their partner, it may be essential to give one person an opportunity to talk to me by herself, but as I had no intimations of abuse or violence with Alex and Melanie, I suggested another joint session, and we arranged to meet again in two weeks’ time.

I ended the session by thanking again Melanie and Alex for giving each other, and me, such a full and detailed picture of how 'unwanted tensions' were affecting their lives. I said that I was also interested that they had recognized some situations when unwanted tensions had been absent, and I suggested that they might like to notice and remember any such occasions between now and the next session, or even times when the tensions receded very slightly. I added that it might be best not to try to make such occasions come about as this might seem rather artificial – just look back at the end of each day, make a mental note or a written note, and check out their observations with each other. 

I hope this sharing with you has given you an overview of the counseling approach I take with couples. Let  me know what you thought about Melanie and Alex's story and how this reflects your own situation by emailing me. You never know, I might be willing to answer ;)

Wishing you Well,

Your Shrink in Bansko