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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and 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Any psychotherapy of the worried well has some comic potential, but the idea of group therapy for couples cries out for sly dramatization. You can practically write the script of the group run by Judith Coché yourself: 5 couples meet once a month for a weekend each time, for a year. Some of them have been coming to the same group for a few years. The therapist sometimes has a guest co-therapist to focus on particular aspects of relationships. The couples get to know each other well, and all of them are motivated to resolve the serious problems in their marriages, even if they are not always open about what those problems are. Revelations are not only at the start of the process, but also all the way through. It would be easy to make the therapy seem self-indulgent and silly, but Laurie Abraham manages to make it appear useful, and her earnest writing highlights the bravery of the couples. Unfortunately, she also makes the therapy rather dull. Still, The Husbands and Wives Club is a helpful overview of couples therapy generally and a revealing depiction of this form of group therapy.
Abraham is a freelance writer and senior editor of Elle magazine; she also takes her responsibilities as a writer very seriously. She audiotaped and transcribed all the sessions, and she does not distort facts about the people in the book, although she does leave out some identifying information. There is one exception: she does disguise one couple who were uncomfortable about having themselves possibly identified. She describes the long sessions in some detail, and it can be easy to get confused about who is who: there's a useful guide to the couples on the book website.
Many readers report finding the book gripping, and those who complain tend to complain about it being too heavy on theory. I had the reverse reaction: I breathed a sigh of relief when the details of a morning session were finally done with, and Abraham got to the ways of explaining them using theoretical models. But Abraham's skill is to be able to explain the theoretical ideas well and integrate them with the story of the therapy. While I can understand the publisher wanting to keep the theory in the background, the book only really comes alive 60 pages in, when Abraham starts talking about the history of marriage counseling and therapy and some of the major approaches to doing it. Coché herself is not firmly wedded to a particular theoretical model, but is strongly influenced by existentialist psychotherapy, systems theory, cognitive behavioral therapy, and attachment theory. Abraham discusses these in small pieces, but it helps to know something about them already. There is a 3-page bibliography at the end of the book, but Abraham is not attempting to give a thorough survey of the literature.
The researcher who gets the most pace is John Gottman, who has become very well known for his studies on communication in marriage and his ability to predict divorce from watching fifteen-minute conflict interactions. The predictor that he emphasizes most is contempt: lack of respect for each other means that a marriage is very likely to fail. Gottman's work has been well-publicized, and is often accepted rather uncritically. Abraham provides a good critical discussion of the weaknesses of the research, showing that the claims of predictive success are not as dramatic as they first seem, and that his claims are also not as new as they are often portrayed. Again, her discussion is far from exhaustive, but so it helps to be familiar with the work to which she is referring, or one can use the authors she discusses as a way to guide one's own further reading. Similarly for the work by Cindy Hazan and Phillip Shaver on attachment theory and romance: this is a more recent development in psychology, and Abraham helps the reader understand it through describing some of their experiments.
So readers will find something here to learn from. Most of it is about the psychology or psychotherapy of couples, rather than group therapy for couples. The basic advantage of this work is, according to Coché at least, that it helps to keep couples more honest and that they are sometimes more willing to hear ideas from their peers rather than a therapist. To what extent this is actually true is hard to say, and I can imagine few people who would be willing to put themselves through such an ordeal except as a last resort. It is still an unconventional method, and is not even included as one of the major approaches in Alan Gurman's 2008 Clinical Handbook of Couple Therapy. Yet it is possible that this is an effective way of solving marital problems; the positive reports at the end of the book on the progress of the couples in their relationships are hopeful indications that really working on deep problems can lead to success.
The most interesting part of the book is actually at the end, when Abraham discusses Murray Bowen's systems theory -- the idea that a family is best understood as a group in itself rather than a collection of interacting individuals. Abraham links this to the ideas of David Schnarch, who argues that the solution in marriages is often for couples to become more differentiated. She proceeds to discuss the work of Stephen Mitchell on relational psychoanalysis. While her discussion of all these authors is brief, they all address what it takes to achieve a long-term good marriage -- how the couple can be close yet remain separate. These raise the larger philosophical question of what romantic love is, and thus show the links between the psychological issues and the philosophical debate, started in Plato's Symposium. The stories and the theories in The Husbands and Wives Club will be of interest not just to psychologists, but also to all people trying to figure out what long term love is and how to achieve it.
© 2010 Christian Perring
Christian Perring, Associate Professor of Philosophy, Dowling College, New York