Saving a relationship through therapy

Almost a century ago, psychoanalyst Carl Jung showed that men and women go through predictable life changes that alter what they want from a relationship. In the empty-nest and retirement years, both partners once again want a companionable partner in adventure - the same kind of person they may have sought out in their single young-adult years.

Predictable life shifts can put stress on a relationship if the partners are moving through them at a different pace. "Any time you go through a lifestyle change, you are likely to be stressed, and therefore there will be relationship stresses," says psychiatrist Judith Landau, director of the Recovery Resource Center in Boulder, CO and a senior advisor to the International Trauma Studies Program at Columbia University.

A couples counselor or family life educator can help, she adds, especially when multiple life changes converge -- as often happens when you're past 50.

For instance, loss of a job at age 55 may cost you your health insurance just when you really need it -- and at about the same time your 80-year-old parents and college-age kids need your help.

That combination of perfectly predictable circumstances could overwhelm anyone, and lead to the kind of anxiety or depression that can strain a relationship. The illness or death of a parent, or part-time responsibility for care of a grandchild, can also constitute stressful life changes.

"We're not trained to think this way," Landau says. "Instead, normal stress can make us think 'There's something wrong with me!' or 'There's something wrong with you!' Then, the battle starts, and the blame flies."

Older couples should recognize that they may need counseling, says Neil Rosenthal, a marriage and family therapist in Colorado, "When you're having repetitive, escalating arguments that you can't resolve on your own, when you feel increasing distance between you, or if one of you feels 'I'm very unhappy here.'" He notes that a good couples therapist behaves as a neutral "referee," advocating for the health of the relationship rather than in support of either partner.

Myths about therapy

Many couples either wait too long or decide not to see a therapist because of certain popular misconceptions:

I'm too old for therapy. Life changes happen at all ages -- in fact, the pace of stressful events may accelerate as we age. With age should come wisdom, and resilience -- not stubborn resentment.

It's too expensive. Many health insurance programs cover part or all of the cost for a specific number of sessions. And many therapists offer a sliding payment scale based on household income. Besides, therapy is often very cheap compared to the long-term costs of separation or divorce-lawyers' fees alone are more expensive than therapy.

Only crazy people need therapy. Few of us are trained to deal with relationship impasse and the powerful emotions that block progress. You don't have to be crazy to feel frustrated and powerless. That's where therapy can help.

My faith will see me through. Ask your pastor about this one. The church probably has a list of local therapists who have helped members of the congregation -- and perhaps the clergy.

If you decide that you need therapy but your partner refuses to go, you may want to arrange an appointment with a therapist for yourself and then ask for help with bringing in your partner. "The therapist can suggest ways to mobilize your support system -- your family and friends -- to get a reluctant partner into therapy," Landau says.

Your kids, who grew up in a generation that is more accepting of therapy and oriented toward mental wellness, may be of real help here. I have a 30-year-old friend who is working very hard to talk her 60-year-old dad into therapy with her unhappy mom.

What kind of therapist do you need?

Family life education can be helpful when the relationship is basically healthy but you want to be pro-active about hanging together through stressful times. Find a Certified Family Life Educator (CFLE) who is accredited by the National Council on Family Relations.

When the relationship is in crisis, look for a licensed couples therapist. Be sure that he or she is certified by the state - your insurer probably won't reimburse for an unlicensed therapist. The Web site for the American Association for Marriage and Family Therapy lets you search for local therapists by ZIP code. Landau suggests that therapists with an expanded listing are likely to have a higher level of training and experience.

How to know if a therapist is right for you

Before committing to a course of therapy with a specific practitioner, do a phone interview. Landau suggests posing these questions:

• How often do you recommend medication (anti-depressants or anti-anxiety meds, for instance)?
• What's your perspective on healthy family and resilience issues? This is therapist short-hand for taking advantage of a family's hidden resources: help from friends and kids, flexibility to change living circumstances, habits and attitudes.
• What is your general philosophy? Therapists train in dozens of different traditions - Freudian, Jungian, theological, trauma-orientation, countertransference orientation, Freirian, diological, and so on. Any good therapist should describe in simple language what general directions he or she has had success with.
• How long have you been in practice?
• Are you comfortable with a goal-oriented approach? That is, will you help us to establish what our goals should be, and help us lay out a plan to achieve them?
• How will you measure success in the course of therapy?

It's also a good idea to ask friends and colleagues in your age range for recommendations. "If you're in your 50s, you probably don't want to go to someone in his or her 20s and just out of school," says Rosenthal. "He or she won't have credibility in your eyes. You want a plan, and specific ideas about issues. You want someone who understands your problems and offers solutions -- someone you can learn from. And there has to be personality compatibility."

If you feel comfortable with the therapist after a chat on the phone, go ahead and schedule an initial consultation -- and expect to pay for the first session. During that hour, you and your partner should both ask yourselves whether you like the therapist and think that you can develop a trusting relationship with him or her.

What to expect from therapy

First, understand that therapy isn't a magic bullet. According to Landau, statistics show that about 40 percent of the couples who see a therapist together end up getting divorced. When each partner sees his or her own therapist individually, the divorce rate is 60 percent. Sara Swift, another Colorado-based therapist, says that her role is sometimes to facilitate a more civil and less damaging parting of ways.

However, Rosenthal notes that, "It's reasonable to expect a growing understanding of the issues within the relationship and how to solve them. You should expect a new set of skills in communicating: listening skills, conflict resolution skills, problem-solving and negotiating skills."

Landau advises a pro-active stance going into therapy. "Ask a new therapist very clearly about the length of therapy," she says. "You should expect some positive progress in four or eight or twelve sessions. If a therapist suggests twice-weekly sessions for a long period - well, that's simply not ethical. And every fourth session, progress should be evaluated: What's been achieved?"

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Check out Dr. Judith Landau's website to learn how to get a loved one into treatment.

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