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Application: Applying Cognitive-Behaviorial TherapyCognitive-behavioral therapy (CBT) focuses on patterns of thinking, with decreased attention on patterns of behavior and emotional components of relationships. Researchers have given an enormous amount of attention to CBT and its application to a variety of individual mental health concerns, but they also have appropriated it for working with couples and, more recently, with families. Many systems purists argue that CBT is an individual-oriented theory that lacks systemic concepts necessary to conceptualize family or couple issues. In the end, you will have to make the decision as a marriage, couple, and family counselor as to whether CBT can address the relational demands of clinical work with couples and families.Choose one video from this week’s Learning Resources to review. As you begin to formulate a theory-based treatment plan, consider how you would maintain focus on the cognitive-behavioral realm of the couples and/or families, yet attend to the emotional dynamics present in the video.The assignment (2–3 pages)Based on the theory demonstrated in the video you chose (cognitive-behavioral therapy with either a couple or family):Define the problem.Formulate a treatment plan including short- and long-term goals.Describe two theory-based interventions you would use and justify your selection.Explain one anticipated outcome of each.
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COUN 6356
Theories and Techniques for Marriage, Couple, and Family Counseling
Week 4 – Our Research Methods
DR. JOHN GOTTMAN: When Bob Levenson and I started doing this research together 34
years ago– Bob is a professor at the University of California, Berkeley– and we were
professors together in Indiana University at that time, 1974. Neither of our relationships
with women were going very well. And I remember one afternoon complaining to Bob
about my current relationship, and bob said to me, very reassuringly, you know John,
you can either have a relationship or you can do research on relationships. And we’re
doing research on relationships.
So I guess we really tried to do this research to find out whether we could learn
something from people who are doing pretty well with their relationships that we could
use in our relationships with women. So I want to tell you a little bit about what our
research methods were like. Isaac Newton, the famous physicist, said, “Non fingo
hypotheses.” I do not frame hypotheses. So we really began this research in the
opposite way from the way you’re trained to do it in graduate school. In graduate
school, they say, don’t analyze your data until you have a hypothesis. And we didn’t
know we were doing so we didn’t have a hypothesis.
So we really began just bringing couples into a laboratory and having them meet at the
end of the day after they’d been apart for about eight hours and asking them to talk
about how their day went. And we also had them talk about an area of continuing
disagreement in their relationship and a positive topic. Not only did we have them talk
about these things, we videotaped them doing that. And we also collected physiological
measures while they were talking that were synchronized to the video timecode. So
think about in 1974, the computer we used to do that was probably as big as this part of
the room. And it did less than your laptop does now.
We were able to collect this data and use the same paradigm over and over again for 34
years. And we showed people their videotapes and asked them to tell us what they
were thinking and feeling by turning a rating dial. And if they felt very negative, turning
it to the left. If they feel very positive, turning into the right. And again, we collected
physiological data. We didn’t know why we were doing these things. But we were
hoping that we would figure out some patterns. So really, we observed and, from that,
we tried to discover patterns. And we did find patterns. And not only that, then we tried
to understand the patterns. That was our third step. And then we got hypotheses. We
also tried to see whether the patterns predicted anything, and we were very surprised
to find that our patterns really predicted a lot. And then on the basis of all those
patterns and that understanding, we started to try to build theory. In other words, we
tried to build a theory that would explain the patterns and explain the differences we
were finding between couples whose relationships were going well and couples whose
relationships weren’t going well.
And then, on the basis of that theory, we tried to design interventions. So let me show
you a very brief film that kind of illustrates the lab the generated these data.
[VIDEO PLAYBACK]
(On-screen Text: “Inside the Family Research Lab…aka ‘The Love Lab”)
– We thought you might like to see the Family Research Lab. This is where couples-happy and not so happy– come to put their marriage under the microscope. This is
where the analysis begins. Right here at the love lab. In his lab in Seattle at the
University of Washington, Dr. Gottman man has used his observations to create realitybased advice for couples. After 30 years and thousands of couples, Gottman has been
able to pinpoint behavior between husbands and wives that can ultimately drive two
people apart.
The lab experience takes several hours. Couples first complete questionnaires
separately about their marriage. Partners are asked about current problems, like
disagreements about finances, or how to raise the kids. Couples meet with a researcher
to complete what’s known as an oral history interview. In the oral history interview,
couples are asked to share the story of how they met. It turns out that couples who
share a lot of warm and affectionate memories of how they met are the ones who are
especially strong. While the couple’s interview is front stage, the research media room is
the all-important backstage. The interview is videotaped and coded by highly trained
observers. They use the Buhlman coding system to look for such basic dimensions as
fondness and admiration, the degree of connection or negativity.
After the interview, couples prepare for a conflict discussion. Research technicians hook
up couples to a variety of physical monitors. Their heart rates are measured. They are
seated in chairs that can measure fidgeting. We call it the jigglometer. Even fingers and
ears are hooked up, allowing us to measure skin conductants or sweaty palms and blood
velocity. The technicians connect the monitors carefully so that the signals are clear for
data analysis. Our computers track the physiology while the videotape records facial
expressions. When someone’s heart rate rises above 95 beats per minute that is a signal
of flooding, or being very upset.
Partners usually need a 20-minute time out to calm down enough to be able to listen to
one another again. Coders evaluate the tapes here. Specially designed monitors have
specific codes related to emotions. Expressions of validation and joy, along with what
Dr. Gottman terms the “four horsemen of the apocalypse”– that includes criticism,
defensiveness, contempt, and stonewalling– are all measured and later analyzed to
predict the relationship stability.
Afterwards, tapes are archived. Thousands of tapes record decades of studies on
couples. Each tape tells a remarkable story. Once Dr. Gottman analyzes the data on a
couple, he meets with them in his office to talk over the findings. Dr. Gottman remains
an optimist about making marriages work. He has been able to challenge some
conventional theories about marriage by listening carefully to couples, rather than
merely heeding his own intuition. For 20 years, Dr. Gottman was awarded the National
Institute of Health’s Research Scientist Award. He has written about this research in
more than 120 and 37 books. Some people will find the mathematics of marriage
interesting, as Dr. Gottman does. More will be interested in his New York Times
bestseller, The Seven Principles For Making Marriage Work (book cover on-screen), or
his most recent book, The Relationship Cure (book cover on-screen).
His work with his wife, Dr. Julie Schwartz-Gottman, has led to the development of a
couple’s therapy and a weekend workshop for couples, all based on scientific principles.
How do couples respond after going through Dr. Gottman’s love lab?
– If every couple in the world had the opportunity to go through this lab and they could
each correct just one thing in their marriage, everybody would be that much happier.
Sometimes it’s easier to let things slip and to not concentrate on making the marriage
work. And that’s what it takes, concentration on making the marriage work. You need to
spend the effort and the time to make your marriage happy.
[END VIDEO PLAYBACK]
DR. JOHN GOTTMAN: OK, so we’re around page 10 in Chapter One in the manual, and
you can read that section to find out more about the kinds of methods we used, and
more detail about the specific studies that we did is given on page 15 of the manual,
that documents the first seven studies that we did in this area. And I just wanted to say
that over the course of all these decades of work– it’s now been about 36 years– we
have really done research that goes across the entire life course. We’re just finishing a
20 longitudinal study that Bob and I started 20 years ago with two groups of couples in
the Bay Area. One group of couples in their 40s and another group of couples in their
60s. And these couples are now, the first group is in their 60s, the second group is in
their 80s. And we didn’t think we get any older when we did this, just the subjects we
studied would get older.
So we’re just finishing that study. So we go really from the newlywed stage all the way
through the life course and study couples as they have babies and watch the babies
develop, and study the children as they develop also, and look at parenting. We’ve
studied gay and lesbian couples in the Bay Area for 12 years as well. So we’ve done the
same kind of research on committed same-sex couples as well as heterosexual couples,
and published results about that as well.
So that’s kind of the research methods that we’ve used over time. I want to give you an
idea what the conclusions are from those research studies. But before I begin that, I’d
like to just bust a couple of common myths.
COUN 6356
Theories and Techniques in Marriage, Couple, and Family Counseling
Wk 4 – The Sound Relationship House
DR. JULIE SCHWARTZ-GOTTMAN: It’s very, very important to realize, everyone that we
need a therapy that can individualize to the couples that we’re seeing. So as we were
talking about before, this is not prescription. It’s not a recipe. It’s something that you
need to be able to individualize. It’s also not a checklist, right. So we can’t go down a
checklist to say, OK. They have to do this, this, this, this, and this. And then we’re
obsolete, and out they go.
So how can we organize the research findings into a therapy that actually really makes
sense? That takes theory, right? So the theory that we have created, John and I
together, looking at the interventions, as well as looking at what couples actually do, the
masters and disasters of relationships, what do they actually do? That’s where our
theory comes in: in terms of the integrating the research into clinical interventions.
So here you have what we call The Sound Relationship House.
(Graphic Onscreen: The Sound Relationship House)
And what I want to do is go through every level of The Sound Relationship House to help
you really feel embedded in the foundation of this intervention work and the
assessment work. OK. So here’s what we’ll do. Remember, all of this is based on
hundredth of a second by hundredth of a second, observing what couples do who make
it work. And what couples do who make it fail.
(Graphic Onscreen: The Sound Relationship House – Build Love Maps)
All right. Bottom level is love maps. Now let me describe to you what a love map is. A
love map is basically the road map of one partner’s inner psychological world; inner
emotional world, and cognitive world, and spiritual world that is known by the other
partner. The trick is, it’s known. It’s known by the other partner.
So we carry within us a whole set of values of meanings, also of preferences, of
priorities, of likes and dislikes. We carry inside of us stresses, pains, history. For
example, if you think for a moment, if you are paired up with another person, think
about this. Do you know what their most embarrassing moment is in childhood? Do you
know the answer to that?
So that is knowing your partner’s love map. It’s building a love map of your partner’s
inner world. So that’s something that we really focus on in terms of strengthening the
friendship of couples. How well do they know each other? And how do they find out
who the other person is?
Well they ask questions. They ask open-ended questions, typically. Like, why did you like
that movie? Or, tell me about your favorite book and what it means to you. Or, what are
you thinking about the remodel of our house? Or, what are you thinking about in terms
of our lives together five years from now? They ask each other open-ended questions.
Now think about it. In your couples in front of you, how much do they ask each other
questions? Most of the time couples are saying statements to one another. They’re
broadcasting. They’re not asking. And so one of the very important skills that we teach
for couples, to help build their friendship, is asking open-ended questions.
That’s how we strengthen building love maps, that first level of the sound relationship
house, in building friendship for couples. And remember, this is a therapy that goes
beyond conflict. It goes into also building friendship. And these are the pieces that are
involved with that.
(Graphic Onscreen: The Sound Relationship House – Share Fondness and Admiration)
OK. Move up one level to shared fondness and admiration. Fondness and admiration is
incredibly important. Remember the four horsemen; criticism, contempt, defensiveness,
stonewalling. Building the fondness and admiration system is probably the best antidote
for dealing with contempt. Because what is contempt? It’s looking down on our partner
in a critical way, it’s believing ourselves to somehow be superior to our partner, and
looking down on them with a little bit of disgust; a little bit of that eye roll.
Well think about what fondness and admiration is. When we looked at our masters of
relationship, what they were doing is admiring their partner; looking up to their partner;
seeing what they really respect about their partner. And that came out of their mouth. It
wasn’t just sitting in their minds, or heart. It came out; out their mouths, out their
hands, they would touch one another. They would express affection with one another.
So when we looked at couples who were really succeeding in their relationships,
whether they were straight, whether they were lesbian and gay, didn’t matter, they
always expressed fondness and admiration for one another. So that was incredibly
important. And it’s something that we work on systematically in this therapy, as you’ll
see, to help build that friendship system, again.
(Graphic Onscreen: The Sound Relationship House – Turn towards)
OK, let’s look at the next level up. Now John talked about that a little bit; that’s turning
towards. So turning towards is really, really interesting. It’s the tiniest little nut and bolt
to change couple’s relationships, but it works. It works. It profoundly influences, not
only the friendship system, but also the conflict system for couples in terms of whether
or not they respond to repairs. Whether or not they really listen to one another. If
there’s turning towards, it makes a huge difference, a huge difference.
So remember, again, it’s the smallest moment. It’s a heartbeat of response that we can
help our couples to be aware of. So just like in fondness and admiration, what we’re
trying to do is increase mindfulness. Help our couples to scan the horizon for what’s
positive about their partner.
We’re doing the same thing with turning towards. We’re helping our partners scan the
moment, scan the time, and scan their partner’s smallest little bids for connection. For
example,
“Hey John.”
“Oh, yeah?” (Directions towards)
Turning towards. That’s all it is. It’s a heartbeat. But one that is pregnant with response.
That’s what we’re really looking for. That’s what we’re trying to create. As opposed to
that painful, stop interrupting me, turning against, or the silence.
How many of you have seen those couples where the one partner is turning towards
them and then the other says nothing. Isn’t that painful? And don’t you feel yourself just
cringe inside? That’s what the partner is doing. So your gut is telling you what the
partner’s response is to that turning away moment. It’s a cringing.
And what we’ve seen in the research is if one partner turns away or against the other
partner, much, much, much less likely that the first partner will try to make a connection
again. Who wants to when you feel kicked in the gut? So, helping our couples be aware
of those moments, of that turning towards versus away and against, is incredibly
important. And we use lots of methods for that, which we’ll be talking about. One of
them is videotape. So we’ll be talking about that.
So it’s building awareness. Again, a lot of this is about building awareness. There is a
movie called Sliding Doors. How many of you have seen that movie with Gwyneth
Paltrow? I have to see everything Gwyneth Paltrow does because she’s so cute. So
Sliding Doors is an amazing movie, because what it shows is a husband in a bedroom
about to have an affair with somebody; the wife is at work, going home because I think
she doesn’t feel well; running for the subway.
And does she make the subway, or do the doors slide shut? If she makes the subway, as
the movie unfolds, she gets home, there is her husband in bed with, I think, her best
friend, what else, of course. Boy, does that make a difference.
Versus, she doesn’t get there quite in time. The doors close shut. She is left to wait a few
minutes. They do their business in the house. By the time she comes home, friend is
gone, totally different relationship.
Well, that’s what turning towards is like. Those are sliding door moments that just,
again, in a heartbeat, make all the difference in the world. So helping our couples be
aware of that is extremely important.
Now, those first three levels of The Sound Relationship House are what build friendship,
what build friendship. And especially important on that level is emotionally distant
couples who really don’t have friendship. They don’t know each other. They don’t know
how to express fondness and admiration. And they certainly don’t turn towards one
another.
So, you know those couples who sit in restaurants and they don’t talk to each other at
all? Guess what they need, those first three levels. That’s what they really need.
(Graphic Onscreen: The Sound Relationship House – The Positive Perspective)
Now, let’s move on. The next level, the positive perspective, is what John was referring
to earlier about Robert Weiss’s work. So here we call it the positive or negative
perspective that is related to positive sentiment override or negative sentiment
override.
So here’s what we mean by that. If the first three levels of the sound relationship are
not working, what happens is that couples begin to build resentment, lots of resentment
against one another. So that if one partner says something that’s relatively neutral, the
other partner responds to it in a negative way, takes it as criticism, may take it as an
attack. And responds with a chip on his or her shoulder, counter attacking back, getting
defensive. That’s the negative sentiment override. Does that make sense?
So, what we’re really talking about there is a feeling that overrides the rest of the
relationship. But, is really based on those first three levels. Now, if the friendship is
sound, if it’s solid, then you have what’s called the positive perspective, or the positive
sentiment override. And what that means is giving your partner the benefit of the
doubt.
So for example, let’s say your partner wakes up really, really grumpy; gets out of bed
and says, “Oh God, why don’t you just make the bed, you never make the bed?” All
right, how’s that going to be heard? The partner who hears that is either going to
respond negatively or can respond positively, can respond positively.
So OK, so bed is made or not made. One partner gets angry about it, says, “What’s the
matter with you?” The other partner goes, “Oh sorry, I’ll make the bed.” Positive
perspective or negative perspective says, “Stop attacking me, what’s the matter with
you?” We’re off and running, negative sentiment override.
Let’s take another moment. “Hey, you know, you’re not supposed to run the microwave
when there’s food in it.” Neutral statement. Negative perspective, “Don’t try to control
me, I know what I’m doing, I read the manuals, you don’t.” Negative perspective.
Positive perspective. “OK.” Simple as that. So negative versus positive perspective
simply means, does one partner gives the other partner the benefit of the doubt. That’s
what it means. Doe …
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