Other Therapy Models

Discernment Counseling: Pros and Cons

I’m following up from last week’s post on Discernment Counseling, where I talked about why I wanted to learn this to begin with, so check that out if you're reading this one first! You guys know, this is all just my personal impression, others will have different experiences. 

I've completed the core training, and now am continuing with the additional supportive training (it's all part of the same package, they just delineate between the core and then additional training). From what I can tally up, it's about 40 hours to complete this training (side note, I'd love for them to have the exact number of hours clearly stated up front because it's a long one!). 

 

PROS

- This is a very well-done, very thoughtfully created training and model. I like that it’s a formal model and there is research behind it with outcome measures. I’m not the kind of person that likes to do something without a model or some structure behind it, so I like that the training has been created this thoughtfully. This to me is the most important pro, because without there being a formal path I wouldn't have any clue about what this stuff is about or what to do with my clients. 

- I like that I have a way to really honor and respect when a client tells me they don't know if they want to be doing couples therapy. 

- I like that the Discernment process is set up to be short-term. Bill Doherty says it really should only be between 1-5 sessions, with the therapist asking at the end of each session if the couples wants another Discernment session.

- I like that the training is mostly audio-recording, so I can clean, cook, and do other stuff around the house while I listen to it. (After a million hours of watching Gottman tapes, glued to my couch every weekend, I am seriously grateful for this feature).

- Bill Doherty is delightful. I like that Bill’s demeanor fits with EFT (gentle, permission-asking, sensitive) even though his style is not (see more under Cons)

- I like that in the individual split sessions, that the work is not just empathy but encouraging the partner to be looking at their role in the cycle, so it’s almost like doing Step 2 but without the other person in the room. This seems to work a little better with these couples because they aren’t totally swimming in their defensive brain with the partner in the room, but with a little space can sometimes look at themselves more. And there is a moment where both couples are in the room after each of their individual time to share one thing they feel comfortable sharing. Think of it like a really separated EFT process, where you distill with one partner alone, bring the other in for the enactment, and then process/distill with the other partner alone, and finish with their enactment.

- I like that I’m handing a couple more than two options: immediate bonding therapy with me or floundering and separating on their own.

- I like being introduced to the concept of the split session. I never had considered splitting an 80 min couples session and checking in with each partner, and sharing a little at the end. In the past, if a couple was really stalled out, I'd have them each come in for an individual session which felt kind of laborious and like too much time with each of them. 

- I like how much transparency Bill brings to the process. He’s super clear with clients about what Discernment counseling is and isn’t, and what the goals are, and what they can expect.

- I like the flexibility that a couple can start couples counseling, and then switch to Discernment at any point. Of course this would also need the clinical perspective of the therapist to decide if that’s appropriate.

- I like that Bill extensively covers additional questions that could come up, like with affairs, mutually ambivalent partners, and more. He has a section called, "Holding the hope for the marriage without sounding like a cheerleader," which is exactly what I need to learn more about.


TIPS

- I have heard from several clients who have been to other Discernment counselors that they DO NOT LIKE Discernment counseling. In all of these cases, the clients didn’t understand what they were really doing. I highly encourage you, if you do this, to be SUPER CLEAR, and repeat yourself often, with the clients that Discernment is:

            - not going to be working on any problems, or fixing anything in their relationship

            - is only for the purpose of getting clarity on what path they want to take: if they want to put in the effort to try couples counseling, separate, or stay without changing things

            - can be stopped at any point and switch to couples counseling


CONS

- Like with anything that’s not EFT, my concern is that people will be way too quick to use this tool instead of trying EFT and seeing what’s possible. I see this as a tool to be used very sparingly, only in the most necessary of cases. I can see a therapist not experienced in EFT thinking Discernment would be appropriate to use with about half their client load. Ahhhh! No! Try EFT!

* If a client contacts our practice saying they want to start with Discernment, I will definitely honor that. But I give them a taste of EFT in the first session, and I have had clients tell me they want to switch to couples therapy quickly after feeling a little EFT.

- Bill’s method in the individual sessions is not EFT. So while I’m listening to the training, it's tough to listen during the parts of how he talks to clients during the individual sessions. He uses a coaching/weighing in method that’s not the EFT style at all. I do see the need for some coaching in this process, because clients have no idea what to do and they are often panicking. The Withdrawers suddenly become super anxious Pursuers, flooding and overwhelming the burnt-out and withdrawn Pursuers. So I get that there should be some coaching, I just think it’s unlikely someone can suddenly change their behavior just because I tell them to. In EFT, we look at behaviors as reactive in the cycle, so to address them as independent and something the person needs to just change without the cycle changing feels incorrect to me. 

- When I'm initially seeing clients individually in the Discernment process, I still have thoughts running through my mind, "Would EFT be better here? Would EFT be showing them something more here?" It's hard to tell up front when Discernment would be better, I almost like it more as something to use when I feel like the couples work has really stalled out due to one partner's ambivalence or super-protectedness. 

- It is really f-ing expensive. It’s about $1,300 for this training. To compare, the entire 4 weekend in-person EFT Core Skills training is $1,600. The Level II Gottman Home Study Training is 20 hours and $550, including videos and a gigantic manual. I struggle with how this is priced and timed out; while I think Bill's pacing and repetition is lovely and helped me learn, I also feel like when I'm on hour 17 of a training, I'm going to pull my hair out to hear another thing repeated. 

FINAL THOUGHTS:

I like the idea of this process, and I like getting trained in it so I’m not just doing something willy-nilly. I see this as beneficial in terms of learning the structure and the pitfalls, and also something I would bring my own style to when I'm talking to the clients. Mostly I like that it gives me some breathing room and flexibility to be able to check in with clients individually in a split session in a non-shaming way, versus keeping everything couples no matter what when I sense one partner is not engaged in the work.

However, this is a huge chunk of money and time, for something I will use sparingly. When I spend this kind of money and time on EFT trainings, it's a totally different experience for me. I want to stay in those forever. I want to live in a house built by Lorrie Brubacher and Jennifer Olden, and every day watch them do something amazing and learn from them. With Discernment, I kind of want to drive by it in my car, and be like, "Oh yeah, there's that great gas station … I'll remember that if I need to stop when I'm in this town again."

WESLEY, SHOULD I INVEST IN THIS TRAINING?

If, like me, you are a super-rule follower and have a passionate love for training certificates, and also have a practice that is mostly only devoted to couples work, then I think this would be valuable. I think it's important to be well-informed about what else is out there that an educated client may know about. I think the pure Discernment process really would be helpful for some clients. I'm also someone who needs for a person in authority to tell me something is allowed before I do it. If Bill says this is the process, then ok, great, now I can use it. Man, I really need to watch some of my sheep-like tendencies and fervent adoration of authority figures. If you love structure and a more coaching style, this might be valuable for you.

There is no doubt that the training is necessary if you want to do a formal Discernment Counseling process with clients, and tell them/the public that you do Discernment Counseling.

However, if, unlike me, you are a free-spirit who has no trouble following their clinical intuition even if it goes against EFT or another formal model, and doesn't require a person in authority to approve your work, then … I don't know if this would be that valuable for you. Maybe check out the book first (see below) and see if it sparks your interest. Of course you can't say you do Discernment Counseling without the formal training, but you may not even want to.

When I consider investing in a training, I think, "what is the big picture here?" With the primary EFT trainings, the big picture is way too vast to explain in even a paragraph. I'll spend my lifetime doing EFT trainings because EFT is everything to me. With Gottman trainings, I would say my big picture reason for doing those trainings is to understand all their amazing research and to really be educated on one of the most dominant models of couples therapy out there, which I think made it worth the time and money to do Levels I and II, even if I don't use hardly any tactile Gottman in the room. With Discernment, I would say the big picture reason is to understand how to pause, honor, and stay with couples when one is leaning very far out of the relationship. As much as I like Bill's voice and presence, and think Discernment is a valuable process, I also struggle with spending all that time and money just on that reason.  

Just my two cents! Have you guys tried this training? Any thoughts or other questions for me?


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Before taking the whole plunge into the training, you can check out Bill’s book:  

 

 

 

 

 

 

 

 

 

Doherty, B., Harris, S. (2017) Helping Couples on the Brink of Divorce, Discernment Counseling for Troubled Relationships. Washington, DC. American Psychological Association

What is Discernment Counseling?

Up until a few months ago, I had never heard the phrase Discernment Counseling. Have you heard of this? Once I was introduced to it, I decided to start the training. It’s a significant financial and time commitment, so hopefully it’s helpful to hear my impressions. It’s a lot to cover so I’ll be doing this in several parts.

What is Discernment Counseling

Discernment Counseling is a process of 1-5 sessions where you split the session and see each partner individually, with some minimal sharing in-between. The goal is NOT to work on the relationship. The goal is to get clarity about which of three paths they want to go down: 1) things stay as they are, they neither separate nor work on the marriage, 2) they separate, or 3) they try 6 months of couples counseling with divorce off the table.

Why this sounded appealing to me in the first place

Most distressed couples I see present with one partner leaning more out of the relationship. Or in the distressed part of the cycle, one will threaten ending the relationship. These couples are not why I was interested in Discernment.

It’s far more rare, but every so often I see a couple where one or both people truly appear to be burnt out to the point they can not put any effort into rebuilding. 

I’ve also felt like in highly reactive couples, where they both are just swimming in negative sentiment override, that it’s really difficult for them to build any alliance with me. Their brains are so flared and flooded that they can barely register me being in the room once their cycle whips up. With these couples I feel like I will lose them in 1-2 sessions.

In these cases, the burnt out/leaning out partner is coming in very wary of the idea of re-bonding. It used to be something they long for, now they don’t even know if they want it. The leaning in partner might be able to share some really lovely attachment pieces pretty quickly. But the idea of hearing their partner’s loving emotions they used to long for, now feels totally smothering.

This is different than someone who feels disbelieving or skeptical about their partner’s attachment emotions. This is when a client gets flooded hearing that their partner has loved them all along, or when the formerly withdrawn partner starts showing up and wanting to spend time with them, and they feel totally suffocated and panic. 

I feel weirdly defensive as I write this. I’m imaging you all saying, “Wesley, but don’t you know that with EFT you do this with the couple together in the room, and you help validate and unpack the partner’s resistance?”

I do, guys, I really do. 95% of the time I think this is the best way. But with 5%, I just feel like that work is going nowhere because the leaning out partner is feeling so much pressure and doesn’t really want to be there at all. 

So my markers for when someone is leaning so far out that I’m questioning if couples therapy is right for them are: smothered, guilty, suffocated, panicked at re-bonding.

If one partner is leaning in, and the other is leaning out, this is so much easier. I don’t know if they will re-bond, but at least one is willing to be, as Bill Doherty says, the “champion for the relationship” while the other is highly ambivalent. The hardest is when both partners are ambivalent, talk about separating all the time, and make half-hearted gestures towards each other but then go back into their flared corners.

I’ve had a few couples where the leaning out partner is so flared that when we start to get to Step 3 with the leaning in partner, they get incredibly overwhelmed at hearing they have been loved the whole time, and want to shut down the process immediately. I’ve also had some couples where no matter what amazing things the Withdrawer is doing and how they are showing up, the burnt-out Pursuer feels suffocated by this love they used to long for. This is different than when a Pursuer is highly defended and shooting lots of bullets to see what their partner will take. When I see that, I think, “score! This Pursuer is still attached.” I’m talking about when the Pursuer does not want to spend time with the Withdrawer, does not want to hear that their partner cares for them, and is annoyed by the Withdrawer.

Overall, I also wanted to try and see what Discernment Counseling was about because I really believe in honoring where each person is. If someone comes in and tells me they are truly thinking of leaving the marriage, I don’t want to brush over that, or act like that will change once I can show them what EFT can do. I want to spend time with where they are, and respect what they are telling me. My hope is that by giving them a process and some space, if they do decide to do the couples counseling they feel like I have respected and not rushed them, and they are entering into it ready to work on the marriage.

I’m half-way through the training, and I like some parts and don’t like other parts. I’ll keep you posted on what I think!

 

If you're interested, learn more about it here: www.discernmentcounseling.com

 

Esther Perel - "Where Should We Begin?" Podcast

Have you heard of Esther Perel? A few years ago she wrote a book called “Mating in Captivity, Reconciling the Erotic and Domestic”. She’s a well-known couples and sex therapist, and one of the aspects of her I really enjoy is she naturally brings a multi-cultural lens to her work. She grew up in Belgium, studied in Israel, and speaks eight languages. She has recently come out with a podcast called “Where Should We Begin,” where you hear her do part of a real session in each episode.

As I was listening to her, I realized how enjoyable it is to listen to a therapy session from a relaxed stated. Usually if I’m listening to an EFT session I’m in a hyper-absorbing mode, trying to catch every detail of what’s happening. When I watch Gottman sessions (through the training videos), I tend to watch more critically, because I’m both learning it and also resisting it. With Esther’s podcast, I think it might be the first time I was able to just listen from an observing place, and really let what was happening wash over me.

As I write this, I'm conscious that my readers are mostly EFT therapists, as I am. A therapist once described to me how he explains his style to other therapists, and it was so perfect I have always remembered it. He said he sees his work in three categories: “How I conceptualize the client, how I am with the client, and how I intervene with the client.” Esther doesn’t use/intervene with EFT, so that may be tough for some EFT therapists to listen to.  I don’t know how she would describe her method, but as an observer I would describe it as balancing a coaching, instructional style with the Dan Wile method of speaking for one client to the other. So fair warning, as an EFT therapist there might be moments where you don’t love how she intervenes with the clients. But I hope that doesn’t prevent you from absorbing how she conceptualizes and is with the clients. Because I think she’s a genius. She is absolutely trauma informed, and I love her belief system about sex and how we are as sexual beings.

In the podcast so far, one of the most fascinating episodes is when she worked with a couple who both have sexual trauma in their pasts, and now are on seemingly different pages with how they approach sex. The male partner, Scott, immediately shuts down when his wife makes sexual requests and wants to have more play sexually, and then she feels shamed and rejected. EFT may have slowed down and spent a lot of time understanding the pursue/withdraw cycle in these moments, and what each are feeling. Esther went more strengths-based, and asked if anything was working for them. They shared that sometimes the male slips into a playful alter-ego, Jean-Claude, and he speaks French in that alter ego. This doesn't seem to be a splitting or dissociation, the client had full access to himself and yet could also embody this role-play. But the client hasn't quite integrated Jean-Claude as a part of himself. Because Esther speaks French, and the client’s wife does not, Esther asked the client to speak to her from Jean-Claude and she translated and spoke to each partner. 

Jean-Claude is free from what Scott is not. Jean-Claude comes from a grounded place, a place connected to his own pleasure. Thus when he touches his wife as Jean-Claude, he is not tentative, scared, or only thinking of he’s getting it right or not. Scott’s wife said she loves being touched by Jean-Claude in that way. Scott said that his wife likes “the bad boy,” and Esther explained that women like the "bad boy" because they are responsible for themselves. She doesn’t have to worry about if he’s ok, or if she needs to feel his anxiety or watch out for him. If he’s taking care of his pleasure, it frees her up to be in her pleasure (Episode 3). These informative comments from Esther help educate me in how she conceptualizes desire. 

Although Esther’s intervention style isn’t EFT, I just adore her work. It is a gift to me to read and hear her thoughts in how she conceptualizes sex and desire. And to hear a therapist do sessions like this on a podcast (with full permission from the clients) is so totally fascinating. I mean this is really bringing therapy out into the world in a totally new way. I would love for non-therapists, especially men, to hear these episodes because I think they are so normalizing and educational for where so many people struggle.

 

Perel, E. (2006) Mating In Captivity. New York, New York: HarperCollins Publishers

Perel, E. (October 8, 2017) Where Should We Begin? Episode 3 [Audio Podcast] Audible. Retrieved from http://itunes.apple.com

Wile, D. (1993) After The Fight. New York, New York: The Guilford Press

 

 

The Gottman Assessment

It might surprise you guys to know about a month ago I started learning The Gottman Method, especially since I am a die-hard fan of EFT. I moved to a new practice recently and they encouraged me to learn Levels I and II of Gottman. I was excited about this, for a few reasons. Other than glancing through some systemic work from Virginia Satir and Salvador Minuchin in grad school, I really don’t have the foundational training in couples therapy the way a therapist who comes from an MFT program might have, so any extra learning about couples and marriage is helpful. I also really like the idea of being able to speak intelligently about other models and why I choose to use EFT. Also, I love learning this stuff, it’s all so fascinating!

Something I think The Gottman Method does really well is their assessment process. I wanted to share a little of that here in case it would be helpful for you guys to use any of this in your work. They do the same set up as EFT, where you have the couples intake, and an individual session each. They also have an online assessment the couple takes (individually) that is an extensive review of how they are feeling in different categories of their relationship.

In the in-person intake, there is a way that the Gottmans ask questions I have found particularly helpful in understanding the couple’s relationship journey. They ask, sequentially:

1.     How did you guys meet, and what led to you dating?

2.     What led to you moving the relationship forward to the next step?

3.     How did you decide to get married?

4.     What was the first year transition of being married like?

5.     How did you decide to have children?

6.     What has the adjustment of becoming parents been like?

These aren’t mind-blowing questions, I’m sure we all ask a version of this, but the way they phrase the questions as, basically, what was the decision making process like, how did you decide to move to the next relational step, I have found gives back way more fruitful answers than I got in the past. It’s helpful to hear if it was a situation that moved things forward (sick parent, job move, pregnancy) or if it was choice based on feelings only. It’s also helpful to hear how much agency each person feels like they have in the relationship. Do they feel like they “have to” go along with decisions because their partner is making them? I feel like I’m getting a more thorough view of their relationship history with these questions.

The online assessment also gives me a view into their relationship I wasn’t seeing before. The online assessment measures so much I can’t cover it all today, but I wanted to highlight one standout today:

Love Maps

This measures how well each partner feels like they know the other’s world. What did they eat for lunch that day? Who are the people they work with? What does it look like when you partner is a stay-at-home parent? What is your partner's favorite way to relax? This might sound small, but I hear so many issues with a couple coming from not understanding the other’s world. If someone really doesn’t understand the work and exhaustion of being a stay-at-home parent, then they have less patience with them, less empathy for things not being done in a certain way. If someone doesn’t understand how lonely their partner feels at a new job, they don’t understand why they want to talk to them more when they come home at the end of the day and are frustrated when that’s not happening. Even before taking the assessment, I hear somewhat frequently that this is a place of hurt for a partner. I hear things like, “she couldn’t name four people I work with, but I can tell you the names of ten people she works with.”

Gottman’s (1999, 2015) research found that an important protector of a marriage is the quality of the couple's friendship. Isn’t that kind of sweet? He found that it was the mundane stuff that built that friendship. If you partner wants to show you a funny youtube video, do you stop and turn towards them? Did one text the other a message of support going into a tough meeting? This helped me understand the importance of turning towards my partner, too, when he makes a bid for connection – even if it’s just showing me something on instagram.

I hope you guys find this helpful, and thank you for letting me share some non-EFT pieces in here with you!

 

 

Gottman, J. M., & Silver, N. (2015, 1999). The seven principles for making marriage work. New York: Three Rivers Press.