Relationship Stressors
Marriage Preparation
Written by Jeffry H. Larson, Ph.D
The Beatles sang, "All you need is love." Your friends might tell you, "Good communication is all you really need." Your parents advise you, "The key is to marry someone with the same values." Everyone has advice these days for people considering marriage, whether it's a first marriage or remarriage. The problem is, none of this advice is totally correct, nor is it totally incorrect.
So, what premarital factors best predict the future success of your marriage? What kinds of couples should not get married? How do you know you are ready to marry? If you are in a serious relationship, should you pursue marriage, break up, or just keep things the same?
Predicting a Satisfying Marriage
Social scientists and clinicians have found two dozen or so specific factors that predict future marital satisfaction. These factors can be viewed as forming a triangle-a model known as the marriage triangle. The three major factors in the triangle are:
- Individual traits: These include an individual's personality traits and emotional health, as well as values, attitudes, and beliefs. Examples of such traits are: flexibility and self-esteem (positive factors), depression and impulsiveness (negative factors), interpersonal skills (e.g., assertiveness), and realistic beliefs about marriage.
- Couple traits: These include couple communication and conflict resolution skills, degree of acquaintance (how long and how well the couple has known each other), similarity of values and goals (positive factors), and living together as a trial marriage (negative factor).
- Personal and relationship contexts: These include family background characteristics such as previous marriages, existing children, the quality of an individual's parents' marriage, family relationship quality, age at marriage, and parents' and friends' approval of the relationship.
Assessing Yourself and Your Relationship
Knowing and understanding the premarital factors discussed above is the first step. The second step is assessing these factors in yourself and your relationship. This can be accomplished most effectively and easily by completing a comprehensive premarital assessment questionnaire (PAQ) and interpreting the results with your partner. Three high-quality PAQs that provide couples with useful feedback on their strengths and weaknesses in each of the areas above include:
- Facilitating Open Couple Communication, Understanding and Study (FOCCUS)
- Relationship Evaluation (RELATE)
- Premarital Preparation and Relationship Enhancement (PREPARE)
Each of these questionnaires can be completed in about an hour and provide you and your partner with a detailed written report about individual traits, couple traits, and contexts of your relationship. Strengths and weaknesses in each area are also highlighted. RELATE can be completed online and provides a self-interpretive report, enabling you to analyze and interpret the results. FOCCUS and PREPARE are used with the assistance of a premarital counselor or clergy person trained in using these instruments. The cost of taking these PAQs is relatively inexpensive ($10 - $30 per couple). All contain questions for people considering remarriage, as well. The accuracy of the results depends on the honesty and insight of the partners when they answered the questions.
These PAQs aim to encourage awareness and couple discussion of strengths and weaknesses, readiness for marriage, and goals that should be met before marrying. Couples find these discussions to be very interesting, informative, and useful. It is important to note that these PAQs are not intended to be like a crystal ball that predicts marital happiness. Rather, the results are used as a way to focus discussions between partners on developing strengths and overcoming weaknesses before they marry. This is important to do because weaknesses that exist before marriage and are unknown or ignored usually develop into bigger problems after marriage. And, since couples in the premarital stage of their relationship are usually younger, happier, and more emotionally engaged and more highly committed to their relationship than at any other time in their relationship history, it makes sense to have these discussions before marriage.
Going from Assessment to Improvement
Going from assessment (using a PAQ) to personal and couple improvement involves 3 key steps:
- Noting the areas of concern found in the PAQ results, such as poor couple communication skills or too short an acquaintance, and celebrating strengths like emotional health and healthy family backgrounds.
- Deciding what is causing the identified problems-for example, poor listening skills or a hesitancy to express feelings, or rushing into marriage too quickly due to pressure or fear.
- Finding and using the resources to help improve the situation-that is, turning weaknesses into strengths. This may include reading self-help books, listening to audio or video tapes, attending a communication skills training group, or premarital counseling. Suggested resources for these options are listed at the end of this brochure. Knowing there are many good resources for enriching marriage after the wedding gives couples more confidence as they enter into marriage.
A PAQ may also be helpful in discovering that further assessment or counseling is needed. For example, if an individual's PAQ results show that she or he is depressed, anxious, or has low self-esteem, a more thorough mental health assessment may be recommended, possibly including therapy. The person's improvement in mood and self-esteem will naturally increase the chances of being happily married.
Premarital Counseling
Most premarital counseling includes using a written questionnaire like one of the PAQs described earlier. Premarital counseling usually involves spending 5 - 7 sessions with a family therapist interpreting test results, setting goals for improvement, and discussing other important topics related to marriage such as finances, roles in marriage, and having children. Premarital counseling also helps the couple improve their communication skills. Most couples rate premarital counseling as very helpful, and it also establishes in their relationship a positive attitude about seeking help if marriage problems arise in the future.
Marriage and family therapists (MFTs) are uniquely trained and qualified to help couples with premarital assessment and counseling. An experienced MFT understands the diverse dynamics of couples and their relationships, and is prepared to assist couples with any issues that may arise.
Domestic Violence
Written by Sandra M. Stith, Ph.D
Domestic violence is all too common in American families. In almost 20 percent of all marriages, couples slap, shove, hit, or otherwise assault each other. Emotional abuse—verbal threats, humiliating or degrading remarks, and controlling behavior—is even more common. If you or someone you love is in an abusive relationship, help is available.
Marital violence is especially common among young couples, and, without intervention, may escalate in intensity or frequency. In many marriages, violence begins with shoving or pushing. Couples frequently ignore early aggressive incidents and believe that once current stressors end, the violence will end. However, even minor acts of violence can escalate over time, increasing the risk of injury or even homicide.
There is no single type of marital violence. Sometimes, controlling behavior on the part of her husband is a woman’s first sign that she may be in an abusive relationship. Her husband may prevent her from seeing friends or family and make her feel guilty or afraid if she chooses to spend time with others. Physical assaults coupled with increased social isolation strengthen his control. Over time, a woman can come to feel like a hostage in her own home.
In other relationships, the violence is different. Both the husband and wife slap or shove each other when they get angry. Often, they are more concerned about the content of their disagreements than the violence itself, and neither partner sees themselves as being abused or controlled. However, even violence that is not part of a controlling, frightening relationship can devastate a marriage, lead to criminal charges and injuries, and have long-term negative effects on children who witness it. There is help for couples like this, too.
How can I get help?
Since domestic violence is a crime, one way to get help is to call the police. If you have been hit by your partner or are afraid for your safety, your first response needs to be to protect yourself and your children. The police can be your first line of defense. You can also call the local Battered Women’s Shelter Organization, community crisis line, or community mental health agency to find out what services are available to you. Most communities have offender treatment, victim support services, and access to a shelter where you and your children can go if you are afraid.
If the violence has not escalated to the point that you are fearful, but you or your partner recognize that the way you argue is not healthy and want to prevent destructive arguing from destroying your marriage or escalating to battering, there is a variety of options available to you. Most communities have anger management or men’s treatment programs that can be found through the mental health services agency. These programs help you learn skills to resolve conflict and handle anger without letting it escalate. Support groups for victims can also help you maintain a commitment to living in a nonviolent household.
In addition to anger management and victim’s support groups, you may want to seek marital therapy if you are both committed to ending the violence and improving the marriage. Marital therapists work with couples to develop strategies for resolving conflict without violence. Make sure that your therapist knows about the violence in your relationship and has experience and training working with marital violence. Through domestic violence–focused marital treatment, couples are given tools to eliminate violence, resolve conflict, and improve marital relationships.
If you decide to leave a violent relationship, a marriage and family therapist can help you and your children deal with the changes in your lives and with the trauma you have each experienced. A marriage and family therapist can help you access your strengths and coping skills to move forward.
What to do if a Friend or Family Member is in a Violent Relationship
If someone you care about is in a violent relationship, let them know you care for them regardless of their decision to stay or leave their partner. Women stay in violent relationships for many reasons, including the mistaken belief that they cannot make it on their own. Many battered women feel isolated and have no one to talk to with about the violence they are experiencing. Ask gently about any injuries or emotional upset you observe and listen without passing judgment. Find out about resources for battered women in your community. If your friend decides to go for help, you may need to accompany her. Most women eventually leave violent situations through the ongoing support of a caring friend or family member.
Forty years ago, most people thought of adoptive parents as couples who could not become pregnant, and who adopted an infant to raise as "their own." Today, some adoptive families are formed in this way and for this reason, but there are many new ways in which adoption brings families together.
Adoption today may include infants born in the United States or abroad, or it may involve children joining their new families at any age before 18. Children may be of the same race as the family they join, or they may not. They may be placed individually or as part of a sibling group. Domestic adoption includes adoption through private adoption agencies, or independently with the assistance of an attorney or other intermediary, and adoption through public agencies. The latter involves children who are adopted from the foster care system, often by relatives, known as kinship adoption. In international adoption, children are placed from countries in Eastern Europe such as Russia, and from South American countries such as Guatemala and Peru. Many children are also adopted from Asia, where China and Korea are the leading countries sending children to the United States.
The Decision to Adopt
Making the important decision to adopt may be one of the most challenging and difficult decisions a person or couple can make. If it is the result of infertility, it may mean giving up the dream of having a child by birth. This can be experienced as a very tragic loss. It is not unusual for any person grappling with this decision to experience a great deal of anxiety and fear, in addition to sadness. They may wonder, "Which type of adoption should I choose? What type of child? Which agency can I trust? Will the child be healthy? Will my extended family accept this?" The process of adoption itself can feel overwhelming, especially in terms of the paperwork involved and the home study that is required prior to approval for adoption. The stress on a marriage can be great, especially if one partner is ready to proceed with adoption before the other.
People who adopt from the foster care system have special concerns as well. Because many children in foster care have special needs, prospective parents are aware of the importance of financial support to provide medical, emotional, or academic support for the children. They may worry that services provided during foster care will end once the child is legally adopted. Kinship adopters particularly have concerns about how to handle future contact and relationships with the child's birth parents.
Whatever the circumstance, family therapists who understand the questions and concerns of prospective adoptive parents can provide the education, support, and counseling to help them through the decision-making process.
Adoptive Parenting and Children
Adoptive parenting is the same as, and different from, parenting children by birth. It is the same in that parents love their children and want what's best for them, and worry about their child's health and well being in the same way that biological parents do. It is different because adopted children face unique challenges and feelings related to being part of an adoptive family. These challenges include feeling different from children who were not adopted, feelings about why they were placed for adoption, feelings about birth parents, as well as concerns about handling questions by peers and adults about their adoption. Adoptive parents need to know how they can help their children to successfully handle those challenges.
When children are having trouble with feelings related to adoption, their behavior often reflects it. Communication about the impact of adoption, within families and also with others, is not easy to initiate.
The emotions can become quite strong and result in new behaviors:
- Withdrawal from others
- Daydreaming in school, changes in school performance (falling grades, not completing homework assignments)
- Angry outbursts, temper tantrums, or aggressive behavior with siblings, peers, or adults
- Anxiety, fearful behavior, or difficulty being apart from parents
- Changes in eating or sleeping patterns
These behaviors can certainly wreak havoc on family relationships and result in worry and conflict. The behaviors do not necessarily mean that the child is experiencing difficulty related to adoption, but only a therapist who understands post-adoption challenges can help decipher the problem. It is important to note that post-adoption issues can also surface during adolescence, a life stage that can often be a challenging time for any family. Teens are trying to figure out their identities: who they are. As teens struggle to formulate their identity and figure out who they are, having two sets of parents can complicate this task because adopted teens must determine how they are like and different from both their adoptive and birth parents, whom they may have little or no information about. Adopted teens often have more anxiety about emotionally separating from parents, as well as leaving home.
The Important Role of Family Therapists
Family therapists can help the adoptive family to understand what impact, if any, adoption may be having, and they can help the parents to learn how they can help their child. Adopted children are sometimes reluctant to discuss adoption with their parents for fear of hurting them. If for example, they are wondering about their birth parents, such thoughts may make them feel disloyal when in fact they love their family very much. A family therapist can provide the support a child needs to open communication with his family. The therapist can also help parents identify other steps to assist their child. For example, both parents and children may need to learn effective ways to handle the many comments and questions they receive from others about adoption.
When school difficulties are involved, the family therapist can assist the family in correctly assessing what the child needs. In addition to emotional difficulties related to adoption, children may be experiencing learning challenges or other difficulties like Attention Deficit Disorder. The therapist can assist the parents in advocating for whatever additional services might be required of the school, such as educational testing and changes in school placement.
An area where family therapists can be particularly helpful to adoptive families is the array of new challenges arising from increased contact between birth and adoptive families. As families work through these relationships, and the way they may change over time, a trained professional can help to ensure positive communication and comfortable boundaries, which benefit the child and strengthen family relationships.
There are times when adoptive parents question whether they are adequately meeting their adopted child's needs. Whether it's anxiety related to talking with their child about adoption, discomfort related to some aspect of their child's personality or functioning, or issues related to relationships with extended family members, family therapists can provide parents with assistance in working out their concerns and strengthening family ties.
Infertility
Written by Beth Cooper-Hilbert, Ph.D
Infertility is commonly defined as the inability to conceive a child or carry a pregnancy to full term. It is one of the most severe crises that a person or couple may ever face, and presents a tremendous physical, emotional, and financial challenge.
Infertility is often a lonely and confusing battle, but not one that has to be fought alone. Treatment for infertility requires a team approach and should include both medical and mental health professionals. As one might expect, infertility places a great deal of emotional strain on individuals and couples, as well as friends and family. Due to the complexity created by infertility, a mental health professional specially trained in dealing with the impact on individuals, couples, and families is often necessary to help get through this crisis.
Effects of Infertility on Individuals and Couples
Most people go through a series of intense feelings after being diagnosed with infertility. Feelings of anger and sadness are quite common, as are feelings of loss and betrayal. A couple's or individual's sadness may turn to grief- grief for the child of their fantasies or grief for the experiences they imagined sharing with the child. Couples, in particular, are likely to experience changes in their relationship. These may include feeling more emotionally distant or needing to withdraw from intimacy. Feelings of guilt and self-blame may also arise, particularly if one of the partners is identified as being the primary cause of the infertility. Additionally, the unfertile partner may fear that the other person might leave the relationship.
Often, individuals and couples experiencing infertility may begin to isolate themselves from friends and family. They may dread attending social functions for fear that uncomfortable discussions about the fertility process may arise. Socializing with friends and family who have children or who are pregnant may also become difficult, especially during periods of difficult diagnostic tests and treatments.
How do I know when to seek help?
While the primary focus of infertility treatment is medical, dealing with the personal and familial implications of infertility is vital for a person’s mental health. Marriage and Family Therapy can be most beneficial when:
- Starting a new treatment or after a failed treatment
- Having to make difficult treatment decisions
- Needing extended family support and assistance
- Considering third party assistance (surrogacy, egg or sperm donation)
- Investigating other options for family building
Marriage and Family Therapy is also helpful when individuals or couples experience:
- Persistent feelings of sadness, guilt, loneliness, anger, and/or anxiety
- Increased disagreements and discord (between partners)
- Strained interpersonal relationships with friends or family
- Difficulty concentrating and remembering
- Social isolation
- Thoughts of suicide or death
How can a Marriage and Family Therapist Help?
The marriage and family therapist will provide his or her clients with a safe, neutral ground in which to discuss the numerous issues related to infertility, and also validate the intense feelings and emotions which often accompany the crisis.
Although marriage and family therapists cannot actually intervene in medical treatments to help a woman become pregnant, they can help individuals wade through the process, communicate better with each other, and gather more support from family and friends. Since marriage and family therapists are trained to focus on an individual or couple within a systems context, they can help persons experiencing infertility to address issues in a clearer way. Therapists are trained to help couples understand how the interactions between the couple and their families can sometimes get in the way and create conflict.
Therapy can also provide an opportunity for individuals and couples to learn more efficient ways of addressing issues, make sense of them, reduce conflict and stress, and make wiser decisions regarding medical treatments. Often, partners have different opinions regarding a particular treatment, which may result in relationship discord. A marriage and family therapist can help the couple negotiate a plan, become more focused, and set an agreeable timeline for treatment. He or she can help evaluate when it is time to change course or stop medical treatment altogether, and help explore other alternatives. Additionally, the therapist can equip the client with helpful resources for infertility, such as referral to support groups, videos, and literature. Support groups are an especially valuable resource that can help individuals and couples cope with infertility and provide the opportunity to learn from other people experiencing the same crisis.
The guidance of a marriage and family therapist is an essential component for resolving the infertility crisis. Therapy addresses the critical issues at hand, and will assist in building constructive bridges to life goals that are realistic and meaningful.