Praxical.Psych

Couple Therapies

Couple distress is maintained by a self-reinforcing negative cycle in which each partner’s protective behaviour triggers the other’s, and it changes when the cycle is made visible and interrupted — by restoring attachment safety, by changing the contingencies, or by building acceptance of what will not change.

1970s – presentCT-CEvidence: Good support
The claim, in one line

Nobody is the patient. The relationship is.

Who built it

  • Susan Johnson

    Psychologist

    Emotionally Focused Couple Therapy: attachment theory applied to adult love, with the negative cycle as the target and the enactment of new bonding events as the mechanism.

    EFT-C
  • John & Julie Gottman

    Psychologists

    Four decades of observational research on what actually predicts divorce, and a method built on those findings: the Four Horsemen, repair attempts, bids for connection, and the Sound Relationship House.

    Gottman Method
  • Andrew Christensen & Neil Jacobson

    Psychologists

    Integrative Behavioral Couple Therapy, which added acceptance to behaviour exchange after finding that traditional behavioural couple therapy produced gains that did not last.

    IBCT

Theory of personality

Contemporary couple therapy is built on adult attachment. Partners are each other’s primary attachment figures, and the question underneath most conflict is not the dishwasher but "are you there for me?" Protest behaviour — criticism, pursuit, demand — is understood as attachment protest rather than as aggression, and withdrawal as deactivation rather than indifference.

The pursue–withdraw cycle

The most common and most damaging pattern, and the one both major approaches target. One partner escalates to get a response; the other withdraws to reduce conflict; each behaviour causes the other. Both are trying to protect the relationship, and together they are dismantling it.

Theory of psychopathology

The Four Horsemen

HorsemanWhat it looks likeAntidote
CriticismAttacking character rather than raising a complaintGentle start-up: "I feel X about Y, I need Z"
ContemptSuperiority, mockery, eye-rolling, sarcasmBuilding a culture of appreciation; the strongest predictor of divorce
DefensivenessCounter-attacking or playing victimAccepting some responsibility, however small
StonewallingShutting down, usually when physiologically floodedSelf-soothing, and a real break of at least twenty minutes

Gottman’s physiological work adds a mechanism: during flooding, heart rate exceeds roughly 100 beats per minute and the capacity for empathy and problem-solving is not available. Continuing to talk in that state is not persistence; it is damage. The break is a physiological intervention, not an avoidance.

Gottman also found that roughly 69% of couple problems are perpetual — rooted in stable differences of personality and value that will not be solved. The task is dialogue about them rather than resolution of them, which is a substantially different therapeutic goal.

Theory of change

EFT for couples

  • De-escalate the negative cycle by making it the shared enemy
  • Access the underlying attachment emotions beneath the protective behaviour
  • Stage new bonding events: enacted reaching and responding
  • Consolidate a new cycle of accessibility and responsiveness

IBCT

  • Formulate the theme, the polarisation process, and the mutual trap
  • Build emotional acceptance through unified detachment and tolerance
  • Add change strategies — behaviour exchange, communication training
  • Accept what will not change, and stop fighting about it

Key concepts

The vocabulary you need to read the literature and to be understood in supervision.

Where it sits in the transtheoretical grid

Which change processes the system leans on, and at what level of content it aims.

Change processes emphasised
  • Helping relationship

    Being open and trusting about problems with someone who cares; the relationship as vehicle, and as medicine in its own right.

  • Consciousness raising

    Increasing information about oneself and the problem - feedback, interpretation, education, observation.

  • Catharsis / dramatic relief

    Experiencing and expressing affect about the problem, whether by corrective emotional experience or by evoking what has been avoided.

  • Counterconditioning

    Substituting an incompatible response for the problem response - relaxation, assertion, exposure, defusion, opposite action.

  • Contingency management

    Rewarding oneself or being rewarded by others for making changes; managing consequences deliberately.

Content levels targeted
  • Current interpersonal conflicts
  • Family / systems conflicts
  • Intrapersonal conflicts
Compare against other systems

Your notes

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
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