Posts Tagged ‘Couples Counseling’

In my San Diego counseling practice at Cunninghamtherapy.com, I have observed a client have a “lightbulb moment” quickly when I have spontaneously come up with a good metaphor. It is sometimes effective to come up with metaphors that are related to the client’s occupation.Most of the time, a good metaphor advances a deepening dialogue and can even access unconscious material. Below are some examples of metaphors I have used (although I have never met a phor I didn’t like!)

…You are just flying through some turbulence. This, too, shall pass.

…You are actually in the vestibule (hallway) of positive, groundbreaking change if you can just find the hidden nugget in this current challenge

…Would you rather be right or be connected?

…What is your partner up against being in a relationship with YOU?

…A tug-of-war doesn’t work if only one pulls. Can you let go?

…Your dynamic is like a teeter totter. Think about your cycles of opposite postures: distancer/pursuer/ or overfunctioner/underfunctioner, or saver/spender, etc

In illustrating the dynamic in an affair, I point out to clients that a three legged stool is more stable than a two legged stool but ONLY in the short run. The relief one gets in the short run (eg “Whew, I’m not broken in love after all!”) often creates just enough complacency to gel into place the chronic problem between the original insiders and keep the problem alive.

…Marriage and family therapy is different from other mental health disciplines. It is broader. It is like climbing to the top of the bleachers to see the game from afar. Now one can see how each individual in the system plays into the gestalt instead of the typical view of the individual practitioner, who tends to view the game from the fifty yard line.

…When a client softens into a more vulnerable posture, I may tentatively ask softly, “How old are you now?”

…Use my red, Russian nesting doll set on the end table and invite thoughts of how the preceding generation in one way or another informs the next. Ask what comes to mind about that. Also, might ask a nervous client to handle the dolls—twisting and untwisting—in session.

I invite you to call me for a complimentary telephone consultation at 619 9906203. Take advantage of the seasoned services of Dr. Cunningham, MFT and begin your couples counseling or individual counseling experience with Cunninghamtherapy.com in this brand new year. You will be glad that you did!


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At Affordable Relationship Counseling, licensed marriage and family therapist, Dr. Barbara Cunningham, specializes in issues of grief and loss. Death, divorce, breakups, pet loss, homicide, suicide, career transitions, moves and many other changes all may herald in a period that the client may experience grief and loss. Dr. Cunningham emphasizes that all people belong to an emotional system. Emotional systems are made up of individuals, all of whom are interdependent upon one another to a greater or lesser degree. Thus, exits from the family system may create a kind of “emotional shock wave effect,” wherein relationships shift among members upon the death of an important family member.

As Dr. Cunningham experiences just such a change…the serious illness of her own mother…she is observant of the emotional process swirling about her and within her. She often advises clients not to make major decisions or changes for a year following the death of an important family member or after a divorce. This is a cautious way to insure that the brain calms down enough to make a rational decision. Homo sapiens are a social species. When we lose a profound attachment, it is an automatic impulse to grieve and even to look for a replacement love object to comfort us in our loss. The idea of doing so is normal…letting the passage of time occur to insure the decision is made with reflection is good insurance. To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.cunninghamtherapy.com or call 619 9906203 for a complimentary telephone consultation.

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At Affordable Relationship Counseling in San Diego, CA , licensed marriage and family therapist, Dr. Barbara Cunningham, often sees clients who present with issues of loneliness around the holidays. It seems that people feel a heightened sense of loss around Thanksgiving and Christmas. Television, movies, magazines, and advertisments seem to emphasize pictures of happy families that are a stark contrast to what people wish they had in their own lives. Often times burned bridges and broken dreams come into bold relief at this time of the year and make it most difficult for people to get through the days of gift giving, Christmas carols, and holiday mirth. Allowing people a safe holding environment to process feelings of vulnerability may be a beginning point.  It takes courage to begin the therapy process. Talk therapy is a proven way to begin. Research has shown that isolation is not good for one’s overall health. If one is not connected, or feels isolated, one is at risk for myriad health problems. Human beings are a social species.  Adaptation to loss can, over time, bring increased integrity and deeper meaning to life. To learn more about Dr. Cunningham’s strength based model of practice, call 619 9906203 or visit her website at http://www.Cunninghamtherapy.com to get more information.

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At Affordable Couples Counseling in San Diego, California, licensed marriage and family therapist Dr. Barbara Cunningham offers couples the opportunity to strengthen the foundation upon which their relationship rests. Research suggests that couples wait an average of six years before seeking help when their relationship is in trouble. The stigma attached to seeking professional help is still ever present in our society. Yet it is far cheaper and the course of therapy may be significantly shorter if couples begin sooner rather than later when their relationship becomes “stuck” in unhelpful patterns.

Premarital therapy offers couples opportunities to discuss hot button issues in a safe, holding environment with a neutral third party. Professionals can facilitate discussion and encourage the respect for difference typified in the healthiest of marriages.

Interestingly, one of the least happy times in marriage may be after the birth of the first child. Often times, the father may feel pushed to the “outside” with the demands of a newborn. Working on the marriage during the pregnancy and preparing for the birth may be a wise investment. A division of labor generated in advance, for example, is one idea that may be helpful.

Distancer/pursuer cycles can create chronic problems that increase the intensity of dissatisfaction on both sides. Such problems are better addressed early on.

To learn more about Dr. Cunningham’s marriage counseling and couples counseling services, visit her website at http://wwww.Cunninghamtherapy.com or call her at 619 9906203 for a complimentary phone consultation

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Dr. Barbara Cunningham, licensed marriage and family therapist,  is a proponent of bibliotherapy and believes that little children adjusting to big changes can benefit from a bibliotherapeutic approach. Talking about sensitive topics is difficult for all of us, and and children are no exception. Whether in play or through the magic of an imaginative and beautifully illustrated narrative, children seem to be able to approach their grief and frustration if psychotherapists provide them with an avenue to go from the outside (story) to the inward emotions and thoughts. What follows is Dr. Cunningham’s review of a great example of this sort of book:

THE SEA CAT DREAMS, by J. R. Poulter, is a beautifully written tale that helps children consider the nature of change. The power of this narrative is in its subtlety. A cat is born on a farm, winds up hidden in a bag of a salty sailor, gets taken from his home to remain with the departing sailor, and after a time at sea, “meows the sailor’s eulogy.” The cat is given to his widow and serves as a comfort to her. At each age and stage of the cat’s life, past times are remembered with the nostalgia that only comes from memory.

Humans are the only species aware of their own impermanence. It may be with the first observation of a falling, dead leaf that a child has a blossoming notion, though dim, of this fact of mortality. However, for the child who comes up close and personal with mortality at a younger age, whether because of the death of a pet or a relative,this book can open a healing dialogue.

With beautiful illustrations and lyrical content, clinicians who treat children coping with change (and change is the one consistent fact of any life course) will want to keep this book on their bookshelf. In THE SEA CAT DREAMS, J.R. Poulter writes metaphorically about the unexpected twists and turns that can occur in life. This little book is a valuable resource for youngsters struggling with difficult changes or who are just adjusting to normal changes, like a move or a new sibling. I highly recommend this book and commend the author for addressing change in a way that can be reflected upon by the very young. Review by Barbara Cunningham, Psy.D., MFT

Dr. Cunningham specializes in issues of grief and loss, and treats these issues from a bibliotherapeutic and play perspective with children.
To learn more about Dr. Cunningham’s psychotherapy and family counseling  practice, visit her at http://www.cunninghamtherapy.com

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Dr. Barbara Cunningham, licensed marriage and family therapist, specializes in relationship counseling for couples and individuals seeking relief from acute problems or for personal growth. She enjoys a busy couples counseling practice and offers working couples evening hours at her office in the heart of San Diego. Whether you are seeking marriage counseling, couples counseling, or individual psychotherapy, Dr. Cunningham has affordable rates and provides a safe environment to work on increasing relational health. Seeking help through counseling is a sign of courage and strength of character. It is not a sign of weakness to enlist the help of a professional in sorting out issues.

Dr. Cunningham encourages couples to continue working on increasing their emotional connection with one another. Even though each partner may think they “know” the other, over time, sometimes this perception stops couples from becoming more engaged. Taking your partner for granted makes a relationship stale. Becoming more curious about how your partner thinks about a myriad number of issues can be stimulating.

One “fun” way to accomplish this goal is to make time for weekly  “pillow talk” evenings. Take a stack of blank 3×5 cards and write a conversation starter in the form of a question on each card and place each completed card in a box. After the children have been put down for the night, or if you do not have children, after you get ready for bed, settle down with your box of 3×5 cards between you. Take turns choosing a card and each of you speak to the topic on the card. Talk, agree, disagree, laugh, and then laugh some more. Be respectful. Demonstrate active listening skills. Do not interrupt. Ask clarifying questions to show interest in hearing what your partner has to say.  See the list below for conversation starter suggestions:

If you knew you had only one week left to live, what would you do with the remaining time?

What do you consider the greatest accomplishment of your life thus far? What do you hope to do that is even better?

Given the choice of anyone in the wold, alive or dead, what five people would you most like to invite to dinner? As your close friends?

Do you believe in free will or in predestination? Why?

For what in your life do you feel most grateful?

Can you name a challenge we faced in our relationship and describe how you were proud of how we handled it as a couple? Of how you handled yourself as an individual?

Talk about a point of pride in your own reaction to an outside challenge that you experienced this week. A regret?

How do you want people to remember you most after you are gone?

In what ways has knowing me influenced you to be a better person? How do you think that I have become a better person as a result of knowing you?

Do you believe that you have enough time? In what ways has your notion of time changed over the years?

Do we spend enough time together? If not, how could we improve our time management to make more time for one another?

Going back to earlier, important romantic relationships in your life, what did you learn about YOURSELF after time passed and you took another look at the breakup? What was YOUR part in the unraveling of that relationship?

As you can see, the list can go on and on. It is almost as much fun to come up with ideas for conversation starters as it is to actually converse about them.  Research has shown that couples who know more rather than less about one another have a more stable and fulfilling relationship. You can never stop getting to know someone better. Curiosity is a kind of aphrodisiac-showing interest in another person’s thoughts, feelings and emotions can be a turn-on!

To learn more about Dr. Cunningham’s model of relationship counseling, visit her website at http://www.Cunninghamtherapy.com or call 619 990-6203 for a complimentary telephone consultation.

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In my practice in San Diego, I specialize in relationship counseling, couples counseling, and marriage counseling. I do counseling with straight, gay, lesbian and transgendered couples in my practice.

Presently, I see a couple with two grown children. They have remained stuck for years in the repetitiveness of a distancer-pursuer cycle. The more he puts up walls, goes into his “cave.” or just gets too busy to make time for them, the more she pursues him by asking to “talk,” and even getting critical and blaming, just to get some reaction-any reaction- out of him. Both partners appear for treatment with a resigned look on their faces and seem to be frustrated and hopeless about their relationship. This cycle has gone on for years, and no matter how many times the woman complains about their lack of connection or no matter how many times the man pleads with his wife to stop nagging and just let him be, the battle continues. Sometimes the battle takes place underground-for example, in his resentment, he knows that it will make his wife angry whenever he is late. So he’s habitually late. His wife knows that it will make him mad if she buys too many new shoes at Nordstrom, so she splurges on multiple pairs of Jimmy Choo’s. Other times, the batttle takes place above ground, and they just go over and over what is stopping them from moving forward until one of them tires of the blaming behavior and withdraws. And so it goes.

When this couple finally appears in my office, early in the assessment phase of treatment, I assign them each two books : The 8 Concepts of Bowen Theory and Extraordinary Relationships, both by Roberta Gilbert, M.D. I explain a bit about my model of practice. I emphasize that when two people are anxious, it is common to blame the other for all the problems. Our brains are hardwired to do this. The work is to use that tiny part of our brain that has evolved above other forms of life and, on a good day, allows us to think about our thinking. Reading the books is an example of using that cognitive capacity to calm down the emotional while at the same time learning a new kind of causality about relationship functioning. Blaming behaviors reflect a linear causality. My model looks at problems from the perspective of a circular causality. This means no one is blame! Instead, problems are co-created, or tri-created and,in some cases, may be rooted in each partner’s multigenerational story as well as unfinished personal business from past relationships that ended poorly.

In order to find out context (with the idea that nothing ever happens in a vacuum anyway), in the second and third sessions, I take a family diagram of three or four generations. I look for patterns of strength as well as  problematic patterns that may repeat over generations. I look at levels of functioning and variation in each generations’s sibling group. I look at patterns of closeness and distance. Some partners come from families who are emotionally expressive and, in the extreme, “into each other’s business.” Oftentimes, the other partner comes from a family that is the polar opposite: family members are distant and isolated from one another, emotionally, and, at times, this can be reflected in family members being flung all over the globe or just not communicative despite living in the same town. I look for levels of functioning academically and professionally. I look for how well members can “hold” intimacy over the long haul through each members’ number of marriages. I look for patterns of loyalty and infidelity. I like to think of this effort as being akin to climbing to the top of the bleachers to see the football game rather than sitting on the fifty yardline. Past is, indeed, prologue.

The assumptions I hold are myriad. Four key assumptions involve the following: 1.) We are all more alike than we are different; 2.) we are interconnected; 3.) the human being has a need for both connection and separateness; and 4.) functioning is reciprocal (for example, the more one overfunctions in relation to another, it may, in part, determine the level of underfunctioning in another).

An example of interconnectivity can be seen in emotional shock wave effects after the death of an important family member. It is common to watch dramatic changes among the relationships of those who were closest to the deceased family member. We all can think of someone, for example, who has been married for many years and one partner dies. Within a year, the other partner passes. It may reflect how profoundly connected the partners may have been, so that even their mortality is affected by the distance of death.

In my view, change is about going outside your comfort zone. It is in a frustrated partner’s comfort zone to blame and criticize the other person to justify why he/she is right. Paradoxically, this blaming effort merely serves to solidy the other partner’s opposing position. There is gridlock. The therapy effort is to work toward being able to visualize your own part in a problematic relationship dynamic. This involves getting some separateness from all the togetherness in order to see how you are impacting the dynamic yourself.

Learning and then applying family systems principles to one’s own life is an ongoing challenge and lifelong process. My model of therapy sets people on the road to making this shift in their thinking. To be able to transform ones thinking from individual (blame) to systemic (cocreated) is a continuing effort. Keeping one’s eye on oneself instead of on other can change a couple’s dynamic in a dramatic way.

Dr. Cunningham has her doctorate with a specialty in marriage and family therapy. She is licensed in the state of California as a marriage and family therapist. Dr. Cunningham has published an academic book chapter on her family systems treatment and has been an adjunct professor at a COAMFT accredited graduate school of marriage and family therapy. She has long life experience and has enjoyed seeing thousands of couples in her career. For more information about Dr. Cunningham’s model of practice, visit her website at http://www.cunninghamtherapy.com or call 619 990-6203 for a complimentary telephone consultation.

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After years of seeing distressed couples as a licensed marriage and family therapist in my office in San Diego, I have learned that love can be messy. Relationship counseling offers couples a counseling opportunity to take on the work of deepening their love in the face of current challenges they are facing.

Judith Viorst got it right when she said, “One advantage of marriage, it seems to me, is that when you fall out of love with him, or he falls out of love with you, it keeps you together until you maybe fall in love again.” Couples who come into marriage  expecting it to be easy are deluding themselves. The good news is that it is in the triumphs over challenges that love can deepen.

It is a “given” that infatuation has a limited shelf life. There is something a bit delusional that drives the euphoria of infatuation. A physical attraction combined with one’s wish to find a companion with whom he/she has a lot in common drives the “urge to merge.” Over time, as warts begin to appear, all the hopes and dreams one pins on a person in one’s wish for a “perfect union” may become shattered. The people who once reflected one another in such a flattering way may begin to find fault or seem less exited. Now, instead of euphoria, one or both become reactive, as they stand by watching another dream crumble. Once again, Judith Viorst shows remarkable insight when she says, “Many of us are done with adolescence before we are done with adolescent love.”Many people seek counseling trying to re-establish that blind euporia that comes from infatuation.

The deeper, more mature love that poets have written about for centuries is borne of hard work and effort. In the case of love, effort means having the capacity to see your part when there are problems and being a proactive rather than a reactive partner. Realistic expectations and the ability to see one’s part in a difficult relational challenge remain part of what defines the successful couple. To learn more about Dr. Cunningham’s model of marriage and family therapy practice, visit her website at http://www.cuuninghamtherapy.comor call 619 9906203 for a complimentary consultation.

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Dr. Cunningham often hears couples come to marriage counseling and relationship counseling with issues related to anger. Each partner often begins couples counseling with a wish for the therapist to “fix” the other.  Counseling aims to help each partner increase their capacity to visualize their own part in the dance. This increased self-responsility to at once be true to expressing your feelings to your intimate other and, still, to decrease blaming him/her is an overarching goal of most psychotherapy within my model, no matter what the presenting problems.

In his book entitled TO A DANCING GOD: NOTES OF A SPIRITUAL TRAVELER, Sam Keen has a dialogue with anger (pp. 114-119).  Anger says, “If you doubt that I am the companion of love, remember the ecstasy of the reconciliation that comes after fighting. After a good expression of clean anger, lovers have established the integrity of their separateness, and they may come together without fearing that either will be eradicated by the act of love. If you can’t fight, you can’t love.”

Interestingly, this quote from Keen has been backed up by specific research in the field. John Gottman’s research disspelled a prevalent myth about marriage. He found that fighting is not predictive of divorce. If couples are engaged with one another and learn principles of “fair” fighting, learning more effective ways to resolve conflict can, in fact, lead the way to deepening relational growth. Notably, important work by John Gottman identified lethal forms of communication between partners that were predictive of divorce and he called them the four “Horsemen of the Apocalypse” (stonewalling, criticism, contempt, and defensiveness). He found that these communication patterns in relationships were dangerous to holding relationships on a course of stability and longevity.

Thus, Keen’s quote is backed up by Gottman’s empirical findings.  Anger that is not expressed or held back may be classified as a kind of stonewalling. So-called happy couples may be ignoring or hiding the anger that exists within and between them. Marital partners who are more able to express anger in a timely, reflective, and respectful manner, especially with a Gottman technique that he referrs to as “soft startups,”  may be more adept at repair attempts and thus are more likely to stay together in a more fulfilling way.

Anger has to be a respected member of the partnership. If not, the couple may not be genuine with themselves or with each other. Furthermore, anger unrecognized or in disguise may be more dangerous than when it is out in the open and dischargeable. Hidden anger can lead to sudden disruptions, including failure in the marriage, a damaged sex life, domestic violence, and anxious child-rearing that may even lead to child abuse. When unconscious and unexpressed anger festers, it grows and becomes regressively more primitive.

If one considers the tasks of loving from the perspective of  Bowen Family Systems Theory, lovers must also be able to establish the integrity of their separateness if they are to remain connected as effective marital partners. If partners are fused too tightly, they will not be able to come together without fearing eradication by the other. Bowen would wholeheartedly agree with Keen that lovers who can cleanly express their anger are likely to be more engaged lovers. Lovers must have a bottom line and be differentiated enough to not “cave in” or accommodate to another just because they fear losing the relationship if they do not give in. Those who can make a move for “self” are also able to freely choose to make a move for “other” instead of just going along, with resentment following closely behind. They are able to be at choice about when they wish to be separate and when they wish to be connected while, at the same, they have a greater capacity to respect a differing need for closeness and/or distance at various times in their partner.

Makeup sex often occurs without a clear resolution to existing problems. It occurs because the couple just gets tired of fighting and feeling all the  negative energy and want to restore the illusion that they are really doing ok without necessarily doing the work to get there. In my view, an accurate description of problems brought to therapy always addresses the reciprocity between a couple and one’s ability to identify or visualize one’s own part in a dynamic. The “automatic” impulse is to focus on what is wrong with other instead of working to see what one’s own part may be and then moving toward changing it. Part of the work in “fair” fighting, from my perspective, then,  is the capacity to “step up” and see what you can do to shift the unhelpful dynamic that led to the fight. Makeup sex can feel goodin the moment, but may be a mere escape from taking responsibility on your end to make things better in the longterm. Makeup sex that does not include each partner’s effort to change can feel euphoric, but without the promise of future increased connectedness. Some people have compared the feeling to getting high on cocaine.

The more you love, the more susceptible you are to being hurt. When a person is hurt, the natural response is anger in some form or other. While anger is a painful emotion, it also brings wakefulness, alertness, and, if it does not burn out of control, can even lead to clearer thinking and action about one’s own functioning in relation to important others. Anger is an emotion creeping into many of our expressions. Problems are tackled, obstacles are attacked, roadblocks are smashed, fears are conquered, and skills are mastered. I believe that it is not enough to be angry about some things.  If you can be aware of your anger, express it with an eye to including in your expression what you have done to trigger such anger-provoking behavior in another, and fight fairly, then you will discover that you can love better and not be in a state of chronic festering resentment Anger needs to be expressed and recognized as an integral part of life and living. At one time or another, it  is part of being transparent to a significant other. Being emotionally “naked” with another is difficult;  the process of this effort describes the challenges in the journey toward increasing transparency. As David Schnarch noted in his book entitled PASSIONATE MARRIAGE, this capacity to increase transparency can lead to what he refers to as ” wall socket sex.”  Certainly, the expression of anger in a nonblaming manner with an eye to what one has done to trigger the other to behave in ways that inspire anger is a helpful, systemic approach to conflict resolution. To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.Cunninghamtherapy.com or call 619 9906203 for a complimentary phone consultation.

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“Anger is a signal, and one worth listening to.” Harriet Lerner

Dr. Barbara Cunningham, licensed marriage and family therapist in San Diego, CA, sees many couples who complain that chronic anger has eaten away at their relationship or marriage over time. What follows are some of  her thoughts on how negative feelings can cut into relational quality.

Anger is an emotion that can erode an individual’s quality of life and play havoc with the dynamic in one’s most important relationships. In my clinical practice, I see many couples who complain that anger has infected their relationship satisfaction. The roller coaster quality of living with someone who has trouble managing his/her anger can be devastating. At http://www.Cunninghamtherapy.com, Dr. Cunningham works on helping people learn new tools and apply new principles to their relationships that can help them lead calmer, more satisfying lives. 

Dr. Cunningham, for example, emphasizes that it is important to be clear about one’s bottom line. What will you do and what won’t you do for the other person? Consider your “yes-es” as carefully as you consider your “no’s.” If you accommodate and give in again and again, over time, resentment toward your partner may build. Then as normal day-to-day stresses of life accumulate, a person with anger management problems may explode and hurt those he or she loves deeply.

A person with anger management problems needs to learn that they can shape their world rather than being at the mercy of outside forces. They need to increase their sense that they can become the CEO of their own life instead of exerting energy upon trying to control others. If a person can become aware of triggers that make them say yes when they really want to say no (or conversely, make them say no when they really want to say yes), they will know where they stop and the other begins.

People who work on developing this type of “emotional muscle” will not be quite as governed by the responses of others. This simple yet difficult self-management skill can help curb resentment toward an important other. When one works on managing one’s own boundaries more carefully, it can help to control the risk of festering and growing resentment and anger. Such an effort can empower people to become long distance runners in the art of intimacy. Dr. Cunningham sees individuals and couples for relationship counseling on issues of all kinds. To learn more, visit her web site at http://www.cunninghamtherapy.com or call for a complimentary phone consultation at 619 9906203.

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