Challenging Cases Blog #2

Jenny Brown PhD : Couple therapy after an affair

Blog written by Aleksandra Trkulja as part of a post grad learning internship 

The second Challenging Cases seminar was presented by Dr Jenny Brown, and looked at couple therapy after an affair – presentation of high anxiety after the crisis of disclosure. After describing the facts of her work with one couple participants were asked to identify their key dilemmas participants identified when working with couples after the discovery of infidelity included; 

• Triangling: establishing a neutral therapeutic relationship when only one client is attending, or when resisting the pull toward the betrayed client.
• The pressure to appease the intense anxiety felt by the couple.
• Exploring how family origin, emotional reactivity and system interactions can fuel anxiety and stress, and not allowing emotional noise to dominate the session.

The group were prompted to consider personal assumptions about affairs. They were encouraged to reflect on how their own family of origin may affect this. The importance of this exercise was to build self-awareness, minimise stereotypes, and maintain a neutral therapeutic relationship. The responses to these reflections included;

• Challenging traditional ideas that men stray from relationships, and that women have a good reason for having an affair.
• How stress reduces people’s capacity to make relationship oriented decisions.
• Multigenerational patterns that are subconsciously inherited. 
• Cultural shame
• The role of religious, or non-religious beliefs 

Dr Brown identified a central clinical theme; the therapist taking a researcher stance that ensures a neutral therapeutic position. This stance aims to understand patterns behind the affair, explore the reactions to the event, and the stressors that exceeded the families coping capacities. The neutrality of the ‘researcher’ stance removes the expectation that the therapist must generate an outcome for the couple. In a case like this, it assists clients to develop the insight into patterns each have brought into the marriage, that can explain the context of the crisis occurring. 

Helping the couple process the betrayal of trust that occurs throughout an affair can help re-work the marriage. Developing a timeline of events conceptualises the client’s relationship, and shows that something bigger than the affair is occurring. In the case presented, the timeline constructed by Dr Brown demonstrates severe stressors in the family system that included death, health issues, and mental health issues in the lead up to the affair. Conceptualising these events helps to shift the client’s reactivity, to settle brain functioning, and develop a wider perspective of the situation. 

By exploring the family’s coping capacity as a system, the therapist can begin to understand how the symptoms of the affair have eventuated. This requires observing the nuclear family emotional process, and how marital patterns for managing togetherness and separateness occur. The degree of fusion affects how people manage chronic and acute stress. 

The family’s lack of differentiation manifests in many ways, but most importantly presents as the web of expectations each has for the other to support one another. These expectations can lie dormant until violated, leading to intense emotional reactivity expressed in conflict or distance, or both. Re-working these expectations in couple therapy after an affair lays the foundation of building a new marriage. Therapists can use calm, focused questions about the relationship to minimise emotional reactivity, and reflect how each client’s reactivity effects the other. 

In couple’s therapy, the therapist is challenged by juggling the rebuilding of trust, and the broader family system that created the backdrop to the affair. This requires honouring both betrayal and family patterns. It will involve exploring the earlier patterns within the marriage including strengths and weaknesses. 

Another challenge for the couple therapist is to determine the difference between individual accountability for betrayal of trust, and components of the family emotional process. Accountability for behaviour can be talked about like any other process, which helps to reduce intensity, and includes the clients in the research process. The therapist can invite thoughts on the demonstration or changes in behaviour that represent accepting responsibility for secrecy and betrayal. 

Therapists can resist invitations to triangle by relying on a strong theoretical systems framework, and managing their own reactivity. Therapists can see reciprocity by asking process questions opposed to opinion questions. Rather than asking what their needs are, explore the client’s non-negotiables and what it looks like for them to hold these in the relationship. This builds the client’s awareness of the process, their emotional reactivity, and how their sensitivity and response triggers the automatic response of the other. The product of this is the client’s ability to objectively view the pattern of the emotional process by regulating and shifting one’s own behaviour. 

This challenging case seminar focused on the complexity couples bring after an affair has occurred. The group discussed the key dilemmas around affairs, their assumptions, and how these might affect clinical engagement. The group considered what they would want to know about the marriage, and how they would explore this. The degree of differentiation in a family system affects their ability to cope with stressors, which the therapist can assess. The clinical challenges included helping clients become self-aware of their reactivity and for the therapist to manage the side taking pull – to stay out of triangles. The therapist does not take responsibility to the future of the marriage. Each spouse will be given space to do their own problem solving about this; using their learning about their marriage dynamic to consider what they are willing and able to change.