Despite its controversy, carefully conceptualized
and delivered couples treatment appears to be at least as effective
as traditional treatment for domestic violence, and preliminary
data suggests that it does not place women at greater risk for
injury. Marriage and family therapists have an important part
to play in continuing to develop and test innovative ways of helping
couples end violence and improve their relationships an
endeavor that promises to improve the quality of the partners
lives as well as those of their children. (Stith, Rosen, McCollum,
Journal of marriage and family therapy, July 2003)
Recent, as well as ongoing research indicates
the advocacy of couples counseling as an effective treatment for
high conflict as well as domestically violent couples. While this
is controversial, if we are able to look past the politics, it
certainly fits with clinical experience as well as with theoretical
models of systemic influences on family dynamics. The overwhelming
research showing that women initiate violence as often as men,
as well as studies that show that lesbian couples experience domestic
violence at the same rate as heterosexual couples would indicate
that a more inclusive approach is indicated. While not ignoring
the fact that women are harmed at a rate 7 times that of men when
violence does occur, if we address the issues of couples violence
from a systemic model we are much more likely to effectively address
the full range and scope of the problem. Current approaches to
couple violence address all incidences of partner violence as
male initiated, motivated by a desire for power and control. While
it cannot be denied that great harm is done in too many instances
of intimate partner violence, the majority of couple violence
takes place at a lower level of mutual combatency. We risk not
addressing the problem by not addressing the full continuum of
the problem honestly and effectively. That said, systemic therapeutic
interventions can help families and individuals gain better insight
to their contributions to dysfunctional family patterns.
Research suggests that three subtypes of batterers
exist (i.e., family only, dysphoric/borderline, and generally
violent/antisocial). Many working in the field have been frustrated
by the limited scope of treatment options. The family only batterer,
without apparent psychopathy is most likely to benefit from couple
therapy. (the majority of domestic violence cases). When we include
the facts regarding reciprocal violence, it makes much more sense
to include both parties in the counseling especially considering
that a women is much more likely to be physically injured in an
exchange.
When assessment shows that there has been couple/family
abuse or that it is likely that high marital discord will lead
to couple violence, regular couple treatment approaches must be
modified. It must first be emphasized that systemic approaches
to family therapy never condone or excuse violent, threatening,
or abusive behavior. It is always emphasized that one is responsible
for ones behavior regardless of external influences or events.
Many therapist working with violent or potentially violent relationships
include most, if not all the following protocols in the therapeutic
process.
What has struck me is that the usual couple therapy approaches
are most often ineffective. Family violence rarely improves by just
teaching better communication skills and I statements.
Most, both men and women, have some investment and/or secondary
gain in the maintenance of the high conflict. Often this is an avoidance
of intimacy. Violence can be a form of passivity, a way of not actively
addressing issues of intimacy. Instead we need to focus on helping
our clients to focus on changing the dysfunctional patterns of interaction
that keep them trapped in the abuse. Help them recognize why they
hold onto the conflict rather than stop. Help them learn the role
they play in perpetuating the pattern, recognize their own triggers
activated by their partners interactions with them, and what to
do about each. I recognize the controversy involved in advocating
this approach. However, most involved in the DV system recognize
that current approaches are woefully inadequate in addressing the
broad range and scope of family violence. When we treat all DV case
from a Power and control, Borderline or generally violent/antisocial
point of view we miss the opportunity to use our skills effectively
in the vast majority of these cases. Our profession is in a unique
position to be able to address what is most often a systemic problem
with sound clinical practices.
In working with this population it has been my experience that
almost all genuinely desire and are willing to do their part for
relationships without abuse or violence. I have been impressed by
their willingness to accept responsibility for their roles in the
dynamics. I have also been encouraged by the willingness of most
men to accept the lead role in stopping any violence in the house
when taught the skills to do so. Quite often I meet with the men
before hand and coach them on the process and how I want them to
participate and respond to make this work. I have rarely been disappointed
in their willingness to take my lead. I have found that with most
couples violence is not about power and control but
instead about not knowing how to handle the out of control feelings
of overwhelm that can occur during an escalating conflict. Once
taught the skills, most are able to prevent the escalation that
can lead to the violence.
Michael Carolla LMFT, is executive director of Touchstone
Counseling in Pleasant Hill, CA. In addition to his regular practice
seeing couples and families, he runs a 52 week domestic violence
treatment intervention program, and conducts regular workshops
on working with high conflict couples.
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