Is It Possible to Get Quick Results? by Dr. Deb Hirschhorn

Dr. Deb Is It Possible to Get Quick Results in Marriage Therapy?

By Deb Hirschhorn, Ph.D.

“Oh, I don’t know, Dr. Deb. I don’t see how it is possible to change my whole marriage around in 13 weeks.

“After all, we’ve gone to therapy for the last 3 years (5 years? 10 years?) and we still don’t have results.

“I got a lot out of my individual therapy. But you know, I’m a kind of stubborn person. I don’t make changes too quickly. It took two years of weekly work to overcome my ____. So how can I change things around so fast in my marriage?”

I have one answer to each of these concerns: You used the wrong vehicle.

Let’s dive into the particulars so you’ll see what I mean.

Wrong Vehicle #1: Behavioral Change

Behavior modification works beautifully with young children, prison inmates, and institutionalized adults. Why? Because you, the parent or the supervisor, have control.

You can dish out reinforcers, you can punish, you can increase the reward ratio (how much of the desired behavior you expect before you give the reinforcer), and so on.

You’re in charge.

When you find the right incentives, little kids eat it up.

But what happens in a marriage? Who holds the reinforcers?

Do you think you do? Think again. Here’s a true story about yours truly. When Covid hit, I had been a regular attendee at the gym. I loved the classes because someone was barking at me to do this or that, and I did not have to exercise any self-motivation.

Suddenly, all that came to an end. My favorite teacher had a live online class and….I’m sorry to admit the truth, but at the last minute I always found something “more pressing” to do. See, in the past, picking myself up and getting out of the house (which was fun in itself) to go to the gym got the process started. The teacher did the rest.

So mid-way through Covid, I got the bright idea of telling my friend that I would tape a class and then we could “meet” by each, separately, doing the class at home. Knowing that she was expecting me to “attend” was the motivation I needed.

Here’s the funny part. To this day, if she does her workout, I do mine. If she has an appointment elsewhere, doggone if I don’t miss my workout.

We simply can’t expect ourselves to be in charge of our own reinforcement schedule, generally speaking. (Yes, there are people who quit smoking on a dime and all that. I’m saying generally speaking.)

But there is an even bigger problem with behavioral change: How do you change that which is emotionally driven?

The limbic system – where emotions are catalogued, activated, and connected to the rest of our brain – is quick, unconscious, and driven by neurotransmitters that act more quickly than you can think. As an example, slow-acting neurotransmitters like dopamine and serotonin take seconds to minutes to transmit messages. The fast-acting ones like glutamate (present in 90% of brain synapses, or spaces) take one-thousandth of a second to move from synapse to synapse in the brain!

As people often complain, “I go from zero to 60 so fast I don’t know what’s happening.”

So how can behaviors, even well-intentioned behavioral techniques manage that?

They can’t.

Wrong Vehicle #2 Emotional Change

It is specifically because of the limitation of behavioral change that therapy focused on emotions was developed. This is a major step in the right direction.

Yet, examination of therapies based on tuning into your own and your partner’s emotions doesn’t necessarily lead to controlling them.

Here is what Sue Johnson, the founder of Emotionally Focused Therapy, told an interviewer:

One lady said to me recently: “Nothing has changed on one level, but everything has changed. I get that my whole life – even from the time I was very small, and now I’m 60 years old – has been an incredible fight. A fight between longing for closeness, feeling empty, alone and deprived of love, and being terrified of closeness. I feel that the only closeness I have known resulted in someone taking me over, me being powerless, me being hurt all the time. I’ve just bounced between those two things my whole life.” And now that she can make sense of her emotions, she finds a way to navigate.

The client made sense of her emotions. That is excellent. But the question is: Could she change them? Could she, to use her own words, no longer feel powerless? Could she stop bouncing between extremes and overcome her fear of closeness?

Johnson explains, “What we do in couples therapy is to help people accept those longings and fears and to find ways to ask for what

they need in a way that pulls the other person close.”

But how? How do they do that now that they understand their fears of vulnerability? How do they overcome the fear? Is understanding enough?

The truth is that as therapies go, this is positive because with the presence of the therapist, the couple may feel safe enough to open up. But it’s not because the couple was taught a new way to choose what emotion they want to have. Now, that would be helpful. I will return to this in a moment.

The couple – and the woman who bounced between closeness and fear of it – do not have a tool to actually come to grips with those two polarities.

Wrong Vehicle #3 Autonomic System Change

When we look at the underlying systems in the body that govern reactions, especially emotional reactions, it becomes apparent that what is often left out of the therapy equation is giving due respect for mindfulness, breathing, and meditation.

We do love to hear ourselves talk, we therapists. I’m no exception; I wasn’t named Devorah for nothing.

But there’s a place for silence, for clearing the head through breathwork and bodywork. The problem with this approach is that it needs to be part of a bigger picture. What, exactly, are we clearing from our heads anyway? And what direction would we want our heads to go in if we could?

These are the primary therapy vehicles, the last one not used as much as it deserves. But individually, they are slow and hard to drive to the right place.

What Is Needed is a System That is Built on the Way Human Beings Actually Operate

These three vehicles are like having a car’s motor, tires, and battery. They’re all important, necessary, and useful. But they must work together to be a “car.”

We like to think. We like to figure things out. We feel more in control when we understand how the world – and we in it – function. So there is a need for the thinking part of the brain to be included in the therapy process.

We also are totally emotional creatures. Most of our decisions are not rational. (See Antonio Damasio on the role of emotion in the making of consciousness.) Therefore, we need

a way to track our emotions so as to be able to change them.

One way that has worked miracles for people in literally changing their emotions is meditation. The reason it works goes way beyond the fact that it distracts us from whatever was bothering us.

In addition, in slowing down our systems, it changes the body’s (and brain’s) chemistry and wiring.

Yet, there is one more tool, even more powerful than the others, that combines emotion, thinking, mindfulness with the ability to take action to make immediate changes, and that is called Internal Family Systems.

I can remember where I was standing when I discovered that this is actually possible.

I had gone to Israel last September for my grandson’s bar mitzvah. I was stuck for two whole weeks in quarantine. In a basement apartment with one window that let in about one ray of light. I knew this would be the case so I took a course to maintain my licensure during the Israeli morning when everyone back here is sleeping. I kind of randomly chose Richard Schwartz’s Internal Family Systems.

So there I was, listening to him, and all of a sudden, it hit me: “You mean, I don’t have to stay in this dark mood because I’m stuck in this dark apartment and can’t even go exercise let alone hug the grandchildren I came here to see?”

Wow. That was powerful. I stood up and took stock.

The dark mood came from a part of me that was rebelling against reality. And I didn’t have to rebel. I could summon a different mood if I liked.

I did a bit of mindful thinking. Which mood did I want? Well, obviously, a happy one. So I thought of how it will be when I got out of jail. I mean, quarantine. And my insides lit up. I imagined talking to the little cutie pies that lived right across the street. Well, I was already talking to them. I imagined talking to them

without our masks. And hugging them. A little tickle started inside me. It was a great feeling. I smiled.

The key to understanding how to do this and why it works is that the moods that come over us are not us. They’re only parts of us. Brush away – gently and appreciatively – these parts, and what is left is our essence, our Selves, our neshamas. That’s who we are and that’s who we can return to whenever we get “taken over” by a part.

So I rolled up my sleeves and completely redid the course that I had created to accompany marriage counseling so as to include – in addition to everything else – an intensive three weeks of IFS. Then, as people started to go through it, I took an extra step: I doubled that. The first three weeks was personal IFS; the second, couples IFS.

Yes, people have been learning to do this in 13 weeks. Can you? Well, that’s not a problem for people who need a little extra hand-holding time. I give that, too. Because sometimes young drivers need a few extra lessons. That’s personal.

The moods that come over us are not us.

Dr. Deb Hirschhorn is a Marriage and Family Therapist. If you want help with your marriage, begin by signing up to watch her Masterclass at https://drdeb. com/myw-masterclass.