The therapist may find one or both individuals in a relationship to be survivors of childhood abuse. Childhood abuse and trauma, which occur in the intimate relationships of the family predictably, create problems in future intimate relationships. The individual's story of abuse can be vicariously traumatizing to the partner. Childhood abuse experiences often fundamentally affect the couple's relationship. The therapist would be challenged as well in the therapeutic process. Russell was the CEO of a technology company. His income afforded him and his wife, Christine an affluent lifestyle. An art history major when she met Russell in college, she was involved in charity work and collected antique furniture with a passion. Russell enjoyed the gentleman rancher life of their large estate and worked often with the horses in his free time after work. He would come in somewhat soiled from a fulfilling but tiring day mucking about the barn. When he plopped himself down on one of the antique pieces, Christine would erupt with rage. She went ballistic! She said, he was fouling the furniture. He was a big man and he might break the chair. Russell was furious in turn that he could not relax on a "damn chair" that he had paid for in the first place. He insisted that he was not filthy and dirtying the furniture- just a bit rank for his exertions. And, the chair wasn't that fragile… and he was not a big whale plopping down on it. He felt that she was making a big deal out of nothing. Christine felt that he was disrespectful of the value of the furniture and of the value she placed on it. Russell felt disrespected in his own home… and by his wife who he thought would be the most appreciative of him.
The therapist had each of them express his and her thoughts and needs. Christine's perspective in particular seemed to be hiding greater intensity than was logically appropriate. Communication training using "I" statements and expressing and owning feelings were not sufficient to break the impasse. Conflict resolution skills did not help. Family-of-origin investigation about the parental roles, spousal roles, expectations, cultural expectations, and so on initially had limited effect. Russell was comfortable being the provider and Christine enjoyed the homemaker role. They both liked the traditional male-female role definitions. That was not the issue. Attempts to negotiate a reasonable compromise about sitting on the furniture proved fruitless. Russell felt he was already reasonable. He cleaned up before he came in and he did not have any problem with draping a towel on the chairs when he sat on them. But that was not good enough for Christine. Russell felt nothing was good enough for her. Therapy remained ineffective until abuse experiences from the family-of-origin were examined and integrated into the current dynamics. "In reviewing the literature, two ideas surface to explain why couples therapy might not be as effective with couples affected by abuse. First, clinicians have noted that it is normative for survivors of abuse not to disclose this history to their therapist (Busby et al., 1993; Johnson, 1989; Josephson & Fong-Beyette, 1987; McCarthy, 1997; Mennen & Pearlmutter, 1993; Miller & Sutherland, 1999; Nelson & Wampler, 2000; Reid, Taylor, & Wampler, 1995; Roche, Runtz, & Hunter, 1999; Sheldon, 1988). Without knowledge of the abuse or without appreciation for how abuse might affect a couple, the therapist will not have the information necessary to optimize treatment (Busby et al., 1993; Cobia, Sobansky, & Ingram, 2004; Feinauer, 1989b; Gelinas, 1983). Second, researchers have noted that individuals and couples affected by childhood abuse are significantly more distressed at the beginning of therapy compared to those not reporting abuse (Busby et al., 1993; Nelson & Wampler, 2000; Wheeler & Walton, 1987). These authors have suggested that differences in individuals and couples before treatment starts may imply a difference in the process and perhaps the outcome of therapy" (Anderson & Miller, 2006, page 354).
An individual who has experienced child sexual abuse may try to "diminish negative thoughts, affective states, and memories of abuse through various coping behaviors including dissociation, substance abuse, casual sexual relationships, and avoidance of intimate relationships" (Davis et al., 2001, page 64). In these attempts to reduce or deal with deep emotional and psychological pain, they can also result in feeling socially isolated, dissatisfaction with relationships, sexual dysfunctions, and vulnerability to being victimized again. Individuals with childhood physical abuse histories reported less intimacy in relationships. Psychological abuse by itself or associated with other abuse can have significant detrimental effects on later adult functioning. Individuals with a history of childhood psychological abuse felt less lovable and likable on a measure of self-esteem. "These findings suggest that psychological abuse may contribute to self-perceptions that impact negatively on interpersonal relationships" (Davis et al., 2001, page 64). The therapist needs to be aware of issues for the abuse victim but also of the influence they have on interactions with non-abused partner. Gender issues and cultural expectations should also be taken into consideration. "Initial results suggest that men in couples reporting sexual abuse are significantly more distressed than those in couples not affected by abuse. Reid and associates (Reid, Wampler, & Taylor, 1996) found that partners of abuse victims report that they continually receive mixed messages from their spouse. Because of this inconsistent interaction, the men were under continual stress and uncertainty. Psychoeducation focusing on the effects of sexual abuse may be a particularly important intervention with this group. It could help the partners of sexual abuse victims understand their partner's behavior and make previous behavior, seen earlier as irrational, rational. Indeed, couples with a history of sexual abuse report psychoeducation as the most beneficial part of therapy (Reid et al., 1996)" (Anderson & Miller, 2006, page 365).
Early in the therapy, Christine had revealed that her father had sexually molested her from 7 to15 years of age. Christine had told Russell this after they had become serious, well before they married. Russell had been very sympathetic and had always tried to be supportive. When he had first learned of this earlier in their relationship, he had to reign in an instinct to confront and beat his future father-in-law senseless. Christine had already cut off her relationship with her father although her siblings had not. Her mother had not protected her and some of her siblings openly doubted her accusation that her father had molested her. Russell felt called by Christine to be her defender. This fit with his upbringing to be a mensch. In many ways, Christine told the therapist that she felt Russell was the partner she needed. Russell admitted to having been a rough character as a kid, but he hated fighting with Christine. Christine acknowledged that Russell was normally very mellow and easy going. He was sensitive and nurturing. Russell felt that Christine was very supportive and usually a great partner. They were content in most aspects of their relationship. Yet, Christine would go nuts over him sitting on the antique furniture when he came in from his sweaty work. The therapist identified that Christine's adamant outrage was disproportionate to Russell's actions. Something made everything more intense for Christine. When the therapist put this together with the behaviors and the information about Christine's childhood sexual abuse experiences, the dots connected. The therapist ventured an interpretation,
"Christine, when you were a little girl… you couldn't stop your father from entering your room and touching you in a way a little girl should not be touched. You couldn't stop him from molesting you for almost eight years… not until you were sixteen were you able to stop him. You finally found your voice and threatened him in no uncertain terms to get the hell away from you. And you told others… And he stopped. And you probably swore, 'Hell no… no one ever is going to molest me again!' So maybe you couldn't protect your own body from your father when you were a little girl… you couldn't protect your own body from being molested, but god damn it! Hell no, no more! You ain't going let Russell 'molest' your body… your antique chairs with his big filthy body! Oh hell no!"
Christine burst into tears and cried to Russell, "I… I… didn't know what I was doing. I'm so sorry." Russell reached for her and said gently, "I'd never hurt you honey. I didn't know either… I didn't know." He held her and rocked her as she cried quietly. "They're just chairs, Christina. They don't matter to me… you matter to me." When Christine was able to talk again, she said, "I'm sorry. I know you're not my dad. I know you'd never hurt me like my dad did… but I get so scared." The therapist told her, "And you're not a little girl anymore. The little girl found her voice and took care of herself and made her father stop. You're a powerful adult with choices. You can choose to be with Russell or you can choose not to be with Russell. Either way, you can protect yourself now." The underlying trauma from childhood sexual abuse had distorted their relationship. Sensitivity and vigilance had intensified to hypersensitivity and hyper-vigilance despite being with Russell who was completely unlike her father. Only when the shadows of family-of-origin sexual abuse were illuminated could their current challenges be deconstructed and desensationalized. What did they decide about Russell sitting on the antique chairs? Whatever! It did not matter. It had mattered only when it unknowingly symbolized something darker and deeper than resting a sweaty body after chores.