6. The Sixth C- Capacity - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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6. The Sixth C- Capacity

Therapist Resources > Therapy Books > Therapy Interruptus

Therapy Interruptus and Clinical Practice,
Building Client Investment from First Contact through the First Session
by Ronald Mah

• Individual client capacity to grow and change determines individual, couple, or family change and success.
• Each partner in a couple has to be affirmatively capable in four areas for therapy and the couple to be successful.
• Each partner in a couple has to see his or her partner as affirmatively capable in four areas for therapy and the couple to be successful.
• Therapy is often about finding or developing greater certainty around ambiguous areas.
• When ambiguous stances are addressed, underlying symbolism and issues around change often are uncovered.
• When one partner becomes negatively definite about one area, the relationship is done.

The therapist can be highly skillful but still find the couple may have limited ability to make the necessary adjustments to improve the relationship.  This may be discovered in the process of therapy or it can be addressed in the first contact or session using the following assessment tool.  Or, the therapist can adapt the principles and strategies from this tool according to his or her own style and orientation.  This tool or intervention seeks to quickly reveal what is the one's and the partner's capacity to grow or to change.  To determine whether a couple to be willing to invest in any manner to build or heal the relationship, each partner is asked the following chart's questions.   The therapist and the couple are looking for "Yes" answers, or at least be hopeful that the answers may be "Yes."  However realistically one or more answers may be "No" or "Maybe."

Partner A (Arthur, for example) answers the four questions in the first column:
1. Can I (Arthur) change or grow- do I have the capacity… that is the will to change or grow?
2. Can I change or grow- do I have the capacity… this time, meaning the ability or skills to change or grow (or can acquire them)?
3. Is it worth it for me to change?
4. Do I have the courage to change or grow?  Am I going to be able to deal with the pain it takes to change?
Continuing, Partner A (Arthur in this example) answers what he or she thinks about his or her partner (Nancy in this example):
5. Do I (Arthur) think my partner (Nancy) can change or grow- does he or she have the capacity… that is the will to change or grow?
6. Do I think my partner can my partner change or grow- does he or she have the capacity… this time, meaning the ability or skills to change or grow (or can acquire them)?
7. Do I think my partner feel it is worth it for him or her to change?
8. Do I think my partner has the courage to change or grow?  Is he or she going to be able to deal with the pain it takes to change?
Partner B- the other partner (Nancy in this example) also answers the four questions in the first column:
9. Can I (Nancy) change or grow- do I have the capacity… that is the will to change or grow?
10. Can I change or grow- do I have the capacity… this time, meaning the ability or skills to change or grow (or can acquire them)?
11. Is it worth it for me to change?
12. Do I have the courage to change or grow?  Am I going to be able to deal with the pain it takes to change?
Continuing, the other partner- Partner B (Nancy in this example) also answers what he or she thinks about his or her partner (Arthur in this example):
13. Do I (Nancy) think my partner (Arthur) can change or grow- does he or she have the capacity… that is the will to change or grow?
14. Do I think my partner can my partner change or grow- does he or she have the capacity… this time meaning the ability or skills to change or grow (or can acquire them)?  
15. Do I think my partner feel it is worth it for him or her to change?
16. Do I think my partner has the courage to change or grow?  Is he or she going to be able to deal with the pain it takes to change?

Many times, one or both clients answer one or more of the questions with, "I don't know," especially about the other person.  This means that the answer is neither "Yes" nor "No."  It is "Maybe." Realistically, many if not most couples come for therapy with several "Maybe" answers among the sixteen questions between them.  Both Arthur and Nancy were not sure about their future as a couple.  That is ok and should be expected.  That is a primary if not the primary reason for coming to therapy.  However, for therapy to be successful (in terms of building or healing the relationship), it must move both partners towards all "Yes" answers.  The therapist's first and continuing goal is to move both members of the couple to gain confidence in his/her own and his/her partner's capacity to grow and change, find it more worthwhile to change and that both will eventually change.  When the relationship does move to each partner having clear firm "Yes" answers to every question- sixteen definitive "Yes" answers, the couple therapy is in a fundamentally different place and has a different process.  This may be so before therapy begins, happen in the first session, develop during the process of therapy, or never happen.  Nancy did not know if Arthur could change.  She did not know if she could change.  Arthur did not know if it was going to be worth it to do the hard work to grow and heal.  Both Nancy and Arthur were terrified at the thought of the marriage ending, but also scared about what it would take emotionally to work through all their issues.  Unless the couple moves to turn any and all "maybe," they will be hard pressed to move in any direction with clear resolution.  If they separate without certainty, doubt could linger indefinitely for both partners.  If they continue together, the couple as individuals and a couple will lack the confidence that the relationship will grow or heal.  With sixteen clear and confident affirmative answers, however there will be a tangible relaxation of the dynamics.  A secure foundation for therapy and the couple’s process would have been established.  A "mistake" or injury will no longer be seen as a crisis of the relationship's viability, but more as an opportunity to do more work and become closer.  In many ways, when the couple gets here, the true therapy is done.  All that is left is the work- perhaps, a lot of work.  If there are eight "Yes" answers from one partner such as Arthur and eight "Yes" answers from the other partner such as Nancy, then there is still healing, work, and problem-solving.  This joint confidence affirms the capacity of the couple to work through their issues.  Confidence and affirmation of capacity makes it possible for the couple to commit to the process of therapy and the couples relationship.  

On the other hand, if there are any "Maybe" answers, the goal of therapy is to work through issues so that any "Maybe" answer becomes definitively either a "Yes" or a "No."  It should be made clear to the couple that "Maybe" answers are expected.  That there is doubt may be essentially why the couple has come to therapy.  The therapist also should be aware that one or both partners may give "Yes" answers to all questions despite having doubts ("Maybe" answers) or even definitive "No" answers.  Such a partner may be either deceiving the other partner and/or engaged in self-deception for any number of reasons: Arthur may be trying to be the good guy, believing that he is supposed to be positive, being in denial, holding secrets (including affairs and plans to leave), and so forth.  The therapist may be immediately aware of the deception from the affect or other non-verbal cues, or subsequently, from observing communication and behaviors.  The therapist's trust and skills in the therapeutic process can incorporate this deception.  In fact, the deception immediately gives the therapist additional and extremely relevant diagnostic information about the partner and the couple.  Nancy, for example may say it is worth it for her to work on the relationship but may more interested in sustaining the family as a unit as opposed to restoring an intimate couple's relationship.

If at any time however, including the initial assessment using this process there is even just one definitive "No," the couple's relationship or marriage is done.  Fifteen "Yes" answers and one "No" would mean the relationship is terminal.  There will be times that the therapist may intuit or realize the definitive "No" answer before the partners.  Often one partner realizes the negative answer before the other partner does.  In either situation, the therapist would then need to help the couple determine if the "No" is genuine or an attempt to manipulate the process or partner.  In couples, where manipulation and intimidation are commonly used to control each other, a threat such as, "I'm done," or "I cannot do this anymore" sound definitive, but may be impulsive rhetoric for the moment.  The threat is damaging and clearly dysfunctional and the partner may "take it back" or justify it later saying, "You know I don't' really mean that."  Therapy should address the problematic communication at all levels (including deeper psychodynamic origins) and set boundaries for handling the emotional reactivity more productively.  The therapist should be aware that any definitive "No" may mean an intimate mutually fulfilling relationship may end or continue to deteriorate, while the relationship may continue in some other form: a business relationship, some dysfunctional painful relationship, an oppressive or manipulative relationship, or some other disconnected emotional relationship.  If the goal of the couple is to maintain the relationship with or without emotional intimacy and mutuality, then the therapist may proceed to help them formulate the boundaries and mechanisms to do so.  However, the therapist should be clear to the partners of the improbability or futility of a continued intimate relationship with one or more negative answers to the sixteen questions.

When the client proclaims that he or she cannot communicate or behave as the therapist or the partner asks of him or her, there may be deeper issues beyond what a change in awareness or insight can initiate.  The answer "No" may be an instinctive fear reaction rather than be definitive of actual ability.  While change is often necessary for couple's relationships to heal or work, change is not always perceived as beneficial.  In the individual's culture or family-of-origin model or for some people and societies, change is considered desirable and inevitable.  For others, change is begrudgingly acceptable.  For still others, is dangerous and to be resisted.  And for some, it is even immoral.  Change can have no substantial to extraordinary important symbolism.  It can mean nothing to implying destruction of a person's entire emotional, psychic, and intellectual organizational foundation.  Individuals from more democratic societies or more functional families will be more likely to find change desirable and safe.  However, individuals from totalitarian or feudal societies or more dysfunctional families will more tend to find change intolerable or dangerous.  The potential negative consequences of change or doing something different can be very severe or draconian- literally life vs. death in some societies, or being left alone or enduring or abuse in some families.  The confusion and conflict over various values and compelling meanings may cause one or both partners to make noncommittal "Maybe" answers.  They may hear the therapist's questions as asking or demanding their willingness to change.  Underlying symbolism that is too intimidating can result in "No" and "Maybe" responses.  The therapist needs to do an assessment of each individual including cultural and family-of-origin models as far as his or her ability to change.  When examining the capacity to change in terms of having the will and/or having the skills, the therapist should not assume the ease of change for each partner or the couple.  This could become a difficult cross-cultural requirement.  For someone who is highly resistant to change or finds change extremely difficult, it may be necessary (for the therapist and/or the partner) to seek relatively small or marginal changes over an extended period, rather than substantial change quickly.

Joseph was raised in a fairly traditional nuclear family with his father working and providing income for the family and his mother being the stay at home mom and homemaker.  Joseph was expected to mow the lawn, do well in school and sports, and go to college to become a professional, while his sisters were expected to clean house, cook occasionally, and go to college to find a prospect to marry.  His first wife fit his expectations extremely well.  However, after ten years of marriage, she died from cancer while still in her thirties.  Now in his forties after another ten years as a widower, Joseph found Lisa.  Lisa was raised in a progressive feminist-friendly family with egalitarian principles.  While her mother and father had respective tasks or roles that each favored and were allowed to own by each other, there were no rigidly defined gender-based tasks.  Despite these differences, Joseph and Lisa were mutually attracted and they eventually married.  To her dismay, Joseph's "cute" anachronistic habits turned out not to be so cute in a joint household.  Not only was Joseph a "traditional" male, he had gotten used to doing whatever he wanted as a widower for ten years.  He had habits that had been modeled by his father in children, supported or deferred to by his first wife for ten years, and virtually calcified as a bachelor widower for another ten years.  He was an "old dog" having trouble learning new tricks!  When they both understood that his difficulty changing was not from just being obstinate but from training and long practice, they accepted that quick major fundamental change was very difficult for him.  They negotiated and agreed for Joseph to make small changes that were less disruptive to him.  Lisa found that Joseph still not doing it "right" was acceptable when she saw that he was doing it "better."  She was pleased with incremental change and especially so because she could tell he was trying.

The therapist might be able to successfully push for significant and large change.  However, if extensive change is not immediately practical, then facilitating small and consistent change would be a reasonable alternative approach.  If a partner or the couple still resists small and consistent change, then the therapist should examine for symbolic issues that even small change disturbs.  The admonition, "don't sweat the small stuff because it is all small stuff," needs to be further qualified with "… unless the small stuff symbolize big nasty stuff!"  This follows the principle, that if it (an intervention, behavior, response, etc.) should work, it will work… unless there is something highly compelling that prevents it from working.  Trauma, abuse, strong cultural values or rules, stress, alcoholism, drug abuse, fear, ego threatening action, and anger are among many compelling experiences that prevent logical interventions or behaviors from being effective.  When the therapist provides a suggestion of something that should work, it is presented as counseling or problem solving.  When the client or the couple is able to readily give affirmative answers to the sixteen questions, then therapy assists in figuring out and activating problem solving.  When the suggestion is resisted and somehow does not work when it should, then the therapist needs to conduct therapy.  Therapy becomes the search for and healing of deeper processes that preclude obvious counseling remedies or preclude clients being able to commit with affirmative responses.  Couples counseling may be defined as telling or showing a couple how to behave well, while couple therapy may be defined as also figuring out why telling or showing is not integrated by the couple.

If however, after exploration the single "No" answer is confirmed as genuine and not transitory, the collection of all the other "Yes" answers cannot mitigate or reverse the finality of the relationships demise.  The lack of a willing partner in the restorative process by default ends the relationship as a committed couple.  One partner may be adamantly positive about continuing working on the relationship, and be rendered helpless by the other partner's single definitive "No" to do anything about it.  If one partner says he or she doesn't have the will or skills or not feel it worthwhile or cannot find the courage to continue trying, then it does not matter what the other partner wants or believes.  Or, if one partner is certain (despite proclamations or protestations to the contrary) that the other partner doesn't have the will or skills or feels it worthwhile or cannot find the courage to continue trying, then continuing to try might become irrelevant.  The other partner may seek to "prove" his or her willingness, skills, sense of worth, or courage, but the first partner may resist and deny the proof's veracity.  Couple therapy may continue, but would shift to some goal other than healing and helping the couple stay together.  It can become separation therapy or evolve to co-parenting therapy.

Georgi realized that she could attain the growth and change necessary to build the relationship.  However, her partner Hallie was not going to give her what she needed.  Hallie was too limited for a variety of reasons.  The best Hallie could do was short of what she wanted; Georgi's partner was not worth the energy and struggle rebuilding the relationship would take.

Julie had compassion for her partner Chappell's traumatic and abusive childhood.  She knew that it affected their relationship.  Julie was willing to work on it with Chappell.  However, Chappell became triggered and overwhelmed when these issues came up in their relationship.  Talking about them made Chappell aggressively defensive and Julie would endure being snapped at.  Julie eventually accepted that her partner was too emotionally fragile to address the issues that had to be resolved for the relationship to work.  Chappell didn't have the ability to grow and change.

Delecia knew that her sexual molestation as a child affected her being able to trust her partner.  A favorite uncle had been molested her for several years.  When Delecia told her family, they didn't believe her and scolded her for lying and making trouble.  It was always hard for her to be intimate- not just sexually.  Her partner Lee understood about the trauma, but also had a hard time with being held at arms length.  Delecia knew she needed to deal with the trauma, but could not find the courage to go back to that pain.  Lee was supportive but that was not enough.  Ultimately, Delecia broke off the relationship rather than deal with it.  This break up with Lee was sadly was Delecia's pattern with relationship after relationship.

As mentioned earlier, it is not unusual for a partner to have already come to one or more definitive "No" answers before coming to or during therapy and be evasive or outright lie about it.  In the process of therapy, the other partner will eventually come to recognize the denial or deception.  Then this other partner will come to his or her own definitive "No" about his or her partner's will or skills or whether he or feels it worthwhile or can find the courage to continue trying.  The couples relationship or marriage then is done for non-denying partner, and subsequently, also for the partner in denial.  Jeanine looked at her wife Frances, understanding the family of origin background (trauma), her defense mechanisms, her frailty, and her injuries and anger, and realized that she could not keep trying.  Frances said she wanted to keep trying, but her commitment seemed marginal at best.  She believed in marriage even although this marriage didn't work for her… or Jeanine either.  Frances didn't believe in quitting, she said.  However to Jeanine, Frances' behavior seemed like she had quit years ago.  Jeanine felt Francis had not been trying for a long time, but Frances' upbringing and moral code required her to stay married.  The long difficult battle for marriage equality weighed heavily on Francis as well.  It would feel like a political and social betrayal to give up a marriage that so many people had fought so long for.  Frances' demons were too powerful or her political allegiance to marriage equality too impenetrable to admit the unfulfilling reality of the marriage.  Frances' words of commitment were not matched by her behavior.  She became more passive-aggressive: forgetting to call, silence, flat responses, and so forth.  After four months of couple therapy, Frances still would not admit she was done because it was not worth it to her anymore.  However, in the process of couple therapy, it became obvious to Jeanine that Frances did not think the relationship was worth it anymore and that she was done.  Although, Frances verbally continued the mythology of trying (perhaps, not to be the "bad guy" who ended the marriage), Jeanine could see that Frances could not or would not grow or change her behavior.  The "Maybe" answers to questions about Frances continued to frustrate Jeanine.  Jeanine finally decided, "No," she did not think it was worth it, and "No," she did not believe Frances had the ability to grow or change.  Although, Jeanine had all "Yes" answers for herself, none of them mattered once she definitively saw through Frances' denial.  Skillful therapeutic processes to discuss issues, teach communication, increase awareness and insight, create emotional connection, and other interventions would ultimately be frustrated if one or both partners are disingenuous.  Often, the therapist may not need to confront or point this out.  The process itself will often reveal the truth to the partner.

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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