Couple Therapy: Types, Issues, and Solutions

• Lecture deals with coupling schedule, therapy, and eating disorders

Couple Therapy Overview

• Main goals are resolving conflicts, improving communication, and enhancing emotional connection.
• Couple therapy originated in psychoanalysis and evolved into family therapy.
• Influential figures include:
  • John Bowlby, attachment theory
  • John Gottman, interpersonal relationship dynamics

Types of Therapy

• Pyschodynamic therapy addresses unresolved internal conflicts affecting relationships
• Cognitive Behavioral Therapy (CBT): Focuses on changing thought patterns and behaviors
• Humanistic Existential Therapy: Centers on emotional self-awareness and personal responsibility
• Systemic Therapy: Views behavior as shaped by family and social dynamics

Issues in Couple Therapy

• Communication Problems in couples include miscommunication.
  • Techniques to improve this issues are using "I" statements and active listening
• Conflict Resolution Strategies involve identifying conflict styles like avoidance, confrontation, and compromise.
• Intimacy and Sexual Issues that present themselves are addressing mismatched sexual drives and unresolved sexual trauma.
• Financial and Parenting Disagreements occur due to varied parenting styles and differing financial priorities.
• Infidelity and Trust Rebuilding: Aims to reestablishing trust and emotional safety

Therapist Role

• Therapists should stay neutral and identify hidden dynamics within the couple.
• Therapists help uncover underlying issues like control and dependency.
• Therapists works to teach boundary setting and maintain healthy boundaries.

Therapy Models

• Emotionally Focused Therapy focuses on strengthening emotional bonds.
• Gottman Method focuses on love maps, managing conflict, and shared meaning.
• CBT and Imago Therapy aim to change negative thoughts and focus on childhood wounds.

Therapy Stages

• Assessment and Goal Setting involves evaluating history and key issues.
• Conflict Resolution involves using tools to resolve conflicts.
• Building Positive Interaction improves interactions through shared activities.
• Maintenance and Relapse Prevention involves coping mechanisms for long-term improvement.

Complex Issues in Couples

• Trauma and Mental Health: Requires integration of trauma-informed care
• Domestic Violence requires prioritizing safety; therapy may not be recommended
• Divorce Counseling aims to end relationships amicably, especially for co-parenting when children are involved

Couple Therapy Outcomes

• Progress is tracked through session notes and self-reports.
• Long-term success depends on continued effort and goal review.

Eating Disorders

• Considered a serious mental health condition involving preoccupation with food and body weight.
• Historical records of eating disorders exist, indicating it is not a new issue.

Types of Eating Disorders

• Anorexia Nervosa involves an intense fear of gaining weight and significant food restriction.
  • Physical issues linked to Anorexia include electrolyte imbalances, cardiac issues, and amenorrhea.
  • Psychological issues linked to Anorexia include anxiety, depression, and OCD.
• Bulimia Nervosa includes binge eating followed by compensatory behaviors like vomiting.
  • Physical issues linked to Bulimia include dental erosion, calluses, and electrolyte imbalances.
  • Psychological issues linked to Bulimia include mood disorders and substance abuse.
• Binge Eating Disorder involves recurrent episodes of eating large amounts of food without purging.
  • Physical issues linked to Binge Eating Disorder include obesity and metabolic syndrome.
  • Psychological issues linked to Binge Eating Disorder include depression and impulsivity.
• Other Disorders: Include atypical anorexia, purging disorder, and avoidant restrictive food intake disorder (Afrid).

Treatment Modalities

• Cognitive Behavioral Therapy (CBT) is the gold standard treatment for bulimia and binge eating.
• Family-Based Treatment is effective for adolescents with anorexia.
• Dialectical Behavior Therapy (DBT) addresses emotional regulation.
• Interpersonal Therapy improves interpersonal relationships.

Pharmacological Treatment

• SSRIs, especially Prozac, help reduce binge-purge cycles in bulimia.
• Atypical Antipsychotics like Olanzapine can help with weight gain and reduce OCD symptoms.
• Binge Eating Disorder Medication includes Vyvanse and Topamax.

Nutritional Rehabilitation

• Treatment involves a gradual increase in food intake.
• Registered Dieticians or nutritionists are consulted

When to Hospitalize

• Severe malnutrition, medical instability, psychiatric danger, or outpatient treatment failure are reasons for hospitalization.

Recovery and Relapse

• Anorexia has a 50-70% recovery rate, while bulimia has an up to 80% recovery rate.
• High relapse rates require long-term follow-up.

Additional Considerations

• Biological factors include genetic predisposition, serotonin and dopamine dysregulation.
• Hormonal dysregulation involves leptin, ghrelin, and cortisol levels.
• Psychosocial factors include cognitive distortions, trauma, and cultural pressures.

Conclusion

• One should focus on notes for updates regarding couples therapy and eating disorders.
• Active participation is needed in preceptor and therapy process.