Love in Action: An Integrative Approach to Last Chance Couple Therapy

• Date: 01 September 2019
• DOI: http://doi.org/10.1111/famp.12474
• Published date: 01 September 2019
• Author: Peter Fraenkel

Love in Action: An Integrative Approach to Last

Chance Couple Therapy

PETER FRAENKEL*

This article presents an integrative approach to the special challenges of therapy with

couples on the brink of dissolution or divorce—who often describe this therapy as their “last

chance.” In some, one partner is considering ending the relationship, and in others, both

partners are considering ending it. Often, these couples have had prior dissatisfying expe ri-

ences in couple therapy. Four types of last chance couples are described: high-conflict cou-

ples; couples in which partners have differin g goals for their lives or different timelines for

reaching shared goals; couples in which one or both partners have acted in a manner that

violates the values, expectations, emotional comfort, or safety of the other; and couples in

which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspecti-

val, theoretically eclectic integrative approach, is enlisted as a general framework for

selecting and sequencing use of particular theories and their associated practices, based on

the three “primary colors” of couple therapy: time frame/focus, level of directiveness, and

change entry point. An additional complementary framework, the creative relational move-

ment approach, is proposed to provide an integrative frame encompassing both language-

based and action-based practices, suggesting that meaning is held and expressed as much

through interaction or “relational motion” as it is through language. Principles of change

are described. Due to the couple’s level of crisis and desire for immediate evidence of possi-

ble improvement, priority is given to action-based interventions in early stages of therapy,

by engaging couples in “experiments in possibility.” Typical action approaches are

described. An extended vignette follows.

Keywords: Integration; Couple Therapy; Brink of Divorce; Thera peutic Palette; Creative

Relational Movement Approach; Motivation in Couple Therapy

Fam Proc 58:569–594, 2019

No place to hide

And nowhere to run

Nothing you can do because a change must come

—From the song, “Love in Action,” on the album Oops!Wrong Planet by Todd Rundgren and

Utopia

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Todd Rundgren’s song captures something essential about where many couples land

before they enter therapy: One or both partners feel the relationship has become

*Department of Psychology, The City College of New York, New York, NY.

Correspondence regarding this article should be addressed to Peter Fraenkel, Department of Psychol-

ogy, The City College of New York, Room 7/120, North Academic Center, 160 Convent Ave., New York,

NY 10031. E-mail: fraenkelorama@gmail.com

1

Songwriters: John Wilcox, Kasim Sulton, Roger Powell, & Todd Rundgren, 1977, Warner Bros. Music.

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Family Process, Vol. 58, No. 3, 2019 ©2019 Family Process Institute

doi: 10.1111/famp.12474

untenable and unlivable and that “a change must come” if they are to stay. This is espe-

cially true in what the present author has termed “last chance couples”—those in which

one or both partners are on the brink of initiating dissolution (if not formally married) or

divorce, often after having tried couple therapy one or more times before (Fraenkel,

2017b, 2018). They want to see some observable change happen as soon as possible. Most

do not come in ready for a more leisurely exploration of thoughts and feelings, and each

partner’s respective psychodynamics and family histories, although they understand

(often grudgingly) that this will eventually be part of the process. Indeed, in the

author’s experience as a New York City-based therapist where psychodynamic therapy

still has a dominant place in the therapeutic ecology, one or both partners’ stated reluc-

tance to engage in couple therapy is often prefaced by some statement to the effect of, “I’ve

been in therapy for years, I really don’t want to talk about my issues with my mother (or

father) anymore. I need to see something change.” Doherty (2002) describes the typical

state of affairs with a new couple as follows:

Couples sessions can be scenes of rapid escalation uncommon in individual therapy, and even in

family therapy. Lose control over the process for 15 seconds and you can have the spouses

screaming at each other and wondering why they’re paying you to watch them mix it up ... even

more unnerving is the fact that couples therapy often begins with the threat that the couple will

split up. Often, one spouse is coming just to drop off his or her partner at a therapist’s doorstep

before exiting. Others are so demoralized that they need an intense infusion of hope before agree-

ing to a second session. Therapists who prefer to take their time doing their favorite lengthy

assessment instead of intervening immediately may lose couples who arrive in crisis and need a

rapid response to stop the bleeding. A laid-back or timid therapist can doom a marriage that

requires quick CPR. If couples therapy were a sport, it would resemble wrestling, not baseball—

because it can be over in a flash if you don’t have your wits about you. (pp. 28–29, italics added)

In a book with the title Love in Action (1993), the venerable Vietnamese Buddhist leader

Thich Nhat Hanh’s heartfelt plea for nonviolent action in political and cultural conflicts

speaks to one of the major foci of effective couple therapy: Therapists must introd uce early

on new skills, or elicit the couple’s submerged existing ones, in vigorous but nonoppres-

sive, fair means of dialogue, problem resolution, and other aspects of interaction. This is

true for couples in high conflict as well as for conflict-avoidant couples, who often fear any

form of engagement will elicit hurtful self-expression by the partner.

This article describes an “action/insight” integrative approach to couple therapy.

Although many of the integrative, as well as “pure-form” approaches to couple therapy

have emphasized the importance of suggesting intersession activities to promote change,

or engage couples in enactments of novel interactional patterns in session, the present

article re-emphasizes the importance of privileging action over insight with couples on the

brink of relationship dissolution (Fraenkel, 2017a, 2018). As early as the first session, cou-

ples need to “experiment with possibility” by initiating novel action. These novel actions,

which often feel irrational at the time given partners’ sense of hopelessness and negative

beliefs and feelings about each other—and which one or both partners might feel little

motivation to try—serve to put a significant “wedge” or bifurcation between the past and

the present towards the future, which then allows partners to step away from and above

their constraining histories and gain further insight into the manner in which their pasts

have lived on in thought, feeling, physiological reactivity, and behavior.

Of course, aside from providing instruction in research-based communication and prob-

lem-solving skills, most of the time in early sessions must be devoted to creating a holding

environment for partners to express their deep dissatisfaction with the relationship, and

to have these feelings witnessed and not challenged by the therapist. As suggested by

other approaches to couple therapy (Scheinkman & Fishbane, 2004), it is crucial early on

to examine the multiple sources of each partner’s sense of vulnerability and to help

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