Repairing Relationships and Therapeutic Approaches

There are many factors that can rupture relationships. Untreated and unmanaged mental health, chronic medical conditions, and substance-use-related concerns are common. Emotional immaturity and lack of skill development can negatively impact relationships. Stressful and traumatic experiences are also over-arching factors that impact the quality of relationships. Some dynamics within relationships may naturally heal over time, especially when there is personal growth, and opportunities to talk about and repair any ruptures. The problem is that only a small percentage of things are readily accessible within the conscious. A majority of awareness is below the surface within the unconscious mind. Therapists can start by working with what is on the surface and can slowly move below over time to help clients gain greater awareness and insight into things that may otherwise stay buried below such as pain from shameful experiences.

Let’s look at therapeutic approaches that may be used to address factors that impact relationships and see what might be most beneficial to your current situation.

Behavioral Therapy may be used to focus on behavioral symptoms by identifying behaviors that are potentially self-destructive or unhealthy. Motivational Interviewing may be used as a complementary strategy to explore and work with any ambivalence about change. Examples of behaviors may include substance use, self-injurious behavior, risky sexual behaviors, disordered eating, and angry outbursts/ abusive behaviors that are impacting relationships.

A similar but related approach, Cognitive Behavior Therapy works to challenge and change unhelpful cognitive distortions (e.g., thoughts, beliefs, and attitudes) while working with the behaviors and improving the ability to cope with and regulate emotions. Therapists may utilize emotionally-focused therapy (EFT) and experiential therapy techniques to explore how painful experiences from the past and emotional expectations from earlier years have developed and contributed to current difficulties which could be applied to individual, couples, or family work.

While partners may want to start with couples therapy, when potentially self-destructive behaviors are present individually and/ or within the relationship such as intimate partner violence, then individual therapy is recommended. Individual works can focus on individual accountability for behavior, assess for safety within the relationship, and provide a solid foundation for future couples’ work after these behaviors are addressed. It is recommended to re-assess where the relationship is in terms of physical and emotional safety as therapists will want to see that progress in individual work is maintained for a period to ensure generalization of skills learned.

Relational therapy therapists may use the therapeutic relationship as a model for future relationships that the client wants to develop by focusing on creating a strong, collaborative, and secure relationship base. Systemic therapy interventions can help clients understand interactions within relationships and the individual dynamics that impact functioning. At this point, couples and family therapy can be a great modality to build on and strengthen interpersonal effectiveness.

Throughout the process of individual and work within relationships, here are some of the awesome outcomes that can be achieved:

• Identification of unhealthy/ self-destructive patterns impacting self & relationships
• Clearly defined goals/ objectives for therapy
• Feeling more in control of being able to manage/ regulate thoughts, feelings, and behavior
• Change in perspective; increased understanding of self and others
• Relational repair and new experiences that set a healthy foundation for future relationships
• Opportunities to learn and practice skills in/ outside of session

Written By: Charlotte Johnson, MA, LPCC