Disrupting Power and Privilege in Couples Therapy

Power disparities underlie many of the issues that couples bring for therapy. People in relationships are not equal; often one partner is systematically conferred unearned advantage and dominance. This article synthesizes results from three qualitative research studies to propose a social justice approach for clinical practice with couples. Interventions are suggested to keep issues of power and privilege a central focus while addressing the ordinary issues partners present for therapy.

Shame,the Affective Side of Secrets: Commentary on Barth’s Hidden Eating Disorders

This paper expands on the ideas presented by Barth’s article on hidden eating disorders. The topic of eating disorders continues to be an important focus of clinical work. Applying constructs related to the experience of shame, I explore the way that feelings of shame may impact an exploration of eating disorders by the patient and clinician.

Focused Countertransference Exploration in Classroom Teaching of Modern Psychoanalytic Candidates

A method of classroom teaching as a paradigm of treatment situations is presented. The focus is on moving candidates from an intellectual to an emotional experience of regression, transference, and countertransference as it is manifested in the classroom setting, and to study these manifestations and the treatment approach used to elicit them. The purpose is to prepare candidates for work with disturbed patients. Some modern and classical psychoanalytic theories and practices are highlighted.

The distribution of financial well-being and income within the household

In this paper we consider the issue of the intra-household distribution of welfare directly using a survey measure of self-perceived economic well-being. We develop a theoretical model of satisfaction within the household for couples. In the empirical analysis we find that husbands and wives often report different levels of financial satisfaction. The most important correlate of relative satisfaction within the household is found to be relative income. This is a direct confirmation of the previously implicit findings and is predicted by our theoretical model.

A Commentary on “Gender Perspectives in Cross-Cultural Couples”

This commentary expands on Kellner’s article by discussing clinical practice with Asian and Euro-American couples. Differences in Western and traditional Asian cultural expectations around intimacy and styles of emotional expression can often lead to misunderstanding among couples. Therapy can also be a challenge for couples when they do not share the same first language. A therapist who only speaks English can inadvertently create an alliance with the partner whose first language is English. On the other hand, bilingual therapists who use both English and an Asian language in the session can face challenges differentiating their roles as a therapist versus a translator. Case illustrations are presented to illustrate these challenges.

Conflict-Oriented Cognitive Behavioral Therapy (CO-CBT): An Integrative Approach to the Treatment of Bulimia Nervosa Patients

The paper describes an integrative approach to the treatment of Bulimia Nervosa that combines Cognitive Behavioral Treatment (CBT) with short-term dynamic treatment, called conflict-oriented cognitive behavioral treatment (CO-CBT). The need to develop an integrative model emerges from the lack of focus on the underlying emotional dynamics in the traditional CBT approach. This article provides a brief literature review of CBT and short-term dynamic therapy as applied to Bulimia Nervosa patients. It describes the CO-CBT treatment model, followed by clinical examples, and a discussion of the importance of incorporating this additional dimension in order to most successfully treat Bulimia Nervosa.

Assessing the geographic distribution of same sex and opposite sex couples across the United States: implications for claims of causality between traditional marriage and same sex unions

The percent of households headed by married couples has recently fallen below 50%, while the percent of unmarried couples (both heterosexual and homosexual) continues to rise. Nationally-representative estimates of unmarried couples which first appeared in the 1990 and 2000 decennial Censuses are now available on an annual basis through the American Community Survey. In this paper we use state-level panel data from 2000–2006 on the percent of households headed by married couples, same sex couples and opposite sex unmarried couples to assess widespread claims in the popular press of causality across living arrangements. Based on Granger causality tests we can reject claims that an increase in same sex couples has caused either a decline in marriage or (except in one case) an increase in heterosexual cohabitation. There is mixed evidence whether or not opposite sex couples may have Granger caused same sex couples, but stronger evidence that marriage and heterosexual cohabitation are interrelated.

The scoring rules in an endogenous election

Plurality rule is mostly criticized from being capable of choosing an alternative considered as worst by a strict majority. This paper considers elections in which the agenda consists of potential candidates strategically choosing whether or not to enter the election. In this context, we examine the ability of scoring rules to fulfil the Condorcet criterion. We show for the case of three potential candidates that Plurality rule is the only scoring rule that satisfies a version of the Condorcet criterion in two cases: 1) when preferences are single-peaked and, 2) when preferences are single-dipped.

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The effects of sexual orientation and marital status on how couples hold their money

Previous research has shown that intrahousehold bargaining power in different-sex couples affects household expenditures and how families hold their money. This article examines the portfolio of bank accounts held by same-sex and different-sex couples and its relationship to bargaining power and individual and relationship characteristics. Data from the U.S. Survey of Consumer Finances suggest that married couples are much more likely to hold money jointly than are same-sex or unmarried different-sex couples, even after accounting for the effects of other characteristics. However, many couples of all types hold money in joint accounts and do so more often in longer term relationships and when rearing children. Proxies for bargaining power help predict whether money will be held in individual accounts for unmarried different-sex and same-sex couples, but not for married couples. These patterns could reflect greater matching of married couples on preferences or the effects of legal and social institutions that differ by marital status and sexual orientation.

Gender Perspective in Cross-Cultural Couples

This article explores gender perspective in clinical work with couples whose romantic choices fall across cultural, racial and religious lines. A conceptual framework is presented to track the dimensions of differences between the two partners in intercultural couples (collective vs. individualistic). The article illustrates how emotional expressiveness, continuum of autonomy, gender differentiation, and sexuality play out in intimate cross-cultural relationships. It also shows how the embedded, culturally assigned gender beliefs and roles are addressed in treatment. Examples from the author’s clinical work are presented throughout the article.

The potential of a couples approach to employment assistance: results of a nonexperimental evaluation

We present findings from a nonexperimental evaluation of an employment program in which both partners in young, low-income, primarily African-American couples simultaneously participated. Mothers participating in the couples program had larger immediate gains in employment and earnings and decreases in TANF receipt following their exit from the program relative to mothers who received employment assistance as individuals. Fathers showed similar although weaker results. These immediate benefits appeared to be driven by higher rates of program completion among couples’ participants. Couples in which both partners completed the program experienced the largest quarterly earnings gains, and couples with greater earnings’ gains were more likely to still be together one year after the program ended. Mothers’ earnings gains eroded in the two years following program completion and many reported new pregnancies and problems with child care. We suggest directions for future programs and encourage future studies to consider the range of mechanisms associated with a couples focus, including potential motivational benefits and unintended consequences.

Homecoming as Safe Haven or the New Front: Attachment and Detachment in Military Couples

Traumatized military couples represent a new population for the application of attachment theory constructs. An innovative clinical social work practice model, grounded in a synthesis of social and psychological theories, aims to assist these couple and families who are navigating very difficult transitions. Since social support is known to be a central protective factor in mediating the long-term adverse effects of combat trauma, this therapeutic focus addresses two compelling problem areas: the disruption of secure attachments and affect dysregulation. The effects of deployment stressors on soldiers, their intimate partners, and their families are discussed in depth. Clinical illustrations highlight the utility of a phase-oriented culturally responsive couple therapy practice approach that has clear clinical implications for military couples.

Is Work-Family Policy Use Related to the Gendered Division of Housework?

Researchers have proposed that work-family policy use may either reinforce or challenge the existing gendered division of labor within couples, but results from prior studies have been inconclusive. Using data from a regional survey of work and family life, we extend this research by focusing on how housework is divided within couples and by differentiating between traditionally female- and male- typed housework tasks. Results show that among dual-earning women, policy use is not related to share of female- or male-typed tasks. Among dual-earning men, policy use is positively related to share of female-typed tasks and negatively related to share of male-typed tasks. These findings suggest that work-family policy use does not reinforce the gendered division of housework.

Therapeutic Ambition,Uncertainty, and Psychotherapy with Heterosexually Married Gay Men: A Short Commentary

A Short Commentary on the article 'Staying Put in the Closet: Examining Clinical Practice and Countertransference Issues in Work with Gay Men Married to Straight Women' by Edward Alessi. The focus is upon countertransference issues, especially therapeutic ambition, in working clinically with heterosexually married gay men. The work of the interpersonal school is emphasized as providing a creative approach to therapeutic ambition with Otto Allen Will's concept of the governing principle of uncertainty.

Commentary on Treatment of Infertile Couples Using Reproductive Technologies: A Complex Matrix

The impact of the reproductive technologies upon infertile couples who require them is both ubiquitous and profound. There is a confluence of issues that co-exist for women and men who use reproductive technologies which creates a complex matrix for both the analytically informed social work clinician and those seeking infertility treatment. The unique merger of life stage issues, identity issues, cultural pressures, and responses to the physical and emotional demands of the necessary technologies, serves to amplify the intensity of encounters in this analytic triad. Consideration of attachment theory while utilizing intersubjective systems theory provides a system of treatment which offers comfort and a place to mourn the multiple losses of repetitive failures of attempts to conceive.

The Role of Affect Regulation in a Case of Attempted Maternal-Filicide Suicide: Commentary on an Act of Despair

A case of attempted maternal-filial suicide is discussed from the perspective of trauma, emotional regulation and defense mechanisms. Case details which include childhood sexual abuse, observed parental violence and emotional neglect allow for an illustration of the impact of childhood family experiences on adult intimacy and coping patterns. Domestic violence and the perception of protection are also explored. Emotional regulation in the experience of despair is approached from an object relations perspective. Based on this, implications for prevention and treatment are presented.

The working spouse penalty/premium and married women’s labor supply

Using data drawn from the Current Population Surveys, this paper provides a consistent explanation for why the presence of a working wife reduces the husband’s wage among managers, but increases the husband’s wage among non-managers. It is not husband’s occupation per se but rather the distribution of husbands’ wage levels that underlies the working spouse penalty or premium. Positive correlations in earnings between married couples that arise from assortative mating make the cross-wage effects of the husbands’ wages on the wives’ hours of work first positive, then negative in cross-sectional data. The phenomenon of a working spouse penalty/premium is simply the flip side of this relationship.

Why do families actually pool their income? Evidence from Denmark

This paper analyzes income-pooling by using a unique Danish data set that includes questions on income pooling among 1,696 couples. The analyses show that most Danish households use some kind of income pooling and that the proportion of income pooled varies considerably according to individual characteristics (age, education, occupation, past partners, upbringing) and household characteristics (household income, duration of marriage, location of residence and the existence of public goods, including children). However, when all variables are evaluated in a common model, the duration of marriage and the existence of children predominantly affect the likelihood of income pooling.

Enhanced Experience of Emotional Arousal in Response to Dynamic Facial Expressions

In this study, we investigated the emotional effect of dynamic presentation of facial expressions. Dynamic and static facial expressions of negative and positive emotions were presented using computer-morphing (Experiment 1) and videos of natural changes (Experiment 2), as well as other dynamic and static mosaic images. Participants rated the valence and arousal of their emotional response to the stimuli. The participants consistently reported higher arousal responses to dynamic than to static presentation of facial expressions and mosaic images for both valences. Dynamic presentation had no effect on the valence ratings. These results suggest that dynamic presentation of emotional facial expressions enhances the overall emotional experience without a corresponding qualitative change in the experience, although this effect is not specific to facial images.

The inverse plurality rule—an axiomatization

Under the ‘inverse plurality rule’, voters specify only their least preferred alternative. Our first result establishes that this rule is the only scoring rule that satisfies the minimal veto condition (MV). We then prove that the inverse plurality rule is characterized by MV and the four well known conditions that characterize scoring rules; namely, Anonymity (A), Neutrality (N), Reinforcement (RE) and Continuity (CO). Our new characterization result is related to the characterizations of approval voting and of the widely used plurality rule. We finally show how the axiomatization of the inverse plurality rule can be extended to the axiomatization of elementary scoring rules (vote for t-alternatives scoring rules). We are indebted to two anonymous referees for their most useful comments.

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