I like to tell clients that the biggest barrier to successful therapy is low intensity. The one-hour-per-week model of therapy is (if you ask me) showing signs of age, and the future is a more intense format. Click here for more on this. But there’s another barrier to successful therapy: we will run into problems if we don’t think about our agenda.

First, there’s your agenda. (And if you’re a couple, you have two!) Maybe you want to vent. Maybe you want to improve your communication skills. Maybe–if you’re being really honest with yourself–you want to win an argument or get your partner to change. Maybe–if you’re being really, really honest!–your agenda in therapy is simply to appease your partner, to score points for showing up in the hopes that s/he will get off your back. Obviously, not all agendas are created equal!

But then there’s my agenda. If a therapist tells you she doesn’t have an agenda, she’s lying. Therapists always have an agenda, whether or not they’re aware of it. And we always have theories, opinions, biases, and buttons (as in, you can push my buttons). To be a good therapist, I need to know this and work with it, keeping what works (such as a good theory) and overcoming what doesn’t (such as an unfair bias or unhelpful opinion).

When we meet, I will always ask about the agenda, and I’ll always try to say at least something about my own. One time I worked with a couple whose agenda was to get the other person to understand something, or stop doing something. Both of them said it that way. “My agenda is to get him to understand that _____.” “My agenda is to get her to stop doing _____.” After they both announced these agendas, I told them that my agenda was quite different. I told them that my agenda was to get each of them to confront themselves about their own lack of understanding and their own bad behavior.

It helped to do this–it always helps to do this–because then both therapist and client can see more clearly what’s in store for them, and decide whether couples counseling is truly the right way to go. Sometimes it’s not. And in that case, we talk about other options for the couple.

But I’m happy to say that most times counseling does turn out to be useful, and we’re able to set an agenda that helps the couple work through their issues and find happiness. But every time we get together, I’m going to ask about agenda. So when you’re getting ready for a session, take some time to think about your hopes, assumptions, and plans for the session. Think about your agenda. I may encourage you to change it when you come in, or it may turn out to be the best path for us to follow. Either way, it pays to think ahead.

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Let’s talk about homework. I have two definitions of it. First, there’s the homework I’ll occasionally encourage clients to do between sessions (okay, not occasionally…often!). Here’s a book I think you’ll like, or maybe you two should try being more present emotionally when you’re having sex (and here’s how), or how about looking at this list and trying out some of the ideas?

Other times, I define ‘homework’ more broadly. During the session–and particularly in a couples session–you and I might notice something you’re doing (or not doing) because you’re scared. (It’s usually fear and anxiety more than anything else!) You’re scared to be honest, scared to reveal a truth, scared to take a risk, scared to say the thing you know will upset your partner, scared to be tender and caring…scared. This can be your homework.

Sometimes homework is a specific task, a self-help book, a technique. But more often it’s the hard and scary work of self-confrontation, both inside the therapy session and out in your own world of home and work and relationships. And here’s a funny thing: if you’re feeling bored–in therapy, let’s say, or more generally in your relationship–then you’re probably scared of something! Fear is a great basic emotion–an emotion that leads to secondary emotions like boredom, anger, sadness. (Sometimes those are basic emotions too, of course. But fear is often at the heart of the dilemmas we face in couples work.)

So I’ll recommend specific homework for you, if that’s what you’d like. But most often I’ll be challenging you to do your ‘personal homework,’ and that’s mostly going to be about your fears. But this isn’t the end of the story. When people face their fears and challenge themselves, their relationships improve. All of the happy couples I know–personally and professionally–have found happiness by confronting their fears. It sounds hard because it is hard. But ‘personal homework’ is the best path to happiness and ecstasy in your relationship.

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This is the best article I’ve seen so far in the Mark Sanford sex scandal. Wait, it’s not a sex scandal–it’s a love scandal. He truly loved Maria, the “other woman” in the story. And he stood tall in his disclosure of the affair, took full responsibility, and expressed genuine remorse. Does that mitigate what he did to his wife, and their marriage?

Yes and no. Sanford faced the cameras alone, told the whole truth about what happened, and neither vilified his lover nor humiliated his wife. By our current national political standards, Sanford was in a class by himself. His wife has filed for a trial separation, and though I don’t know either of them, I think it’s a safe guess that she’s not immediately seeking divorce in part because he has behaved honorably…at least for the last few days.

In the article I linked to above, Cristina Nehring writes, “Let us hope that Mark and his graceful wife (who to her credit, both initiated a trial separation, and allowed him to explain his affair to the world alone, without holding his hand as though she was a babysitter who had reclaimed her charge) can put things together again in a new, imaginative, and electric way.”

I share that hope. The fact that Sanford truly loved his ‘mistress’* might make it both easier and harder to reconcile with his wife and have a new, “electric” marriage with her. Easier because in his confession of love, Sanford sounded like an emotionally aware, thoughtful man who did finally face up to what he had done. He’s not a misbehaving boy who forces his wife to play the thankless role of jilted babysitter. And it might be harder because this truly was the flowering of a new, loving relationship, and no doubt both Sanford and his wife will have a great deal to wrestle with. Sanford must not only make amends to her if he wants to rebuild his marriage (and, most likely, if he wants to look in the mirror without wincing). He will also have to discern with her whether they both want to build powerful intimacy and passion in a true marriage of love.

Only men and women can do that kind of thing.

* I used the word ‘mistress’ here because I couldn’t think of a better moniker for ‘the other woman.’ But I dislike the word ‘mistress.’ To me it evokes outdated images of powerful men and their femmes fatales. If you have a better term for this, please let me know!

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Couples, I’m cross-posting this article about my role in our work together. When I get to the part about the referee, you might understand what I’m talking about!

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This month marks my eleventh year as a psychotherapist, and every time I reach an anniversary or milestone, I reflect on my work, and my profession. This year, I’m reflecting on the difficulty people face when they come to counseling and start grappling with the concept of ‘differentiation.’

If you don’t know what the word ‘differentiation’ means, don’t worry. It’s not my favorite word, and not the best way to describe the concept to which it refers. Here it is in English: differentiation is the ability to draw close to people you love without giving in to the pressure they put on you to change, while at the same time not being indifferent to them. Still confusing? How about this: differentiation is, in short, taking almost nothing personally. Your partner is mad at you? Differentiation means that you are not indifferent to that, but you’re also not getting all defensive. Your parent is trying to run your life, even though you’re in your 30′s? Differentiation means that you understand your parent’s motivations, and you’re standing your ground without cutting yourself off from your meddling parent.

Here’s the thing: the more I work with people on this concept, the more I come to realize how hard it is to learn and practice it. It seems like we’re just hard-wired to take things personally and be over-involved with each other. When someone criticizes us, we naturally get defensive. It just happens, and usually within a few seconds! So there are times in my work when it feels like I’m asking fish not to swim, or birds not to fly.

But even if it feels like that, it’s actually the opposite. To be undifferentiated is a lot like being frozen, stuck, mired in the mud. It’s a fish who can’t escape to open sea and swim gracefully with her school. It’s a bird who can’t take flight in a beautiful aerodynamic pattern with his flock.

So, I’ll keep at it. I’m enjoying my work very much these days, so I’ve got at least another eleven years (or 22, or 33) to help more people take flight.

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I should say first of all that I admire and respect Elizabeth Edwards. She’s bright, sensitive, reflective, and funny. That’s four gold stars in her favor! I’ve even blogged about her. But lately I’ve been concerned about her. In fact, I disagree with some of the things she has said (and written) of late. The newsmagazine Time recently published an excerpt of Edwards’s latest book, “Resilience,” and in the excerpt she was writing about her husband’s affair, her own cancer diagnosis, and all the emotional upheaval her marriage has endured. At one point she said that because of her cancer diagnosis, it was she, not he, who “needed a selfless partner.”

Whoa. Back up.

First, let me say this: John Edwards was behaving like a cad. According to the standards of his own marriage, he should not have slept with Rielle Hunter. He’s right to say that he was behaving like a narcissist, and he was betraying his wife. Not good. Seriously. But–and again, I like Elizabeth Edwards!–if you’ve just been diagnosed with cancer, that does not mean that you alone get to be the partner in your marriage who deserves a “selfless partner.” It’s reasonable for you to expect that your partner will not step out on you–and it makes perfect sense if you’re upset with your partner for doing just that–but even if you’ve been diagnosed with a terminal illness, your marriage continues to unfold as a union of two full-grown adults, two people who have chosen to draw close to one another in a lasting bond of intimacy and commitment. This means that even though you’re sick, the ethics of your union call you to be mindful of your spouse’s needs, even if there’s nothing you can do–or should do–about them.

I know this might be hard to hear, but I should say that I write it as someone who knows a person who died of cancer. Though I haven’t dealt with terminal illness in my own committed relationship, I know a couple who dealt with this, and I’m here to tell you that it’s important that couples face these crises in this way. As poignant and upsetting as cancer can be, it does not excuse you from the ethical dimensions of your relationship.

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…discussed in my advice column. Couples, this one’s for you!

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It feels immodest to do this, but I recently received a thank-you from a client and have their permission to reprint it here. You know what? Sometimes couples therapy really helps!

The client wrote, “(We) are doing very well–in fact, we had a long discussion recently about how couples therapy with you has helped us over time. We both agreed that the conversations we had during (and because of) therapy fundamentally increased our understanding of one another–emotionally, intellectually, and sexually. What we learned with you has allowed us to continue growing on our own to wonderful effect, and our relationship right now is better than ever.”

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