Untreated Psychiatric Disorders Can Affect Couples Counseling

We all come to couples counseling for a variety of reasons. As a couples therapist, I often hear similar complaints from clients, “he just doesn’t listen to me,” or, “we fight all the time.” Also on the list, “we’ve stopped having sex,” or “can you just change her?” While couples counseling can be the perfect venue to give you tools and tips on how to communicate better, resolve conflict differently, liven up your sex life, and make important relational changes, there are a few things that will stop the process right in its tracks.

Untreated psychiatric disorders will make couples counseling incredibly difficult. If you’re struggling with depression, anxiety, ADHD or any other psychiatric disorder, it is imperative that you get individualized treatment, first. Treatment typically includes a thorough assessment by a specialized professional, either a psychiatrist or a therapist in that particular field of study. If you don’t get individualized treatment first, your couples therapist will give you tools and tips that either you’re unable to utilize (yet). Your therapy sessions will be met with either failed attempts or frustration. All things that you want to avoid as you venture down the vulnerable journey of couples therapy.

While it is the hopes of many clients to change their relationship, such as wanting better sex, more aliveness, stronger communication, less fighting, and so on – the very first step is to take a look at yourself. If you are struggling independently, your treatment comes first , before couples therapy.

One example to illustrate this point is the classic case of someone struggling with undiagnosed adult ADHD. One partner complains that the other is late, lacks of organization, has the inability to prioritize and is unaccountable. It is easy for the other to potentially pin this on characterological factors, saying things like, “he’s just like this,” or “he’s selfish and doesn’t think of me.” However, what if your partner has undiagnosed ADHD? Your partner could be struggling with something outside of their control.

Another excellent example to display the importance is that of undiagnosed depression. A partner may complain that their spouse “never gets out of bed,” is “irritable,” often is “tired and lacks motivation.” Again, these are all signs that could point to a diagnosis of depression – but what if your spouse is convinced that it is because “you just don’t care,” or “you’re lazy.” Your spouse will end up persecuting you on behaviors that may have be out of your control.

Clients struggling with reoccurring symptoms that seem out of the ordinary may need individualized treatment. Through a thorough assessment, skills and coaching, the client has the ability to make individual changes that will impact their relationship. Once the psychiatric disorder is stabilized, couples counseling can be extremely beneficial. Skills such as communication, conflict stabilization, sex, and intimacy issues can be addressed – the very ingredients that help couples and relationships have stronger and more intimate connections.

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For more articles and information from Erika Boissiere, MFT – Founder of the Relationship Institute of San Francisco, please visit www.trisf.com or  call 415-519-6446.

Adult ADHD Relationships

There is considerable information out there about adult ADHD relationships. Unfortunately, the bulk of this information focuses on the negative effects adult ADHD has on relationships. I think it is of equal importance to give some attention to how adult ADHD can actually prevent the person with ADHD from being empowered in their relationship. This lack of empowerment can limit one’s ability to change or even get out of a bad relationship.

I see this often with clients who “come out of the ADHD fog” as I have named it. When adults are too distracted, forgetful, or struggling to maintain work or school performance, they often don’t have the psychological resources to address their romantic relationships. Something that also makes this problem worse, is that most adults with ADHD have considerable shame and self-doubt, which leads them to believe that any relationship struggles they face, are their own fault. It is true that adult ADHD can wreak havoc on relationships. However, this does not give clemency to the non-ADHD partner, nor does it mean that issues unrelated to adult ADHD also plague some relationships.

It is an honor to accompany my clients on their journey towards change. We all deserve healthy, symbiotic, and supportive relationships. Those people challenged by adult ADHD need to know and believe that also, so they may advocate for themselves and shape their lives in a positive way. There are many people walking around San Francisco that I have worked with around adult ADHD relationships through Cognitive Behavioral Therapy (CBT), skills training, and relationship work. To know that there are people who are out of the fog and living life to it’s fullest, and know that I touched their lives, gives me a great big smile inside.

Couples Counseling San Francisco

San Francisco and the surrounding areas (Silicon Valley, Berkeley, Menlo Park, Palo Alto etc.) are full of psychotherapists providing couples counseling. Unfortunately, there seems to be a large amount of therapists treating couples without adequate direction and focus on goals. It is very common for a couple to come to me with the same complaints about previous therapy. Often the husband or boyfriend feels “ganged up on” or the couple feels that they paid weekly to fight in-front of someone and were sent home without anything to try or practice.

I work diligently with couples of all combinations to quickly identify the reasons that have brought them to my office, their individual goals, and their shared goals. I believe it is paramount to have clear goals in couples therapy in order for it to be effective. Couples in San Francisco and the Silicon Valley are often pressed for time and want to feel that they are being provided with tools and skills to improve their relationship on a weekly basis. My entire practice, whether working with individuals or couples in therapy is focused on using research based and targeted treatments, such as Cognitive Behavioral Therapy (CBT).

In my work with couples in counseling, I bring in elements of the Gottman Method, Relational Life Therapy, and Emotionally Focused Therapy (EFT) in a way that is specific to the couple. No two couples are the same and every couple deserves individualized treatment.

If my approach sounds like a good fit you and your partner, give me a call so we can explore working together.

Contact Phil here.