New Tactic for Troubled Couples

Accept, Not Attack

Medically Reviewed by Craig H. Kliger, MD
5 min read

Feb. 19, 2001 -- Trouble at home? If you and your spouse are headed for marriage counseling or therapy, be forewarned of its less than stellar track record. Only about half of the couples that seek professional help for crumbling marriages are able to meaningfully improve their relationships. And many relationships that seem to improve are in trouble again within two years, according to researchers.

Andrew Christensen, PhD, a professor of psychology at UCLA, hopes to improve those odds with an innovative new type of marriage therapy called integrative couple therapy, or ICT.

The prevailing mantra of couple therapy is that, in order to minimize conflict, partners in an unhappy union should work toward common ground by changing their behaviors. An extrovert husband, for example, might agree to more romantic evenings at home if his homebody spouse agrees to join him in nights on the town with their friends.

ICT turns this approach around completely by encouraging couples to accept the very differences that are tearing their relationships apart.

A study of the technique, published in the April 2000 issue of the Journal of Consulting and Clinical Psychology, compared the impact of ICT with the impact of behavioral couple therapy (BCT), a popular form of therapy that emphasizes behavioral change. Following therapy, 70% of the couples undergoing ICT were significantly improved compared with 55% of the couples undergoing BCT, according to Christensen and his co-authors.

Although the preliminary study was small -- involving only 21 couples, randomly assigned either to ICT or BCT -- the results were striking enough to impress the National Institute of Mental Health, which has granted $3 million for a five-year follow-up study comparing the two techniques. It is the largest grant ever awarded by the NIMH for research on marital therapy.

ICT, more popularly dubbed "acceptance therapy," is the brainchild of Christensen and the late Neil Jacobson, PhD, who was a professor of psychology at the University of Washington in Seattle until his death in 1999.

The two therapists, both experts in BCT, found themselves frustrated at the high failure rate of that approach, and decided to de-emphasize the push for change. "The natural inclination is to try to change your partner, but efforts directed solely at change often accentuate the conflict," Christensen says. Sometimes people just can't change, he says, but even if they can, requests for change from a partner often foster resentment.

Acceptance therapy shifts the emphasis to developing empathy between partners through understanding. "When you genuinely accept your partner, and understand what he or she is experiencing emotionally, you can stop pushing each others' buttons," Christensen says.

In acceptance therapy, a couple and therapist develop a clear description of the couple's relationship -- one upon which both partners can agree. Christensen calls this process writing the "story" of a relationship.

They identify the typical situations that trigger conflict and examine the dynamics that occur when they argue. Central to the technique is identifying the motives and emotions that underlie each partner's behavior. These revelations often come as a surprise, Christensen says.

When Kathy and Bill (they asked that their real names not be used) came to Christensen, their 15-year marriage was falling apart. Kathy complained that Bill was excessively controlling. Bill countered that Kathy would not or could not stick to agreements that they made during their arguments.

As they rehashed scenes from their life, the couple came to identify the unspoken emotions that lay beneath many of their arguments. Kathy said that Bill's tone of voice when they argued was so troubling that she simply shut down. She wasn't giving in to his way of thinking, as Bill assumed, but tuning him out.

Bill explained that his compulsiveness was not motivated by a desire to keep Kathy under his thumb, but by a need to impose order on his own life.

Ironically, change -- which is de-emphasized in acceptance therapy -- is often one of its most significant results. Kathy softened when she realized that Bill's insecurity stemmed from a chaotic childhood and the uncertainties related to his job as a Hollywood screenwriter. And once Bill understood the devastating impact his tone of voice had on Kathy, he found himself listening carefully to how he came across.

"When couples know their own stories and develop empathy and acceptance of each other, they typically make adjustments in their lives that lower the emotional volume in their interactions," Christensen says.

As therapy progressed, Bill and Kathy's interactions reflected a greater appreciation of each other, and each reported an enhanced sense of intimacy and satisfaction, Christensen says.

For therapists, the appeal of acceptance therapy lies in its ability to help couples reconcile what appears to be irreconcilable. "Every relationship has its own set of unsolvable problems," says Daniel B. Wile, PhD, a psychologist in private practice in Oakland, Ca., and author of several books on conflict resolution for couples. "The behavioral approach focuses on what things need to be changed and how to change them. But if that can't happen -- if the differences can't be resolved -- acceptance therapy allows the therapist to take the crucial next step."

For couples who want to experiment with the approach on their own, Christensen and Jacobson have co-authored Reconcilable Differences, a self-help book for troubled couples.

You also can find out how well the two of you accept each other's behavior by completing an online survey put together by Christensen and his colleagues. When you complete the survey, you will find out how your acceptance levels compare with couples that are happily married and those that are not. The survey can be found at The researchers say they keep the responses confidential as part of their work and collect no personal identifying information.

Susan Chollar is a freelance writer who has written about health, behavior, and science for Woman's Day, Health, American Health, McCall's, and Redbook. She lives in Corralitos, Calif.