How to resolve core underlying issues in couples therapy?

The most important question clients ask me is “How to resolve core underlying issues in couples therapy?” People say that after doing marriage counselling or couples therapy for many months, and even years, they essentially keep going in circles.

What is the reason for going in circles in therapy in general and in couples therapy in particular?

The main reason is that the couple, and their therapist, are not focusing on the underlying issues. They are probably discussing things on the surface. The core issues are not being addressed.

An iceberg model of surface versus underlying issues in relationships

In order to see the difference between the surface issue and an underlying issue, it is useful to imagine an iceberg. There is the tip of the iceberg. We can imagine that the tip is equivalent to a surface issue that couples usually encounter. For instance, imagine a situation when the wife was looking for her toothbrush in the morning. She asked her husband if he knew where it was. Image the husband raising his voice while saying “You should know where your stuff is! I am not your servant!” This is an example of a surface issue.

From my experience, when couples start disagreeing on such surface issues they often vent. They vent to each other, about each other. In addition, people often try to persuade the other person that they are wrong. The husband may try to persuade his wife that she is irresponsible or lazy. He basically tries to win in this argument. The wife may try to persuade her husband that his tone of voice is unacceptable and that he has an anger management issue, at best. She too tries to win the argument. They do not work as a team. Does that sound familiar?

Whenever I point out this cycle to my clients, they inevitable ask me “Okay, this pattern is obviously wrong. But what should we do instead?” I always love it when people ask practical questions. It gives me a chance to give them practical answers!

My answer is the following. The only purpose of your communication should be to team up with the goal of looking for the underlying issues. Stop focusing on the tip of the iceberg and start diving deeper into the underlying core issues. Now, what do I mean by the underlying issues?

In the example above when the wife asked about her toothbrush and the husband yelled at her, an underlying issue may be that of control. It may be that of dealing with authority. Can you see the potential connection between asking about a toothbrush and dealing with authority? If not, then you are not alone. Sometimes it takes me a full session, or two, to get from a surface issue the couple presents to the right underlying issue.

An example of moving from surface to underlying issues in couples counselling

Here is a more specific example of an underlying issue. The husband and wife had a fight when the central humidifier broke down. He wanted to buy a new one. She wanted to hire someone to repair the broken device. This disagreement was in line with their frequent arguments about finances. This is a surface issue. They keep fighting about finances frequently.

A competent couples therapist can ask this couple something like “What do you think is really happening here?” Alternatively, the therapist may offer his own interpretation based on the information he has about the couple.

Let us say that in this situation the wife offered her thoughts on what might be happening. She said that when they started dating, she was younger than him. He was established at work. She was a student. He provided financially and as a result had more of a say on how to spend, save, and invest money. She went along because she wasn’t yet financially savvy and because she didn’t feel the right to negotiate due to lack of income.

Over the years, she developed her career and is now close to him in terms of income. She feels more confident about her financial knowledge and feels the right to negotiate as an equal. The husband did not adapt to this change. He is still seeing his wife as a less established partner in the relationship. As a result, they fight about finances now much more than in the past. The humidifier is simply the latest example of the battleground over financial power in the family.

Power, influence, and being equals in financial decisions due to the wife’s growth is the underlying issue. The fight about the humidifier is the surface issue. Their general arguments about finances are also on the surface.

A competent couples therapist should be able to help the couple find the underlying core issues in their relationship. When the core issues are addressed, the surface issues start to go away.