Couples Therapy: Recovering from Intimacy Ruptures
Couples therapy can be a delicate journey, one that we ensure couples are ready to partake in. We treat couples for a variety of issues related to intimacy: intimate partner betrayal, substance abuse disorders, libido/sexual issues, parenting/loss/grief, love addiction/avoidance dynamics, and high conflict relationships.
Our couples recovery program entails:
Individual Therapy and Couples Therapy: Each person entering treatment for sexual issues needs support. During Phase I of our intimacy recovery program, couples are often in crisis and emotions are incredibly volatile. Starting couples therapy before each person has the accurate and adequate support can prove disastrous. Therefore, individual therapy weaves in IFS, EMDR, and Carnes’ CBT task model of sexual recovery as well as partner recovery essentials for betrayal trauma. Each person is provided a safe space to gain plenty of emotional and mental support, along with working together in therapy to heal their relationship when they are ready to begin couples therapy. Stability is Necessary! For couples who ask to begin couples therapy right away but whose relationship is volatile and unstable, we ask that couples begin working on their own issues in individual therapy first, each with one of our expert clinicians. At intake, we assist couples in determining the best fit for their relationship.
Couples Intensives (5 days): We address a variety of issues through a lens of IFS-IFIO (Intimacy From the Inside Out) and often weave in the couples addressing intimacy, betrayal, trust, accountability, sex, honesty, connectedness, communication, Neurodifferences and intimacy, and more. Click on our Intensives page for more information.
Addiction or Out of Control Behavioral Issues: If there is an addiction present, we wait to start couples therapy until each person gains necessary stability and support.
Theory/Model/Approach to Couples: Our approach to couples therapy is multi-faceted based on where the couple is at in their relationship. We primarily use the IFIO (Intimacy from the Inside Out) which is IFS for couple therapy. We incorporate some aspects of Gottman Therapy which is evidence based and fantastic for couples who are stable. At times, we may also offer psychoeducation around in key aspects of Carnes’ Task Based approach (if there are out of control relational or sexual issues present) to assist couples in learning healthy communication, trust, boundaries, improve sexual and non-sexual intimacy, explore desire, eroticism, connection.
An Open Mind: We are open-minded; LGBTQ, polyamorous, triad, pod, omnisexual, etc. friendly, and supportive of a variety of sexual issues, values and beliefs, as long as there is not a violation of anyone’s human rights (i.e., domestic abuse, risk to children, harm to anyone against their consent). We acknowledge that every relationship is unique and couples have their own values and belief systems (i.e., some couples may enjoy Polyamory, BDSM, Kink, Fetishism, Furry-Phenom). We do our best to meet individuals where they are at with no judgment.
Couples therapY for Separation or Divorce:
Although we primarily work with couples with intimate betrayal who are hoping to stay together, we also provide couples therapy for couples who are separated or seeking divorce. This allows for each to gain some foundational tools to ensure that as they consciously uncouple, they do so with a sense of emotional safety, clarity, compassion, and courage.
Our Intimacy Recovery Treatment Phases
+ Phase I, "Discovery"
We know there are many reasons why an individual copes via sexual behavior that becomes compulsive. For instance, their neurotype may result in having low levels of dopamine and intense pleasure seeking behavior. Likewise, unresolved trauma (any incident deemed as shameful may cause trauma), attachment issues, emotional dysregulation or sensory stimulation dysfunction, adverse childhood experiences, and/or an inability to emotionally regulate. In order to identify an individual's neurotype as well as deep-seated wounding, during this phase we provide clients with a thorough intake assessment (lasts between 3-5 sessions). This entails a clinical interview, the assignment and review of the largest, validated broadband measure of problematic sexual behavior, the Sexual Dependency Inventory 4.0 (SDI 4.0). For the betrayed partner/spouse we assign and review the Inventory for Partner Attachment, Stress and Trauma (IPAST). These assessments allow us to establish an accurate treatment plan for both individuals in the coupleship. We typically recommend other assessment measures to accurately identify other mental health issues (depression, anxiety, PTSD), neuro-different issues (Autism Spectrum Disorder), as well as other forms of coping.
During Phase I of our sexual recovery program, individuals and their partners begin to identify and process the shock, denial, anger, grief, and mental and physical symptoms related to the out of control sexual behavior that has damaged the relationship. This is often the crisis management/resolution phase of recovery where both individuals in the relationship need extra support in order to comprehend the array of emotions and physical symptoms that they are experiencing. Many couples request an intake together only to find out that they are not stable enough yet to work in couples therapy and both need the support of their own clinician (CSAT and/or a trauma-informed therapist) and group (our groups are all based on Carnes Task Model and facilitated by CSATs). Therefore, in Phase I each person works with an assigned therapist and attends weekly group to gain mental and emotional stability prior to incorporating couples therapy. Some individuals and couples attend our intensive program which includes attending our program 5-days or longer and immersing themselves in a deeply transformative process. See our intensive page for details on how to accelerate your recovery.
+ Phase II, "Recovery"
During Phase II, individuals and their partners start coming to terms with the reality, impact, and magnitude of the out of control sexual behavior. Individuals in this phase actively work out of evidenced based Task-Focused Workbooks created by Drs. Patrick and Stephanie Carnes, Ph.D. to heal. Our clincial team often observes individuals and couples working diligently on their own recovery via individual therapy and group by incorporating Carnes' Task Based Model along with the wealth of tools and support provided to partners via Facing Heartbreak (Carnes, S., Lee, M., Rodriguez,A.) and other supplemental resources.
EMDR (Eye Movement Desensitization and Reprocessing) therapy and IFS (Internal Family Systems) model are incorporated into the treatment process to explore and heal family of origin issues, shame, guilt, and trauma re-enactment and ego/feeling states that have impacted one's coping. Disclosure is typically done during this phase of treatment when both parties are stable. We also begin incorporating once per month couples therapy. Communication, boundaries, and the dynamics of intimacy are often addressed during this phase. Some couples attend a 5-day intensive at this stage to dive deep inter their healing either separately for stabilization and intensive support, or together.
+ Phase III, "ELEVATION"
By Phase III, individuals and their partners have actively participated and completed Phase I and Phase II. During this phase, we incorporate couples therapy into treatment on a weekly to bi-weekly basis in order to ensure couples are improving their communication as well as strengthening the overall health of their relationship. Some couples request a 3-5 day couples intensive at this stage to strengthen their connection via IFS, yoga therapy, and more.
By this time, couples are also encouraged to attend our bi-weekly couples web group to advance their skills in understanding one another better.
+ Escalated Addictions
Some of the individuals who attend our program admit to escalating in their pornography and/or sexual addiction. This includes escalating into dangerous, risky, problematic, and illegal sexual behavior such as the viewing or downloading child pornography (also known as child sexual exploitation materials or CSEM), acts of lewdness (flashing one's genitals in public), soliciting prostitution (escorts, "sugar babies"), and spousal rape. We know that addressing these issues bu providing accurate treatment interventions is especially important, since, according to two of the leading psychologists, researchers, and sex offender providers, Marshall and Marshall (2012), “... a substantial number of sexual offenders meet criteria for sexual preoccupation, which is often referred to as ‘sexual addiction [and] sexual preoccupation has been identified as the dynamic factor most strongly predictive for reoffending".
Our approach takes into account that many individuals who escalate in their acting out are not legally involved. Most come to us in hopes of getting help to prevent them from causing further harm to others and to prevent them from becoming legally involved. We also are cognizant that all of these individuals have significant shame as a result of their actions. Therefore, our program places emphasis on treating the illegal behavior while not perpetuating shaming an individuals’ actions. We know after all, that shame-based treatment approaches are not effective in creating long-term change. Many clients request an intensive to immerse themselves in healing from their EA and accelerate their recovery.
Our program also provides aftercare treatment for individuals who have successfully completed traditional sex offender treatment and are in need of continual support as they struggle with pornography or sexual addiction that was not addressed in court-ordered therapy program.