Cognitive behavioral therapy for marital problems in a case study

Cog Beh Therapy

With respect to the businessman who comes to see the therapist about the problems in his marriage, there are two issues immediately apparent from the brief case history. The first is the man's unwillingness to accept any responsibility for the success of the relationship. He is immediately defensive, blaming his wife for all their problems. He claims that she is hypercritical and that she is "probably" suffering from PMS. Without getting the wife's side of the story, it is impossible to know the extent of her complaints against her husband, the degree to which she feels they need help, and the amount of effort she is willing to expend -- and has already expended -- to put the marriage back on track, if that is in fact what she wants. It is unlikely she has had a formal diagnosis of PMS. Used in this context, "PMS" is a misogynist's way of dismissing a woman's feelings as frivolous.

The second issue is the man's drinking. He denies he is an alcoholic because he does not fit the profile he has created in his own mind based on experiences with his own father and his wife's father. People under the influence of alcohol behave in many different ways and do not necessarily hit their spouses, miss work, or sing at the top of their lungs in the middle of Main Street. The man is able to talk his way out of a DUI arrest, thanks to an attorney. His ability to do this exacerbates his feelings of denial and invincibility. He can tell himself that the breathalyzer readings were false and he was, therefore, not drunk. With this "proof" that he does not have a drinking problem, he can continue to blame the problems of the marriage solely on his wife.

According to the Mayo Clinic, alcoholism is a chronic and progressive disease in which individuals continue to use alcohol even when it causes problems. "It's possible to have a problem with alcohol, even when it has not progressed to the point of alcoholism. Problem drinking means you drink too much at times, causing repeated problems in your life, although you're not completely dependent on alcohol" ("Alcoholism: Definition," 2012). The man certainly appears to fit the definition, at the very least, of a problem drinker.

For the purpose of this paper, it will be assumed that the man is going to begin therapy on his own, without the presence of his wife, and that he is sincerely committed to saving his marriage. The therapist can use Cognitive Behavioral Therapy (CBT) which is often used to identify and address unproductive thoughts that underlie decisions that consistently produce negative results (Hodge, 2011). One of the first things the therapist will want to do is to increase the incidence of positive behaviors. The man can be taught the importance of caring behaviors or caring gestures -- behaviors that show interest, respect, concern or affection -- which can be offered several times a week and demonstrate to the man that his wife is valued and the relationship is important (Wiseman & Beach, 2011, p. 527). Increasing the frequency of positive behaviors can bring about the decrease of negative behaviors. In other words, the man is encouraged to develop a habit of making pleasant conversation with his wife at the breakfast table, for example, or giving her sincere compliments. As with couples therapy, the man is encouraged to engage in the positive behavior whether or not he feels it is reciprocated by his wife. The man may be surprised to see that, before too much time passes, his wife is also engaging in more positive behavior. Encouraging people to attend to the positive may help reduce these tendencies [of negative thoughts and behaviors and promote greater hope for the relationship (Wiseman & Beach, p. 528).