For post graduate students

1. Marital therapy
Chairperson : Dr.Sushil kherada Presenter : Dr. Sumeet kaur
Sr. Prof and HOD. PG Resident, Psychiatry
Dept of psychiatry RNTMC , Udaipur

2. Nature and definition of marriage
● Marriage, as defined by “The Oxford Dictionary” is a formal union of man and woman, by
which they become husband and wife, i.e., it is a consensual and contractual relationship
recognized by law.
American psychological association
marriage
n. the social institution in which two (or, less frequently, more) people commit
themselves to a socially sanctioned relationship in which sexual intercourse is
legitimated and there is legally recognized responsibility for any offspring as well as
for each other. Although there are exceptions, the marital partners typically live
together in the same residence. See also common-law marriage; domestic
partnership; group marriage; same-sex marriage.

4. ● It is a social commitment with multiple emotional, social and occupational demands
● Marriage is a socially acceptable way to satisfy the basic human need for sexual gratification. It thus forms
the basis for procreation and building up of family.
● In India, it is almost compulsory for every individual to marry and “settle down.” Not being married is
considered a stigma, whereas being married translates into elevation in social status.
● Marriages in India have certain distinctive features viz.
○ It is usually an arranged relation between two families with little scope for personal choices.[2]
○ There exists patriarchal ideology and the husband is considered head of the family and
breadwinner.[2]
○ Women have social pressure to accept a position subservient to males, to control their sexual
impulses and to subordinate their personal preferences to the needs of the family and kin group.[3]
○ There is a strong social and moral compulsion to continue the relationship despite facing
difficulties/problems in the marriage. Divorce is frowned upon in the traditional Indian society.

7. Hindu Marriage Act, 1955
According to Hinduism, marriage is a sacred relationship.[7] In some Hindu systems of
marriage, there is no role for the state as marriage remained a private affair within the
social realm.
This Act applies -
a. to any person who is a Hindu by religion in any of its forms or developments, including a
Virashaiva, a Lingayat or a follower of the Brahmo, Prarthana or Arya Samaj;
B.to any person who is a Buddhist, Jain or Sikh by religion; and
C. to any other person domiciled in the territories to which this Act extends who is not a
Muslim, Christian, Parsi or Jew by religion, unless it is proved that any such person would
not have been governed by the Hindu law or by any custom or usage as part of that law in
respect of any of the matters dealt with herein if this Act had not been passed.

8. A marriage is directly registered by the Registrar of Marriage under section 8 of Hindu
Marriage Act-1955 on the same working day.
Verification of all the documents is carried out on the date of application and thereafter
Marriage is registered on the same working day by the registrar of marriage appointed
by the Govt. of India and marriage certificate is issued.

9. Section 5. A marriage may be solemnised between any two Hindus, if the following conditions are
fulfilled, namely-
● neither party has a spouse living at the time of the marriage
● at the time of the marriage, neither party-
is incapable of giving a valid consent to it in consequence of unsoundness of mind; or
though capable of giving a valid consent, has been suffering from mental disorder of such a
kind or to such an extent as to be unfit for marriage and the procreation of children;
● the bridegroom has completed the age of twenty-one years at the time of the marriage;
● the parties are not within the degrees of prohibited relationship unless the custom or usage
governing each of them permits of a marriage between the two;
● the parties are not sapindas of each other, unless the custom or usage governing each of them
permits of a marriage between the two."

10. Guardianship
Section 6 of the Hindu Marriage Act specifies the guardianship for marriage.
Wherever the consent of a guardian in marriage is necessary for a bride under this Act,
the persons entitled to give such consent are the following: the father; the mother; the
paternal grandfather; the paternal grandmother; the brother by full blood; the brother by
half blood; etc.
Section 7 of the Hindu Marriage Act recognises the ceremonies and customs of
marriage. Hindu marriage may be solemnised in accordance with the customary rites
and ceremonies of either party.
Such rites and rituals include the Saptapadi—the taking of seven steps by the
bridegroom and the bride jointly before the sacred fire. The marriage becomes
complete and binding when the seventh step is taken.

11. Nullity of marriage and divorce
● the marriage has not been consummated due to impotency, may be complete or partial impotency (for example
conditions such as impotence quoad hoc),
● contravention of the valid consent mental illness condition specified in Section 5, or
● that the respondent at the time of the marriage was pregnant by someone other than the petitioner.
● Divorce can be sought by husband or wife on certain grounds, including:
○ continuous period of desertion for two or more years,
○ conversion to a religion other than Hindu,
○ mental abnormality,
○ venereal disease, and
○ leprosy.
● A wife can also present a petition for the dissolution of marriage on the ground of if the husband marries again after
the commencement of his first marriage or if the husband has been guilty of rape, sodomy, or bestiality.
● Newly married couples cannot file a petition for divorce within one year of marriage.

12. Marriage Laws (Amendment) Bill, 2010
Based on recommendations of the Law Commission, a legislation was proposed. The
Marriage Laws (Amendment) Bill, 2010 to amend the Hindu Marriage Act, 1955 and the
Special Marriage Act, 1954 to making divorce easier on ground of irretrievable
breakdown of marriage was introduced in the parliament in 2012.
Supreme Court ruling in 2012
The Supreme Court of India exercised its powers under Article 142 of the Constitution
of India and ruled in August 2012 that marriages can be ended by mutual consent
before expiry of the cooling period of six months stipulated in the Hindu Marriage Act,
1955.
It is only after the expiry of the six months that the couple can move second application
for the dissolution of their marriage.

13. What do parents look for in a good match?
● The external appearance of the boy or girl, that is, height, skin, colour, physique,
attractive face, long hair, etc., takes a high priority in the choice.
● Economic status of the family plays an important role: dowry settlement from the
girl's parents, family income of the boy, property and business of both families are
considered vital.
● Education and job security of the boy, and in our current context, also that of the girl
are considered seriously in middle and high-income group families.
● Health of both;
● Home-making skills of the girl; and
● Matching of horoscopes is yet another consideration.
In poor and less literate families, in villages and slum communities, these criteria hardly
have any importance. Religion, caste and social status certainly carry much more
weight.

14. What do young people look for in a good match?
The most attractive thing for both boys and girls of mamageable age is the physical
appearance of the partner.
Basically, young people from rural or urban areas are attracted to physical traits and
outward behaviour in people of the opposite sex. Basing one's choice of a life partner on
any of the above factors alone does not guarantee a happy married life.

15. What should one look for in a good marriage partner?
The maturity and health of a partner are important factors in a successful
marriage. These similarities can be divided into four groups:
1. Basic orientation of life with regard to values, views on religion, goals, and
convictions;
2. Ideas about marriage in relation to fidelity, sex, children, and in-laws;
3. Personal Factors Suchas age,education,socialandeconomicstatus;and
4. General factors, which include cultural, social, and political backgrounds.

16. Marriage and mental health
The relationship between marriage and mental health can be explored in several ways.
Few important dimensions to this issue are as follows:
● Marriage as a stressful life event which can lead to development of mental-health
problems.
● Effect of marriage on mental health of men and women in the direction of protecting
them against mental disorders. Effect of marriage on pre-existing mental illness,
e.g., Psychoses, alcohol use disorders.
● Outcome of marriage in major psychiatric disorders like schizophrenia.

17. ● Marriage may be stressful for vulnerable people, which may lead to development of
mental-health problems.
● Certain personality traits and disorders like dependence, passiveness, aggression,
histrionicity, paranoia and obsession, especially when aggression is a marked
feature, have a high incidence of severe marital discord.
● When compared to well-adjusted couples, divorce seeking couples have a high
psychiatric morbidity, with more neurotic traits.
● Studies in male neurotics showed that inability of wife to escape from husband's
constant neurotic behavior may contribute to her marital tension. Eventually
separate outlook of both spouses may lead to independent and separate activities
and further increase conflicts and gradual alienation.

18. DOES MARRIAGE PROTECT?
married men have a statistically significant delay (1-2 years) in onset of psychotic symptoms in
schizophrenic illness, when compared with single men.
Married men are found to have the lowest rate of depression, as compared to divorced/separated men in whom
rates were highest. In the National Survey of mental health and well-being of adults in Australia (1997), it was
found that when a range of types of mental disorders are considered, marriage reduces the risk of mental
disorders for both men and women (mood disorders, anxiety disorders, drug and alcohol use disorders).
there is an association between marriage and lower alcohol consumption. However, there is evidence also that
heavy drinking adversely impacts marital quality and stability and that there is increased consumption in response
to transition to divorce.
Marriages, particularly when reinforced by children, significantly lessen the risks of suicide.
Marital and family problems can be important stressors leading to suicidal behavior, especially in case of married
women, for whom in the traditional Indian social fabric, separation/divorce is not a very feasible alternative to
problems such as marital discord, dowry demands and ill-treatment/cruelty by in-laws in a joint family structure.
The potential of marriage to reduce certain kinds of mental-health problems probably owes itself to the beneficial
effects it confers in terms of increasing personal and social support. Marriage adds to social status and may
decrease stigma.

19. EFFECT OF MARRIAGE ON PRE-EXISTING MENTAL ILLNESSES
In the presence of mental illness, if marriage is done under pressure, there exists a strong possibility of
deterioration of mental condition.
This is particularly true in case of female psychotic patients in India.
Various stressors described as being responsible for exacerbations/relapse of illness are uncertainty of marriage
being fixed-up, dowry-related issues, moving to a new home, difficulty in continuing necessary medications and
having required follow-ups with the psychiatrist, stress of first sexual experience, pregnancy and childbirth.
Expressed emotions in the spouse's family may be high, which can worsen the course of illness and predispose to
relapses. The situation becomes worse for the woman in Indian society as she has exited her existing social
supports to move to her husband's household. Higher psychiatric morbidity exists after childbirth, particularly in
areas of functional psychoses and depressive illness.
Most of the women married to mentally ill men, however, get sparse support from their own family and they remain
stuck in a difficult situation due to their dependence on the male spouse for reasons of social, financial and
personal security and/or for the sake of children.

20. “Couples” and “Marriages”
The term “couple therapy” has recently come to replace the historically more familiar term “marital therapy” because of its emphasis on the
bond between two people, without the associated judgmental tone of social value implied by the traditional term.
In the therapy world, the terms are usually used interchangeably. Whether therapeutic methods operate similarly with “marriages” and with
“couple” relationships in which there is commitment but no legal bond
The Supreme Court has repeatedly recognized the right to marry an individual of one’s own choice as being part of one’s
Fundamental Rights under Article 21.
Status of same sex marriage in India?
IN 2018, the Supreme Court decriminalized homosexuality as an offence vide its pronouncements in Navtej Singh Johar vs. Union of India
(2018). The Court read down provisions of Section 377 (unnatural offences) of the Indian Penal Code and thus legitimized same-sex
relationships, but on one crucial aspect, the judgment remained silent.
The question of the validity of homosexual marriages is currently being considered by the Delhi High Court in the matter of Abhijeet Iyer Mitra
vs. Union of India.
The Centre has argued that marriage under the Special Marriage Act, 1954 is only permissible between a biological man and a biological
woman.
However, in case the right to marry homosexual individuals is refused, it would have numerous repercussions on their fundamental rights.

21. Any two persons of any gender can enter into a live-in relationship. This means that there could be a legally valid
live-in relationship between-
(A) A man and a woman (both unmarried)
(B) A married man and an unmarried woman
(C) An unmarried man and a married woman. A relationship of this nature was held to be illegal in India before
2018 and would have made the man liable for the offence of adultery. But, in 2018, in the case of Joseph Shine V.
UOI[4], adultery was declared to be no more a criminal offence.
(D) Same sex partners. A relationship of this nature was considered unnatural and was a criminal offence before
2018. But in 2018, the Supreme Court in the case of Navtej Singh V. UOI[5], decriminalized homosexuality.
The only condition which needs to be fulfilled in all the above categories is that both the partners must be adults
(above 18 years of age). Live-in relationship with a minor is illegal.
In the case of Indra Sarma V. VKV Sarma, the Supreme Court observed,that a live-in relationship is neither a
crime nor a sin.
live-in relationship falls under the ambit of ‘Right to life and personal liberty’, which is guaranteed to every person
by article 21 of the Indian constitution and thereby, stopping a person from entering into a live-in relationship
would be violative of article 21 of the constitution and thus unconstitutional.

22. LEGAL IMPLICATIONS OF A LIVE-IN RELATIONSHIP
Protection of Woman from Domestic Violence Act, 2005
Section 125 of Code of Criminal Procedure, 1973
what is the legitimacy of the child which is born out of live-in relationship? And what
rights does he get?

23. Happy couples vs distressed couples
A successful marriage requires falling in love many times, always with the same person. —Mignon McLaughlin
A healthy marriage is one in which only one person is crazy at a time.—Heinz Kohut
Do married people really live longer, or does it just seem that way — Steven wright
Eventhe happiest and healthiest couples will face areas of difference and disagreement, which are assumed to
be both normal and inevitable.
distress is not caused by such differences, disagreements, or conflicts between partners. In contrast, distress is
caused by the destructive ways that some couples respond to these inevitable incompatibilities.
In the early phases of a relationship, acceptance and tolerance of differences come easily to many couples. In
fact, in many relationships, partners cite one another’s differences as the source of their attraction.
Differences between partners are likely to create difficulties when these differences spring from vulnerabilities
within each partner rather than mere differences in preference.

24. Three destructive patterns frequently characterized distressed couples’ conflicts over their
differences: mutual coercion, vilification, and polarization.
Over time, as distressed couples experience an erosion in their willingness to accept, tolerate, and
compromise around one another’s differences, they no longer look upon each other’s styles as
sources of attraction; they begin to exert efforts to change their partners.
Early on these change efforts may entail direct requests and gentle persuasion. However, if these
efforts fail, partners may resort to negative behaviors such as criticizing, withdrawing, yelling,
inducing guilt, and so forth. According to coercion theory (Jacobson & Christensen, 1998; Patterson
& Hops, 1972), these negative behaviors are often inadvertently and mutually reinforced.
As these patterns of mutual coercion become more frequent and common, partners begin to see
one another not as different but as deficient. In essence, they begin to vilify one another.
As vilification takes hold, each partner feels increasingly justified in his or her efforts to reform the
wayward other.

25. As the differences between partners increasingly become a source of conflict, they
tend to intensify or polarize; the chasm between the two partners grows wider and
wider. In the face of the troubling behavior of the other, each partner exercises more
and more of the behavior at which he or she is already proficient.
Therefore, through these processes of mutual coercion, vilification, and polarization,
distress is generated—not by the differences between partners, but by partners’
attempts to eliminate such differences.

26. In contrast to distressed couples, happy couples are able to confront their
differences with greater acceptance and tolerance.
From a theoretical standpoint (Cordova, 2001), “acceptance” is behavior that occurs in
the presence of aversive stimuli. It refers to responding to such stimuli not with
behavior that functions to avoid, escape, or destroy, but with behavior that functions to
maintain or to increase contact.
From a couple’s stand- point, acceptance means not being drawn into patterns of
coercion, vilification, and polarization.
Partners are able to maintain their positive connection despite and, at times, maybe
even because of their differences.

27. What promotes acceptance in happy couples?
Perhaps their differences are not as great,
perhaps their individual personalities are not as threatened by differences, or
perhaps there is greater social support for their union.
These individual and contextual factors probably interact reciprocally with greater
acceptance, so that, for example, greater acceptance in the relationship leads to
partners feeling less threatened by their differences, which in turn leads to greater
acceptance in the relationship.

28. What Is Marital Counselling?
Marital counselling, which is also called ‘marriage
counseling’ or ‘marital therapy’, is a form of
counselling for married couples or couples who are
engaged and are on their path of getting married.
There is difference between real and ideal life and
sometimes striding for ideal life can lead to conflict.
Most of the conflicts in marriages arise because
either of the partner or both the partners strive to
maintain an ideal marriage.
In marriage counselling, the counsellor helps the
couple understand each other’s behaviors and few
aspects of their personality, and most importantly
they guide the couple to accept their spouse as they
are.

29. FACTORS THAT CONTRIBUTE TO MARITAL DISTRESS
1) Faulty patterns of communication: A typical pattern that can be identified in this regard
is reciprocated negative behaviour which implies if one spouse behaves negatively, the
partner is likely to respond in kind, and thus starts a chain of escalating negative interaction
(Gottman, 1979)(escalating criticism).
2) Faulty patterns of emotional reaction:
more impulsive, strong and negative reactions.
High reactivity in distressed couples may increase the likelihood of misunderstanding and
poor communication. Since spouses are so used to of feeling attacked, they may cease to
listen carefully to one another and instead be prepared for a counter attack to the initial
criticism.

30. 3) Poor coping skills and inability to resolve conflicts:
an inability to resolve conflicts.
Lack of conflict resolution skills leave couples with a backlog of unresolved fights and
conflicts which may also contribute to negative expectations about future conflicts and
make engagement in constructive problem-solving even likely to occur in their
relationship.
4) Reinforcement erosion:
This occurs when partners lose the satisfaction that was once present in the
relationship. This might be attributed to habituation: behaviours that were pleasing at
one time are not as important anywhere.
They may fail to appreciate each other’s efforts, take each other for granted, or have
new and different needs that their partners have not yet learned to meet.
One or both spouses may have stopped doing some of the nice things that formerly
helped to provide many warm feelings between them.

31. TWELVE (12) DESTRUCTIVE WAYS OF SPOILING A MARITAL/ SPOUSAL
RELATIONSHIP
1) Frequent critical comments, especially in the presence of relatives and friends.
2) Frequent neglect of the partner in terms of being self-occupied even when the partner is around, not sparing exclusive time for the
partner to have interaction or dialogue on regular basis.
3) Being insensitive or intentionally neglecting the partner’s needs and necessities.
4) Despising the partner by showing frequent aggression
5) Not considering the partner’s opinion as worthy while taking decisions involving personal career, or other family, friends or finance
related issues.
6) Taking the partner for granted, that is, not using words of appreciation, gratitude or acknowledgement of efforts towards the partner
from time to time.
7) Devaluing the partner in public by being indifferent or neutral when others pass critical comments about your spouse/ partner.
8) Sticking on to the ‘bygones’ (emotional baggage from the past arguments and fights) thereby repeatedly dragging in old and much
discussed issues.
9) Devaluing the significance of important days and dates in a year that might hold some emotional significance for one partner.
10) Criticising each other’s native family and friends.
11) Frequentlyinvolvingfamilyandfriendstoresolvemaritalconflictandissues.
12) Getting abusive and physically violent with the partner.

32. Reasons for Seeking Couple Counseling
1) Increased frequency of arguments between partners due to poor communication
pattern;
2) Emerging differences in opinions or value system;
3) Strained relationship between couple due to certain emerging familial issues;
4) Dissatisfaction in sexual relationship;
5) Feeling of being trapped in stale relationship due to lack of common interests and
shared activities;
6) Constant dispute between the couple leading to excessive distress or
psychopathology such as depression or alcohol abuse in one or both the partners;
7) Extramarital affair;
8) Few or frequent instances of intimate partner violence.

33. Few of the most important benefits that the couple can get after or during the marital
counselling sessions are:
● Transparency in discussing any issue.
● Communicating clearly.
● Understanding each other better.
● Reaching to a decision collectively.
● Helps in achieving personal growth.
Individuality is most important in one’s life. But most of the times, we are recognized by
the roles we play. In marriage too, the individual is looked as only wife or as only
husband.
Here the individuality of a person might get lost which could lead to varied issues in the
marriage.
Marital counsellor helps the couple to understand that sometime they just need to
understand that their partner is not just their wife or husband, but they are an
individual too and understanding that is the most essential benefit of marital counselling.

35. Pre-Marital Counselling
Marriage is the most intimate of all human relationships, where couples share intellectual, social,
emotional, spiritual, and physical relationships.
● Premarital counseling is a type of therapy that helps couples prepare for marriage.
● Pre-marital counselling can be opted by couples who are in a relationship and want to
take their relationship to next level, i.e., marriage.
● Here, the counsellor can help the couple to understand their compatibility, their beliefs
and values and many other aspects which will help them to understand the partner in a
better way.
● This type of therapy is a good resource for learning more about each other and is
intended to help develop a deeper level of interspousal communication.

36. The Topics
Expectations Around Marriage: setting realistic expectations about marriage means that
the relationship will require frequent deposits in order to flourish and remain healthy.
● Healthy Communication
● Finances
● Beliefs.,Values
● Roles in family ,Responsibilities in family
● Sex and Intimacy including information of STDs
● Family planning
● Decision-making processes
● Conflicts and results

37. 1. What Do You Appreciate Most About Your Partner and Your Relationship?
2. Are You on the Same Page About Having Children?
3. How Will You Handle Your Relationships With Your Families?
4. What Does Spirituality Mean to You?
5. What Does Sex Mean for Both of You?
6. How Do You Look at Spending Versus Saving?
7. How Are You Going to Handle Your Finances (Together or Separately)?
8. How Will You Resolve Future Conflicts?

42. APPROACHES TO COUPLE COUNSELING

43. Psychodynamic (or Insight-oriented) Couple Counseling
The central concept in the psychoanalytic position, as reviewed by Daniell (1985) and
Meissner (1978), is the inner, often unconscious world of the two partners determining
the nature of their interaction and their responses to changing circumstances.
It is as though each partner has an unconscious impression about the nature of
relationship and their partner’s personality which in disturbed marriages bears
very little resemblance to what more objective observers perceive.
Counseling aims to help the partners to become aware of these inner worlds and their
origins enabling them to reduce misunderstandings through insight, and to get in touch
with their own feelings and those of their partner.
The principal outcome is liberation of the relationship from past adverse influences
and a corresponding diminution of problems.

44. Systems Couple Counseling
concepts developed by therapists such as Minuchin (1974) and Haley (1980) in their
work with families
A central concept here is enmeshment, an excessive involvement of one person with
the other person. It is most common in relationships between parents and their growing
children; this type of enmeshment is also seen in couple relationships where one
partner wants to be more intimate in couple relationships
The concept of intimacy may relate to many aspects of life including sexual, physical,
emotional, and ‘operational’ (Crowe and Ridley, 1990). The term ‘operational’ here
refers to sharing of plans and information about each other.
A conflict may arise between partners on how close or distant they wish to be in respect
to one or more of these spheres. Systemic counseling attempts to clarify the degree of
optimal distance.

45. Behavioural Couple Counseling
brief and highly structured, and relies largely on currently observable and reported behaviour.
This approach functions on the premise that the troubled couples have reached either a very low level of
mutual positive reinforcement or are using overly coercive methods to control each other’s behaviour.
A major component — contingency contracting, — the spouses were trained to modify their own
behaviour in order to effect a specified desired change in their mate’s behaviour.
Includes — ‘reciprocity negotiation’ and ‘communication training’.
In reciprocity negotiation, each partner is asked to say what alternative behaviours they desire in their
partner. These behaviours must be described in specific terms, for example ‘talk to me for half an hour
when you come in from work’ rather than ‘take more notice of me’. Each partner agrees a way of
rewarding the other when the desired behaviour is carried out.
under communication training, the couple is encouraged to communicate more directly and
unambiguously to each other about feelings, plans, or perceptions; to listen to one another patiently, to
provide feedback about what is heard and understood; and to express individual wishes more clearly.

46. Cognitive Behavioural Couple Counseling
Aaron Beck (1988) has applied his cognitive-behavioural scheme to the problems of
couples, identifying in their communication misunderstandings, generalisations, and
focus on negative aspects of a problem, typical of the thinking of depressed clients.
His approach involves the same therapeutic processes which have been successful in
treating depression: challenging assumptions; reducing expectations; relaxing absolute
rules; and focusing on the positive rather than the negative.
There is an analysis of repetitive cycles of cognitive behavioural disturbance, in which
each partner attributes negative or holistic intentions to the other. These distortions,
dealt with in both individual and conjoint sessions, are examined to promote
understanding and, in turn, to modify miscommunication.

47. Emotionally Focused (EF) Couple Counseling
Emotionally focused couples counseling is a brief intervention that seeks to change
partners’ problematic interaction styles and emotional responses so that a stronger and
more secure emotional bond can be established (Johnson et al., 1999).
This treatment approach assumes that negative affect and associated destructive
interactional styles create marital distress. Further, it is believed that a more secure
attachment to one’s partner is necessary to stabilise a dyadic relationship.

49. PROCESS OF COUPLE COUNSELING

50. 1 Goals and Objectives of Couple Counseling Process
The goal of couples counseling is to understand the relationship dynamic of the couple,
and to identify areas of strain and frustration which add stress to the partnership.
2 Assessment in Couple Counseling
Couple counseling, like any other counseling process, involves assessment of target
problems.
The purpose of the process of assessment is to develop a comprehensive
understanding about the nature of problem and the couple’s suitability and commitment
for counseling.

51. Stages of Assessment Process
a) Taking an initial interview and identifying problem areas in a conjoint session
b) Taking a detailed relationship history in a conjoint session
c) Holding individual interview sessions with each partner so as to get individual
impressions about the nature of problem
d) Assessing the strengths of the relationship and the couple’s suitability for marital
counseling in a conjoint as well as individual session

52. Few of the pertinent scales specifically used for assessing marital satisfaction are
mentioned below:
1) Dyadic Adjustment Scale (Spanier, 1976) provides a global measure of marital
satisfaction, id widely used, and norms are available;
2) Areas of Change Questionnaire (Weiss, Hops, & Patterson, 1973) is a measure of
the degree of dissatisfaction with a number of common presenting problems;
3) Marital Satisfaction Inventory (Snyder, 1981) yields a comprehensive MMPI- like
profile of distress in nine content areas for each spouse, plus Global distress and validity
scores;
4) Marital Status Inventory (Weiss & Cerreto, 1980) provides what can be referred to
as ‘how many toes out the door’, i.e. how many specific steps the spouse has taken
towards divorce and separation.

53. 3 Intervention Process and Techniques in Couple Counseling
The intervention process begins by trying to renew some warm feelings by having
spouses do nice things for each other in an attempt to provide some immediate relief
from current difficulties and to provide a basis for later interventions.
Techniques Used in Couple Counseling
a) Behaviour exchange: Behaviour exchange engages both spouses in activities
designed to increase each other’s marital satisfaction.
thoughtful, fairly simple, low effort behaviours that can be readily incorporated into
spouses’ daily repertoires.
Behaviour exchange is designed to induce short-term positive changes in the pattern of
interaction early in counseling, and to have immediate effects in the couple’s life outside
of counseling, and thereby lay the groundwork needed for work on other major issues.

54. b) Cognitive Interventions:
Relabelling or reinterpreting partner behaviour is a powerful intervention that may be constantly on the
lookout for distorted and/or dysfunctional thinking, and should intervene regardless of the content or
phase in the counseling,
One rationale is simply that even if the negative assumptions about a spouse’s behaviours are partially
true, there are likely to be other more positive things contributing to the partner’s behaviours as
well, and that the angry or hurt spouse might feel better if he or she thought about the partner’s behaviour
differently.
c) Communication Training:
difficulties with expressive and receptive communication skills are linked to a host of other typical
complaints: lack of understanding, insufficient attention to each other, poor listening, conflict escalation,
and difficulty in problem solving.
These communication skills are the building blocks for the problem-solving techniques in the following
section.

55. d) Problem Solving:
problem solving skills provide the couple with a framework to be their own ‘counselors’ with many
subsequent problems.
Problem solving training has two discrete phases: problem definition and problem solution. This two-
phase process helps couples to avoid proposing changes before the problem has been defined, and
helps them to continue to redefine the problem when a solution to the originally defined problem has not
been found.
e) Reducing conflict: Troubleshooting:
Trouble shooting is a technique designed to teach couples conflict de-escalation (keeping conflict from
getting increasingly more hostile and damaging), which facilitates conflict resolution. The two steps
involved in trouble shooting are:
• Reconstruction of the argument involves an exploration of the intent and impact of each step in the
argument, and clarification of the feelings, thoughts, and assumptions of each spouse at each step.
• Exploration of the cognitive and behavioural options of each spouse at each step that might have
reduced the negative feelings or de-escalated the conflict. This may be accomplished by simply asking
each spouse ‘What was a different way of thinking about your partner’s actions at that time’ or ‘what else
it could have meant?’

56. f) Affection and sexual enrichment:
It is not uncommon for couples who present for couple counseling to also have some
specific sexual dysfunction. For these couples, counseling time is devoted to ameliorate
the dysfunction.

57. How Does Marital Therapy Work?
Marital therapy is no magic. The couple needs to put in their 100 percent for them to
see the results.
The cause of any issue can be deep rooted and uncovering that is what happens in a
counselling session.
In marital counselling sessions, different activities and talk therapy help the couple to
gain insight.
Usually, the biggest issue in the life of a married couple is ‘misunderstandings’, and
conflicts arise due to misunderstandings.
In marital counselling sessions, the counsellor paraphrases whatever the individual
says, so that the exact emotion or feeling reaches to their spouse, which then
reduces the chances of misunderstandings.

58. What Is The Goal Of Marital Therapy?
The goal of marital therapy can vary from couple to couple depending on what issue
each couple is facing.
Some of the essential goals in marital therapy can be guiding the couple towards clear
communication, making them empathetic towards each other’s needs, reducing the
defences between them, discovering each other’s ‘self’, i.e., their individuality etc.

59. Thank you.

60. 1. Kaplan and Sadock's Comprehensive Textbook of Psychiatry , 10th Edition
2. Wolberg LR. The technique of psychotherapy.
3. Stuart, R.B. (1980). Helping Couples Change: A Social Learning Approach to
Marital Therapy. Guildford press, New York.
4. Jacobson, N.S. & Gurman, A.S. (ed.) (1986). Clinical Handbook of Marital Therapy.
Guilford press, New York.
5. Diwan P. The Hindu Marriage Act, 1955. International & Comparative Law
Quarterly. 1957 Apr;6(2):263-72.
6. Srivastava A. Marriage as a perceived panacea to mental illness in India: Reality
check. Indian journal of psychiatry. 2013 Jan;55(Suppl 2):S239
References