What’s THE Problem

What’s THE Problem?

While this might seem like a simple question, in couple therapy practice it’s anything but easy to answer. Couples go to therapy when something happens. Something they can’t resolve on their own, that causes enough distress they’re willing to talk to a therapist about it. You’ve met them right? They think they know what the problem is and they expect you to fix it. One partner says it is “X” the other says it’s “Y” and if you let them, they’ll give endless examples both trying to prove they’re right.

So, what’s THE Problem? This is the first question I ask in couple therapy training and supervision. Couples are distressed when they come to you and you’re eager to help them. When I ask the next question: Help them do what? It focuses your efforts where they will do the most good, on identifying the cause of relational distress.

THE Problem

There are many problems you could focus on, but in order to reduce relational distress (the goal of couple therapy) you must target the cause of relational distress. The topic, the “X” that distresses a couple enough to go to therapy, prompts THE Problem, but “X” is a symptom of relational distress, not the cause of it. The dynamic between partners when they disagree about “X” causes relational distress – THIS “CAUSAL DYNAMIC” IS THE Problem. 

When you’re eager to help but you don’t know the difference between problems and THE Problem, you get pulled into the causal dynamic trying to help couples solve “X”. Your intentions are good, but you’re making the same mistake they are. You’re focusing on the symptoms of distress, instead of identifying the cause of distress.

In this article you will learn the difference between problems and THE Problem, between the symptoms and the cause of relational distress. So you can alter the causal dynamic, reduce relational distress, improve the couple relationship and achieve the goal of couple therapy.

Target the causal dynamic

The definitions and examples that follow clarify the difference between problems and THE Problem. It’s important to accurately identify THE Problem because it is the target of your interventions throughout the relationship improvement journey. You will use your preferred model-specific interventions to alter the causal dynamic (THE Problem), reduce relational distress and improve the couple relationship.

Problems/symptoms

Problems are the topics, events and questions couples argue about. They are the “X” and “Y” they give endless examples of both trying to prove they’re right. For example, let’s say Jon and Jesse come to you distressed about Jesse’s drinking. This is a problem, a symptom of relational distress, not THE Problem, the cause of the relational distress.

THE Problem/cause

THE Problem is the dynamic between partners when they disagree about “X”. It is how they relate to each other and what they DO when they disagree. It’s THE WAY they say, what they say when they disagree. 

When Jon and Jesse disagree about Jesse’s drinking, Jon attacks Jesse with examples trying to prove the drinking is a problem. When Jon does this, Jesse defensively tries to invalidate Jon’s examples. This attack and defend dynamic between them causes relational distress – THIS “CAUSAL DYNAMIC” IS THE Problem.

THE Problem is playing out right in front of you in this example. I’ve given it a name, “the fight to be right” because it’s such a common causal dynamic. Jesse reacts to Jon’s attack in an escalated attempt to disprove his concerns. Do you see the shift from a problem to THE Problem here? The minute Jon speaks it’s clear they’ve had the conversation before. The WAY Jon communicates his concerns – as valid as they may be – are “an attack,” a harsh start-up as the Gottmans would say and it hijacks the conversation. This is the causal dynamic – THE Problem. The content, the words you hear are about the problem, but what you see, what Jon and Jesse DO when they disagree about the problem, is THE Problem.

By the time Jon and Jesse get to couple therapy they’re not able to talk about Jesse’s drinking or anything they disagree about, without engaging in this causal dynamic. As a result their problems don’t get resolved. Relational distress multiplies when their concerns, feelings and experiences are invalidated and it perpetuates the fight to be right. The symptoms of distress, the unresolved problems AND the cause of distress, the dynamic between Jon and Jesse when they disagree, will continue unless you identify and treat the causal dynamic.

For Example:

Let’s look at a similar experience to clear up any lingering confusion. A baby with an ear infection is a great example. When piercing screams wake you at night, you rush to your baby and find them in pain and fever soaked. You give the baby something to reduce the fever and pain, but it wears off and the symptoms come back, getting worse each time. So you go to the doctor to figure out what’s wrong; to find the cause of the baby’s distressing symptoms. The doctor examines the baby and identifies an ear infection as the cause of distress. And it’s only once the cause of distress – the ear infection, is identified and treated, that the symptoms of distress – the fever and pain stop and THE Problem is solved. 

The couple relationship is similar. Jon and Jesse talk about Jesse’s drinking but they disagree and the problem continues, getting worse each time they talk about it. So they go to therapy to figure out what’s wrong; to find the cause of their distressing symptoms. And it’s only once the cause of distress – the dynamic between them when they disagree is identified and treated – that the symptoms of distress, arguments about Jesse’s drinking stop and THE Problem doesn’t automatically hijack their discussions. As a result, their relational distress is reduced and their relationship improves.

Target the cause of distress

Now don’t get me wrong here, reducing relational distress is more nuanced than treating an ear infection, but as you read in the example, in order to solve or reduce the severity of THE Problem you must target the cause of distress. Problems are A problem yes, but problems are SYMPTOMS of distress not the CAUSE of distress. In couple therapy practice you reduce the distress created by the symptoms and the cause, but you do it by targeting the cause of relational distress.

So, What’s THE Problem?

THE Problem is the dynamic between partners when they disagree. You could say THE Problem is the fight to be right. Or THE Problem is the attack and defend dynamic Jesse and Jon are stuck in. Both are correct because both identify the causal dynamic – THE Problem. 

Help Them Do What?

Once you know what THE Problem is you are ready to answer the next question, Help Them Do What? You could say you will help Jesse and Jon understand and change their behavioural reactions when they disagree so they can discuss the problem. By targeting the causal dynamic you have a better chance of solving THE Problem and the symptoms that perpetuate it. Reducing relational distress is THE GOAL of couple therapy. When you achieve this goal, you’ve improved the relationship and couples like Jon and Jesse are delighted with this successful outcome.

Now, there’s only one more thing for you to do. Pat yourself on the back my friend because you did it, you achieved the goal of couple therapy! And every time you achieve this goal you will get better at doing it. Your confidence will grow with your effectiveness and before you know it, you’ll be enjoying a rewarding and successful career as a couple therapist. I hope you enjoy the journey.

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