“When you tell lies, it costs your brain a heck of a lot more resources than when you tell the truth.” Dr. Kang Lee, a professor at the University of Toronto, (https://www.washingtonpost.com/national/health-science/politicians-lie-actually-were-all-pretty-good-at-it-by-age-5/2016/04/28/7ca64708-073a-11e6-b283-e79d81c63c1b_story.html).
I quote Dr. Lee because he supports something I have seen in couples therapy and relationship therapy with individuals for a long time. Most, if not all, of the clients who come to me that are harboring important information from their spouse or significant other will, at times, talk to me about the burden of keeping secrets. And there is almost always some relief (often along with other consequences) when the secrets come out.
My point? Keeping secrets is a powerful and often devastating issue in relationships, and it takes mental energy to keep them. What do you want in your relationship? What happens if you open up and share your secrets? And what happens when you don’t?
I do not see my job as a couples counselor to get people to tell there secrets. But it is also not necessarily my job to help them hold their secrets. One goal of my work is to help the clients that come to me to understand the consequences of their thinking, their feelings, their actions, and their secrets. That is, in many ways, the focus of couples and relationship work (and the latter is often done in individual therapy). I don’t know what the best thing is for you to do with your secrets. But couples therapy, relationship therapy, and individual therapy are all ways that a therapist can help one to figure out the costs and benefits of secrets, as well as what they are thinking and feeling.
It most cases, it doesn’t, but let me explain some different things to you about therapy and insurance.
People often think they can use their insurance for couples counseling or marital counseling. And prospective patients will call and ask if I “take” their insurance. Let’s look at these two issues.
The vast majority of insurance does not cover couples counseling or marital counseling. There are a small few that cover (I have heard the insurance for Google covers couples therapy but I don’t know that for sure) and I once heard the Blue Cross paid under one of its many plans. And sometimes therapists will bill for one of the couple if he or she has a diagnosis, but that can be tricky. If the session does not deal with the issue the patient with the diagnosis brings, then it should not be billed as part of the treatment for the patient. It is usually best to assume it is not covered, BUT to find out for certain call your insurance company and ask them if couples or marital counseling is covered under your specific policy.
Many therapists, myself included, can bill most every insurance company for you, and in that way they/I “take” your insurance plan. You may be asking if the therapist will send in your claims. Some therapists don’t, but most do. I am set up to easily send in (also called “submit”) your claims.
But you are probably actually asking (when you say, “Do you take my insurance?”) is if the therapist is “in the network,” “in your plan,” or “in-network.” A therapist is in or out of your network and you can usually look that up online or you can ask him/her. Rarely, but it does happen, a provider can get on your plan to work with you, temporarily work with you for an agreed upon rate. Sometimes that works out well enough that the therapist will do it, and there are times when it will not be enough of a benefit for the therapist to make that choice. When a therapist is in your network, you will, most likely, have to pay less to reach your deductible (the part you have to pay in full before insurance starts paying), your co-insurance will pay more (meaning that when your insurance does start paying they will pay more of the total allowed fee than if you use an out-of-network provider), and your out-of-pocket-maximum will be less than when seeing an out-of-network provider (meaning you will pay less overall, “out of your pocket,” to see the in-network provider than the out-of-network provider). So you will, most likely, pay more out of your pocket and your insurance will pay less for you if you see someone out-of-network. But realize that many plans still pay well for you to see an out-of-network provider. I have seen multiple patients where the out-of-network rates paid just under 70% of the fee when the deductible was met, and I have seen patients where their out-of-network portion was much higher than their in-network costs. The best way to know, again, is to call your insurance company and ask.
So if it costs more, why would anyone choose to see a marital or couples counselor who is out of network? It will usually cost more, but it is more private (the insurance company is not a part of it and doesn’t not know anything about it). You may also be willing to pay more to see the provider of your choice. A better qualified provider may well save you money in the long haul.
Whatever the case, I am always willing to help you get to a therapist if I am not the right one for you, if I am not under your plan and you need the savings that an in-network provider would bring you. If you need the help, it is important to go and get it!
In my professional information I recently received the following information:
APA member Scott Pytluk, PhD
Bucket list for two: Sharing wildest dreams can bring a couple closer — Chicago Tribune
“When partners plan for the future together, as long as there’s flexibility in it, they’re expressing a joint sense of hope about their lives together. Couples flourish when there are mutually agreed-upon goals and dreams.”
I believe that this kind of information can be valuable to couples, so I am passing it on to you. Try to share your dreams. Work on goals and dreams together.
And I am a couples and relationship therapist. A couple that is in trouble can often not share “wildest dreams” with one another. So we could use Dr. Pytluk’s information in this way also: if you can’t share your wildest dreams with each other, why not? Often the answer is because there are tensions or problems in the relationship and the couple doesn’t want to share much of anything with each other. So if you can’t share your wildest dreams, can you talk about what is bothering you with him/her? If you can’t talk with each other without getting into an argument, perhaps it is time to see professional help (couples therapy, I would recommend).
So how well are you talking with each other? Can you share your wildest dreams? How about what is bothering you (in a way that your significant other can hear you)?
Actually I had two cases of couples that finished up their therapy this week and it set me to thinking about what happened. How is it they are done with couples therapy? How do couples begin to think that they are done with the work and can go back to their lives without going to couples counseling anymore?
Of course, different couples come with different needs, problems, and concerns so they don’t always “complete” the same sorts of things to feel done with the therapy. And there are often, also, some signs that occur that the couple is doing better, that they are on their way to a successful marriage and don’t need a therapist anymore. The first that comes to mind is that they argue differently. Arguments come up in all marriages. (Note: some couples don’t really talk about an argument and may not argue out loud, but that is not the norm and those kinds of couples have a different set of problems to deal with.) How the couple gets through the argument is what seems to make the difference. Is there resolution for many of their arguments? The couple that feels finished with their couples therapy, usually, are arguing differently because of the work of the therapy: they are having important changes in the arguing and they are coming to agreements about what to do more often. They are arguing better.
An aspect of arguing that I often notice and point out to the couple has to do with how they will begin to do two things during their more productive arguing: they will deal with the details BUT they also will deal with how they are arguing with each other. I have noticed that couples that argue better or more productively move much more easily in and out of the details and how they are treating each other. When couples don’t do this, they often “crash” in the argument and either escalate the anger and get nowhere except to feel badly or they quit and nothing is resolved.
Getting through arguments, therefore, and how a couple argues are signs of difficulty in the relationship, are also signs of progress in the therapy, and even are a sign that the couple no longer needs the therapist. Arguing well, and fluidly moving between details and how they treat each other, are very important issues in a couple’s relationship, and worth your time to look at and work on as a couple.
There is an interesting TED talk that you can view that I recommend to you by Mandy Len Cantron. Go to TED.com and search for her name or “falling in love” and you will find it. It is just under 14 minutes long. She was researching falling in love and happened to try it herself. In the research, the couple would read and answer 36 questions that were increasingly personal and then stare into each others eyes for four minutes. In the research, people were falling in love after doing this with each other. And Mandy, herself, fell in love with her friend (and he with her). She got a great deal of attention from people because this is an important topic for almost all of us. The question that she gets most often is, “Are you still together?” I’ll let watch the video (she doesn’t tell the answer until towards the end) to find out.
I have the suspicion that a majority of individuals who come to counseling about relationships think that someone else needs to change. In couples counseling, it is often the case that each patient tells me how the other (their spouse, significant other, etc.) is doing something wrong or something that causes problems. If the “Other” would just change things would be better. This last part is not said aloud, though I sometimes say it aloud, something I do when a thought or feeling is present in some way but not very fully expressed. “So if he would just do it your way then everything would be fine,” I might say (I have to be careful and not say this sarcastically or sound sarcastic, and I don’t mean it that way but it can be taken that way). We all would like others to do a number of things that would make our life easier. But in couples therapy, the two are usually locked into ways they each want the other to change and nothing is changing. So YOU have to change, or can you begin to think about that. It must be said that he/she has to change also…
So if you are in a relationship and locked in a conflict and find yourself thinking a lot about how he/she needs to change, try to also look at what you need to be changing. It could make a significant difference…
I find myself often referring to “the edge” for a couple as they talk about aspects of how they relate to one another. I will take my hands, holding them flat, twist one hand 90 degrees, and then bring the fingertips together, trying to show with my hands how they are crossing each other, how they are hitting each others “edge.” I have seen some aspect of this with the majority of couples in marital and couples therapy.
Sometimes one or both of the couple will think that it might be easier if they were with someone else, and that may be true, but my belief is that they would still “hit the edge” with a new relationship they would be in; it might be a different edge, but they will eventually bump up against their edges. If you are going to be around someone enough and/or have enough invested emotionally together, then the “edge” will come up. To try to define this “edge”: it is where you cross each other, where what he or she does grates on you, where you offend your significant other though you didn’t mean to do that at all—it is where, even though you may do well in many ways as a couple, you “bump up against each other” and it hurts. Many times, a couple will recoil when this happens, and some of the time that probably works out fine. But it is also often true that couples need to “get through” what happens when they crash into each other emotionally. So the edge is not really a bad thing, though most couples would think so.
Finding out more about you and your partner’s vulnerabilities can be a way to soften both edges, learning that it is ok for your partner to have feelings, learning to deal with your feelings that come up when your partner has feelings, building trust where it is difficult to do so—these are all ways of softening the edges, deepening the relationship, building intimacy, and countering the pain of “crashing edges.”
As you would guess, there are many reasons a couple might go to couples therapy. An affair is often the breaking open of troubles in a relationship that spurs a couple to seek professional help. And it is often the case that problems had been simmering for a while before the affair started. There is work to be done about the affair but also about the relationship if this is the case. And there are other reasons couples seek help.
A number of couples have come for couples psychotherapy because they were not communicating as well as they would like, or not like the used to. This is a very good reason to seek therapy—the situation is usually not as bad and repair can happen with less work. But there is work to be done, change that would be important, when a couple comes for this reason.
Couples also come because of disagreements, and sometimes those disagreements are about disciplining the children. The task might well be in couples therapy to get the two to respect each other more and find a way that works for both of them better than what they are doing differently from each other. Other disagreements that have come to couples counseling include disagreements over: their estates (who gets what, who takes care of whom), how much drinking or chemicals one partner is using, time away from home by one of the couple, lying, spending differences, larger family issues (getting along with the in-laws, or the sister, or the parent, etc.), sexual frequency issues, betrayal (emotional, with pornography, etc.), religious conflicts (who goes to church and how often for example), along with many others you might be able to think of. Helping the couple to communicate more clearly, see their patterns, look to him/herself instead of the other can all be a part of the work to change disagreements. Helping the couple to get through a disagreement is a good step—many couples don’t get through certain types of disagreements on their own, so helping them to get to a resolution is often helpful and can propel the couple into a better relationship.
Couples often don’t like emotions, actually certain, specific emotions, in the significant other. They can often shut down an interaction or argument when certain feelings come up and then they never resolve the issue. Learning to allow the other to have at least part of what he/she is feeling can also make significant progress and growth for a relationship.
And couples sometimes come to couples therapy when one wants out of the relationship (whether she/he is saying that or not) and needs help of some kind to get to her/his goal: to end the relationship. This is a valid reason to come to couples therapy, though one of the two people is often unhappy with that goal. The therapist’s job, in my opinion, is to help each person become healthier and help the relationship to be healthier, not necessarily to make sure they stay together. If the couple wants to make sure that they stay together, if this is one of the couple’s goals, then the therapist will work towards that. If one or both want to end the relationship, the therapist will help the two work on the relationship, even if headed in that direction, watching for opportunities to make the relationship work better, not pushing the therapist’s goals or values (whatever they might be), but helping the couple with theirs. This can mean that couples therapy, even successful couples therapy, may mean that the couple move apart and sometimes divorce.
I was sitting in a session, recently, with a couple and we were talking about their arguing. Since I have listened to numerous couples in marital and couples counseling over the years, I have thought a lot about and watched quite a few arguments. Over time, one of the aspects of arguing that I began to see was that it was emotional expression. Emotions are really not so good or bad in and of themselves: it is what you do with them that can be very, very important. Couples who don’t express their emotions with each other sometimes do just fine, but sometimes the feelings/thoughts build and come out in some form, and it is not always pleasant (a burst of anger is an example). If you and your significant other or spouse can argue well, congratulations. Many can’t and many couples need help with arguing, or, said another way, they need help with expressing their emotions to one another. Emotions could be thought of as another type of thinking, a part of us that is trying to tell us (or our significant other) something we feel/think. So as a couples therapist, I am tuned into what the people in front of me are thinking and feeling, and what they are expressing about those thoughts and feelings. In fact, a major portion of the work in individual or couples counseling is to help with what you are thinking and feeling. When you understand your thoughts and feelings better, you can make better decisions. And you can talk to one another more clearly. Watch for another post on emotions soon…
And keep on working on your relationships…
I often see couples who have some aspect of their finances as a flash point for their problems. As a couples therapist working with them, I am not too concerned if they are going into debt or if they should use a high percentage credit card or how much should they pay for interest on a house: I am not a financial adviser in that I am not the one to tell them the best way to invest, save, or spend. They have come in as a couple and one of my tasks is, often, to help them get to the same place (or a lot closer) about their finances. And not getting to the same place is, I believe, what often has brought them to me seeking couples therapy, whether they understand that or not. When a couple gets to a financial difficulty, it often can also be seen as a conflict, about each thinking they know what to do, about each having values (often long standing) about what is the right thing to do or the right way to spend. But the issue in couples therapy is to get each of the partners to see that they may have to make some change if they are to be a couple. Sometimes they compromise; sometimes it goes one way and sometimes the other. That is, if they are willing to move beyond being locked in their position, if they are willing to work on being a couple (instead of just being a “single,” that is, just doing it his or her way). Often, the answer is in their ability to be a couple, to work toward closer mutuality.