Resources for Counselors
Watch here to see the recent webinar presented by Dr. Fitzgibbons.
Excessive anger is one of the major reasons why couples seek marital counseling. Most mental health professionals have had little if any training on empirically proven methods for treating such anger and resentment. Rick Fitzgibbons, M.D., the director of the Institute for Marital Healing and maritalhealing.com has been a pioneer with Bob Enright, Ph.D., University of Wisconsin, in demonstrating the remarkable clinical effectiveness of the psychotherapeutic uses of forgiveness in the treatment of excessive anger in marriages and in major DSM -IV-TR disorders.
Rick has worked effectively with several thousands couples over the past 32 years and has offered many marital conferences including for eight years at Catholic Familyland (www.familyland.org) in Bloomingdale, Ohio.
Therapists who work with couples can benefit from taking the APA approved forgiveness course offered by Dr. Bob Enright at www.forgiveness-institute.org which is based on our textbook. Also, a training video from the American Psychological Association Psychotherapy Videos on the use of forgiveness done by Bob and Rick can be informative. To learn more about this video, please click here.
The IMH also offers opportunity for ongoing supervision for mental heatlh professionals for marital therapy. This training can assist therapists in learning how to employ empirically proven methods for resolving excessive anger described in the marital chapter of Helping Clients Forgive: An Empirically Proven Method for Resolving Anger and Restoring Hope, American Psychological Association Books, 2000.
In Michael Posternak's recent study of 1300 outpatients in 2002 at Brown University, approximately one half of the patients reported currently experiencing moderate-to-severe levels of subjective anger, and about one quarter had demonstrated aggressive behavior in the preceding week. This level of anger was found to be comparable to the levels of depressed mood and psychic anxiety reported in his sample. His conclusion was that anger and aggression are prominent in psychiatric outpatients to a degree that may rival that of dperession and anxiety. He stated that it is important that clinicians routinely screen for these anger symptoms, Posternak MA, Zimmerman M, 2002.
In all the clinical chapters of Helping Clients Forgive research studies are presented which also demonstrate the high prevalence of active and passive-aggressive anger in most DSM IV disorders. Therapist can assist their clients in uncovering their anger by the use of subjective and objective anger measures which are found at the beginning and end of the angry spouse chapter. Also, a child and adolescent anger checklist is available in the child chapter. Spouses can rate the angry behaviors of their partner on the anger checklist. Parents regularly use the child anger checklist to identify a child's active and passive-aggressive anger.
Self-knowledge in mental health professionals
Self-knowledge in mental health professionals is essential if they are going to help spouses with serious marital stresses. Marital therapists will unconsciously resist uncovering and addressing the conflicts which interfere with healthy marital self-giving such a need to control, excessive anger or selfishness in their patients unless they have addressed these emotional and character weaknesses within themselves.
Growth in self-knowledge can be obtained by exploring the history of secure attachment relationships with each parent, with siblings and with friends. Since each parent has special gifts and also weaknesses, disappointments should be uncovered with each parent. Also, an attempt should be made to understand the parent's childhood conflicts which interfered with healthy emotional self-giving. Then, past forgiveness exercises should be employed to resolve parental anger. These exercises are described in detail in the chapter on marital anger.
Since the most common conflict we address in spouses is the tendency to control as a result of damage to trust in childhood, modeling after a controlling parent or selfishness, therapists should explore this conflict within themselves. Completing the mistrust checklist in the evaluate your marriage chapter, as well as other checklists in that chapter, can uncover these conflicts. Reading the controlling spouse chapter can facilitate a healing of this common conflict.
Other conflicts in self-giving which therapists should consider in their own lives include:
- Excessive anger
- Confidence weaknesses
- Negative parental modeling
- Excessive sense of responsibility
- Disordered self-giving
- Lack of charity
- Neglect of spiritual life
- Character weaknesses.
Many of these weaknesses can be uncovered by completing the appropriate checklists in the evaluate your marriage chapter on this site. Finally, chapters on this site which address the conflicts in marital self-giving can enable therapists to resolve their own emotional and character weaknesses and then become more effective in the healing and strengthening of marriages.
Anger misdirected at the mental health professional
In article I authored in the journal Psychotherapy in 1986 on the cognitive and emotive uses of forgiveness I described in the process of forgiveness section the importance of responding to a patient's angry transferrence.
"In the initial stages of the process of forgiveness, the patient’s anger is often misdirected at the therapist as a defense against facing the inflicted pain. In the patients with borderline, sociopathic, hysteric personality disorders and other patients with significant anger, it may be necessary to develop a therapeutic contract in which the patient agrees to work on forgiveness exercises daily in relationships indicated by the therapist, if therapy is to continue. The inappropriate expression of anger at the therapist does not benefit anyone and simply delays the resolution of the patient’s pain.
The next resistance encountered occurs when patients excessively and exclusively blame those closest to them for their anger. This is especially the case when there has been childhood emotional trauma with parents. This resistance can be worked through by helping the patient understand the degree to which his emotional needs were not met by his parents and then by exploring the common ways in which masked anger with parents is misdirected through childhood, adolescence, and adult life."
In our professional experience unresolved parental anger is the major source of misdirected anger at mental health professionals. Excessive resentment due to severe loneliness is another source of such inappropriate anger.
Unfortunately, not a small number of individuals do not want to let go of their intense anger and even may even enjoy the expression and misdirection of their anger because of the desire for revenge, the compulsive need to control or feelings of inadequacy and jealousy.
Marital therapy: State of the art
We recommend that mental health professionals familiarize themselves with Dr. Bill Doherty's, Family Social Science Department at the University of Minnesota, important online talk that he gave at the Smart Marriages Conference in 1990 entitled, How Therapy Can Be Hazardous To Your Marital Health, in which he describes the present many serious problems with marital therapy.
He co-founded in 2005 the National Registry of Marriage Friendly Therapists, with Pepperdine University psychology professor Kathleen S. Wenger. To join the registry, therapists must agree with a "values" statement that affirms "the unique value of marriage and the importance of lifelong commitment in marriage."
Also, a recent study highlighted some of the serious problems which exist in the field of marital therapy. As Cheryl Wetzstein wrote recently in the Washington Times (9/14/2008), "For decades, we've heard the advice. Marriage in trouble? Go see a counselor."
Today a number of mental health professionals think marriage counseling may be hazardous to marital health. James D. Wright, a sociologist at the University of Central Florida, who studied 600 couples in Louisian, stated, "The counseling profession is trying to help you through the divorce, not help you repair the marriage." In that sense, he said, "marriage counseling is more like divorce counseling."
He found that when struggling spouses went for marital counseling, many ended up divorce. He stated, "Our results suggest that couples who receive marital counseling [during marriage] are substantially more likely to divorce than couples who forgo this option," Mr. Wright and his colleagues wrote. In fact, getting marital counseling raised the chances for divorce by two or three times.
Mr. Wright's views are that until there's evidence that marital counseling actually helps couples strengthen their marriages, their research strongly cautions against such counseling, much less making it mandatory.
We recommend that couples call and screen therapists before making an appointment to be certain that they are marriage friendly counselors who hold great respect for marriage and are commited to strengthening and protecting marriages.