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Archive for the ‘Psychopathologies’ Category

On Borderlines and Narcissistics: A Marriage Skills Alternative to Pathologization

By Susan Heitler, Ph.D., author, From Conflict to Resolution

www.therapyhelp.com

For therapy with the so-called personality disorders of borderlines and narcissists, a non-pathologizing orientation can be helpful. These are folks who function in a borderline or narcissistic matter, that is, in a way that is emotionally stormy and ‘all about me.’ In both syndromes, the folks are not sick; they are unskilled, and as a result they make very difficult marriage partners.

In this regard, it is important to note that there are alternatives to the notion, which fits for some but by no means all borderline and narcissistic folks, that their problem is too much childhood suffering and pain. Too much success, especially success at getting one’s way by ignoring others’ concerns while expecting others to respond to one’s own, can create these disorders with or without what we usually think of as emotional injuries.

What folks sometimes refer to as “spoiled” kids, emotional kids who always get their way because they have overpowered their parents with their intense emotional storms, are at risk for becoming borderlines. Specially talented kids, at the same time, are at risk for what I call “tall man syndrome,” i.e., becoming narcissists. They are at risk for feeling so talented or tall or smart that what they want seems to them, and often to others as well, as far more important than what others want.

In other words, borderline and narcissistic syndromes are patterns of response to situations in which what they want feels sacred and what others want, irrelevant.

This model of personality disorders, based on conflict resolution theory, (see From Conflict to Resolution by Susan Heitler) leads to a practical treatment response. Teach narcissists and borderlines to listen and become responsive to others’ concerns, teach them win-win conflict resolution, and they will learn to function with emotional health and personal maturity.

A key part of the skill set narcissists and borderline personalities need to learn, in order to do win-win conflict resolution, is emotional self-regulation. After years of pitching fits to get what they want, they typically need much coaching to learn to recognize anger as it begins to arise, remove themselves from the situation, self-soothe, and then return in a calm problem-solving mode to find win-win solutions.

This treatment approach requires first that the therapist become an expert in conflict resolution, and then that the therapist become a great coach for conveying the skills to clients. For a free download on Therapist as Conflict Resolution coach, go to www.therapyhelp.com.

In sum, with enough confrontation on their old ways of powering over others, plus coaching in win-win skills, borderlines and narcissists who want to grow up can become great folks with normal to excellent potential for partnership.

Conflict Resolution for Counselors and Couples

Conflict Resolution: Essential Skills for Couples and Their Counselors

Susan Heitler, Ph.D.

Denver, Colorado drheitler@gmail.com

Abstract

Marriage and relationship counselors need expertise in conflict resolution to work effectively with couples in distress. Couples’ ineffective conflict resolution skills result in anger and arguing, depression, anxiety disorders, and obsessive-compulsive syndromes such as excessive drinking, eating disorders etc. Each of these disorders stems from a specific ineffective conflict resolution pattern. Effective conflict resolution habits, by contrast with the symptom-producing patterns, lead to outcomes that feel positive to the participants. Healthy conflict resolution pathways begin with expression of participants’ initial positions, continue with detailed exploration of their underlying concerns, and conclude with creation of a plan of action or solution set responsive to all of the specified concerns. Success in traversing this pathway requires that information be shared in accordance with principles of open and cooperative information flow.

Conflict Resolution: Essential Skills forWorking With Couples

Expertise in conflict resolution appears to be a foundational skill set for effective therapeutic counseling with couples. Couples who seek counseling frequently ask explicitly for help resolving their conflicts. Conflict resolution expertise enables a counselor to respond to these mediation requests. Counselors also need this expertise to be able to teach couples to live in cooperative partnership; improved communication and conflict resolution skills can enable couples to address subsequent differences more effectively on their own. This article reviews the work in this area contributed by a therapist whose interest in the conflict resolution literature of international relations, business, and law has led to incorporation of this literature into her own clinical work and writings.

Differences inevitably arise when two partners try to conduct the business of living together as one team. These differences can corrode marital affection by creating stress, tension, and anxiety, irritation, resentment and arguments, and depression. Handled with effective, mutually considerate, conflict resolution strategies, however, differences can lead to decisions that both spouses endorse and appreciate, enhancing both spouses’ personal sense of well-being and also their affection for each other. Counselors need to be able to guide and coach couples in these healthy dialogue and conflict resolution skills.

From a conflict resolution treatment perspective, the several ways that therapists can help couples with their conflicts define the three goals of couple counseling:

(1) symptom reduction, that is, relief from the anxiety, depression, anger, etc that are perpetuated by poorly handled conflicts.

(2) resolution of the various issues about which the couple has been adversarial and

(3) skill improvement for subsequent partnership effectiveness and peace in the home.

While conflict resolution can be regarded as lying at the heart of the therapy project, the counseling and psychotherapy literatures thus far have offered little guidance in the domain of collaborative dispute resolution. Surprisingly few books on therapy even include the word “conflict”, much less conflict resolution, in their index. Rather, advances in conflict resolution theory and techniques have developed primarily in the realms of business, international relations, and legal mediation. In my prior books and articles I have translated ideas from this mediation literature into the vocabulary of personal relationships and therapy (Heitler, 1987, 1990, 1992, 1994, 1995, 1997, 1998, 1999, 2000, 2001). The current article distills from these writings the essential skills that a therapist or counselor needs to facilitate conflict resolution with couples in distress.

Signs That Indicate A Need for Conflict Resolution

Negative emotions of all types signal conflicts. Anger and arguing signal overt conflict. In addition, stress, tense silence, feelings of anxiety or depression, and addictive impulses all suggest brewing differences.

Conflict refers to any situation in which people experience pulls in apparently differing directions (Heitler, 1990), with or without overt fighting. That is, the term conflict, as it is used in this article, is not limited to situations with explicit fight behavior. Sometimes the differences are about the issue under discussion, such as a decision or a plan of action. At other times the differences can be about an event that has occurred in thepast. Sometimes the differences have little to do with the topic of discussion, and instead stem from someone disliking the way the other is speaking or responding, that is, from glitches in collaborative dialogue skills.

The conflicts signaled by negative emotions can occur in various realms. Intrapsychic conflicts pit a person’s own various preferences, fears, desires, values, and other motivations against each other. For instance, Norma might feel torn between wanting to finish the dishes and wanting to go outside for a walk in the evening twilight, or Joel might feel tempted to leave a troubled marriage and yet fear living as a single person. Interpersonal conflicts occur between two or more individuals. Norma may want to finish the dishes and Joel may want her to join him on an evening walk. Intergroup conflicts may involve neighborhoods, businesses, ethnic groups, nations, or any group entities, small or large. Lastly, reality conflicts develop between a person or group and facts of life. Norma and Joel may feel upset because of frustrating financial constraints or because one of them has been struck with a debilitating illness. While the same principles of conflict resolution apply in all of these realms, this article will focus on resolving conflict in the interpersonal realm–specifically, between partners in a marriage relationship.

Persistent or particularly strong negative emotions generally indicate the presence of a conflict with deeply felt or high priority concerns. Strong negative emotions also may indicate that the process of dealing with the conflict has been sub-optimal. The more important the issues in conflict, the more vital it becomes that the process be a healthy—that is, a process of collaborative conflict resolution characterized by

  • Mutual information sharing through respectful talking and listening–not a powering-over process based on insistence, coercion, threats, or violence
  • A cooperative tone, devoid of blame, accusation, or antagonism, and characterized instead by attitudes of mutual respect.
  • A win-win process that seeks to understand the concerns of all participants, and then concludes with an outcome responsive to all of these concerns.

When differences emerge in a healthy marriage, spouses express their personal concerns, listen respectfully to each other, and emerge with a win-win solution that is responsive to the concerns of both partners. In less emotionally sanguine marriages, by contrast, spouses detour away from win-win conflict resolution, heading instead down one or more of four ineffective pathways. All of these detours lead to either win-lose (one person gets they want but the other does not) or lose-lose outcomes. Each of these four detours from healthy resolution pathways results in a specific type of psychopathology.

  • Anger — The fight pathway is most obviously labeled as conflict. This pathway involves winning disagreements by escalating anger intensity—by getting louder, speaking more rapidly, and in some cases eventually by hurting the other. Negative energy enables one party to intimidate, dominate, and thereby coerce the other into giving what one wants (Heitler, 1990, 1995).
  • Depression — The submit pathway involves giving up on satisfying one’s preferences (Heitler, 1990, 1994, 1995b). In an adversarial or potentially adversarial interaction one party may choose to minimize the risks of fighting by giving up on getting what s/he wants. Depression is the by-product of giving up and loss.
  • Anxiety — The freeze pathway involves an immobilization response to conflict. Anxiety hovers when neither side in a conflict moves forward with explicit discussion or action. Instead, on-going disagreement produces a stalemated state of tension without resolution (Heitler, 1990, 1995).
  • Obsessive-compulsive and addictive disorders — The flight route utilizes the distraction of drugs, alcohol, or obsessive-compulsive habits as an escape route from conflict. By turning away from a conflict into distracting activities or thoughts, participants end the fighting but leave the conflict unresolved (Heitler, 1990).

Thus the two main indicators of ineffective conflict resolution are (1) one or more of the four primary symptoms if emotional distress (anger, depression, anxiety/tension/stress, or addictive/obsessive-compulsives behaviors) and/or (2) continued unresolved conflicts.

The Three Steps of Conflict Resolution

Effective collaborative conflict resolution flows through three main steps.

1. Express initial positions

2. Explore underlying concerns

3. Create a solution set responsive to all the concerns of both participants.

In order to traverse these three steps successfully, participants in a cooperative conflict resolution process must communicate in a manner consistent with cooperation. Adherence to the principles of collaborative communication insures the smooth information flow upon which conflict resolution depends.

When participants deviate from smooth information flow principles, discussions polarize and become increasingly adversarial in tone. Participants begin to experience themselves in opposition to each other, and to feel irritated or angry. Continuation of a dialogue with poor skills increasingly risks deterioration into argument and escalation into fighting.

When participants in a dialogue are able to sustain a positive emotional tone and utilize cooperative communication patterns, their dialogue will look like shared decisionmaking. Actually, conflict resolution on the one hand, and shared decision-making on the other, both utilize the same three steps of expressing initial positions, exploring underlying concerns, and then creating mutually satisfactory solutions. The main difference is that we tend to use the term conflict resolution when two people have locked into negative stances and it is necessary to reduce their antagonistic, judgmental, or coercive attitudes toward each other. In these situations, negative emotions such as tension, frustration, or irritation will predominate and will need to be reduced in order to move forward cooperatively. The counselor’s first task therefore in conflict resolution is to facilitate the couple’s transformation from enemy stances to quieter more collaborative interactions. For this change to occur, the counselor must truly believe that cooperative talk is predictably more effective than hostile fighting for dealing with differences. Judeo-Christian non-violent ethics, as well as the Western democratic tradition, rest on this belief—and contrast sharply with cultures in which winning by overpowering is valued above mutually beneficial negotiation via words.

The following example illustrates the three steps and the various sub-skills necessary for success in solving conflict dilemmas. Joel and Norma find themselves in conflict—i.e., facing a dilemma–about when to leave the party they plan to attend that night.

Step One: Express Initial Positions

Joel: I’d like to plan to leave the party tonight early.

Norma: Umm. I was hoping we’d stay on until the very end –and probably to be the last ones to leave.

Joel: Stay to the end? We need to talk this over then to figure out when we’ll leave so we have a plan that’s ok with both of us.

For this first step to proceed effectively, each participant needs to verbalize his/her initial position or concerns. For instance, Joel may think, “I’d like to plan to leave the party tonight early,” but not voice his preference. Merely thinking about what he would like would not suffice. Asking what Norma wants to do without also putting his own perspective on the table also would not suffice. “Say it” is the first principle of healthy dialogue (Heitler, 1997).

Norma needs to listen respectfully to her husband’s statement, and then verbalize her own preference—which Joel in turn needs to hear. Norma might respond, for instance, “Oh really? We need to talk then because I was hoping to stay on at the party until the very end –and probably to be the last ones to leave.” Joel too needs to respond in a way that acknowledges what he hears. At each step, symmetry is vital. Both Joel and Norma need to verbalize their preferences; and both need to give evidence of digesting the other’s preferences. For instance, Joel might indicate what he has heard by thinking aloud, “Stay to the end? We need to talk this over to figure out when to leave so we’re both ok with it.”

Conflicts smolder if they are not openly expressed. If Joel, instead of expressing his desire to leave the party early, had suppressed the impulse to say what he wanted, the dialogue would have derailed at the outset, never launching at all. Self-suppression, and resultant too narrow information flow, invites subsequent resentment, depression, or overt anger. When Joel felt ready to leave the party and his wife wanted to stay on, unpleasant feelings would have begun to emerge.

Other violations of basic communication guidelines (see Heitler, 1997) can similarly derail the conflict resolution process. For instance, if Joel had initiated the discussion with a complaint, “I hate the way you stay so late at parties,” rather than a request, he could have inadvertently torpedoed any subsequent cooperative dialogue. Complaints focus on the negative, on what is wrong, what one does not like. Complaints generate resistance and defensive responses. Requests, by contrast, focus on would likes rather than don’t wants, propelling dialogue forward. Likewise, if Joel had initiated the discussion by saying to Norma, “I want to leave early tonight; don’t give me a hard time about that!” With this controlling stance, telling Norma what he wants her to do instead of encouraging her to voice her perspective, Joel would have invited either an

angry or a depressed response from Norma.

Positive listening skills are similarly vital. If instead of listening openly for what makes sense about her husband’s request, Norma had retorted with defensiveness, criticism, or a toxic comment–“I do not stay late. You’re the one who’s usually last to leave”–tensions would have escalated. What I term “bilateral listening” skills also are essential (Heitler, 1997). Preoccupation with satisfying one’s own concerns without regard to the partner’s, that is, narcissism, predicts marital difficulty. Similarly, too much focus on pleasing the spouse at the expense of heeding one’s own concerns, that is, excessive altruism, also predicts marriage problems. Bilateral listening, by contrast, involves heeding both one’s own and one’s partner’s concerns and results in mutual benefit for both partners.

Joel and Norma have clarified their differing initial preferences. Both have spoken their initial preferences, and both have given respectful evidence of having heard the other. Once expressing initial positions has been thus accomplished, bringing the conflict into both partners’ awareness, a good technique for bridging from the first to the second steps is to frame the differing initial positions in terms of one over-arching problem statement. For instance, Joel and Norma frame their dilemma as a problem with deciding what time they will leave their party.

How a problem is framed has significant implications for the subsequent tone of discussion. Tensions tend to rise if either partner frames the problem as who is going to win—i.e., my way or your way. Tensions also tend to rise if either partner feels that the problem is being defined as something that is wrong with one of the people (self or other), rather than that the problem is a genuine problem. That is, the problem is not that Joel is asocial or Norma too garrulous; the problem is what time to leave. Defining the problem with a neutral umbrella dilemma label such as “what time to leave” clarifies that the subsequent decision-making process is likely to be collaborative, working together toward a shared goal.

Step Two: Explore Underlying Concerns

Joel: I want to leave the party early because I been feeling tired and I don’t want to get sick with our vacation coming up.

Norma: Yes, I don’t want you getting sick either. At the same time, I’d like to stay late at the party to show appreciation to our hosts, Ginny and David. They are our best friends. Making their party a priority consolidates our friendship.

Joel: I appreciate how good you are about keeping friendships nourished. I tend not to think about those kinds of things. I just go to a party, have fun, and then come home.. Which, by the way, brings to mind my other concern. I’m worried that the car has been having problems. I won’t be happy if it’s past midnight, the garages are closed, and the car breaks down on the way home.

Norma: We definitely need to figure out something about that car. One other concern for me–we’ve been kind of out of the loop socially, working too much. I’m looking forward to the party as a time I can re-connect with our friends and our relatives. Everyone will be there.

This second step of conflict resolution requires that participants identify the dimensions of the situation to which the position they initially suggested was a solution. Joel and Norma both look inward, using “insight” and listening closely to their inner murmurings, and then verbalizing the concerns they have discovered.

For success at this second step, participants need the cognitive flexibility to be able to loosen their attachments to the positions they had initially expressed. If they stay attached to their initial solution ideas, locked in cognitive rigidity, participants will argue for or against their position rather than allow themselves to “explore.” Convincing and debating are conflict resolution strategies intended to control or dominate; these modes of dialogue are incompatible with “exploration”. Insistence and persuasion techniques begin with a conclusion and then present arguments to persuade the other of the rightness of this initial conclusion. Exploration, by contrast, utilizes initial positions as starting points for pursuing further understanding, for deepening and broadening both parties’ understanding of their own and their spouse’s underlying concerns.

Exploration is most effective when the process identifies specific details relevant to each concern. For instance, what did Joel mean by “early” and what did Norma mean by “late?” Why is he tired? What specifically does he fear may break down on the car? What specifically might lead Norma’s party-host friends to feel insulted, and what would matter to them as evidence of friendship? With which friends and relatives did Norma especially want to connect? What would count as connecting? The more that the specifics of underlying concerns have been clarified, the more likely it will be that the couple will find solutions that are successfully responsive to their concerns. Specifics of positions can be problematic; but specifics in understanding underlying concerns significantly facilitate discovery of win-win solutions.

Both participants’ concerns need to be conceptualized as factors added to one list, the single list of “our concerns.” In a loving relationship, any concern expressed by one participant immediately becomes a concern of the other. Each concern becomes a parameter of their shared dilemma and is valued by both of them. The skill of bilateral listening again is relevant. Partners need to be able to heed with equal significance both their own and their partner’s concerns. As in the first step, some individuals will tend to err on the side of egocentrism, hearing only the dimensions of import to themselves. Others may err on the side of excessive altruism (often labeled co-dependency), that is exquisite attunement to the other person’s preferences with inadequate attention to their own concerns. Bilateral listening may be one of the best indicators of emotional maturity and an excellent predictor of marital success. With narcissistic, co-dependent, and hysteric and other less mature personality types, by contrast, a therapist has to repeatedly remind spouses, “I think there’s two of you here. Are you hearing both?”

Fortunately, concerns tend not to be mutually exclusive, the way action plans (initial positions) may be. Concerns come in the form of preferences, desires, values, fears, etc—these are the parameters of the problem to be solved. Joel and Norma’s concerns included fatigue, car problems, and friendship. Solutions, by contrast, are action plans. Whereas Joel and Norma cannot leave a party and stay at the party simultaneously, they should be able to find a plan of action that is responsive to their various concerns.

This difference between positions and concerns is the active ingredient that makes cooperative win-win settlement possible. The initial positions suggested in step one are only some of many possible solutions to any given set of concerns. A good solution or plan of action is win-win if it is responsive to all of both participants’ underlying concerns. Neither participant’s initial position may turn out to be the eventual chosen solution, but as long as both participants feel that their concerns are heeded in the outcome, they will experience the process as win-win.

Positional bargaining is the term used in the mediation literature to describe the adversarial negotiation that occurs when participants lock into step one, arguing over whose position will prevail instead of proceeding together to a joint exploration of their underlying concerns. Positional bargaining typically devolves into a tug of war. One participant wins and one loses depending upon who has more power or perhaps more investment in the outcome. The best that participants in a positional bargaining process can hope for in terms of mutual gain is a compromise, that is, a solution in which both participants give up some of what they want.

In the conflict resolution literature, positional bargaining is contrasted with interest-based bargaining. The latter process looks behind initial positions to “the interests that lie behind the positions.” This shift of focus is essential, but the terminology of interests that lie behind positions does not prove helpful in helping the shift to occur when the subject is personal psychological conflict resolution situations. Asking Joel and Norma what their “interests” are in their dilemma about party departure time makes little sense. I change the terminology of interests that lie behind positions to concerns that lie 0beneath the positions. (Heitler, 1993) By contrast with interests, the word concerns feels compatible with psychological phenomena such as desires, fears, preferences, and values. Asking Joel and Norma their concerns about when to leave the party is a meaningful question, one that helps them identify the relevant dimensions of their dilemma.

The metaphor of interests that lie behind positions needs a change as well in order to dovetail with how people think about personal situations. Psychological conceptualizations generally utilize a vertical, not horizontal, metaphor. We talk about the “sub” conscious, “deeper” issues, and “buried” memories. I recommend therefore changing from a metaphor of interests that are lying behind positions to a metaphor of exploring the concerns underlying initial positions.

Step Three: Create a Win-win Solution Set

Again, vocabulary is important. I use the term solution set to clarify that effective collaborative solutions generally involve a number of different actions, not a single action. A successfully win-win plan needs multiple elements in order to respond to all the concerns that have been identified. For instance, a solution set for Joel and Norma might include the following aspects: Joel would take an hour to nap in the afternoon, so that he is less fatigued. During Joel’s nap Norma could bring the car to a mechanic to check and remedy the potential breakdown. With these two concerns accounted for, Joel and Norma could then stay at the party as late as either would like. Alternatively, or perhaps in addition, Joel and Norma might decide that they could tell their hosts on arrival how much they appreciate their friendship, and that they nonetheless are

preparing for their vacation travel and consequently will need to leave earlier than their usual party departure time. With this information, their hosts would be less likely to take an early departure personally. As to Norma’s visits with her friends and relatives, Norma could keep an eye on the clock to pace how much time she had with each. A triage ahead of time could further enable her to plan with whom she would want to spend considerable time, and with whom a brief cordial greeting would suffice.

Having arrived at step three, creating solutions, does not negate the possibility of returning to step two, exploring underlying concerns. In fact, complex conflict negotiations often go back and forth multiple times between creating possible solutions, and discovering additional concerns. As they talk more, for instance, Norma may realize that staying out too late could create a problem with their new puppy. And Joel might add that he has to get up early the next morning to work on papers from his office that need to be attended to before they depart on their vacation trip. Their solution set will have to factor in these additional variables.

When the solution set feels complete, one further question can increase the odds that the ensuing consensus proves lasting. “Are there any little pieces of this that still feel unfinished?” For instance, Norma and Joel may have agreed that 11:00 p.m. will be the final time by which they will leave. In response to the question, “Are there any little pieces of this that still feel unfinished?” Joel than may realize, “What if it turns out that the party is just getting going then, and both of us are really enjoying the evening?”

Note that this successful conflict resolution involved no compromise. Flexibility is vital, but compromise leaves everyone feeling compromised. Rather, the process was cooperative and the outcome was genuinely win-win.

Conflict Resolution and Information Flow

Information flow provides the current upon which effective conflict resolution rides. Smooth information flow occurs when information is openly shared, and openly received. By contrast, information presented in a threatening manner, or resisted with defensiveness, results in blocked, diverted, or turbulent information flow.

Because conflict resolution is dependent upon smooth flow of shared information, i.e., on the skills of collaborative dialogue, a therapist must continuously monitor the details of how spouses are talking and listening to each other. Information ceases to flow smoothly the moment any principles of collaborative dialogue are violated. The therapist’s job therefore includes teaching collaborative communication skills, plus continual prompting, coaching, and repairing of violations these skills. Otherwise, escalated emotions and adversarial stances will cause turbulent information flow and will disrupt effective communication.

What treatment methods can keep a couple’s information flow positive and smooth?

  • Skills can be taught. They can be introduced one by one (Heitler, 1987, 1990, 1992, 1994, 1995a, 1997, 2000) and then practiced and reinforced with skill drills. Alternatively, couples can be encouraged to take a couple communication course prior to or during treatment (Heitler, 1999).
  • Skills can be prompted one (Heitler, 1990, 1992, 1995a, 2000). For instance, if a husband’s frown indicates criticism about to flow, the therapist can prompt more positive and insight-focused delivery by suggesting sentence stems such as “My concern is …” or “I would like …” (rather than “I don’t want …”). Similarly, to prompt effective listening, after one spouse has spoken the counselor can turn to the other spouse with the question, “What makes sense to you in what your partner just said?” or can suggest the sentence stem, “I appreciate ….”
  • Skills can be reinstated by a quick after-the-violation repair from the therapist (Heitler, 1990, 1992, 1995a, 2000). For instance, the therapist can invite a second draft of the comment, e.g., “How might you express the same concern in a way that talks about yourself rather than about your spouse?” Or the therapist can translate for the offending spouse by moving his/her chair in next to the spouse (it helps to use a chair with wheels) and reiterating the spouse’s comments in more collaborative language. “You spend money like a leaky faucet,” for instance, could be translated, “I get worried that we won’t have enough cash to pay our bills when I spending that’s not in the budget we’ve planned.”

Underlying these coaching and monitoring techniques is an assumption of zero tolerance for communication violations. Prevention is preferable; if unsuccessful, immediate intervention toward re-establishment of smooth information flow is essential. Prevention and rapid intervention keep conflict resolution dialogue safe and constructive.

Marriage Education: The Preventive Strategy

In medicine, treatments that remedy the pain and damage of medical disorders are certainly helpful, but preventive approaches can be far less expensive, prevent the damage altogether, and can reach far broader numbers of people. Teaching people to use seat belts, for instance, is far more inexpensive and broadly effective than setting broken limbs and treating head injuries after car accidents. Similarly, marriage education that teaches skills of communication and conflict resolution, particularly in the first years of pre and early marriage, can give couples lifelong skills for healthy collaborative partnership.

Perhaps then, one of the most important roles for the pastoral counselor may be to insure that every church has marriage education programs. Young people, premarriage couples, post-divorce individuals who want to do better in their next marriage, and also married people facing life transitions such as the addition of children and the emptying of the nest can benefit. All of the skills described above can be taught in psychoeducational programs. Hopefully, in the years ahead, in addition to helping wounded and conflictual couples to repair their difficulties, pastoral counseling will define its mission also as providing preventive marriage education.

References from Dr. Heitler’s Publications

Heitler, S. (1987). Conflict resolution: A framework for integration. Journal of Integrative and Eclectic Psychotherapy, 6,3, New York: Brunner Mazel.

Heitler, S. (1990). From Conflict to Resolution,. New York: Norton & Co. Released by Norton as a trade paperback, Dec. ’93.

Heitler, S. (1992).Working With Couples in Conflict (2-tape audio set). New York: W.W. Norton & Co.

Heitler, S. (1994a). Conflict Resolution for Couples (2-tape audio set). Denver: TherapyHelp.com.

Heitler, S. (1994b) Depression: A Disorder of Power (audio). Denver: TherapyHelp.com.

Heitler, S. (1995a). The Angry Couple: Conflict-Focused Treatment (video). NY: Newbridge, from the master therapist video series, Assessment & Treatment of Psychological Disorders. Current publisher, Denver: TherapyHelp.com.

Heitler, S. (1995b). Anxiety: Friend or Foe? (audio). Denver: TherapyHelp.com.

Heitler, S. (1995c). Resolving conflicts; lifting depression. Treatment Today, Fall, p. 31.

Heitler, S. (1997). The Power of Two: Secrets to a Strong & Loving Marriage. Oakland: New Harbinger.

Heitler, S. (1998). Treating high-conflict couples. In Psychologists’ Desk Reference. Koocher, G., Norcross, J. & Hill, S. (eds.), New York: Oxford.

Heitler, S. (1999). Power of Two Marriage Skills Workshops: Teaching and Marketing Manual. (curriculum guide)Denver: TherapyHelp.com.

Heitler, S. (2000). Conflict resolution and conflict-focused therapy. In Comparative Treatments of Relationship Dysfunction, Dattilio, F and Bevilacqua, L, eds., New York: Springer.

Heitler, S. (in press). Conflict resolution treatment perspectives on combining individual and marriage therapy. J. Psychotherapy Integration.

Resolution, Not Conflict; Dr. Heitler's blog on Psychology Today
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