madden 2005 five useful questions in couples therapy

8/2/2019 Madden 2005 Five Useful Questions in Couples Therapy

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Five Useful Questionsin Couples TherapyMichael Madden

Practice Notes

This article describes an approach to couples coun-seling in which the use of questioning is the majortherapeutic intervention. It describes my journey fromusing questions to gather information to employingquestions as clinical interventions in their own right. Itnotes that small questions can change the tone, moodand direction of the session, while bigger questionsopen up the social and moral context of couple life.F ive examples o f these 'b igger ' ques t ions aredescribed, I conclude that successful questions openup new areas for discussion, avoid a narrow 'problem'focus, and stimulate yet more questions.

In a conventional session, most of the therapist's questionsostensibly are designed to help him or her formulate anassessment. The questions themselves are not normallyregarded as interventions to help clients. Yet, many ques-tions do have therapeutic effects on family members(directly) through the implications of the question and/or(indirectly) through the verbal and non verbal responses offamily members to them (Tomm, 1987: 3),

IntroductionFor over 20 years I have had a fascinarion with rhe thera-peutic possibilities of the use of questions in couplescounselling and this paper maps my journey in the use ofquestioning to produce relationship change.When I left the Family Court and began private practicein 1986, I was excited about new possibilities in coupleswork. For the previous six years I had worked almost exclu-sively with separating couples in the court context andbecome worn down by the sense of 'too little too late' thataccompanied court counsellors' work as they engaged withseparation issues and new parenting arrangements.Limitations of time and restrictions inherent in legalprocesses reduced the scope and duration of my couplework, and pressure to reach a parenting agreement in coun-selling was often frustrating to both clients and counsellors.I began private practice with a desire to 'open up' the con-versation with couples and expand the possibilities of sharedideas about the experience of being in an ongoing relation-ship. I was intrigued by Tomm's way of thinking and in

particular by the way questions could open up the session toan enormous range of possibilities.So, I began to ask couples questions, at first hesitantly,but gradually with a sense of freedom and excitement thatmade the work feel very different from what I had known.My focus shifted from a reasonably ordered and sequentialexploration of a couple's relationship problems to a morefree-floating question and answer session. I tried to push theboundaries of what was acceptable to talk about and I madeit my goal to give the couple an interesting and differentexperience of talking together. I saw that stalemates in rela-tionships were usually paralleled by a conversationalstalemate (' Whenever I say this he/she says that') and I quicklynoticed that when I asked questions that stimulated curios-ity, both partners were able to engage with me and oneanother in a re-energised conversation. I remembered earlierdefinitions of therapy as 'a corrective emotional experience'(Alexander, 1946: 66-70) and questions seemed to offer thecouple a 'corrective experience' of being able to talk to oneanother differently. It soon became clear tha t this was a verydifferent sort of therapeu tic conversation.

The most obvious difference was that the mood in theroom changed dramatically. Sadness, guilt, blame andrecrimination were replaced by curiosity, thoughtfulnessand an enthusiasm for talking that I had rarely encoun-tered in earlier couples work. At the same time my ownexperience of the work was quite different. I felt muchlighter, much freer to move in unusual directions andmost importantly I felt free of the burden to take a posi-tion or comment on complaints partners had about oneanother, I remembered Michael White's advice to be waryof ^problem saturated conversations' and by use of questionswas able to keep conversations moving into, out of, andaround the heavy ground.

Michael Madden works in private practicein Melbourne. Address for correspondence:madden@bigpond,netau.


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Michael Madden

Sm al l Quest ionsWhen I began working in this way and experienced such ashift in mood, I was curious about how far this could go. Ifound m yself pushing the boundaries of what was 'appropri-ate' to talk about in sessions. I began to play with the ideatha t i t m igh t be more he lp fu l to unhappy coup les toprovide them with an interesting and entertaining conversa-tion with me and simply ignore the stated reason for theirseeking help. I wondered whether the improvement in theirtalk with one another around trivial subjects might helpthem comm unicate b etter about serious issues.

I found myself responding to almost anything clientssaid with a question. I made no distinction between seriotisand trivial questions. Any comment frotn one of the pairelicited a question from me. If they told me the traffic washeavy I asked which way they had come, about who drovethe car, whether that person always drove, whether theywere happy with that driv ing arrangement . If they haddropped children at school on the way I asked about thechildren, the school, why they chose that school, whetherthey wanted their children to have the same or differenttype of schooling to thetnselves. If they had been to a tnovieI asked about their favourite films, actors, cinemas.

All these types of quest ions soon had both partnersengaging with me and one another in an open and ani-mated conversation. Sometimes this sort of talk occupied allor most of the session and I lived in trepidation of beingtold . We didn't come here to talk ahout this! Sometimes Iwotild ask whether it was okay to keep talking like this orwhether we should get on with the problem. Almost alwayscouples wanted to keep going the way we were. My measurefor the effectiveness of the session was the degree to whicheach took part in the session and the mood between thepartners at the end of the session. I remembered the follow-ing description of Socrates:

.,, his most curious feature was a habit of approachingAthenians of every class, age and occupation and bluntlyasking them, without worrying whether they would thinkhim eccentric or infuriating, to explain with precision whythey held certain commonsense beliefs and what they tookto be the meaning of life (De Botton, 2000: l 4- t5 ).

B ig Quest ionsAlthough I had wanted to explore whether, by concen-trating on small questions, I could let the big questionslook after themselves, I came to see that something morewas needed.

One's behaviour to a partner is shaped by numerousassumpt ions abou t oneself, the o ther and the world . Iwanted to explore the thinking behind what we do in rela-tionships. I wanted to reshape our conversation from the'I ' to the 'We' and try to develop an increased relationshipconsciousness. I needed some bigger questions to be usedin conjunction with the smaller ones. Smaller questionsremain an excellent circuit breaker and mood lifter and

seemed to allow the couple to approach the bigger ques-t ions wi th much more con f idence in the i r ab i l i ty tocommunicate. Gradually I began to devise questions thatinvited couples to connect with the thinking behind theirthinking and to have a relationship conversation withoutblame and despair.

Quest ion O n e'How did yo u get the courage to talk to a stranger aboutyour relationship?'This question reflects my wish to understand the experienceof the couple seeking help and conveys my respect for thework they are undertaking. Many people have told me oftheir anxiety about approaching counsel l ing with theirpartner and expressed their fear that it will make thingsworse. I do think it takes courage and I see their seekinghelp as an act of trust on their part, eliciting a correspond-ing sense of responsibi l i ty on mine. Unlike individualcounselling, couples work carries the risk that your accountof your feelings and experiences may be challenged and den-igrated by your partner in front of a third person. I put a lotof effort into creating a safety net at the start of the processand often reassure people that I will do my best to helpthem make it better but that I will also act to prevent itgetting worse.

Q u e s t i o n T w o'D o you th ink the problems In th e relationship are mo re todo w it h things inside o r things outside the relationship?'This question addresses my abiding interest in the connec-tion between personal and public life. Most couples seekexplanations for their unhappiness in popular accounts ofhappiness , which frequently bear l i t t le connect ion withlived experience. So at first the question is often answeredby reference to perceived personal faults or immutable dif-fe rences be tween them 'W e have a communicationproblem' and 'We are just such different people' perceptionsthat offer litde encouragement or hope for change.

This question, and variants upon it, open up other waysof thinking abo ut the relationship. For example, How does your work affect your relationship with your

family? When your children have problems, do you feel closer or

further apart as a couple? Does the frightening state of the wo rld conflict impac t on

your relationship? Do tensions in your amilies ofori^n affect your relationship?Close questioning about the social context opens up avenuesthat feel more man^eable and seem potentially more recep-tive to change than fixed definitions of difference. Thisquestion may also elicit stories of a traumatic event, often thedeath of a loved one, that offer ftirther reflections on the painin the relationship, and opportunities for shared and overdue


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Five Useful Questions in Couples Therapygrieving for such a loss can be the most helpful part ofcouples work.

Context questions offer the possibility of locating painmore accurately at its source. We know that in intimaterelationships unresolved feelings from elsewhere are oftenprojected onto one's partner. I sometimes offer the observa-t ion that there 's no point having a partner a nd blamingoneself for feeling unhappy! A partner who speaks of losingfeeling for the other can be asked: Have you lost feelings for anyone or anything else? Has this happened before, and how long did it last? What parts of your life do you have good eelings about? How could you tell if you were depressed or unhappy in your

relationship?In this way a person can be helped to explore not just that ithurts but where it hurts.

Question Three'What do yo u notice about other relationships that is likeor un like your own?'This question invites a curiosity about other relationshipsand offers the couple the chance to identify their relation-ship expectations. Almost all couples I see think that theirrelationship is much worse than others they know, thoughwhen asked how they know, it turns out to be mostly guess-work. We are all curious about other people's relationshipsand reality TV offers the chance to be voyeurs in relation toothers. However, what we see on TV are people who arepretending to live their private lives, but because they do sofor public consumption, the experience is inevitably falsi-fied. The truth , of course, is that the substance of ourbehaviour with our partners remains mostly behind closeddoors and not available to outsiders.

However, where other couples are perceived as beinghappier, questions about why they seem to be happy, andwhat things they do that seem to help their relationship cansharpen the focus on ways of living together that can beenhancing. Couples often notice for example that others arebetter at fighting and making up, and questions around stylesof conflict manag ement explore alternative behaviours.

I sometimes tell stories other couples tell me goodand bad about their relationship, and invite couples tocomment on them. These sorts of conversations broadenour focus on the world of relationships and provide muchneeded input on the scope and nature of o ther peoples 'struggles to be happy together. Almost always, a couple ismuch relieved by these accounts and able to understandtheir own situation in a more comfortable light.

Question Four' If your relationship does improve, which of you will bemore likely to have changed?'I move very lightly and tentatively around the issue ofchange and wan t to p ro tec t my pos i t ion o f ' cu r ious

onlooker' very carefully. We know that holding the middleground is essential in couples work and to respond to pres-sure from one partner to push the other to change can be tolose the ability to move freely in other parts of the conversa-t ion . How ever, I do want to keep the idea of chang esomev/here in the background so that we may be able tonotice it if and when it comes,

I might ask this question with the disclaimer that I amnot encouraging anyone to change but invi t ing both towonder about the possibility of a different experience withone another. Questions about life changes each has beenthrough, and questions about changes in their life togetheroffer the perspective of a relationship as a work in progressand change as inevitable. Out work together can then bechara cterise d as faci l i tat ing a chan ge process tha t hasbecome temporarily stuck and needs moving.

Th e image here is of the thera pis t as the plu mb erunblocking the drains rather than the doctor performingopen-heart surgery! A question that refiects my notion ofchange is: 'Do you think your stuckness is because of who youare or have you just developed some bad habitsV

Question Five'Didyou learn anything in your own family that has helpedor hindered you in this relationship?'I have left this question till last, though many therapists seefamily of origin work as central to understanding currentrelationships. By asking about family history in this way, Iexp lo re the c l i en t ' s percep t ion abou t the connect ionbetween the past and the present. Some clients see earlierfamily life as very influential on present life and some donot. I want to understand the person's own framework ofexplanation and work as far as possible within that. I cer-tainly do not want to spend a long t ime taking familyhistories where this is seen as irrelevant to present concern s.

Another more oblique question about earlier life, 'Areyou trying to be the same sort of parent as your m other/fatherwas to you', invites reflections about who we are and wherewe come from.

Both of these questions about the past are seen as rele-vant to current concerns and seem to elicit less inhibitedconversations than more formal history-taking questions. Aswith all bigger questions, the client's response determinesfurther questions and allows me to present myself as simplycurious about why they think people act as they do, witho utbeing seen to privilege any particular explanation.

C o n c l u s i o nIn developing these questions it has been necessary to elimi-nate other interventions I previously relied on, I gave upmost inquiries about factual information and concentratedon exploring attitudes. I have tried to minimise talk aboutproblems and solutions and pushed couples to think abouthow they think about relationships and family life. Thechal lenge to keep the conversa t ion open and moving


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Michael Maddenforward is a constant one for the couple therapist. Invitationsto follow a trail into dark and depressing problem areas canbe politely sidestepped by a question which opens up analternative pathway, Tomm himself notes how easily we canbe drawn back into a problem focus even when the couplehave moved on.

One of my 'innocent' questions appeared to have stimu-lated the re-emergence of serious marital conflict. Itoccurred during a follow up session in which the couplewere talking about the fact that they had not had any argu-ments for several weeks. In other words, there had been amajor improvement in the marriage. After a lively andenjoyable discussion about these changes I asked 'Whatproblems would you like to talk about today?' Followingthis seemingly innocuous question, the couple graduallydrifted into a bitter argument about which of the two ofthem needed further therapy I privately reconstnjcted theimprovement as 'transient and unstable' and resumed mytreatment of their chronic marital difficulties, I remainedcompletely blind to the fact that I had inadvertently tr ig-gered the deterioration until a colleague pointed it out tome on the videotape. In retrospect the assumption behindthe question ,,, that problems needed to be identifiedand/or clarified before I could act therapeutically ... turnedout to be limiting and pathogenic (Tomm, 1987 :4].

We can now speculate that it may have been more helpfulto this couple to ask some questions about the positive

change they had reported, e.g, what had they done differ-ently to avoid arguments, what does it feel like to stoparguing, and how long they hoped the change would last.

So , questions that seem helpful in couples work have adefining feature: viz, that they open rather than close thescope of the conversation, that they avoid too directly afocus on problems and finally, that they encourage morequestions. My own experience of working with couples inthis way is that the shared experience of investigating couplelife can turn the process into one where original problemsbrought to counsel l ing often dissolve and are in turnreplaced by a more co-operative and curious relationship.

Re fe rencesAlexander, R, 1946, The Corrective Emotional Experience,

In F, Alexander, Thoma s M , F rench et al,. PsychoanalyticTherapy: Principles and A pplications, NY, Ronald,

De Botton, Alain , 2000, The Consolations of Philosophy,Ringwood, Vic, Hamish Ham ilton,T o m m , K , , 1 9 8 7 , I n t e rv e n t i v e In t e rv i e w i n g : P a r t I ,

Strategising as a Fourth Guideline for the Therapist,Family Process, 26 : 3 -13 ,

White, M,, 1989, Introduction, In M, White & D, Epston,Literate Means to Theraputic Ends, Adelaide, Dulwich, M

First T ime in My LifeFirst time in my lifeI ve looked out a window and seen the snow

falling.Falling into my working day I meanFalling into my lifeAs opposed to the times I ve gone looking for itSeen it on the newsGot in the car all rugged upAnd gone searchingLike a small holiday.

This time I'd simply risen and showeredIn the warm house we'd shared togetherAs if everything was normalDriven to the work we'd shared togetherAs if everything was OKAs if everything would go onBeing this way

As opposed to the distance that is now betw een us.I hope the boy you found and lovedStill loves you. I hop e the fire you hadIn your heart still burns for youWhen you want it toNo t when you don't like it didBetween us two. I hopeOne day you may look out the windowAnd see the snow falling and think of meWithout rancour, without bitternessWithout regret. With only the knowledgeOf that cold place we leftAnd the clean snow falling.

L yn d on W al k e rSaturday, Au2:ust 4 , 2001,


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madden 2005 five useful questions in couples therapy

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