Not since Strom Thurmond’s and Jesse Helms’ departures has the retirement of a reactionary Republican given me such a frisson.
But does marital therapy work? Not nearly as well as it should, researchers say. Two years after ending counseling, studies find, 25 percent of couples are worse off than they were when they started, and after four years, up to 38 percent are divorced.” (New York Times )
I have conflicting thoughts about this news. First, I welcome the continuing trend toward recognizing that the emperor has no clothes in mental health care. I found it big news when research strongly supported the counterintuitive conclusion the critical incident debriefing and other emergency intervention techniques after traumas may not prevent survivors from developing post-traumatic stress. In fact, they may increase the risk. Similarly, we now learn that couples therapy may not save troubled relationships.
But is that evidence it is ineffective? In a great many cases, talking about a couple’s problems frankly may hasten the end of a doomed relationship, which is in my opinion as legitimate a purpose of couples therapy as saving a relationship at all costs. After all, the therapist is not making the decision about whether the marriage lives or dies; s/he is just facilitating the couple getting to what they really want.
We in psychiatry use alot of anticonvulsant drugs for modulation of mood and impulses. I can see it now; they are going to make the same methodological mistakes they have made in concluding that antidepressants exacerbate suicide risk, about which I have written here in detail.