MFT6106-4
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Northcentral University *
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6106
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Communications
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Apr 3, 2024
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docx
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Uploaded by deanadfletcher
Case Study Merryl (35) and George (35) are a married couple that have been together for five years. George initiates the conversation by stating he initially contemplated
therapy because he felt a distance between him and Merryl and hoped to have someone help bring them closer. George stated that six months ago, he tried to bring back the things he did at the beginning of their marriage, like bringing flowers home randomly or surprising his wife with dates. He realized that he had become too busy to do them consistently. However, Merryl would cancel or reschedule their date night due to work. Whenever George would try to be intimate, Merryl would make an excuse for why she could not participate. Merryl agreed that he stopped doing his consistent shows of affection, and when she tried to initiate it in his place, he was then too busy to participate. That led her to an emotional affair with a coworker that had tried to flirt with her before. Where she felt neglected at home, she felt wanted at work. A month ago, George confronted Merryl about a possible affair. When confronted, Merryl admitted to the affair but confessed that there had not been any physical contact. Merryl states that she does feel remorseful about the affair. George admits that he feels betrayed and is unsure of how he feels about Merryl. He often dreams of her flirting with a man that often leads to physical affairs. He remembers that she admitted that it was never physical, but that is what his mind does. George understands that Merryl is remorseful, but the affair has been hard to forgive.
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Systems Theory Attachment bonds are created from the attachment styles of self, created in childhood and the attachment styles of the spouse. They can influence relationship satisfaction, sexual satisfaction, intimacy, communication, conflict resolution styles, commitment, and propensity for domestic violence (Fish et al., 2012). There
are four attachment styles: secure, preoccupied, dismissing, and fearful. Those with secure attachment styles rarely participate in acts of infidelity as they are low
in anxiety and avoidance attachment styles. Those with preoccupied attachment styles have high anxiety and low avoidance. Dismissing individuals have low anxiety and high avoidance. Those who are fearful have high levels of both anxiety and avoidance. Those who have high levels of attachment anxiety are more likely to participate in forms of infidelity (Fish et al.,2012). Merryl reported that the affair began sometime after she attempted to be intimate with George when she saw that work took more of his time. When George does not show his appreciation for it or welcome it, Merryl feels abandoned and begins an emotional affair with a coworker. Although she knows it is wrong, she feels appreciated, which helps her self-esteem. Fish et al. (2012) define infidelity as an act that breaks the agreement of sexual monogamy between two individuals who are either dating, married or in a committed relationship. The four main types of infidelity are physical infidelity, emotional infidelity, combined affairs, and cyber-infidelity. Physical infidelity, or sexual affairs, is the most common type of affair that occurs when sexual acts occur outside of the monogamous relationship. Emotional infidelity occurs when a partner gives their love, time, and attention to someone outside of the relationship (Fish et al., 2012; Makinen & Ediger,2011). Fish et al. (2012) mention combined
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affairs as the greatest threat to marriage as it combines physical and emotional attachment. Cyber-infidelity occurs when a partner uses the internet to cross the boundaries of their monogamous relationship (Makinen & Ediger, 2011). When infidelity occurs in a relationship, in emotionally focused couples therapy (EFT), it is looked at as an attachment injury. Makinen & Ediger (2011) define an attachment injury as a perceived abandonment, betrayal, or breach in trust during extreme vulnerability or intense need for support expected of attachment figures. It is considered an intense trauma, calling the entire relationship into question as it is a violation of trust and must be dealt with for the relationship to thrive (Schade & Sandberg, 2012). With this trauma, the violated spouse often feels intense emotions that resemble Post-Traumatic Stress Disorder (PTSD) symptoms. The injured partner may often report having vivid images or nightmares of the affair, and when awake, they may dwell on the memory and distress of the affair (Makinen & Ediger, 2011). George reported that he had had nightmares of Merryl moving forward with her admitted flirtations. He also stated that he felt betrayed by Merryl’s actions. George presents with some PTSD symptoms.
In this case, George and Merryl want to stay together. To repair the attachment bond, the couple must work toward forgiveness by gradually healing the attachment injury. Emotionally Focused Therapy (EFT) has been known to be an effective therapeutic process when dealing with affairs, and couples have reported improvement in marital satisfaction and forgiveness (Schade & Sandberg,
2012). Using the Attachment Injury Resolution Model as a healing process, George
and Merryl can establish a greater sense of control established by the early steps. The later steps in the recovery process focus on gradually fostering emotional
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openness in marriage and rebuilding trust (Bird et al., 2007). Makinen and Ediger (2011) state that the process of change occurs in three stages: 1) de-escalation of the negative cycle, 2) restructuring of the emotions, and 3) consolidation. Bird et al. (2007) summarize the model’s steps. Falling in the first stage of de-escalation: (1) self-awareness, (2) increased emotional expression, (3) other awareness, (4) softening of emotions. In the second stage of the change process, the model focuses on (5) giving up blame and accepting responsibility and (6) establishing accountability. Finally, in the last stage of the change process, the model works towards (7) restoring trust. With the proper motivation, Merryl and George can begin the gradual process of forgiveness, learning from their mistakes, and moving
forward (Abrahamson et al., 2011).
Goals for Therapy
In stage 1 of therapy, the goal is to place infidelity in the context of the negative cycle (Makinen & Ediger, 2011). First, George must recognize and acknowledge the hurt he feels from Merryl’s betrayal and learn how to express his thoughts and feelings to Merryl. Next, George will learn to gain an awareness of Merryl’s perspectives, thoughts, and feelings. In the final process of this stage, George will learn to soften his anger and hostility toward Merryl. In reverse, Merryl will learn to recognize the pain and neglect she felt from her perceived neglect and how to express her feelings when she feels ignored or neglected. Merryl will gain awareness of George’s perspective, thoughts, and feelings, then learn to soften her anger and hostility toward George. When restructuring emotions as a part of stage 2, George and Merryl will learn to decrease blaming each other and accept responsibility for their actions.
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As a result of this, they will both learn to be accountable to themselves as a final step of stage 2. In stage 3, restoring trust will come over time with gradual changes that show each other they are committed to each other. As emotions of guilt and betrayal begin to wane, forgiveness will come over time (Bird et al., 2007).
Treatment Plan When treating Merryl and George, we start by building a therapeutic relationship by encouraging them both that I am qualified to help them. Letting them know that therapy is a process that can take time and effort. After reviewing my qualifications, we will discuss their goals for these sessions. Although they may want individual sessions, they will know that sessions will be as couples, and there will be a “no secrets” policy that allows transparency with each session. We will go
over the realistic expectations for therapy. This includes reiterating that forgiveness and rebuilding trust takes time and effort but encouraging me to be there every step to guide them through it. The next step for me would be to normalize the behavior that has occurred. They both need to know that these actions happen often in relationships. Taking the step to come to therapy proves they are ready to recommit to each other. Once we have come to a place of comfort, we may begin working towards each goal. Termination of Treatment.
With each step completed, George and Merryl will be closer to forgiveness. Forgiveness may not be attained while continuing therapy, but with the motivation to repair and continue to hope, they can recover a
version of what they once had. Termination will come when George and Merryl can
both express their feelings in a neutral manner, accepting how one another feels
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and holding themselves accountable instead of each other. The completion of forgiveness may not be by termination of treatment, but they will have the tools to continue working toward it. Reflections. In conclusion, with the three stages used in EFT, George and Merryl may continue to work toward complete forgiveness. With the new dynamic, they may not be exactly as they were before the affair, but they can be a better version of themselves.
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References Abrahamson, I., Hussain, R., Khan, A., & Schofield, M. J. (2011). What helps couples rebuild their relationship after infidelity? Journal of Family Issues
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(11), 1494–1519. https://doi.org/10.1177/0192513x11424257 Bird, M. H., Butler, M. H., & Fife, S. T. (2007). The process of couple healing following infidelity: a qualitative study. Journal of Couple & Relationship Therapy
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(4), 1–25. https://doi.org/10.1300/j398v06n04_01 Fish, J. N., Pavkov, T. W., Wetchler, J. L., & Bercik, J. (2012). Characteristics of those who participate in infidelity: The role of adult attachment and differentiation in extradyadic experiences. The American Journal of Family Therapy
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(3), 214–229. https://doi.org/10.1080/01926187.2011.601192 Makinen, J. A., & Ediger, L. (2011). Rebuilding Bonds after the traumatic impact of
infidelity. In J. L. Furrow, S. M. Johnson, B. A Bradley (Eds), The emotionally focused casebook: New directions in treating couples
(pp. 247–268). New York, NY: Routledge. Schade, L. C., & Sandberg, J. G. (2012). Healing the attachment injury of marital infidelity using emotionally focused couples therapy: A case illustration. The American Journal of Family Therapy
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(5), 434–444. https://doi.org/10.1080/01926187.2011.631374