This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Relationships After TBI. Dr. Emilie E. Godwin discusses What Couples Counseling is Like from the Therapist's Perspective.

Well, typically it depends on exactly what the couple is coming into counseling for. But the first session will be as sort of get to know you. I will tell the family or the couple my ideas about therapy and counseling and how I think after brain injury can be useful. I’ll ask them what their goals are. If they knew that counseling had been successful what would be different? What would have changed? And we’ll sort of go from there. Often I ask people to tell their story, tell me what about today or now brought them into the office? And then we begin to form a relationship with one another as well.

There are a lot of different things that I think people are intimidated about when it comes to therapy. I think some people worry that they’re going to be laid out on a couch and talking about you know interactions with their mother when they were two. It’s kind of a general idea that a lot of people have.

I think sometimes too it’s frightening people have built up self protection, especially the idea of couple’s counseling for some people if they’re not sharing their feelings with one another, if they are sort of holding onto the frustrations that they have to protect the other person, there’s a fear that those things will come spilling out and they won’t be able to do the damage control that they think they’re doing now. The reality is that people convey a lot more than they think they’re conveying in their relationships anyway.

And I always tell people you know they’re in control of the therapy session, they don’t, no one has to share anything that they don’t want to share. And there’s never going to be a time when they’re told that they have to talk about something that they don’t feel comfortable talking about. So I think that that can be, that can put to rest some fears, sometimes for people. I also think that there is sort of a cultural, there’s a cultural expectation that if we are really strong that we can do this on our own. And unfortunately that’s really probably the opposite path that someone would want to take after a brain injury, the more help, the better.

And, in fact, literature on couples who are resilient after brain injury shows that people who seek help are the people who do the better in the long run. So there’s kind of this juxtaposition between people’s desire to get help and get answers with the idea that if they really were tough then they could figure out these problems by themselves without someone else guiding them.

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