Sexual issues within a couple who have become parents

Love is “a chance, transformed into destiny by a continuous choice” according to Paul Ricoeur.

Couples who decide to have children face new challenges, and it can be difficult to maintain a romantic relationship while learning to become parents. This explains the increase in requests for couples therapy in recent years.

This type of therapy is a difficult task because partners are often ambivalent about their commitment to the couple, especially if they have suffered for a long time before consulting. 

The systemic and strategic approach makes it possible to address a variety of relational issues, such as communication difficulties, interpersonal conflicts, sexual problems and challenges related to parenting. It has therefore helped to revolutionize family therapy and couples therapy.

How can the practitioner put this therapeutic approach at the service of the system?

Who to meet for systemic couples therapy?

Family therapy was born in the fifties/sixties at a time when systemics made it possible to focus no longer on the intrapsychic exploration of problems but on the way in which they are part of a systemic dynamic and on how to transform them. at the interactional level. At that time, the method was based on the belief that all members of a system, whether the family, parents and children, or the couple, had to be met at the same time (Anger, 2011).

According to Bowen (1976), couple therapy involves understanding the individual both horizontally (the dimension of the couple) and vertically (the development of the family). His theory, called General System Theory or Bowen System Theory, is a strong contribution to the intergenerational family therapy movement, but comes in opposition to the Palo Alto MRI System Theory, because it affirms the importance of including the entirety of the family of origin in the therapeutic process and even advises to receive all living members of the couple's family, in order to observe their emotional interactions.

According to systems theory, a change affecting one member of the system affects the entire system. (Weakland, 1983). Acting on one of the members of the system already makes it possible to disrupt negative communication loops and seek a new, more functional balance. In this sense, a systemic analysis of the problem and individual therapy could act indirectly on the couple system, if one of the elements of this system implemented strategies allowing it to change its behavior and its way of thinking. Thus, we speak of indirect therapy whenever the recipient of the intervention is not the person who presents for consultation at the therapist's office (Piquet, 2022).

One of the spouses (the most motivated) can therefore consult for the benefit of the recipient of the intervention, sometimes suffering: their spouse or their couple. Indirect therapy which serves to change the relationship by first changing the client's behavior can have a positive effect on the couple by changing the other's behavior in response, retroactively. (Servais, 2022)

In fact, according to Bradley (2008), it was observed that until the 1970s, couple therapy for two people was rarely practiced. There was a sort of social denial of marital problems, following the old saying that dirty laundry is washed in the family. Then, the more common recourse to divorce and the secularization of societies (the priest no longer being the only person capable of helping) encouraged couples to consult together. Previously, the most motivated partner generally took the initiative for an individual journey. However, although society has become more accepting of psychotherapy and the offer of couples therapy has expanded, still

today, when faced with a couple problem, we still very often resort to individual therapy, possibly bilateral.

Very categorically, Sauzède-Lagarde (2019) recommends an inflexible framework in which couple therapy cannot be done indirectly, it is unacceptable to meet the spouses separately at the risk of creating subsystems whose secrets would create boundaries and bias an already delicate alliance. Likewise, "following work as a couple, proposing too quickly to one of the partners to extend the work in individual therapy could risk designating this person as the person responsible or even directly as being the couple's problem: "this He is the problem, take him to therapy!” This would be a regrettable choice exonerating the couple and the other partner from all responsibility” (Sauzède-Lagarde, 2019, p31).

According to Neuburger (2019, p12), “the difference between the couple and the family is considerable: a family essentially relies to exist on the transmission of a difference while the couple is the invention of a difference. The couple is not transmitted and is not intended to transmit. It is the smallest of all institutions which is self-constructed, which is born and dies in a limited space of time, while it is very difficult to locate the beginnings of a family. » When we meet a family, our client is unique whereas in a couple, our client is double (Neuburger, 2019). For Neuburger (LACT N3 course), couples therapy through the support of only one of the two spouses is certainly possible, if we have no choice, but his experience leads him to conclude that it is a very limited process which could at best serve to slow down a separation already underway. According to him, it is possible to become aware of the two visions of the world in a couple's session and to see them confront or come together by observing the relational dynamics. It is therefore not necessary to see them separately.

There is therefore no consensus and I cannot resist quoting the humor of Erickson (Haley, 1985, p32) who responds to a client wishing to meet him alone before the session with her husband: “Yes, certainly, I I’ll see it alone, first, but leave it to me and don’t say anything about it before the session.” In the waiting room, he'll say, "I can see either of you alone to start." It's my way of working. You agree, I suppose. Come on, ladies first! ". Obviously, if the gentleman had requested this interview, Erickson would have said “Come sir, I will leave the last word to your wife”.

The identity of the couple: relationship and belonging

According to Neuburger (2019), love represents the founding myth of the couple. “The love of the couple itself as an institution, as a whole containing two elements. The couple therefore teaches us the “two” in the set sense of the term: to be a couple is to be in love with the “two” (Neuburger, 2003, p.174). There are two loves: relational love, love for each other and love for the small institution that is the 'couple-house', which they create together and represents their commitment. Neuburger defines identity

as the emerging quality of our relationships and belongings. Overall, this is a major identity support, especially when it comes to each person's gender identity. The feeling of being recognized as a man or a woman is the main source of one's sense of existence and ensures one's mental health. “We expect love to make us feel like a man or a woman thanks to its gaze, thanks to its attitudes, thanks to its desire, and not only from a sexual activity that can be experienced as purely mechanical” Neuburger, 2008). The result of this observation is that when one of the partners no longer feels considered as a man or a woman, a breakup or depression is not far away.

“Some couples in fact value the sexual relationship to the detriment of the dimension of belonging.

The opposite is more common, which sees the mutual aid relationship supplanting the sexual relationship, creating another form of imbalance. This situation is most often linked to the fact that the couple has decided to create a family”

(Neuburger, 2019, p147).

Co-parenting and couple dynamics

A “parent couple” is considered to be united by two types of bonds: a marital bond and a co-parental bond (McHale & Irace, 2011). The marital bond refers, among other things, to the dimensions of affection, intimacy, sexuality or even the marital satisfaction of the partners, while the co-parental bond reflects the fact that the partners share the responsibility of educating and taking care of their children. children. The study of the co-parental bond, which resists separation and divorce while the marital bond dissolves in almost one case out of

two, has taken on more and more importance in recent decades in research on the family.

According to Minuchin (1974), individual, couple, siblings are subsystems defined by generation, sex, interest or the nature of the tasks to be performed. These subsystems are temporary in nature and are built on a common project and temporary alliances. The concept of co-parenting otherwise known as the “parental executive subsystem” describes the function of parents to coordinate in the care and education of their children.

Parental responsibility that is not shared equitably can manifest itself in different ways, including an unequal distribution of tasks related to child rearing, care and household management. When one partner takes on a disproportionate share of parenting responsibilities, it can lead to feelings of unfairness, resentment, and overwhelm in that partner, while the other partner may feel less invested in the parenting role and lose a sense of responsibility. 'membership.

Thus, couples sometimes come without a relationship problem but present a co-parenting problem that affects their relationship. “A couple can love each other and not have the same point of view on the educational principles of children. Moreover, what determined two individuals to become a couple is rarely the fact of having the same point of view on the education of children. » (Neuburger, 2019, p98). However, parents must stand together and agree on an educational model, probably renouncing a part of individual convictions or respective family traditions. Sometimes this effort is complex and becomes a source of dissatisfaction or even conflicts which can go so far as to damage the desire of the other and the sexuality of couples.

In this case, he recommends taking inspiration from the 'happiness of the divorced' and exercising educational power alternately rather than always together. The couple can thus decide that, for a week, all decisions will be made by only one of the two parents with the formal prohibition of criticizing the decision of the other.

Along the same lines, research by Belsky et al. (1985) reveal that a satisfactory couple relationship represents the most important factor for competent parenting behavior. Conversely, an unsatisfactory or conflicting marital relationship has a negative influence on parents' ability to care for their children.

In his book Family Conflicts, Nardone (2018), explains that families are positioned on a continuum of emotional deprivation/overprotection. He thus describes six patterns of family interactions (overprotective, democratic-permissive, altruistic, random, delegatory, authoritarian). Each pattern has its priorities and differences regarding the mode of communication, the nature of relationships, the rules of operation, the actions and the consequences of these actions. He also observes that the majority of relational conflicts that his team deals with at the CTS are linked to the difficulty of parents in positioning themselves in front of their children as adults holding any authority. By wanting a child, by making it an absolute priority in the desire to be “good parents”, they end up putting their life as a couple second, sometimes opening the door to their bedroom to child who then destabilizes the intimacy of the couple. Couples don't wear out, they neglect each other

(Neuburger, Lact 2023).

Marital satisfaction

Quebec sociologist Lucy Roy (2014, p5) explains that “if at a certain time, the man and woman who formed the couple had no more importance than the families they united, today the decision to form a couple only relates to emotional, individual, personal, conditional interests, based on performance, choices and “individualizing” rights. [...] The “We” has given way to the power of a hyper-emotional “I”. [...] Couples have become 'fragile' and 'ephemeral'. If this notion of performance actually makes individuals increasingly demanding, even intransigent, about what they can 'get out of the couple', then we can understand why marital satisfaction becomes a central contemporary aspect in couple therapy. It is all the more important to work with systemic therapy on the relationship and interactional dynamics rather than on people (so as not to do more of what people already do).

Influenced by studies on communication (Bateson, Jackson, Haley and Weakland, 1956) and by general systems theory (Bertalanffy, 1967), work on marital satisfaction has also gradually focused on interactions between spouses and not. more about their respective personalities.

The Marital Adjustment Test (MAT) by Locke and Wallace (1959) and the Dyadic Adjustment Scale (DAS) 2 by Spanier (1976) are the two most widespread and recognized tests for assessing marital satisfaction.

John Gottman, American psychologist, is recognized as one of the greatest specialists in couples. Honorary professor at the University of Washington, co-founder of the “Gottman Relationship Institute”, he is today a reference on the subject of marital satisfaction. In the 1970s, couples were welcomed into his Lov Lab. Thanks to his observations and measurements, Gottman claims to be able to predict a couple's marital future by 91%, after watching five minutes of interactions between spouses.

According to Gottman and Levenson (2000), satisfied and dissatisfied couples differ above all in their way of handling negative emotions, of managing conflicts and especially the way of getting out of these conflicts.

Men's marital satisfaction manifests itself in connection with tenderness. The decline in marital satisfaction in the year following birth is primarily linked to differences concerning sexuality and physical tenderness.

Sexuality in the couple

Sexual satisfaction appears to be an emerging quality of the couple, a form of expression of the relationship influenced by the overall quality of communication and intimacy in the couple. Sexual satisfaction can be an indicator of marital satisfaction and a predictor of marital longevity.

Bozon (1998), a specialist in the sociology of sexuality and the couple, expresses that “In contemporary societies, a marital relationship is not conceivable without sexual activity between the spouses” (Bozon, 1998, p.175). Dissociated from procreation, individualized, it has become a central element in the construction of the marital relationship. More and more, our society is moving towards an ideal of reciprocity and greater consideration of female desire. However, Michel Bozon affirms that "representations of sexuality are marked by a divide which continues to oppose a feminine sexuality thought primarily in the register of affectivity, relationships, procreation and conjugality, to a sexuality masculine thought mainly in the register of natural needs, individual desire, pleasure” (Bozon 1998, p72).

Bozon notes that an unequal distribution of power in couple dynamics can contribute to problems with intimacy and satisfaction. Sexual practices can even become a currency of exchange in the name of a “fair market” and no longer be part of a “cycle of gift”. Neuburger (2019) speaks of retaliation or sexual strikes, where one of the partners may decide that sexual intercourse is a reward and no longer a natural component of the couple. After several years of married life, there is generally a decrease in the intensity of sexual activity (Bozon, 1998), then a stabilization (lower frequency of activity, reduction in desire, etc.). This is due to a change in the function of a couple's sexual relationship that has lasted for several years; the latter seeks, in fact, a time of shared intimacy, which goes beyond physical pleasure and a sort of routine of sexual relations that the partners adopt.

John Gottman (2000) states that the primary reason for couples who come to consult him is sexuality, or its absence. Among his explanations:

• Feedback loops are created between sexual satisfaction and overall marital satisfaction.
• Certain external factors, such as financial, work or family stress, can influence sexual satisfaction by affecting the emotional and physical availability of partners.
• Certain modes of communication and negative behaviors (criticism, contempt, attentive defensiveness, evasion) damage tenderness and mutual esteem. Unexpressed or misinterpreted expectations about each person's desires can create obstacles to sexual satisfaction.
• According to Gottman (2000), it is therefore a question of welcoming attempts at rapprochement and agreeing to let oneself be influenced by the other. Open communication and negotiation can ensure that the needs and desires of each partner are taken into account.

Sexual satisfaction is not enough for a couple's marital satisfaction, but when it is present in the relationship, it would strengthen positive feelings and the relationship itself (Neuburger, 2015). According to him, the lack of desire in the couple can be symptomatic either of an interpersonal relationship problem or of a problem of the relationship of belonging to the couple.

How to approach secrets in couples therapy

Although Neuburger (2019) does not recommend individual meetings, he acknowledges that sometimes we can organize an individual session when we feel that one of the two is not really engaged in the therapy or seems to be playing a double game (withdrawal). is sometimes symptomatic, or the inability to project oneself into an objective). He then recommends proposing to the spouses to meet them separately. In order to manage possible secrets, he will state “what you say cannot be considered a secret and I reserve the right to use or not this information in a future session”.

Also, Neuberger (Lact 2023) told us that when he held a secret, he did not reveal it directly at the risk of creating resistance and damaging the alliance. In research, he allows himself to question the consequences of the spouses' actions and to use alternative choice questioning to suggest possibilities not previously considered. He could ask for example: What do you think of a couple who no longer have sex when one of them feels the desire and the other refuses any intimacy?

lasting or does it lead to an inexorable temptation to be unfaithful?

When Haley (1985, p31) asked Erickson: "If you have a family over and you see one person separately, then another, then everyone, how do you deal with the issue of confidential information, secrets between a family member and you?

Mr. Erickson replied: “I am very hypocritical in this area. I explain, with great care, to my patient that our interview is strictly confidential. I am bound by professional secrecy for all my interviews. I'm definitely not going to tell your partner what you're telling me. For me, all this is confidential.

I don't know what you're going to do. But whatever you do, it will be good. You can use this information as you wish. And, believe me, I will say the same thing to your spouse about their own secrets. This creates a terrible pressure and I also put them in a rivalry, a competition which pushes them to make everything go well. I give them permission to do what is necessary by assuring them that everything will be okay. »

The secret of one of the spouses, shared with the therapist, is part of the scope of therapy. When one of the partners in couple therapy shares a confidential secret with the therapist, this secret becomes an element of the therapeutic dynamic because it demarcates a new boundary, it creates a subsystem of which the therapist is aware. One way or another it will be necessary to integrate it into the therapy process. Secrecy can serve as a starting point for broader discussions about communication, trust, and deeper issues within the couple. The therapist will not be able to reveal the content of the secret but will inform of the existence of a secret and question its function.

Between neutrality and resonance: the curiosity of the therapist

For Bowen (1978), the therapist must work on himself, so as not to find himself overwhelmed by his own affects; he will therefore have to work on his own problems of self-differentiation, anxiety and triangulation. The formation of relational triangles in which therapists participate constitutes an essential element of therapy. The therapist must be aware of the fact that he is being used by the family, and take a step back from this phenomenon. Bowen speaks of detriangulation to express the therapist's control over his or her own participation in the emotional process.

Sauzede (2019, p22) warns about the introspection that the therapist must carry out: “it is essential to develop the clinical posture with a couple, that the therapist questions himself with regard to his history, his parental couple, and couples that could have been constructed or deconstructed over the course of his life.”

According to Neuburger (2019), the neutrality of the therapist does not mean objectivity, the therapist will have opinions and feelings regarding what happens in the session and must be able to exploit them in session and in supervision. The therapist will, however, ensure that these are not normative judgments which could find their origin in a supposedly irrefutable logical level, that of morality.

Gregory Bateson calls the therapist a “participant observer.” He can only identify in the presence of the couple what is significant about him. Neuburger (2019) also advises leaving the role of simple observer and being attentive to the interaction, namely what is happening between him and the couple he meets, with whom he creates a system. So he does not look through the keyhole but becomes an actor and part of the world. He is responsible for his perceptions and can open the field to curiosity.

And according to M. Elkaïm (2002, p35), “when the therapist encounters a system, he is dealing with the formidable capacity of this system to emotionally infect those who approach it, to integrate it into its own mode of functioning. Is this an obstacle, the therapist then having to try to purify himself in order to remain neutral? Or on the contrary, we cannot assume that the system cannot be modified independently of the type of emotional resonance that it arouses in the therapist. It is therefore important that the therapist be on the lookout for this emotional resonance to see action on the system, from within. Ex: If the therapist feels irritation, he can ask himself the question: "What is the use for my client that I am irritated?" What is its function for him? Why does he want to irritate me? What is the function of my experience in relation to them? Why do I feel these feelings, precisely in this specific context? ". It is about establishing an inner dialogue for the therapist and from this dialogue enriching the

dialogue with the patient.

The game of alliances

Haley (1985) addresses the issue of alliances and coalitions within couples. It explores how couples can form rigid alliances against the problems or against the therapist and how a therapist can play with these alliances to promote constructive change. Interviewed by Haley, Erickson states that the therapist must master his position and juggle between a high position when he fixes his frame and an emphatic low position encouraging the couple to express themselves and feel heard, which will create the alliance. But he can also voluntarily provoke the couple's coalition against him, causing withdrawal or confrontation (Safran and Muran, 2000). This rebellion against the therapist could stimulate an energy conducive to change by making the couple experience a couple alliance sometimes lost for a long time.

In couples therapy, the therapeutic alliance is delicate since it must already take into account a pre-existing alliance, that of the couple. This dynamic can easily include the presence of the therapist or, on the contrary, reject it. The construction of the therapeutic alliance with the couple is also achieved through a collaborative relationship with each member of the couple, especially when the therapist opts for an alternation of individual and collective meetings. The therapist will therefore take care to take into account the expectations and objectives of each person, without giving the impression of favoring one of the spouses or taking sides.

Working with couples and families involves building an alliance not only with several people, but also with the couple or family entity, which presents itself as a system in difficulty. (Minuchin, 1979). During the session, the therapist must master his verbal and non-verbal, direct and non-direct, analog and digital communication, in order to be as synchronic as possible with his clients and also remain very attentive to his bodily sensations (this that he sees, hears and feels) which would allow him to sense the connections or separations of his clients.

The end-of-session evaluation questionnaire for strategic brief therapy is an excellent tool to be able to adjust in the event of deviation.

Training in brief systemic and strategic therapy 

LACT offers several live certified web training courses with 50 international trainers:

• Generalist systemic training
• DU relationship clinic with the University of Paris 8
• Clinical Master of Giorgio Nardone LACT/CTS
• Systemic Coach Training

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