Dr. Allison Lux: Illuminating Effective Couples Therapy
Introduction
Dr. Allison Lux, a private practitioner and adjunct professor based in Monroe, LA, was kind enough to share her perspective as a couple and family therapist with MFT Matters. Dr. Lux approaches couples therapy from an attachment perspective, utilizing emotionally focused therapy as a core model, but integrates other techniques, approaches, and ways of being with clients to suit their needs. Her presentation at the most recent AAMFT Fall conference (2011) on moments of accessibility, responsiveness, and engagement as seen through an EFT lens helped to contextualize how attachment wounds may be observed within couples interactional patterns and how systemic therapists may intervene effectively and ethically.
Included below are excerpts from an audiotaped telephone interview with Dr. Lux conducted on October 1st, 2011.
The Interview
On Dr. Lux’s MFT journey and choosing couples therapy as a specialty:
When Dr. Lux studied psychology in her undergraduate career, she was drawn towards human behavior and the concept of couples and families as relational systems. As she started the Master of Arts program in Marriage and Family Therapy at University of Louisiana at Monroe, Dr. Lux remembers experiencing a combination of exhilaration and wonder at the principles underlying systemic thinking: “Once you change the way you look at the world, you can never go back. You’re forever changed for that experience, and everyone around you will react to that change.”
Dr. Lux gravitated towards couples work during the second year in her master’s program when she realized that she loved both the challenge and satisfaction inherent in working with couples. “(My) interest in the dynamics between intimate partners and human sexuality made couples therapy a really good fit for me,” says Lux. During her practicum experience in the PhD program and through her work with couples in a nonprofit clinic that specialized in sexual abuse, domestic violence, and trauma, Dr. Lux discovered that the very dynamics and challenges that repelled other clinicians attracted her to working with couples. “Couples work was very intimidating for many other therapists; but the clinic knew to call me when they presented for intake. . . I loved the challenge,” remembers Dr. Lux.
What couples therapy models do you use most often when working with couples?
Dr. Lux naturally sees couple (and family) dynamics through an attachment lens. Dr. Sue Johnson’s conceptualization of problem development and change embodied in the Emotionally Focused Couple Therapy (EFT) approach resonated with Dr. Lux because her anecdotal experience with intimate partner conflict and dysfunction so correlated with the theory. In the final analysis, however, she prioritizes client needs over rigid adherence to a specific model. “First, I wait until I meet a client and determine where they are and what they need before locking in on a model. Many times, I utilize a core of emotionally focused therapy, but I’m not afraid to incorporate elements of John Gottman’s work, as well as collaborative language and solution-focused approaches as necessary. Often I’ll ask a client, ‘what has been working’? Sometimes, I’ll give cognitive-behavioral influenced homework.”
What about working with couples do you find most challenging?
“Whenever one or both partners is emotionally disengaged and that can come in many forms. Usually, one person has already moved out or filed for divorce and they’re coming in as a last-ditch effort and one person has probably already ‘checked out’. They are coming in for couples therapy, but really its one partner trying to make sure that the other will be okay without them. My success rate for these kinds of couples is not very good, but I’m careful not to take responsibility for that outcome.” For Dr. Lux, intercession of one form or another is critical before partners enter this point of no return. She urges therapists, even in the context of individual therapy, to advocate for couple’s intervention if early warning signs of disengagement are apparent.
What elements of couple therapy do you find the most rewarding?
Dr. Lux shares, “When a couple comes in and the foundation of their relationship is based on respect and a true friendship, and they’ve built the intimacy and closeness upon it . . . and they may have gone off track little bit, and have stresses, maybe dealing with [life change], but after I’ve worked with them for a few sessions and they come back in and they have that spark in their eyes – and they’re looking at each other, and they’re laughing and they’re holding hands – and to know that I was able to be a part of that journey. That’s rewarding. That pumps me up!”
How do you approach person of the therapist issues when working with couples?
“I have good boundaries. I know that I am with that couple in that session, in the therapy room, in the moment, but once they leave I don’t take responsibility for their actions.” She elaborates, “I can see that if you didn’t do that or to find some way to be able to shut your brain off . . . you could get burned out really easily, especially if you are consistently working with couples who are in a desperate situation. It can be draining. If you’re working with a couple and after a few sessions they decide to get divorced, you have to respect that clients are the experts in their own lives and the therapist should not take responsibility for their decisions.”
What have you found most effective when working with couples?
“Flexibility”- although Dr. Lux is passionate about and competent in emotionally focused therapy, she is quick to emphasize that no two couples are exactly alike. This perspective prompted her to research and become familiar with disparate models and techniques that could be brought to bear for the unique needs of different clients. Dr. Lux advises a balance between competence (expertise with a certain preferred model) and creativity (serving the unique needs of the client with fresh approaches). She encourages student therapists to be their authentic selves in the therapy room and cautions about becoming too married to one particular model.
What advice would you give to couples and family therapy students who are interested in specializing in couple therapy?
In addition to the guidance offered in other responses, Dr. Lux advises students to consider several important things:
- In order to provide the most effective therapy possible and to continue the healthy process of professional growth, Dr. Lux encourages MFT students to consistently read and research about new developments in the field of couple therapy and of MFT in general.
- She urges student therapists to continuously monitor how well therapy is going from both a person of the therapist and client-centered perspective. Is there a strong alliance? Are the clients’ goals being addressed in therapy? Is progress being made? If therapy is not working as well as it could, Lux urges newer therapists/ students to reevaluate and seek objective counsel and/or supervision. Dr. Lux believes that competent therapists are always questioning what is being experienced in therapy and often ask themselves: “The next time I do this, how can I do it better?”
- According to Dr. Lux, it can be difficult for student therapists to accept that when couples consider or contemplate change, it can destabilize things in the short-term. Dr. Lux believes that this is usually normal and healthy and cautions new therapists against getting too quickly derailed by the stress of this kind of conflict. She advises students to stick to the processes and goals established for therapy unless there is new information that renders the established approach or model untenable (such as domestic violence).
- “If I was going to give advice to other therapists, especially students, about couple therapy I would say first make sure that you see both partners in session every chance you get and secondly, you have to be willing to jump into couples interactions when necessary to de-escalate,” states Lux. “Sometimes when couples get loud, new therapists are intimidated, but when you see that pattern you’ve just got to jump in and ‘catch bullets’. I think of two foundational principles to this day: first, one cannot not communicate and second, all behavior makes sense in context. It is important to not get too caught up in couples blaming cycles, rationales, or other content and to remember to prioritize the systemic or process-based interactions.”
- Dr. Lux strongly believes that therapists should be able to talk about sexuality and intimacy calmly, frankly, and objectively when communicating with couples. “If you work with couples, they need to know that you as the therapist are okay talking about it and sometimes you have to open the door for them by asking a question (about intimacy). Clients can sometimes beat around the bush and the therapist’s comfort level and knowledge is often a key factor in their opening up about what may be a crucial issue in their relationship,” Dr. Lux says.
With respect to boundaries:
- Dr. Lux remarks, “It really helped me after a session to go to one of my teammates or a supervisor while I was preparing to write the session notes and process the case with them for a few minutes. Secondly, I think there is real value in writing your session notes immediately after a session, put it in the file and put it away. As a student, it’s hard to say ‘never take your work home with you’; you’re going to. You’re going to think about people; you’re going to worry about some of the (clients) that you worked with that day. As you become more experienced you’ll start to let some of that go.” In addition, Dr. Lux believes that all therapists should make time for relaxation, pleasurable activities, and quality time with loved ones and family. “It energizes you, clears your mind, and gets you ready to get back in the game,” she states.
Are you willing to describe a case where you felt the outcome was highly successful? . . . not as successful? What were the teachable moments in each?
“Last summer, I had a couple that were not living together but had been dating for almost five years. And they were asking, ‘Are we ready to take the next step in our relationship?’ I first saw the woman and she told me that after all these years, they had broken up after talking about changes in the relationship. And she had tried to swallow a bunch of pills and commit suicide. Of course, after helping her become stable over some time, they finally came in together. When they first came in to session as a couple, he was defensive and referred to previous couples therapist as very preachy, always ‘firing questions at us’; he was very defensive and I thought, ‘What did I get myself into?’ After working with them for several months and exploring each of their perspectives . . . they came in one session and I noticed something on her finger. She had this huge engagement ring on! And I said, ‘So what is this?’ They had gone on vacation and he had proposed to her . . . and he had agreed to put his house on the market so they could move in together. They were so in love; and they told me, ‘this is where we were trying to get to but didn’t know how to get there’.”
The teachable moment: “Connect with both partners. Often one partner of a couple will feel like they are being dragged into therapy, and as the therapist, you need to immediately find a way to connect with this person – because if you don’t they’re not coming back. I was listening for what didn’t work with his previous therapy and knew that I needed to do something different, so I put my notepad down and asked him to tell me about his life — tell me what I need to know.” In a later session, the woman (now a wife) communicated how Dr. Lux’ decidedly non-expert stance turned out to be the perfect approach for the couple to start deconstructing the cycles of blame.
Dr. Lux also shared a case where her zeal to help resurrect a couple’s marriage obscured the fact that one of the partners had simply moved on. In this case, the wife (who had experienced considerable trauma as a child) had most recently witnessed her husband’s infidelity and had experienced the heartbreak of a miscarriage. Dr. Lux recalls, “She had these two or three horrible attachment injuries and no matter what her husband promised, she could never really trust him. I remember reaching out to her emotionally, exploring her fragile attachments and I thought that at times she would ‘go there’ with me, but in the end, I always perceived a barrier . . . that could not be crossed.” Dr. Lux believes that, as resilient therapists, we must be willing to accept that the best we have to give may simply not be enough. “Not all marriages and intimate partnerships are destined to bear fruit,” she laments.
Do you incorporate a feminist, multicultural, and/or postmodern lens into couples and family therapy?
“I consider it all systemic – whether you call it postmodern or feminist or culturally bound. It’s all systemic to me in and no matter who I’m working with, I consider all aspects of the system and that includes power, culture, and values. If you’re going to be truly systemic you’re going to have to consider all of these aspects when working with clients,” states Lux.
In the context of you as a professional, is there a question that you’ve always wanted someone to ask, but no one ever has?
“One question deals with how I was able to gain confidence in working with couples. I like to reassure students that it is a process. You’re going to be uncomfortable at first; we all are! Systemic therapy is different – it’s a different way of looking at the world and it takes time to become comfortable working with couples and intimate partner dynamics – be patient and learn from every experience you have with a couple. . . be a noticer and learn about yourself. ‘What works for you? What doesn’t work for you? ‘You may want to use EFT with a couple, but if it’s not working try something different – because if you’re uncomfortable the client is definitely going to pick up on that too. In regards to couples therapy, I think there are two books that every therapist should read – the latest edition of the Clinical Handbook of Couples Therapy and Systemic Sex Therapy. Those two books include the basic essentials of working effectively with couples.
Vitae
Allison C. Lux, Ph.D., L.M.F.T., L.P.C., N.C.C. Director
~ Doctorate of Philosophy (Ph.D.) in Marriage and Family Therapy from the University of Louisiana at Monroe (May 2011)
~ Doctoral dissertation focused on Marriage and Family Therapists’ using PREPARE in premarital counseling
~ Master of Arts (M.A.) in Marriage and Family Therapy (May 2007)
~ Licensed Marriage and Family Therapist (L.M.F.T.)
~ Licensed Professional Counselor (L.P.C.)
~ National Certified Counselor (N.C.C.)
~ Certified facilitator of PREPARE/ ENRICH since 2009
~ AAMFT Clinical Member and supervisor-in-training
~ Member of American Counseling Association, American Association of Sexuality Educators Counselors and Therapists, Louisiana Association of Marriage and Family Therapy, and Louisiana Counseling Association
~ Has provided counseling services at various settings since 2006
~ Has received additional training in premarital counseling, emotionally-focused couple therapy, human sexuality, domestic violence, and sexual assault.
~ Has published articles in peer-reviewed journals in the U.S. and China
~ Presents locally, state-wide, and nationally on various therapy topics
(Reprinted with permission from Lux Counseling [website, 2011])
MFT Matters 