English, some Spanish, some French
Saturdays, weekday evenings and daytimes
I am not on any insurance panels, but most major insurance companies have been willing to reimburse clients for a significant portion of my fees. I ask clients to pay me by check or cash at each session, and I provide billing statments for reimbursment submission.
I am happy for clients to choose where they belong financially in my sliding scale, between $150 and $120 per hour.
I am a Licensed Independent Clinical Social Worker, (Washington License Number LW60080832, and California License Number LC9324). I currently teach as an Adjunct Faculty Member of the California Institute of Integral Studies, and maintain a private psychotherapy practice in both Washington and California. A copy of my resume may be seen on my website, thirdwavebehavioral.com.
I began doing clinical work as an undergraduate at Yale University, and since then I‘ve worked with couples, families and individual clients for 39 years. For the past 20 years I have trained and supervised Marriage and Family Therapist Interns as Clinical Director of Clement Street Counseling Center (8 years) and New Perspectives Center for Counseling (12 years), while maintaining a private practice on the side. During these years I’ve trained 160 therapists for at least a year each and supervised their work with nearly two thousand clients.
In teaching a weekly didactic seminar on clinical topics all these years, I discovered the truth of the saying that the best way to learn a subject is to teach it. My students have challenged me to be clear in the way I think and speak about doing therapy, skillful in the way that I demonstrate therapeutic interventions, and up to date with the most effective new treatment technologies. The diversity of the thousands of clients we’ve discussed and hearing about the effect of the interventions we’ve devised has informed my understanding of the human predicament and how to transform it in a caring and efficient manner.
In October 2005 I left the Clinical Directorship at New Perspectives (though I continue to do some teaching and supervision there), in order to concentrate on my private practice. I began teaching a class on DBT at the California Institute of Integral Studies in 2007, and began working on a transition to the Seattle in 2008, after falling in love with my wife, Kathy Cruze, who is also a therapist (we married in 2010).
When people ask me how I work with couples I usually start by saying that my first principle is flexibility of approach. In 38 years of doing and teaching psychotherapy I’ve studied and taught a great variety of clinical methodologies, and many different theoretical points of view and techniques find expression in my client sessions in response to the needs of the moment. I’m comfortable with a wide range of issues, from sexuality to spirituality, communication problems to severe emotional disturbance, parenting issues to substance abuse and infidelity.
After hearing about the goals that each member of the couple bring to the first session, and getting to know a bit about the strengths of the relationship as well as its difficulties, I’ve almost always been able to tell a couple at the end of the first session how I would basically recommend we proceed. How the work unfolds over time will depend on what emerges as it becomes safe for each member of the couple to express more about what they’ve been thinking, feeling and doing – my therapeutic approach will then respond to what seems most helpful.
For the past several years I almost always begin in a treatment frame based upon the work of John and Julie Gottman. I usually suggest that clients purchase two copies of “The Seven Principles for Making Marriage Work” (New York: Three Rivers Press, 1999) after our first session and use it as a workbook while we proceed through the therapy. To support and deepen the Gottman techniques I frequently bring in material about DBT Emotional Regulation and Interpersonal Effectiveness Skills. I almost always spend some time in the first session pointing out the inevitability of the way that a couple’s problems have evolved and circled around on themselves – it really couldn’t be otherwise than that they have the difficulties they do. This is a point of view that comes from family systems, object relations family therapy, behavioral and transpersonal models.
It’s because the Gottman approach provides the initial framework of therapy, and because I utilize most of his techniques somewhere in the therapy, that I am referring to my work as Gottman Couples Therapy. To avoid possible confusion in using this name, I need to let you at this point that I am not yet a “Certified Gottman Therapist”, though I am now in the pipeline to become one. I have been using Gottman techniques for twelve years, completed the five-day Advanced Study course in 2006, and have taught the techniques to my psychotherapy interns on a regular basis for the past six years. I completed the 4 day Live Workshop in 2010 that begins the Certification Practicum, and am now in the consultation and video review process required to become a “Certified Gottman Therapist”.
Moving beyond blame and defensiveness is essential to the creation of a therapeutic environment in which members of a couple can safely experiment with new ways of relating to each other. It is the task of the therapist to support this safety by moderating conflict in the early stages of therapy, and in focusing attention on the positive intentions of each member of the couple.
One of my favorite stories on this theme comes from the 18th century Hasidic masters, in which a married couple has come for counseling with a Rabbi in his home. The wife complains bitterly about the way that her husband has let her down, and at the end of her tirade the Rabbi says, “You’re right!” Then it’s the husband’s turn, and he is equally blaming about how his wife has not given him what he needs. Once again, the Rabbi listens carefully and then says, “You’re right!” At this point, the Rabbi’s own wife comes into the parlor, having overheard all this from the kitchen. She points out to the Rabbi that the couple has vehemently and directly disagreed with one another, and that he has told each of them that they are right. She tells him, “They can’t both be right!” The Rabbi looks at her and says, “You know, dear, you’re right!”
It is the therapist’s job to support what is right about each person’s point of view at a time when it is too difficult for the partner to see this. Gradually, the therapist helps members of the couple to see the positives more clearly and express them in a more effective way.
In the wake of an affair
There are few events in the life of a couple more catastrophic than the revelation of an extramarital affair by one of the partners. Surviving and healing from this predicament is a daunting task – most couples need therapeutic assistance, and even with this support the process is painful and uncertain in outcome.
What goes on within relationships where affairs happen is complex and variable, but most of the time the relationship itself has been troubled long before the affair. Sometimes part of that trouble is that one of the partners is not aware of how damaged the relationship has become in the eyes of the other. It is easy for people to slide into ways of being with each other that are unsatisfying and destroy the connection between them. Once that happens, it can become even easier for a partner to find someone else who appears to offer what is missing in the marriage.
When an affair becomes known, the sense of betrayal that is experienced by the partner who was cheated on is usually overwhelming and catastrophic, and must be validated and addressed at the very beginning of therapy. At the same time, the therapist must also bring compassionate understanding to the factors and process by which the person who cheated came to enact that betrayal. In this way we begin to explore whether and how the couple may heal their relationship and perhaps become happy together.
How the Gottman approach helps
In the past few years I have been working with a large number of couples in this difficult circumstance, and have found John Gottman’s book, Making Love Last, an extraordinarily useful addition to the materials and interventions that are part of the Gottman method. It is the book that I ask both members of my couples to read when there has been an affair, as it provides a sense of the general structure of how our work will proceed, as well as specific interventions along the way. It even has a checklist procedure to help betrayed partners evaluate whether to give the betrayer a second chance by working on the relationship.
At a large structural scale, the work of healing is likely to move through stages Gottman calls “Atonement, Attunement, and Attachment”. As much as couples -- particularly the betraying partner -- would like to know how long these stages last, there is no way to know ahead of time.
In the Atonement stage, Gottman says, “Rebuilding cannot begin without the cheater’s continual expression of remorse, even in the face of the partner’s profound skepticism. Throughout this phase, the betrayer must remain patient and nondefensive.” This is difficult to do without therapeutic support, because the betrayed partner is so hurt and angry that the betrayer inevitably responds with a great deal of defensiveness. Containing this emotionality in a reasonably safe environment is essential to the healing process.
Gottman describes one of the many paradoxes that apply to this situation: even as we know that affairs take place within the context of troubled relationships, “Atonement cannot occur if the cheater insists that the victim take partial blame for the affair…. If a partner strayed in the midst of difficult circumstances, it may seem unfair for him or her to take all of the blame. But he or she must. Healing requires that the cheater listen to and understand the other’s pain”. It is only this kind of responsibility-taking that demonstrates sufficient desire to heal the damage caused by the betrayer’s actions.
On the other hand, Gottman says that in order for there to be a chance for the relationship, “the betrayed partner needs to work at not shutting the door on forgiveness. If he or she gets stuck in a position of inconsolable hurt and anger, the couple will not be able to resolve conflicts. The wounded partner must agree to cooperate as long as the betrayer is making the same effort.”
In the Atonement phase, there are a number of sub-tasks that must be carried out within the safety of the therapy office. (This safety is created by the therapist’s ability to understand what each partner is going through, even when the other partner cannot.) These sub-tasks include confessions about the lover, how the affair began, and how it was carried out – over time, all of the betrayed partner’s many questions must be answered, with the exception of sexual details.
The betrayer must make ongoing behavior changes to provide greater transparency and verification of his or her commitment to be faithful in the future. There are discussions to explore and understand the details of what went wrong in the marriage, and about the cheater’s reasons for returning to work on the marriage. There is an agreement that “any future infidelity will mean the permanent end of the relationship.” The last subtask of the phase is that the injured partner “begins to forgive”, meaning that “the deceived partner is willing to cooperate and trust, even in the face of uncertainty” and inevitable triggering of memories about the affair that occur in the ongoing life of the couple.
Although it is unpredictable how long these Atonement tasks will take to accomplish, I have usually seen couples gradually progress into phase two, “Attunement”. “After the couple emerge from the atonement stage with tentative forgiveness, they come together to build a new relationship. First, they acknowledge that the old one didn’t meet both of their needs. The victim should not be blamed for this past deficiency, but he or she must cooperate in constructing a new approach.” The communication techniques and therapeutic interventions brought into this sub-phase resemble the ones that Gottman therapists utilize with all couples, though there is a special emphasis on the rebuilding of trust and prioritizing the couple relationship over competing demands.
The “Attachment” phase includes work on rebuilding the couple’s sexual relationship, which is likely to have been severely damaged by the revelation of the betrayal. Making Love Last has useful guides for discussions about sex, and effective interventions for helping partners communicate about their availability for romance. In general, the book is quite helpful as a workbook and cookbook for healing.
What I bring to this work
I have been working with couples about affairs for 40 years, and have seen most of the possible variations of this extraordinarily difficult – and extraordinarily human – situation. Having lived through cultural periods such as the 1960’s -- when there was dramatic relationship and sexual experimentation -- I have a mostly non-judgmental attitude toward what arises in relationships, balanced by a deep appreciation of the suffering that is created by infidelity and lying, and a strong commitment to supporting faithfulness in marriages.
As a male therapist, I’ve usually had success at connecting with male clients who are nervous or reluctant about entering couples therapy, and in conveying an understanding of the biological and social pressures that impact men. On the other hand, I’ve been a committed feminist since the mid 60’s, and a staunch advocate for women to stand up for themselves in relationships, as well as in societal roles.
Eight years of working with Child Protective Services, and my role as a father with three children, insure that I stay aware of the impact of parental relationships upon children in the family. Forty-five years of mindfulness training, and intensive training in DBT emotional regulation skills, helps me bring a calming influence to the intensely heated emotional moments that frequently occur between partners after an affair has been revealed.
One way in which my work is different from standard Gottman protocol involves couples in which the partner having an affair has not broken off contact with the other member of that affair. The Gottman rule is to not start treatment with such a couple until the betraying partner breaks off all contact with that other member. There is validity to this position, because it is very difficult for a couple to make progress on healing their relationship until the breakup of the affair is accomplished.
However, I have found it beneficial in some cases to work with couples even thought the other relationship is still occurring. I have sometimes been able to provid couples with a safe place to discuss what has happened to them, helping the betraying partner make a decision about whether to end the affair or the marriage, while also supporting the betrayed spouse with the additionally painful uncertainty of this situation. In some cases, betrayed spouses who have been willing to wait for some agreed period of time while the affair relationship went through its developmental process, have found their partner willing to break it off and recommit to the original relationship in a strong enough way that healing could occur. Of course, this approach is not right for everyone, and some betrayed spouses have benefited from making an immediate ultimatum that their partner must end the other relationship.
Since I am Advanced Intensively Trained in Dialectical Behavior Therapy (DBT) I specialize in working with high conflict couples where one or both members of the couple may get extremely emotional, resulting in expressions of rage, anxiety and panic, depression or even suicidal behaviors.
I help a lot of couples deal with difficult adolescent or adult children, who may be exhibitiing self-harm or suicidal behaviors, oppositional or defiant disorders, depression or inability to get out into their own lives.
I also have a lot of experience, both professionally and personally, with the special challenges within blended families after divorces.