Important aspects of couples therapy, from the cognitive-behavioral approach

Cognitive-behavioral couples therapy has focused on the detailed analysis of everyday conflicts that can lead to the breakdown of the relationship, and discusses how problems appear and how they remain. From this approach, a predominance of negative over positive interactions has been identified. This therapy aims to achieve an effective intervention, focusing on increasing the exchange of positive behaviors, improving communication and problem solving (Costa and Serrat, 1982; Cordova and Jacobson; 1993; Bradbury and Karney, 1993; Cáceres , 1996; Lawrence, Eldridge and Chistensen, 1998; Halford, 1998; Christensen, 1999; Finchman and Beach, 1999a; Christensen and Heavey, 1999).

The couple as a social entity

The couple is an entity based on the relationship between two people and as a social entity, the couple behaves as a unit and is thus recognized by those around them. It is within the couple as a social institution where dyadic relationships between its members occur.

At present, neither the intention to form a family nor to translate the relationship into an explicit contract (marriage) are necessary for a social environment to consider that two people constitute a couple (until recently if this was the case), broadening the concept as a couple.

The implicit objective with which each member joins the couple is to make the other's life happier and fuller and to receive similar treatment. To do this, they exchange behaviors and share, from a social point of view, a series of goods and activities. Some of the assets and activities they share are:

The body: it is the most specific characteristic of the couple. Couples are distinguished because they share the body with the other. Sexual relations are maintained exclusively between them, while the relationship exists (when sexual relations take place outside the couple, the continuity of the couple is seriously jeopardized).

Economic assets: there is an economic commitment by which different assets are shared. They usually have a house in common, although currently couples who have different houses and alternate life together for short periods, with separate lives, each in their apartment (they have an eternal dating relationship, in which they do not there is a project to deepen and share more). The commitment to share economic assets may or may not be legally supported; in common-law couples there is no legal commitment to share assets and generally the rules that they are to follow explicitly are not agreed. The logistics part of sharing consumer goods must be highlighted, for example, if an apartment is shared, it is necessary to determine who is in charge of each domestic task. It is usually a major source of conflict in couples, because men are not used to doing housework.

Paternity / maternity: it is one of the reasons that lead to establish stability in the couple, but this is also changing. The proportion of children born to single women is increasing, becoming the majority in countries such as Iceland, Sweden or Norway.

There are other elements that are shared in some way, such as social prestige and friends, but it is not done exclusively and the variation of the degree of a couple. For example, exclusivity when it comes to sharing time and leisure has changed significantly. Although it has never been decisive for men, now that the demand is less and less and the freedom of each member of the couple to have their independent leisure moments. They must be taken into account because prioritizing economic security in the case of women or social prestige in the case of men can lead to significant distortions and long-term conflicts.

Sharing goods and activities is what defines the couple as a social entity. In every society there are rules that determine how to do it. But social demands are less and less and with increasing frequency couples set their own rules regardless of current uses and customs, implicitly and explicitly define what goods and activities they share and to what degree they do so; many times thinking that being outside the norm is going to help them not have the problems that are at the root of failures in coexistence. In any case, it is necessary to establish a way of sharing that has to work, combining the personal interests of each member of the couple. Attachment in couple relationships

Not only are goods shared, behaviors are also exchanged, so a very important aspect is mutual support. It is reflected in the formula of being together in health and illness, in joys and sorrows.

Our learning of what mutual support is like in the couple takes place within the family in which we were born. One of the first behaviors we develop in her is attachment. Attachment behavior was defined by Bolwy (1969) as the search for protection against extreme threats and it is mainly specified in the child, in seeking the protection of the mother. Within attachment, help-seeking behaviors and the response they have obtained have been considered. Factors such as the availability of the parents, their acceptance, their respect and the facilitation of their own autonomy, the search for help in stressful situations and the satisfaction that is found in the help obtained are included. Attachment is also reflected in an interest in maintaining relationships with parents and the affection felt for them (Kenny, 1985). As adults, we seek companionship to reduce our anxiety and to find support in threatening situations (Moya, 1997).

A social function of the couple is to maintain and help the other and what is done and how it is done, will be related to attachment behaviors and this is recognized by society in the financial aid that is given in the event of the death of the spouse . The motivations around attachment are an important cause of the maintenance or dissolution of couples. The weight it has on the constitution of the couple has begun to be taken into account in therapy.

Personal goals in the couple and dominance relationships

When the couple is formed, each member pursues some objectives (implicit or explicit) that he wants to obtain in the relationship. They are not immutable goals over time, throughout the life of the couple, their importance changes depending on individual and social development or the phase in which they are: if they have small or older children, if they are retired, with pressures economic, etc. (Lawrence, Eldridge and Christensen, 1998).

Initially, sex is very important and then other factors such as conversational or emotional aspects take precedence. The objectives of both have to be combined and coordinated at all times, so that the couple can function. When they are not harmonized, problems appear (Epstein et al, 1993).

Managing shared money can be an example of how the couple works as a social entity. The needs and objectives that each member wants to solve with the money are made explicit in the communication and mutual understanding. There has to be a method for setting priorities for using the money. The way to fix them is a reflection of the distribution of power in the couple. The priorities must be accepted and acceptable by both. As a social entity, a joint and coordinated decision is taken.

Money is not the only element in which power relations are reflected, in reality they occur in each and every one of the goods that are shared. In the internal world of the couple, one of the partners may have more capacity to get the other to agree to do what he wants. A power structure is established, defined as the ability to influence others to do what one wants, but power depends on the management of resources that one has (Harper, 1985).

The power structure in the couple is reflected in dominance relationships. Dominance is a fundamental element in the balance of the couple and if a dominance relationship is not established, problems are assured. Problems arise when the decisions that are made lead to a negative outcome for the other person (Gottman, 1979).

Communication and problem solving

Cognitive behavioral therapy has incorporated communication skills training as an important element to resolve conflicts in the couple (Costa and Serrat, 1982). The competences required to make a decision are different from those required to develop intimacy (we could communicate well with the partner to be able to make decisions, but not to share feelings or emotions).

The solution of the problems that arise in the couple, has to start from the fact that the two are able to communicate and need to have the ability to generate alternatives and value them for the achievement of the proposed end. This requires problem solving skills. If they are lacking, training is necessary that has been successfully addressed by classic cognitive-behavioral therapy (Costa and Serrat, 1982). The commitment in the couple

Commitment is the decision to belong to a social entity, the couple. It is the decision that, despite the difficulties that arise, the couple will continue to fight effectively against the problems (Beck, 1988). The decision that broadens the commitment to the couple is personal, but it is maintained many times for social reasons, religious beliefs, customs and social pressures from the family of origin or the context in which one lives. When divorce was prohibited and social pressure against separations was very strong, it was forced to maintain negative and destructive relationships for the person, especially for many women. Nowadays, society has stopped putting pressure and the media downplay the aversive aspects of the separations. Maintaining the decision to form a couple today does not condemn us to suffering when it becomes unbearable, a break is possible and the social pressure to avoid it is less and less.

There is no doubt that when more and more goods and behaviors are shared, the commitment grows stronger. When the apartment is bought together, an important step has been taken in the commitment to the couple, which increases when they have children, etc. Partial decisions are strengthening the global decision to stay and fight for the couple, the separation becomes increasingly hard and difficult. Economic conditions are a factor that weighs on the continuity of the couple, separation leads to a decrease in the economic status of both and can be very serious for those who have fewer economic resources and which usually coincide with those who have invested the most in the couple , for example, spending time caring for children or sacrificing professional career to follow the other.

The commitment with the couple has an important influence on the resolution of conflicts. Greater commitment helps to accommodate and contribute to the negative behaviors of the other (Finchan and Beach, 1999). Both harmonious and non-harmonious couples tend to enter the process of negative reciprocity (responding to negative responses with negative responses because it is the least effort involved). When the commitment is great and there is no time pressure, a greater effort is made to respond constructively. If one of the members does not perceive the commitment of the other, she enters a relationship that leads to negative reciprocity with more probability, thus deteriorating the couple.

Stemberg (1996) highlights the importance of commitment in his triangular theory of love, since he considers it as one of the components of love and independent of others, such as falling in love or intimacy.

The couple as a dyadic relationship

The criteria by which couples are formed have changed over time. Today, couple relationships are built on the basis of love and intimacy (Kearl, 2001). However, little by little clinical psychology has investigated these two concepts and until a few years ago they had not been significantly incorporated into couples therapy (Johnson and Lebow, 2000).

In therapy, the emphasis has been on equity in relationship equity and positive behavior changes (Costa and Serrat, 1982). The lack of these two facets are the clearest manifestations of the rupture. However, more and more frequently, couples who consider how to fall in love again or how to regain their illusion appear at the consultation.

Love

From a psychological point of view, falling in love is an emotion and as such, it is a consequence of the circumstances (own and others) and of the evaluation we make of them. Falling in love produces a great physiological arousal that causes us well-being and predisposes us not to see or excuse the defects of the loved one and to need them, as well as wanting to be with them at all times. It also leads us to reveal intimate aspects, give them emotional and moral support, show interest in their own and express affection by any method (Moya, 1997).

The process of falling in love is as follows: a person can fall in love because they feel loneliness, sexual need, dissatisfaction or because of the need for changes, then an object arouses their interest, for a series of reasons such as its novelty, its attractiveness or its proximity . If that person is given a promising moment, a brief response from the object that suggests interest, with a short amount of time, can generate fantasies. After this sequence, no more than a simple confirmation (real or imaginary) is needed to produce falling in love (Frijda, 1988). When the only basis of the couple is falling in love (an emotion), the "law of habituation" can occur, that is, the continued pleasure fades and love itself gradually loses its magic. This law condemns the couple that is constituted by love, to failure and justifies the fate of a large number of couples based exclusively on falling in love (the emotion is extinguished and the couple will dissolve). To keep falling in love, it is enough to keep in mind what would happen if you were not with that partner, so that the emotion of love is maintained and renewed. When the infatuation wears off, the relationship doesn't necessarily go away or fail. Falling in love disposes us to make the other person happy, not so much in a balanced relationship, but as an altruistic relationship, in the sense of giving to the other without expecting much in return (Frijda, 1988). Falling in love induces some cognitive distortions, such as the one that leads us to see the other as a perfect person and to ignore the defects they have or the one that makes us feel important (Moya, 1997).

Intimacy and validation

Falling in love is a volatile emotion and cannot be considered as the element that will cement long-lasting and happy relationships. Intimacy and validation is something more lasting.

Intimacy is the first objective that is sought in the couple. In a marriage, the first objective is to have someone who listens and understands you, with whom you can express yourself without limits and can obtain reinforcement for what in other environments you would be looked down upon (Markman & Hahlweg, 1993).

Validation in the couple implies a total openness, a self-disclosure, which can include facts and feelings that could be socially punished but that will be received with acceptance by the other. This is how intimacy is built. Validation is a process that begins with self-disclosure behavior that makes us look weak and vulnerable. Self-disclosure followed by acceptance generates a feeling of warmth and support that is a consequence of intimacy and predisposes us to continue it (Cordova & Scott, 2001).

In addition to self-regulation, affection and sex are other elements that build intimacy. Sex implies a certain intimacy and its practice enhances it in a significant way (however, sex does not necessarily imply it, sexual relations have always been given without the need for the slightest intimacy) (Paul, 2000).

The elements necessary to maintain intimacy in the couple are the expression of any emotion, the associated acceptance, the displays of affection and the practice of sex. In self-regulation, over time there is a habituation (what at the beginning of the relationship was dangerous to reveal, then it becomes natural and it is already known that it will be well received). Telling things that make us weak or criticized in other contexts is another factor that maintains intimacy. Although falling in love predisposes us to unconditional acceptance of the object of our love, when it weakens, acceptance is mediated by social norms, external influences and personal criteria, which causes certain behaviors to be rejected or punished. and limits to privacy are established. If these limits are not met, the relationship may suffer, since behaviors that go against their own beliefs and interests may be admitted.

Intimacy has a social aspect and this social aspect of intimacy is the degree to which the privacy of the relationship with others (such as families of origin, friends, etc.) is maintained. Privacy in the couple means that a separation from the family of origin to be a different unit and priority over parents and siblings. The difficulties and problems due to not having built independence are very important: they are due both to the parents' lack of ability to give their children autonomy and allow them to become independent, as well as the failure of the couple to establish independence and from this point on In view, intimacy is the basis on which the couple is constituted as an independent social entity.

The triangular theory of love

Stemberg (1986) raises his triangular theory of love, where he states that it has three basic components: passion, commitment, and intimacy.

The figure shows the different forms of love that can occur in a couple, according to the triangular theory of love.

Passion would correspond to falling in love, and as this shoots up quickly, it also tends to fade quickly. The commitment grows slowly as decisions are made as a couple. The concept of intimacy is more complex in Stemberg, since it includes behaviors such as attachment, communication and dominance. The concepts of the theory of love are complex and are not independent of each other. Passion usually generates intimacy, commitment helps when creating intimacy, passion and intimacy can generate commitment and vice versa.

The conflict in the couple

The crisis in the couple would not be reflected only with the divorce, but the ways of relating to each other are significantly changing. Courtships become stable and do not always end in marriage. Today, many couples move in together without an explicit commitment or have long-lasting, fulfilling relationships from separate homes.

The social changes we are experiencing have led to and increased relationship problems and possibly special training is needed to face the relationship successfully, so a therapeutic intervention from couples therapy or a prevention program could help to alleviate the crisis. But it is a social phenomenon that must be sought for social causes, in which the progress of women towards equality with men plays an important role.

Conflict areas

Disputes in marriages often arise over responsibilities (who is in charge of doing things), power (who decides what to do), finances, relationships with members of the family of origin, caring for children, social and work activities outside the family, sexuality and intimacy, and communication (Weissman et al, 2000).

There are some areas in which problems appear frequently, such as the perception of inequality in the distribution of work, but they are not unsolvable and do not lead to breakdown (although they do embitter the relationship). However, there are other sources of conflict that attack the very constitution of the couple's relationship, such as extramarital sex, drinking and drugs, which predict divorce with quite certainty. In the same vein, we must consider the husband's jealousy and the wife's madness in spending money (Fishman and Beach, 1999).

Conflicts in the couple can be grouped around the fundamental aspects that structure the couple:

• Intimacy: the limits that exist between the two spouses in the degree of intimacy and sharing are identified as areas of marital conflict, along with the balance between power and control in the couple's decision-making. Some elements such as the expression of affection such as details, sex, etc., affect intimacy (Epstein et al., 1991).

• Commitment: it is the degree of investment that each husband puts in the couple. Investment includes instrumental investment (which is the behavioral effort made to maintain or improve the relationship) and expressive investment (which is the effort made to make the other person happy) (Epstein et al., 1991).

• Dominance: affects the balance between power / control in the couple's decision making. In this section, important elements such as money, the use of leisure time, the distribution of work at home, the priorities in the development of the professional career of each member are included (Epstein et al., 1991). The very existence of a relationship of dominance in the couple has been mentioned as a cause of conflict and injustice, especially from the point of view of the theory of equitable relationships, but it has not been empirically demonstrated that this is the case (Gottman, 1998).

• Attachment: attachment behaviors are learned in infancy and become automated. Responding behaviors to requests for help are also learned in the family of origin. If the expectations generated by the requests of the other are not met, serious problems can occur in the couple. The fact that the behaviors are automatic, non-conscious and very basic, makes conflicts in this aspect very serious and not always explicit, giving rise to strong emotions that do not find an adequate expression for their solution

• Problems in communication and problem solving: once a conflict appears in any area, the mechanisms to solve it are triggered in the couple. If they fail to do so, relationship patterns are established in the couple that perpetuate or aggravate it. When time passes without finding a solution or problems multiply, the origin of the difficulties is forgotten and it seems that there are no triggers for the situation and that it is the coexistence itself that becomes problematic. When you have good communication and problem solving skills, you are more likely to have a happy partner.

Violence

A large percentage of couples who go to the office have episodes or problems with violence, but only a small proportion mention it as an important reason for asking for help, except when it is very extreme.

The prevalence of male-to-female violence is the same as that of female to male, although the effects of the difference in strength are not comparable, male violence more often leads to physical harm and produces a lot of fear in life. woman (Hafford, 2000).

Among the causes of violence is the lack of skills, because it occurs more frequently in men who do not have the necessary to handle conflicts, that is, they are less assertive and have less capacity to solve problems. One of the origins of these deficits is in having witnessed violence and even having been subjected to it, in their family of origin. The effect of this exposure differs in men and women: while in men the probability of non-verbal violence increases, in women it increases the negative cognitions that give rise to depression or anxiety (Hafford, 2000).

How are the conflicts in the couple

It is in the periods in which important changes occur that serious conflicts are more likely to be triggered, changes such as paternity / maternity, abandonment of children at home, retirement, a serious illness, etc., can be the Trigger for a problem that can be latent for a long time.

Couples with conflicts have more discussions and interactions that are problematic and it is very difficult to find a way out of these problems. From the cognitive-behavioral approach, the type of interaction that occurs associated with the existence of conflicts and that contributes to perpetuate problems has been studied, as well as its behavioral, cognitive and physiological components have been identified.

Behavioral components

Behavioral patterns that occur in couples have been determined. According to Finchman and Beach (1999):

The most problematic is when a negative communication is responded to with another negative communication from the other, establishing a reciprocity in the negativity that can end in a ladder of violence. Women tend to contribute more to verbal escalation. Women who do not do it, it is because they have more capacity to reason in those circumstances, about their thoughts and change the most automatic response. This pattern of negative reciprocity also appears in marriages that do not have problems, but very often, in them a negative interaction is often followed by a positive response or no response. The pattern of positive reciprocity occurs in both types of marriages (Gottman, 1998). It is then the negative reciprocity that is frequently associated with relationship problems. This pattern is an absorbing state, from which it is very difficult to get out.

Another problematic pattern appears when the woman gives hostile responses while the man withdraws and does not respond, which increases the hostility in the woman. In harmonious marriages this pattern can also occur, although less frequently and often, it ends with the withdrawal of both.

One of the methods used to solve communication problems is the use of metacommunication, that is, reflection or analysis on the way in which communication is taking place in the couple. For example, it is said "you are not listening to me", to try to have a listening, but the aggressive non-verbal message is generally accompanied by an aggressive verbal component and the one that responds, does it to the aggressive component, which leads to more discussions , getting into a vicious circle. In smooth marriages, they respond to metacommunication and not to the emotional component.

As problematic communication patterns, Gottman (1998) adds the presence of the four horsemen of the Apocalypse that can lead the couple to divorce: criticism, defensive attitude, contempt and talking a lot so that the other cannot have an opinion. For the author, criticism leads to the other riders. All these patterns of behavior are intended to resolve the conflict; however Not only do they not solve them, but they perpetuate it and the interaction itself becomes the problem that leads to separation.

Conflicts do not always lead to breakup, since a type of conflict has been reported in which the husband gets angry and starts the discussion in order to solve the problem; When it is successful, the relationship can be strengthened and in these cases, the conflict experienced by the children is not negative for them, and is even an opportunity to learn to be assertive.

Cognitive components

The cognitive elements that precede conflict and can sometimes trigger it have also been studied. Epstein et al. (1993) identify the following:

• Selective attention: the members of the couple tend to value in a different way the frequency with which certain behaviors occur, noting what hurts them and frequently, they search in history as a couple for similar facts with which they try to confirm their current perception or justifying their fear of something aversive happening.

• Attributions: the attribution of the problem to certain causes is seen as a necessary element for its solution; hence the importance of attributions being done correctly. One type of attributions that increase problems are those in which the responsibility for common problems is attributed to the other. The same occurs with those in which the negative behavior of the other is attributed to bad intentions, being almost impossible to prove its falsehood. This type of attributions intensifies the conflict by increasing the verbal attacks that try to blame and shame the other.

  • In couples in conflict, the main causes of conflict are attributed to global, internal and stable traits that are impossible to change. When they lose hope of changing the other they can escalate into aggression or withdraw and become depressed.

  • Among the problems generated by poorly made attributions, is that of attributing to the other, the ability to make the change necessary to solve the problem, assuming that he does not do it because he does not want to and then he is blamed and attacked.

  • The discrepancy in the attributions on the cause of the problems, may in turn be the cause of problems. For example, if the wife believes that the husband thinks her personality is the cause of the problems and does not agree, this again becomes a focus of disagreement.

• Expectations: if you do not have expectations of a solution, the possibility that the problems will be solved is much lower, since you stop looking for and trying. As a consequence, depression problems can occur, due to helplessness. When they have the belief that problems can be solved, they have a better chance of being solved.

• Assumptions and standards: if there is a discrepancy between what the spouses believe the marriage should be and what it is perceived to be (both in quality and quality), problems are assured. They do not have to be aware of the discrepancy for conflicts to appear. However, the real differences between the standards of both components have little correlation with the level of satisfaction of the marriage, as long as there is no discrepancy between what "should be and what is", each of them may think that meet in marriage.

Irrational beliefs can be a source of conflict in couples, such as: disagreeing is destructive in the relationship; the members of the couple must be able to find out the wishes, thoughts and emotions of the other; the partners cannot change themselves or the nature of the relationship; one must be a perfect sexual partner for the other; conflicts between men and women are due to innate differences associated with sex that are shown in needs and personality, among other irrational beliefs (Eidelson and Epstein, 1982).

Physiological components

Physiological differences between men and women can influence couple conflicts. Men show larger increases in autonomic activity in the face of stress, changes that are more easily triggered and take longer to recover than in women. As a consequence, they try to generate a rational climate within relationships, for which they adopt more conciliatory and less conflict-generating patterns, and if it begins, they tend to withdraw before the woman. When her anger and hostility generate anger and hostility in him, it generates fear in her, which generates more hostility and anger in him and the scale of the conflict occurs (Gottman and Levenson, 1996). The differences in physiological reactivity may be in the explanation of the demand pattern of the woman-withdrawal of the man, the excess of excitement predisposes the man to initiate the withdrawal in the face of the woman's demands, reaching the point of not paying any attention to it. (Gottman, 1998).

Long-term impact of marital conflict

Married people have better physical and mental health than those who are not married: they have lower mortality, perform less risky behaviors and control their health better, complying better with medical prescriptions, they have a higher frequency in their sexual behavior that is more satisfactory. It is possible that these differences are because they are happily married, but it is also possible that they are because the healthiest tend to marry more often. Controlling for the variable of the degree of health when one becomes an adult, there is a lower risk of death in married couples, which would indicate that the lower mortality is due to marriage (Mathew et al. 2001). However, these advantages apply, only when there are no conflicts in the marriage and a continuous conflict, leads to less activation and greater stress in its components and this may be the explanation for the great impact that physical and mental health has on the members of the couple and their children (Finchman and Beach, 1999).

Marital conflict and health

The inability to face the relationship is related to the lack of skills or emotional problems and problems in the couple, influence their physical and mental health.

It is proven that conflicts more likely trigger problems such as depression, bipolar disorder, alcoholism, eating disorders, etc. Car accident rates are also increasing. Depression is the problem that is most related to separations and conflicts; When a married patient is depressed, it is important to analyze if there is an associated relationship problem, it is possible that the depression has deteriorated it, but it is also likely that among the triggers of the depression, there are problems with the partner. Your condition will improve if your relationship improves.

Marital conflicts are related to poorer physical health and to some specific diseases such as heart disease, cancer, chronic pain, disorders of the immune system and mortality from any type of disease. There is evidence that those who have lived through the divorce of their parents and their own have a life expectancy eight years less than the rest.

Marital conflict and its influence with children

Another harmful effect of couple conflicts is the negative impact it has on the behavior of children. Conflicts in the couple do not occur in isolation, but are associated with other problems is depression and the existing relationship with the children that are closely related to the difficulties of the couple, has a similar influence on the behavior of the children to that of conflicts between the couple and when it is added to the conflicts between the parents, behavioral problems in the offspring are significantly enhanced (Finchman and Osborne, 1993).

When parent-child relationships are conflictive, children's behavior is affected and deteriorates. If there are conflicts between the parents, especially if certain levels of violence are reached, the parents' relationship with the children tends to deteriorate even further and is also tinged with violence. In these cases, the imbalances in the children's behavior are considerably enhanced (Finchman and Osborne, 1993).

However, conflicts between parents do not necessarily affect children. Sometimes, especially if they are solved in an appropriate way and the child is able to understand what is happening and how it has been solved, they can be a reason for learning to solve similar problems. The child's perception of the conflict and its reactions is more important than what happens objectively.

It is important to distinguish between dissatisfaction in marriage and conflict. Problems with children are related to conflicts between parents, not so much to a problem of satisfaction in marriage.

• Frequency: the more frequent the conflicts, the greater the probability of finding tendencies towards violence on the part of the child and the more affected they are.

• Intensity: physical aggression is more related to problems than verbal aggression or minor aggression. The greater the intensity of verbal conflicts, the more helplessness it produces in the child.

• Mode of expression: different forms are distinguished such as physical, verbal and non-verbal. The latter is worse than the verbal because it is more difficult to solve.

• Content: if conflicts are about children, they have a lot of impact on them.

They are trying to solve something that is totally out of their ability. For this reason, when the explicit reason for the conflict is the children, they appear in these greater feelings of shame, guilt, fear of being involved in the conflict or being required for their direct or indirect intervention.

Children who constantly witness their parents' conflicts have more problems than those in which divorce puts an end to those conflicts (Weiss, 1989). Divorce is supposed to put an end to overt problems and arguments between parents, which does not always happen. The capacities for our relationships, we learn from those we observe in our parents, so that there is an inversely proportional relationship between parental conflicts and the intimacy that children reach in adolescence. Divorce is also negatively related to the intimacy of descendants, but less significantly (Ensign, 1998).

Evaluation

The objective of the evaluation is to discover which are the areas of conflict and the way in which they occur, detecting the behaviors, cognitions and emotions involved. Initially, it is about determining what is the starting point in the quality of the relationship when they come for consultation, for which a general purpose questionnaire can be used with the Marital Adjustment Scale or the Dyadic Adjustment Scale. They are scales that distinguish conflictive and non-conflictive couples, as well as they serve to be able to evaluate progress in therapy.

According to Cordova and Jacobson (1993), the evaluation can continue with a vision of the problem that brings the couple to the consultation, for which the therapist can ask a series of questions such as:

• How is the couple affected?

• What are the elements that divide them?

• How do these elements manifest in the relationship?

• What is the couple's commitment to the relationship?

• What are the strengths that keep you together?

• How can treatment help them?

The areas that must be considered in the evaluation are the seven Cs of Birchler, Doumas and Fals-Slewart (1989), which propose a behavioral frame of reference to evaluate marital problems:

• Character: it is necessary to detect if there is any psychopathology in the members of the couple and see if it must be treated, as well as if it is done through couples therapy or individually.

• Cultural and social context: including religious, ethnic and family-of-origin aspects that may cause problems within the couple.

• Contract: including the implicit expectations that spouses have about the relationship that may be unattainable or dysfunctional.

• Commitment: it is the decision to belong to a couple or the decision that, despite the difficulties that arise, the couple will continue to fight effectively against the problems.

• Beware: especially the exchange of positive behaviors.

• Communication: to detect any of the problems or lack of skills.

• Capacity: to solve problems, taking into account the relationships of power and dominance that have been detected in the couple.

Passion, attachment and intimacy must also be evaluated:

In the evaluation of passion, sexual behavior should be included (not only if there are problems, but if it is frequent and one of the existing sexual behavior questionnaires can be used.

• In the evaluation of passion, sexual behavior should be included (not only if there are problems, but if it is frequent and one of the existing sexual behavior questionnaires can be used.

• The evaluation of attachment behaviors includes those learned in the family of origin and the expectations they have regarding the couple; the interest they have in maintaining relationships with parents and the affection felt for them, the search for help in stressful situations, and the satisfaction found in the help obtained must be evaluated in a general way.

• In the assessment of intimacy, questionnaires such as the one proposed by Stemberg or the one by Lamieux and Hale can be used.

Until recently, cognitive behavioral therapy did not deal directly with conflicts in the areas of commitment, intimacy, attachment or emotions that are a fundamental part of the relationship. The evolution is towards the inclusion of these areas as direct intervention objectives.

With these evaluation elements and always starting from the specific requests of the patients, an explanation is given of where the problem lies and what the path to the solution may be. It must be taken into account that the return of an evaluation is, in some way, an intervention, since it acts on the expectations of solution and continuity of the relationship and attributions can be strengthened that hinder the subsequent intervention.

Treatment

From a cognitive-behavioral point of view, a relationship is defined as an exchange of behaviors (Halford, 1998). When a relationship fails, the sharing of negative behaviors predominates. One of the causes is the lack of skills to communicate and solve problems, so initially cognitive-behavioral therapy has focused on providing the couple with these skills.

Cognitive-behavioral therapy starts from the functional analysis of problem behaviors. It is about determining the problem behaviors to establish the treatment program.

The basic goals of treatment are:

• Increased exchange of positive behaviors for which the behavioral contract is used. For this reason, the treatment includes teaching the negotiation techniques necessary to make contracts.

• Training in social skills such as communication and problem solving.

• Cognitive changes to manage beliefs, attributions, etc.

Once the existing problems and the behaviors involved in them have been defined, the treatment program is established by selecting the specific techniques that allow change. The general strategies that are followed are listed below, depending on the objectives.

Exchange of positive behaviors

To achieve this objective, the fundamentals of behavior modification are taught, learning how a behavior responds to its consequences, how to extinguish and promote behaviors, etc. (Costa and Serrat, 1982).

Techniques are used and taught to carry out contracts, which have to be free, without impositions, using clear and explicit terms, without margin for interpretations, which contain advantages for both. It must be taken into account that the behaviors included in the contract have to be already incorporated into the behavioral repertoire of the one who has to do them (Costa and Serrat, 1982).

According to Cáceres (1996), a series of techniques and games are used that promote the exchange of positive behaviors, among them:

• Catch the couple doing something nice and let them know.

• Have a list of wishes that the other can make.

• Observe the pleasant behavior of the partner to avoid selective attention.

• Remember the places, dates, songs, etc., that have been symbols of the things that have united the couple.

Communication skills training and problem solving

A staggered treatment is proposed and adapted to each couple, which begins with training in the communication skills necessary to maintain a conversation, continues with those necessary to express wishes and feelings and finally, the specific problem-solving is entered.

The foundation is having conversational skills that include:

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Carrying a conversation, which implies changing the subject, taking the floor, passing the word and closing the conversation (all based on a specific language in which the terms that are used have to refer to observable and quantifiable elements, timely and convenient, focusing on positive verbal and non-verbal information).

Active listening, for which you have to take into account posture and eye contact, use the right tone, avoid value judgments and use empathy exhaustively.

With these skills as a basis, we proceed to increase those necessary for the expression of desires and feelings, both like and dislike, to do it in such a way that it does not harm the other and is constructive. It teaches how to manage anger in a positive way, eliminating both the cycles in which the woman gives hostile responses while the man withdraws, as well as those other episodes of violence or anger that assault unexpectedly. Thus, one acts against criticism as a means of solving problems, against the defensive attitude, practicing listening and expressing feelings, to proceed against contempt and lack of listening.

When you have these skills, you tackle problem-solving training itself. The first point is to build the right occasion and avoid discussions in places and times that are not. They allow calm communication. Then it is about defining the problem starting with something positive, being specific, expressing feelings and admitting the role that one has in the problem. All briefly and making it clear that you do not want to solve but only raise it. Later, it is time to focus on the solutions, asking the other to change their behavior that would solve the problem, always remembering that it has to include reciprocity and commitment and with positive consequences for both, along with follow-up elements that remind us of the agreement reached (Costa and Serrat, 1982).

For when the solution is not clear, techniques such as brainstorming are taught in which with an unconditional collaboration between the two, they generate possibilities for a solution without a critical sense and only later is its possibility evaluated.

Cognitive changes

In cognitive behavioral therapy, when distorted cognitive components are involved, it is about detecting and restructuring attributions, expectations, irrational beliefs, etc. They are modified by eliminating attributions to hidden motives or intentions, moderating or changing expectations, the standards learned in the expectations, the standards learned in the families of origin or by preconceived ideas, to adapt them to the possibilities of the couple, attacking the ideas irrational, etc. The very explanations and attributions that are given to conflicts can be a source of marital adjustment or maladjustment.

The techniques used are cognitive restructuring, Socratic dialogue, scientific testing of hypotheses, etc. Logical analysis is used to set expectations on your site. To modify assumptions and standards, Socratic dialogue is used, in which the consequences of living by those standards are questioned and evaluated, such as "you should never be angry with your partner." The ability to constructively use metacommunication to edit thoughts and make it effective is taught, modifying the way in which one is speaking and avoiding following the paths of emotion that lead to escalating violence.

The techniques used to promote acceptance, according to Halford (1998), are:

• Empathy: meeting with empathy towards the other around the problem, to develop an understanding of the problem, understanding and respecting the point of view of the other, although not justifying it. For this, the problems are discussed together with the therapist's modeling and they are encouraged to express their feelings and vulnerability.

• Objectivity: using objectivity to see the problem with a less emotional tinge. Objective analysis is promoted to remove emotion that introduces cognitive distortions.

• Tolerance: building tolerance with the goal of reducing negative emotion caused by the spouse's behavior or its outcomes. For this, the technique most used is exposure, that is, maintaining the aversive stimulus without giving avoidance responses.

• Self-care: it is about changing one's behavior to achieve elsewhere what the couple does not give, for example, making new friends, etc.

With acceptance, the understanding of the other is created or expanded and consequently, intimacy is improved. Showing weaknesses in the couple (such as feelings associated with attachment, loneliness and the need for acceptance and support), places the subject in a position to start a new process of strengthening intimacy and, therefore, of the couple.

One of the difficulties that appear in couples therapy is that each one attributes the problem to the other and places the responsibility for change on him. Halford (1998), has proposed self-regulating behavioral couple therapy, which places special emphasis on clarifying with each component what can be changed to solve problems, always within the philosophy of achieving one's own goals in the couple.

Reference: García, J. A. (2002). La terapia de pareja desde la perspectiva cognitivo conductual. Consultado el 2 de julio de 2020 de la página http://www.psicoterapeutas.com/pacientes/pareja.htm#_Toc12016515