The Marriage Clinic: A Scientifically Based Marital Therapy

The Marriage Clinic: A Scientifically Based Marital Therapy John M. Gottman. New York: W. W. Norton & Company (www.wwnorton.com). 1999, 456 pp., $49.00 (hardcover). The dedication of The Marriage Clinic is written by John M. Gottman to his friend, Neil Jacobson, with a simple acknowledgment of his late colleague's efforts to understand marital relationships and to realistically appraise the value of modern marital therapy. It is an appropriate introduction to this remarkable book which fulfills the promises of both its title and subtitle. Gottman scrutinizes existing research, including his own, rejects myths about marriage, and offers a theory based on scientific investigations of marital processes. This is followed by a thorough and detailed description of his clinical practice, which intertwines the assessment process and modularized treatment, both of which are clearly linked to his theory. Part I presents an analysis of the literature on marital relationships, healthy as well as distressed, and a theory of marriage that provides the rationale for the clinical approaches described in the subsequent sections. The dictum that a clear and reasonable conceptualization of the problem must precede treatment is taken seriously here. Chapter 1 clarifies popular misconceptions about the nature of the dysfunction in a failing marriage, debunks myths about divorce, and defines the critical structural and functional components of a successful marriage. Gottman challenges common views of active listening, anger expression, and reciprocity, among other process variables that have figured prominently in theories of and therapies for marital distress. He recognizes that most members of successful marriages do not act like marital therapists or like the star students of marital therapy programs. Chapter 2 discusses the interactions of behavior, perception and cognitive processes, and physiological functioning during exchanges between couples. Although Gottman does not relate his findings to modern theories of emotion, they are clearly consistent and this adds to the already solid credibility of his ideas. Conventional and simplistic views of homeostatic mechanisms in family systems are challenged and replaced with a more complex, yet quantifiable, set of concepts. The four categories of behavior that place a couple at risk and must be targeted by the therapist are described and examples are given. Particular attention is given to contemptuous behavior, which Gottman states should be treated like physical abuse, barred rather than reflected empathically. The importance of repair mechanisms that moderate the inevitable conflict between members of a couple is described and the problem of diffuse physiological arousal is considered in a manner that readers will find compelling and practical, however biologically oriented they are. Chapter 3 provides what is often absent in theories of psychopathology: an empirically based description of adaptive, functional, and positive normative behavior. Again, myths are dispelled, this time about the necessary and sufficient conditions for marital satisfaction, as Gottman presents his own model of a wellfunctioning marriage, the Sound Marital House Theory. Case examples of couples who demonstrate different degrees of conflict avoidance and emotionality are presented, with annotated transcripts of their dialogues. …