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The Heart of Couple Therapy


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Table of Contents

1. Introduction: Dilemmas and Choices in Couple Therapy
2. What Is a Good Relationship?
3. Principles and Methods
4. The First Session
5. The Individual in the System: A Critical Pathway to Change
6. Common Underlying Relationship Issues and How to Address Them
7. From the First to the Second Session: Clinical Illustrations
8. The Genogram: A Window into the Psyche
9. "The Things They Carry": Working with Legacy Issues
10. Deepening Connections
11. Troubleshooting Common Challenges
Epilogue. Principles of Change in Individual and Couple Therapy, Paul L. Wachtel

About the Author

Ellen F. Wachtel, PhD, JD, has a private practice in individual and couple therapy in New York City and is on the adjunct faculty of the Ackerman Institute for the Family. For many years Dr. Wachtel worked with Physicians for Human Rights and HealthRight International doing evaluations of people seeking political asylum, and she has mentored other psychologists volunteering with these organizations. Her books include We Love Each Other, But...: Simple Secrets to Strengthen Your Relationship and Make Love Last. She gives workshops on couples and families both in the United States and internationally.


"This is the best book I know on the day-to-day practice of couple therapy. With a rare combination of clarity and depth, Wachtel illuminates how the most difficult topics can be addressed in a way that leaves couples feeling both reassured and motivated to grow. This book is a treasure."--Harriet Lerner, PhD, author of The Dance of Anger and Why Won't You Apologize?

"The author describes the moment-to-moment decisions a therapist is called upon to make from the first moment of the first session. I know of no better first book for beginning students wanting to know how to do couple therapy and for experienced therapists seeking new ideas. Opening this book, you feel the presence of a master therapist who has drawn from the wisdom of the field and passed it through the filter of her decades of experience, finely tuned intelligence, and deep humanity. I kept thinking, 'Yes, that's exactly what happens in a session--and, hey, Ellen Wachtel has come up with a great way to deal with it.'"--Daniel B. Wile, PhD, private practice, Oakland, California

"All couple therapists will benefit immensely from diving into this engaging, highly readable book. With honesty and depth, Wachtel offers thoughtful insights and suggestions to help therapists navigate everyday dilemmas. She guides the reader through such essentials as approaching the first meeting, transitioning to the second session, conducting a genogram, and working through core underlying relational issues. Reading this book encouraged me to deeply reflect on my own practice. It is one of those books that I will keep on my shelf for reference when I next get stuck or hit an impasse with clients."--Rhonda Goldman, PhD, affiliate therapist, The Family Institute at Northwestern University

"An invaluable comprehensive guide to doing couple work, from a talented, seasoned therapist. Wachtel doesn't miss any of the conundrums of couple therapy. She eschews pathologizing, instead fostering possibilities. This book is a 'must' for all couple therapists. Reading it is like having an excellent supervisor by your side."--Marcia Sheinberg, LCSW, Director of Training and Clinical Services, Ackerman Institute for the Family

"A marvelous book, filled with clinical wisdom. Wachtel shares with the reader her integrative approach that illuminates the essence of couple therapy. She offers couple therapists and students practical insights and direction about the critical choice points involved in this form of therapy. Rich with instructive clinical vignettes, this book should be on the required reading list for every couple therapy course, and part of every couple therapist's library."--Jay L. Lebow, PhD, ABPP, LMFT, Senior Scholar and Clinical Professor, The Family Institute at Northwestern University

"The work described in this book is largely rooted in the same set of underlying principles that provide the foundation for good therapeutic work of all sorts. And as Ellen demonstrates so amply, these principles can be taught....Good couple therapy is not achieved by following the right manual but by establishing the right relationship and by proceeding in a way that builds upon the basic processes of change that have been shown in countless studies...to be the foundations of change in the way people act, feel, and perceive themselves and others. By building skillfully upon those processes and principles, the therapist...can enhance her effectiveness as a clinician."--from the Epilogue by Paul L. Wachtel, PhD

"This is an excellent guide to the nuts and bolts of couple therapy. It also explores issues related to the quality of the therapeutic relationship and its specifics when working with couples or knowing when it is ethical to stop therapy. The author uses vignettes to illustrate her points, which provides a sense of realism and practicality. This book enables readers to experience the wisdom the author has accumulated through years of working with couples. It is useful to both novice and more expert therapists who may get stuck on specific issues. It also extends beyond therapy with couples as some of the principles the author discusses are applicable in working with individuals and families as well."--Doody's Review Service

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