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RESEARCH PRODUCT

Depression : The differing Narratives of Couples in Couple Therapy

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Introduction When a person becomes depressed, partnership can either be a source of strength, advancing recovery, or a source of further suffering, harming the health of both partners (Cordova & Gee, 2001). Also, depression in one spouse can create feelings of helplessness and hopelessness in both spouses (Cordova & Gee). These are some of the reasons why couple therapy has been used with persons diagnosed with depression and their spouses. Yet, according to Denton and Burwell's (2006) experience, which is similar to our own, the spouses of depressed patients often are not part of the treatment in psychiatric outpatient care, and hence feel unsupported, uninformed, isolated, confused, and frustrated. When one of the spouses is depressed, a goal in using couple therapy as treatment for depression can be considered to be the development of a stronger sense of agency in both spouses (Holma & Aaltonen, 1998). According to White and Epston (1990), the objective of therapeutic work is to recruit an audience for a new and preferred self-narrative in the medium of the social world. In the couple therapy situation, one could regard both the therapist and the spouse as an audience for the depressed person's narrative. The spouse also can be regarded as a person who shares and who can co-construct the depressed partner's narrative. If the depressed person's spouse is present, the description of life can become more comprehensive and more complex, and in this way it can help the couple acquire a stronger sense of agency, find new ways of seeing their situation as well as new ways of behaving in it (White & Epston). In recent decades, increasing attention has been paid to couple therapy in working with depressed persons (e.g., Beach, 2001; Beach, Finchman, & Katz, 1998; Denton & Burwell, 2006; Gillian & Cottone, 2005; Gupta, Coyne, & Beach, 2003; Keitner & Miller, 1990; Mead, 2002). For example, Gupta et al. recommended that couple therapy should be used when the couple reports significant relationship discord. Researchers such as Cordova and Gee (2001) and Coyne and Benazon (2001) have recommended working with couples whose relationship is satisfactory. Involvement of the spouse in the treatment of a depressed person has been considered to be important (Denton & Burwell). Obstacles and difficulties in involving the spouses in the treatment have been reported (Gupta et al.). Couples may find it difficult or disagreeable if they sense that their relationship is to blame for depression. On the other hand, couples who seek therapy because they have problems in their relationship and who do not collaborate well, may find it senseless if collaboration is the means for addressing their problems. In addition, committing to conjoint sessions can be difficult for couples due to pressures of work and childcare responsibilities (Gupta et al.). Studies dealing with couple therapy for depression have mostly dealt with treatment effectiveness. Beach and O'Leary (1992) studied cognitive-behavioral couple therapy; Emanuels-Zuurveen and Emmelkamp (1996) studied communication-focused couple therapy; Foley, Rounsaville, Weissman, Sholomskas, and Chevron (1989) studied interpersonal couple therapy; Teichman, Bar-el, Shor, Sirota, and Elizur (1995) studied cognitive-systemic couple therapy and Leff, Vearnals, Brewin, Wolff, Alexander, Asen, et al. (2000) studied systemic couple therapy. The authors of these reports have indicated that couple therapy approaches are as effective as individual therapy in helping depressed people, and that couple therapy also increases marital satisfaction. In addition to studying the effectiveness of couple therapy for depression, there is also a need to do more psychotherapy research that would utilize qualitative methods, with a view toward obtaining a more detailed picture of what actually happens in therapy sessions (Moon, Dillon, & Sprenkle, 1990). …