Preface xiii
AI-use Declaration xvi

Part I The Principles of the Module-based Approach in Couple Therapy 1

1 Introduction 3
1.1 Different Perspectives in Couple Therapy 3
1.1.1 Approaches Emphasizing Differentiation 4
1.1.2 Approaches Emphasizing Attachment 5
1.2 Foundations of the Schema Therapy Model 6
1.2.1 Early Maladaptive Schemas 6
1.2.2 Schema Coping Styles 9
1.2.2.1 Schema Overcompensation, or Don't Judge the Book by Its Cover! 10
1.2.3 The Mode Model 11

2 The Principles of Schema Couple Therapy 14
2.1 The Development of the Couple Perspective in Schema Therapy 14
2.2 Why Couple Therapy—or at Least an Interpersonal Perspective? 16
2.3 Proceeding from Individual to Couple Therapy 17
2.3.1 Inviting the Partner to a Diagnostic Session 18
2.3.2 Encouraging the Partner to Attend 18
2.3.3 Helping Clients Accept Partner Involvement 19
2.3.4 Preparing Clients for the Expanded Setting 19
2.4 Special Features of Schema Couple Therapy 20

3 The Modular Approach 21
3.1 Why a Modular Approach? 21
3.2 The Basement: Our Simplified Dimensional Model 22
3.3 Why Stand Up Together? 26
3.4 Attention Control and Meditation 27
3.5 The Case Conceptualization—MCC 30
3.6 The Core Construct—The Mode Cycle 33
3.7 How Do We Choose Our Partners? 37

4 Details About the Therapeutic Process 38
4.1 Why Do We Focus on In-session Work? 39
4.2 Why (Almost) No Systematic Intake? 42
4.3 Why Combine Couple and Individual Sessions? 46
4.4 Why One Therapist? 47
4.5 How Do We Handle Secrets and Confidentiality? 48
4.5.1 The "Process-oriented" Position (Eckhard Roediger) 49
4.5.2 The "Abstinent" Position (Eva Frank-Noyon) 50
4.6 What Role Does Clarifying the Contract Play? 52
4.6.1 Eckhard Roediger 52
4.6.2 Eva Frank-Noyon 53
4.7 Positions in the Therapy Process 54
4.8 Why Do We Use Joint Imagery? 57
4.9 Structuring the Relationship and the Therapy Process 59
4.10 Notes on Online Work with Couples 67

Part II The Module System 71

5 Introduction to the Module System 73
5.1 The Three Therapeutic Steps 73
5.2 Additional Modules 76
5.3 The Core Ideas of Therapy 77

6 The Specific Modules 79
6.1 Module 1: Introducing the Model 79
6.2 Module 2: Case Conceptualization—Linking the Model with the Couple's Displayed Mode Cycle 82
6.3 Module 3: Stop the Mode Cycle (Timeout) 85
6.4 Module 4: Balancing and Vision (Best Day Imagery) 88
6.4.1 Next Step: Vision of the Relationship—Balancing Giving and Receiving 90
6.4.1.1 Option 1: "Best Day" Imagery (Short-term Perspective) 91
6.4.1.2 Option 2: Future Vision (Long-term Perspective) 91
6.5 Module 5: Accessing the Vulnerable Side—Empathy Exercise 92
6.6 Module 6: Activating Attachment Resources—Honeymoon Imagination 99
6.7 Module 7: Accessing the Self-assertion Side—Empowerment Exercise 100
6.8 Module 8: Dealing with Inner Critic Voices or Dysfunctional Beliefs 103
6.9 Module 9: Recognizing Schemas—Joint Imagery Exercise 110
6.10 Module 10: Training the Adult Mode 113
6.11 Module 11: Connection Dialogs 114
6.11.1 Steps of Connection Dialog 116
6.12 Module 12: The Homework Toolbox—Exercises for the Couple Between Sessions 117

7 Supplementary Modules 120
7.1 Module 13: Supporting Possible Outcomes of Couple Therapy 120
7.2 Module 14: Dealing with Strong Emotions 123
7.2.1 Part 1: Venting Anger 123
7.2.2 Part 2: A New Beginning 125
7.3 Module 15: Dealing with Ambivalences 126
7.4 Module 16: Telling One's Own Story 128

Part III Specific Issues in Couple Therapy 129

8 Most Prevalent Challenging Issues in Working with Couples 131
8.1 "Ground Rules" for Problem-solving 131
8.2 Terminating a Stuck Therapy 132
8.3 Violence in Couple Therapy 135
8.4 Addictive Behaviors 139
8.5 Jealousy 141
8.5.1 Therapeutic Work with Jealousy 142
8.6 Financial Issues 143
8.6.1 Organizational Considerations for Handling Money in Relationships 144
8.7 Problems Related to Wanting or Not Wanting Children 145
8.7.1 Couples Wanting Kids 145
8.7.2 Conflicts About Having Children or Not 147
8.8 In-laws and Families of Origin 150x Contents
8.8.1 Case Vignette 1—Cultural Expectations 151
8.8.2 Case Vignette 2—Everyday Overstimulation 151
8.9 Significant Transitions and Role Changes 152
8.9.1 When a Dyad Turns into a Triad—Starting a Family 152
8.9.2 The Empty Nest—Children Moving Out 154
8.9.3 Getting Out of Work/Retirement 154
8.9.4 Serious Illness of a Partner or Child 155
8.10 Differences in Temperament, Values, Traditions, Interests 156
8.10.1 Value Conflicts 156
8.10.2 Dealing with Complementary Coping Modes 157

9 Dealing with Ambivalence 159
9.1 Shall I Stay or Shall I Go? 159
9.1.1 Case Example: Simon and Jaqueline 160
9.2 Therapeutic Approach: Recognize and Integrate 161
9.2.1 Recognizing the Relevant Parts 161
9.2.1.1 Chair Work—Example Procedure 161
9.2.1.2 Reflection Questions to Clarify Motives 162
9.3 Four-field Matrix: Systematically Organizing Pros and Cons 163
9.4 Integrating the Parts: From "Either–Or" to "Both–And" 164
9.4.1 Stance: Tolerate and Explore Ambivalence 164
9.4.2 Imagery: Exploring Emotional Resonance 164
9.4.3 Behavioral Experiments 165

10 Affairs 166
10.1 Introduction 166
10.2 Some Data and Considerations 166
10.3 A Therapeutic Perspective at Affairs 167
10.4 Case Examples 168
10.5 A Schema-therapeutic View of Motives and Levels of Injury 170
10.6 The Schema-therapeutic Approach to Affairs 172
10.7 Conclusion 176
10.8 Theses on "Forgiving" After an Affair 176
10.9 Final Note on Whom to Share the Affair with 182

11 Steps Toward Reconciliation and Forgiveness 184
11.1 Resolving "Unfinished Business" in Individual Sessions 184
11.2 Dealing with Injuries in Relationships 187
11.3 Steps Toward Forgiveness 188
11.4 Conclusion 192Contents xi

12 Sexual Issues 193
12.1 Myths, Desire, and Low Desire from a Schema-therapeutic Perspective 193
12.2 The Dynamics of Desire Discrepancies 196
12.3 Therapeutic Interventions 199
12.3.1 Homework and Experiments 199
12.3.2 Exercises to Foster Intimacy and Embodied Presence 200
12.3.3 The Sexual Body Maps 201
12.3.3.1 Homework Assignment 204
12.3.4 The Sexual Landscape 204

13 The Evidence Base of This Approach 206
13.1 Comparing Experiential and Cognitive-based Interventions 207
13.2 Comparing Schema-based Interventions with a Communication Training in Combined Individual and Couple Sessions with Personality-disordered Clients 207
13.3 Effects of a Couple Therapy with High-conflict Couples 209
13.3.1 Measures 209
13.3.2 Results 209
13.3.2.1 Baseline Stability 210
13.3.2.2 Daily Process Measures (VAS) 210
13.3.2.3 Relationship Functioning (DAS Data) 210
13.3.2.4 Heterogeneity of Change 210
13.3.2.5 Dyadic Dynamics 210
13.3.2.6 Clinical Interpretation 210
13.3.2.7 Closing Remarks 211

References 213
Listing of Metaphors 220
Index 221