the fifty-minute hour & couples therapy

Fifty minutes is often too short a session to get at the core of what brings a couple to see me. Let’t break it down: Usually, it is one out of the two (the couple) who has suggested to go see a therapist. Rarely, is it the case that both partners feel the need and desire to reach out for support. imageSo from the get go, one of the two is less than enthusiastic about “going to see someone” and, thus, there is a built-in resistance, if you will, that is a little more cemented in the dynamic from the onset, more so than is seen in a 1:1 counseling session. So, the stage is set (more times than not)… and the client (the resistant one) is probably glad there’s only 45-50 minutes to endure. Typically, however, a session has a break-in period where the conversation meanders– where the client(s) might talk about a movie they recently saw, or global warming, or the latest terrorist threat, etc.— pretty much any subject that has as little to do as possible with their immediate situation and difficulties. The clock tick tocks and often by the time the couple is anywhere near bringing their point of conflict to light, the 50 minute hour is nearing its close. In my experience, I have found that allowing my sessions with a couple to run more into a mini-marathon yields unpredictable benefits. Letting a session run over sometimes into as much time as needed allows a couple to truly come up against themselves and their issues in a more natural way. Over this extended time period, this “real” time, if you will, without the external pressure or contrived time-limit set in stone, the story invariably unfolds and the dynamic of the relationship reveals itself in a way that might not happen as readily as with a “sorry our time is up, but hold that thought for next time”- technique/limitation. Not each and every session necessarily needs to go into overtime, but there are definitely times when it makes sense to let it flow and let it go, allowing for a suspension of time and an invitation for an authentic interaction to unfold.

In conjunction with extending time beyond the predetermined and vastly accepted 50 -minute hour, I have found meeting with a couple in their own space versus the therapy office can be extremely conducive to and in service of the therapeutic process. I have spent hours with some couples on their own turf and have seen something very similar to a “home field advantage” take place almost magically before my eyes. Somehow the familiarity of one’s own environment, versus the formality of going to the therapist’s office, provides the groundwork for an openness that could (and often does) take many, many sessions to establish.

In a NY TImes article about the 50 -minute hour, we learn : “Therapists weren’t always clock-watchers. Freud, who was notoriously unorthodox with his patients, was often lax about time. During the summer of 1910, Gustav Mahler, in a state of deep depression, sought Freud’s help. He was having heart problems and had learned that his wife, Alma, was having an affair with Walter Gropius, a much younger man with a promising career as an architect. Freud and Mahler met in Leiden, where, during the course of some four hours, Freud conducted a peripatetic psychoanalytic consultation as he and Mahler walked leisurely through the streets and along the canals of the city. Mahler telegraphed Alma the next morning to say “Feeling cheerful. Interesting discussion.” Following the consultation, Mahler apparently recovered his sexual potency and reconciled with Alma, though he died a year later.

 If you’d care to read the whole NY Times piece, click the link below.

Click to read NY Times article on the 50-minute-hour