School of Behavioral & Brain Sciences;
School of Interdisciplinary Studies
PhD, The University of Texas at Austin
Intimacy Development, Marital Relations, and Depression
Five years in the writing is my current book-in-progress, Intimacy-Oriented Couple Therapy, which addresses the psychological risks and challenges that intimacy creates for couple relationships. It offers an assessment and treatment model for identifying and intervening with the problems of individuals and couples who are struggling with intimacy issues or find themselves unable to form or sustain rewarding intimate relationships. Written for practitioners, Intimacy-Oriented Couple Therapy is both a model for conceptualizing intimacy problems and a framework for assessment and treatment planning. The book draws heavily on research that has illuminated the inner workings of couple relationships and identified the most effective treatment strategies for treating distressed couples.
Intimacy-Oriented Therapy is a cognitive-behavioral treatment, and like others that preceded it, it relies on direct observation of couple interaction and interventions that teach partners how to communicate and solve problems more effectively (see Jacobson & Margolin, 1979; Baucom & Epstein, 1990; Christensen et al., 2000; Epstein & Baucom, 2002). Unique to this approach is a cognitive-behavioral conceptualization of intimacy problems that uses observational assessment techniques. Couple therapies are now evolving into more specifically targeted treatments for particular sets of couple problems (e.g., Johnson, 2004). Intimacy-Oriented Therapy integrates cognitive behavioral and Bowenian approaches to couple therapy in order to offer a fresh approach for conceptualizing relational intimacy and its dilemmas and for treating problematic efforts to cope with its risks and rewards.
The book first organizes problems with intimacy into three intimacy dilemmas, each of which emerges from one or more of the psychological rewards and risks inherent in intimate relating. The dilemmas are normal outgrowths of intimacy, but a couple’s efforts to cope with them can exacerbate the problems that they create. Efforts to cope go awry when the very behaviors used to address the problems have negative relational consequences. Individual partners’ beliefs, attitudes, and expectations further contribute to intimacy problems by intensifying negative interpretations of partner behavior and subsequent negative affect.
The Intimacy Signature Assessment protocol measures behavioral, cognitive, and affective aspects of the couple relationship and individual psychological functioning that affect couple satisfaction, harmony, and stability and individual partner mental health and well-being. Intimate-behavior check-lists help therapists make systematic observations about couple intimacy and to make connections between observations and intervention strategies. The Intimacy Signature includes intimacy schema check-lists in which schemas have been paired with common defensive behaviors, an approach reminiscent of cognitively oriented approaches to other kinds of couple problems (Baucom & Epstein, 1990; Epstein & Baucom, 2003). The comprehensive couple interviews and the Enmeshment-Differentiation-Unrelatedness check-list were inspired by Bowen’s (1985) family systems approach.
Intimacy-Oriented interventions are first organized by intimacy dilemma, and then according to the primary target of the intervention: therapeutic alliance, behavior, problematic beliefs or thinking patterns, or affect regulation. My premise is that it is not the presence of intimacy dilemmas themselves that creates a need for treatment, but rather it is ineffective efforts to cope with these dilemmas that create relationship distress. The therapist’s challenge is to identify the intimacy dilemma that is driving the distressed couple’s characteristically unfocused, vitriolic conflict behavior and persuade partners who would rather blame one another that it is worth their while to face their own intimacy-related anxieties. This book offers a guide through the confusion by identifying key themes that underlie dysfunctional efforts to cope and that are amenable to therapeutic intervention.
Prager, K.J. and Roberts, L. (2004). Deep Intimate Connection: Self and Intimacy in Couple Relationships. In Mashek, D. and Aron, A. (Eds.) The Handbook on Closeness and Intimacy. Lawrence-Ehrlbaum.
Prager, K.J. (2002). Intimacy. Encyclopedia of Marriage and the Family. New York : Macmillion.
Prager, K.J. (2000). Intimacy in Personal Relationships. In S. Hendrick and C. Hendrick (Eds.), Close Relationships: 229-244. Thousand Oaks, CA : Sage.