One of the advantages of attending professional workshops, especially those given by so called big names in psychotherapy, is that I don't necessarily learn much that is new to me but I am confirmed in what I'm doing by nationally known experts. That always makes me feel good.

Such was the case with a workshop on marital and family therapy which was just presented in Helena by Monica McGoldrick, a social worker from New Jersey who pioneered the use of the genogram to understand multigenerational dynamics.

In doing marital therapy, McGoldrick subscribes to the theory that our relationships with our parents as we were growing up influences our marital relationships. In marital therapy, we have to achieve a level of differentiation to make positive changes in our marriages.

To me, differentiation means a number of things: that we have good self-esteem, that our ego boundaries are secure so we don't lose ourselves in our marriages, and that we have healed our past relations with our parents so they don't contaminate our marital relations. We have differentiated the past from the present, ourselves from our parents and our spouses from our parents. We no longer react to our spouses through the prism of our experiences with our parents.

Some examples of contamination might help: Sally's father was an abusive alcoholic when she was a child. Not having done any therapy for her childhood experiences, she sees her husband as an angry person when, in reality, temper is not so serious a problem with him. And she becomes naggingly anxious if he has one or two beers.

Bob's mother was controlling, intrusive and overly protective as he was growing up. He becomes excessively angry when his wife asks him to do a simple chore, accusing her of being a controlling nag just like his mother.

During a break, I told McGoldrick that I like to take a few sessions during marital therapy, before getting to present problems, to do individual therapy about the childhood of each spouse in the presence of the other. In fact, I have them ask questions of each other rather than my doing the explorations of family histories.

I'm pleased to report she thought this was a good idea.

What this procedure does is promotes greater intimacy between spouses, develops insight into each others behaviors and reduces blaming of the other and self-blaming.

So why do a fair number of spouses resist this procedure even though it has several benefits, the most important of which is to increase the chances of successfully resolving marital problems?

Simply because it might hurt. None of us likes to deal with pain, be it emotional or physical, or to admit our parents made some mistakes and left some scars.

But no one promises that effective therapy will be easy. In fact, it often has to be painful to be effective.

Once the pain is acknowledged and expressed, however, it is greatly reduced if not eliminated altogether. And it can no longer contaminate and distort the present.

Everyone has problems, wrote Scott Peck, author of several books on mental health, but most people either ignore their problems, or deny them, or drink them away. It is only the wisest and bravest among us who can submit themselves to the difficult process of self examination which takes place in the psychotherapist's office.

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