For this month's newsletter, I thought I'd do something different, and share highlights from a few of the sessions of a recent couples' conference in Los Angeles. Each year The Couples Institute co-sponsors a couples' conference with the Milton Erickson Foundation. This meeting is designed to bring together specialists who focus on different aspects of couples therapy. Since I presented several sessions myself, I was unable to attend all of the other sessions, so I'm giving you just a few sprinklings from a very rich program.

One of our new presenters was Esther Perel, a therapist from New York. She presented a dynamic program on “Mating in Captivity.” She discussed the dialectic between the emotional and the erotic stressing that what is safe and easily available is not usually erotic and what is erotic is usually not safe. Safety, familiarity and predictability may be emotionally attractive, yet sexually undesirable.

She encouraged couples therapists to recognize the inverse relationship between greater emotional intimacy and the loss of sexual desire. She even shocked the audience by suggesting that cuddling may undermine the sexuality in a couple's life. Such intimacy, or comfort love, often creates a fear of entrapment that leads to erotic withdrawal and difficulty sexualizing the partner.

She suggested three elements as part of the therapy process:
1. Encouraging couples to introduce small transgressions, illicit strivings, and passionate idealization into the midst of their safe and predictable life
2. Granting permission for an active fantasy life that is shared and unshared.
3. Accepting the dichotomy of men's need for power, control and dominance and women's need for connection and affiliation. (Both clients and therapists)

Above all, she reminded us that secrecy, surprise and unpredictability are all preconditions for sexual interest!

Another presenter was Dr. Daniel Amen, a specialist in attention deficit disorder. A side-benefit of his discussions about clutter and disorganization were his tips on how to nourish a healthy brain and prevent Alzheimers. After all, what therapist wouldn't want a healthy brain?

Strategies for Preventing Alzheimers and Nourishing your Brain
1. Regularly eat the best brain foods: blueberries, oranges, beans, broccoli, spinach, pumpkin, oats, soy beans, salmon, lean turkey, yogurt, brazil nuts and walnuts.
2. Take Multi-Vitamins, extra vitamin C and E, and folic acid.
3. Exercise your brain by getting 15 minutes of new learning each day.
4. Get enough sleep. Less than 7 hours per night can decrease the blood flow to the brain.
5. Exercise your body including doing hand-eye coordination exercises.
6. Protect your head from injury. Wear helmets and be sure your kids wear helmets when doing sports.
7. Listen to music and have sex.
8. Avoid toxic substances.

Many of these just take developing new habits–habits that may extend your life and help you keep thinking clearly along the way!

Janis Spring, one of our well respected previous presenters, returned this year and presented material from her new book on forgiveness, “The Challenge to Forgive, The Choice not to.” She described two unhealthy approaches to forgiveness:
1. Cheap forgiveness. A quick and easy pardon with no processing of the emotion and no coming to terms with the injury. This is often unilateral, unconditional and a compulsive attempt at peace keeping.
2. Refusing to forgive. She described this as a reactive, rigid, often compulsive response to a violation that leaves the person stuck stewing in their own hostile juices. This is a decision to continue to punish the offender and reject reconciliation, even if the self is punished in the process.

Cloe Madanes, in her engaging way, summarized the “8 Master Steps of Couples Therapy.”
1. Define a problem so it can be solved.
2. Expand the unit so you have leverage.
3. Use direct and indirect influence.
4. Change the social context.
5. Change small patterns of interaction (where/when discussions take place).
6. Re-arrange the hierarchy.
7. Revisit the past-change early decisions.
8. Clarify values.

And a last thought for reflection…
Helen Fisher brought to our attention the fact that SSRIs often jeopardize the ability to fall in love -or feel the intensity of love. This may be particularly relevant for single depressed clients on medication, who are hoping to find a new partner.

Helen also has a wonderful new book. “Why We Love: The Nature and Chemistry of Romantic Love.” It is always stimulating to keep up with Helen's latest research.

Pete and I presented workshops and panels, including new material from our latest professional resource, “High Impact Couples Therapy.” This 5-CD set reveals the secrets of starting and sustaining effective therapy, even with the most difficult couples. We illustrate how to create a context for change that includes: illuminating the partners' vision, changing the process for discussing highly charged issues, managing emotional reactivity, and resolving intrapsychic conflicts. For more information or to order, visit High Impact Couples Therapy

And good luck with your “Challenging Couples.”