Need Management Therapy (Nmt): A New Science of Love, Intimacy, and Relationships

By Robert N. Johansen Ph.D and Todd W. Gaffaney Ph.D

Divorce, separation, and couple breakups are on the rise in the United States of America, with about 48 percent of couples breaking up within nine years of starting a committed relationship.

Only a minority of distressed couples ever seek couple counseling—and those that stay together do not necessarily enjoy healthy relationships. Just as sadly, marriage counselors divorce at or about the national average.

The Need Management Therapy model asserts that positive change is possible and even likely. The authors offer a treatment package both for the professional in practice and a self-help guide for the non-professional.

We have successfully treated hundreds of couple-clients using the NMT model. We are now conducting a randomized pretest posttest two group design investigating several crucial NMT hypothesis (pending). Preliminary data suggest that significant and meaningful change may be achieved in just a few sessions.

When the NMT model is applied, couples report not fighting as much—and sometimes, fighting stops altogether. Communication improves dramatically.

If you’re passionate about making your relationship work, you’ll find a new science of love, intimacy, and relationships in Need Management Therapy.

• Language: English
• Publisher: Archway Publishing
• Release date: Mar 25, 2021
• ISBN: 9781480899285

Robert N. Johansen Ph.D

Robert N. Johansen, Ph.D., is a member of the American Psychological Association and co-director of the Cerritos Psychological Center, where he has been in practice for forty hears, specializing in couple’s therapy and supervising interns. Robert has coauthored two relationship books and has taught psychology at several colleges/universities, and has lectured at UCLA, the Milton Erickson International Foundation, CAMFT, NPR, ABC radio, UCI educational TV, and continuing education at Alliant International University. He is married with three children and three grand-children and enjoys traveling with his wife. Todd W. Gaffaney, Ph.D., is a distinguished retired professor of psychology (emeritus) at Cerritos College, where he taught from 1975 to 2019. In 2010, Todd was awarded “the most outstanding professor” at the college. Todd is also a long-standing and active member of the American Psychological Association (college division). Currently, he is an adjunct faculty at Pepperdine Graduate School in psychology. He is a co-author of two books on the intimate relationships and a nationally known “motivational speaker” on relationship health, war/combat psychology, and the science of how and why people change. Todd is certified as a life and relationship coach/trainer in private practice. He has been married forty-two years with three adult children, eight grandchildren, two great-grandchildren, and one small dog.

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Copyright © 2021 Robert N. Johansen, Ph.D and Todd W. Gaffaney, Ph.D.

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ISBN: 978-1-4808-9927-8 (sc)

ISBN: 978-1-4808-9926-1 (hc)

ISBN: 978-1-4808-9928-5 (e)

Library of Congress Control Number: 2020922381

Archway Publishing rev. date: 03/22/2021

Contents

Dedications

Professional Acknowledgements

Praise for the NMT Model

Other Publications on Need Management Therapy

A Note to Our Readers

Preface

THE CRISIS IN COUPLE RELATIONSHIPS

PART 1 Theoretical

and Research Foundations

1.     Recent Theoretical Approaches to Couple Therapy

PREVIEW

BOOK TITLE AND PURPOSE

NMT’S SPECIAL FEATURES

NMT: BASIC WORKING ASSUMPTIONS (OUR BIASES AND BLIND SPOTS)

THE HISTORY AND EVOLUTION OF NMT

OVERVIEW OF THE NMT TREATMENT MODAL (A BRIEF, FUN GLANCE AT IT ALL)

ALTERNATIVE MODELS OF COUPLE THERAPY

POSTSCRIPT: THE PSYCHOTHERAPY INTEGRATION MOVEMENT

2.     Why Relationships Fail and Succeed Our Theory of Love

PREVIEW

THE CRISIS IN COUPLE RELATIONSHIPS

WHY DO INTIMATE RELATIONSHIPS FAIL?

COMMUNICATION PROBLEMS (COUPLE COMBAT)

HOW NMT VIEWS COUPLE FAILURE

EARLY LOVE RESEARCH (A SCIENTIST LOOKS AT LOVE)

THE TRIANGULAR THEORY OF LOVE (THE EXPERIENCE OF LOVE)

THE ATTACHMENT THEORY OF LOVE (EARLY AND LATE BONDING)

3.     Foundations of Need Management Therapy

PREVIEW

TWO ESSENTIAL RELATIONSHIPS

THE FORMATIVE RELATIONSHIP

EARLY RELATIONSHIP INFLUENCES

THE REVEALED RELATIONSHIP

THE PAST AND THE PRESENT (CAN’T HAVE ONE WITHOUT THE OTHER!)

NMT: DEVELOPMENTAL PERSPECTIVE

Part 2 The Three Pillars of

Need Management Therapy

4.     NMT’s First Pillar: Need Identification

PREVIEW

INTERPERSONAL CONFLICT (LOVING THOSE WITH WHOM WE ARE AT ODDS)

A THEORY OF BLAMING (PARTNERS UNDER ATTACK)

THE IMPLICIT STORY (BLIND BUT NOW I SEE)

NEED IDENTIFICATION (DEFINING MYSELF)

THE SELF-STRUCTURE (THE I OR ME)

NEED IDENTIFICATION APPLIED (SELF-INTIMACY)

THE CHANGE PROCESS (WHAT ACTUALLY WORKS AND WHY)

5.     NMT’s Second Pillar: Need Legitimization

PREVIEW

NEED LEGITIMIZATION: THE APPROBATION OF FUNDAMENTAL NEEDS

COMPASSION (ACCEPTANCE OF SELF AND PARTNER)

THE CHANGE PROCESS (WHAT WORKS AND WHY)

6.     NMT’s Third Pillar: Need Representation

PREVIEW

THE STEPS OF NEED REPRESENTATION

NMT AND THE PROCESS OF CHANGE (WHAT WORKS AND WHY)

THE PSYCHOLOGY OF RISKING

THE HEATH OF THE RELATIONSHIP

THE LONG AND SHORT OF NMT (A QUICK FIX)

EVALUATION OF THE NMT MODEL

7.     Need Management Therapy Applied: A Case Study

PREVIEW

NMT CASE STUDY: NICK AND ANGIE

NMT: NEED IDENTIFICATION

NMT: NEED LEGITIMATION

NMT: NEED REPRESENATION (THE I/THOU RELATIONSHIP)

NEED AND AFFECT EXPRESSION

PRIORITIZATION OF NEED MANAGEMENT OVER NEED GRATIFICATION

THE OUTCOMES OF THE STUDY

8.     The Complexities, Challenges, and the Uniqueness of the Intimate Relationship

PREVIEW

COMPLEXITIES AND CHALLENGES

OUR THEORY OF LOVE

EMOTIONAL AND INTIMACY

INTELLIGENCE

NMT’S THREE ORGANIZING

PERSPECTIVES

THE UNIQUENESS OF THE

INTIMATE RELATIONSHIP

ON BECOMING ONE’S OWN PARENT

THE HEALTH BENEFITS OF THE

INTIMATE RELATIONSHIP

INTIMACY IS THE BEST VEHICLE

FOR CHANGE AND GROWTH

9.     The NMT Perspective on Culture

PREVIEW

THE APA MANDATE (OUR ETHICS CZAR)

CULTURE: MAJOR CONCEPTS

NMT, CULTURE, AND UNIVERSAL HUMAN NEEDS

10.   The NMT Perspective on Gender

PREVIEW

GENDER RELATED TERMS

TRADITIONAL MALE SEX ROLE ISSUES

TRADITIONAL FEMALE SEX ROLE ISSUES

GENDER SOLUTIONS (NEW WAYS TO THINK ABOUT GENDER)

NMT SOLUTIONS: GENDER STEREOTYPES AND BEHAVIORS

DIVERSE SEXUAL ORIENTATIONS (THE LGBTQ COMMUNITY)

Epilogue

Appendix A

PSYCHOTHERAPY, TRAINING, CONSULTATION, AND RESEARCH

Appendix B

FIVE FRQUENTLY ASKED QUESTIONS ABOUT NMT

Appendix C

THE RUNGS OF NEED MANAGEMENT ASSESSMENT

Appendix D

SURVEY THE DAMAGE OF THE PAST– A QUICK ASSESSMENT TOOL

Glossary: The NMT Vocabulary

References (Our Reading List)

About the Author

Dedications

This NMT book is dedicated to Vi (my wife) and three adult children (Sherice, Wendy, and Matt). It is only through their ongoing encouragement, emotional support and caring, and fundamental respect that I have been able to pursue my dreams as an author, professor, therapist, researcher, relationship coach, and most importantly, an opportunity to be a more open, honest, and kinder person. With love, Todd.

To my over 25,000 students across 44 years of teaching clinical courses, Rob and I are proud and grateful for their willingness and courage to allow us so many opportunities to explore our early ideas on love and intimacy through lectures, class exercises and demonstrations, and most of all through personal storytelling and life disclosures. We give you our heartfelt thanks.

Anne, you are always there supporting my efforts in countless ways – you attend to the demands of our daily lives, taking on many of our shared responsibilities, so that I can attend to the work of developing NMT. Your own contributions to NMT are invaluable, your feedback has been wise, and well-considered. At your side, I feel the joys and challenges of our relationship shaping who I am and who we are – without you, my growth and development would not be the same. Your faithful, devoted love will live in me forever.

Ian, you have my endless gratitude for your love, your inestimable insights on NMT, and your untiring efforts that brought NMT to the refiner’s fire of empirical science. You and Kristie exemplify a strong, loving partnership, and you provide more than enviable parenting to Dean, Katie, and Shane, our dearest grandchildren. I love you forevermore.

Lauren, who you are enriches our family ad infinitum. The love you bring your mother and me, your brother and his family, and the love you share with Jason is a source of ongoing and profound joy to us. Thank you, and Jason for deepening the meaning of our lives with your talents and your art. I love you forevermore.

To our clients, Todd and I are deeply grateful to you for the privilege and honor you grant us to enter your lives so personally and hopefully – your aspirations and courage inspire us – a million times. Thank you!

Professional Acknowledgements

We would like to express our deepest gratitude for the many graduate students and therapists who have made substantial contributions toward the training, writing, teaching, and research of our need management therapy model.

Our list includes (no special order):

• Cynthia Alvarez, M.A. – Research Coordinator – Training

• Patsy Rodriguez – Research Coordinator – Training

• Emily Fernandez – Research Assistant – Training

• Jennifer Hernandez – Research Assistant – Training

• Hanna Deguzman – Research Assistant – Training – Private Conversation

• Laura Aguirre – Research Assistant – Training

• Carlos Osorio – Research Assistant - Training

• Princess Florendo - Research Assistant – Training

• Saqib Iqbal, LCSW – Research-based NMT Therapist – Training

• Jessica Ramey, PsyD intern - Research-based NMT Therapist – Training

• Ken Mazey, Ph.D – Clinical Psychologist – Private Practice - Psychotherapist, Lecturer, - Personal Conversations on NMT Theory & Research

• Deana Porter, MSW, LMFT – Director- Low Cost Community Counseling Therapy – Training, Research, Teacher, and Research-based NMT therapist

• Lester Mindus, Ph.D. Clinical Psychologist – Co-Director Cerritos Psychological Center – Training and Personal Conversations

• Ian Johansen, Ph.D. Clinical Psychologist - Private Practice - First NMT Researcher – Ongoing NMT Therapist

Endless Thanks, Robert and Todd

Praise for the NMT Model

The newest version of this remarkable approach to couples’ therapy broadens its approach to diverse cultures and gender role issues, and not in the least, the service of reducing gender role polarization. The Need Management Therapy approach helps couples hear each other, nurture each other, and enable their best selves. This is a comprehensive and wonderful goal.

Les Mindus, Ph.D – Clinical Psychologist in Private Practice

– Co-Director of the Cerritos Psychological Center

I had the privilege of providing Needs Management Therapy training (NMT) with couples as part of Drs. Johansen and Gaffaney’s research program. The strategies that couples learned were simple, yet effective. The simple and powerful communication skills in this training are essential for couples at every stage of their development.

Saqib Iqbal, Licensed Clinical Social Worker, Private Practice

Carefully crafted, systematic, and a complete way at looking at the management of human needs through taking responsibility and accountability for our needs while communicating them in a healthy way to our mate. Need Management Therapy allows respect, acceptance, and love to flourish toward creating a genuine and deep intimacy between couples.

Foojan Zeine, Psy. D. - LMFT – Originator of the Awareness

Integration Theory, and the author of Life Reset – the Awareness

Integration path to creating the Life you Want.

I have read the first eight chapters of Need Management Therapy and found them to be most enlightening. In fact, last evening, I had a very productive hour-long exchange with my lady friend regarding my still rudimentary understanding of the NMT concepts. She was very intrigued and we made some early progress confessing to our own recent cases of need mismanagement. Undoubtably, more progress is expected in the days ahead.

I feel, of course, somewhat ill equipped to speak with any authority on the merits of NMT, however, I sense tremendous potential for this therapy to be highly effective for all relationships.

Because (1) I believe the principles of NMT are, with some effort, very understandable; (2) the principles give each of us a much more comprehensive knowledge of the intimate relationship and its proclivity for conflict and (3) NMT identifies and promotes the ability within each of us to implement positive and lasting personal growth in ourselves as well as our relationships.

Gordon Massie, BA in Economics and MBA in Finance from the

University of California, Berkeley Senior Investment Advisor at AIG –

Author, "The Whistleblower’s Dilemma: Confronting Fraud at AIG

This new book on couple’s therapy will delight readers longing to improve their relationships, and the quality of their everyday communications with loved ones. The authors offer a guided tour of an innovative therapy process and pinpoint the pathways to change for couples in crisis. Anyone involved in an intimate relationship who wants to achieve long-term emotional balance and integration, will benefit from reading Need Management Therapy. Psychotherapists from all persuasions will be honed by the insights, guidance, and detailed strategies of this book.

Ken Mazey, Ph.D - Clinical Psychologist – Private Practice –

Professor, Lecturer, UCLA Honors Collegium Program.

Now that I counsel couples with NMT, I find they do less finger pointing at their spouse, and their expectations of me, to fix their partner is reduced. Each client gets to understand, legitimize, and learn skills to manage his or her fundamental needs Best of all, they are now reporting a higher level of happiness with their relationships. I find this model to be so effective I am teaching it to my supervisees.

Deana Porter, MSW, LMFT – Director of the Low

Cost Community Counseling Center

This book has changed my approach in working with clients. It is a must-read premier for anyone in the field who wishes to master the art of helping people understand how to foster better therapy outcomes.

It is clear, concise, and reader-friendly. I have adopted NMT for my counseling clients.

Pauline Urbani, MA. - LMFT and PsyD intern – PsyD graduate

student at the California Professional School of Chicago

Need Management Therapy has become my go-to therapeutic approach when working with couples and individuals with relational issues.

This approach gives the therapist a clear and concise road map for dealing with a multitude of relationship challenges. I have witnessed my clients absorb the formulaic tenets of NMT and apply them to their lives in a matter of weeks. Even my clients with complex relational expectations have rapidly transformed their dysfunctional communication patterns that have eroded their marriages for years. This therapeutic discipline has become one of my most valuable and versatile tools for helping my clients with intrapersonal awareness, self-validation and self-advocacy.

Ian Johansen, Ph.D - Clinical Psychologist – Private Practice – NMT Therapist,

Researcher, and National and International Workshop Presenter and Teacher

Need Management Therapy will give you the practical tools you need to resolve your relationship problems and reconnect in ways you never would have imagined as possible. This is a must read for those who want to improve their intimate relationship.

Amber Trueblood, LMFT, MBA – Author of Stretch Marks

– Speaker and host of Stretch Marks podcast.

Other Publications on

Need Management Therapy

A New Paradigm for Couples Therapy – The Therapist, a professional publication of the California Association of Marriage and Family Therapists, (May, 2006).

Making Love: How to Create, Enjoy, and Sustain Intimacy- Untread - Reads, San Francisco, Ca. - May, (2010).

A Note to Our Readers

Just a quick heads-up: Our book is a hybrid, meaning, we’re targeting two audiences - a general readership, or non-professional audience (those who like to dabble in self-help psychology), and the professional community (therapists, clinicians, and counselors). If you have an interest in psychology and related sciences, but don’t have a lot of familiarity with this subject matter, you might find some parts of our book more readable, relatable, or enjoyable than others.

For example, the preface, and the beginning sections of chapter one, along with chapters two, eight, nine, and ten, are written in lighter, and more engaging prose that may help pique and sustain your interests in delving deeper into material that you might otherwise find dry or academic. Also, to make our pre-book-heads-up complete, there are exercises at the close of each chapter and at the back of the book that personalize the content of the chapters, making the ideas immediately applicable. We’re hoping there’s a lot for you to look forward to!

To our professional readers, our wish is that you find yourselves at-home and in largely familiar conceptual territory on the pages of our book. We looked in every nook and cranny that we could, to construct, and support our theory and treatment method; we believe you’ll find it well-nested in the relevant science. But more, we hope you will find our new thinking on love and the intimate relationship, invigorating, thought-provoking, and, perhaps, you’ll choose to incorporate it into your own repertoire of clinical skills for helping couples. If you’d like to use our model in your particular treatment venue or practice setting, and need more information, we’ve provided our contact information at the end of the book.

To you all, enjoy the reading!

Robert and Todd

Preface

THE CRISIS IN COUPLE

RELATIONSHIPS

The Love and Intimacy Challenge

(Is it Sustainable?)

Without question the intimate relationship is complex, difficult, and challenging, therefore, not surprisingly, it often fails. And when it does, it can devastate us, not only emotionally, but physically. Next to losing a partner to death, divorce and separation rank number two on the top ten list of stressors (Holmes & Rahe, 1967).

Let’s briefly trudge through the very sobering statistics on divorce: One marriage dies every thirty-six seconds! In the aggregate, the failure rate is roughly 48% for first marriages (National Center for Health Statistics, 2004). And cohabitation, despite its rising popularity, is not an answer, or an escape; couples who live together fail at a slightly higher rate (Rosenfield, et. al., 2019). Nor do these statistics suggest that couples who survive, the nondivorced, or unseparated, bask in a haven of blissful togetherness, enjoying flourishing relationships. No doubt, an inestimable number of relationships hang by a thread, are inwardly fragile, and held together for questionable reasons related to social, family, religious pressures, or, to retain a necessary but rocky instability out of fear, economic necessity, or for the sake of the children, etc. This is bad news, and it gets worse.

A Statistical Nightmare

At its statistical best, the marriage, or cohabitation survival rate is roughly a coin flip. The rate of cure for many forms of cancer is higher! Alarmingly, couples who marry for the second and third time, divorce at stratospheric levels; Sixty percent for second marriages, and 70 percent for the third round of nuptials (Rosenfield, et. al., 2009). Famed English writer, Samuel Johnson, once quipped, Remarriage is the triumph of hope over experience! Further, most distressed couples rarely seek therapy, and regrettably, when they do, it is often too late. Sadly, the news gets darker still.

Ironically, and embarrassingly, marriage counselors divorce at, or around the national average, and, according to some studies at an even higher rate than the average! (Deutsch, 1984; McCoy, and Asmodt, 2010; Klag, 1997). And to pile irony atop irony, a significant number of them don’t seek treatment! (Deutsch, 1984). Think of it, the professionals charged with the sacrosanct duty of protecting the vitality and health of our relationships, divorce at the same rate!

In defense of our beleaguered colleagues, we strongly believe these bewildering statistics reflect the inherent difficulties of the intimate relationship, as well as the need for new, integrative, and improved couple treatment models (Murstein, & Mink, 2004). (A quick sidebar: every intimate relationship you have ever been a part of, except the one you may be in now, has failed, otherwise you would still be a part of it.) All relationships end by one means or another; you break-up, your partner dies, or, you die. Despite this mirthless fact, Alfred Lord Tennyson insightfully encouraged us, Tis better to have loved and lost than to never have loved at all, which is the choice the overwhelming majority of us make.

The NMT Point of View (Our Best Thinking)

Like you, we are appalled by these high-soaring divorce statistics. And we confess, we too, are statistical victims. Frankly, a sizable chunk of our motivation for developing a new couples treatment model is based upon our own personal suffering. Remember Fredrich Nietzsche’s famous epigram, quoted so often it has morphed into a cliche: Whatever doesn’t kill you simply makes you better. Well, here’s our better, the NMT treatment model, it’s the sublimation of our conjoint divorce pain!

We would like to help others avoid the emotional suffering of separation and divorce, especially in cases where children are involved. By creating a model that is an effective, short term, and easily applied treatment for couples, we hope to reduce this suffering. As you now know, we named our approach, Need Management Therapy, and we offer it as an alternative to current treatment choices, or, to the risky gamble of a mere rolling of the dice, the 50% chance of treading the slippery slopes of separation and divorce.

With this said, we are pleased to introduce our new treatment model! It comes neatly packaged with our equally new theory of love, both of which are firmly planted in the cognitive behavioral school of thought (CBT). Couched within CBT’s supporting purview, NMT has developed, as a CBT derivative, its own practical, easily learned and applied approach that can untangle couples twisted in stress and crisis, and it can also be readily deployed to improve relationships regardless of their level of affliction, or their purported health. We confidently propose that the NMT treatment approach offers hope as an aspiring antidote for the crushing divorce statistics and their disastrous after effects. There is reason to be hopeful!

The Power and Transmission of Hope

In both his earlier, and more recent writings, Jerome Franks (1961; 1991) makes a compelling argument that most forms of therapy - including couple therapy - instill hope as a contributing agent of change. The NMT approach is very sympathetic to Frank’s argument, but carries the ball a little further down field. Meaning, we contend that hope, in and of itself, is a powerful change agent that can positively sway the course of treatment. Keep this thought in mind, as we glimpse at how the NMT therapist first mobilizes, and then transmits hope to our couple-clients.

From the outset of the treatment process, we encourage our couple-clients to be hopeful that they are capable of change regardless of any backlogged, stultifying past conflict, or other personal problems. By supporting openness to new ways of thinking about the couple relationship, and the just-over-the-horizon benefits of doing the work of NMT therapy, couple-clients can be more hopeful and confident as they take on the challenges of self-exploration, and the calculated risk-taking that are a part of the NMT treatment process. Moreover, they can acquire the motivation to learn more effective ways to manage their personal needs, and the intense emotions that attend them (Norcross, 2019).

Our Passion on Display

We purposely make our passion about the NMT model transparent, as another means of injecting hope into our couple-clients. Our belief and confidence in the model have been strengthened by years of clinical experience. Optimally, we’d like our zealousness to be openly exhibited, on parade, and even inspiring. Coincidentally, but not surprisingly, there is new, provocative research which suggests that particular therapeutic approaches may have limited effectiveness. Alternatively, a better predictor of outcome success may be the client’s perception of the strength of the therapist’s belief and passion, in their treatment model, along with its techniques (Wampold, 2015., 2019). Our interpretation of Wampold’s research findings is that the therapist’s passion for a particular brand of therapy, and its techniques, can foster hope, and once instilled, hope can motivate couples to take actions they might not otherwise have taken. Hence, hope itself can serve as a powerful agent of change.

While we have limited access to reliable evidence on the passion other therapists have for their treatment models and techniques, nevertheless, we can reaffirm our enthusiasm about our new NMT model. You’ll hear it clearly expressed in the voice of our writing, and you’d see it with equal clarity at our presentations. Indeed, the very existence of this book itself, and the sacrifices required to write it, is tangible proof of our confidence in the model’s clinical applicability, potency, and its advantages to our clients, and our readers, both nonprofessional and professional alike.

It is our hope that NMT’s masterstroke is the relative ease of learning its straightforward, stepwise approach that can offer a speedy fix for couple conflict, and related relationship stressors. Because it can be a quick study, on occasion, we’ve actually observed couples making significant progress in as few as one to two sessions of treatment. Yes, when it comes to couple therapy, this is hopeful talk indeed. In fact, could it be more hopeful?

We thank you for reading these introductory remarks. It is our sincere desire that you’ll enjoy and benefit from the remainder of our book, and find additional help in the exercises at the end of each chapter and the appendices at the back of the book. If you wish to have therapy, training, or both, please go to our contact information at the end of the book, we’ll be happy to help (see Appendix A).

With gratitude and best wishes,

Rob and Todd

PART 1

Theoretical and Research

Foundations

CHAPTER 1

Recent Theoretical Approaches

to Couple Therapy

PREVIEW

Let’s begin! Chapter 1 will roll out the red carpet with what we hope will be an enticing introduction to our newly crafted theory of love, and couple’s - treatment model, inventum novum! We’ll eagerly present several paragraphs introducing the model-framing, science-based assumptions that underlie our theory. This will set the conceptual table for a brief introduction to need management therapy’s (NMT) theory of love, and our couple’s therapy approach that flows directly from it.

We’ll compare and contrast the NMT treatment model with two currently preeminent couple’s therapy models, and discuss our criteria for selecting these particular approaches. Then, we’ll finish the chapter with a discussion of the psychotherapy integration movement, focusing specifically on its application to couple’s therapy. We’ll summarize the current events in this growing area of research, and conclude with NMT’s vision of couples’ therapy integration.

BOOK TITLE AND PURPOSE

We’ve titled our new book Need Management Therapy (NMT): A New Science of Love, Intimacy, and Relationships. Our goal is to broadcast our approach to a wide-ranging audience of non-professionals, and professionals alike, as a unique, and advantageous alternative to conventional thinking about the intimate relationship, and current couples’ therapies. Doubtless, a large portion of both groups of readers are already navigating, with varying degrees of success, what is convincingly the most complex, and therefore, most challenging relationship - the intimate one. Moreover, to our professional colleagues, we invite you to consider a new treatment model for couples, whose methods are easily learned, implemented, and yet still promise clinical effectiveness.

As mentioned, we anticipate that the majority of our readers are already involved in a close relationship, or desire to be in one, or have lost a close relationship, or are considering re-entering the marketplace. Certainly, as human beings it can be said we are all hardwired to seek and maintain close, securing, and satisfying attachments with others. Given the intricacies of the intimate relationship, we’d also expect that many of our readers might ask: what personal qualities, skills, or tools are most useful for traversing the craggy, but fulfilling landscape of the intimate relationship?

To answer, we are proposing NMT’s theory of love, and its treatment methods that are based on the methods of science - more than two hundred and eighty scientific citations covering thirty-five pages of references. NMT has distilled from this large body of literature a stepwise, and practical treatment method, a simple recipe, as it were, that offers partners more than common sense directives, and cheerleading-type admonitions often found in the self-help literature; nor is it merely arm-chair speculation, but instead it is grounded in the science of the psychology of relationship change.

More specifically, the NMT treatment package offers its own operational definition of couples’ communication - that is, an easy-to-comprehend, step-by-step set of evidence-based mechanics for managing individual, and couple needs. It also weighs the lingering influences of the couple’s early, or past relationships, providing insight from these, and specific interventions for behavioral change. Further, the NMT model also addresses current-day issues, in order to furnish a comprehensive treatment plan for couple’s therapy, as well as an in-home, self-help program for the non-professional desiring relationship improvement.

In the sections ahead, we’ll unfold a detailed and sizable explanation of these concepts along with a supportive rationale for their use in the NMT model. This is our pledge.

NMT’S SPECIAL FEATURES

Integration (Adding to the Mix)

Above all, NMT aspires to be an integrative model and attempts to do this from within general psychology as well as expanding CBT to include elements from other therapy approaches. Consider these forms of integration: First, NMT incorporates relevant research findings from academic psychology including developmental neuroscience, and the psychology of emotion. Second, NMT reaches beyond the borders of cognitive behavior therapy (CBT), to nurture itself with psychodynamic concepts (the importance of early relationships), and interpersonal models (relationship interactions) in order to improve its breadth, depth, clinical utility, and potency.

Working from within CBT’s flexible framework - while trying to put all possible oars in the water - NMT welcomes fresh, divergent ideas from other systems of thought, which may open new dimensions of exploration in couples’ therapy. For example, CBT helps the couple by exploring the role of cognition in understanding and effectively treating core dysfunctional thoughts that are handicapping the individual’s mental health, and the health of the couple’s relationship.

However, CBT typically does not directly target affective behavior and interpersonal relationships within the therapeutic context to the same extent as do the experiential-therapy approaches. Nor does it achieve the depth of analysis that may be indicated in many couple cases. Given these concerns, we are confident that the right amalgam of approaches may better equip the NMT therapist. Our overriding expectation is to meet the individual needs of our clients with a therapeutic broad-brush, without force-feeding a particular mode of thinking, whether it is CBT, or any other system of therapy. Integration and flexibility are our goals.

The key to NMT’s integration efforts is the joint merger of systems thinking (interpersonal interactions) and the psychodynamic emphasis upon structural damage in early childhood, all couched neatly within the CBT framework. Such a merger is intended to better equip the NMT therapist to intervene therapeutically at several levels: an early structural level (childhood reconstructed memories); a contemporaneous couple interactional level (current communication patterns); or, at any point along the continuum between the past and the present. While disparate treatment approaches may be complementary to each other, theoretically, a combination of approaches might encourage the elimination of non-complementary, or antagonistic, or - worse - competing types of treatment, by replacing them with a joining of forces for a new CBT expansion that can promise greater clinical effectiveness.

A head-turning body of evidence shows that CBT and other single model therapies still show a significant clinical shortfall (some clients drop out prematurely, or do not show recognizable improvement) which begs for explanation and perhaps new innovative and integrative treatments models (Glass, et. al., 1988., Margolin, 1981., Norcross & Goldfried, 2019., Seligman, 1995., Wampold, 2013, 2015). We firmly believe that an integration among the varieties of couples’ therapy approaches, again a new merger, may well reduce this failure rate, enhancing not only the statistical, but also the clinical impact of treatment. With this in mind, it is NMT’s mission statement to evolve as a fully integrated variant of CBT. We are betting that this is the best direction to take at this time.

User Friendly (A Clinician’s Dream!)

Despite NMT’s recent emergence, it ambitiously enters the workplace of couples’ therapy with growing confidence, taking pride that its methods are easily learned, user-friendly, yet clinically potent. To illustrate, in May 2019, the authors trained four non-NMT therapists in the methods, procedures, and core ideas of NMT. These newly trained therapists then treated real couple clients who were randomly assigned to them as part of our experimental research program, which was specifically designed to test the effectiveness of the full range of NMT change agents. The training was accomplished within approximately five hours, a short training regime, indeed, when compared to other schools of couple therapy! NMT’s Occam’s Razor!

By contrast, John Gottman’s certificated training consists of three competency levels which can require two years of mentored instruction (the Gottman Institute, 2019). And indeed, the founders of emotion- focused couples therapy readily confess to the extensive training needed to master their techniques, admitting that novice therapists, and even those with extensive experience, can stumble over their complicated methods (Greenberg and Johnson, & Johnson, 2010). Despite these criticisms, both Gottman’s methods, and those of EFCT enjoy empirical support, and considerable popularity. For these accomplishments, we admire and applaud them!

A Brief Detour in Grateful Tribute to Science

Before going further, we humbly acknowledge, with a heavy dose of respect and commendation, that the NMT model stands upon the very capable, sturdy shoulders of the many theoreticians, researchers, scientists, and practicing clinicians representing the diverse fields of: cognitive psychology, psychodynamic psychology, object relations theory, developmental psychology, attachment theory, developmental neuroscience, the psychology of emotions, systems theory, and emotional intelligence. Certainly, an impressive group!

By deliberately cherry picking its key ingredients from these varied and ripened fields of thought, NMT distills what it considers to be its nexus of concepts: need identification, need legitimization, and need representation. These blue-blooded concepts are the elite ruling class of the NMT treatment approach. Because they are the defining pillars of the NMT model, they will occupy center stage in the upcoming chapters of this book. As we push on, they will also be highlighted for the benefits that can be bountifully harvested from their implementation - both in and out - of therapy. Our clinical experience backs this admittedly heady pronouncement!

Marching in lockstep to the steady drum beat of cognitive reasoning, the NMT doctrine emphasizes how significant and sustained change in cognition promotes therapeutic change in emotion, which, in turn, can organize new and adaptive behaviors. As would be expected, a sizable share of the heavy lifting of therapeutic change takes place by modifying specific cognitive distortions, NMT style, and replacing them with new, more flexible and adaptive ones (as is done with old, broken car parts!). Sadly, however, these same crippling cognitive distortions express themselves in the commonly observed patterns of labeling, blaming, nasty accusations, or other partner maligning characterizations, a phenomenon NMT refers to as explicit story-telling. There’ll be more to come on these hamstringing couple predilections, and we’ll furnish a complete explanation of explicit story-telling in chapter 4.

Our gratitude would be incomplete without pointing out how the various non-cognitive schools of therapy we’ve admired for so long, and now lean upon,