Premarital Counseling

1. DR. POOSHA DARBHA, PHD
Preparing Men & Women
for Marriage

2. The Kipling’s Six
‘honest serving tools’
 Why
 When
 Who
 What
 How
 Where

3. WHY ?
‘ An ounce of prevention
is worth a pound of cure.’
- Benjamin Franklin

4. Why … ?
Preparation necessary because -
 Marriage is the most complex and challenging of all human relationships.
 In the natural course to life most individuals are reared and prepared to go in for
marriage.
 There is hardly any objective training to begin marital life for the majority
 Marital happiness & harmony do not happen on their own, not even in love
marriages. It needs to be cultivated Involves great effort, commitment and
endurance to make it last a lifetime.
 When two families join through marriage there occurs a new family system.
Each of the married persons come from different upbringings with very different
role models;
Bring their own values, opinions and history into a relationship,
and they might not always match their partner's.
 Many people go into marriage believing that it will fulfill their social, financial,
sexual and emotional needs — and that's not always the case.

5. Why…?
 Arranged marriages predominate in India & cross all caste lines, regional boundaries and language barriers – They call
for tremendous adjustment, especially for women.
 Unrealistic expectations
 Poor communication
 Curtailment of freedom
 Over-involvement of families
 Financial matters
 Identity issues, Ego and Power struggles
 Sexual myths, misconceptions and dysfunctions
 Controlling fertility and planning for children
 Lack of love, care, support & trust
 Domestic violence and abuse
 Behavioral, Intellectual and emotional incompatibility;
 Lifestyle habits associated with eating, cleanliness, order & discipline, dress, superstitions, spending behaviour,
recreational activities, alcohol & substance abuse etc
 Infidelity
 Spiritual incompatibility …etc.
Often lead to marital dissatisfaction, conflicts, distress, discord, DV, and/or divorce

6. Why…?
PREPARATION necessary to address all the above issues and more
 To enhance relationship
 Help couples learn important skills in the areas of Communication,
Conflict Resolution, Financial Management, and Stress Management.
• Increase insight and awareness in important areas such as Expectations,
Sexuality, Spiritual Beliefs, Roles, and Personality Differences.
• Help couples develop personal, couple, and family goals.
• Collective thinking & decision making

7. The Paradox of troubled marriages
 10 – 22 years of formal education for livelihood…
but zero education & preparation for a married life
 Extravagant prep for wedding, minimal investment in marriage
 Rapidly evolving society – increased pace of life - changing gender role
expectations, stagnant gender stereotypes – stress and tension –financial
pressures – family over-involvement
 Kundalini, wealth & financial status taking precedence over psychological,
intellectual, emotional & behavioural compatibility and preparedness
 Studies that indicate only 10 to 35 percent of couples receive any type of
marriage preparation. Many couples do not seek help until they are highly
distressed
- Some don’t seek help at all.

8. Benefits of marriage preparation
Happily married couples tend to have
- better physical and emotional health,
- greater financial stability and increased wealth,
- more sexual satisfaction,
- and children that do better academically, relationally and emotionally …
… than those of single or unhappily married couples (Carlson, 2006).

9. To WHO ?
• Groups
• Families
• Couples
• Individuals
• Pre-marital
• ‘Re-marital’
• Premarital couples
with kids
• Cohabiting
• Gay couples
• Transgender couples

10. By Who?
 Mental Health Professionals:
Psychologists, Psychiatrists, Counselors, social workers, sexologists, and
marriage and family therapists.
 Relationship Coaches:
 provide relationship help with an emphasis on solving problems and
learning new skills.
 Clergy/Pastoral Counselors:
 typically deliver the majority of premarital training and perform weddings.
 Elders in the family
 Grannies, mother/father, aunts, uncles
 Other resources: Self-help books, DVDs, online content when
money and time are concerns.

11. How?
• Premarital Education,
coaching*
• Premarital Counseling*
*Usually 4-6 sessions

13. What?
What does PME/PMC address
 Communication – How does the couple communicate? Do they currently have an adaptive or maladaptive method for
discussing important issues? How can they enhance their ability to communicate?
 Conflict resolution – How does each partner resolve conflicts? How do their perceptions of issues correspond? How
can they improve their ability to come to terms on issues on which they disagree?
 Define marital expectations and beliefs – What does each partner expect from the relationship? People sometimes
enter relationships with different expectations as to what constitutes a successful marriage. They often are unaware
that their expectations differ until they are already married, which can lead to serious issues. A premarital therapist
encourages each partner to discuss their expectations, after which the couple can work toward finding ways to
compromise.
 Roles
 Personal values & beliefs – Do the partners have similar personal values? Research demonstrates that shared values
are more important than common interests, and couples with the same values have a better chance of staying together.
 Finances – Can the couple talk about financial issues? Many people are uncomfortable when discussing their personal
finances, and issues with spending and budgeting often create conflicts in marriages. The counselor helps each partner
determine his or her own financial style and then works with the couple in resolving these issues.
 Family – Do both partners want to have children? If so, how many children does each person want? For each partner,
what is the optimal time to begin a family?
 Family Relationships & Interactions
 Sex and intimacy – Are both partners equally comfortable — or uncomfortable — when discussing sex? What does
each partner expect in terms of intimacy and a sexual relationship? Couples should speak honestly and openly about
sex, even if they have chosen to remain celibate until marriage. An ability to discuss these issues without reservations
helps lead to a successful marriage.

14. HOW? - Some Instruments/Programs
1. PREPARE/ENRICH (Olson and Olson, 1999)
2. Relationship Enhancement (RE)
(Cavedo and Guerney) 1999
3. COUPLE COMMUNICATION
(Miller and Sherrard, 1999
4. Prevention and Relationship Enhancement Program
(PREP) (Stanley, Blumberg, and Markman, 1999)
5. Practical Application of Intimate Relationship Skills
(PAIRS) (Gordon and Durana, 1999)
6. ACME-style marriage enrichment (Dyer & Dyer, 1999) …

15. Advantages of Instruments
 Structured and Systematic
 Validity for construct* (Ex: Can differentiate between couples
in harmony and those in conflict with 85% accuracy)
 Reliability
 Predictability
*subject matter one wishes to measure in a survey

16. HOW? – The Process
 Pre-Assessment through questionnaire
 Analysis and identification of problem areas to “work up
on”
 Specific suggestions/counseling/therapy on those issues
 Post-assessment

17. Outcomes
 Reduced risk of divorce
 Improved relationship skills and satisfaction.
 [In a survey of 3,334 couples, premarital education programs were
found to reduce divorce by 31% (Stanley, Amato, Johnson, &
Markman, 2006).
 Increased Marital satisfaction,
higher commitment,
and lower marital conflict.
 A meta-analysis of 13 studies of premarital programs  significant
improvement in couples who received PME
 Couples who participated in the PREPARE program improved their
couple satisfaction
& improved on 10 out of 13 areas of their relationship (Knutson &
Olson, 2003).

18. What the Counselor /Coach /Educator should possess
 Ethical and Legal Considerations in Premarital Counseling
 For counselors, premarital therapy poses both ethical and legal considerations. Some issues to consider
include:
 Understanding the Scope of Practice & Responsibility
 Premarital therapists must understand the scope of their responsibilities and conduct premarital
therapy sessions accordingly. Therapists should not provide professional services that are beyond their
field of expertise based on education, experience, or lack thereof. A counselor providing premarital
therapy should have specific knowledge and expertise in this specific form of treatment.
 Confidentiality
 Adherence to privacy is important in therapy: It allows couples and individuals an opportunity to
confide in their therapist. Premarital therapists are bound by law to protect their clients’ privacy, which
can be difficult in actual practice. However, the therapist should explain the couple’s right to
confidentiality at the outset of treatment.
 Patient Privilege
 Therapists are obligated to protect their client’s information even when called upon to testify in legal
proceedings. However, counselors must disclose some specific information, no matter how private, to
the authorities, including when they believe that clients might harm themselves or others. The
counselor should clearly explain the concept of patient privilege during the couple’s initial session.

19.  Counselling about sex is necessary because sex is still a
taboo in India
 No formal sex education; lack of basic sex knowledge
 Myths, misconceptions, unrealistic expectations rampant.
 Abuse, violence and rape within marriage
 Poor work-life balance,
 Faulty lifestyle habits
 NCDs on the rise

20. Common female sexual concerns
 Virginity
 Fear of pregnancy
 Contraception – emergency pills
 Problems of desire, arousal and
orgasm
 Body image
 Fear of pain in intercourse
 Sexual Pain Disorder
 Penis size
 Vaginal discharges
 Frequency of intercourse
 Fertile period
 Breast size and shape
 Sexual aversion and avoidance
 Oral sex
 Sexual initiative
 Religious concerns about sex
 Age, Menopause and sex
 Care & Affection
 Obligatory sex
 Sexual violence
 Marital insecurity &
abandonment anxiety
 Lesbianism
 Gender

21. Common MALE sexual concerns
 Penis size, shape, angle of erection,
Curvature
 Penis shrinkage
 Scrotal concerns (swelling unequal size,
hanging)
 Masturbation
 Nocturnal emissions
 Premature ejaculation
 Erectile Dysfunction
 Frequency of intercourse
 Refractory period
 Porn watching
 Hymenal virginity
 Desire (libido) issues
 Desire discrepancy
 Prepuce matters (para-/phimosis), chordee
 Infidelity
 STI concerns
 Fertile period
 Performance anxiety
 Burden of satisfying the partner
 Partner demand
 Low Sexual self-esteem/confidence
 Fear of failure, intimidation, insult
 Situational anorgasmia
 Semen quantity, consistency
 Precoital fluid
 ‘semen’ in urine/passing stools
 Sexual orientation/dysphoria
 Gender identity issues
 Sexual violence/abuse
 Kinky sex
 Unrealistic expectations…
 Painful intercourse
 Sexual insecurity and paranoia
 Sex Foods
 Google ‘baba’ syndrome a.k.a
google assisted self-diagnosis syndrome

22. Concerns common for both
 Sexual likes and dislikes
 Sex talk
 Safe sex
 Simultaneous orgasm
 Seminal effluvium
 Sex during pregnancy
 Sex during menstruation
 Female ejaculation
 Sex equals intercourse
 Sexual readiness
 Stress and sex

23.  PLISSIT
to resolve sexual concerns, myths
and minor problems

24. Thank you!