What is it about?
Most couples in long-term relationships know what it feels like to stop talking about the things that matter. The resentment builds quietly. Each partner assumes the other can see the hurt. Neither says the words out loud. Over time, the silence itself becomes a kind of wall. This case report describes a short course of therapy with one couple, married eighteen years, who had reached that point. Both partners wanted to reconnect but felt stuck. Standard couples therapy, especially Emotionally Focused Therapy, often works through empathy and emotional expression. This study tested a different approach: Strategic Family Therapy, a directive method in which the therapist actively disrupts entrenched patterns rather than waiting for insight to emerge. Over three 90-minute sessions, the therapist used radical honesty, defined as direct, structured confrontation paired with what the authors call radical presence, meaning the therapist remains emotionally attuned and non-defensive even while applying pressure. Specific techniques included challenging blame directly, prescribing avoidance in reverse, and assigning a structured exercise in which each partner disclosed a long-withheld truth. The result was a shift from mutual blame to shared accountability. Neither partner reported the relationship as "fixed," but both moved from defensive silence to engaged honesty. The study suggests that, for couples stuck in long-term resentment, deliberate disruption by the therapist can work where empathy and insight alone sometimes stall.
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Why is it important?
Resentment in long-term marriages is one of the most common reasons couples seek therapy, and one of the hardest patterns to interrupt. Emotionally Focused Therapy (EFT) is well-supported by decades of research and is often considered the standard of care. This case report does not reject EFT. It demonstrates that a different approach, Strategic Family Therapy, can succeed with couples for whom empathic, emotion-focused work has not been sufficient or has not been the right fit. The case contributes three things. First, it operationalizes "radical honesty" as a deliberate therapeutic technique, distinct from catharsis or venting, and ties it to a specific theoretical lineage running from Gregory Bateson's communication theory through Jay Haley's strategic model. Second, it pairs that technique with "radical presence," a relational stance in which the therapist maintains emotional attunement even while applying directive pressure. Third, it offers a transparent account of the method, including verbatim therapist statements, intervention-by-intervention rationale, and the limits of a single-case design. The work is timely because the field is reconsidering how much emphasis to place on empathy, validation, and passive support as universal defaults. For clinicians working with couples entrenched in long-standing avoidance, the report offers a tested alternative: structured confrontation, conducted ethically and relationally, can move couples past stuck points that softer approaches may not reach.
Perspectives
I wrote this case report because most published accounts of Strategic Family Therapy treat it as either outdated or coercive. The first reading is empirically wrong. The second is theoretically lazy. Strategic therapy, properly grounded in Batesonian systems theory and conducted with the relational attunement that Shotter and McNamee call radical presence, is neither. It is a deliberate, ethically accountable form of disruption. The therapist takes temporary, structured authority not to dominate the couple, but to expose the recursive loops they cannot see from inside. What this case taught me, again, is that systems theory is not a metaphor for clinical work. It is the operating logic. Resentment is not a feeling one partner has. It is a feedback loop both partners maintain. You cannot interview your way out of a feedback loop. You can only interrupt it, and the interruption has to be done by someone with enough relational standing to make the disruption land. That is the ethical weight of the role, and it is also what makes the work worth doing. The intervention sequence in this case is not a protocol. It is a structured decision-making process, responsive in real time to what the couple was doing in the room. That distinction matters. Strategic therapy gets criticized for being rigid and formulaic, when in practice it is the opposite: it demands that the clinician read the system, moment by moment, and choose the move that has the best chance of shifting it. The three-session timeline in this report shows that responsiveness in action. Each intervention was selected because of what the previous one revealed, not because it appeared on a checklist. I also wrote this case because single-case reports, conducted transparently, still earn their place in the clinical record. The work is brief by design. Strategic therapy is not in the business of reconstructing the past or narrating the history that produced the present pattern. Haley was clear: he did not need to know what happened before. He was looking at what was happening in front of him, in the room, in that moment, to begin the undoing. This case follows that logic. The work began in the first 15 to 20 minutes, in the interaction, in the body language, in the silence between two people sitting across from each other. What the past contributed stays in the past. What matters is what the system is doing now and what the therapist can do, now, to interrupt it. I publish this case not as a manifesto for SFT, but as an honest record of one couple, three sessions, and a method that is too often dismissed before it is examined. The field needs both the evidence and the clinical record. This is one entry in that record.
Assoc. Prof. Ezra N. S. Lockhart
National University
Read the Original
This page is a summary of: Case Report: Treating Marital Resentment with Radical Honesty in Strategic Family Therapy <i>{under peer review}</i>, Mental Health Open, February 2026, Global Institute for Mental Health Innovations, Networking and Development a.s.b.l.,
DOI: 10.64257/5eazg357.
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