As in all approaches to therapy, the effectiveness of marriage and family therapy depends on the strength of the clients' desire to overcome the difficulties that have motivated them to ask for help. Goodwill and commitment to change may or may not be there. Sometimes a therapist can help clients become aware of their deep-seated but habitually ignored feelings of warmth toward one another. At other times, marriage therapy may lead to separation and divorce, if a couple comes to realize that their goals really are not compatible and what each needs or wants from the relationship the other is not able or willing to give. Marriage therapy and family therapy are not magic wands that can be waved over trouble to make things better. Therapists can make specific recommendations, they can help a couple or family become explicitly aware of destructive patterns, they can point to and illustrate constructive ways of interacting, and they can sometimes use therapeutic strategies to break old habits and make room for care and sensitivity to the needs of wife, husband, and children. These interventions from a therapist can be very {203} helpful, perhaps even crucial, but they are, at most, _catalysts_ for change: real and lasting changes can only come from clients themselves. Marriage or family therapy is ideally an educational experience. What wife, husband, and children do with what they have learned is, in the end, up to them. Family therapy has been especially effective in dealing with these problems: * problems due to conflicts among family members * emotional disturbances in children * some cases of schizophrenia where members of the family are frequently not well-individuated--each person's identity is so bound up with the outlooks and behavior of other family members that no one has a clear sense of his or her own personal identity and separateness * problems that are interlocking, where the difficulties of one member of the family cannot be resolved without the cooperation of the others * problems experienced by a family when a child becomes old enough to leave home Family therapy has been much _less_ effective in treating paranoia in one member of the family, and behavioral problems stemming from sexual disorders. Marriage therapy has been effective in helping couples with any of these characteristics or problems: * They communicate and interact in ways that lead to conflict, frustration, anger, and unhappiness. * They are insufficiently sensitive to one another's needs. * They have unstated and conflicting expectations concerning their relationships. * They will work together to help one partner overcome individual difficulties. {204} 15 CHANNELING AWARENESS: Exercise, Biofeedback, Relaxation Training, Hypnosis, and Meditation