This study aimed to investigate the effect of couple-centered counseling by the Gottman method on the intimacy of infertile couples in Hamadan. The analysis results revealed a statistically significant difference between infertile women participating in the control and intervention groups. In other words, there was a significant difference between women who received training and women who had no training. Also, Gottman couple therapy has been effective in the marital intimacy of infertile women. According to the results of statistical analysis and comparison of the average intimacy scores in men in the post-intervention stage, it is inferred that Gottman-centered couple counseling has some effect on the marital intimacy of infertile men.
Infertility is an important stressor in a couple’s life as it is very difficult to accept failure in pregnancy. In this respect, many couples experience a recurring treatment without progress, and a feeling of weakness in achieving the goal (childbearing) appears in them. Although infertility is not a disease, it can cause significant emotional disturbances. This problem leaves many psychological and social complications and delays and interferes with various aspects of the couple’s performance, including sexual activity, self-confidence, and emotional communication . Experience of painstaking treatments and feelings of rejection, fatigue, confusion, and despair are among the cases that infertile couples face. All of these factors can affect the couple’s emotional connection and, therefore, their success in treatment .
Intimacy is an important human need and a dynamic process with internal roots based on mutual trust and respect. In this regard, clinical studies have shown that the root of many marital problems is the lack of intimacy between couples. With the help of his seven principles, John Gottman describes how a marital relationship succeeds or fails. This scholar also offers ways to facilitate change in these relationships through educational, psychological, preventative, and therapeutic interventions. These solutions, called the Seven Principles of Success in Marriage, determine the extent to which couples maintain their friendship, intimacy, and passion . The goal of Gottman couple therapy is primarily to help couples rebuild and strengthen friendships with each other  and ultimately lead to proper intimacy and interpersonal growth . In addition, Gottman couple therapy helps couples learn that there are differences between them. The therapy asserts that these differences are not indelible, and couples must learn to adapt to these persistent problems .
Gottman considered the following seven principles to achieve the goal: designing a love plan, cultivating love and admiration, turning to each other instead of avoiding each other, accepting the spouse’s influence, solving solvable problems, overcoming permanent problems, and creating common meaning. He also used strategies such as gratitude, early marriage memories, and an emotional bank account to increase intimacy and love between couples , which we also relied on in the educational package videos.
The results of this study are consistent with those of Soheili et al. (2020), who showed that group counseling based on Gottman couple therapy has a positive effect on marital intimacy in female nurses . Likewise, Mortazavi et al. (2020) concluded that the relationship prevention and improvement program based on the combined approach of Gottman and Glasser is effective in marital intimacy .
The present study’s findings are also consistent with those of Sehat et al. (2021). These researchers reported that combination therapy based on emotion and solution is effective in marital intimacy and marital adjustment and can reduce hostile, reprehensible, and domineering behaviors and communication problems, thereby improving intimacy in conflicting couples . Zarei et al. (2018) examined the effectiveness of group counseling based on choice theory and Gottman’s theory on marital intimacy and marital conflicts in married women. They eventually concluded that group counseling based on Gottman’s theory significantly increases intimacy and reduces conflict , which is in line with our findings.
The findings of the present study are opposed to those of Besharat Ghara Maleki (2021), who reported that counseling in the method of forgiveness therapy is ineffective in the marital intimacy of couples with emotional divorce . Also, these results are inconsistent with those of Arabpour (2012), who proposed the Glaser theory is ineffective in improving the intimate relationship of couples .
The present study showed that couple-centered counseling as an easy and low-cost method increased marital intimacy among infertile women. In fact, couple-centered counseling is a supportive and solution-based approach that aims to identify problems, suggest appropriate solutions, and ultimately encourage people to change their behavior. This approach covers all components effective in interpersonal relationships. Since couple-centered education is much more effective than educating women alone, many studies have suggested considering the role of education and counseling in future research.
Based on the study results, it can be stated that Gottman places great emphasis on love and respect to deal with the negative aspects of marriage. In the Gottman curriculum, effective communication skills training can help couples establish an effective relationship for growth and prosperity and reduce the persistence of negative and destructive feelings during the marital relationship. Infertile couples may experience more emotional distress and divorce due to the stress of not having a child. However, Gottman’s method helps increase the desire to continue the marital relationship, reduce marital incompatibility and conflict, and provide more intimacy and satisfaction for couples .
When women in couple-centered counseling sessions received various training along with related exercises to reach the seven Gottman principles, all of this helped them feel more intimate with their husbands. In counseling sessions, familiarity with conflict resolution and effective communication skills helped couples realize that some problems in their marital relationship may never be resolved, and they need to learn how to deal with and manage conflict. The couple realized that establishing an effective relationship with their spouse could better understand each other’s needs and wants. Accordingly, the degree of intimacy between them would increase. Also, in these sessions, couples were introduced with four incorrect communication patterns called four riders: criticism, insult and humiliation, defensiveness, and the formation of a stone wall. They received explanations about these four factors’ destructive and negative impacts on marital relationships and learned how to replace correct behavior with behavior.
Overall, Gottman’s counseling taught couples, especially infertile women, that they could more easily deal with many of their problems, such as infertility, by creating a common sense, thus increasing marital intimacy among women. Intimate relationships and better communication patterns of these couples can go through the stages of infertility treatment better than before.
Limitations and strengths
Unlike most interventional studies that focus on training women, the counseling sessions in the present study were based on couples’ relationships and Gottman’s counseling content. Another strength of our work was the preparation of Gottman’s counseling package (counseling videos and practicing the sessions) and its presentation to couples, in addition to face-to-face counseling sessions.
One limitation of our work was the absence of a psychologist in counseling sessions. We resolved this issue by referring the couples to a psychologist upon their request after the last counseling session. Another limitation was the small number of samples due to time constraints, which reduces its generalize ability to the whole community.
Furthermore, the non-cooperation of some men to participate in counseling sessions slowed down the sampling rate. Therefore, we held online counseling sessions for some of them. Besides, some others were excluded from the study due to creating problems in emotional communication.