PACT and Love: Small Moves, Big Movement

Guest blog by Rachel Cahn, MA, LPC, PACT faculty, Boulder, CO

Website: www.rachelcahn.com

Andrea and Brent (not their real names) have been married for twenty-three years, and have been struggling since their youngest son left for college. Now that their focus is no longer on their children, the distance between them is apparent. In session, they describe a recent conflict around Andrea’s birthday. Brent usually orchestrates lavish celebrations with many guests, while avoiding the quieter interpersonal aspect of the occasion (which she relishes). Andrea’s most recent birthday took place while they were at an event with extended family, and Brent’s attention was focused on another family member. Andrea felt dropped when Brent didn’t even acknowledge the day with her, and he felt guilty and shut down in the wake of Andrea’s disappointment. Describing the week is painful for both of them: Brent anxiously averts his gaze from Andrea, and hurt is visible in her dim eyes and sad face. Brent looks confused about what to do next.

Although as a PACT therapist I see a deeper issue to take up about protecting their relationship with each other while managing others (their children, extended family; or what we call thirds in PACT parlance), the immediate situation is pressing. The experience is unresolved because there has been no repair. I signal Brent with my eyes to return his gaze to Andrea and prompt him to make an apology to her. He expresses remorse in his own words for missing her birthday. Repair has begun. I roll my chair next to his and whisper an idea that came to me, for him to sing “Happy Birthday” to her. He smiles, pauses for a moment, looks into her eyes and haltingly sings the song we have all heard sung to us since our early childhood. She wells up, and by the end of the song, tears stream down her face. “That was all I wanted,” she says as she folds into his arms.

This was one of those small moments in which love is revealed. Too often, couples come into my office worrying that they are lost to each other, or thinking they have to become different people if they are to find happiness together. As a PACT therapist, it is my job to facilitate small yet powerful experiences that reveal what is true about them as a couple. Finding the chinks in their defensive armor of emotional self-preservation and moving them toward sensitive and loving action helps restore them to each other, and exposes love where it has been obscured or feared lost.

These actions tend to be small and concentrated, yet they convey caring and connection in a deeply personal way. These movements often begin with eye contact, close proximity, and a tone of voice and touch that signal safety and friendliness. Sincere bids that are very specific to each other touch those inner places longing to be known, met, and loved. PACT facilitates couples finding each other in ways that make their relationship feel primary and irreplaceable.

Secure functioning is often about making small moves that have a big impact. When two people learn to do this for each other on a repeated basis, they are naturally motivated to continue this process. The fruition is that love reawakens where there had been a closing into fear, frustration, and distance. Couples experience that the result can be profound, and that the path there can be uncomplicated and workable. It can be as simple as singing “Happy Birthday.”

The Secure Family Asana

Guest blog by Lon Rankin, LPCC, PACT faculty, Santa Fe, NM
Website: LonRankin.com
Email: Lon@ThePACTInstitute.com

Every species of mammal uses the limbic system—the social, emotional, relational part of the brain—to create strong bonds that provide safety and a felt sense of security. Adult-child bonding is especially crucial for the development of the complex human brain and nervous system, and the development of an internal felt sense of security in the world—both real and perceived. When parents are too often inattentive of their child’s emotional needs, this bonding does not happen optimally, and the injury of insecurity can prevail.

Memories, especially negative ones, are extremely powerful in influencing our perception of the world and our behaviors. Our subjective experience is colored by our past. All experiences, at any age, involving fear and threat are “velcroed” into the memory system in the interest of self-protection, but memories from childhood have particular potency. Children do not survive very long without parental attention and protection, and times of parental inattention, misattunement, and neglect are perceived as profoundly threatening. These memories become deeply wired into the brain and imprinted in the mind. (This is the basis for the value of inner child work in modern psychotherapy.) Many of the patients we work with are reacting from these often implicit and unconscious, velcroed threat memories and their activation, without proper awareness and attention from their partner.

PACT therapists understand the workings of this internal safety and security system, and the importance of this area in our work with couples. As PACT therapists, we motivate movement from projected, negative, internalized relational blueprints toward secure functioning within the primary partnership. In moving couples in this direction, we understand the importance of partners “holding each other in mind,” especially in these places of old injury. We ask them to take on the mantle of the attending parent in these areas of distress by holding their partner and their partner’s history in mind.

Toward this end, I often do the following exercise with my patients. My wife’s passion for yoga helped me envision this practice, so I affectionately call it the Secure Family Asana. (Āsana is a Sanskrit term to describe yoga postures that can promote change.)

At an appropriate place in a couple’s treatment, I invite them to sit face to face and interactively regulate each other. I have both partners imagine their arms around both their own inner child and their partner’s inner child (see Figure 1). I ask the couple to imagine being attentive parents to the places of childhood insecurity, and for this to be mutual, face to face and eye to eye.

Figure 1

 PACT Asana jpeg

 

 

 

 

 

 

Using this imagery and practicing it externally can promote the replacement of insecure blueprints within the procedural memory system. An internalized felt sense of comforting safety can then enhance secure functioning within the couple in times of distress, rather than the repetition of injury from the original memory patterns.

As PACT therapists, we know that secure functioning is characterized by a balance of valuing both self and the relationship. Therefore, we encourage couples to tend their own historical and present-time hurts, as well as be there for their partner’s hurts. Two strong, secure, internalized partners regulate these past injuries and their repetitive projected activations together. Old hurts are securely attended to in a mutual manner, rather than being allowed to take over and threaten the partnership.

This Secure Family Asana exercise embodies the tending of self and other, in both past and present. It encourages the healing of old hurts, and the growth of an internalized reparative family system. Couples can practice it to powerfully support their movement toward secure functioning.

Accelerating Development with PACT

Guest blog by Jeff Pincus, LCSW, PACT faculty, Boulder, CO
Website: CouplesTherapyBoulder.com
Email: Jeff@ThePACTInstitute.com

Emotional development doesn’t happen in isolation. The entire field of psychotherapy rests upon the premise that one human being can help another to move beyond vestigial strategies developed in the context of the distant past and to live life in a way that is less encumbered by personal history. We consider this to be emotional or psychological growth. Part of the blessing of being human is that this process can be ongoing as we learn, grow, and continue to develop across our entire lifespan.

As a PACT therapist, PACT trainer, and husband who continues to put PACT principles to the test in my own marriage, I have been awed by the acceleration of development and maturation that occurs within a committed partnership when both parties co-create a foundation of secure functioning. This is the bedrock that PACT helps couples stand upon, and that supports a resurgence of development where there has been regression, idleness, and apathy.

Many models of couple therapy have merit. What sets PACT apart is its understanding about how the processes of emotional maturation, individuation, and differentiation actually occur. We are biologically wired for curiosity, creativity, and learning, but these functions can only take place when the experience of safety and security is online. When our safety and security are perceived to be at risk, our attention and behaviors are dominated by the tasks of mobilizing away from threat (fleeing), subduing danger (fighting), or shutting down (collapse). When processes organized around the drive for survival consume a relationship, couples stay in an immature state where there is no room for practicing and learning to occur. As clinicians, when we witness these behaviors in the therapy, we consider such ineffective strategies to be “acting out.”

Secure functioning both requires and facilitates each partner to develop emotionally, take pro-relationship risks with each other, and be collaborative. As PACT therapists, we expect this from our clients. We see their potential, and we are willing to push them when necessary so that they actually taste their capacity to be better. During a session, this may be in the form of directing them to reach out even when their instinctual impulse is to withdraw, to maintain eye contact when the habitual tendency is to gaze avert, or to say something loving when the reflex is to attack or defend.

Through such practicing, each member of the dyad risks shedding old, primitive defenses to become a more resilient and robust adult. Each takes greater responsibility for the current state of the relationship, and for moving it forward toward deeper satisfaction. This is true differentiation. PACT helps couples become their best adult selves in a relationship where growth and personal development are a natural outcome of love and commitment.

Copyright Jeff Pincus

Esalen Couples Retreat 2015 — Wired for Love: An Insider’s Guide to Your Relationship

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Working Bottom Up in PACT

Guest blog by Karen Berry, PhD, PACT faculty, New York, NY
Email:  Karen@ThePACTInstitute.com

Bottom-up interventions are the bread and butter of PACT. These interventions can be simple to execute, yet powerful in their effect. For example, the therapist can ask partners to face one another, with the therapeutic intention of using eye gazing to reduce their allostatic load. Compared with habitual long, slow, top-down conversations, bottom-up interventions more readily empower the couple to use their neurological systems to affect change in the relationship.

All clinicians have seen how a couple can become reactive and operated out of conditioned responses from childhood. Their brains can register threat in nano seconds. The autonomic nervous system (ANS) moves at lightning speed in response to facial gestures, dangerous words and phrases, jerky gestures, tone and prosody, as well as general body language. PACT therapists watch moment-to-moment shifts of the ANS, implicit expressions in the face, voice, eyes, and body posture and body language to assess what is happening between partners’ two nervous systems. Content takes a backseat to process.

Sam and Margaret have been married for almost 10 years, and their marriage has been sexless for the last 5 years. Margaret is troubled by their lack of sex and wants closeness in their relationship again. Sam bows his head and shamefully admits he has had no interest. Using an enactment of the couple reuniting after a day apart allows me as a PACT therapist to take a closer look at what’s actually going on for them.

Sam is in the den with the boys, and Margaret comes in to say a momentary hello, but then launches into questioning him about the whys and hows of his day with the children. As she is standing over him, he is sinking into the couch, disinterested. His guard is clearly up.

I have them reenact this event several times. I ask Margaret to give a sincerely warm hello to her man, who has been at home caring for the kids all day. I begin to notice subtle shifts in both their bodies, which reflects their increased friendliness. Then I ask her to sit alongside Sam after the warm hello and make eye contact while she checks in with him about the day. As they do this, I observe more shifts in both their nervous systems. They are more relaxed and they begin to move closer to each other.

Lastly I ask Margaret to sit on the floor while inquiring about the boys. The result is amazing. Sam shifts dramatically. She looks at me and says, “Do you see what I see?” I nod. Sam’s face is soft and engaged, and he’s leaning in warmly toward her. As they continue talking, the warmth becomes sensual and exciting for both of them. This couple have begun to lay the groundwork for increased friendliness and possibilities for play between them.

As PACT therapists, we regard sex as an aspect of play. If partners are unable to play together, it is highly unlikely they will engage sexually. And when the partner who wants sex operates in ways that are perceived as threatening, with little or no self-awareness, her or she is unlikely to attract the other to genuinely say yes to sex.

The use of bottom-up interventions makes PACT a “show me therapy,” rather than a “tell me therapy.” PACT therapists work in real time with couples in the office, reenacting psychobiological scenarios that can make palpable and possible differences at home.

Copyright Karen Berry

Power Couples…Activate!

Guest blog by Eva Van Prooyen, M.F.T., PACT faculty, Los Angeles CA
Website:  Eva.VP.com
Email:  Eva@ThePACTInstitute.com

Healthy, secure relationships are a source of vital energy. PACT therapists know people feel good when they understand how to be successful partners. We are energized by a secure connection to another person. Our need to be securely attached is so powerful that it can get us through the hardest of times and help us float through day-to-day routines with ease, skill, and grace.

Secure functioning is based on a high degree of respect for one another’s experience. Interactions and shared experiences are fair, just, and sensitive. If your partner feels even slightly unwanted, undervalued, disliked, unseen, or unimportant, he or she will—quite frankly—act weird and underperform in the relationship.

Insecurity and insecure attachment negatively affect brain performance. Development can be slowed down because the brain is using most of its resources to manage being in survival mode instead of being free to move toward evolution, growth, and complexity.

In general, couples can get tripped up in creating a secure and healthy relationship and end up not liking their partners, situations, or experiences because they don’t know what to do or how to manage them. This can leave them feeling badly about themselves as well as their partner.

In line with the main treatment goals of PACT, couples are encouraged (and ultimately expected) to both know themselves and know their partner.  That is, to know who they are and how they move through the world, and also to understand who their partner is, and how he or she operates. To be clear, that is not how they wish their partner operates, but how their partner actually operates, navigates, and maneuvers through the world. This knowledge, which requires a healthy dose of curiosity and attention, creates a strong foundation of understanding. It pushes forth the secure-functioning principles that “your partner is your responsibility and in your care,” and “you are responsible for knowing how to manage your partner.” Your partner then holds a sacred and honored position no one else in the world gets to occupy. That said, we often joke that actual wedding vows should probably include, “I take you to be my perfect pain in the butt.”

PACT teaches couples how to manage their partners so they can move and shift them into better states of mind and moods; lower their stress level; and decrease their sense of threat, anxiety, and depression.

The idea of being responsible for knowing and caring for your partner in this way and putting the relationship first tends to be the hard sell for some couples. When you truly understand the benefits of adopting this idea, the stance of “but it’s always about them, it never gets to be about me” loses its power as an argument.

My answer is, “You do this because it serves you and is good for you. You get your needs met by shoring up the vulnerabilities in your partner so he or she can in return do the same for you. You both get the benefits of that investment.”

Love and genuine connection create libidinal energy—life force energy that can be renewed in an instant through a simple act of friendliness, a glance, a look, a moment, and a knowing that “my person likes me.” Part of creating a secure relationship is making sure you are helping your partner perform at an optimal level. To do that, messages that communicate “I’m good at you,” “I’m good at being with you,” and “You are in my care” must be reflected every day.

If you want to put this into practice, one way I encourage that is to pay attention to everything your partner hears you say about him or her. What messages are you conveying? Another thing you can do is to introduce your partner to other people, when you are together in public, in a way that is elevating.

PACT principles help couples enjoy the experience of being loved for who they are, as well as appreciate all the day-to-day benefits their relationship brings.

Copyright Eva Van Prooyen

Red Sky in the Morning, Sailors Take Warning

Guest blog by Elaine Tuccio, LCSW, PACT faculty, Austin, TX

One of the most common complaints made by couples who come to therapy is that they feel they do not know how to communicate well with one another. The words “we have problems communicating,” or something along those lines, are often preceded or followed by a deep sigh—the signal of long-held misery and defeat.

The PACT therapist using the Partner Attachment Inventory (PAI) can obtain enough information within the first session to help a couple see that their problems are not simply communication. In fact, where couples tend to falter most is in reading signs and signals—the nonverbal cadence on which primary attachment relationships are built. Life’s forces have caused drift in their relationships. A mix of financial stress, betrayal, conflicting priorities of career and family, and addictions have thrown them into survival mode. As a result of early unmet developmental needs and attachment injuries, they find themselves at sea in their adult romantic partnership. Instead of smooth sailing, they tack too much or lean too little.

Consider Chuck and Tina, who are committed, loving parents to a child with cerebral palsy. In therapy, Chuck voiced frustration that his wife would not talk with him. Tina listened to every word as she held back tears, bit her lower lip, and wrung her hands, then stammered out words to defend herself. Both partners were clearly expressive, but in their own learned attachment style of communication. Tina’s parents had poured all their energy into their kids, but she couldn’t recall them talking at length with one another. They divorced when she was ten. Chuck’s father left when he was two. His doting mother never remarried, and he spent a lot of time alone in front of the television. The PAI helped this couple discover that neither was raised with examples of partners negotiating. This significant finding built hope for Chuck and Tina and helped them see that both wanted to communicate but they did not know how—yet.

Old-time sailors knew to be on the lookout for atmospheric changes, to stay in constant communication with their shipmates, and to point ahead always. As young sailors, they were guided by masters of the sea and learned to expect the best but plan for the worst, and leave nothing to chance. Not everyone entering a relationship is fortunate enough to be launched in a boat rigged for all sailing conditions. PACT therapists are trained to be master navigators at the helm. We help couples help themselves on rocky seas, in and out of narrow channels, and around sandbars. We teach them to distinguish between a red sky in the morning and a red sky at night so they can avoid storms that may be brewing and instead delight in life as it is—wonderful, unpredictable, painful, loving, beautiful, and forever changing.

Copyright Elaine Tuccio

Discovering New Steps to Shift a Couple’s Dance

Guest blog by John Grey, Ph.D., PACT faculty, Berkeley CA, website: www.soulmateoracle.com

Partners caught in ongoing distress lose sight of how to shift their negative dynamics. Although their dance could change if either made a small but significant move, neither seems to know a move to take things in a positive direction. So rather than acting from a sense of agency, each feels powerless and at the effect of the other.

From a PACT viewpoint, we maintain that each partner has the power to change their mutual dance. We know that, as primary attachment figures, they have a great deal of influence and hold a uniquely powerful position in each others’ brains. Each has the potential to sway the other in a new direction. Part of our work is to expand the repertoire each brings to the dance floor. We point out where they inadvertently step on each other’s feet and demonstrate in real time how a different move here or there relieves distress and helps them feel more connected.

PACT presupposes such moves can be made. In fact, we expect partners to make them and wonder, often aloud, why they don’t. Typically, each professes ignorance over steps to take that would reduce distress. Having no idea about what else to do, an avoidant husband yet again automatically backs away from his wife’s snarky remarks or harsh tone. Or she, acting out angry protest, doesn’t seem to know how to reach for him in a way that pulls him to her, so instead pushes him away.

In PACT, we assume they have it in them to take counterintuitive steps that will lead them to a secure dance. And, like a choreographer, we nudge them in that direction. We instruct them overtly, suggesting moves such as “Get closer, hold hands, gaze into each other’s eyes….” There is also utility in assuming the moves already lie dormant within them, simply waiting to be awakened. I love to uncover hidden resources within partners by presupposing they already exist.

For instance, if they have kids and I already know they provide secure attachment responses to their children, I usually can bank on the mind-altering question “What would you do if this were your precious three-year old child ______?” filling in the blank with whatever behavior seems to be triggering (e.g., crying, throwing a fit, accusing you of being a bad parent, pulling away, hiding in his or her room).

I have been amazed to see how quickly this simple query can add new steps to the dance. For example, the avoidant husband above may move on his own initiative toward his angrily protesting wife and feel renewed strength, empathy, value, and importance as he holds her, reassures her, and calms her—a move he usually made with his daughter, but never conceived of with his mate. At this point, discussing how a younger part of the brain takes us over is often a useful way to strengthen the probability of future caring responses.

It can be profitable to assume people have the inner resources for positive change, but don’t yet quite realize how to hook these up and enact them. Dormant brain circuitry can be plugged in, reweighted, and brought online in their partnership. PACT operates from these kinds of powerful presuppositions. We assume each partner has the power and ability to have a positive impact in their dynamic. We realize how important each is to the other’s brain once they have been elected to the post of primary attachment figure. Knowing infant-caregiver attachment research, we realize the power of the moves partners can make once they fully realize they are in each other’s care. Like patient choreographers, we keep nudging them to dance more securely together.

Copyright John Grey

Secure Enough to Be Spontaneous

Guest blog by Hans Jorg Stahlschmidt, Ph.D., PACT faculty, Berkeley CA, website: http://www.stahlschmidt-therapy.com/

Burnout is common among psychotherapists. Countless articles and books deal with reasons for and prevention of burnout. However, some instances of burnout are nearly impossible to prevent, given dysfunctional institutional settings, demanding and taxing work hours, and a difficult and acting out clientele. Many commentators have opined that psychotherapists may lack sufficient self-care to counter the ongoing stress of dealing with the psychological pain and trauma of their patients, especially in the context of isolation characteristic of this profession.

For me, becoming a PACT therapist has proven to be the best burnout prevention. This approach requires a strong therapeutic frame and a complex set of skills that is rooted in a defined conceptual foundation. It also allows a freedom I have not experienced in other therapeutic approaches. This is the freedom to make use of one’s self and to allow spontaneity in the therapy room. This, in turn, makes work not only more fun and more exciting, but also more rewarding.

PACT focuses on the expressions and signals of the autonomic nervous system. PACT therapy is a bottom-up, show-me process. As therapists, we have to know about our own facial expressions, gestures, and how we come across to others, so we can regulate more intentionally and effectively. To be master regulators who can facilitate a more real, truthful, and authentic relationship between partners, we have to be able to regulate ourselves.

The emphasis in PACT is on “regulating,” which does not mean controlling or being neutral or reserved. I remember being in a psychoanalytic training group 22 years ago and feeling I had to apply a sense of carefulness and guardedness because self-expression that revealed too much about my personhood would contaminate the therapeutic work. That stance required me to exhibit reserve and the control of emotional expression in order to be seen as a neutral figure upon whom the patient could project his or her inner processes. The interaction was limited, and spontaneity rare.

As humans, we can feel and see the difference between a limbic smile and a social smile. Our patients can detect the difference between artificial warmth and authentic warmth, and between simulated empathy and authentic empathy. Because we are in the business of limbic regulation, as therapists we can’t rely on social and artificial signaling in our interactions with couples. We have to be able to bring into play real responses.

Our patients can detect our fear and will not trust us if we pretend. If we are overly guarded, we will not be effective in our attempts to move a couple toward secure functioning. We need both a sense of our own security and a sense of freedom to be able to let feelings, thoughts, impulses, and desires arise and guide our interactions so they do not create a “minefield” and resemble the more careful and guarded stance of previous approaches.

My freedom starts when I greet a couple in the waiting room. I am really happy to see them. I look forward to being with them. I can’t help but smile. I think it is a limbic smile. It is part of “falling in love” with the couples with whom I work. Ten years ago, I did not always fall in love with the couples with whom I worked. But now I do.

An essential challenge to becoming a PACT therapist is to move oneself toward secure functioning. With a stance of secure functioning, the internal regulatory and emotional field of the therapist is not experienced as a minefield that necessitates stepping carefully and gingerly. Rather, the internal vicissitudes can be trusted, and the freedom to risk spontaneous expression can be modeled for the couple.

According to PACT, a therapist is more like a host who can make the couple feel at ease than like an intimidating expert. PACT therapists develop the capacity to relax and then move in. They find a rhythm in their work that includes spontaneity and the ability to trust their own sources of inspiration. In the words of Stan Tatkin, we move from inspiration rather than pressure.

Copyright Hans Stahlschmidt

Betrayal Causes Trauma

In matters of betrayal—lying, cheating, stealing—the breach of the attachment system is acute and often long lasting and can be understood neurologically as a trauma-related problem.

Franklin and Zeynep, a couple in their early 40s with two young children, came to therapy because of a discovered set of sexual affairs. Franklin, an American-born academician, was found to have an affair with one of his students. Zeynep, a Turkish-born emergency room nurse, discovered the affair after accidentally viewing Franklin’s phone text messages. The texts were explicitly sexual and contained incontrovertible evidence of Franklin’s deceptions and betrayals. Although Franklin was contrite and desperately wanted to be let back into the relationship, he had great difficulty dealing with Zeynep’s unrelenting preoccupation with his affair. She wanted to know details. Fearful of making matters worse, he refused to give details. Zeynep would wake up in the middle of the night crying, and suddenly burst into a rage while they drove to dinner. She did not want Franklin to touch her. He was not to sleep in their marital bed. Franklin’s patience was at an end. He began to believe that Zeynep was purposely punishing him and was invested in making his life a living hell. Neither partner wanted the relationship to end, but neither could escape the strong wake of the betrayal itself.

PACT therapists will recognize that betrayal by a primary attachment figure is likely to be processed as trauma. Betrayals in adult romantic partnerships most commonly revolve around sex and/or finances, but central to all betrayals is the matter of deception. Partners who feel deceived by their loved ones suffer a particular kind of loss that can affect the historical memory of that relationship. Deceived partners will review the entire relationship in an attempt to reorganize their experiences of self and other. This review reorients the memory toward doubt, fear, and rage. In Zeynep’s case, we see that she could not stop thinking about Franklin’s betrayal and demanding details. Even though he did not provide details, her brain filled in its own details, which fed her doubt and fear. Flooded by these emotions, she would alternately withdraw from him and rage at him.

Once initiated, this review process cannot be interrupted because the brain must reorganize and adapt to the new information. As in PTSD, the brain and body must metabolize the trauma and cope with amygdalar hyperactivity as the amygdala responds to multiple internal and external triggers. However, different from PTSD, betrayal forces a hippocampal review and re-contextualization of the past with new information from the present. PTSD usually does not compel the brain to review past events; in fact, victims of PTSD commonly wish to avoid any review of the traumatic event, and their hippocampal function can be compromised by the traumatic event.

Betrayal, therefore, usually leads to a preoccupation with the new reality-shattering information. This presents an enormous challenge to the couple attempting to recover from it. Like Zeynep, the victim cannot stop being preoccupied with the past, present, and future, nor escape the emotional volatility that accompanies this process. The perpetrator therefore must tolerate the other partner’s perseveration and emotional volatility, as well as the constant questioning, grief, and anger that come with the healing process. In this case, Franklin had to learn patience for the couple to have any chance at rebuilding their relationship. Somewhat ironically, the perpetrator is in a unique position as not only the cause of the trauma but also its solution. This is not an easy task for the perpetrator to perform. Yet, the PACT therapist takes the position that the betraying partner must provide ongoing and sufficient support to regulate disturbing states related to the trauma whenever they arise.

Copyright © 2003-2014 Stan Tatkin, PsyD – all rights reserved

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