The PACT Institute Blog

Moving From Misattunement to Coregulation

By Beth Newton, LCSW, LCAS
PACT Level II, PACT Ambassador
Durham, NC
https://newtoncounseling.com/

Every week I sit in my office watching couples struggle with coregulation. Coregulation is defined as warm and responsive interactions that provide support and that help someone understand, express, and modulate his or her feelings, thoughts, and behaviors (Gillespie, 2015). Through coregulation, children learn how to manage their attention and emotions in order to complete tasks, control impulses, and solve problems (McClelland & Tominey, 2014). This requires them to attune to subtle cues of distress, curiosity, bids for attention, fear, and joy. The concept of coregulation can also be applied to adult relationships.  

As a therapist, I often work with couples in which one or both partners experienced parental misattunments, neglect, or abuse. The fear and insecurity they experienced as children led to poor self-regulation (internal) and coregulation (with another) skills, resulting in stress and lack of attunement in their current relationship. Moreover, if adults experienced chronic childhood stress, their hypothalamic pituitary adrenal (HPA) axis habituated and sustains activity. This “on switch” can lead to underdevelopment of the prefrontal cortex, which moderates social behavior, complex thinking, and decision making (Kumar et al., 2014).  

As a PACT therapist, I know that when an individual is not skilled at coregulation—and by extension, self-regulation—he or she will often report that a partner is not safe. Moreover, when the HPA axis is in overdrive, the individual cannot attune to self or a partner. When a partner has experienced dysregulated parents, he or she lacks the capacity to pivot toward a choice that balances the relationship. In the PACT model, we evaluate each partner’s regulatory capacities, and then help the couple deal with compromised skills and capacities.  

I work with a couple named Bill and Diego. They have been married for 5 years and have seen at least three couple therapists in that time. Bill’s mother had depression and a personality disorder. His job was to soothe her and ignore his own needs. He reported she did not do anything for him that “wasn’t really about her.” Diego learned at an early age that his homosexuality did not fit into his strict religious household. He reported a great deal of pressure to be good and nice, with no room for self-expression. Both partners developed the belief they would be punished for expressing their own needs and desires.  

These men are locked in a cycle of fear that their needs will not be met by their partner. When one begins to talk about a need, the other interrupts with his own need. In our early sessions, they exhibited disorganized behaviors, such as over-control and mild collapse, resistance to receiving or giving compassion or repair, attacking bids for connection and repair, and numerous withdraws from each other and me. This only turned around after I recognized my out of countertransference and stepped in to become the master regulator for Bill and Diego.  

To challenge their acting out, I began setting limits for the session. I helped them see that they were rejecting me in the same way that they rejected each other. We agreed that the following behaviors would help them gain control: 

  • Cooperate with therapy and their PACT therapist 
  • Agree to take breaks and practice slowed breathing while on break 
  • Return from break and determine readiness to receive repairs or help 
  • Agree to accept regulation by the therapist in the form of (a) stopping attacking behavior, (b) coaching for repairs, (c) guidance on emotional expression, (d) encouragement, (e) accountability, (f) repetition of skills  

The structure I created each week helped me offer warmth and sincerity when things were really challenging. My ability to act as a regulated parent allowed me to attune to Bill’s and Diego’s underlying fears and to express compassion. They learned how to self-regulate during breaks, accept help, and allow coaching when they did not know what to do. My ability to step in as master regulator moved them toward greater attunement to their own and their partner’s needs.  

I still work with Bill and Diego. When they are on break, I continue to help them with breathing, tracking objects or sounds, and muscle relaxation. They work on coregulation during break by practicing statements such as “I love you. I am taking a break so I can come back to us. I promise I’ll be back in 10 minutes.” I use my ability to ground them through structure, compassion, and good-natured challenge, so they can develop coregulation and secure functioning.  

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References 

Gillespie, L. (2015). It takes two: The role of co-regulation in building self-regulation skills. YC Young Children, 70(3), 94–96.  

Kumar, S., Hultman, R., Hughes, D., Michel, N., Katz, B. M., & Dzirasa, K. (2014). Prefrontal cortex reactivity underlies trait vulnerability to chronic social defeat stress. Nature Communications5, 4537.  

McClelland, M. M., & Tominey, S. L. (2014). The development of self-regulation and executive function in young children. Washington, DC: Zero to Three.  

Tatkin, S. (2017). How couples change: A psychobiological approach to couple therapy (PACT). In M. Solomon & D. J. Siegel (Eds.), How people change: Relationships and neuroplasticity in psychotherapy (pp. 221–246). New York, NY: W. W. Norton. 

 

 

 

 

All People Are Difficult, But You Shouldn’t Be Too Difficult

by Stan Tatkin, PsyD, MFT

As a couple therapist, I know how difficult people can be. Actually, as a person on this planet and a romantic partner to my wife, Tracey, I count myself as one of those difficult people. Indeed, in no way do I put myself above any of the other annoying people out there. Yet here I am, writing about how to be less of a pain in the ass. Well, while I know I can be difficult, I know how not to be too difficult. And the line between them is actually clearer than you might think. Here’s how not to cross it.

When I work with couples, our goal is for them to become secure functioning. Secure functioning partners are least difficult with and toward each other. That’s because they understand their purpose: To ensure each other’s absolute, unequivocal sense of safety and security. Partners are equal stakeholders in this endeavor, therefore, they agree to make life easier for each other, not harder. That’s one of the main principles of secure functioning relationships.

Oh, wait, you think you’re not difficult? Let me tell you, you are. Here’s why:

  1. Your brain. Though a very impressive organ, your brain is prone to lots of errors, especially in social situations. For example,
    • Your brain all too often conflates social cues (faces, voices, movements, postures, words, and phrases) with real danger.
    • Your brain is mostly automatic, memory-based, and therefore confuses current events with previous experience via a lightning fast memory and recognition system.
    • Your brain constantly replaces missing evidence with made up “facts.”
    • Your brain imagines things that are not there.
  2. Your biology. Your development plays a considerable role in how difficult you are. Your biology affects your ability to:
    • Manage your impulses.
    • Tolerate frustration.
    • Shift your attention at will.
    • Manage your state of arousal.
    • Socially-emotionally act and react appropriately under stress.
    • Make decisions.
    • Override what feels good for what does good.
    • Remain self-aware in real time.
  3. Nature. You are genetically predisposed as a homo sapien to be aggressive, self-interested, and prone to dislike people who are “too familiar to ignore, but too different to tolerate.”1
  4. Nurture. Your experiences and memories shape who you become.   If you experienced any trauma, especially in early childhood that remains unresolved, you are likely to be hyper-reactive to threat cues, both internally and externally.

This is not an exhaustive list. The ways to be difficult are limitless. However, that you and I are difficult is not a problem. It’s when we cross the line and become too difficult, that is the problem. How does focusing on secure functioning help?

Secure functioning partners co-create their own kind of social contract which protects them from each other. These are “golden rules” in that they are, if agreed upon, undisputable and therefore help partners rein in difficult behavior.

One golden rule could (and should) be, “We protect each other in public.” Keri and Dave, for example, agreed to this principle. They both decided that it served both a personal and mutual good. In the example below, they are out to dinner with another couple. Dave is an actor and he received news that he won a co-starring role in a major motion picture. He told Keri that he signed a non-disclosure agreement and to keep it to herself.

Keri: [to the other couple] The other night Dave got news that he’s doing the next (fill in the blank).

Dave: [turns his head away in anger]

Keri: What? [raising her shoulders and hands in a disdainful, questioning manner]

Dave: [quietly in her ear] Remember what I told you earlier. Don’t talk about this.

Keri: [out loud] Oh come on. It’s great news. I’m proud of you.

At this point, Keri has stepped over the line and has become too difficult. That she reflexively said something that he explicitly told her not to say breaks an agreed upon principle. However, that she continued to violate the principle when reminded by Dave – that is what defines being too difficult. It also shifts Dave’s experience of Keri from annoying to threatening.

Here’s how it should have gone:

Keri: [to the other couple] The other night Dave got news that he’s doing the next (fill in the blank).

Dave: [turns his head away in anger]

Keri: [covering her mouth in horror, turns to Dave] I’m so sorry. I forgot. I’m so sorry, really I am. [to the other couple] I just betrayed Dave by telling you that. [back to Dave] I am so very sorry I did that.

Dave: [to couple] I’m under an NDA so no one is supposed to know this. Keri’s very excited for me about this. Please, keep this to yourselves.

Keri: [whispers in Dave’s ear] I’m so sorry.

Now that is an example of repair and recognition of being difficult.

Other examples of being too difficult include:

  • Persistently not releasing your partner after a satisfactory repair.
  • Not being willing to bargain with your partner.
  • When bargaining, not providing alternatives following the word “no.”
  • Being unwilling to admit your wrongs and make amends.
  • Being unwilling to see your partner’s point of view.
  • Not being curious.
  • Persistently stubborn.
  • Persistently inflexible.
  • Persistently conflict avoidant.
  • Continually failing to check with your partner when discussing them in public.
  • Continually disregarding your partner when together in public.
  • Persistently (and unapologetically) failing to keep your word.
  • Persistently talking too much.
  • Persistently talking too little.

Again, this is by no means a definitive list. But notice the wording in here. It’s not about reflexively doing something that makes you difficult for your partner. It’s about the refusal to stop when cued that makes you too difficult. It’s also about the refusal to repair the hurt and makes things right.

We are all fundamentally automatic creatures – all day, every day. Our brain cannot possibly remember the countless changes in behavior our partners require under various circumstances. That’s why telling your partner to never again embarrass you in public, while understandable, can never work. Your partner will do something again, and likely without any malicious intent. It will be far more effective to remind your partner just before entering a public situation. “When we go in, please don’t make any jokes at my cost, okay?” If your partner is not too difficult, they will comply. If they don’t, well, now you have a problem. If they slip (which should not happen), and remain unapologetic, it’s likely time to move on.  

Because we are all mostly automatic, we shouldn’t be faulted for many of the knee-jerk behaviors we do without thought and, at times, without intention. We are, however, responsible for what we do after we do something stupid, thoughtless, or insensitive. We are all difficult in one way or another. The challenge for secure functioning couples is in not crossing the line to becoming too difficult.

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NOTES:

  1. Harari, Yuval Noah. Sapiens: A Brief History of Humankind (p. 18). HarperCollins. Kindle Edition.

Pause, Allow, Soften, Breathe, Appreciate: PACT Therapist Self-Care

Uri Talmor, M.A., L.P.C.
PACT Level II
Boulder Colorado
http://www.consciousheartintegration.com/

A couple come into my office, already in argument mode. They emanate Neanderthal-reptilian contempt, talking over each other, and perceiving most of what comes out of the other’s mouth as an attack.

Immediately, some snarky down-the-middle possible responses fill my mind: “You two are really good at hurting each other.” Or “You’re both really good at making the other person wrong.”

I take a deep breath, soften a little on the inside. It hurts to watch them; there is so much pain. I wonder, “Is this what their children feel? Is this what I felt growing up?”

She’s crying now, but he’s continuing to talk. Why hasn’t he slowed down? Where’s his sensitivity to her pain? He’s missing her. Doesn’t he see she’s gone?

With some couples, these types of mis-attuned moments are chronic. They seem to be trapped in altered states of angst, unable to fully see the human they’re partnered with. Usually I take for granted that these people care about each other, based on where I’ve seen them go in previous sessions, but there are periods when the care has been sucked clear out of the room.

In such moments, I turn to the tools I’ve learned from PACT that can help me shift these mis-attunement ruts. In particular, I juxtapose these couple therapy moments with a memory of volunteering for a Level II demo with Stan. It was a short demo but made a powerful imprint on me.

There I was, sitting in front of a male colleague (for context, I’m heterosexual) and Stan was watching us. We made eye contact, role playing a couple I had asked a question about. Stan threw out a couple of comments, and in a matter of what seemed like seconds, I felt like I had entered a relationship wind tunnel. The rest of the room fell away, and I felt focused on, aware of, and connected to this colleague in a way I rarely experience with anyone. My whole being was attuned to him, to what was happening between us. It was easy; graceful; and as cliché as it may sound, a flow state.

I was stunned at how quickly Stan got us there, using cross-questions and cross-comments. His timing was perfect; his own tone of voice and regulation seemed at ease and relaxed. We could both rest in his care, as he gently prompted us to be in each other’s. The two of us shifted quickly into a state of secure functioning because we could feed off how solidly Stan was with us.

As PACT therapists, our own self-care is so important. One of the most valuable things I can bring to couples is my own ability for co-regulation. To this end, I’d like to share some tips that work for me.

  • Early bedtime. I’m a different creature on days when I’ve fallen into auto-regulating to YouTube until the wee hours. I’ve asked my partner to help hold me accountable, to drag me to bed if she has to. What self-care practice would most improve your ability to self-regulate?
  • Consistent peer consultation. I’m lucky to live in an area where PACT has taken off, so I have a handful of colleagues with whom I can get together and share cases. Every time we touch base, I feel recharged and rejuvenated. You can also do this with colleagues long distance.
  • The PACT serenity prayer. I find it to be such a simple and powerful reminder.
  • The breath. I pause and self-regulate throughout the session with my breath. Usually it doesn’t take long, especially when combined with mindful acceptance. I’ve observed Stan do this simply by getting up and grabbing his smoothie from somewhere else in the room. With some couples, that’s all it takes; with others, I need more frequent internal support so I can stay with them. Pause, allow, soften, breathe, appreciate.
  • Work on my own issues. I can’t imagine a day when I won’t be in my own therapy or doing some form of personal growth work. Most of us were born into internships; doing our work is a necessity. If you haven’t done your own PACT therapy, I recommend putting that high on your priority list.

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How Learning to Facilitate PACT for Couples Helped Me Finally Meet the Love of My Life

By Sefora Janel Ray, MFT
Berkeley, CA
http://therapytothrive.com/

I had no idea when I took the PACT training to become a couples therapist that it would affect my personal life so dramatically. I can confidently say now that the reason I’m in a secure relationship is because I took the PACT training and learned how my attachment style affected my dating life. Through PACT, I gained the understanding and skills that helped me to find the love of my life and to create a fully supportive partnership.

I’m a therapist, so I knew for years that I had what is known in PACT as the wave style of attachment (also called the anxious ambivalent or the angry resistant attachment style). My parents divorced when I was five; both my parents worked full time, and I didn’t get the individualized attention and care from them that I craved. They were both very angry and critical of each other, which sometimes leaked onto my sister and me. In adulthood, I was aware that the lack of attention—from my father, especially—affected my attachment style in relationships with men, but I generally interpreted that to mean I was attracted to the wrong kind of man. I wasn’t sure what else I was doing that was recreating my wave attachment style.

Then PACT taught me a number of things:

1. Being a wave led me to overly rely on talking to regulate my nervous system.

Before PACT, I frequently reached out to people I was dating to “talk,” thinking I wanted to connect with them. In reality, I was trying to regulate my experience of feeling anxious. I wanted to talk about what wasn’t working for me… or how I felt disconnected… or my need for reassurance. The talking was more about feeling dysregulated than about connecting with the other person.

Through watching couples and their styles of attachment in the PACT training, I started to see that I was not taking responsibility for how I was regulating my nervous system. When I began to take full responsibility for my anxious feelings, I took a lot more of those conversations to friends instead of bringing my anxiety to the people I was dating.

2. I realized I was dating a lot of islands. 

In other words, I was dating people with an avoidant style of attachment who didn’t crave a sense of connection. They were more comfortable being on their own, and generally felt uneasy with talking, relating, and connecting as a way to support their own nervous systems. They wanted to be alone when they were upset, which was the exact opposite of what I needed from a partner.

I began to identify and understand islands. Whereas I previously had an unconscious attraction to them, I developed an aversion to this style of attachment and stopped choosing them for relationships.

3. I learned to ask questions that showed me someone’s attachment style.

I was being trained to ask questions of my clients to help me identify their attachment styles, so I knew what questions to ask my dates.

I started casually bringing those questions into my early dates, mixed in with conversation and banter: What do you do when you’re stressed? How do you handle conflict? What was your relationship like with your parents? How did your parents respond when you needed something? The answers to these questions were extremely illuminating.

4. I began to visually, somatically, and energetically understand what securely attached people felt and looked like.

This helped me pick them out in crowds and even with just a picture on their online dating profile. Ultimately, this helped me pick out my partner. The training showed me what it looks like when a securely attached partner responds to his or her partner’s cues in a relationship, and I began to expect someone to respond to me in that way.

5. I let go of people who were not meeting my needs.

The PACT training helped me to clarify my needs so well that I stopped trying to fix the person I was dating to fit my attachment style. I also became better at communicating when it was clear that a potential partner and I had different styles of relating and we ultimately weren’t going to be compatible.

6. I noticed my pattern of being angry and disappointed.

I did more concentrated therapy sessions on my anger and my disappointment as these related to my parents and to people I dated. Therapy helped me understand how I brought my disappointment with my dad into my dating life. I created unfair expectations for the people I was dating, right out of the gate. In particular, I expected men who were like my father to change into what I needed, which constantly led to disappointment. Instead, I began to understand that those men would likely never relate to me the way I needed.

7. I practiced receiving.

I started to pay attention when love and attention were given to me, instead of focusing on the lack of love I perceived. I made a practice of appreciating the love and attention my friends and community gave me, and I created a meditation for myself in which I visualized receiving and taking in the care and help I deserve.

8. I slowed down in dating.

Though it was difficult, I started to see that I didn’t need to make the perfect relationship happen all at once. I realized that if someone was interested in me, he would facilitate the next connection or next date, and I didn’t need to make it happen all the time. In the past, my wave attachment style led me to try to connect and get close very quickly with dates in order to know I was okay. As I recognized this tendency, I was able to discern more quickly that someone wasn’t right for me.

9. I was able to recognize my securely attached partner and love of my life.

I was able to recognize from the earliest of interactions with my partner that he was someone I could count on and someone with whom I could be in a secure relationship. He was even a little bit wave oriented: he wanted to talk about things and feel connected, and he was more interested in being with me than being apart.

Even though I recognized that our attachment styles aligned, I still went slower with him than I had in the past. I concentrated on connecting with him purely because I wanted to be connected to him, and less as a means of calming my anxiety. But our attachment styles aligning meant I didn’t feel anxious with him. He wrote to me often, planned dates, communicated, and showed up.

Today, I am incredibly grateful to PACT for supporting my growth and helping me identify and understand how my attachment style affected in my dating life. I continue to use that information to support couples in their relationship dynamics, and I use PACT frequently with my single clients who are trying to find a secure relationship.

Power Dynamics and Management of Thirds: Avoiding Triangulation in Therapy

Debra L. Kaplan, MA, LPC, CSAT-S
PACT level 1
Tucson, AZ
debrakaplancounseling.com

Couple therapy is challenging, and some clinicians find it too intimidating to attempt. They worry, for example, that a misattuned observation could alienate not just one but both partners. There are also potential issues involving tact, timing of interventions, and poor management of session structure. For a PACT therapist, the greater challenge lies not in working with what is known but rather in what often underlies why couples seek therapy: their inability to tolerate and regulate individual and dydadic stress. Addressing the early development of partners’ attachment experiences with their primary caregivers provides the PACT therapist with vital information about intrusions in the couple bond, as well as helps to assess the partners’ capacities for coregulation (the ability to manage their emotions, as well as know when and how to soothe or excite each other).

Intrusions into a relationship might be due to children, work, family, or other life stressors and are a normal part of life. Secure-functioning couples tolerate these interruptions and maintain coregulation, even if the intrusions stress their ability to preserve their couple bond. However, some partners are unable to tolerate this and turn to a “safe third” outside the relationship—such as a person, place, or thing. This is called triangulation. Individuals who experienced insecure attachment by caregivers are more likely to use triangulation in adult romantic relationships. This can create betrayal and abandonment if one or both partners focus prolonged attention on a safe third, to the exclusion of the other.

A PACT therapist will address triangulation using a technique we call management of thirds. This intervention helps the couple shift toward secure functioning and coregulation.

Kristin and Leo came to couple therapy several years ago to resolve their endless arguing. She shared that they often included their son in their arguments, and now they were on the brink of separation.

Kristin was an only child, and her parents divorced when she was young. Her childhood was fraught with tension and hostility due to her parents competing for her attention. She remembers feeling lonely and invisible when her parents argued about her, which is similar to how she feels when she and Leo argue.

Leo’s mother was a stay-at-home mom, and his father worked at the family business. Leo’s father had several affairs, which led to violent arguments in the home. To make matters worse, Leo’s mother vented her anger about the affairs to Leo, and he felt caught in the middle.

Early in our work, Kristin and Leo arrived at a session in the throes of an argument about the previous evening. They took their place in the office and continued the fight.

Leo: [to therapist] She does this to me every time. She makes me out to be the heavy. Do you see what I have to put up with? Maybe you can talk some sense into her.

Kristin: [to therapist] And he’s worried about my behavior! Why can’t he see what he does? It was when he decided to get involved that our son couldn’t take it and stormed off and locked himself in his room.

Leo: [to therapist] Wise kid, right? He’s learning early.

Therapist: I’m curious. Most if not all of your arguments focus on your son, correct?

Leo: [to therapist] I’m telling you. She doesn’t see what she does, but our son certainly does. He’s smart to run from her.

Therapist: From what I can tell, he runs from both of you.

Leo and Kristin: What do you mean?

Therapist: You’re both trying to win my approval in this session and not trying to communicate with one another. I’m not surprised your son runs for cover. I suspect you use your son just like you are using me—for his approval.

Leo: That sounds like a lot of pressure for him to have to deal with.

Kristin: I feel awful.

Therapist: You both use me much like you were used by your parents. Kristin, you felt lonely and invisible. Leo, your mother vented her anger to you about your father. Maybe it’s time you speak directly to each other and begin to recognize and honor each other. You don’t need your son’s approval, but he needs you to learn how to handle your own problems. Let’s begin with what you need from each other.

After this session, Kristin and Leo started the tough but valuable work of caretaking their relationship. Their childhoods had not taught them about healthy dyadic communication or emotional regulation. I helped them see that they used their son much in the same way their parents used them. Moreover, their triangulation included using me, their therapist, as a safe third. When they turned to address me, I redirected them into the care of their partner, where their focus needed to be. The PACT technique of  management of thirds interrupted their triangulation by helping them coregulate and operate as a securely functioning two-person system.

 

One Way Memory Impacts Your Relationship (and it might not be the way you think) 

Inga Gentile, MFT
PACT faculty
Oslo, Norway
www.ingagentile.com

“Why does she always seem to get clingy right when I have to go out of town for work?”

“Why does he lock himself in his office after work and watch Netflix while I’m alone in the living room?”

Many couples experience confusion and frustration related to often repeated scenarios like these. But it’s not a sign that your partner doesn’t love you. Or that you’re not the right fit.

There’s actually a psychobiological reason these scenarios play out among couples everywhere. It’s called implicit memory. Implicit memory begins at birth and is unconscious and nonverbal. It precedes declarative memory, which refers to the conscious recollection of facts and events. Implicit memory, on the other hand, because it involves older, more primitive parts of your brain, operates rapidly and largely outside of your awareness.

How does implicit memory play out in your relationships? One way is through your attachment style. Your attachment style is based on your experiences early on in life, and the type of care you received from your parents or first caregivers. Those experiences – especially in the first two years of life as the brain structures needed to support declarative memory develop – become stored as implicit memory and drive much of the way you act and interact with those closest to you. These implicit memories can be activated by everyday events, like separations and reunions, and because there isn’t an awareness that you are remembering something as there is with declarative memory, it can be mystifying.

Seen in this light, a partner who clings at the moment her loved one is leaving isn’t intentionally trying to make her partner’s life difficult; she may have early experiences of separation that induce distress and in turn activate her attachment system to seek proximity and comfort.

If your partner is sensitive in this way, move towards them, physically or verbally. Embrace them, look them in the eyes and say something like, “I know you get anxious when I go away.  I want you to know I’ll never leave you.” If you’re the one in distress, be aware of your response and take responsibility. Ask your partner for what you need: “It’s hard for me when you leave. Can you please hug me tight and tell me that I’m the only person for you ever?”

The partner who locks himself in his office isn’t necessarily trying to punish his partner by being withholding but may have difficulties with transitions from one state (work) to another (home) and may lean towards “alone time” as a way to reset—again, a possible adaptation to early relational experiences.

One sensitive way to respond: Say in a friendly tone, “I know you need some time alone. Netflix together in the living room in 10 minutes, baby!” Conversely, the partner could take responsibility for his hardwired tendency by understanding that, although it might feel unfamiliar, learning to “reset” in the presence of his partner can actually be soothing, on a nervous system level.

Appreciating that memory exists in many forms—both conscious and unconscious—can help you create mutually satisfying and safe relationships: Understand what drives your own reactions. Learn what drives those of your partner. Take responsibility for your own automatic reactions. And be sensitive to those of your partner.

Learn and practice new ways of meeting and caring for one another’s implicit memories in the present and watch what happens in the future.

Back to School with the 3Rs

Allison Howe, LMHC 
PACT Level II 
Saratoga Springs, NY 
http://www.facebook.com/AllisonHoweLMHC

As PACT-trained therapists, it is perplexing when we find ourselves working with a couple who are not moving into secure functioning. There are a number of factors to consider: Is there a deal breaker that hasn’t been addressed? Are both partners truly committed? Are resources outside the therapy office allocated to restructuring the relationship? 

As we work to move couples from a one-person psychological system into a two-person system, we are facilitating the development of skills. Learning to have relaxed and mutually satisfying conversations requires skill. However, when partners demonstrate curiosity and interest in their partner, they are taking an essential step forward. Their time and attention are a precious resource and are too often in short supply.  

The changes we are endorsing require clear messaging, repetition, and lots of support. The job of a PACT therapist is to help couples gain clarity and understand that creating new neural pathways in the brain requires practice. This is the reality. The reflexive systems are deeply rooted, and it is unrealistic to believe we can create a new system without time, attention, and practice. 

In the same way a coach gives his or her athlete a training plan, I encourage couples to practice outside the therapy session. Recently, I worked with a couple who are making forward strides. However, I observed a missed opportunity at our last meeting. More specifically, there wasn’t a clear structure in place for them to reflect and review the changes that were indeed taking place. The following dialogue took place: 

Carmen: “Did you notice how I handled things differently this week? “ 

Liam: “I’m not sure what you are referring to. Are you talking about the conversation on our porch with my friend Tim? “ 

Carmen: “Yes. That is what I’m talking about. “ 

Liam: “Well, I know I handled things differently!” 

This couple was consciously considering the way they do business with each other, but I observed that as time elapsed, their memory of the event became a bit unclear in terms of detail and sequence. While positive steps in a secure direction were being taken, not sharing these experiences was a lost opportunity. So I had them do the following exercise, which is designed to gather evidence of progress. 

Exercise: REVEAL, RECOGNIZE, REINFORCE 

Instructions for therapist: Have couple sit face to face. Encourage both partners to keep their messages friendly and succinct.  

Step 1: REVEAL: 

Partner A: Take a moment to reflect on your recent interactions or experiences with your partner. Identify a behavior aligned with your secure-functioning goals. Examples include but are not limited to distress relief, quick repair, contact maintenance, or management of thirds. Reveal the behavior to your partner.  

Step 2: RECOGNIZE: 

Partner B responds to Partner A by acknowledging this positive step.  

Step 3: REINFORCE: 

Discuss together how this change is positive for the relationship. This is a moment to feel good together. Switch and repeat the steps with Partner B moving to Step #1.  

When Carmen and Liam used this exercise in our session, the following dialogue occurred. 

Carmen: “Remember when Tim was visiting? Well, I did what I usually do. I became sarcastic and made a joke at your expense. Tim noticed. I’m sure you did. But that’s not the change!” 

Liam: “What did you do differently?” 

Carmen: [REVEAL] “I came up to you before bed, looked into your eyes, and said I was sorry for it. It’s not okay for me to do that anymore.” 

Liam: [RECOGNIZE] “I do remember you coming up to me and apologizing. I appreciated it. Thank you, and it matters to me that you are paying attention.” 

Carmen: [REINFORCE] “I want to repair things quickly the way I did that night. That’s so much better for us. I also want to quit being snarky with you. I know these changes are good for us.” 

Liam: “I agree. This feels so much better than the old ways. Now can I tell you my change? [REVEAL] I was bothered by your joke, especially in front of Tim. I made a conscious decision in that moment that I wanted to change how I handled it. You know, I withdraw from you when this kind of thing happens. I decided that has to stop. I decided I was going to let this go and not punish you with my silence. If I was feeling upset the next morning, I promised myself to talk to you about it.”  

Carmen: [RECOGNIZE] [smiles] “Thank you. I have suffered a lot when you pull away from me. I know that is a big change for you.” 

Liam: [REINFORCE] “A big change. And a good one.”  

Carmen: [REINFORCE] “This feels like a big deal. We are on a better path.” 

What does this exercise accomplish? Having the couple face one another while mutually amplifying the positive enables coregulation. Learning to uphold Grice’s maxims for the quality, quantity, relevance, and manner of the message fosters secure functioning. Additionally, focusing couples on true behavioral changes makes the implicit fully explicit. This exercise encourages increased interdependence, with a focus on both self and other. Finally, with the focus on positive change, the exercise can bring much needed vitality to a couple as they make sustainable change.  

Using Quality Moments to Soothe or Bypass Core Vulnerabilites

Inga Gentile, MFT
PACT faculty
Oslo, Norway
www.ingagentile.com

Many couples tell me they simply don’t have the time they need to set aside to address issues in their relationship daily. They are too tired at night, mornings are too hectic, and their days are a blur. However, there are things they can do and ways they can be toward one another to help create greater safety and security in their relationship.

One way to increase secure functioning in your relationship is to be aware of the core vulnerabilities that underlie chronic distress for you and your partner. Stan Tatkin (2012) talked about the three or four core vulnerabilities most people have, usually rooted in childhood experiences. Secure-functioning couples realize it is their job to be aware of such vulnerabilities and to tend to injuries when needed. They don’t spend a lot of time complaining that an injury shouldn’t be there or shouldn’t ache so much; rather, they make a point of creating quality moments during which they can say and do things that have a positive impact on each other’s self-esteem and sense of security.

This is important when you find yourselves in a distressed situation as well as when you are in either a non-distressed situation or a situation that is building toward a point of distress. In each case, you can make an effort to circumvent or diffuse reactions linked to your core vulnerabilities. Do this by knowing what makes each of you feel bad as well as what makes you feel good. Use this information often in large and small ways.

Paul and Anna are a couple in their thirties with no children. One of Paul’s core vulnerabilities is a fear of being blamed. Another vulnerability is feeling he can’t get it right with those he loves. When he senses that Anna might blame him, he freezes or withdraws. Fear of abandonment and fear of being a burden are two of Anna’s core vulnerabilities. She experiences Paul’s freezing and withdrawal as abandonment of her. Experiencing his withdrawal as abandonment confirms her belief that she is a burden to him, and she often responds by amping up her criticism of him.

After they worked in therapy to uncover their core vulnerabilities and reshape their narrative around who they are and why they behave as they do, Paul and Anna began to practice in real time saying and doing things to shift the other’s state, and then paying attention to what happens. In session, we worked on their physical impulses to move toward or away from one another in moments of distress. Here is one example of how that played out at home.

When Paul comes home from work, Anna is in the kitchen washing dishes. As soon as he walks in, she begins to complain to him about her day. He picks up a yogurt and starts to eat it. She says, “I can’t believe you can just stand there and eat when I told you I haven’t eaten all day.”

Instead of feeling blamed and withdrawing, Paul makes the decision to move toward Anna in a friendly (and unexpected) way. As she is speaking, he offers a spoonful of his yogurt, holding it up to her mouth for her to eat. She tastes the yogurt and begins to laugh.

In this quality moment, Paul shifts Anna’s state and assuages her core vulnerability of being a burden. He is able to listen closely to her words, feel her distress, and understand that she is hungry. Because he isn’t feeling attacked, his impulse is to nurture her. This is mutually rewarding because Anna expects to be abandoned, especially when she is fussy, and instead feels soothed. Additionally, she is touched by his ability to get it right with her in a way that perhaps no one else could.

This couple demonstrated an ability to soothe and to give each other what they most need in the present, thus bypassing their core vulnerabilities. When it comes to such quality moments, frequency and precision (and not necessarily duration) go a long way toward creating a greater sense of safety and security.

Reference

Tatkin, S. (2012). Wired for love: How understanding your partner’s brain can help you defuse conflicts and spark intimacy. Oakland, CA: New Harbinger.

Creating Community, Deepening Intention

by Carolyn Sharp, LICSW
PACT level 3 candidate
Seattle, WA
http://www.carolynsharp.com/

One of the richest aspects of the PACT approach is the experiential, embodied nature of the sessions. Over the course of a 2- to 3-hour session, couples develop a felt understanding of one another and of a new way of relating. As a PACT practitioner, I am continually awed by the power of this approach to help couples reach new levels of connection and healing. In the last year, I began offering couple therapy intensives and retreats as two ways to multiply and deepen that experience over many hours on back-to-back days, and provide opportunities for PACT interventions on steroids.

In a call to me, Bess described through tears her love for her husband of 15 years, Theo, and the ways she had hurt him despite this love. Emotional infidelities had created fissures in the trust and safety of their connection, and both were questioning whether they could get it back. Because of the critical nature of their struggle, they decided to commit to an intensive, where they would spend 3 days in therapy and go deeper into the source of a very hurtful pattern. They would spend 7 hours each day in sessions, with long blocks for lunch. At night, they would continue to work on their connection through assigned exercises.

Jacob and Michael, married almost 30 years, came to therapy also on the verge of separation. Deeply entrenched habits of disconnection and avoidance had landed them in a place of bitterness and hostility. Early PACT sessions helped them clarify their intentions to stay together and their ownership of their respective contributions to their problems. Having learned new habits and acquired a better understanding of their wired responses, they signed up for a retreat my colleague Sara Slater and I developed as an opportunity to deepen their connection through a guided practice over a long weekend.

Through their intensive of 20 therapy hours over 3 days, Bess and Theo continually deepened their understanding and commitment to the process, learning things about each other that they had never imagined. That focused time alone with a therapist created safety to discuss very vulnerable and deeply personal mistakes in the relationship. With no downtime between sessions to distract from the process, they remained focused on repairing and rebuilding, and spent their evenings in powerful connection. Over the course of the intensive, Theo fully completed repair with Bess, and was honestly and deeply forgiven. Simultaneously, Bess came to a felt understanding of the ways she had betrayed and abandoned Theo, and was able to repair and develop ways of maintaining her care of him. By the end of the third day, they not only had a return to early feelings of love and interest in one another but had built on it with plans and agreements for maintaining their connection. Sitting with this couple for 3 days, I watched them fall back in love with each other, and they left looking younger, lighter, and more deeply connected in ways that can take much longer in traditional PACT sessions.

At our retreat, Michael and Jacob, together with five other couples, were led through a shared experience of exploration of each other and of their relationship, interspersed with relaxation and recreation. Sitting in circle with the community of couples—each in different phases of their relationship, with varied challenges—Michael and Jacob found a commonality of struggle in maintaining connection and desire through the hiccups and setbacks of life. Over the 3 days together in a bucolic setting, the experiential exercises and activities led them through a progressively deepening process, challenging them to further understand and work through the habits that had led to disconnection. These couples built a community of understanding and accountability through shared struggle and laughter, as well as the care offered for their common vulnerabilities. This allowed each couple to relax while breaking down barriers and deepening their commitments. In sessions following the retreat, Jacob and Michael had left behind their defensiveness and were able to regularly reach toward each other in ways I had not seen them do. Now, months later, they have found a level of intimacy and safety with each other that they never had before.

The opportunity to do intensive, sustained work in a residential retreat or therapy intensive creates a unique means of deepening connection that is very different from couple therapy sessions. Investing an entire weekend in a setting where the only focus is on each other and the relationship magnifies the awareness and presence in the work together. When I began offering retreats and intensives, I naively thought that just having more time with a couple would lead to greater rewards. Instead, I found that being in a setting away from life, the intention to commit to a substantial block of time and resources, and the process that unfolds over multiple days together combine to contribute to the greatest growth.

Secure-Functioning Essentials: Taking Care of Yourself and Your Partner at the Same Time

by Stan Tatkin, PsyD, MFT

Many partners ask me how to take care simultaneously of themselves and of their partner. In practical terms, this can be difficult to carry off. Similarly, some couple therapists find it difficult to convey the principle of simultaneous care to couples they treat. This blog shows you how to incorporate this principle into your practice and your relationship.

First, we have a neurobiological reality to circumnavigate. Human beings are largely driven by self-interests, particularly when overtired, overstressed, or under-resourced, and even more so when threatened. When partners engage in conflict, it is vital to understand the tendency to mistake even a loved one as adversarial, or worse, predatory. The predisposition to error in this direction is a feature of the human impulse to survive. The brain centers responsible for mistaking a friend for a foe are famously expeditious, indiscriminate, and ruthless. This primitive facet of the mind and body is untamable; no amount of therapy will prevent most threat recognition from triggering a reflexive behavior. Though insecurely attached individuals (and those with unresolved trauma) are more likely to trigger easily and often, secure individuals are not immune to acting like the animals we all are. The smart thing for couple therapists to do is to work with this issue so couples can learn how to circumvent the tendency to shoot first and ask questions later.1

It can be helpful for partners to think in terms of fire prevention and fire extinguishing. The therapist can help them become trained firefighters. See a glowing ember and put it out fast! Engulfed in a blaze, dump a lot of cold water everywhere! Eventually, the couple are guided toward becoming good stewards of their safety and security, and that begins and ends with the principles of taking care of the self and other at the same time. However, the therapist may have to triage fire extinguishing and prevention, and determine which is most urgent.

Insecure-functioning partners are inclined to take care of themselves only. One person takes a stand for himself or herself, while fully disregarding the other partner’s sensitivities, sensibilities, concerns, fears, wants, and historical injuries. Partners prime each other with dog-whistle-like behavioral cues that telegraph threatening intensions. An astute therapist can quickly detect these implicit signals prior to them becoming explicit. Video replay (if immediate) is sometimes helpful, though a rapidly kindled couple can become fired up with this technique. For these couples, the principle of self/other simultaneous care must come last in the treatment plan. They set too many fires and may “gladly” let them burn.2

The human capacity to cooperate and collaborate dates back to the beginning of the H. sapiens species, It’s in our DNA to share, bargain, trade, and keep the peace. Our species would have otherwise died out with the Neanderthals. Fairness is not a modern invention. For two autonomous individuals to get what they want and need, they have to ensure both parties benefit or they will get nothing but trouble. That stratagem must always be in play to keep the peace and to prosper. Neanderthals did not have the brain capacity to bargain, trade, or imagine win-win scenarios. We are, by contrast, supposed to have that capacity, and yet we seem to be Neanderthal in our love relationships!

The couple is the smallest unit of a social group. As such, it must operate under social rules if it is to survive. Though the couple represents a hierarchy with regard to children, its own structure is preferably egalitarian. So, if a couple seek real happiness, harmony, and freedom from chronic distress, they must be willing to care for themselves and each other at the same time, or suffer the consequences. A couple therapist cannot make a couple do this, but the therapist can and should expect nothing less.

If partners are good at fire extinguishing and becoming better at fire prevention, but could improve their skillfulness, the following exercise can be done during session. Video playback can be additionally helpful in giving the couple immediate feedback.

Here are the rules:

  1. A time frame is established.
  2. The partners must remain orderly and stick to one topic/subject only; refrain from talking over each other (too much); and keep the back and forth going, without one person holding the stage too long.
  3. Each partner must present his or her wish, fear, or complaint, along with his or her full understanding of the other’s wishes, fears, or complaints. Usually, the latter is best done before presenting one’s own agenda.3
    • If the topic involves a wish or want, partners must flow into bargaining mode (e.g., back and forth of suggestions, options, bids, offers). Neither partner can say no without making a counter offer or suggestion.
  4. Both partners are expected to pay close attention to both narratives, and explicit and implicit facial and gestural cueing. They are tasked with cross-checking what they hear with what they see and sense.
    • Partners must not become bogged down, or they will go down the rabbit hole toward threat (“You’re not happy.” “No, I’m fine.” No, you’re not.”).
    • Partners must not become distracted or derailed by their sensitivity to the other’s facial or gestural cues (“Why did you give me that look?” “I didn’t give you a look.” “Why are you being so snippy?”).
  5. The partners must achieve something at the end of the time limit, and both must ensure the other’s well-being by the end. They must finish as lovers, not business partners.
  6. There must be no residue of unhappiness, unless one partner is appropriately feeling down after accepting his or her own misdeed.

Before a couple can understand the principle of simultaneous self and other care, their therapist must fully understand and practice it himself or herself. Therapists shouldn’t expect clients to do what they cannot or won’t do themselves.

Can anyone apply this principle flawlessly at all times? Of course not. But this is a principle worthy of practice. It’s one of the best ways to prevent fires in our closest relationships.

Notes:

  1. Some endogenous and exogenous strategies can dampen threat perceptions and responses. Regarding the former, 10 to 15 minutes of a mindfulness exercise known to increase parasympathetic tone can raise the threshold for a fight/flight response and increase recovery time. Additionally, some empirical clinical reports show response-time delays and lowered threat perception in individuals who are mildly under the influence of cannabis, CBD, MDMA, benzodiazepines, Kratom, or beta blockers. Obviously, a couple therapist cannot ethically recommend medications or street drugs.
  2. Some couples may be captured by a runaway noradrenergic, hypothalamic process they can’t overcome with conventional interventions. Noradrenaline is responsible for focus and attention. Highly kindled fight/flight reactions include hypervigilance and hyperfocus on a partner’s threat cues.
  3. The therapist should help the partners lead with relief (known in PACT terminology as disarming the partner’s “primitives” before proceeding).
  4. When one partner accepts having hurt the other, it is important to experience the pain. Just don’t wallow in it or make the hurt partner pay by withdrawing.