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Therapist Self-Regulation, or Flying into a Hurricane

by Hans Jorg Stahlschmidt, Ph.D., PACT faculty, Berkeley, CA
Website: www.stahlschmidt-therapy.com
Email: stahlschmidt@comcast.net

Some couple therapists have referred to their work as flying a helicopter into a hurricane. Perhaps the metaphor is inflated, but couple therapy is certainly an enterprise that can create acute anxiety. Like a pilot, a therapist needs the skills and training that make it possible to stay calm and alert when the going feels treacherous and unexpected turbulence appears seemingly out of nowhere. Interestingly, some Air Force pilots, called “hurricane hunters,” are specially trained to fly into the eye of the hurricane to collect weather data. Maybe that is like what we are trained to do in PACT: instead of fearing and avoiding conflict, we are trained to fly into it with our capacities to collect data and navigate skillfully intact.

Besides this hurricane-related skill set, a couple therapist needs the ability to hang out in uncertainties, to act not out of anxiety but out of creative insight that is the expression of an integration of limbic system and frontal cortex. In other words, the therapist relies on a solid self-regulatory capability

The therapist’s task is to be fully present when focusing on the couple, capable of what Bion (1962) speaks of a therapist metabolizing the error-filled process of the couple, similar to a mother’s ability for maternal reverie. The capacity to be a master regulator is, in essence, the ability to tolerate and manage anxiety in such a way that one can become an agent of change. The process requires a transparent self that has the ability to relinquish defensive strategies and tolerate anxiety.

As passengers look to the pilot hoping to find confidence in his or her expression, a reassurance they are in good hands as they lean back and buckle their seatbelts, so a couple in the varying states of activation and vulnerability that bring them to therapy need to feel the therapist’s confident and caring presence. From the couple’s perspective, a dysregulated therapist is potentially impaired in all important functions.

Dysregulated therapists are perceived as misattuned because their ability for attunement is hindered by the activation of alarm or threat. They are experienced as relatively unempathetic because of interference from relational processing areas around the orbital frontal cortex. For instance, if the therapist is experiencing an inordinate amount of threat, his or her understanding and conceptual assessment of the couple’s situation may be inadequate and even tilted because the prefrontal cortex, as an executive and regulating center, does not have the necessary resources to inhibit impulses, down-regulate high arousal, and think in an integrated fashion.

The ability to challenge a couple’s maladaptive patterns and their respective defensive systems cannot be effective and on target when the therapist is preoccupied with his or her own emotional reaction in a way that clouds the task at hand and hinders the necessary therapeutic interventions. The dysregulated therapist ceases to function as the master regulator in the room. The couple may experience the therapist as “nice” but weak, as absent and detached, as avoidant and distancing, or perhaps as needy or even threatening. Such a therapist is “dangerous” in the sense that the partners may feel ensnared in regressive dynamics, pushed into parentified roles, or hopeless about the therapeutic process and the prospect of their relationship in general.

I have painted a relatively stark and dark picture of a highly anxious or fearful therapist and his or her impact on therapy. Of course, we all are vulnerable to periods of dysregulation. The point is that the development of a durable and solid capacity to work through and manage our own anxieties as therapists is crucial for the therapeutic process.

To help a couple we, as therapists, have to be able to step in to regulate the emotionality, tension, anger, or upset in the room in a way that is not distancing or reactive, not judgmental or self-referential, but rather that is real, empathic, and focused on the conflict at hand. This regulation has to be bottom up not only for the couple but also for the therapist. This regulatory process has to be anchored in the body and has to include emotional processing that can lead to integration and solidity.

The most important aspect of self-regulation for PACT therapists is being anchored within a comprehensive and effective therapeutic model. This model gives us the frame as well as the modalities to process and transform anxiety into “play,” worries into curiosity, and negative expectations and shame into a frank acknowledgment of imperfection or sharing one’s own humanity in a therapeutically effective fashion. The model in and of itself is regulatory for the therapist. It prepares him or her for the worst and the best, for being in minefields, in fog, or in the middle of a hurricane. The PACT therapist is ready for both the high- and the low-functioning couple.

The PACT principles and operating methods are like a psychological GPS system that helps orient therapists in our work. This GPS also helps couples to re-map their minds and relational brains and to get better at finding their partners. It helps them to give up old dysfunctional habits and to develop more relational new ones. Although at the outset of therapy, we don’t know how the travel will unfold and who partners really are, we do know that our GPS works under almost any condition. This certainty and the continuous recalibration to the basic frame and principles of PACT are probably the most valuable tools a therapist has for self-management of anxiety.

References

Bion, W. R. (1962). Learning from experience. London, UK: Heinemann Medical Books.

Copyright Hans Jorg Stahlschmidt Ph.D.

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4 Comments

  1. wonderful post, whilst reading, nodding and smiling, all the time 🙂 thanks , it´s exactly how and what you say that produces my agreement

    Like

  2. Mari A. Lee, LMFT, CSAT-S says:

    Hi Stan, The link to this doesn’t work  Mari A. Lee, LMFT, CSAT-S Licensed Marriage & Family Therapist #47920 Certified Sex Addiction Therapist & CSAT-S Supervisor Phone: (818) 521-4370 Website:www.marileetherapy.com Email: marileetherapy@yahoo.com Facebook : https://www.facebook.com/MariALeeTherapy?ref=hl

    Author of: “The Creative Clinician: Exercises and Activities for Clients and Group Therapy”

    Author of: “Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts” “Every person faces challenges and deserves to have trusted and experienced support. I help my clients move beyond stress, sadness, shame and betrayal in order to create a joyful life and healthy relationships that they are proud of.” – Mari A.Lee, LMFT, CSAT-S

    CANCELLATIONS: There is a 48-hour cancellation policy. If you need to cancel or reschedule an appointment, please notify me as soon as possible. If there is 48-hour notice, you will not be charged. Thank you for respecting this clinical boundary as my professional time for your session has been set aside specifically for you.

    OUT OF SESSION CONTACT: Unless this is an emergency, I ask that you please bring your questions into your session. Every attempt will be made to return your email within 24-hours during a regular work week. If you are experiencing a life threatening emergency, please call 911 immediately.

    NOTE TO NEW CLIENTS: If you are a new client seeking therapy, my policy is to return all new client emails within 48 hours.

    ILLNESS POLICY: If you are ill, we will conduct your session via teletherapy [phone]. Please do not come into the office, session or group with a virus, cough or any other potentially contagious illness. Thank you for respecting this clinical boundary.

    NOTICE OF CONFIDENTIALITY: This email and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to which they are addressed. If you are not the intended recipient or the person responsible for delivering this email to the intended recipient, be advised that you have received this email in error and that any use, dissemination, forwarding, printing or copying of this email is strictly prohibited by law. If you have received this email in error, please notify the sender by replying to this email and then delete the email and attachments from your computer immediately. Thank you.

    From: Stan Tatkin — A Blog To: marileetherapy@yahoo.com Sent: Friday, September 4, 2015 8:44 PM Subject: [New post] Therapist Self-Regulation, or Flying into a Hurricane #yiv6501724940 a:hover {color:red;}#yiv6501724940 a {text-decoration:none;color:#0088cc;}#yiv6501724940 a.yiv6501724940primaryactionlink:link, #yiv6501724940 a.yiv6501724940primaryactionlink:visited {background-color:#2585B2;color:#fff;}#yiv6501724940 a.yiv6501724940primaryactionlink:hover, #yiv6501724940 a.yiv6501724940primaryactionlink:active {background-color:#11729E;color:#fff;}#yiv6501724940 WordPress.com | stantatkinblog posted: “Guest blog by Hans Jorg Stahlschmidt, Ph.D., PACT faculty, Berkeley, CAWebsite: http://www.stahlschmidt-therapy.comEmail: stahlschmidt@comcast.netSome couple therapists have referred to their work as flying a helicopter into a hurricane. Perhaps the meta” | |

    Like

  3. rsolley says:

    The hurricane/helicopter quote was from Pete Pearson, PhD, of the Couples Institute 🙂

    Like

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