by Eda Arduman, Ma., clinical psychologist couple therapist
Level 2 PACT therapist
Istanbul Bilgi University clinical supervisor instructor
Clinical Psychology MFT Master Program
It has been said that intimate relationships are not for the faint hearted, yet research shows us time and time again that the pleasure and reliability of relationships provide us with the resiliency to overcome the challenges life often presents. Some of the hurdles life throws are external (e.g., an economic crisis or severe illness of a loved one or divorce of parents) and others are internal (e.g., states of ambivalence, self-sabotage, and depression). Sometimes an external event spurs an internal reaction that interrupts movement; the braking mechanism acts as a counterforce to expansion and results in contraction.
The PACT therapist works with couples in severe conflict who are responding at a pace at which their minds cannot keep up with their words. The couple are trying to say things to each other, but their brains are simply registering each other’s microexpressions, tone of voice, and gestures. The more they try to talk, the more things spiral out of control. Though humorous in a Woody Allen movie, remaining in a state of high arousal for a prolonged period of time with no resolution can take a heavy toll on both partners.
Ferhat and Şirin came to therapy when their son was a year and a half old. They were stuck in a cycle of discontentment. Until the birth of their son, they shared hobbies and had a satisfying relationship. Now, however, they frequently argued about parenting responsibilities and time spent together or apart. Both have the insecure attachment style PACT refers to as island, and thus they were in the habit of solving problems through individualistic solutions. “Let’s just be happy alone” was their motto.
During our initial session, it came out that Şirin had survived a life-threatening bike accident just before her pregnancy. A car hit and nearly killed her. During the debriefing process, she claimed that what bothered her most was not the accident itself but seeing the bike totaled. She had lost all desire to buy or even ride another bike. She had no idea her loss of interest might be the result of trauma.
Having trained in Eye Movement Desensıtızatıon Reprocessing (EMDR), I decided to apply EMDR in conjunction with my PACT skills. EMDR protocol requires the patient to establish a safe haven in his or her mind. The corresponding PACT protocol entails using the partner as the safe retreat and moving the couple toward secure functioning. I had Sirin sit on Ferhat’s lap because face-to-face interaction was too dysregulating for both of them while in high-arousal states. He was able to hug her back with his body and stroke her arms with open palms in a firm manner.
The exploration went fairly smoothly until we came to the memory of another bike. Sirin’s face became still, and she started trembling and had difficulty following the movement of my hand—all signs of the disorganized-type dysregulatıon. She froze and started to talk about the bike her parents bought her when she was 13, at the same time they told her they were getting divorced. Her face lost affect and her hand began to shake. Even though her body was trembling, her voice and words were dissociated from the rest of her body. She continued to talk about the bike her parents had given her and how she used to ride off to freedom on it.
Noticing the dissociation, her husband moved forward and started to stroke her face. This annoyed her, and she brushed him off. With my support, he began rubbing her arms and knees as she continued to talk about the bike. I urged him to stroke her with wide palms because small finger brushes were ticklish for her. She started to shake and sob. She moved onto her husband’s lap, where he held her firmly as she continued to share how her life changed following her parents’ divorce.
As they jointly calmed down, Sirin and Ferhat were able to move into the fear they had regarding their own relationship. The ruined bike symbolized the loss of an internal as well as external vehicle that took Sirin to freedom. The ruin of the bike, followed by multiple surgeries and months of immobility, and then her pregnancy and all the infant-related responsibilities had resulted in her internally and externally relinquishing her freedom. This resulted in her coming to the unconscious, erroneous conclusion that her husband was the guardian to the jail her traumas had constructed.
Working with PACT allowed Sirin to experience that freedom was possible with her husband. Having built a scaffold of secure functioning, the couple were able to complete the cycle of rupture and repair at a real level, without falling into old habits. They expressed a new felt intimacy and trust, which had been missing in their relationship since the accident.