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:
- A time frame is established.
- 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.
- 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.
- 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?”).
- 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.
- 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.
- 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.
- 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.
- The therapist should help the partners lead with relief (known in PACT terminology as disarming the partner’s “primitives” before proceeding).
- 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.